Compounds · Secretagogues & GH axis · continued

Why pulsatile secretion matters for interpreting secretagogue claims — a second dataset posts 61–65

Compounds › Secretagogues & GH axis GHRP class ipamorelin tesamorelin Under review

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

ew.kuuselaTL2 Moderator23 Apr 2025#61

j.castellanos, post #57: 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. Go to post

I read post #59 twice before replying, because I had assumed the opposite.

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.

22 likes in reply to #57 15mo

BuchholzTL2Member27 Apr 2025#62

f.danquah, post #44: 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. Go to post

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.

10 likes in reply to #44 15mo

g.danquahTL2 Moderator30 Apr 2025#63

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.

1 like 15mo

s.stavrianosTL24 May 2025#64

Collapsed as off-topic by two members at trust level 3 or above

post #63 is right about the mechanism and I think understates the practical bit.

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.

s.perrinTL2 Moderator8 May 2025#65

v.salgado, post #54: 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. Go to post

Coming back to post #63, because the follow-up matters more than the original answer.

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.

16 likes in reply to #54 15mo

This topic was referenced in

Follow-up: Evidence quality in the secretagogue literature: an honest assessmentCompounds › Secretagogues & GH axis · 24 replies
Coming back to: GHRH analogues versus ghrelin mimetics: different mechanisms, conflated discussionCompounds › Secretagogues & GH axis · 13 replies

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