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GH-axis

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GHRH analog

Sermorelin

Also known as: Geref, GHRH (1-29), GRF 1-29

FDA-approved historically for pediatric GH deficiency. Adult anti-aging use is widespread but off-label and weakly supported.

Reviewed 2026-05-04

What it does

Sermorelin is a 29-amino-acid synthetic fragment representing the biologically active N-terminus of human growth hormone-releasing hormone. It was FDA-approved as Geref in 1997 for diagnosis and treatment of growth hormone deficiency in children, and the brand was voluntarily discontinued in 2008 for commercial reasons (not safety). It remains widely available through compounding pharmacies and has become the default 'GHRH on a script' in adult anti-aging clinics, despite the adult-use evidence base being substantially weaker than the pediatric one.

Used for

Dose

Starting
200 mcg · once daily at bedtime
Common
350 mcg · once daily at bedtime
Upper
500 mcg · once daily at bedtime
When
BedtimeGHRH analog — same window as CJC-1295. Bedtime, empty stomach. Shorter pulse than CJC, but the alignment with natural early-night GH secretion is identical.
How long
6 months on / 2 months off
Site
subcutaneous
Food
fasted

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⚠ Caution

  • Active malignancy (theoretical concern from raised IGF-1)
  • Severe obesity with GH-suppression (response is blunted)
  • Pituitary surgery, irradiation, or trauma — confirm axis with endocrinology first
  • Pregnancy and breastfeeding
  • Hypothyroidism (correct first; hypothyroidism blunts GH response)
  • Hypersensitivity to sermorelin or compounding excipients
  • Concomitant glucocorticoid therapy (suppresses GH response)

Medications & conditions

  • Sermorelin with corticosteroid — blunted GH responseUser is taking a corticosteroid. Chronic high-dose glucocorticoid use suppresses the hypothalamic-pituitary axis and attenuates the GH-releasing effect of sermorelin. Benefit may be substantially reduced until steroid dose is tapered.

Will it work for me?

Establish a baseline (2–3 readings over 1–2 weeks before starting), then track at consistent intervals.

Blood markers
  • Tier 1 — Human RCTIGF-1↑· by 8 weeks; stay within age-adjusted range — do not chase supraphysiologicSermorelin produces a gentler rise than CJC analogs — typically 20–50% from baseline.
Imaging
  • Tier 2 — Human observationalLean mass % via DEXA↑· 12 weeks+
Functional & psychometric
  • Tier 3 — Animal / in vitroSleep quality (PSQI)↓· 2–4 weeksLower PSQI = better sleep.

Your stack

Track this peptide in your protocol — dose, schedule, vials on hand, refill projection. Stays in your browser; no account needed.

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Use this peptide

Cycling

6 months on, 2 months off.

Co-injection & overlap

Redundant with

  • CJC-1295 — Both are GHRH-receptor agonists driving the same pituitary somatotroph pathway; combining them does not produce additive GH secretion and doubles receptor-saturation and tachyphylaxis risk.; typically run one, not both.
Reconstitution & storage
VialBAC waterConcentrationShelf life
10 mg3 mL300 mcg per 9 units1 month

Compounded sermorelin is supplied in a range of vial sizes (3 mg, 5 mg, 15 mg). For vial sizes not in the table, use the calculator to land on whole-number unit doses on a U-100 syringe.

Storage. Lyophilized: refrigerate 2–8 °C; protected from light. Reconstituted: refrigerate 2–8 °C, use within 30 days; do not freeze.

Open the peptide calculator →

Nasal delivery

Not suitable for nasal delivery. SQ only — protein structure and the need for systemic delivery to the pituitary make nasal absorption non-viable.

Monitoring & questions

Reported side effects
  • Injection site reactions (most common; flushing, erythema, mild pain)
  • Headache
  • Flushing or warmth shortly after injection
  • Dysgeusia (transient altered taste)
  • Nausea, dizziness (uncommon)
  • Hyperglycemia / worsened insulin resistance with chronic use
  • Theoretical risk of carpal tunnel-like symptoms with sustained high IGF-1
Biomarkers Juno tracks

Reference

How it works

Binds the pituitary GHRH receptor and stimulates pulsatile endogenous GH release. Because GH is released in physiologic pulses, sermorelin preserves negative-feedback regulation that exogenous recombinant GH bypasses — a frequently cited reason for preferring GHRH analogs over rhGH. Tachyphylaxis (diminished response with continuous exposure) is a well-documented limitation.

EvidenceTier 1 — Human RCT

Tiers are per indication. The same molecule can be Tier 1 for one use and Tier 4 for another — the tier reflects published literature, not community framing.

Pediatric growth hormone deficiency

Tier 1high confidence

Multi-center pediatric trials supporting the original Geref approval in 1997 demonstrated improved height velocity in children with confirmed GH deficiency. FDA-approved indication; brand later discontinued for commercial reasons.

Serono Laboratories et al. 1997Thorner M et al. 1996

Adult GH deficiency / age-related GH decline

Tier 3high confidence

Small open-label and short-duration human studies demonstrate that sermorelin raises GH and IGF-1 in adults. Studies designed to demonstrate clinical benefit on body composition, strength, sleep, or quality-of-life endpoints in healthy adults are scarce, small, and largely unreplicated. Adult use remains off-label.

Walker RF et al. 2006

Sleep quality / slow-wave sleep

Tier 3medium confidence

GHRH analogs increase slow-wave sleep in small mechanistic sleep-lab studies. No large RCTs in healthy adults using sermorelin specifically with sleep as a primary endpoint. The mechanism is plausible; the indication-specific human evidence is thin.

Walker RF et al. 2006

Body composition / lean mass in healthy adults

Tier 3high confidence

No replicated RCTs in healthy adults with body-composition endpoints. Inferences are extrapolated from broader GHRH-class literature (mostly tesamorelin in HIV lipodystrophy) and from rhGH studies. Anti-aging clinic claims of 'sermorelin builds muscle' are not supported by sermorelin-specific human RCTs.

No primary citations are anchored to this indication — the tier reflects the absence of usable literature, not a missing reference.

Citations (3)
  1. [1]
    Once daily subcutaneous growth hormone-releasing hormone therapy accelerates growth in growth hormone-deficient children during the first year of therapy
    Thorner M, Rochiccioli P, Colle M, et al. · Journal of Clinical Endocrinology & Metabolism · 1996 · PMID 8675578
    Tier 1 evidence for pediatric GH deficiency; basis for the original Geref approval.
    View source
  2. [2]
    Sermorelin: a better approach to management of adult-onset growth hormone insufficiency?
    Walker RF · Clinical Interventions in Aging · 2006 · PMID 16972038
    Adult-use review used to anchor Tier 3 for adult GH-decline and sleep indications.
    View source
  3. [3]
    Geref (sermorelin acetate) Prescribing Information (historical)
    Serono Laboratories · FDA-approved label (discontinued) · 1997
    Historical FDA approval status, dose, and contraindications for the pediatric indication.
    View source