Muscle & Strength

This category has one of the widest gaps between effect size and risk in the database. Resistance training and several supplements combine higher grades with comparatively favourable Safety scores in studied settings. Other compounds have large, well-documented muscle-building effects alongside serious health and legal consequences. The rankings keep those axes visible side by side.

Strong evidence and lower reported risk

Resistance training has the highest composite in this category. Creatine monohydrate is extensively studied, with reliable strength and lean-mass gains and generally favourable safety findings. Adequate protein and, to a lesser degree, beta-alanine and HMB also occupy the evidence-backed, lower-risk portion of the ranking.

Approved and nonmedical contexts

Testosterone replacement has efficacy evidence in hypogonadal men, and the TRAVERSE trial (2023) found no increase in major cardiac events versus placebo in a higher-risk hypogonadal population. Supraphysiological use has a different safety profile and is illegal without a prescription. SARMs such as ostarine produce anabolic effects alongside liver, cardiovascular, and hormone-suppression risks; they are not approved for human use and are banned in sport.

Large effect, large cost

Classic anabolic steroids such as trenbolone and oxymetholone produce large anabolic effects alongside substantial reported harms, reflected in very low Safety scores. GH-secretagogue peptides such as ipamorelin, CJC-1295, and MK-677 raise growth hormone and IGF-1, while human outcome evidence remains thin and much of the supply is gray-market. The safety context label makes those findings visible without replacing the Benefit axis.