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.
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.
post #6 is right about the mechanism and I think understates the practical bit.
I disagree with the reply above, and I think the disagreement is substantive rather than terminological.
The distinction being drawn does not survive when you look at the published data for this specific question. I would be glad to be shown wrong on this, because the version I am arguing against is more convenient.
This follows post #15 rather than contradicting it.
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.
This follows post #20 rather than contradicting it.
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.
Worth separating two things that post #26 runs together.
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.
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.
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.
Read the full topic (54 posts)
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Follow-up: Tesamorelin has an approved indication — what that changes about the evidence
Posting this under the heading it deserves: Tesamorelin has an approved indication — what that changes about the evidence Everything below is what sits behind that. Comparing STEP 8 ( JAMA , 2022) with…
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+63 | 68 | 18k | 14mo |
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Secretagogues and glucose tolerance: the mechanistic concern — what changed since
Secretagogues and glucose tolerance: the mechanistic concern — what changed since Writing it up because I had to work it out twice and would rather nobody else did. I have seen STEP 1 ( N Engl J Med , 2021)…
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+2 | 6 | 31k | 2mo |
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About the Secretagogues & GH axis category
Growth-hormone secretagogues and related compounds. Evidence quality here is markedly lower and we say so. This post is a community wiki: any member at trust level 3 or above can edit it, and every edit is…
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+6 | 10 | 1.1k | 14mo |
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What a well-designed human trial of a secretagogue would look like
What a well-designed human trial of a secretagogue would look like I have a specific reason for asking rather than idle curiosity, and the context is below. I have seen SUSTAIN 6 ( N Engl J Med , 2016) cited…
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2 | 7.2k | 18mo | |
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Follow-up: Evidence quality in the secretagogue literature: an honest assessment
On the subject in the title: Evidence quality in the secretagogue literature: an honest assessment Working notes rather than a conclusion. Comparing PIONEER 6 ( N Engl J Med , 2019) with LEADER ( N Engl J Med…
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+20 | 24 | 18k | 4mo |
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Follow-up: Tesamorelin has an approved indication — what that changes about the evidence
Posting this under the heading it deserves: Tesamorelin has an approved indication — what that changes about the evidence Everything below is what sits behind that. Comparing STEP 8 ( JAMA , 2022) with…
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+63 | 68 | 18k | 14mo |
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What would change my mind about repair peptides: a specific answer
What would change my mind about repair peptides: a specific answer — that is the question, and I have not found it answered plainly anywhere I have looked. Session topic: SURMOUNT-4 ( JAMA , 2024). Please…
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+26 | 30 | 1.1k | 23h |
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When a preprint is the best available evidence and we say so — a second dataset
When a preprint is the best available evidence and we say so — a second dataset I have a specific reason for asking rather than idle curiosity, and the context is below. I have seen SUSTAIN 6 ( N Engl J Med ,…
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+20 | 24 | 36k | 14mo |
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Contributing data without breaching anyone's privacy — what changed since
On the subject in the title: Contributing data without breaching anyone's privacy — what changed since Working notes rather than a conclusion. A documentation question rather than an analytical one. I have a…
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2 | 58k | 17mo | |
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Confounding by indication, explained with a concrete example
On the subject in the title: Confounding by indication, explained with a concrete example Working notes rather than a conclusion. Comparing SURMOUNT-1 ( N Engl J Med , 2022) with SURPASS-2 ( N Engl J Med ,…
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+21 | 25 | 21k | 11mo |