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Growth hormone axis and muscle.
Almost all of this category is about one hormone, approached indirectly.
13 compounds tracked in this category
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In theory, this class is designed to raise your own growth hormone rather than replace it, stimulating the pituitary through either the GHRH receptor or the ghrelin receptor, on the logic that natural pulsatile release preserves the body's own feedback limits. A separate branch aims to release the brake on muscle growth by blocking myostatin. The reasoning is sound. The human outcome data mostly is not.
Unmarked, FDA approved° legal over the counter† under FDA review, not yet permitted* not FDA approved‡ documented safety concern
| Compound | What is known |
|---|---|
| Tesamorelin | Approved as Egrifta for HIV-associated lipodystrophy. Off-label use is a different question from approval. |
| Sermorelin† | The most defensible GHRH analogue, historically compoundable, unlike most of this category. Human data is moderate rather than strong. |
| CJC-1295 (with or without DAC)* | Off Category 2 since April 2026 but never moved to Category 1. Neither prohibited nor authorized, the most misrepresented status in the market. Human data is limited to early pharmacokinetic work. |
| Ipamorelin* | Same posture as CJC-1295. Off the restricted list is not the same as cleared, and human evidence is limited. |
| GHRP-2 / GHRP-6* | Remain restricted for compounding. Limited human data. |
| IGF-1 LR3* | Unapproved. No controlled human efficacy data. |
| PEG-MGF / MGF† | Advisory review scheduled before the end of February 2027. Nothing decided, and no human efficacy data. |
| Follistatin 344* | Preclinical. Myostatin pathway manipulation has no human safety record. |
| ACE-031‡ | Development was discontinued after bleeding and telangiectasia events in human trials. This is a known safety signal, not an unknown. |
| GDF-8 / myostatin agents* | Investigational only. No human efficacy or safety data. |
| Hexarelin* | Unapproved secretagogue. |
| CJC-1295 + Ipamorelin* | A combination, not a compound. Stacking two unapproved agents does not improve the evidence for either. |
| AICAR* | No approved human use. Preclinical and research contexts only. |
The science behind this category
Growth hormone is released from the pituitary in pulses, mostly during deep sleep, under the control of two opposing signals: GHRH, which stimulates release, and somatostatin, which suppresses it. Ghrelin, the hunger hormone, also stimulates release through a separate receptor. Growth hormone then drives IGF-1 production in the liver, and IGF-1 does most of the downstream work on muscle and connective tissue.
The compounds here split cleanly. GHRH analogues, sermorelin, tesamorelin, CJC-1295, mimic the stimulating signal. Ghrelin mimetics or secretagogues, ipamorelin, GHRP-2, GHRP-6, hexarelin, MK-677, work through the other receptor. Both are pitched as safer than injecting growth hormone directly, on the logic that they preserve the body's own pulsatile pattern and its natural feedback limits.
The safety argument depends on preserving pulsatility. Long-acting versions undercut it. CJC-1295 with DAC has a half-life of roughly six to eight days, producing sustained elevation rather than pulses. At that point the distinction from direct growth hormone administration is weaker than the marketing suggests, and the same concerns apply: effects on glucose handling, and the theoretical risk of promoting growth in existing malignancies.
Follistatin 344, ACE-031, and GDF-8 agents work on a different pathway entirely, blocking myostatin, which normally limits muscle growth. This is real biology with dramatic preclinical results. It is also where the clearest human harm signal on this site sits: ACE-031 development was discontinued after bleeding and telangiectasia events in trials. That is a documented outcome, not a theoretical concern.
Tesamorelin is approved, for HIV-associated lipodystrophy specifically. Sermorelin is the most defensible of the rest. CJC-1295 and ipamorelin came off Category 2 in April 2026 without moving to Category 1, and were not among the seven reviewed in July. They sit outside the process.
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