What it is

A GH secretagogue is a peptide (a small protein) that signals your pituitary gland to release more of your own growth hormone. It is not growth hormone itself. We use two, one step at a time:

• Ipamorelin works like ghrelin, a natural hormone from your stomach that switches on GH release. It is our gentlest step.
• Tesamorelin is a modified form of the natural brain signal that switches on GH release.¹

Your doctor tells you which one to use, based on your blood test. You use only one at a time.

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How to take it

• Inject it once a day at bedtime, on weekdays only (5 days a week). Most of your own GH is released in deep sleep, so a bedtime dose works with your body’s natural rhythm.^(2,3)
• Do not eat for 2–3 hours before your injection. Raised blood sugar after a meal lowers GH release, so an empty stomach lets the medicine work better.³
• Use the number of units written on your label, with an insulin syringe. Your doctor changes your treatment by changing the step, so always check the label on your current vial.
• Use it for the cycle your doctor sets, then rest for the same length of time. The rest helps the next cycle work again.
• Never mix two peptides in one syringe, and never use two GH peptides together. Using one at a time lets us read your blood test clearly and see what each step does.

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Preparing your vial

You mix each vial once, then use it for your injections.³

1. Mix. Wash your hands and clean the tops of both vials with an alcohol swab. Draw up the amount of sterile water written on your label, and inject it slowly down the side of the powder vial. Swirl gently until the liquid is clear. Do not shake.
2. Label. Write the date and time you mixed it on the vial, so you know when it expires.
3. Draw your dose. Clean the vial top and let it dry. Draw air into the syringe equal to your dose, push the air into the vial, turn the vial upside down and draw the number of units on your label. Remove any air bubbles and check the dose again.
4. Inject. Choose a spot on your belly, 2–3 cm away from the navel. Clean the skin and let it dry. Pinch a fold of skin, insert the needle straight in (or at a slant if you are very lean), inject slowly, wait 2–3 seconds, then take the needle out.
5. Use a new spot each time. A small red, itchy patch where you inject is the most common side effect, and moving the spot each time helps prevent it.¹
6. Dispose safely. Put used needles and syringes in a sharps container or a hard plastic bottle with a tight lid. Never reuse a needle or syringe.

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If you miss a dose

Skip the missed dose and take the next one at the usual time. Do not take two doses to make up. Your IGF-1 level stays steady through the day, so one missed dose makes little difference.⁴

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If you stop

No source we use describes withdrawal symptoms after stopping. When you stop, your level returns to where it was before treatment within about 2 weeks. In a study of one of the peptides we use, the body’s own GH release went back to its starting point, not lower.⁵ The benefits fade over time once you stop. In the trials, belly fat slowly came back after treatment ended.¹ This is why we tell you that results last only while you are on treatment.

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Please stop

• Any other GH-boosting product, such as other peptides, growth hormone injections or MK-677. Using two together pushes IGF-1 higher, side effects are more likely, and we can no longer read your blood test clearly.
• Biotin, for 3 days before every blood test. Biotin is found in many hair, skin and nail supplements, and it can make hormone results falsely high or low.

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Tell us if you take

None of these means you cannot use this medicine. Some medicines and GH affect each other, so knowing what you take helps us look after you more closely.

• Steroid tablets or injections taken regularly, such as prednisolone. High doses of steroids strongly lower GH and IGF-1, so the medicine may not work well, and GH changes how your body clears steroids.¹ We wait until you have finished the steroid course.
• Thyroid medicine (levothyroxine). GH can lower your thyroid hormone level. We check it at your Annual Panel and adjust your thyroid medicine if needed.⁴
• The contraceptive pill or estrogen tablets. Estrogen taken by mouth lowers the IGF-1 your liver makes, so your blood test may read lower.⁴ You can keep taking it. Please tell us before you stop it or switch to a patch or gel, because your IGF-1 may rise.
• Testosterone or DHEA. These raise IGF-1.⁶ Your regular blood test will show this, so no extra test is needed.
• Seizure medicines, cyclosporine, or other medicines your liver clears. GH may change how your body clears them, so we let the doctor who prescribes them know.¹
• Any new medicine you start while on treatment, so we can check that the two work well together.

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Contact us if you notice

These can be signs that your IGF-1 has risen higher than it should, or, rarely, that your cortisol has fallen. They are very rare in people who follow our plan, because we start with the gentlest step and check your blood in every cycle. We tell you so that you know what to look out for, as part of good care.

• Swelling of the hands or feet, numb or painful fingers, joint or muscle pain. These can mean your level is too high. In trials, they were a little more common than with placebo and went away when the medicine was stopped.¹ We check your IGF-1.
• Dizziness when you stand up, infections that last unusually long, or feeling very tired. GH can lower cortisol, a stress hormone. We pause the medicine and check your cortisol.⁴
• Redness or itching where you inject. This is the most common side effect. Move to a new spot each time.¹
• Pregnancy. Stop the medicine and tell us.¹
• A serious illness, major surgery or a hospital stay. Pause the medicine until you have recovered, and tell us. In very sick people, high levels of growth hormone have been linked with a higher death rate.¹

These usually have other causes, and we will check to be sure. Go to a hospital the same day if you have a rash all over, hives, swelling of the face or throat, trouble breathing, a racing heart or fainting (signs of an allergic reaction); a severe headache that does not go away, or blurred vision; or chest pain, shortness of breath, or swollen legs with tiredness.^(1,4)

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How to store it

• Before mixing: keep the powder vials in the fridge, at 2–8°C.
• After mixing: keep the vial in the fridge, at 2–8°C. Use it within 30 days of the date you mixed it, and throw away anything left after 30 days. Our supplier sets this limit to keep the medicine clean and working well.^(3,7)
• Keep it out of the sight and reach of children.

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Help your own growth hormone

What you do every day affects how much GH your body makes:

• Sleep well. Most GH is released in deep sleep.²
• Stay lean. Fat inside the belly lowers GH release.²
• Eat enough protein. Protein helps your body make IGF-1.
• Cut down on sugar, white flour, alcohol and caffeine. Raised blood sugar lowers GH release.
• Try interval exercise, short bursts of hard effort with rest in between. Exercise boosts GH release.⁴
• Don’t smoke.
• Avoid very low-calorie diets for weeks at a time. Eating too little for a long time lowers GH and IGF-1.
• Correct other low hormones. Other hormones, such as thyroid, testosterone and estrogen, help your body release GH.

Medically reviewed by Dr. Chontirot, MD · Medical licence no. 36583 · Last reviewed: 31 October 2026

References

1. Tesamorelin for injection, for subcutaneous use. US prescribing information. Revised 3/2025.
2. Olarescu NC, Gunawardane K, et al. Normal Physiology of Growth Hormone in Normal Adults. In: Feingold KR, et al., editors. Endotext. MDText.com; updated 2025.
3. Supplier’s patient instructions for ipamorelin 5 mg vial and tesamorelin 10 mg vial.
4. Yuen KCJ, Biller BMK, Radovick S, et al. American Association of Clinical Endocrinologists and American College of Endocrinology Guidelines for Management of Growth Hormone Deficiency in Adults and Patients Transitioning from Pediatric to Adult Care. Endocr Pract. 2019;25(11).
5. Stanley TL, Chen CY, Branch KL, Makimura H, Grinspoon SK. Effects of a Growth Hormone-Releasing Hormone Analog on Endogenous GH Pulsatility and Insulin Sensitivity in Healthy Men. J Clin Endocrinol Metab. 2011;96(1):150–158.
6. Feldt-Rasmussen U, Klose M. Adult Growth Hormone Deficiency – Clinical Management. In: Feingold KR, et al., editors. Endotext. MDText.com; updated 2022.
7. Supplier’s pricing, reconstitution and administration protocol for peptides.

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