Growth Hormone Secretagogues
GH secretagogues reliably raise GH and IGF-1 (target engagement is real), but improvements in functional outcomes, body composition, or "anti-aging" endpoints are largely unproven in healthy people. The best-controlled trials (MK-677) showed biomarker changes without clinical benefit. The only FDA-approved agent (tesamorelin) is approved for a narrow HIV-lipodystrophy indication. The dominant risks are IGF-1-mediated oncologic concern, insulin resistance, and fluid retention.
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Compounds Covered (8)
Tesamorelin (Egrifta)
The only FDA-approved GH secretagogue. A synthetic GHRH analog approved specifically for HIV-associated lipodystrophy, not general anti-aging.
MK-677 (Ibutamoren)
An oral, non-peptide ghrelin receptor agonist with the most human data in this class — including a 2-year trial showing biomarker changes WITHOUT functional benefit.
Ipamorelin
The first selective GH secretagogue — releases GH without raising ACTH, cortisol, or prolactin even at very high doses. Popular for its "clean" profile but with weak efficacy evidence.
CJC-1295 with DAC
A long-acting GHRH analog with Drug Affinity Complex (DAC) for albumin binding. Creates sustained "GH bleed" rather than natural pulses. Development was discontinued.
Sermorelin (GHRH 1-29)
The oldest GHRH analog with historical pediatric GHD trials. Available via 503A compounding but with limited modern evidence for adult use.
GHRP-2 (Pralmorelin)
A potent hexapeptide GH secretagogue approved in Japan as a diagnostic agent. Raises prolactin, ACTH, and cortisol — less selective than ipamorelin.
GHRP-6
The strongest appetite-stimulating GH secretagogue. Used primarily for bulking due to its intense orexigenic effect. Raises cortisol and prolactin.
Hexarelin
The most potent GH secretagogue peptide — but with documented rapid desensitization. GH response declines significantly by week 4.
Comparison Notes
Only tesamorelin is FDA-approved (HIV lipodystrophy). MK-677 has the most human data but showed no functional benefit in a 2-year trial. CJC-1295 and Ipamorelin were placed in FDA Category 2 (Oct 2023). In April 2026, 12 peptides were removed from Category 2 but NOT moved to Category 1 — regulatory limbo.
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