Ingredients | Amount Per Serving |
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7 mg | |
Testosterone Support/Anti-Aromatase Blend
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425 mg |
(Bulbine natalensis )
(P.E.)
(Bulbine natalensis Genus: Bulbine Species: natalensis Note: P.E. )
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(Mucuna pruriens )
(98% L-Dopa)
(Mucuna pruriens (Form: 98% L-Dopa) Genus: Mucuna Species: pruriens )
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(Tribulus terrestris )
(45% Saponins)
(Tribulus terrestris extract (Form: 45% Saponins) Genus: Tribulus Species: terrestris )
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(10% lcariin)
(Horny Goat Weed extract (Form: 10% lcariin) )
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Gelatin, Silica, Magnesium Stearate, Stearic Acid (Alt. Name: C18:0)
There is concern about this product because it contains a drug or drug-like substance that may not be safe when used without appropriate medical supervision.
This product has been discontinued by the manufacturer.
Below is general information about the effectiveness of the known ingredients contained in the product SARM Extreme. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
Below is general information about the safety of the known ingredients contained in the product SARM Extreme. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
POSSIBLY UNSAFE ...when used orally or parenterally. The U.S. Food and Drug Administration and other regulatory agencies warn that dietary supplements containing aromatase inhibitors are dangerous. Adverse effects associated with aromatase inhibitors include aggressive behavior, adrenal insufficiency, decreased rate of bone maturation and growth, decreased sperm production, infertility, kidney failure, and liver dysfunction (91094,102468).
PREGNANCY AND LACTATION: POSSIBLY UNSAFE
when used orally or parenterally.
The U.S. Food and Drug Administration and other regulatory agencies warn that dietary supplements containing aromatase inhibitors are dangerous (91094). Avoid using.
There is insufficient reliable information available about the safety of Bulbine natalensis when used orally or topically.
PREGNANCY: POSSIBLY UNSAFE
when used orally in large amounts.
Animal research shows that Bulbine natalensis stem extract might be embryotoxic when administered at a dose of 100 mg/kg (91624). Until more is known about its effects in humans, avoid using during pregnancy.
There is insufficient reliable information about the safety of using topical Bulbine natalensis during pregnancy; avoid using.
LACTATION:
Insufficient reliable information available; avoid using.
POSSIBLY SAFE ...when used orally and appropriately. Powdered formulations of cowhage seed that are standardized to provide levodopa 75-400 mg daily have been used with apparent safety for up to 20 weeks (7020,7203,97266).
POSSIBLY UNSAFE ...when the hair of the cowhage bean pod is used orally or topically. The bean pod hairs are strong irritants and can cause severe itching, burning, and inflammation (18).
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
POSSIBLY SAFE ...when horny goat weed extract is used orally and appropriately, short-term. A specific extract of horny goat weed containing 60 mg icariin, 15 mg daidzein, and 3 mg genistein (Xianling Gubao; Tong Ji Tang Pharmacal Company) has been used daily with apparent safety for up to 24 months (14900,97268). Another aqueous extract of horny goat weed containing up to 25.36% icariin has been used in a dose of 300 mL daily with apparent safety for up to 6 months (55452). Another horny goat weed extract has been used with apparent safety at doses up to 1000 mg daily (providing 200 mg icariin) for up to 30 days (108311).
POSSIBLY UNSAFE ...when used orally long-term or in high doses. Long-term use, or taking high doses of some species of horny goat weed, has been linked to serious adverse effects including respiratory arrest (10346).
PREGNANCY: POSSIBLY UNSAFE
when used orally.
Horny goat weed might have androgenic activity (10346). Theoretically, it might harm a developing fetus; avoid using.
LACTATION:
Insufficient reliable information available; avoid using.
POSSIBLY UNSAFE ...when used orally. Ostarine 1-3 mg daily has been used with apparent safety under medical supervision for up to 12-16 weeks by most patients in clinical studies (98832,98833). However, there are concerns about the potential of ostarine and other selective androgen receptor modulators (SARMs) to cause serious adverse reactions, including hepatotoxicity, myocardial infarction, and stroke (98840,106197). No long-term safety studies have been conducted (98840).
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
LIKELY UNSAFE ...when the spine-covered fruit is used orally. There have been reports of bilateral pneumothorax and bronchial polyp after oral consumption of the spine-covered fruit (818).
PREGNANCY: POSSIBLY UNSAFE
when used orally.
Animal research suggests that tribulus might adversely affect fetal development (12674); avoid using.
LACTATION:
Insufficient reliable information available; avoid using.
Below is general information about the interactions of the known ingredients contained in the product SARM Extreme. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
Theoretically, combining Bulbine natalensis leaf with drugs that have anticoagulant or antiplatelet activity might increase the risk of bruising and bleeding.
Details
In vitro research shows that Bulbine natalensis ground leaf extract inhibits platelet aggregation (91620).
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Theoretically, Bulbine natalensis stem might reduce the levels and clinical effects of CYP1A2 substrates.
Details
In vitro research shows that Bulbine natalensis stem extract slightly induces CYP1A2 mRNA expression and enzyme activity (108669). Theoretically, this may increase the metabolism of CYP1A2 substrates; however, this has not been studied in humans.
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Theoretically, Bulbine natalensis stem might reduce the levels and clinical effects of CYP2C9 substrates.
Details
In vitro research shows that Bulbine natalensis stem extract induces CYP2C9 mRNA expression and enzyme activity (108671). Theoretically, this may increase the metabolism of CYP2C9 substrates; however, this has not been studied in humans.
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Theoretically, Bulbine natalensis stem might reduce the levels and clinical effects of CYP3A4 substrates.
Details
In vitro research shows that Bulbine natalensis stem extract induces CYP3A4 mRNA expression and enzyme activity (108671). Theoretically, this may increase the metabolism of CYP3A4 substrates, but this has not been studied in humans.
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Theoretically, Bulbine natalensis stem might increase the risk of adverse effects and toxicity when taken with digoxin.
Details
Bulbine natalensis stem may contain cardiac glycosides (91617), although it is unclear if these chemicals are present in clinically relevant concentrations.
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Theoretically, Bulbine natalensis stem might increase the levels and clinical effects of p-glycoprotein substrates.
Details
In vitro research shows that Bulbine natalensis stem extract induces p-glycoprotein mRNA expression; however, effects on transporter expression were not evaluated (108669).
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Theoretically, using Bulbine natalensis stem with testosterone replacement therapy might increase the risk of adverse effects.
Details
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Theoretically, concomitant use of cowhage and anesthesia might increase the risk of arrhythmias.
Details
Cowhage contains levodopa (7020,7205,46334,46336,94723,94724). Use of levodopa with cyclopropane or halogenated hydrocarbon anesthesia has led to arrhythmias. Other anesthetics have not been implicated (15). Use other anesthetics in patients taking cowhage or tell patients to stop taking cowhage at least 2 weeks before surgery.
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Theoretically, concomitant use of cowhage and antidiabetes drugs might increase the risk of hypoglycemia.
Details
Animal research shows that cowhage might have hypoglycemic effects (7221).
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Theoretically, use of cowhage might decrease the clinical effects of antipsychotic drugs.
Details
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Theoretically, concomitant use of cowhage and guanethidine might increase the risk of hypotension.
Details
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Concomitant use can increase the risk of levodopa-related adverse effects.
Details
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Theoretically, concomitant use of cowhage and methyldopa might increase the risk of hypotension.
Details
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Theoretically, concomitant use of cowhage and non-selective MAOIs might increase the risk of hypertensive crisis.
Details
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Theoretically, use of TCAs might reduce the levels and clinical effects of cowhage.
Details
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Theoretically, horny goat weed might increase the risk of bleeding.
Details
In vitro research and animal research shows that horny goat weed can inhibit platelet aggregation and thrombus formation (105832). This effect has not been reported in humans.
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Theoretically, horny goat weed might increase the risk of hypotension.
Details
Laboratory research suggests that horny goat weed might have hypotensive effects (10346). This effect has not been reported in humans.
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Theoretically, horny goat weed might increase the effects and side effects of CYP1A2 substrates.
Details
In vitro, horny goat weed leaf extract inhibits CYP1A2 (97267). This effect has not been reported in humans.
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Theoretically, horny goat weed might increase the effects and side effects of CYP2B6 substrates.
Details
In vitro, horny goat weed leaf extract inhibits CYP2B6 (97267). This effect has not been reported in humans.
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Theoretically, horny goat weed might increase the effects and side effects of CYP3A4 substrates.
Details
In vitro, horny goat weed extract inhibits CYP3A4 and suppresses CYP3A4 mRNA expression (112708). This effect has not been reported in humans.
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Theoretically, concomitant use of horny goat weed with estrogens might increase their therapeutic and adverse effects.
Details
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Theoretically, ostarine might increase levels of drugs metabolized by CYP2C9, although clinical research suggests this is not clinically relevant.
Details
Although in vitro research suggests that ostarine inhibits CYP2C9, more robust clinical research shows that ostarine does not significantly affect CYP2C9 (98834).
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Theoretically, concomitant use of ostarine with CYP3A4 inducers could decrease the clinical effects of ostarine.
Details
Ostarine is partially metabolized by CYP3A4. Clinical research shows that taking rifampin, a potent inducer of CYP3A4, reduces the maximum plasma concentration of ostarine by 23% and the area under the curve by 43% (98834).
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Theoretically, concomitant use of ostarine with CYP3A4 inhibitors could increase the effects and adverse effects of ostarine, although this is unlikely to be clinically significant.
Details
Ostarine is partially metabolized by CYP3A4. However, clinical research shows that taking itraconazole, a potent inhibitor of CYP3A4, had minimal effects on the levels of ostarine in the body (98834).
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Theoretically, concomitant use with hepatotoxic drugs might increase the risk of adverse hepatotoxic effects.
Details
Some clinical research shows that ostarine can increase alanine aminotransferase, a marker of liver damage, in some patients (98832,98833). Additionally, the U.S. Food and Drug Administration warns that supplements containing SARMs, such as ostarine, have been associated with reports of liver toxicity (94879,94880,94881) and there are at least two reports of drug-induced liver injury attributed to the use of ostarine (106197,111385).
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Theoretically, concomitant use of ostarine with probenecid could increase the effects and adverse effects of ostarine.
Details
Clinical research shows that probenecid increases ostarine levels and slows the clearance of ostarine, likely via inhibition of UDP-glucuronosyltransferase (UGT). Ostarine is partially metabolized by UGT (98834).
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Theoretically, concomitant use of ostarine with rifampin could decrease the clinical effects of ostarine.
Details
Clinical research shows that taking rifampin with ostarine reduces the maximum plasma concentration of ostarine by 23% and the area under the curve by 43% (98834). Ostarine is partially metabolized by cytochrome P450 3A4 (CYP3A4), and rifampin is a potent CYP3A4 inducer.
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Taking tribulus with antidiabetes drugs might increase the risk of hypoglycemia.
Details
Clinical research shows that Tribulus can lower blood glucose levels in adults with type 2 diabetes who are taking antidiabetes medications (97327).
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Theoretically, taking tribulus with antihypertensive drugs might increase the risk of hypotension.
Details
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Theoretically, tribulus might increase the levels and clinical effects of lithium.
Details
Tribulus is thought to have diuretic properties (12681). Due to these potential diuretic effects, tribulus might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
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Below is general information about the adverse effects of the known ingredients contained in the product SARM Extreme. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
General ...No adverse effects have been reported. However, a thorough evaluation of safety outcomes has not been conducted.
Other ...Analysis of Bulbine natalensis root obtained from open street markets in South Africa shows that the plant root might contain high levels of aluminum (5559 mg/kg dry weight) and iron (4164 mg/kg dry weight). Theoretically, ingestion of plants containing this quantity of aluminum might impair cognitive function and lead to neurodegenerative diseases. Ingestion of plants containing this quantity of iron might cause gastric discomfort, nausea, vomiting, diarrhea, and/or perforation of the gut wall (91621).
General
...Orally, adverse effects to cowhage seem to be rare; however, a thorough safety evaluation has not been conducted.
Topically, cowhage bean pod or seed may be unsafe.
Most Common Adverse Effects:
Orally: Diarrhea, flatulence, mucosal irritation.
Topically: Erythema, pruritus, rash.
Cardiovascular ...Orally, cowhage has been reported to cause palpitations (7021,7203)
Dermatologic
...Orally, ingestion of hairs from the bean pod or seed can result in significant mucosal irritation and should be avoided.
Topically, hairs on cowhage bean pod or seed can cause severe pruritus (6898). Symptoms include severe itching, burning, inflammation, and erythematous macular rashes (18,6898). Symptoms resolve spontaneously within several hours, but may also be relieved with antihistamines (6898). The hairs can be removed from the skin by washing, but the hairs can also be retained, and transferred to other people, in fabrics and carpets. Clothing and other materials that come in contact with cowhage hairs should also be thoroughly washed (6898).
Gastrointestinal ...Orally, cowhage has been reported to cause flatulence, diarrhea, and dry mouth (7021,7203). Orally, a specific powdered cowhage seed extract (Zandopa, formerly HP-200; Zandu Pharmaceuticals) has been reported to cause nausea, abdominal distention, and vomiting in clinical research when taken in amounts of 22.5-67.5 grams divided into 2-5 doses per day (7020).
Musculoskeletal ...Orally, dyskinesia has been reported in clinical research in about 3% of patients taking a specific powdered cowhage seed extract (Zandopa, formerly HP-200; Zandu Pharmaceuticals) 22. 5-67.5 grams divided into 2-5 doses daily (7020).
Neurologic/CNS ...Orally, cowhage has been reported to cause headaches (7021,7203). Orally, insomnia has been reported in clinical research in about 3% of patients taking a specific powdered cowhage seed extract (Zandopa, formerly HP-200; Zandu Pharmaceuticals) 22.5 grams to 67.5 grams divided into 2-5 doses daily (7020).
Psychiatric ...In a case report, cowhage caused an outbreak of acute toxic psychosis. Symptoms of psychosis included confusion, giddiness, agitation, hallucinations, and paranoid delusions. The cowhage-induced psychosis was successfully treated with intravenous chlorpromazine (7021).
Other ...Orally, cowhage has been reported to cause sweating and changes in urine color, (7021,7203). Theoretically, due to the levodopa constituent, cowhage is likely to cause the same adverse effects that have been attributed to purified, prescription levodopa. Some of these side effects include elevated liver enzymes, respiratory disturbances, urinary retention, muscle cramps, and priapism (15). However, these effects have not yet been reported for cowhage.
General
...Orally, horny goat weed seems to be well tolerated when used short-term.
Most Common Adverse Effects:
Orally: Dizziness, dry mouth, nosebleed, thirst, and vomiting.
Serious Adverse Effects (Rare):
Orally: Respiratory arrest.
Cardiovascular ...A 66-year-old male with a history of cardiovascular disease developed tachyarrhythmia after taking horny goat weed for 2 weeks (13006). It is not clear if this product contained only horny goat weed or a combination of ingredients; therefore, assigning causality is not possible.
Gastrointestinal ...Orally, long-term use of horny goat weed has been associated with reports of vomiting, dry mouth, thirst, and nosebleed (10346).
Hepatic ...A case of hepatotoxicity characterized by abdominal pain, nausea, vomiting, and fever has been reported in a 40-year-old male patient with hepatitis C, after a month of taking one tablet daily of a combination product containing horny goat weed and multiple other ingredients (Enzyte, Vianda). Symptoms improved following cessation of the product, but it is not clear if they were due to horny goat weed, another ingredients, or hepatitis C (91590). An observational study over 24 years found 26 cases of drug-induced hepatoxicity associated with horny goat weed (112707).
Musculoskeletal ...Orally, large doses of horny goat weed may cause exaggeration of tendon reflexes to the point of spasm (10346).
Neurologic/CNS ...Orally, long-term use of horny goat weed has been associated with reports of dizziness (10346).
Psychiatric ...There is a case report of hypomania in a 66-year-old male who took horny goat weed for 2 weeks (13006). It is not clear if this product contained only horny goat weed or a combination of ingredients; therefore, assigning causality is not possible.
Pulmonary/Respiratory ...Orally, large doses of horny goat weed may cause respiratory arrest (10346).
General
...Orally, ostarine is possibly unsafe.
Most Common Adverse Effects:
Orally: Abdominal pain, anorexia, constipation, diarrhea, nausea, and transient increases in alanine aminotransferase (ALT) levels.
Serious Adverse Effects (Rare):
Orally: Hepatotoxicity.
Cardiovascular ...Orally, in a 12-week study of healthy elderly patients taking ostarine daily, high-density lipoprotein (HDL) cholesterol levels decreased by 9 mg/dL and 15 mg/dL with ostarine 1 mg and 3 mg, respectively, when compared with placebo (98833). Theoretically, reductions in HDL reported with ostarine could potentially increase the risk for adverse cardiovascular effects. In fact, the U.S. Food and Drug Administration also warns that supplements containing SARMs, such as ostarine, have been associated with increased risk of myocardial infarction and stroke (94879,94880,94881,98840).
Gastrointestinal ...Orally, ostarine has been commonly reported to cause gastrointestinal adverse effects (98832,98833). In a 16-week study of cancer patients taking ostarine 1-3 mg daily, nausea, diarrhea, constipation, abdominal pain, and anorexia occurred in 10% or more of patients, which was more common than with placebo. Vomiting was also commonly reported, although the incidence was slightly lower than placebo (98832). In a 12-week study of healthy elderly patients taking ostarine 1-3 mg by mouth daily, diarrhea occurred more frequently with ostarine than with placebo. Nausea was also reported, but at the same rate as placebo (98833).
Hematologic ...Orally, in a 16-week study of cancer patients taking ostarine 1-3 mg daily, anemia and thrombocytopenia were reported more frequently with ostarine than with placebo, although the rate of occurrence in both groups was similar (98832).
Hepatic
...Orally, in a 16-week study of cancer patients taking ostarine 1-3 mg daily, a transient increase in alanine aminotransferase (ALT) of 2- to 4-times the upper limit of normal occurred in 7.
4% of patients taking ostarine 3 mg (98832). In a 12-week study of healthy elderly patients taking ostarine by mouth daily, an increase in ALT was reported in 4.2% of patients taking ostarine 1 mg and 20.8% of patients taking ostarine 3 mg. ALT levels did not change in the placebo group. In most cases, ALT levels resolved over the course of the study without the need to discontinue treatment. However, one patient's ALT increased to over 4-times the upper limit of normal, which required discontinuation of ostarine. The patient's ALT returned to normal after treatment discontinuation (98833).
The U.S. Food and Drug Administration also warns that supplements containing SARMs, such as ostarine, have been associated with reports of liver toxicity (94879,94880,94881). There are at least two reports of drug-induced liver injury (DILI) attributed to ostarine. In one case, a 40-year-male developed DILI, characterized by anorexia, diarrhea, lethargy, weight loss, and jaundice, after taking ostarine to improve weight training and increase muscle mass for 2 months. The patient's symptoms and liver function tests improved gradually over several months after discontinuation of ostarine (106197). In another case, a 31-year-old male presented with a probable DILI characterized by pruritus, dark urine, and elevated transaminases for 1 week after using ostarine for 3 weeks. The DILI and associated signs and symptoms resolved within weeks after discontinuation of ostarine (111385).
In one case, a 43-year-old male taking ostarine and cardarine to increase muscle mass presented with several signs and symptoms associated with DILI, including epigastric pain, dark urine, and elevated liver function tests. The patient claims the supplements were used short-term for a few days before cycling a long distance. However, based on the pharmacokinetic properties of these products and the levels detected in the patient's blood, hair, and urine, researchers suggest that longer-term use was present. The patient's symptoms resolved within a few weeks after discontinuation of both supplements (111382). It is unclear if these adverse effects are due to ostarine, cardarine, or the combination.
Musculoskeletal
...Orally, in a 12-week study of healthy elderly patients taking ostarine 1-3 mg daily, back pain was reported in 25% of patients (98833).
However, in a 16-week study of cancer patients taking ostarine 1-3 mg daily, back pain occurred at a similar rate with ostarine and placebo (98832).
In one case, a 43-year-old male taking ostarine and cardarine to increase muscle mass presented with several symptoms, including myalgia and rhabdomyolysis with elevated creatine phosphokinase (CPK). The patient claims the supplements were used short-term for a few days before cycling a long distance. However, based on the pharmacokinetic properties of these products and the levels detected in the patient's blood, hair, and urine, researchers suggest that longer-term use was present. The patient's symptoms resolved within a few weeks after discontinuation of both supplements (111382). It is unclear if these adverse effects are due to ostarine, cardarine, or the combination.
Neurologic/CNS ...Orally, in a 16-week study of cancer patients taking ostarine 1-3 mg daily, headache occurred more frequently with ostarine than with placebo. Fatigue was also commonly reported, but at a rate similar to placebo (98832). In a 12-week study of healthy elderly patients taking ostarine 1-3 mg daily, headache occurred in 29% of patients, which was more common than with placebo. Fatigue was also reported, but at a lower rate than with placebo (98833). The U.S. Food and Drug Administration also warns that supplements containing SARMs, such as ostarine, have been associated with increased risk of stroke (94879,94880,94881).
Pulmonary/Respiratory ...Orally, in a 16-week study of cancer patients taking ostarine 1-3 mg daily, pneumonia occurred more frequently with ostarine than with placebo. Cough and dyspnea were also reported, but at rates slightly lower than placebo (98832). In a 12-week study of healthy elderly patients taking ostarine 1-3 mg daily, cough occurred more frequently with ostarine than with placebo (98833).
Other ...Orally, in a 16-week study of cancer patients taking ostarine 1-3 mg daily, pyrexia occurred more frequently with ostarine than with placebo (98832).
General
...Orally, tribulus seems to be well tolerated.
Serious Adverse Effects (Rare):
Orally: Cases of liver and kidney injury, seizures, and chronic painful erection with impaired sexual function have been reported. Pneumothorax and bronchial polyp after consuming the spine-covered tribulus fruit have been reported.
Gastrointestinal ...Orally, tribulus can cause abdominal pain, cramping, nausea, vomiting, diarrhea, and constipation (92022,92027). However, in one study, the rates of these gastrointestinal complaints were similar for patients taking tribulus and those receiving placebo (92022).
Genitourinary ...In one case report, a patient taking two tribulus tablets (unknown dose) daily for 15 days presented to the local emergency department with a painful erection lasting 72 hours. The priapism was resolved with medical management; however, post-episode sexual function was impaired (92023).
Hepatic ...In one case report, a patient drinking tribulus water 2 liters daily for two days presented with lower limb weakness, seizures, hepatitis, and acute kidney injury. The patient's condition improved after hemodialysis and discontinuation of tribulus water (92069).
Neurologic/CNS ...Orally, tribulus has been reported to cause general excitation and insomnia. These symptoms were reversed upon discontinuation of the drug or decreasing the dose (78867). In one case report, a patient drinking tribulus water 2 liters daily for two days presented with lower limb weakness, seizures, hepatitis, and acute kidney injury. The patient's condition improved after hemodialysis and discontinuation of tribulus water (92069).
Pulmonary/Respiratory ...In one case report, a patient developed a bilateral pneumothorax after consuming the spine-covered fruit of tribulus (818). In another case report, a patient developed a polyp in the lobar bronchus of the right interior lobe due to the presence of a tribulus fruit spine (78852).
Renal ...In one case report, a patient drinking tribulus water 2 liters daily for two days presented with lower limb weakness, seizures, hepatitis, and acute kidney injury. The patient's condition improved after hemodialysis and discontinuation of the tribulus water (92069). In another case report, a healthy male taking one tribulus tablet (unknown dose) daily for a few months for bodybuilding purposes developed hyperbilirubinemia followed by acute kidney failure 2-3 weeks later. The patient was managed with intravenous fluids and a low-salt, low-protein diet (92025).
Other ...In one case report, gynecomastia was observed in a male weightlifter taking an herbal combination product containing tribulus. However, it is not clear if this adverse effect can be attributed to tribulus alone (78859).