Condition Hub

Growth Hormone Axis

Peptides that stimulate endogenous growth hormone release and IGF-1 production.

Clinical Overview

Growth Hormone Axis

Peptides that stimulate endogenous growth hormone release and IGF-1 production.

3 peptides1 FDA-approvedSubcutaneous injection (SC) · subcutaneous · Subcutaneous injectionLast reviewed · April 22, 2026

Growth-hormone-axis peptides stimulate endogenous pituitary GH secretion, in contrast to exogenous recombinant GH. Combining a GHRH analog with a GH secretagogue (commonly CJC-1295 + ipamorelin) is synergistic because the two classes act on distinct pituitary receptors.

Mechanism Classes

  • GHRH analogs

    Sermorelin, tesamorelin, and CJC-1295 activate the growth-hormone-releasing hormone receptor on pituitary somatotrophs, stimulating endogenous GH secretion.

  • Growth hormone secretagogues (GHS)

    Ipamorelin, GHRP-2/6, and hexarelin act on the ghrelin receptor (GHS-R1a) to trigger additional GH release, synergistic with GHRH analogs.

  • Combination therapy

    CJC-1295 (no-DAC) with ipamorelin is the most common clinical combination, dosed together subcutaneously at bedtime to leverage natural GH pulsatility.

Regulatory Status

FDA-Approved

  • Tesamorelin (HIV lipodystrophy)
  • Sermorelin (historical pediatric GH deficiency)

Investigational / Off-Label

  • CJC-1295 / Ipamorelin
  • Hexarelin

Tesamorelin is FDA-approved but frequently used off-label for adult indications. Sermorelin's historical FDA approval was withdrawn; current compounded use is off-label.

Evidence Base

Tesamorelin has FDA-approval-grade RCT data for lipodystrophy. Sermorelin has decades of historical clinical use. GH secretagogues (ipamorelin, hexarelin) have supportive but not approval-grade human data for adult indications.

Primary-Literature References

39

Across 3 linked monographs

Prescribing Considerations

  1. 1Baseline IGF-1, comprehensive metabolic panel, and pituitary axis screening before initiating therapy.
  2. 2Target IGF-1 in mid-to-upper range of age-appropriate normal — avoid supra-physiologic levels.
  3. 3Active or recent malignancy is a contraindication (IGF-1 mitogenic potential).
  4. 4Active proliferative diabetic retinopathy is a contraindication.
  5. 5Caution in uncontrolled diabetes (GH antagonizes insulin) and severe sleep apnea.
  6. 6Dose at bedtime to coincide with natural GH pulsatility; recheck IGF-1 at 6–12 weeks after reaching target dose.
Peer-reviewed clinical references · last reviewed April 22, 2026PeptidePrescriber · Clinical Reference

Peptides in this category(3)

Clinical monographs for each agent — dosing ranges, safety profile, evidence, and prescribing considerations.

Hormone OptimizationModerate Evidenceavailablesubcutaneous

Sermorelin

Synthetic GHRH(1-29) fragment for physiologic growth hormone optimization

Primary indication: Growth hormone optimization and anti-aging (off-label via compounding pharmacies)

Sermorelin acetate is a synthetic 29-amino-acid peptide corresponding to the biologically active N-terminal segment of endogenous growth hormone-releasing hormone (GHRH). Originally FDA-approved as Geref/Geref Diagnostic for diagnosing and treating GH deficiency, the commercial product was discontinued around 2008 due to manufacturing and business reasons — not safety concerns. Today, sermorelin is one of the most widely prescribed peptides in functional and regenerative medicine, stimulating the pituitary to release GH in a physiologic, pulsatile pattern that preserves natural feedback mechanisms.

Read full guide

1 additional monograph in this category is in clinical review and will be published soon.

Get matched with a vetted compounding pharmacy

Tell us what you prescribe. We manually vet compounding-pharmacy partners for identity testing, purity, endotoxin limits, and shipping reliability. When you qualify, we introduce you directly — no cost, no sales reps.

For licensed healthcare professionals only. We don't sell your information. You control whether any introduction actually happens.

Frequently Asked Questions