Peptide therapy vs HGH.

Human growth hormone (HGH) is recombinant somatropin — the hormone itself, injected. It bypasses the pituitary entirely and produces supraphysiologic levels that do not follow your body's natural pulses.

Secretagogue peptides — sermorelin, tesamorelin, CJC-1295, ipamorelin — stimulate your own pituitary to release growth hormone in its normal pulsatile rhythm, mostly during deep sleep. Negative feedback stays intact, which is the key safety distinction: the body can still shut the signal off.

Practically, that means secretagogues produce a gentler, physiologic rise in IGF-1 rather than the sustained spike of injected HGH — and they only work if your pituitary is capable of responding, which is why they are not a treatment for true pituitary failure.

This is the part most marketing pages skip. HGH is one of the very few drugs with federal criminal restrictions on off-label distribution. Under 21 U.S.C. § 333(e), distributing or possessing HGH for any use other than a condition specifically authorized by the FDA is a felony. Anti-aging, athletic performance, and general "wellness" are explicitly not authorized indications.

Legitimate adult indications are narrow: documented adult growth hormone deficiency confirmed by stimulation testing, HIV-related wasting, and short bowel syndrome, among a short list of others. Any clinic offering HGH for anti-aging is describing something that is not lawful.

Peptides sit in a different but also complicated place. Several growth hormone secretagogues are available through licensed compounding pharmacies when prescribed by a clinician; others have been restricted. Tesamorelin is FDA-approved for a specific indication. Availability has shifted repeatedly in recent years, so what a clinic can lawfully prescribe today is a real question, not a formality.

In adults with confirmed growth hormone deficiency, replacement improves body composition, bone density, lipids, and quality of life. That population is real, and treatment there is well-supported.

In healthy older adults without deficiency, the evidence is much weaker. A well-known systematic review found that growth hormone in the healthy elderly produced small changes in lean mass and fat mass with a meaningful increase in soft-tissue edema, joint pain, gynecomastia, and glucose intolerance — and no demonstrated improvement in strength or function. The authors concluded it could not be recommended as an anti-aging therapy.

For secretagogues, tesamorelin has the strongest human data in its approved indication, where it reduces visceral adipose tissue. Data for sermorelin, ipamorelin, and CJC-1295 in healthy adults is thinner — mechanistically sound, clinically promising, but not the same tier of evidence as a large randomized trial. Anyone telling you otherwise is selling.

Growth hormone signaling is rarely the first lever worth pulling. In practice, the patients asking about HGH are describing fatigue, poor recovery, midsection fat, and declining strength — and in the overwhelming majority, the actual drivers are sex hormone decline, insulin resistance, inadequate protein, insufficient resistance training, and short sleep.

Correct those first. They are cheaper, safer, and better evidenced. If a growth hormone axis question remains after that, it deserves proper evaluation — IGF-1, a metabolic panel, and stimulation testing where indicated — not a subscription.

See how we approach peptide therapy and where it fits alongside hormone optimization.