Sermorelin vs Tesamorelin vs Ipamorelin: How Do They Actually Compare?

October 2, 2026
Liv Health editorial team
4 min read

Key Takeaways

All three prompt your pituitary gland to release its own growth hormone. None of them is growth hormone itself.
Sermorelin and tesamorelin act on the same receptor, the one for growth hormone-releasing hormone (GHRH). Ipamorelin works through the ghrelin receptor instead.
In a small study, older men's growth hormone and IGF-1 levels rose after 14 days of GHRH injections at the higher dose tested.
Tesamorelin is best known for its trial results in adults with HIV-associated lipodystrophy.
Liv offers sermorelin, not tesamorelin or ipamorelin.

These three peptides often come up together, because each one prompts your body to release its own growth hormone. They differ in how they do it, what they're approved for and whether Liv offers them.

How They Work

All three work through the system your body already uses to control growth hormone release. Part of that system is growth hormone-releasing hormone, a signal from your hypothalamus. It tells your pituitary to make your own growth hormone and release it in bursts rather than a steady stream, as tesamorelin's approved labeling describes it.

The Three, Side by Side

Sermorelin: an analog of naturally occurring growth hormone-releasing hormone, specifically growth hormone releasing factor 1-29 NH2-acetate. It's the working end of the natural hormone, and it binds the same pituitary receptors. Somatostatin, your body's own brake, still keeps it in check. Your growth hormone comes in bursts, rather than at the constant level injected growth hormone gives (Walker, Clinical Interventions in Aging, 2006).

Tesamorelin: the same receptor, a bigger molecule. Its approved labeling describes it as the 44 amino acids of human GRF, the body's own growth hormone-releasing hormone, plus a six-carbon chain attached at one end. In lab testing, it binds and stimulates human GRF receptors with potency similar to the body's own GRF.

Ipamorelin: a different door into the same room. It's a synthetic five-amino-acid peptide that acts like ghrelin, activating ghrelin receptors in the hypothalamus and on the pituitary rather than the GHRH receptor. It was introduced in 1998 as the first selective growth hormone secretagogue. It earned that name by releasing growth hormone without raising cortisol or ACTH, the pituitary signal that triggers cortisol. GHRP-6 and GHRP-2, the compounds it was derived from, raised both. FDA's 2024 review describes the same profile.

WHAT SEPARATES THEM

Two act on one receptor. The third does not.

	Sermorelin	Tesamorelin	Ipamorelin
Receptor it acts on	GHRH receptor	GHRH receptor	Ghrelin receptor
Primary focus	Supports the pituitary's own GH release	Excess abdominal fat, HIV lipodystrophy	No established use
FDA status	Approved product discontinued 2008	Approved and marketed	No approved product

Sermorelin is the one Liv supplies.

Sources: EGRIFTA WR labeling (sections 1, 11, 12.1); Raun et al., Eur J Endocrinol 1998; FDA PCAC briefing document, 29 October 2024.

Key Differences and Uses

	Sermorelin	Tesamorelin	Ipamorelin
What it is	GHRH analog, the 1-29 fragment	GHRH analog, 44 amino acids plus a hexenoyl chain	Synthetic five-amino-acid peptide that acts like ghrelin
Receptor	GHRH receptor	GHRH receptor	Ghrelin receptor
Primary focus	Supports the pituitary's own growth hormone release	Reduction of excess abdominal fat in adults with HIV-associated lipodystrophy	No established use. Its one published efficacy trial was in postoperative ileus
Study results	Small studies in older adults: hormone levels at 2 weeks, thinking tests at 6 months	26-week trials: visceral fat down 18% and 14%	Its one published efficacy trial missed its endpoints
Effect on cortisol	Not characterized here	Not characterized here	No significant rise, the finding it's known for
Available from Liv	Yes, if your provider prescribes it	No	No

Start with an evaluation

What Sermorelin May Help With

Sermorelin raised hormone levels in older men, and older adults taking it did better on thinking tests, in two small studies. Older men's growth hormone and IGF-1 levels rose after 14 days of GHRH injections at the higher dose tested, in a small study. Older adults did better on tests of thinking and attention after six months of sermorelin injections, in a separate study.

What Tesamorelin's Trials Found

Tesamorelin lowered visceral fat, the fat around the organs, in two 26-week controlled trials in adults with HIV-associated lipodystrophy. It fell by 18% in one study and 14% in the other, compared with small changes on placebo. People kept on treatment for a further 26 weeks held the reduction, and those switched to placebo rebounded.

How You and Your Provider Track Your Response

Under Liv's protocol, you'll have an IGF-1 blood test at 2 to 6 weeks, and your provider looks at the result alongside your sleep data and how you feel.

Your provider reviews your history before you start and checks in on you before each refill. Liv's protocol includes a planned pause, called a washout, intended to limit tolerance. Your provider will tell you when to take it. Check with your provider before changing your dose.

Which One Should You Consider?

If you're choosing through Liv, it's sermorelin. Tesamorelin is a brand-name prescription drug for a specific condition, and Liv doesn't offer it or ipamorelin. If sermorelin is right for you, a licensed provider prescribes it and a licensed pharmacy prepares it for you.

Bring your goals and questions, and your provider will help you decide whether sermorelin fits. When you're ready, start with an evaluation.

Related reading: What an evaluation covers · The NAD+ supplement guide

Frequently Asked Questions

What is the main difference between sermorelin and ipamorelin?

The receptor. Sermorelin is an analog of growth hormone-releasing hormone and binds the GHRH receptor.

Ipamorelin is a five-amino-acid peptide that acts like ghrelin and binds the ghrelin receptor instead. Both lead to growth hormone release from the pituitary, by different routes.

Is tesamorelin stronger than sermorelin?

They're used for different things, so strength isn't the useful comparison. Tesamorelin's labeling describes its potency at the receptor as similar to your body's own GHRH.

What sets tesamorelin apart is its controlled trial results in its approved population, adults with HIV-associated lipodystrophy. Sermorelin is the one Liv offers, if your provider prescribes it.

Does ipamorelin really avoid raising cortisol?

Yes, in the 1998 study that introduced it: it raised growth hormone without raising ACTH or cortisol, where GHRP-6 and GHRP-2 raised both. That work was done in swine. The prolactin claim often attached to it isn't a difference, because none of the compounds tested affected prolactin.

What did studies of sermorelin find?

Older men's hormone levels were higher after two weeks, and older adults did better on thinking tests after six months. In a small study, ten healthy older men (average age 68) received GHRH-(1-29) injections twice daily for 14 days at each of two doses.

The doses were 0.5 mg and 1 mg, and growth hormone and IGF-1 rose significantly only at 1 mg twice daily. These were hormone measurements, not a promise that symptoms improve in two weeks, and the study regimen isn't dosing advice. The study included men only, and it didn't use Liv's compounded preparation.

In a randomized, placebo-controlled study, 100 adults ages 60 to 85 started six months of injected sermorelin acetate (GEREF), and 89 completed it. They began at 1 mg nightly, and some had their dose adjusted.

Improvements appeared on several cognitive tests and didn't depend on gender or estrogen status. The study looked at cognitive tests, not dementia prevention, longer life or a percentage improvement in everyday memory.

It didn't include adults ages 35 to 55, and it used GEREF, not a compounded preparation.

Will sermorelin work for me?

Your provider measures how you respond. Liv's protocol calls for an IGF-1 blood test at 2 to 6 weeks, reviewed alongside your sleep data and how you feel.

A change in IGF-1 doesn't necessarily mean you'll notice a benefit, particularly if your level was already adequate. Your provider considers both your results and your experience when discussing whether to continue.

Is there an FDA-approved sermorelin?

Not on the market today. GEREF, a sermorelin acetate injection, was an FDA-approved product that its sponsor discontinued in December 2008. FDA later determined it wasn't withdrawn from sale for reasons of safety or effectiveness.

Through Liv, sermorelin is compounded: a licensed pharmacy prepares it specifically for you. The FDA doesn't approve compounded medicines for safety, quality or how they're made.

Does Liv offer tesamorelin?

No. Tesamorelin is FDA-approved as the brand-name drug EGRIFTA for reducing excess abdominal fat in adults with HIV-associated lipodystrophy, as its prescribing information states.

Does Liv offer ipamorelin?

No. FDA lists ipamorelin acetate among ingredients that may present significant safety risks when outsourcing facilities compound with them, an entry dated September 29, 2023.

FDA says compounded drugs containing it may pose a risk of immune reactions when given by certain routes, because the peptide can clump or carry related impurities. FDA adds that ipamorelin's unnatural amino acids make the peptide harder to characterize.

FDA also cites a published study that identified serious adverse events when ipamorelin was given by IV to help the gut move food along. For certain other injectable routes, FDA says it doesn't have enough safety information to know whether the drug would cause harm.

References

Corpas, E., Harman, S. M., Piñeyro, M. A., Roberson, R., & Blackman, M. R. (1992). Growth hormone (GH)-releasing hormone-(1-29) twice daily reverses the decreased GH and insulin-like growth factor-I levels in old men. Journal of Clinical Endocrinology and Metabolism, 75(2), 530-535. https://pubmed.ncbi.nlm.nih.gov/1379256/

Federal Register. (2013). Determination that GEREF (sermorelin acetate) injection and GEREF Diagnostic were not withdrawn from sale for reasons of safety or effectiveness, 78 FR 14104, March 4, 2013. Cited by name; the Federal Register page could not be retrieved automatically.

Raun, K., Hansen, B. S., Johansen, N. L., Thøgersen, H., Madsen, K., Ankersen, M., & Andersen, P. H. (1998). Ipamorelin, the first selective growth hormone secretagogue. European Journal of Endocrinology, 139(5), 552-561. https://pubmed.ncbi.nlm.nih.gov/9849822/

Theratechnologies Inc. (2025). EGRIFTA WR (tesamorelin) for injection, for subcutaneous use: Prescribing information. DailyMed, U.S. National Library of Medicine. SPL set id 839334d3-8c1d-4c26-9036-2ab524a6ea75, SPL version 2, revised March 2025. Sections 1, 11, 12.1, 12.3 and 14. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=839334d3-8c1d-4c26-9036-2ab524a6ea75

U.S. Food and Drug Administration. (2023). Certain bulk drug substances for use in compounding that may present significant safety risks, ipamorelin acetate entry, September 29, 2023. Read October 1, 2026. https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks

U.S. Food and Drug Administration. (2024). FDA briefing document, Pharmacy Compounding Advisory Committee meeting, October 29, 2024: ipamorelin-related bulk drug substances. https://www.fda.gov/media/182088/download

Vitiello, M. V., Moe, K. E., Merriam, G. R., Mazzoni, G., Buchner, D. H., & Schwartz, R. S. (2006). Growth hormone releasing hormone improves the cognition of healthy older adults. Neurobiology of Aging, 27(2), 318-323. https://faculty.washington.edu/vitiello/Recent%20Publications/GHRH%20and%20Cognition%20in%20Aging.pdf

Walker, R. F. (2006). Sermorelin: A better approach to management of adult-onset growth hormone insufficiency? Clinical Interventions in Aging, 1(4), 307-308. https://pmc.ncbi.nlm.nih.gov/articles/PMC2699646/

Important Information

The FDA does not approve compounded medications for safety, quality, or manufacturing. Some medications dispensed through Liv are compounded; where a product is FDA-approved, its approved labeling governs its use. Prescriptions and a medical evaluation are required for certain products. The information provided on this blog is for general informational purposes only. It is not intended as a substitute for professional advice from a qualified healthcare professional and should not be relied upon as personal health advice. The information contained in this blog is not meant to diagnose, treat, cure, or prevent any disease. Readers are advised to consult with a qualified healthcare professional for any medical concerns, including side effects. Use of this blog's information is at your own risk.

Liv Health is not a medical provider. Liv connects individuals with independent licensed healthcare providers who independently evaluate each patient to determine whether a prescription treatment program is appropriate. All prescriptions are written at the sole discretion of the licensed provider. Medications are filled by state-licensed pharmacies. Please consult a licensed healthcare provider before making any medical decisions.