Growth Hormone Peptides Ranked: Which Ones Actually Work?
Which growth hormone peptide is worth taking, if any?
Tesamorelin, at 6.2, and only if you have a clinical reason. Every one of the nine scores 6.2 or lower, so the category tops out at worth trying and never reaches recommended. One member has a Phase 3 trial and a label. The other eight are sold on a mechanism nobody has tested for the outcome you want.
- Nothing here scores above 6.2. This is the rare category where the honest headline is that most of it is not worth it.
- Tesamorelin is the only member with an approved indication, a Phase 3 trial and a real label. It also costs the most, at about $250 to $500 a month.
- Ipamorelin ties for first at 6.2 and wins zero use cases. It ranks there because its downside profile is the cleanest in the category, not because anything it does has been measured.
- The best-evidenced member is MK-677, which ranks eighth. It has a two-year randomized trial and a 563-patient pivotal trial, and both of them are bad news.
- Seven of the nine have no legal pharmacy channel. Two do, and one of those two is only compounded.
- The ranking is the live score. When a member's score moves, this page moves with it.
The Ranking
9 interventions ranked by live BioHarmony score.
Rank 1: Tesamorelin
6.2 / 10 Worth tryingStabilized GHRH analogue. FDA approved for HIV lipodystrophy. BioHarmony 6.2, worth trying.
Rank 1: Ipamorelin
6.2 / 10 Worth tryingTied for first, and the clearest illustration in this whole ranking of what the BioHarmony score actually measures. Ipamorelin is the selective one: it raises growth hormone without meaningfully moving cortisol or prolactin (Raun 1998), which is a real and well-documented advantage over the older peptides. What it does not have is any evidence it does anything. Its only completed human efficacy trial, in 114 post-surgical patients, failed (Beck 2014), and development stopped there. It scores 2.0 for body composition, last or near-last in every use case on this page. Pick it if you want the cleanest side-effect profile in the category and accept that the benefits are untested.
Selective ghrelin-receptor secretagogue. No approved product. BioHarmony 6.2, worth trying.
Rank 3: Sermorelin (GHRH 1-29)
5.9 / 10 Worth tryingThird, on credentials rather than results. It is the only member that was ever FDA approved in its own right, sold as Geref on the back of a 110-patient pediatric trial that roughly doubled height velocity (Thorner 1996). That pedigree is why it outranks the peptides below it. The adult case is much thinner: a 14-day crossover reversed age-related growth hormone and IGF-1 decline in older men (Corpas 1992), and a 16-week trial of a stabilized analogue raised lean mass in men but not women (Khorram 1997). Pick it over CJC-1295 when you want the same GHRH pulse with a compounded prescription behind it instead of a research vial.
GHRH 1-29. Formerly FDA approved as Geref, now compounded only. BioHarmony 5.9, worth trying.
Rank 4: CJC-1295 No DAC (Mod GRF 1-29)
5.8 / 10 Worth tryingFourth, and the one people actually inject. Mod GRF 1-29 clears in about 30 minutes, so it produces the brief natural-shaped pulse the DAC form does not, and that is why the community prefers it. The problem is that every human dataset on this molecule belongs to the DAC version (Teichman 2006, Ionescu and Frohman 2006). The no-DAC form you buy has never been tested in a published human trial in any form. It outranks the DAC version by 0.3 on the strength of the pulsatile profile alone. Pick it over sermorelin only if you specifically want the ipamorelin stack and accept the sourcing.
Mod GRF 1-29, the short-acting GHRH analogue. BioHarmony 5.8, worth trying.
Rank 5: GHRP-2 (Pralmorelin)
5.5 / 10 🤷 NeutralFifth, and the strongest raw releaser in the batch. A single dose produces a peak growth-hormone response about three times the area under the curve of an equal GHRH dose (Tiulpakov 1995), and a 30-day infusion held growth hormone and IGF-1 elevated with normal safety labs (Bowers 2004). It is also the only member with a regulatory approval outside the US, as a Japanese single-dose diagnostic test for growth-hormone deficiency (Chihara 2007). The cost of that power is selectivity: it raises prolactin, ACTH and cortisol (Arvat 1997) and increased ad-libitum food intake by about 36 percent in lean men (Laferrere 2005).
Pralmorelin. Approved in Japan as a diagnostic test only. BioHarmony 5.5, neutral.
Rank 5: CJC-1295
5.5 / 10 🤷 NeutralTied for fifth, and the version this category has largely moved away from. The DAC form binds albumin and holds growth hormone elevated for 6 to 8 days, which is convenient and non-physiological, and it is the form that carries the actual human pharmacology (Teichman 2006). It still wins four use cases outright, more than any member except tesamorelin: muscle growth at 5.5, recovery at 5.0, sleep at 5.0 and skin at 4.0. Those are the highest numbers on this page after tesamorelin's, from a molecule with no outcome trial. It sits at 5.5 because FDA placed CJC-1295 on the compounding restriction listing and a sustained IGF-1 bleed is the wrong shape for the risk.
The DAC form, long-acting. On the FDA compounding restriction listing. BioHarmony 5.5, neutral.
Rank 7: GHRP-6
5.1 / 10 🤷 NeutralSeventh, and historically the most important compound here. GHRP-6 was the tool used to clone the growth-hormone-secretagogue receptor (Howard 1996), which led directly to the discovery of ghrelin (Kojima 1999). A synthetic peptide reverse-engineered a hormone system. For the reason people buy it, there is nothing: the growth-hormone rise is real (Bowers 1990) and no trial shows it produces fat loss or muscle. It carries the heaviest appetite load of the group, and that hunger is dissociated from the growth hormone entirely (Locke 1995), so it fights a cut and only helps a bulk.
The original growth-hormone-releasing peptide. BioHarmony 5.1, neutral.
Rank 8: MK-677 (Ibutamoren)
4.9 / 10 🤷 NeutralEighth, with the deepest evidence base on the page, which is exactly why it ranks here. Ibutamoren is oral, once daily, and raises IGF-1 into the young-adult range (Chapman 1996). A two-year randomized trial added about 1.1 kg of fat-free mass and produced no gain in strength or function, while glucose rose and insulin sensitivity fell (Nass 2008). A 563-patient Alzheimer's trial failed despite IGF-1 rising about 73 percent (Sevigny 2008). A hip-fracture Phase IIb was stopped early for a congestive-heart-failure signal (Adunsky 2011). This is what a well-tested growth-hormone secretagogue looks like.
Ibutamoren, the only oral member. Never approved. BioHarmony 4.9, neutral.
Rank 9: AOD-9604
4.6 / 10 🤷 NeutralLast, and the only member that is a failed drug rather than an untested one. AOD-9604 is the 176-191 fat-loss fragment of growth hormone, and it does not release growth hormone at all. In obese rats, oral dosing cut body-weight gain by more than half (Heffernan 2000). In people, the developer's controlled weight-loss program did not beat placebo and was abandoned (Stier 2014). It is genuinely safe, with no adverse-event reports found in FDA's 2024 review, which means the case against it is not danger. It is that you are buying an answered question.
Growth-hormone fragment 176-191, not a secretagogue. BioHarmony 4.6, neutral.
Best Pick by Use Case
| Use Case | Winner | Runner-Up | Why |
|---|---|---|---|
| Body Composition | Tesamorelin 7.5 | CJC-1295 6.0 | The row the whole category is bought for, and the spread is the story. Tesamorelin's 7.5 rests on a Phase 3 trial with a measured visceral-fat endpoint. CJC-1295's 6.0 rests on class extrapolation from that same tesamorelin data. Below those two the numbers collapse: ipamorelin and AOD-9604 both score 2.0, and the median member scores 4.2. |
| Hormonal | Tesamorelin 7.5 | CJC-1295 5.5 | Only six of the nine carry a hormonal subrating at all, which is a strange gap in a category defined by hormones. It reflects what was measured rather than what was claimed: raising IGF-1 on a lab panel is not the same finding as changing a hormonal outcome, and only tesamorelin has the second kind. |
| Muscle Growth | CJC-1295 5.5 | Tesamorelin 4.5 | The one row tesamorelin does not win, and read it carefully. CJC-1295's 5.5 is a mechanism score, not an outcome: no human trial has measured muscle on this molecule. Ipamorelin, the peptide most often sold for this exact purpose, scores 1.9, second from bottom. |
| Recovery Repair | CJC-1295 5.0 | Tesamorelin 4.5 | A tight row where seven of nine members sit between 1.8 and 4.0. GHRP-2 and sermorelin both reach 4.0 here, their best showing on the page, which is worth knowing if recovery rather than body composition is the reason you are reading. |
| Sleep Quality | CJC-1295 5.0 | Tesamorelin 4.5 | Better sleep is the most consistently reported subjective effect across this whole category, and it is also the best-supported at the class level: GHRH promotes non-REM sleep in human sleep paradigms (Schussler 2006), and MK-677 increased deep stage-IV and REM sleep by roughly 50 percent (Copinschi 1997). MK-677 scores 4.0 here, its highest row. |
| Metabolic Health | Tesamorelin 7.0 | AOD-9604 2.0 | The widest gap on the page, five full points between first and second, and the runner-up is the member ranked last overall. Every other member sits at 1.0 to 1.8. Growth-hormone-axis stimulation tends to worsen glucose control rather than improve it, which is why MK-677 scores 1.6 here despite having the most metabolic data of the eight. |
| Geriatric | Tesamorelin 6.0 | Sermorelin (GHRH 1-29) 2.6 | Older adults with lower baseline output are the population every report in this category names as the most likely responders, and it is also the population where the growth-hormone axis was tested most directly (Corpas 1992, Khorram 1997). MK-677 ties sermorelin at 2.6, held down by the trial that was stopped for a heart-failure signal in frail elderly patients. |
| Injury Recovery | CJC-1295 4.0 | Tesamorelin 3.5 | Nine members, and the top score is a 4.0 built on mechanism. This is the cleanest example of the category's core problem: an entire class sold for healing carries no human injury endpoint anywhere in its literature. |
| Energy | Tesamorelin 4.0 | CJC-1295 4.0 | A dead heat at 4.0, so read this row as a tie rather than a win. Nobody takes these peptides for energy and the numbers agree: the other seven members sit between 1.6 and 2.6. |
| Healthspan | Tesamorelin 5.5 | Sermorelin (GHRH 1-29) 2.0 | Worth pausing on. Raising IGF-1 for decades is not obviously a healthspan strategy, and the pooled prospective data linking IGF-1 to breast-cancer risk is the reason every report here lists active or prior cancer as a contraindication. The low scores in this row are a considered position, not missing data. |
At a Glance
Tesamorelin
- Efficacy 4.3
- Breadth 4.0
- Evidence 4.6
- Speed 2.5
- Durability 1.5
- Bioindividuality 4.0
- Safety Risk 1.9
- Side Effects 2.3
- Cost 4.0
- Effort 2.5
- Opportunity Cost 2.5
- Dependency 3.5
- Reversibility 2.0
- Body Composition
- Hormonal
- Metabolic Health
- Liver Detox
Stabilized GHRH analogue. FDA approved for HIV lipodystrophy. BioHarmony 6.2, worth trying.
Ipamorelin
- Efficacy 3.3
- Breadth 3.3
- Evidence 3.3
- Speed 3.2
- Durability 2.4
- Bioindividuality 3.3
- Safety Risk 1.8
- Side Effects 1.6
- Cost 2.6
- Effort 3.0
- Opportunity Cost 2.2
- Dependency 2.6
- Reversibility 1.6
- Sleep Quality
- Recovery Repair
- Bone Joint
- Injury Recovery
Selective ghrelin-receptor secretagogue. No approved product. BioHarmony 6.2, worth trying.
Sermorelin (GHRH 1-29)
- Efficacy 3.2
- Breadth 3.2
- Evidence 3.8
- Speed 3.0
- Durability 2.0
- Bioindividuality 3.3
- Safety Risk 1.8
- Side Effects 1.9
- Cost 2.8
- Effort 3.2
- Opportunity Cost 2.8
- Dependency 2.8
- Reversibility 1.8
- Body Composition
- Recovery Repair
- Sleep Quality
- Geriatric
GHRH 1-29. Formerly FDA approved as Geref, now compounded only. BioHarmony 5.9, worth trying.
CJC-1295 No DAC (Mod GRF 1-29)
- Efficacy 3.0
- Breadth 3.3
- Evidence 3.2
- Speed 3.5
- Durability 2.0
- Bioindividuality 3.2
- Safety Risk 1.8
- Side Effects 2.0
- Cost 2.6
- Effort 3.2
- Opportunity Cost 2.6
- Dependency 2.6
- Reversibility 1.8
- Sleep Quality
- Recovery Repair
- Body Composition
- Injury Recovery
Mod GRF 1-29, the short-acting GHRH analogue. BioHarmony 5.8, worth trying.
GHRP-2 (Pralmorelin)
- Efficacy 3.3
- Breadth 3.2
- Evidence 3.4
- Speed 3.6
- Durability 2.0
- Bioindividuality 3.2
- Safety Risk 2.4
- Side Effects 2.6
- Cost 2.6
- Effort 3.2
- Opportunity Cost 2.8
- Dependency 2.5
- Reversibility 1.7
- Body Composition
- Recovery Repair
- Geriatric
- Sleep Quality
Pralmorelin. Approved in Japan as a diagnostic test only. BioHarmony 5.5, neutral.
CJC-1295
- Efficacy 2.8
- Breadth 3.0
- Evidence 2.8
- Speed 3.3
- Durability 1.8
- Bioindividuality 2.9
- Safety Risk 2.3
- Side Effects 2.4
- Cost 2.6
- Effort 3.6
- Opportunity Cost 2.0
- Dependency 1.9
- Reversibility 1.4
- Body Composition
- Hormonal
- Muscle Growth
- Sleep Quality
The DAC form, long-acting. On the FDA compounding restriction listing. BioHarmony 5.5, neutral.
GHRP-6
- Efficacy 3.0
- Breadth 2.8
- Evidence 3.2
- Speed 3.0
- Durability 2.0
- Bioindividuality 2.8
- Safety Risk 1.9
- Side Effects 3.4
- Cost 2.6
- Effort 3.2
- Opportunity Cost 3.2
- Dependency 2.6
- Reversibility 1.8
- Body Composition
- Muscle Growth
- Cardiovascular
- Recovery Repair
The original growth-hormone-releasing peptide. BioHarmony 5.1, neutral.
MK-677 (Ibutamoren)
- Efficacy 3.5
- Breadth 3.4
- Evidence 3.8
- Speed 3.6
- Durability 2.0
- Bioindividuality 3.3
- Safety Risk 3.4
- Side Effects 3.4
- Cost 2.4
- Effort 1.8
- Opportunity Cost 2.6
- Dependency 3.2
- Reversibility 2.0
- Body Composition
- Sleep Quality
- Muscle Growth
- Recovery Repair
Ibutamoren, the only oral member. Never approved. BioHarmony 4.9, neutral.
AOD-9604
- Efficacy 1.4
- Breadth 1.6
- Evidence 1.8
- Speed 2.0
- Durability 2.0
- Bioindividuality 2.0
- Safety Risk 1.8
- Side Effects 1.6
- Cost 2.8
- Effort 3.0
- Opportunity Cost 3.5
- Dependency 1.8
- Reversibility 1.6
- Body Composition
- Bone Joint
- Metabolic Health
- Recovery Repair
Growth-hormone fragment 176-191, not a secretagogue. BioHarmony 4.6, neutral.
Cost Comparison
| Intervention | Monthly Cost | Notes |
|---|---|---|
| Tesamorelin | $250 to $500 | ESTIMATE, priced 2026-09-07, compounding-pharmacy channel, at 2 mg subcutaneous daily in the evening. Compounded tesamorelin through telehealth prescribers runs about $250 to $500 a month. Branded Egrifta SV can reach several thousand dollars a month without coverage. The most expensive line on this table and the only one with a Phase 3 trial behind it. |
| Sermorelin | $129 to $250 | ESTIMATE, priced 2026-09-08, telehealth compounded channel, at 100 mcg. Telehealth programs advertise $129 to $149 a month on multi-month plans and clinic-bundled programs run $175 to $250. Sermorelin exists only as a compounded preparation now, so this is the accessible legitimate band rather than a pharmacy list price. |
| CJC-1295 (DAC) | $80 to $200 | ESTIMATE, priced 2026-09-08, research-vial channel, at the weekly 1 to 2 mg DAC protocol. Before purity and endotoxin testing, syringes, bacteriostatic water and IGF-1 lab monitoring, which are not optional on this channel. |
| AOD-9604 | $72 to $99 | ESTIMATE, priced 2026-09-08, research-vial channel. 5 mg vials run about $40 to $55; 300 mcg daily consumes 9 mg, roughly 1.8 vials per 30 days. The third most expensive vial on the page for the member with the only failed human efficacy program. |
| MK-677 (ibutamoren) | $30 to $60 | ESTIMATE, priced 2026-09-08, research-chemical channel, at the 10 to 12.5 mg starter dose. Wide because there is no legitimate channel to price against. Identity testing and periodic glucose and IGF-1 labs are not in this figure, and on the evidence they are the part you should not skip. |
| CJC-1295 No DAC (Mod GRF 1-29) | $30 to $55 | ESTIMATE, priced 2026-09-08, research-vial channel, at 100 mcg once daily. A 5 mg vial at $30 to $60 gives 50 doses, about 1.6 months, plus water and syringes. The dominant real-world protocol adds ipamorelin one to three times daily and IGF-1 labs, which costs several times this line. |
| Ipamorelin | $25 to $60 | ESTIMATE, priced 2026-09-07, research-vial channel, at 100 to 150 mcg. A 5 mg vial at $25 to $50 gives 33 to 50 doses, plus $8 to $13 of water, syringes and swabs. Compounded ipamorelin through a clinic runs $40 to $90 per vial instead. |
| GHRP-2 (pralmorelin) | $20 to $40 | ESTIMATE, priced 2026-09-07, research-vial channel, at 100 mcg. A 5 mg vial at $20 to $45 gives 50 doses, about 1.7 months of once-daily use, plus roughly $8 to $13 a month of supplies. |
| GHRP-6 | $20 to $40 | ESTIMATE, priced 2026-09-07, research-vial channel, at 100 mcg. Same arithmetic as GHRP-2: a 5 mg vial at $20 to $45, 50 doses, plus supplies. The cheapest line on the page, and the appetite it drives will cost you more in groceries than the peptide costs. |
| The difference | $20 to $500, and price tracks legitimacy rather than effect | The two members with a legitimate channel, tesamorelin and sermorelin, are the two most expensive lines and the two with the most regulatory history. The seven research-vial members run $20 to $200 and none of them has a human outcome trial. Every figure carries a pricing date, and none of the vial prices include the third-party certificate of analysis those reports say is mandatory. |
Who Should Pick What?
You have a diagnosed clinical reason and a prescriber
Tesamorelin
It is the only member with a Phase 3 trial, an approved indication and a current FDA label, and it holds the top score in the category for body composition, hormonal, metabolic health and cognition. The narrow label is HIV-associated lipodystrophy, so the honest version of this row is that you need a clinician to tell you whether you are inside or outside it.
You want the growth-hormone axis nudged with the least risk
Ipamorelin
It raises growth hormone without meaningfully moving cortisol or prolactin (Raun 1998), which is the cleanest profile of the nine and the reason it ties for first. Go in knowing that its only completed human efficacy trial failed, that it scores 2.0 for body composition, and that you are buying a low-harm experiment rather than an expected result.
You want the same idea with a prescription behind it
Sermorelin (GHRH 1-29)
It is the only member ever approved in its own right and the only GHRH-class option you can obtain as a compounded prescription for roughly $129 to $250 a month rather than as a research vial. The adult evidence is mixed and thinner than the pedigree suggests, so treat the regulatory history as a quality-of-supply argument, not an efficacy one.
Deeper sleep is the actual thing you want
CJC-1295
Sleep is the best-supported effect in this category at the class level (Schussler 2006) and the most consistently reported subjective one. CJC-1295 holds the top sleep subrating at 5.0 and MK-677 is the only member with a dedicated human sleep trial. Both carry real costs, so the first move is still to fix sleep without a peptide.
You are running a hard bulk and want the appetite
GHRP-6
The one place its biggest flaw is a feature. GHRP-6 drives hunger through a pathway separate from growth hormone (Locke 1995), so if eating in a surplus is the bottleneck it does something no other member does. For every other goal it is the weakest practical choice on the page.
You want oral convenience and no needles
MK-677 (Ibutamoren)
It is the only oral member, and it is the one this ranking argues hardest against. A two-year trial produced 1.1 kg of fat-free mass with no functional gain and worse glucose control (Nass 2008), and a hip-fracture trial stopped early on a heart-failure signal (Adunsky 2011). Choose it only with glucose monitoring and a specific tolerance for that trade.
You are chasing fat loss and nothing else
Tesamorelin
Tesamorelin is the only member with a measured fat endpoint in humans, and even it is measured in one clinical population. AOD-9604, the member marketed specifically for this, failed its controlled human weight-loss program (Stier 2014). If fat loss is the whole goal, this category is not where the answer is.
You are healthy, under 40, and want more growth hormone
Tie
None of the nine. Every report in this category names older adults with lower baseline output as the likeliest responders, no member has an outcome trial in healthy young adults, and chronically raising IGF-1 is the reason active or prior cancer is a contraindication across the whole class. This is the row where the answer is to not start.
You are a drug-tested athlete
Tie
None of the nine, without exception. Growth-hormone-releasing factors and secretagogues are prohibited at all times under WADA category S2, and AOD-9604 has been detected in confiscated vials in doping casework. There is no member of this category that is safe for tested sport.
How This Ranking Is Built
- Ranked by
- the live BioHarmony overall score
- What is included
- Every published BioHarmony intervention report whose purpose is raising your own growth hormone, by any route: the GHRH receptor on the pituitary (tesamorelin, sermorelin, both CJC-1295 forms) or the ghrelin receptor GHS-R1a (ipamorelin, GHRP-2, GHRP-6, MK-677). Injecting growth hormone itself is out of scope, and no BioHarmony report exists for it. AOD-9604 is included as the one boundary case: it is a fragment of the growth-hormone molecule rather than a releaser, and it is ranked here because it is sold, priced and searched against these peptides. Adding a new report inside this boundary adds a row.
- Kept current
- Positions and scores are read live from each intervention report on every page load, so the order re-renders the moment any member is rescored. Membership is rebuilt nightly against the inclusion rule above.
The order on this page is the live BioHarmony overall score, read from each member's report when the page renders. It is not an editorial ranking, and nothing about it is fixed. When a member's score changes, the row moves that night.
Ties are shown as ties. Tesamorelin and ipamorelin sit at 6.2, and GHRP-2 and CJC-1295 sit at 5.5. Within a tie the order is by upside total, the sum of the benefit dimensions before risk is subtracted. That is a tiebreak, not a ranking: treat tied members as equivalent.
The headline finding is the ceiling. Every member scores 6.2 or below, which in BioHarmony terms is the top of worth trying, and nothing in this category reaches recommended. That is unusual. Most categories have at least one member that clears the bar. Here the reason is structural: eight of the nine have no human trial measuring the outcome they are sold for, and the ninth, MK-677, has several that came back negative.
Read the composite and the use-case table together, because they disagree in a useful way. Ipamorelin ties for first on the composite and wins nothing. It gets there on a clean safety and side-effect profile, which the score weighs alongside effect size. CJC-1295 ranks fifth and wins four use cases, because its efficacy subratings are mechanism-based while its access and regulatory scores are poor. A high composite in this category often means low harm rather than high benefit.
Two members are boundary cases and both are disclosed rather than hidden. AOD-9604 does not release growth hormone; it is a fragment of the molecule, ranked here because it is sold and searched against these peptides. MK-677 is an oral non-peptide, ranked here because it hits the same GHS-R1a receptor as the injectable ghrelin-receptor members.
Costs in the table are ESTIMATES with a pricing date. Two members have a legitimate channel to price against: tesamorelin through compounding telehealth and sermorelin through compounded prescription programs. The other seven are priced as research vials, where purity is vendor-dependent and a third-party certificate of analysis is a real line item nobody includes in the advertised price.
Injecting growth hormone itself is deliberately out of scope. It is the comparator every member of this category is a workaround for, it is a controlled substance for non-approved use in the US, and no BioHarmony report exists for it yet. Every member of this class is also prohibited at all times in tested sport under WADA category S2.
Research Highlights
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Mechanism Difference
Two receptors, and confusing them is the most common mistake in this category. Tesamorelin, sermorelin and both CJC-1295 forms are GHRH analogues: they hit the growth-hormone-releasing-hormone receptor on pituitary somatotrophs and produce a pulse shaped like the one your body makes. Ipamorelin, GHRP-2, GHRP-6 and MK-677 hit GHS-R1a, the ghrelin receptor, which is a different lever on the same gland and also the reason several of them make you hungry.That difference is why the two arms get stacked. A GHRH analogue and a ghrelin-receptor agonist together produce more growth hormone than either alone, a synergy documented in humans since the early trials (Leal-Cerro 1995), and CJC-1295 no-DAC plus ipamorelin is the dominant real-world protocol because of it. Note what that synergy is evidence of: more growth hormone in the blood. It is not evidence of an outcome.AOD-9604 sits outside both arms. It is the tail fragment of the growth-hormone molecule, and it does not bind the growth-hormone receptor or release growth hormone at all (Ng 2000). It is ranked here because it is sold and searched inside this category, not because it belongs to it mechanistically.
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Safety Comparison
One contraindication appears on every report in this category, and it is the same one: active or hormone-sensitive cancer. The reason is IGF-1. Every member of this class raises it, that is the whole point, and pooled prospective data links higher circulating IGF-1 to breast-cancer risk (Endogenous Hormones and Breast Cancer Collaborative Group 2010). The evidence links the marker to risk, not these drugs to cancer, and no member has been shown to cause it. Every report treats that as a reason to exclude anyone with a cancer history rather than a reason to relax.After that the exclusions diverge by receptor. The ghrelin-receptor members carry the off-target load: GHRP-2 and GHRP-6 raise prolactin, ACTH and cortisol (Arvat 1997), and MK-677 reliably worsens glucose control and was stopped in one frail-elderly trial for a congestive-heart-failure signal (Adunsky 2011). Ipamorelin is the exception on that arm, and its selectivity is its main claim (Raun 1998). The GHRH members carry less off-target activity and instead carry an injection-site and flushing burden.Diabetes or poor glucose control is named on eight of the nine. Pregnancy is named on all nine. And five of them name the same non-clinical exclusion: no way to verify what is actually in the vial.
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Cost Comparison
The cost table inverts the usual relationship between price and evidence, and it does so cleanly. The two most expensive lines, tesamorelin at roughly $250 to $500 a month and sermorelin at $129 to $250, are the only two members with a legitimate channel and the only two with genuine regulatory history. Everything cheaper is a research vial.That gap is not a markup. It is the price of a product standard: a compounded or approved preparation arrives with an identity, a concentration and a sterility assurance, and a research vial arrives with a label and nothing behind it. Every report in this category recommends a third-party HPLC and mass-spec certificate of analysis on gray-market material, and none of the vial prices quoted here include it.Add the monitoring. IGF-1 and glucose labs are named as necessary on most of these reports, and on MK-677 they are the difference between a monitored experiment and an unmonitored glucose problem. A $30 vial with $150 of quarterly labs is not a $30 intervention.
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Evidence Maturity
The most useful thing in this ranking is the inverse relationship between how much a member has been tested and where it lands. MK-677 has a two-year randomized trial, a 563-patient pivotal trial and a terminated Phase IIb, which is more human data than anything else here, and it ranks eighth of nine. Ipamorelin has one completed human efficacy trial, which failed, and it ties for first.That is not a bug in the scoring. It is what happens when a category is mostly untested: an untested compound scores on mechanism plus a clean safety read, while a tested one scores on results. MK-677's results came back negative on function, negative on Alzheimer's progression and negative on glucose, and the score reflects them.The practical consequence is that a high rank here should be read as low demonstrated harm rather than high demonstrated benefit, everywhere except tesamorelin. Tesamorelin is the only member whose position rests on a trial that measured an outcome and found one.
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Editorial Verdict
For most people reading this, the answer is none of them, and that is not a hedge. Nothing in this category scores above 6.2, no member other than tesamorelin has a human trial measuring the outcome it is sold for, and the best-tested member of the nine produced 1.1 kg of fat-free mass over two years with no strength or functional gain and worse glucose control.If you have a clinical reason and a prescriber, tesamorelin is the real answer and the only one with a label. If you want the mechanism with the least exposure, ipamorelin is the cleanest and you should expect nothing measurable from it. If you want a prescription rather than a vial, sermorelin is the route.Everything else on this page is worth understanding and not worth sourcing. Sleep is the effect people report most and the one with the best class-level support, and it is also the cheapest thing to fix without a peptide. Before any of this, the honest first move is training, protein and sleep, because that is what the growth-hormone axis responds to anyway.
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Ranking Stability
This ranking is not an opinion that gets refreshed quarterly. The order is the live BioHarmony overall score for each member, resolved when the page loads, so a rescoring of any one report reorders the page that night without an editorial pass.Expect less movement here than in a category full of active drug development. Most of the literature behind these nine is decades old: GHRP-6 dates to 1990, sermorelin's pivotal trial to 1996, ipamorelin's characterization to 1998. Seven of the nine have no ongoing program that would generate a new outcome trial, and the events that would move them, an approval or a Phase 3 readout, are not scheduled.The realistic movers are regulatory rather than clinical. A change to the FDA compounding lists would move CJC-1295 and the access scores of several others in one step, and that is the thing to watch. The current gap between first and last is 1.6 points.
Frequently Asked Questions
- Which growth hormone peptide actually works?
- Tesamorelin, and only for what it was tested on. It is the only member of this ranking with a Phase 3 trial that measured an outcome, a five-RCT meta-analysis behind it and a current FDA label, and it scores 6.2. Its indication is excess abdominal fat in adults with HIV-associated lipodystrophy, not general fat loss. Every other member here is sold on a mechanism that has never been tested for the result you want.
- Why does nothing in this category score above 6.2?
- Because eight of the nine have no human trial measuring the outcome they are marketed for, and the ninth has several that came back negative. The BioHarmony overall weighs evidence quality, safety, access, cost and practicality alongside effect size. A compound with an elegant mechanism, no outcome data and a research-vial supply chain cannot score above worth trying no matter how good the mechanism is.
- Is ipamorelin better than CJC-1295?
- On the composite score, yes: 6.2 against 5.5. On every use case in the table, no. CJC-1295 wins muscle growth 5.5 to 1.9, recovery 5.0 to 2.4 and sleep 5.0 to 2.8. Ipamorelin ranks higher because it is the selective one, raising growth hormone without moving cortisol or prolactin, so it scores well on the safety and side-effect dimensions. Read that as lower harm rather than more benefit.
- Should I stack CJC-1295 with ipamorelin?
- That is the dominant real-world protocol, and the reason for it is genuine: a GHRH analogue and a ghrelin-receptor agonist together produce more growth hormone than either alone, which has been documented in humans since the early trials. What the synergy is evidence of is more growth hormone in the blood. No human trial has tested this specific pair for any outcome, and neither peptide has an outcome trial alone.
- Is MK-677 worth it since it has the most research?
- The research is the argument against it. A two-year randomized trial added about 1.1 kg of fat-free mass with no gain in strength or physical function while fasting glucose rose and insulin sensitivity fell. A 563-patient Alzheimer's trial failed despite IGF-1 rising about 73 percent. A hip-fracture trial was stopped early for a heart-failure signal. Merck developed it for years and never brought it to market. It ranks eighth at 4.9.
- Does AOD-9604 work for fat loss?
- No, on the only human test it has. Oral AOD-9604 cut body-weight gain by more than half in obese rats, and the developer's controlled human weight-loss program did not beat placebo and was abandoned. It is safe: FDA found no adverse-event reports in its 2024 review. It scores 4.6, last in this ranking, because the problem is not risk. It is that you are buying a question that was already answered.
- Will these raise my growth hormone enough to matter?
- They will raise it. That part is well documented across the category, from GHRP-2 holding IGF-1 on a plateau for 30 days to MK-677 raising IGF-1 into the young-adult range. Whether raising it changes anything you care about is the open question, and MK-677's Alzheimer's trial is the cleanest test of it so far: IGF-1 rose about 73 percent and nothing improved. Treat a lab number as a lab number.
- What do I need to monitor if I run one of these?
- IGF-1 and fasting glucose at minimum, baseline and follow-up, and the reports in this category treat those as necessary rather than optional. On MK-677 the glucose drift is a documented, reliable effect rather than a theoretical one. On any gray-market member, add a lot-matched third-party HPLC and mass-spec certificate of analysis, because mislabeling in this channel is documented, not hypothetical.
- Are any of these safe for a drug-tested athlete?
- None of them. Growth-hormone-releasing factors and growth-hormone secretagogues are prohibited at all times under WADA category S2, and the prohibition covers both arms of this category. AOD-9604 has been detected in confiscated vials in doping casework. There is no member of this ranking that a tested athlete can use.
- How often does this ranking change?
- Whenever any member's score changes. The order is the live BioHarmony overall pulled from each report at render time, and a rescoring reorders the page that night. Expect this category to move slowly: most of its literature is decades old, seven of the nine have no active development program, and the likeliest mover is a regulatory change to the FDA compounding lists rather than a new trial.
Evidence Sources
- RCT Metabolic Effects of a Growth Hormone-Releasing Factor in Patients with HIV (2007) Landmark Phase 3 trial behind the tesamorelin approval; reduced visceral adipose tissue and raised IGF-1, with more adverse-event withdrawals than placebo. The anchor for tesamorelin's 7.5 body-composition subrating.
- Meta-analysis Body composition, hepatic fat, metabolic and safety outcomes of tesamorelin: a meta-analysis of RCTs (2026) Five RCTs; reductions in visceral fat, trunk fat, limb fat, hepatic fat percentage and waist circumference, with increased lean body mass. The strongest pooled evidence in this category.
- RCT Effect of Tesamorelin on Visceral Fat and Liver Fat in HIV-Infected Patients With Abdominal Fat Accumulation (2014) 50-person randomized trial; tesamorelin reduced both visceral fat and liver fat over six months. A measured fat endpoint, which no other member of this category has.
- RCT Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: randomized, double-blind, multicentre trial (2019) 61 participants with HIV-associated NAFLD; reduced liver fat. Supports tesamorelin's position as the only member with organ-level outcome data.
- RCT Growth hormone-releasing hormone improves cognitive function in adults with mild cognitive impairment and healthy older adults (2012) 20-week cognition RCT of GHRH analogue therapy. The basis for tesamorelin's 6.5 cognition subrating, the highest in the category by nearly five points.
- Regulatory FDA 2025 EGRIFTA WR prescribing label (2025) Current labeling: indication, limitations, contraindications and dosing. The only current FDA label held by any member of this ranking.
- Observational Ipamorelin, the First Selective Growth Hormone Secretagogue (1998) Defining selectivity characterization: ipamorelin releases growth hormone with no significant ACTH or cortisol rise, while GHRP-2 had higher potency and did raise both. The evidence behind ipamorelin's joint-first rank.
- RCT Ipamorelin for postoperative ileus: Phase 2 randomized trial (2014) 114 patients; failed its primary endpoint at p=0.15 and development was discontinued. The only completed human efficacy trial ipamorelin has.
- Systematic review Growth hormone secretagogues: a review of efficacy and safety (2018) Class safety review noting few long-term controlled studies, a glucose and insulin-sensitivity concern, and an unfilled cancer-data gap. Applies to every ghrelin-receptor member here.
- RCT Once-daily subcutaneous GHRH 1-29 in growth-hormone-deficient children (1996) 110 prepubertal children; height velocity rose from 4.1 to 8.0 cm per year at six months with 74 percent good responders. The pivotal trial behind sermorelin's former FDA approval as Geref.
- RCT GHRH 1-29 versus growth hormone in children with hypothalamic growth-hormone deficiency (1993) 60 children, six months; GHRH produced 9.2 to 9.3 cm per year against 14.6 for growth hormone itself. A direct head-to-head showing the secretagogue route is weaker than the hormone.
- RCT GHRH 1-29 reverses age-related growth-hormone and IGF-1 decline in older men (1992) 14-day crossover trial; the strongest adult datapoint that the somatotroph axis stays responsive to GHRH with age. Behind the geriatric subratings across the GHRH arm.
- RCT Stabilized GHRH 1-29 analogue for 16 weeks in older men and women (1997) Raised lean body mass, well-being and skin thickness in older men, with no lean-mass gain in women. The best adult outcome signal in the GHRH arm and it is sex-dependent.
- RCT Prolonged stimulation of growth hormone and IGF-1 secretion by CJC-1295 (2006) CJC-1295 with DAC raised growth hormone 2 to 10 times and IGF-1 1.5 to 3 times in healthy adults. The only human pharmacology either CJC-1295 form has, and it belongs to the DAC version.
- RCT Pulsatile secretion of growth hormone persists during continuous stimulation by CJC-1295 (2006) Mean growth hormone rose about 46 percent and IGF-1 about 45 percent with pulsatility preserved. Measures endocrine dynamics, not body composition or any outcome.
- RCT Growth hormone-releasing hormone promotes non-REM sleep (2006) Human sleep paradigm. Class-level evidence for the sleep effect users report most consistently across the GHRH arm; not specific to any one member.
- RCT GHRPs stimulate growth hormone, prolactin, ACTH and cortisol in man (1997) GHRP-2 at 1 to 2 mcg per kilogram raised prolactin, ACTH and cortisol, with cortisol-releasing activity comparable to CRH. The off-target load that separates GHRP-2 and GHRP-6 from ipamorelin.
- RCT Subcutaneous GHRP-2 increases food intake in lean healthy men (2005) Ad-libitum food intake rose 35.9 percent versus saline. The clearest quantified off-target effect in the ghrelin-receptor arm.
- RCT Pivotal KP-102 diagnostic validation for growth-hormone deficiency (2007) Peak growth hormone 84.6 against 1.36 mcg per litre, with a 15 mcg per litre deficiency cutoff. The trial behind GHRP-2's Japanese approval, which is a diagnostic approval and not a treatment approval.
- RCT Thirty-day subcutaneous GHRP-2 infusion in older adults (2004) Growth hormone held 1.8 to 3 times elevated and IGF-1 on a stable plateau with normal safety labs. The strongest sustained biomarker evidence in the ghrelin-receptor arm, and a biomarker is all it is.
- RCT GHRP-6 stimulates growth-hormone release in normal men (1990) The seminal in-man study establishing GHRP-6 as a genuine human secretagogue with GHRH synergy. The oldest citation in this ranking and still the basis for stacking the two arms.
- Animal study Intracerebroventricular GHRP-6 stimulates eating without affecting plasma growth hormone (1995) Rodent study showing the appetite effect is dissociated from growth hormone. The mechanism behind GHRP-6's hunger being a separate problem rather than a side effect of the pulse.
- Observational Cloning and characterization of the growth hormone secretagogue receptor (1996) GHRP-6 was the pharmacological tool used to identify GHS-R1a, the receptor four members of this ranking act on. That work led to the discovery of ghrelin itself.
- RCT Effects of an oral growth hormone secretagogue on body composition in healthy older adults over two years (2008) 65 participants; MK-677 added about 1.1 kg of fat-free mass with no strength or functional gain, while fasting glucose rose and insulin sensitivity fell. The central negative result in this category.
- RCT Growth hormone secretagogue MK-677 in Alzheimer disease: pivotal trial (2008) 563 patients; no clinical effect on disease progression despite IGF-1 rising about 73 percent. Target engagement without benefit, which is the cleanest available test of the raise-IGF-1 hypothesis.
- RCT MK-677 hip-fracture Phase IIb terminated early (2011) Stopped early for a congestive-heart-failure safety signal in frail elderly patients. The reason MK-677's geriatric subrating sits at 2.6 despite it being the best-studied member.
- RCT MK-677 dose-response in healthy elderly adults (1996) 25 mg daily raised 24-hour growth hormone about 97 percent and IGF-1 into the young-adult range, with fasting glucose rising. Both halves of MK-677's profile in one trial.
- RCT MK-677 increases deep stage-IV and REM sleep (1997) Roughly 50 percent increases in deep and REM sleep in young subjects. The only dedicated human sleep trial in this category.
- Observational Analysis of ingredients in products sold online as SARMs (2017) Of 44 products, many were mislabeled and ibutamoren appeared as an undeclared ingredient. Direct evidence for the purity-verification requirement on the gray-market channel.
- Animal study Oral AOD9604 reduces body-weight gain in obese Zucker rats (2000) Cut body-weight gain by more than half over 19 days while raising adipose lipolysis, with no harm to insulin sensitivity. The strongest AOD-9604 result, and it is in rodents.
- Systematic review AOD9604 as a doping agent: analytical and regulatory review (2014) Documents AOD-9604 as a growth-hormone fragment marketed to mimic lipolysis, sold on the internet, banned by WADA and detected in confiscated vials. Records that the controlled human weight-loss program did not beat placebo.
- Regulatory FDA 2024 Pharmacy Compounding Advisory Committee briefing materials on AOD-9604 (2024) FAERS and literature searched through January 2024 with no adverse-event reports found for AOD-9604. The evidence that its problem is inefficacy rather than harm.
- Meta-analysis IGF1, IGFBP3 and breast cancer risk: pooled prospective analysis (2010) Links higher circulating IGF-1 to breast-cancer risk. Supports caution around chronically raising IGF-1 rather than proving any member of this category causes cancer, and it is why cancer history excludes all nine.
- Regulatory FDA: certain bulk drug substances nominated for compounding that may present significant safety risks (2026) Lists CJC-1295 safety concerns including immunogenicity. The regulatory position that keeps both CJC-1295 forms on the gray market rather than in compounding pharmacies.
Glossary
Quick reference for the medical and technical terms used in this comparison.
- GH Growth Hormone
- The pituitary hormone every member of this ranking is trying to raise, released in pulses rather than continuously. Injecting it directly is out of scope here.
- GHRH Growth Hormone-Releasing Hormone
- The hypothalamic signal that tells the pituitary to fire a growth-hormone pulse. Tesamorelin, sermorelin and both CJC-1295 forms are analogues of it.
- GHS-R1a Growth Hormone Secretagogue Receptor 1a
- The ghrelin receptor, the second lever on the same gland. Ipamorelin, GHRP-2, GHRP-6 and MK-677 act here, which is also why several of them raise appetite.
- GHRP Growth Hormone-Releasing Peptide
- The peptide family acting at GHS-R1a. GHRP-6 came first and was the tool used to find the receptor; GHRP-2 is more potent; ipamorelin is the selective one.
- IGF-1 Insulin-Like Growth Factor 1
- The liver-produced downstream signal that growth hormone actually works through, the marker users track, and the pathway behind the cancer contraindication on all nine reports.
- DAC Drug Affinity Complex
- The albumin-binding modification that stretches CJC-1295's half-life from minutes to 6 to 8 days. It is what separates the two CJC-1295 entries in this ranking.
- Mod GRF 1-29 Modified Growth Hormone-Releasing Factor 1-29
- The common name for CJC-1295 without DAC, the short-acting form that clears in about 30 minutes and preserves the natural pulse shape.
- VAT Visceral Adipose Tissue
- Deep abdominal fat around the organs, and the measured endpoint in tesamorelin's Phase 3 trial. The only fat outcome in this category with a randomized trial behind it.
- Secretagogue A compound that makes a gland secrete
- Everything in this ranking except AOD-9604, which is a fragment of the hormone itself rather than something that triggers its release.
- Pulsatility Pulsed rather than continuous release
- Growth hormone is normally released in bursts. Preserving that shape is the argument for the no-DAC form over DAC, and it is a physiology argument rather than an outcome one.
- COA Certificate of Analysis
- The third-party HPLC and mass-spec report that establishes what is actually in a research vial. Seven of the nine members here require one, and none of the quoted prices include it.
- WADA S2 World Anti-Doping Agency category S2
- Peptide hormones, growth factors and related substances, prohibited at all times in tested sport. Every member of this ranking falls under it.
First, and the only member of this category that clears the bar most readers assume the whole category has already cleared. It is FDA approved for a narrow indication, it reduced visceral fat in a landmark Phase 3 trial (Falutz 2007), a five-RCT meta-analysis confirms visceral, trunk and hepatic fat reduction with increased lean mass (Badran 2026), and a separate randomized trial measured liver fat directly (Stanley 2014). It holds the top subrating in the category for body composition at 7.5, hormonal at 7.5, metabolic health at 7.0 and cognition at 6.5. The score stops at 6.2 because the label is HIV-associated lipodystrophy, the fat comes back when you stop, and it is the most expensive line on the page.