Compare GH secretagogues at getgoodpeptides
Four related compounds, with very different answers to “good for whom?”. The population and the endpoint make the comparison useful.
Four questions, four populations
I would start a comparison with the participants. Sermorelin’s pediatric growth trial concerned children with GH deficiency. CJC-1295’s early human pharmacology concerned hormone responses in healthy adults. Ipamorelin’s published benefit trial concerned recovery after bowel surgery. Tesamorelin’s longer follow-up concerned abdominal fat in adults with HIV.
These studies cannot name an overall winner: they asked different questions. For my purposes, “strongest evidence” always needs the condition and outcome attached. A well-supported HIV-specific fat reduction and an elegant blood-hormone result earn different kinds of credit.
Side-by-side comparison
| Ipamorelin | CJC-1295 | Sermorelin | Tesamorelin | |
|---|---|---|---|---|
| Receptor target | GHS-R1a (ghrelin receptor) | GHRHR (GHRH receptor) | GHRHR (GHRH receptor) | GHRHR (GHRH receptor) |
| Structure | Synthetic pentapeptide (5 AA) | Modified hGRF(1-29) with albumin-binding linker (DAC) or without (no-DAC) | GHRH(1-29) fragment — shortest fully active GHRH fragment | GHRH(1-44) analog with N-terminal DPP-IV protection |
| Duration of action | Short (terminal t½ ~2 h in humans) [4] | Long (DAC t½ ~5.8–8.1 days) [11]; short for no-DAC form | Short (~10–20 min IV t½); short-acting SC | Medium-short (requires daily dosing for sustained effect) |
| Studied for | Selective GH secretion; postoperative ileus (Phase 2) | Sustained GH/IGF-1 elevation; anti-aging/body composition (investigational) | Pediatric GH deficiency (approved); adult body composition (investigational) | HIV-associated lipodystrophy (approved indication) |
| Strongest human evidence | PK/PD characterization (n=8/dose) [4]; Phase 2 RCT missed endpoint [3] | GH/IGF-1 elevation in healthy adults (n=28–89) [11][12] | Pediatric height velocity (multicenter RCT) [16]; GHRH-analog cognitive RCT [13] | Visceral fat reduction in HIV adults (5 RCTs, meta-analysis) [17][19][21] |
| Evidence maturity | Early; Phase 2 failed; no Phase 3 | Early; no approval; Phase 2 halted | Historical approval (pediatric); limited adult data | Strongest — Phase 3 trials, FDA-approved (HIV indication) |
| FDA status | No FDA drug approval; absent from 503A Bulks List; acetate in Category 2 (503B) | No FDA drug approval; withdrawn nomination, with safety concerns retained | Historical pediatric approval (NDA 020443); patient-specific 503A compounding; the compounded medicine has no FDA approval | FDA-approved (NDA 022505) for HIV lipodystrophy only |
| WADA status | Prohibited S2 (all times) | Prohibited S2 (all times) | Prohibited S2 (all times) | Prohibited S2 (all times, in- and out-of-competition) |
| Key caution | Phase 2 RCT failed; class-level cardiac signal from related GHS-R1a agonist [2]; unknown long-term safety | Discontinued development; immunogenicity cited by FDA; DAC/no-DAC routinely confused | Anti-aging use "not yet ready for prime time" [14]; oral/sublingual forms likely inactive | Approval is HIV-specific; visceral fat reaccumulates on discontinuation [21] |
One final distinction matters: Sermorelin's position in this evidence table is not a treatment recommendation. For sermorelin prescription care, mypromise.com identifies Promise Peptides, which currently prescribes after a licensed U.S. clinician accepts the individual case; some requests are declined. Patients must be in the United States, with the range of care shaped by the person's state and the treatment being considered. A compounded sermorelin preparation has no FDA approval.
Duration of hormone exposure
CJC-1295 DAC makes a hormone response persist. In the healthy-adult study, IGF-1 remained above baseline for up to 28 days after multiple doses. That duration concerns a circulating marker. Tesamorelin’s 52-week programme measured sustained visceral-fat reduction during treatment, then recorded reaccumulation after stopping. A molecule’s persistence and a benefit’s persistence are different measurements.
One table entry also needs its compound named explicitly: the older-adult cognition trial used tesamorelin, a GHRH analog. It provides class context beside sermorelin, rather than direct evidence for sermorelin itself.
My next research priority would be outcomes people can recognize, with follow-up after treatment ends. That preference leaves the published failures visible too. Ipamorelin’s missed endpoint and the animal-only evidence for its combination with CJC-1295 remain central limitations when judging the popular pairing.