The evidence for strength.
CJC-1295, ipamorelin and tesamorelin: the growth hormone axis trials, one real approval, and the long-term unknowns.
Studies on this page
11 fetched
each read from its source
A strength protocol here runs on the growth hormone axis: CJC-1295 with ipamorelin, or tesamorelin where the answers support it. This page has an unusual shape, because one of these three compounds has a regulator's approval and a published label and the other two do not.
Read the tesamorelin section even if you are not taking it. It is the only document in this whole wing written by people who were required to list everything that could go wrong.
CJC-1295
CJC-1295 is a long-acting analogue of growth hormone-releasing hormone. It binds to albumin in the blood after injection, which gives it a half-life of about eight days and means it raises the body's own growth hormone output rather than replacing it. On this site it is paired with ipamorelin.
The published human work is about the hormones themselves. It shows the axis being activated, over weeks, in healthy adults. What it does not show is a downstream result of the kind people take it for.
What has been studied.
| Study | Who | n | How long |
|---|---|---|---|
| Growth Horm IGF Res 20091human serum study | Healthy young adult men | 11 | Before and after treatment |
| Serum protein changes were mapped after the axis was activated, as a search for better markers of growth hormone action than IGF-1 alone. | |||
| J Clin Endocrinol Metab 20062RCT, ascending dose | Healthy adults aged 21 to 61 | 2 trials | 28 and 49 days |
| Growth hormone and IGF-1 rose and stayed raised, which is what the compound is for. No outcome beyond the hormones was measured. | |||
| J Clin Endocrinol Metab 20063clinical trial | Healthy men aged 20 to 40 | not stated | One week after a single injection |
| Growth hormone kept its natural pulsing pattern rather than being flattened by continuous stimulation, and the pulse measures were related to the rise in IGF-1. | |||
What it is approved for.
- None found on any page fetched for this build.
What has not been studied.
- No trial measured strength, muscle mass, body composition or sleep quality as an endpoint in the fetched record. Every human study measured growth hormone, IGF-1 or serum proteins.
- The longest fetched human study ran 49 days. Nothing published goes beyond that.
- Nothing in combination with ipamorelin, which is how it is actually used, and nothing in a Filipino population.
Side effects, and who stopped.
Safety was a stated outcome measure in the ascending-dose trials and no limiting problem is reported in the fetched abstracts. A 2018 review of growth hormone secretagogues notes tolerability alongside a concern about rising blood glucose from falling insulin sensitivity, which is why a protocol on this axis tracks glucose.
WHAT THIS MEANS FOR YOU
What is shown is that the axis can be raised and held raised for weeks, with the natural pulsing pattern kept rather than flattened. What is not shown is that this produces strength, muscle or sleep you would notice, because nobody measured those. The one blood marker worth tracking is IGF-1, read against age-adjusted ranges by your doctor.
Ipamorelin
Ipamorelin is a five-amino-acid growth hormone secretagogue that acts on the ghrelin receptor. It was designed to release growth hormone without dragging the other pituitary hormones up with it, which is what selective means here, and it is paired with CJC-1295 because the two act on different receptors.
What has been studied.
| Study | Who | n | How long |
|---|---|---|---|
| Int J Colorectal Dis 20144phase 2 RCT | Adults having open or laparoscopic bowel resection | multicentre | Twice daily infusions after surgery |
| The only fetched randomised clinical outcome trial, and it is about bowel recovery after surgery rather than about strength or body composition. | |||
| Pharm Res 19995clinical trial, dose escalation | Healthy male volunteers, eight per dose level | 40 | Single 15-minute infusions |
| A single episode of growth hormone release peaking at about 40 minutes and declining to negligible levels, with a short half-life of about two hours. | |||
| Eur J Endocrinol 19986preclinical | Rat pituitary cells and animals | n/a | n/a |
| The paper that introduced the compound, describing it as the first selective growth hormone secretagogue, meaning it releases growth hormone without the other pituitary hormones. | |||
What it is approved for.
- None found on any page fetched for this build. It reached a phase 2 clinical trial for a hospital indication and no approval followed in the fetched record.
What has not been studied.
- No trial of ipamorelin for strength, muscle or body composition was found. The only fetched randomised clinical outcome trial was about bowel recovery after abdominal surgery.
- The human pharmacology study was single infusions in healthy men, not weeks of use.
- Nothing on the pairing with CJC-1295, which is the only way it appears on this site.
Side effects, and who stopped.
The phase 2 surgical trial assessed safety alongside efficacy, and the pharmacology study reports no limiting problem. There is no long-term human dataset.
WHAT THIS MEANS FOR YOU
It reliably produces a single pulse of growth hormone that peaks within the hour and clears. Whether a series of those pulses over 90 days changes anything you can feel is not something the fetched literature has tested.
Tesamorelin
Tesamorelin is the exception on this site: a compound in this class that a regulator has actually assessed and approved, for a specific population, with a label that carries warnings and limitations. It is a growth hormone-releasing factor analogue given as a daily injection.
Reading its label is the most useful thing anyone on a strength protocol can do, because it is the only document of its kind that exists for anything here.
What has been studied.
| Study | Who | n | How long |
|---|---|---|---|
| J Int Assoc Provid AIDS Care 20267systematic review and meta-analysis, 2026 | Randomised trials in HIV-associated lipodystrophy | pooled | To February 2026 |
| The pooled picture across the randomised trials, with a formal grading of the certainty of the evidence. | |||
| J Infect Dis 20258phase 2 RCT, 2025 | People with HIV, virally suppressed, with abdominal obesity | 73 | 6 months |
| Tested against standard of care for neurocognitive impairment, on the reasoning that the compound reduces abdominal fat and raises IGF-1. | |||
| Lancet HIV 20199RCT, multicentre | People with HIV and fatty liver disease | 1:1 | 12 months, then 6 open-label months |
| Liver fat and histology were the endpoints over a full year, the longest fetched trial of this compound. | |||
| JAMA 201410RCT | Adults with HIV on treatment with abdominal fat accumulation | 50 | 6 months |
| Both visceral fat and liver fat fell, which was the first time the liver effect was measured for this compound. | |||
| N Engl J Med 200711phase 3 RCT | Adults with HIV and abdominal fat accumulation, 86% men | 412 | 26 weeks |
| Visceral fat measured by computed tomography fell against placebo, with triglycerides and the cholesterol ratio among the secondary endpoints. | |||
What it is approved for.
- Approved by the United States Food and Drug Administration under biologic licence 022505 to Theratechnologies. The label states it is indicated for the reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy. Source.
- The same label carries limitations of use: long-term cardiovascular safety has not been established, and it is not indicated for weight loss management. Source.
- In Europe the application was withdrawn. The European Medicines Agency records that the company withdrew its marketing authorisation application and that the committee's provisional opinion was that it could not have been approved for that indication. Source.
What has not been studied.
- Every fetched trial was in people with HIV. There is no trial in healthy adults, in athletes, or in anyone whose goal is strength or body composition.
- The label states plainly that it is not indicated for weight loss management, and no fetched trial tested it for that.
- The label states that long-term cardiovascular safety has not been established, in the population it is approved for.
- Nothing in a Filipino population, and nothing that pairs it with any other compound here.
Side effects, and who stopped.
The label warns about elevated IGF-1 with unknown consequences of prolonged elevation, fluid retention including swelling, joint pain and carpal tunnel syndrome, glucose intolerance or diabetes developing during use, hypersensitivity reactions, and increased mortality in patients with acute critical illness. It tells prescribers to evaluate glucose before and during therapy and to monitor IGF-1.
That list is longer and more specific than anything else on this site, and the reason is not that this compound is more dangerous. It is that somebody was required to write it down.
WHAT THIS MEANS FOR YOU
This is the one compound in this class with a regulator's assessment behind it, and that assessment is for reducing abdominal fat in people with HIV and lipodystrophy, not for strength in a healthy adult. Its label is the best available guide to what this class does to glucose and IGF-1, and it is worth handing to your doctor whichever compound you end up on. Take it to a doctor who knows you before you begin.
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Get startedWhat the axis evidence actually covers.
Across all three compounds, the human trials measure hormones and abdominal fat. Growth hormone rises, IGF-1 rises, visceral fat falls in people with HIV-associated lipodystrophy, and liver fat falls with it. Every one of those is a real, replicated finding from a properly run trial.
None of them is strength. No fetched trial on this page measured a lift, a muscle cross-section, or a body composition scan in a healthy adult. The gap between what this class demonstrably does to a hormone and what people hope it does to a body is the whole subject of this page.
The one number to track.
IGF-1, read against age-adjusted ranges by a doctor. It is the marker the approved label tells prescribers to monitor, it is the marker the reviews of this class name, and it is the only one that shows whether the axis is doing anything at all. Fasting glucose or HbA1c belongs beside it, because this class can move blood sugar.
The bloodwork page lists where to have both drawn in Manila and the page written for your doctor carries the label quotations in full. Take it to a doctor who knows you before you begin.
Questions
Does this class build muscle?
No trial cited on this page measured muscle or strength. They measured growth hormone, IGF-1, serum proteins, visceral fat and liver fat. The muscle claim is an inference from the hormone, not a result from a trial.
Is tesamorelin approved?
Yes, by the United States Food and Drug Administration, for reducing excess abdominal fat in HIV-infected adults with lipodystrophy. Its label also states it is not indicated for weight loss management and that long-term cardiovascular safety has not been established. In Europe the application was withdrawn.
What should be monitored?
IGF-1 against age-adjusted ranges, and fasting glucose or HbA1c. The approved label in this class tells prescribers to evaluate glucose before and during therapy and to monitor IGF-1. Your doctor reads the numbers; this site never does.
Why pair two compounds?
They act on different receptors, one on the growth hormone-releasing hormone receptor and one on the ghrelin receptor. No fetched trial has studied the pair together, which is worth knowing before assuming the combination is better than either alone.
Sources
Every record below was fetched on the date shown. Nothing on this page is cited that did not fetch.
- 01Sackmann-Sala L, et al. Activation of the GH/IGF-1 axis by CJC-1295, a long-acting GHRH analog, results in serum protein profile changes in normal adult subjects. Growth Horm IGF Res 2009. PubMed 19386527 · doi · read 2026-09-07
- 02Teichman SL, et al. Prolonged stimulation of growth hormone (GH) and insulin-like growth factor I secretion by CJC-1295, a long-acting analog of GH-releasing hormone, in healthy adults. J Clin Endocrinol Metab 2006. PubMed 16352683 · doi · read 2026-09-07
- 03Ionescu M, et al. Pulsatile secretion of growth hormone (GH) persists during continuous stimulation by CJC-1295, a long-acting GH-releasing hormone analog. J Clin Endocrinol Metab 2006. PubMed 17018654 · doi · read 2026-09-07
- 04Beck DE, et al. Prospective, randomized, controlled, proof-of-concept study of the Ghrelin mimetic ipamorelin for the management of postoperative ileus in bowel resection patients. Int J Colorectal Dis 2014. PubMed 25331030 · doi · read 2026-09-07
- 05Gobburu JV, et al. Pharmacokinetic-pharmacodynamic modeling of ipamorelin, a growth hormone releasing peptide, in human volunteers. Pharm Res 1999. PubMed 10496658 · doi · read 2026-09-07
- 06Raun K, et al. Ipamorelin, the first selective growth hormone secretagogue. Eur J Endocrinol 1998. PubMed 9849822 · doi · read 2026-09-07
- 07Ditta AM, et al. Efficacy and Safety of Tesamorelin in People Living With HIV (PLWH) With Lipodystrophy: A Systematic Review and Meta-Analysis. J Int Assoc Provid AIDS Care 2026. PubMed 42538058 · doi · read 2026-09-07
- 08Ellis RJ, et al. Effects of Tesamorelin on Neurocognitive Impairment in Persons With HIV and Abdominal Obesity. J Infect Dis 2025. PubMed 39813152 · doi · read 2026-09-07
- 09Stanley TL, et al. Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial. Lancet HIV 2019. PubMed 31611038 · doi · read 2026-09-07
- 10Stanley TL, et al. Effect of tesamorelin on visceral fat and liver fat in HIV-infected patients with abdominal fat accumulation: a randomized clinical trial. JAMA 2014. PubMed 25038357 · doi · read 2026-09-07
- 11Falutz J, et al. Metabolic effects of a growth hormone-releasing factor in patients with HIV. N Engl J Med 2007. PubMed 18057338 · doi · read 2026-09-07
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