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Testosterone suppression : Even lower-dose SARMs like Ostarine can reduce natural testosterone levels after just a few weeks, leading to symptoms like fatigue, low libido, and mood changes Liver toxicity : Some SARMs, especially YK-11 and S23 , have shown hepatotoxicity similar to oral steroids like Superdrol or Anavar Lipid imbalance : SARMs can lower HDL (good cholesterol) and increase LDL (bad cholesterol), elevating long-term cardiovascular risk Hormonal rebound : Abruptly discontinuing SARMs without Clomid or Nolvadex may result in a hormonal crash Mood changes and aggression : While rare, some users report increased irritability, depression, or anxiety due to hormone disruption Despite being marketed as safer, SARMs still exert significant hormonal effects and are associated with adverse events including liver injury, hypogonadism, and lipid alterations (Garey et al., LiverTox )

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Semaglutide was the most cost-effective treatment compared to exenatide, dulaglutide, liraglutide, or no treatment in short-term analyses (approximately one and a half years) that assessed quality-adjusted life years and incremental cost-effectiveness ratios [135,136,137,138,139,140,141,142,143,144]