SARMs may cause elevated liver enzymes, reduced HDL cholesterol, and suppression of the HPG axis. While they generally have fewer side effects than anabolic steroids, long-term safety remains uncertain. Anabolic steroids, on the other hand, are associated with liver damage, cardiovascular problems, hormonal imbalances, and psychiatric effects. They can also lead to acne, hair loss, and prostate enlargement. Always consult a healthcare professional before use.