Sermorelin
C+ 5.6/10
- Evidence
- Weak-Moderate (Vittone 1997 J Clin Endocrinol Metab — n=19 aged 55-71, 10 mcg/kg SC nightly x 16 wk, increased nocturnal GH, IGF-1, lean mass +1.26 kg, skin thickness, well-being); Strong (pediatric GHD diagnostic — historical FDA approval 1997 as Geref); never formally FDA-approved for adult anti-aging use (4.5/10)
- Benefit
- Med (5/10)
- Risk
- Low-Med (injection site reactions most common; preservation of physiological feedback minimizes HPA disruption; no measurable cortisol or prolactin elevation; theoretical insulin resistance at chronic supraphysiological exposure) (7/10 safety)
- Legality
- Originally FDA-approved (Geref, Serono 1997 for pediatric GHD diagnosis); commercially withdrawn 2008 (Serono cited economic — not safety — reasons); currently legally compoundable from 503A/503B pharmacies in the US — SURVIVED the April 22 2026 FDA 503A Category 2 actions that removed 12 other peptides including dihexa
- Dose
- Typical biohacker anti-aging: 200-500 mcg subQ at bedtime; pediatric GHD diagnostic 1 mcg/kg single IV/SC
- Class
- Anabolic
- Last reviewed
- Jun 8, 2026
Read Off Label grades Sermorelin as C+ (5.6/10) based on weak-moderate evidence, med benefit magnitude, and a low-med-risk safety profile.
The most "physiologic" GH-axis intervention because it preserves pulsatile release and somatostatin feedback — the short half-life (~10 min) means the pituitary continues to follow its endogenous rhythm rather than being chronically activated.
Typical use: Typical biohacker anti-aging: 200-500 mcg subQ at bedtime; pediatric GHD diagnostic 1 mcg/kg single IV/SC — Originally FDA-approved (Geref, Serono 1997 for pediatric GHD diagnosis); commercially withdrawn 2008 (Serono cited economic — not safety — reasons); currently legally compoundable from 503A/503B pharmacies in the US — SURVIVED the April 22 2026 FDA 503A Category 2 actions that removed 12 other peptides including dihexa.
What it is
The most "physiologic" GH-axis intervention because it preserves pulsatile release and somatostatin feedback — the short half-life (~10 min) means the pituitary continues to follow its endogenous rhythm rather than being chronically activated. Geref (Serono) was withdrawn 2008 for commercial reasons after the small pediatric-GHD market couldn't sustain manufacturing — FDA explicitly confirmed the withdrawal was NOT for safety or efficacy concerns. Remains the most-prescribed GHRH analog in compounding-pharmacy peptide protocols and is legally compoundable as of the April 2026 FDA 503A Category 2 update (sermorelin was NOT among the 12 peptides removed). **Clinical evidence**: the canonical aging trial remains Vittone 1997 — modest but real lean mass and IGF-1 effects after 16 weeks. No new major RCTs in 2024-2026 — the evidence base is thin and old. **Trend in practice**: increasingly displaced by CJC-1295 + ipamorelin combo stacks in compounding-clinic protocols because the dual-pathway combo produces larger measurable effects (at the cost of flattening the physiological pulse with the DAC variant, or requiring multiple daily injections without DAC). Sermorelin remains the choice for "most physiologic" GH-axis stack and for patients sensitive to flushing or water retention common with CJC. **Compounding-pharmacy access caveat**: sourcing from a legitimate 503A or 503B pharmacy is essential — gray-market "sermorelin" in research-chemical channels is poorly characterized. **Sport context**: not specifically named on the WADA Prohibited List but GHRH analogs as a class fall under WADA S2 (peptide hormones).
Mechanism
N-terminal 29-amino-acid fragment of endogenous GHRH; native receptor agonist at GHRH-R; very short half-life (~10 min) — preserves physiological GH pulsatility and somatostatin feedback; binds the same pituitary receptor as endogenous GHRH so the release pattern remains pulsatile rather than tonic (contrast: CJC-1295 with DAC flattens the pulse over multi-day exposure)