Geref, GHRH(1-29)
Evidence Grade C — Moderate human evidence. 21 published studies, 14 human. 25 registered clinical trials.
Sermorelin is a shortened form of growth hormone-releasing hormone that retains full biological activity. It was previously sold as Geref for growth hormone deficiency before being voluntarily withdrawn in 2009 for commercial reasons (not safety concerns). It remains one of the most commonly prescribed compounds through US compounding pharmacies, particularly in anti-ageing and hormone optimisation clinics.
21 published studies: 14 human, 0 animal, 3 in-vitro, 3 reviews
Sermorelin was formerly marketed as Geref (Serono) before voluntary withdrawal in 2009. The FDA confirmed the withdrawal was not related to safety or effectiveness. Research suggests it remains one of the most commonly prescribed compounds through US compounding pharmacies, particularly in anti-ageing and hormone optimisation clinics.
Research suggests sermorelin's appeal lies in its more physiological approach to growth hormone enhancement compared to direct growth hormone injection — it preserves pulsatile release and feedback regulation. However, clinical evidence for its use in adults outside the original paediatric growth hormone deficiency indication is limited, and its very short half-life requiring daily injection is a practical limitation. Compounding pharmacy formulations are not subject to the same regulatory oversight as FDA-approved products.
Like tesamorelin, sermorelin works by stimulating the pituitary gland to produce its own growth hormone rather than replacing it directly. It binds to the same GHRH receptor and triggers the same natural growth hormone release pattern. The body's feedback systems remain active, meaning growth hormone production does not exceed physiological levels. Its very short half-life (approximately eight minutes) means it is typically injected at bedtime to coincide with the body's natural nocturnal growth hormone pulse.
Research suggests sermorelin's appeal lies in its physiological approach — rather than replacing growth hormone directly, it stimulates the pituitary to produce its own, preserving the body's natural pulsatile release pattern and feedback regulation. This is considered potentially safer than direct growth hormone injection. However, no large randomised controlled trials exist for its current compounding pharmacy uses (anti-ageing, body composition improvement). The very short half-life (approximately 8 minutes) requires daily injection, typically at bedtime. Compounding pharmacy formulations are not subject to the same regulatory oversight as previously approved products. The FDA's consideration of its bulk drug substance status has raised questions about future compounding availability.
Tesamorelin as an Adjunct to Exercise for Improving Physical Function in HIV
Growth Hormone Releasing Hormone Analog to Improve Nonalcoholic Fatty Liver Disease and Associated Cardiovascular Risk
The Effect of Growth Hormone Releasing Hormone on Cognitive Function in Individuals With Mild Cognitive Impairment
Study of Intranasal Octreotide (DP1038) in Healthy Adult Volunteers
Dehydroepiandrosterone Versus Growth Hormone in Women Undergoing ICSI With Expected Poor Ovarian Response
The information on this page is provided for educational and research reference purposes only. This is not medical advice. Always consult a qualified healthcare professional before making any health-related decisions.
Somatropin has been available since the mid-1980s and is one of the most established peptide therapies. It is sold under numerous brand names including Genotropin, Humatrope, Norditropin, and Omnitrope (the first biosimilar approved in the US, 2006). Approved indications include childhood and adult growth hormone deficiency, Turner syndrome, children born small for gestational age, Prader-Willi syndrome, idiopathic short stature, and short stature from chronic kidney disease. Daily injection has been the main burden of somatropin therapy, particularly for paediatric patients who may require years of treatment. This has driven the development of once-weekly alternatives (somatrogon and somapacitan), which are gradually changing the treatment landscape. Annual treatment costs remain substantial, and concerns about misuse in anti-ageing and performance enhancement contexts are ongoing.
Tesamorelin is marketed as Egrifta SV (approved November 2010) for the reduction of excess abdominal fat in HIV-infected patients with lipodystrophy. In clinical trials, it reduced visceral fat by approximately 15% compared to a 5% increase with placebo, and this reduction was sustained with continued treatment. Tesamorelin occupies a unique niche — it is the only approved GHRH analogue and the only medication specifically approved for HIV-associated lipodystrophy. Beyond its approved indication, it has attracted research interest for potential effects on liver fat, cognitive function, and peripheral neuropathy. Fat reduction reverses when treatment stops, and it is not approved for general weight loss or body composition purposes.
Somatrogon is marketed as Ngenla (approved June 2023) for paediatric growth hormone deficiency in children aged 3 years and older. In the pivotal trial, once-weekly somatrogon produced growth rates equivalent to daily somatropin injections (10.1 cm/year versus 9.8 cm/year), confirming that reducing injection frequency does not compromise growth outcomes. Ngenla represents a meaningful advance for paediatric patients and their families, reducing injections from 365 to 52 per year. Treatment adherence has been a persistent challenge with daily growth hormone, and weekly dosing is expected to improve long-term outcomes through better compliance. Somatrogon competes directly with somapacitan (Sogroya), the other approved weekly growth hormone, creating a new generation of less burdensome treatment options.
