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Compounds · Secretagogues & GH axis · continued

Follow-up: Tesamorelin has an approved indication — what that changes about the evidence posts 31–60

This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.

TD
t.demirTL2 Moderator26 Mar 2025#31

Ipamorelin selectivity claims originate in preclinical characterisation and are reasonably well supported for what they claim: less effect on cortisol and prolactin than earlier GHRPs. Whether that translates to something clinically meaningful is a different question from whether the selectivity is real.

0 likes 16mo
K
KTurkingtonTL3Regular28 Mar 2025#32

CJC-1295 with and without DAC: the version with a drug affinity complex binds albumin covalently and persists for days. The version without it does not persist. Supplier labelling frequently does not distinguish them clearly, so confirming which you have is important.

21 likes 16mo
AF
a.friskTL2 Moderator29 Mar 2025#33
t.demir, post #31: Ipamorelin selectivity claims originate in preclinical characterisation and are reasonably well supported for what they claim: less effect on cortisol and prolactin than earlier GHRPs. Whether that translates to something clinically meaningful is a different question from whether the selectivity is real. Go to post

Coming back to post #31, because the follow-up matters more than the original answer.

What a well-designed human trial of a secretagogue would look like: randomised, placebo-controlled, adequate sample size, IGF-1 as primary outcome, muscle and strength as secondary outcomes, adequate follow-up duration. Very few secretagogue trials meet that description.

5 likes in reply to #31 16mo
TN
t.ndiayeTL2 Moderator31 Mar 2025#34
h.bhattacharya, post #24: CJC-1295 with and without DAC: the version with a drug affinity complex binds albumin covalently and persists for days. The version without it does not persist. Supplier labelling frequently does not distinguish them clearly, so confirming which you have is important. Go to post

Picking up post #31: that is the part I would want checked first.

Reading a rodent study on a secretagogue without over-extrapolating: rodent studies can show a mechanism is plausible. They cannot show magnitude of effect in humans or safety profile in humans. That gap is larger for secretagogues than for incretin agonists because the human evidence is thinner.

0 likes in reply to #24 16mo
NM
n.moreauTL2 Moderator2 Apr 2025#35

Practical note that does not fit anywhere else. Whatever you conclude from this topic, write down what you did and when. The single most useful thing in your own records is not any individual result; it is that they are dated and consecutive.

0 likes 16mo
PM
p.mbekiTL2 Moderator3 Apr 2025#36

post #35 is right about the mechanism and I think understates the practical bit.

Secretagogues and glucose tolerance: there is a mechanistic concern that sustained growth hormone elevation might impair glucose tolerance. The clinical relevance of this concern in practice is not well established.

28 likes 16mo
CB
c.bakkerTL2 Moderator5 Apr 2025#37

I read post #35 twice before replying, because I had assumed the opposite.

GHRH analogues versus ghrelin mimetics are often conflated but they are different mechanisms. GHRH analogues (like CJC-1295) cause the pituitary to release growth hormone. Ghrelin mimetics (like GHRPs) act on the ghrelin receptor directly. The effect on growth hormone secretion is similar but the mechanisms are distinct.

9 likes 16mo
JN
j.nascimentoTL2 Moderator7 Apr 2025#38
t.demir, post #31: Ipamorelin selectivity claims originate in preclinical characterisation and are reasonably well supported for what they claim: less effect on cortisol and prolactin than earlier GHRPs. Whether that translates to something clinically meaningful is a different question from whether the selectivity is real. Go to post

Development history is more informative than speculation: ipamorelin was investigated clinically for post-operative ileus and was not taken forward to registration. That it was not brought to market tells you something about the cost-benefit calculation that any amount of forum enthusiasm does not.

2 likes in reply to #31 16mo
MA
mi.amankwahTL2 Moderator8 Apr 2025#39

On post #35 — agreed on the reasoning, with one qualification.

Why this subcategory is stricter about sourcing than most: the evidence base is weaker and that is precisely why documentation quality matters more. A supplier page that clearly identifies the compound and the purity is more valuable for secretagogues than for incretin agonists where the evidence base is stronger.

0 likes 16mo
AD
ambient_draftTL3Regular10 Apr 2025 · edited#40
r.torrence, post #19: Evidence quality in the secretagogue literature is honestly weaker than in the incretin literature. Large randomised controlled trials are rare. Most evidence is mechanistic or from small studies. This is why this subcategory has higher sourcing standards than most. Go to post

post #39 answers the question as asked. The question underneath it is different.

Tesamorelin has an approved indication in HIV-associated lipodystrophy. That is the only compound in this class with a registration-quality evidence base from a proper trial programme. Generalising from that narrow population to healthy adults is a substantial extrapolation.

0 likes in reply to #19 16mo
CL
coldchain_liuTL3Regular12 Apr 2025#41

Pulsatile secretion matters because growth hormone is secreted in pulses, not continuously. A single post-dose growth hormone level is nearly uninterpretable. Assessing this class properly requires serial sampling or an integrated measure like IGF-1, and almost nothing published online does either.

0 likes 16mo
SK
s.kuuselaTL213 Apr 2025#42
TY
two_year_lineTL3Regular15 Apr 2025#43

For anyone arriving from a search: the marked solution above is the direct answer, and the replies underneath it add the caveats that make it safe to use.

12 likes 15mo
AP
au.pereiraTL2 Moderator17 Apr 2025 · edited#44

IGF-1 as a surrogate: it is a better integrated measure than a spot growth hormone level and it is still a surrogate, with all the caveats that come with surrogates. Stable or rising IGF-1 is not the same as "this is working" in any health-related sense.

25 likes 15mo
BD
baseline_driftTL2Analytical chemist18 Apr 2025#45
t.ndiaye, post #34: Picking up post #31: that is the part I would want checked first. Reading a rodent study on a secretagogue without over-extrapolating: rodent studies can show a mechanism is plausible. They cannot show magnitude of effect in humans or safety profile in humans. That gap is larger for secretagogues than for incretin agonists because the… Go to post

post #44 is right about the mechanism and I think understates the practical bit.

CJC-1295 with and without DAC: the version with a drug affinity complex binds albumin covalently and persists for days. The version without it does not persist. Supplier labelling frequently does not distinguish them clearly, so confirming which you have is important.

1 like in reply to #34 15mo
NO
n.oseiTL2 Moderator20 Apr 2025#46
baseline_drift, post #45: post #44 is right about the mechanism and I think understates the practical bit. CJC-1295 with and without DAC: the version with a drug affinity complex binds albumin covalently and persists for days. The version without it does not persist. Supplier labelling frequently does not distinguish them clearly, so confirming which you have is… Go to post

Worth separating two things that post #42 runs together.

Ipamorelin selectivity claims originate in preclinical characterisation and are reasonably well supported for what they claim: less effect on cortisol and prolactin than earlier GHRPs. Whether that translates to something clinically meaningful is a different question from whether the selectivity is real.

7 likes in reply to #45 15mo
PM
physio_marchettiTL2Physiotherapist21 Apr 2025#47

Reading a rodent study on a secretagogue without over-extrapolating: rodent studies can show a mechanism is plausible. They cannot show magnitude of effect in humans or safety profile in humans. That gap is larger for secretagogues than for incretin agonists because the human evidence is thinner.

17 likes 15mo
JI
j.iyerTL2 Moderator23 Apr 2025#48

Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing.

The correction was fair and I had been repeating something I had not checked carefully enough.

0 likes 15mo
K
KLindqvistTL425 Apr 2025#49
CT
c.tullochTL2 Moderator26 Apr 2025#50

Why this subcategory is stricter about sourcing than most: the evidence base is weaker and that is precisely why documentation quality matters more. A supplier page that clearly identifies the compound and the purity is more valuable for secretagogues than for incretin agonists where the evidence base is stronger.

11 likes 15mo
L
LeitermanTL3Regular28 Apr 2025#51

I read post #49 twice before replying, because I had assumed the opposite.

What a well-designed human trial of a secretagogue would look like: randomised, placebo-controlled, adequate sample size, IGF-1 as primary outcome, muscle and strength as secondary outcomes, adequate follow-up duration. Very few secretagogue trials meet that description.

0 likes 15mo
NS
n.serranoTL2 Moderator29 Apr 2025 · edited#52

Secretagogues and glucose tolerance: there is a mechanistic concern that sustained growth hormone elevation might impair glucose tolerance. The clinical relevance of this concern in practice is not well established.

23 likes 15mo
RM
r.marsdenTL3Regular1 May 2025#53
bac_water, post #5: post #4 is right about the mechanism and I think understates the practical bit. Reading a rodent study on a secretagogue without over-extrapolating: rodent studies can show a mechanism is plausible. They cannot show magnitude of effect in humans or safety profile in humans. That gap is larger for secretagogues than for incretin agonists… Go to post

Two things before anyone answers the substance.

First, the context in the first post is clear and specific. Second, the question is framed so that an answer can actually address it. Both are the norm here and both matter more than they sound.

11 likes in reply to #5 15mo
FF
f.fontaineTL2 Moderator2 May 2025#54

post #53 is right about the mechanism and I think understates the practical bit.

Development history is more informative than speculation: ipamorelin was investigated clinically for post-operative ileus and was not taken forward to registration. That it was not brought to market tells you something about the cost-benefit calculation that any amount of forum enthusiasm does not.

3 likes 15mo
P
PSundbergTL2Member4 May 2025#55

Evidence quality in the secretagogue literature is honestly weaker than in the incretin literature. Large randomised controlled trials are rare. Most evidence is mechanistic or from small studies. This is why this subcategory has higher sourcing standards than most.

0 likes 15mo
YE
y.eriksenTL2 Moderator5 May 2025#56

GHRH analogues versus ghrelin mimetics are often conflated but they are different mechanisms. GHRH analogues (like CJC-1295) cause the pituitary to release growth hormone. Ghrelin mimetics (like GHRPs) act on the ghrelin receptor directly. The effect on growth hormone secretion is similar but the mechanisms are distinct.

31 likes 15mo
ST
sterile_tableTL3Regular7 May 2025#57
figure_review, post #11: Coming back to post #9, because the follow-up matters more than the original answer. GHRH analogues versus ghrelin mimetics are often conflated but they are different mechanisms. GHRH analogues (like CJC-1295) cause the pituitary to release growth hormone. Ghrelin mimetics (like GHRPs) act on the ghrelin receptor directly. The effect on… Go to post

On post #53 — agreed on the reasoning, with one qualification.

Tesamorelin has an approved indication in HIV-associated lipodystrophy. That is the only compound in this class with a registration-quality evidence base from a proper trial programme. Generalising from that narrow population to healthy adults is a substantial extrapolation.

16 likes in reply to #11 15mo
MR
m.ramosTL2 Moderator8 May 2025#58

post #57 answers the question as asked. The question underneath it is different.

For anyone arriving from a search: the marked solution above is the direct answer, and the replies underneath it add the caveats that make it safe to use.

6 likes 15mo
CR
curious_readerTL1Member10 May 2025#59

Pulsatile secretion matters because growth hormone is secreted in pulses, not continuously. A single post-dose growth hormone level is nearly uninterpretable. Assessing this class properly requires serial sampling or an integrated measure like IGF-1, and almost nothing published online does either.

1 like 15mo
JI
j.ivaturiTL2 Moderator11 May 2025#60
t.demir, post #31: Ipamorelin selectivity claims originate in preclinical characterisation and are reasonably well supported for what they claim: less effect on cortisol and prolactin than earlier GHRPs. Whether that translates to something clinically meaningful is a different question from whether the selectivity is real. Go to post

This follows post #57 rather than contradicting it.

For anyone arriving from a search: the marked solution above is the direct answer, and the replies underneath it add the caveats that make it safe to use.

0 likes in reply to #31 15mo