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Growth Hormone Peptides: GHRH Analogs vs Ghrelin Mimetics, and Their Evidence

Every growth hormone peptide works through one of two receptors. Only one holds a current FDA approval, and the FDA flags several of the rest for safety risks.

Article type
Evidence
Sources
10
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7 min
By Craig PalmerPublished

Growth hormone peptides is a label for a mixed group of molecules that share one goal: getting the pituitary gland to release more of its own growth hormone rather than injecting growth hormone itself. They reach that goal through two different doors, and the door matters for everything else, from side effects to legal status.

This page sorts them by receptor and sets out the human evidence for each. What they did to muscle is covered separately in peptides for muscle growth.

Two receptors, one gland

The first door is the receptor for growth-hormone-releasing hormone, the signal the hypothalamus sends to the pituitary to start a pulse of growth hormone; sermorelin, tesamorelin and CJC-1295 are all built from that hormone's sequence.

The second door is the growth hormone secretagogue receptor, whose natural key is ghrelin, a hormone best known for hunger. In mice bred without that receptor, ghrelin no longer triggered either growth hormone release or eating, which established it as the receptor through which ghrelin does both [1].

That shared receptor is why appetite keeps turning up in the side-effect lists of ghrelin mimetics, and why the two families behave differently even when they reach the same pituitary. The same mouse study found that animals without the receptor were not dwarfs, suggesting that ghrelin amplifies growth hormone pulses rather than being essential to them, though that part is the authors’ interpretation rather than a direct measurement [1].

One practical consequence has been proposed for the ghrelin mimetics. Because they work through the body’s own pulsatile release and its feedback loops, a 2018 review argued they can avoid the very high growth hormone levels that injected hormone can produce [2]. The same review found few long-term, rigorously controlled studies and flagged rising blood sugar as a concern.

The molecules, side by side

Growth hormone peptides by receptor, with their human evidence and U.S. status
MoleculeReceptorHuman evidenceU.S. status
SermorelinGHRHSmall trials; once approved as GEREFCompoundable
TesamorelinGHRHRandomized trials in HIV lipodystrophyApproved as Egrifta WR
CJC-1295GHRHDosing studies in healthy adultsFDA cites serious adverse events
IpamorelinGhrelinOne dosing study, one phase 2 trial503B Category 2
GHRP-2, GHRP-6GhrelinLimited503B Category 2
MK-677 (not a peptide)GhrelinRandomized trials in older adults503A and 503B Category 2
Growth hormone peptides by receptor, with their human evidence and U.S. status

The GHRH analogs

Sermorelin is the first 29 amino acids of the natural hormone, and it was sold as GEREF, an injection approved for testing pituitary function and for treating growth hormone deficiency in children. The maker discontinued it, and in 2013 the FDA determined it was not withdrawn for safety or effectiveness reasons [6]. Whether it works without a needle is covered in sermorelin nasal spray.

Tesamorelin is a modified analog of the same hormone, and it has the strongest evidence in the group. In a trial of 412 adults with HIV and excess abdominal fat, 2 mg injected daily for 26 weeks cut visceral fat by 15.2%, against a 5.0% rise on placebo, and raised IGF-I by 81.0% [3].

Its current label, for Egrifta WR, limits it to reducing excess abdominal fat in adults with HIV and lipodystrophy, and states that it is not indicated for weight loss [7]. It warns of glucose intolerance, fluid retention and raised IGF-1. The full record is in the tesamorelin evidence review, and how it differs from the older GHRH analog is in tesamorelin vs sermorelin.

CJC-1295 was engineered to last far longer. In healthy adults, one injection raised growth hormone 2- to 10-fold for 6 days or more, with an estimated half-life of 5.8 to 8.1 days [4]. That long exposure is the design choice, and it is also the difference from the brief natural pulse the other analogs mimic. The FDA says it has identified serious adverse events with CJC-1295, including a raised heart rate and a systemic vasodilatory reaction [8].

The ghrelin mimetics

The ghrelin-receptor group began with small synthetic peptides such as GHRP-2 and GHRP-6, and ipamorelin is a later, five-amino-acid member of the group. The FDA lists GHRP-6 for effects on cortisol and rising blood glucose, and GHRP-2 for reports of serious events that include pancreatitis, though it notes causality has not been established [8].

Ipamorelin’s human record is a dosing study and a bowel-surgery trial, covered in the ipamorelin evidence review, with its safety record in ipamorelin side effects.

The best-studied drug on this receptor is not a peptide at all. MK-677, also called ibutamoren, is a pill. In 65 healthy adults aged 60 to 81, 25 mg a day raised growth hormone and IGF-I to young-adult levels and increased fat-free mass, but did not improve strength or function [5]. Fasting glucose rose and insulin sensitivity fell.

Where sleep fits

These peptides are widely marketed for sleep, and the natural releasing hormone has changed sleep stages in small human studies. Those studies, and the ones that found no benefit, are gathered in peptides for sleep.

What this means

Of the whole class, sermorelin is the one with a clear basis for compounding, the FDA's 2013 GEREF determination, and tesamorelin is the one with a current approval, for one narrow use. Every other molecule here is research-only, and none has an established human dose for muscle, sleep or aging.

Athletes face a flat rule: the 2026 World Anti-Doping Agency list prohibits GHRH and its analogs, including sermorelin, tesamorelin and CJC-1295, and the ghrelin mimetics, including ipamorelin and MK-677, at all times [10]. For approved options with human sleep data, start at the sleep goal page.

Frequently asked questions

What are growth hormone peptides?
Molecules that get the pituitary gland to release more of its own growth hormone. They work through either the GHRH receptor (sermorelin, tesamorelin, CJC-1295) or the ghrelin receptor (ipamorelin, GHRP-2, GHRP-6).
Which growth hormone peptides are FDA approved?
Tesamorelin, as Egrifta WR, for reducing excess abdominal fat in adults with HIV and lipodystrophy. Sermorelin was approved as GEREF, which was discontinued; the FDA determined in 2013 that it was not withdrawn for safety or effectiveness reasons.
What is the difference between a GHRH analog and a ghrelin mimetic?
A GHRH analog copies the hypothalamic hormone that starts a growth hormone pulse. A ghrelin mimetic acts on the ghrelin receptor, the same receptor that drives hunger, which is why appetite changes show up in its side effects.
Are growth hormone peptides legal in sport?
No. The 2026 World Anti-Doping Agency Prohibited List bans GHRH and its analogs and the growth hormone secretagogues, including sermorelin, tesamorelin, CJC-1295, ipamorelin and MK-677, at all times.

Sources

10 cited
  1. 1Sun Y, Wang P, Zheng H, Smith RG (2004). Ghrelin stimulation of growth hormone release and appetite is mediated through the growth hormone secretagogue receptor Proceedings of the National Academy of Sciences of the United States of America. PMID 15070777
  2. 2Sigalos JT, Pastuszak AW (2018). The Safety and Efficacy of Growth Hormone Secretagogues Sexual Medicine Reviews. PMID 28400207
  3. 3Falutz J, Allas S, Blot K, Potvin D, Kotler D, Somero M, et al. (2007). Metabolic effects of a growth hormone-releasing factor in patients with HIV New England Journal of Medicine. PMID 18057338
  4. 4Teichman SL, Neale A, Lawrence B, Gagnon C, Castaigne JP, Frohman LA (2006). 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 and Metabolism. PMID 16352683
  5. 5Nass R, Pezzoli SS, Oliveri MC, Patrie JT, Harrell FE Jr, Clasey JL, et al. (2008). Effects of an oral ghrelin mimetic on body composition and clinical outcomes in healthy older adults: a randomized trial Annals of Internal Medicine. PMID 18981485
  6. 6U.S. Food and Drug Administration (2013). Determination That GEREF (Sermorelin Acetate) Injection, 0.5 Milligrams Base/Vial and 1.0 Milligrams Base/Vial, and GEREF (Sermorelin Acetate) Injection, 0.05 Milligrams Base/Amp, Were Not Withdrawn From Sale for Reasons of Safety or Effectiveness Federal Register, document 2013-04827 (March 4, 2013). Source
  7. 7Theratechnologies Inc. (2025). EGRIFTA WR (tesamorelin) for injection, for subcutaneous use: prescribing information (revised 03/2025) DailyMed. Source
  8. 8U.S. Food and Drug Administration (2026). Certain Bulk Drug Substances for Use in Compounding that May Present Significant Safety Risks FDA, Human Drug Compounding (content current as of April 22, 2026). Source
  9. 9U.S. Food and Drug Administration (2026). Bulk Drug Substances Nominated for Use in Compounding Under Section 503A of the Federal Food, Drug, and Cosmetic Act (updated May 14, 2026) FDA. Source
  10. 10World Anti-Doping Agency (2026). World Anti-Doping Code International Standard: Prohibited List 2026 WADA. Source

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