Curriculum
Module 05 · 50 min

Growth Hormone Secretagogues

CJC-1295, ipamorelin, sermorelin, tesamorelin, MK-677 — what's approved, what's compounded, what's hype.

ClinicalAdvanced
Core topics

What's covered

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Learning objectives

By the end of this module you will be able to

  • L01Distinguish FDA-approved secretagogues (tesamorelin) from compounded peptides.
  • L02Counsel a patient on the IGF-1 / glucose / sleep apnea risk triad.
Expected takeaways

What you should walk away believing

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Lesson · Core emphasis

What this means for you

Patient summary

These peptides ask your pituitary to make more growth hormone. Only one (tesamorelin) is approved for a specific HIV-related condition. Most are sold by anti-aging clinics with very thin evidence and real metabolic risks.

Clinician summary

CJC-1295/ipamorelin stacks dominate the compounded market. Patients often present with elevated IGF-1, new glucose intolerance, fluid retention, or worsened OSA. Ask about peptide use in any patient with new acromegaloid symptoms.

Advanced note

Mechanistic case for cycling GH/IGF-1 elevation as either anti- or pro-aging is unresolved; mTOR/IGF-1 pathways favor longevity at lower tone in model organisms — at odds with the marketing.

Evidence-graded claims

What the data say

A
Tesamorelin reduces visceral adipose tissue in HIV-associated lipodystrophy
FDA-approved 2010 based on RCT data.
D
CJC-1295 + ipamorelin safely improves body composition in healthy adults
No published RCTs; compounded only; raises IGF-1 with mitogenic concerns.
E
MK-677 (ibutamoren) is safe for chronic use in healthy adults
Studies in elderly showed ↑ glucose, ↑ HbA1c, edema, CHF signal in frail.
Quick check

Test yourself

Q1FDA-approved indication for tesamorelin?
Q2Patient on compounded CJC-1295 develops pre-diabetes. Most likely contributor?
Flashcards · Spaced repetition

Lock it in — review what's due

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GHRH vs ghrelin pathway?
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Glossary

Key terms & abbreviations

GHSGrowth hormone secretagogue
Any molecule that promotes endogenous GH release, typically via GHRHR or GHSR (ghrelin) agonism.
References · 4

Sources cited in this module

  1. [1]
    World Anti-Doping Code Prohibited List 2025
    WADA · 2025Regulatory · T1
  2. [2]
    Category 2 list — bulk drug substances under 503A (includes ipamorelin, CJC-1295, BPC-157)
    FDA Pharmacy Compounding Advisory Committee · 2023Regulatory · T1
  3. [3]
    Evaluation and Treatment of Adult Growth Hormone Deficiency: Endocrine Society Guideline
    Molitch ME. et al. · JCEM · 2011Guideline · T1
  4. [4]
    Prolonged stimulation of GH and IGF-I secretion by CJC-1295, a long-acting analog of GHRH, in healthy adults
    Teichman SL. et al. · JCEM · 2006RCT · T2
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