Sermorelin Peptide: Benefits, side effects, dosage details, and how it works

In 2023, one published review counted more than 80 approved peptide drugs on the pharmaceutical market, and the number has almost certainly grown since then.1 That’s a lot to keep track of, and most people are aware of just a handful — a few for weight loss, and maybe a couple that weightlifters use to improve their gains.

Perhaps less familiar are peptides that may help you achieve both weight loss and muscle gain, like sermorelin.

If you’ve been looking for a streamlined solution for your cuts, gains, and other health outcomes, this guide is for you. We examine not only how sermorelin works on fat and muscle but also what it can do for cognitive health and physical energy. Along the way, we discuss its safety, pharmaceutical availability, and usefulness compared to another peptide called tesamorelin.

Over the past two decades, Innerbody Research has helped tens of millions of readers make more informed decisions about staying healthy and living healthier lifestyles.

Therapeutic peptides are a growing and multifaceted pharmaceutical space, one that we’ve been exploring for years. Our team has studied the literature, consulted with prescribers, spoken with users, and tried peptides for ourselves. All told, we’ve spent more than 200 hours on the subject, and the research hours grow by the week. Our ongoing familiarity with the subject allows us to give you the most complete profile on sermorelin that’s currently possible.

Additionally, like all health-related content on this website, this guide was thoroughly vetted by one or more members of our Medical Review Board for accuracy and will continue to be monitored for updates by our editorial team.

Sermorelin (a.k.a. sermorelin acetate) is a laboratory-made therapeutic compound meant to resemble a naturally occurring chemical in the human body — or, in technical terms, a synthetic peptide hormone analog. Distributed under the brand names Geref and Geref Diagnostic, it gained FDA approval in 1997 as a treatment for growth hormone deficiency but was discontinued in 2008 — not out of concern for safety or lack of efficacy, but because of manufacturing difficulties.2 3 Yet it remains available in compounded form with a prescription from a licensed healthcare provider.

The chemical that sermorelin mimics is called growth hormone-releasing hormone (GHRH). As a naturally occurring chemical, GHRH derives from the hypothalamus, an area of the brain that coordinates the bodily system (i.e., the endocrine system) responsible for controlling just about every important function needed for internal stability — growth, energy, metabolism, and reproduction, as well as responses to injury, stress, and mood.4 5

True to its name, GHRH causes the pituitary gland to release growth hormone. Growth hormone affects practically every bodily tissue and organ.6 It’s chiefly responsible for facilitating physical growth and metabolism, the process of converting food into usable energy.7

The metabolic effects of growth hormone are due to its stimulating effect on the production of insulin-like growth factor-1 (IGF-1), which is important for regulating body composition. Low IGF-1 levels correspond with high body fat and vice versa.8

Because sermorelin is currently available only as a non-FDA-approved compounded medication, its therapeutic uses are entirely off-label. Most commonly, doctors will prescribe it for the following health conditions:

Growth hormone deficiency

According to a 2012 review published in BioDrugs, sermorelin’s primary therapeutic use has been to diagnose growth hormone deficiency.9 With a normally functioning pituitary gland, a patient’s growth hormone levels should reach a peak value within a specific time frame after sermorelin administration. If their levels don’t rise to a significant enough degree, they might have a growth hormone deficiency. Because sermorelin’s effects are “rapid and relatively specific” for diagnostic purposes, it has resulted in fewer false positives in patients without a deficiency compared to other tests.9

Also, as a GHRH analog, sermorelin can do double-duty as a treatment for the deficiencies it helps to diagnose, though its efficacy may leave users wanting. To illustrate, the authors of that aforementioned 2012 review referred to a multicenter study of 80 children in which subjects received a daily subcutaneous injection equal to 30mcg/kg. The subjects, on average, demonstrated some height increase but less so than individuals who received a different GHRH analog called somatropin.9

Muscle gain and fat loss

Sermorelin is perhaps more sought after for two of its purported secondary uses: muscle gain and fat loss. The two are believed to occur concurrently, but the research has been mixed. Three studies highlight the disparities in findings:

Viewed together, the three studies imply that sermorelin has real but perhaps limited potential as a fat burner and muscle builder. At the same time, there’s probably enough evidence to support sermorelin’s utility toward body recomposition, which may explain its relative popularity among strength trainers and bodybuilders.

Antiaging

Antiaging is another of sermorelin’s secondary uses. Its action on the aging process relates to the natural hormonal changes that occur as we grow older. For example, the pituitary gland undergoes structural alterations that result in reduced growth hormone production, which in turn leads to age-related muscle loss.23 In a 2006 editorial, biologist Richard F. Walker of the Society for Applied Research in Aging noted that sermorelin may help regain pituitary function and “slow the cascade of ... hormone failure” so as to “[preserve] not only youthful anatomy but also youthful physiology.”24

However, the Mayo Clinic warns that growth hormone therapy is a dubious treatment for age-related health conditions and notes that experts recommend against it.25

Sermorelin increases growth hormone, which itself increases IGF-1, and together they have several positive health implications. Apart from the potential effects on lean mass gain and fat loss, the literature suggests that GHRH analogs like sermorelin may theoretically trigger improvements in the following peripheral areas of health:

Sermorelin is generally safe for use among individuals with relevant diagnoses, such as growth hormone deficiency. And because it’s a prescription-only medication, the prescribing physician functions as a first-line intermediary who can identify contraindications such as:19

• Allergy: Practically anything can be a potential allergen, including sermorelin. A person who’s allergic to sermorelin should avoid it at all costs given the risk of anaphylaxis.
• Breastfeeding: There’s insufficient evidence to determine whether sermorelin is secreted through breastmilk or whether it’s safe for an infant to consume. Pregnant women should avoid it for the same reason.20
• Drug interactions: Sermorelin may interact with certain prescription and over-the-counter medicines, including but not limited to glucocorticoids, insulin, muscarinic antagonists (e.g., atropine), thyroid medications, medications that contain or release somatostatin, and aspirin.20
• Underactive thyroid: Having an underactive thyroid may interfere with sermorelin’s effects.

Injectable peptides, in general, are not without side effects, either. Sermorelin’s most common side effect is irritation at the injection site. In rare cases, one might experience dizziness, flushing, headache, sleepiness, or restlessness, as well as allergic-type reactions such as itching and difficulty swallowing. If you exhibit a rare side effect, you should immediately alert your doctor.

Research-grade vs. pharmaceutical-grade sermorelin

Some peptides sold online are research-grade, which means they’re for laboratory use only. Research-grade drugs are less strictly monitored for contaminants, so they aren’t safe for humans to use. So, when you’re shopping for sermorelin through a telehealth provider, make sure the product is categorized as “pharmaceutical-grade” or “GMP API” (good manufacturing practices for active pharmaceutical ingredients).31 These labels mean it has been approved by the Food & Drug Administration to be safe for humans (note that this is different from FDA approval for specific uses).32

The process of acquiring and using sermorelin is similar to other peptides, only with key differences in dosage quantities and the timeline of effects. From prescription to maintenance, here’s what to expect:

Preliminary lab tests

Your prescribing physician will likely confirm your candidacy for sermorelin with lab tests.20 The tests involve drawing and analyzing your blood for biomarkers that indicate you for or exclude you from treatment. For example, test results that show that you have low IGF-1 levels would be a positive indicator, whereas a contraindicating health condition would be an exclusion criterion.

Dosing and administration

Sermorelin is typically an injectable medication. The standard dose is lower than what we’ve seen in clinical studies — 200mcg (0.2mg) to 300mcg (0.3mg) rather than 1-2mg21 — but exact dosages can vary. For example, a much smaller patient will need a lower dose, whereas someone with greater body mass or a resistance to the medication will likely need a higher one.

Injections may be administered at a healthcare facility or at home.

At-home injections are self-administered. The medication comes as a powder that must first be reconstituted with bacteriostatic water. Patients approved for at-home dosing ought to be provided with a kit that includes everything they need to reconstitute and inject the medication (e.g., needle syringes, alcohol swabs, a vial of bacteriostatic water, and a vial of powder).

The reconstitution process generally goes like this:

• Using a needle syringe, draw out the prescribed measure of bacteriostatic water and slowly add it to the sermorelin powder.
• Dissolve the powder to make a solution. Don’t shake the bottle.
• Again using the needle syringe, draw out the prescribed measure of sermorelin solution.
• Select an injection site (e.g., belly, thigh, or arm). Sterilize the site.
• Insert the syringe needle into the injection site. Depress the plunger to inject the medication.
• Dispose of the used needle syringe.
• Store the remaining medication.

While sermorelin is most commonly an injectable, it’s also available in oral forms: tablets, lozenges, and troches. Oral sermorelin faces a barrier to absorption in the gastrointestinal tract, whose acidic environment degrades the peptide, but there are technologies such as permeation enhancers and acid-stabilizing coatings that can protect it as it travels through the body.33 If you’re put off by needles, discuss the possibility of switching to an oral alternative with your doctor.

Storage

For at-home patients using injectable sermorelin, a vial of reconstituted powder is ordinarily meant to last a month, and excess medication must be stored in the fridge after every use. The ideal storage temperature is 36 and 46 degrees Fahrenheit (2-8 degrees Celsius).21

There’s no need to refrigerate the syringes, alcohol swabs, or excess bacteriostatic water. They can be left out at room temperature.

You shouldn’t need to cover the top of your medication vial, either. Most often, the vial is sealed with a “self-healing” stopper whose elastic-like material closes over any punctures made in it. Effectively, it seals itself.

Oral sermorelin should be shelf-stable as long as it’s kept away from extreme temperatures, but ask your doctor about proper storage procedures to be sure.

Treatment protocol

The standard sermorelin treatment protocol entails:

• Five doses per week
• Nighttime dosages (to coincide with your body’s natural growth hormone release)22
• Regular laboratory testing to track your body’s response (e.g., whether your IGF-1 levels are increasing)

While the onset of effects may vary depending on various factors — age, body mass, desired health outcomes — sermorelin treatment generally follows a three-part timeline:

• Initiation: In the first 1-4 weeks, your physician monitors your tolerance and response to the medication.
• Optimization: In weeks 5-16, your physician continues to track your progress toward your health goals and may adjust the protocol based on their findings.
• Maintenance: After initiation and optimization, your physician should have dialed in your dose for the best results. From there, it’s about ongoing treatment and periodic biomarker evaluations.

As with many other peptides, sermorelin’s effects taper off after you stop taking it. Still, you should continue to see biomarker improvements even when you aren’t actively dosing. For example, in at least one study, IGF-1 levels remained above baseline for two weeks after treatment ended.10

The most appropriate candidates for sermorelin are people who have or suspect they have a growth hormone deficiency. (As we said, sermorelin has been both a diagnostic tool and treatment for this health condition.)9 In adults, symptoms of growth hormone deficiency include but aren’t limited to:34

• Increased body fat, especially around the waist
• Decreased muscle mass and strength
• Decreased bone density and strength
• Decreased libido and sexual function
• Mood changes, such as anxiety and depression
• Fatigue

Secondary potential candidates are individuals interested in body recomposition — a population that includes strength trainers and bodybuilders. However, sermorelin is not appropriate for any competitive strength trainers and bodybuilders, as the World Anti-Doping Agency includes it on its Prohibited List.26

Of final note, it’s not uncommon for physicians to prescribe sermorelin to treat age-related muscle loss, but there’s limited scientific support for its efficacy in this area.25

Sermorelin has been available for decades through clinics and other healthcare facilities. Although it has been discontinued as an FDA-approved medication, physicians continue to prescribe it in compounded form for off-label use. Such is the case with many therapeutic peptides: private clients have long had access.

The telehealth space has begun to catch on and is trying to catch up, but relatively few telehealth platforms currently deal in peptides other than GLP-1 receptor agonists (e.g., Ozempic and Wegovy).

That being said, at least one reputable online provider carries sermorelin, and that’s Eden Health. Eden classifies it under “Cardio + Strength,” which is indeed one of its most common contemporary uses. A prescription starts as low as $246 per month, though the exact cost will depend on the specifics of your treatment plan.

Otherwise, we recommend speaking with your primary care provider if you’re interested in sermorelin. Besides Eden Health, the clinic route is your best bet for getting high-quality, pharmaceutical-grade compounded sermorelin. As the telehealth space continues to play catch-up, you should be wary of businesses seeking to fill the vacuum with products that aren’t fit for human use (i.e., research-grade peptides meant only for laboratory purposes).

With everything you’ve read so far about sermorelin, some of you may have noticed that it sounds a lot like a different therapeutic peptide called tesamorelin.

They do have several qualities in common. The suffix -morelin itself indicates a functional similarity, as it literally means “growth hormone-release stimulating peptide.”27 But there are enough key differences between them that neither would be appropriately interchangeable with the other. For example: