Only one of the four common growth hormone peptides, tesamorelin, is FDA-approved, and only for HIV-associated fat accumulation. The other three are compounded preparations.
Growth hormone peptides are short amino acid chains that raise the body's own growth hormone output instead of injecting growth hormone directly. They split into two mechanistic classes. GHRH analogs copy the hypothalamic signal that tells the pituitary to release GH [1]. Secretagogues act on a separate receptor, the ghrelin receptor, to trigger a GH pulse through a different pathway [5]. Four peptides account for nearly everything a legitimate telehealth clinic prescribes: sermorelin, CJC-1295, ipamorelin, and tesamorelin.
- Growth hormone peptides raise your own GH; they do not inject GH
- GHRH analogs (sermorelin, CJC-1295, tesamorelin) and secretagogues (ipamorelin) act on two different receptors [1][5]
- Sermorelin is the standard first-line choice; CJC-1295 with DAC cuts injection frequency [3]
- Tesamorelin is the only FDA-approved option and the only one with phase 3 visceral fat data [6][7]
- Every protocol needs a baseline IGF-1 and a 90-day retest
The Two Classes: GHRH Analogs vs Secretagogues
GHRH analogs bind the GHRH receptor in the anterior pituitary and increase pulsatile GH release on the body's own schedule. Sermorelin, CJC-1295, and tesamorelin are all GHRH analogs [1]. Because the somatostatin feedback loop stays intact, GH output remains self-limiting rather than open-ended.
Secretagogues act on the ghrelin receptor (GHSR), not the GHRH receptor. Ipamorelin is the secretagogue used in current practice [5]. The two pathways are additive, which is why a GHRH analog and a secretagogue are often prescribed together rather than either one alone.
A GHRH analog and a secretagogue hit different receptors and lift the somatostatin brake at the same time. That is the mechanistic basis for stacking one of each, rather than doubling up within a single class.
Whichever class a peptide belongs to, the shared readout is IGF-1. Growth hormone itself is released in short pulses and is hard to measure on a single blood draw. IGF-1, produced by the liver in response to GH, stays steadier through the day and is the marker every one of these protocols is monitored against [2].
The Four Peptides Worth Knowing
Sermorelin
Sermorelin is a 29-amino acid GHRH analog, the shortest fully active fragment of natural GHRH [1]. It is dosed nightly at 100 to 300 mcg subcutaneously at bedtime to align with the natural post-sleep GH pulse. Its half-life is only minutes, so nightly dosing is required. It is the standard first-line peptide for age-related GH decline.
CJC-1295
CJC-1295 is a GHRH analog engineered to last far longer than sermorelin. The version with a drug affinity complex (DAC) binds to albumin in the blood and produces GH and IGF-1 elevation lasting several days after a single dose [3]. A short-acting version without DAC, correctly called mod-GRF(1-29) [4], clears in minutes and is dosed like sermorelin. The with-DAC versus without-DAC difference drives the whole protocol.
Ipamorelin
Ipamorelin is the selective secretagogue. In the study that introduced it, it released GH without the rise in cortisol, prolactin, or ACTH seen with earlier compounds in its class [5]. That selectivity is why it is the preferred stacking partner for a GHRH analog. Its selectivity data is stronger than its outcome data, so it is almost always run alongside a GHRH analog rather than on its own.
Tesamorelin
Tesamorelin is the one GHRH analog in this group with FDA approval, and only for HIV-associated lipodystrophy, not general anti-aging use [7]. In pooled phase 3 trials it reduced visceral adipose tissue by roughly 15% over 26 weeks [6]. It is the most rigorously studied peptide here and also the most expensive.
Growth Hormone Peptides Compared
| Peptide | Class | Dosing | Half-life | Best understood use |
|---|---|---|---|---|
| Sermorelin | GHRH analog | Nightly | Minutes | First-line age-related GH decline |
| CJC-1295 (with DAC) | GHRH analog | Weekly | 6 to 8 days | Sustained IGF-1, fewer injections |
| CJC-1295 (no DAC) | GHRH analog | 1 to 3x daily | ~30 minutes | Pulsed protocol with ipamorelin |
| Ipamorelin | Secretagogue (GHRP) | 1 to 3x daily | ~2 hours | Stacking partner, second pathway |
| Tesamorelin | GHRH analog | Daily | ~30 to 40 minutes | FDA-approved for HIV visceral fat |
How to Think About Choosing
Start with the goal and the evidence, not the peptide. For age-related GH decline with a documented low IGF-1, sermorelin is the standard entry point because it has the longest track record and the simplest protocol [2].
- Simplest protocol and lowest cost: sermorelin monotherapy
- Fewer injections and steadier IGF-1: CJC-1295 with DAC
- Two-pathway effect: a GHRH analog paired with ipamorelin
- Documented visceral fat reduction: tesamorelin, at higher cost [6]
Cost tracks the evidence roughly in that order. Sermorelin monotherapy is the least expensive, combination stacks with ipamorelin sit in the middle, and tesamorelin is the most costly because it is a branded, FDA-approved drug rather than a compounded peptide [7]. Matching spend to how strong the data is for your specific goal is a more useful filter than chasing the newest compound.
Every one of these requires a baseline IGF-1 before prescribing and a retest around 90 days. A provider who moves from intake form to prescription without a lab draw is skipping the one measurement that tells you whether the protocol is working or pushing you above the normal range. That single omission is the most reliable way to separate a serious program from a marketing funnel.
The peptide matters less than the monitoring. SystemLabs runs a baseline IGF-1 before prescribing and retests to confirm your response, so dose changes follow data instead of guesswork.
Regulatory Status
Only tesamorelin holds active FDA approval, and only for HIV-associated lipodystrophy [7]. Sermorelin, CJC-1295, and ipamorelin are compounded preparations, not FDA-approved drugs. FDA has placed CJC-1295 and ipamorelin on its list of bulk substances that may present significant safety risks for compounding [8]. All of these peptides are prohibited in competition by the World Anti-Doping Agency as growth hormone releasing factors [9].
What Growth Hormone Peptides Do Not Do
What these peptides do and what they do not do are often confused. They raise GH and the downstream IGF-1 that carries most of the clinical effect. They are not weight-loss drugs, and none of them build muscle without a training stimulus.
- They do not replace testosterone or thyroid hormone; low testosterone or hypothyroidism needs its own treatment
- They are not a fat-loss shortcut; tesamorelin's visceral fat effect required 26 weeks of daily dosing [6]
- Lean mass gains depend on resistance training and adequate protein
- The effect reverses when the protocol stops, since it depends on ongoing pituitary stimulation
The realistic outcome over a 6-month protocol is better sleep, gradual body composition change, and an IGF-1 that moves from low-normal into the middle of the age-adjusted range [2]. Patients expecting the rapid changes marketed for synthetic HGH will be disappointed. Monthly cost also spreads widely, from roughly $79 for sermorelin monotherapy to several hundred dollars for tesamorelin, which is worth weighing against how strong the evidence is for each.
Bottom Line
Frequently Asked Questions
What are growth hormone peptides?
Growth hormone peptides are short amino acid chains that raise the body's own growth hormone output rather than delivering GH directly. They fall into two classes: GHRH analogs such as sermorelin, CJC-1295, and tesamorelin that act on the pituitary GHRH receptor [1], and secretagogues such as ipamorelin that act on the separate ghrelin receptor [5]. The two classes are additive and are often prescribed together.
Which growth hormone peptide is best?
There is no single best peptide; the right one depends on the goal. Sermorelin is the standard first-line choice for age-related GH decline because of its track record and simple nightly protocol [2]. CJC-1295 with DAC reduces injections to weekly [3]. Tesamorelin has the strongest evidence, with roughly 15% visceral fat reduction in phase 3 trials, but is the most expensive and FDA-approved only for HIV lipodystrophy [6][7].
Are growth hormone peptides the same as HGH?
No. HGH (somatropin) is growth hormone injected directly into the bloodstream. Growth hormone peptides stimulate the pituitary to produce its own GH, which keeps the somatostatin feedback loop intact and self-limiting [1]. This is the mechanistic difference that separates peptides like sermorelin from synthetic HGH.
Are growth hormone peptides legal?
Sermorelin, CJC-1295, and ipamorelin are legal to prescribe as compounded preparations but are not FDA-approved. FDA lists CJC-1295 and ipamorelin among bulk substances that may present significant safety risks for compounding [8]. Tesamorelin is FDA-approved for HIV-associated lipodystrophy only [7]. All are banned in competition by WADA [9].
Do growth hormone peptides actually work?
GHRH analogs measurably raise IGF-1, the primary downstream biomarker, within weeks of starting a correct protocol [2]. Tesamorelin reduced visceral fat by about 15% in controlled phase 3 trials [6]. The evidence is strongest for GHRH analogs; ipamorelin's selectivity is well documented but its human efficacy data is thinner, which is why it is stacked rather than run alone [5].
References
- Sermorelin: a review of its use in the diagnosis and treatment of children with idiopathic growth hormone deficiency BioDrugs, 1999. PMID: 18031173. https://pubmed.ncbi.nlm.nih.gov/18031173/
- Endocrine and metabolic effects of long-term administration of [Nle27]growth hormone-releasing hormone-(1-29)-NH2 in age-advanced men and women Journal of Clinical Endocrinology & Metabolism, 1997. PMID: 9141536. https://pubmed.ncbi.nlm.nih.gov/9141536/
- Prolonged stimulation of growth hormone (GH) and insulin-like growth factor I secretion by CJC-1295, a long-acting analog of GH-releasing hormone, in healthy adults Journal of Clinical Endocrinology & Metabolism, 2006. PMID: 16352683. https://pubmed.ncbi.nlm.nih.gov/16352683/
- Human growth hormone-releasing factor (hGRF)1-29-albumin bioconjugates activate the GRF receptor on the anterior pituitary in rats: identification of CJC-1295 as a long-lasting GRF analog Endocrinology, 2005. PMID: 15817669. https://pubmed.ncbi.nlm.nih.gov/15817669/
- Ipamorelin, the first selective growth hormone secretagogue European Journal of Endocrinology, 1998. PMID: 9849822. https://pubmed.ncbi.nlm.nih.gov/9849822/
- Effects of tesamorelin (TH9507), a growth hormone-releasing factor analog, in HIV-infected patients with excess abdominal fat: a pooled analysis of two multicenter, double-blind placebo-controlled phase 3 trials with safety extension data Journal of Clinical Endocrinology & Metabolism, 2010. PMID: 20554713. https://pubmed.ncbi.nlm.nih.gov/20554713/
- EGRIFTA SV (tesamorelin) for injection: full prescribing information DailyMed, U.S. National Library of Medicine, 2025. FDA-approved labeling. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3d783378-b02d-4f19-99dd-0fc91a042224
- Certain bulk drug substances for use in compounding that may present significant safety risks FDA.gov, Human Drug Compounding, 2026. FDA Category 2 bulk substances list. https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks
- The 2026 Prohibited List: International Standard, section S2.2.4 growth hormone releasing factors World Anti-Doping Agency, 2026. WADA 2026 Prohibited List. https://www.wada-ama.org/en/resources/2026-prohibited-list
