Cholestatic Drug-Induced Liver Injury From Rad-140 Successfully Treated With Corticosteroids

Selective androgen receptor modulators (SARMs) are anabolic compounds that modulate androgen activity. They have been increasingly used in supplements to enhance performance and muscle growth despite not being Food and Drug Administration approved. Their use has been associated with a cholestatic pattern of liver injury similar to that seen by anabolic androgens. Treatment is primarily supportive with drug cessation and cholestasis can take weeks to months to normalize. We present an atypical case of prolonged cholestasis caused by the readily available selective androgen receptor modulator called RAD-140 that was successfully managed with corticosteroids.