By Rob Khaler
About the Author: Rob Kahler is a Clinical Liaison at Strive Pharmacy who works closely with healthcare providers to simplify clinical education and make personalized compounding feel approachable, practical, and patient-focused.
Sermorelin: What Clinicians Need to Know
- Mechanism: Sermorelin acetate functions as a GHRH analog that activates the pituitary to release growth hormone (GH).1
- Clinical Use: Supports adults with low GH, fatigue, or muscle loss, especially common in patients using GLP-1 medications.2
- Administration: Taken nightly, five days per week, on an empty stomach for optimal potential outcomes.
Compounded Sermorelin: Restoring the Pituitary’s Endogenous Rhythm
How can clinicians support adult growth hormone deficiency without suppressing the endogenous function of the pituitary gland?
Sermorelin acetate is a lab-made analog of growth hormone–releasing hormone (GHRH) that helps the body do what it’s designed to do—produce its own growth hormone. By encouraging the body to release its own growth hormone (GH), sermorelin helps bring the body’s endogenous rhythm back into balance.1
Sermorelin offers a personalized way to address age-related growth hormone decline and support metabolic balance—helping patients feel and function their best as part of an integrative, healthy-aging approach.
How Sermorelin Works: Mechanism and Pharmacokinetics
Sermorelin acts on GHRH receptors in the anterior pituitary, triggering pulsatile GH release that closely mirrors endogenous nocturnal GH surges.1
A few key points for clinicians:
- Short half-life (10–12 min): This quick clearance supports physiologic GH pulses rather than continuous stimulation.¹
- Preserved feedback loops: IGF-1 and somatostatin feedback acts to keep GH levels within physiologic norms.3
- Avoids pituitary suppression: By avoiding supraphysiologic levels and inducing episodic pulses within a circadian rhythm context, sermorelin causes minimal pituitary suppression or tachyphylaxis, and does not perturb adjacent hormonal feedback loops.4
“Sermorelin’s biggest advantage is that it helps the body produce its own growth hormone while keeping its endogenous feedback systems—like IGF-1 and somatostatin—in balance.”1
Practical Applications and Patient Selection
Sermorelin was originally studied for pediatric GH deficiency but is now widely used in adults with growth hormone deficiency (AGHD) and age-related GH decline.4
Primary Uses
- Adults with low IGF-1 levels, reduced lean body mass, or chronic fatigue.5
- Patients using GLP-1 receptor agonists who exhibit decreased energy levels, slower recovery, or muscle loss during weight management.5
- Sermorelin may complement estrogen or testosterone replacement regimens for their diverse effects on energy levels, body composition, bone health, libido and skin.
- Individuals pursuing metabolic optimization or longevity care with emphasis on sleep, cognition, and tissue repair.6,7
How Sermorelin Supports Muscle Preservation in GLP-1 Users
GLP-1 receptor agonists such as semaglutide can reduce muscle mass by lowering appetite, caloric intake, and indirectly decreasing anabolic signaling through the GH–IGF-1 axis.8 Sermorelin counteracts this by restoring physiologic GH pulses and helping to improve protein synthesis, muscle recovery, and insulin sensitivity.
Available dosage forms at Strive Pharmacy
- Injectable vials (1 mg/mL) for subcutaneous use and optimal bioavailability.
- Mini troches (600 mcg) for buccal absorption and convenience.
- Nasal sprays (1000 mcg/mL) for ease of use and improved adherence.
Sermorelin Dosing Protocols and Administration
A common initial protocol is:
- Sermorelin Acetate 1 mg/mL (3 mL vial): Inject 0.15-0.3 mL SUBQ nightly on an empty stomach for 5 out of 7 days per week.
- Sermorelin Acetate 600 mcg Mini Troche: Dissolve one troche buccally nightly on an empty stomach for 5 out of 7 days per week.
- Sermorelin 1000 mcg/mL Nasal Spray: Use 1 spray nasally up to 3 times daily for 5 out of 7 days a week
Potential Benefits of Sermorelin
Sermorelin offers a physiologic approach to restoring growth hormone balance, supporting a wide range of systemic and functional benefits. Its effects extend beyond body composition, influencing energy, metabolism, and long-term wellness outcomes.
Exercise Performance and Recovery
By stimulating endogenous growth hormone secretion, sermorelin may promote fast post-exercise recovery, improved tissue repair, and greater exercise endurance. Restoration of physiologic GH levels can make strenuous training more sustainable while enhancing overall energy and motivation for physical activity.¹
Supported Muscle Strength and Composition
Age-related decline in GH often leads to reduced muscle mass and a slower metabolic rate. Sermorelin supports lean body mass through improved protein synthesis and lipid metabolism, encouraging favorable shifts in body composition. Enhanced GH signaling may also increase satellite cell activation, supporting muscle hypertrophy and strength gains over time.5
Supported Bone Health and Density
Growth hormone plays a vital role in skeletal remodeling and calcium homeostasis. By restoring GH pulsatility, sermorelin may improve bone mineral density and structural integrity, helping reduce fracture risk and allowing patients to maintain active lifestyles with fewer limitations.9
Cardiovascular and Metabolic Support
Research has suggested that GH deficiency is linked to dyslipidemia, increased visceral fat, and elevated cardiovascular risk. Sermorelin’s normalization of GH–IGF-1 axis function may improve lipid profiles, support vascular health, and contribute to better cardiac resilience and overall metabolic stability.6
Potential Side Effects and Limitations
Sermorelin is generally well-tolerated when monitored appropriately.
Common reactions:
- Mild injection-site irritation or redness.10
Limitations:
- Do not use in cancer or tumor.11
Expected Timeline of Potential Clinical Response
Note: Outcomes are not guaranteed. Individual experiences may vary.
Weeks 1–2: May see noticeable improvement in sleep depth and morning energy.
Weeks 3–6: Enhanced focus, faster recovery, increased libido, and skin tone.
Months 2–3: Visible body composition improvement and greater endurance.
Months 6 and beyond: Sustained lean mass, improved bone density, and overall vitality.
Potential improvements depend on adherence, dosage alignment, and concurrent lifestyle factors such as sleep and nutrition.12
The Strive Compounding Approach
At Strive Pharmacy, we view compounded formulations as precision tools designed around each patient’s unique physiology. Sermorelin is often discussed in the context of healthy-aging and vitality medicine, aligning with our mission to empower the body’s own intelligence rather than override it.
Our pharmacists collaborate closely with prescribers to:
- Develop dosing protocols customized to individual physiology.
- Adjust formulation type to help improve adherence and absorption.
- Provide clinical education and documentation for ongoing support.
Partner with Strive and Learn More About Sermorelin
Strive collaborates with healthcare providers nationwide to create customized compounded formulations. Our pharmacists offer clinical guidance, flexible dosing, and education to optimize outcomes for every patient.
If you’re not yet a Strive provider, now is the perfect time to get connected.
Join our next Strive Session webinar to explore how compounded sermorelin supports physiologic growth hormone balance and long-term metabolic health. You’ll have the opportunity to directly ask our clinical team questions and gain practical insights you can bring into your practice.
[Register for the next Strive Session] or [Become a Strive Provider] today to get started.
References
- Sinha DK, Balasubramanian A, Tatem AJ, Rivera-Mirabal J, Yu J, Kovac J, et al. Beyond the androgen receptor: the role of growth hormone secretagogues in the modern management of body composition in hypogonadal males. Transl Androl Urol. 2020;9(Suppl 2):S149–S159. doi:10.21037/tau.2019.11.30. PMID: 32257855; PMCID: PMC7108996.
- Friedman SD, Baker LD, Borson S, Jensen JE, Barsness SM, Craft S, et al. Growth hormone–releasing hormone effects on brain γ-aminobutyric acid levels in mild cognitive impairment and healthy aging. JAMA Neurol. 2013;70(7):883–890. doi:10.1001/jamaneurol.2013.1425. PMID: 23689947; PMCID: PMC3764915.
- Namba H, Morita S, Melmed S. Insulin-like growth factor-I action on growth hormone secretion and messenger ribonucleic acid levels: interaction with somatostatin. Endocrinology. 1989;124(4):1794–1799. doi:10.1210/endo-124-4-1794. PMID: 2564339.
- Walker RF. Sermorelin: a better approach to management of adult-onset growth hormone insufficiency? Clin Interv Aging. 2006;1(4):307–308. doi:10.2147/ciia.2006.1.4.307. PMID: 18046908; PMCID: PMC2699646.
- Velloso CP. Regulation of muscle mass by growth hormone and IGF-I. Br J Pharmacol. 2008;154(3):557–568. doi:10.1038/bjp.2008.153. PMID: 18500379; PMCID: PMC2439518.
- Caicedo D, Díaz O, Devesa P, Devesa J. Growth hormone (GH) and the cardiovascular system. Int J Mol Sci. 2018;19(1):290. doi:10.3390/ijms19010290. PMID: 29346331; PMCID: PMC5796235.
- Morselli LL, Nedeltcheva A, Leproult R, Spiegel K, Martino E, Legros JJ, et al. Impact of growth hormone replacement therapy on sleep in adult patients with growth hormone deficiency of pituitary origin. Eur J Endocrinol. 2013;168(5):763–770.
- Jeromson S, Baranowski B, Akcan M, Waters BD, Eisner K, Bellucci A, et al. Semaglutide impacts skeletal muscle to a similar extent as caloric restriction in mice with diet-induced obesity. J Physiol. 2025 Sep 22. doi:10.1113/JP289449. Epub ahead of print. PMID: 40982727.
- Sasanuma H, Nakata M, Parmila K, Nakae J, Yada T. PDK1–FoxO1 pathway in AgRP neurons of the arcuate nucleus promotes bone formation via the GHRH–GH–IGF-1 axis. Mol Metab. 2017;6(5):428–439. doi:10.1016/j.molmet.2017.02.003. PMID: 28462077; PMCID: PMC5404105.
- Mayo Clinic. Sermorelin (injection route) – Description. Drug information provided by Merative, Micromedex®. Updated January 31, 2025.
- Boguszewski MCS, Boguszewski CL, Chemaitilly W, Cohen LE, Gebauer J, Higham C, et al. Safety of growth hormone replacement in survivors of cancer and intracranial and pituitary tumours: a consensus statement. Eur J Endocrinol. 2022;186(6):P35–P52. doi:10.1530/EJE-21-1186. PMID: 35319491; PMCID: PMC9066587.
- Merriam GR, Barness S, Buchner D, et al. Growth hormone–releasing hormone treatment in normal aging. J Anti-Aging Med. 2001;4:331–343.
Disclaimer:
The information provided in this article is for informational and educational purposes only. Refer to the cited references for more information regarding the content presented. The creators of this content disclaim any liability for decisions made based on the information presented. The information provided relates to patient-specific compounding. Compounded medications are specially prepared for individual patient needs and, as such, have not been reviewed or approved by the U.S. Food and Drug Administration (FDA). Prescribers should use their independent clinical judgment when determining appropriateness for individual patients.
