Hexarelin — Potent Growth Hormone Secretagogue — Growth Hormone

Synthetic hexapeptide GHSR agonist producing potent GH release. Research peptide with some clinical trial data.

Overview

Hexarelin (Examorelin, HEX) is a synthetic hexapeptide growth hormone secretagogue that activates the growth hormone secretagogue receptor (GHSR-1a), also known as the ghrelin receptor. Developed in the 1990s, hexarelin is one of the most potent GHRPs in terms of acute GH release. In clinical studies, a single subcutaneous injection of hexarelin 1-2 mcg/kg produced GH peaks of 30-80 ng/mL within 15-30 minutes, significantly exceeding the response to GHRH alone. Unlike GHRH analogs, hexarelin acts through the ghrelin receptor pathway, which has both GH-releasing and non-GH effects including cardioprotective properties. Studies have demonstrated that hexarelin improves cardiac function in heart failure patients, protects against ischemia-reperfusion injury, and has direct cardioprotective effects mediated through cardiac GHSR-1a receptors (CD36). However, hexarelin is notable for rapid desensitization — with daily use, GH responses can diminish within 2-4 weeks, necessitating cycling or intermittent dosing. Hexarelin also causes more cortisol and prolactin elevation than ipamorelin, making ipamorelin the preferred GHRP for most optimization applications. Hexarelin has completed Phase 2 trials in GH deficiency and heart failure but has not progressed to approval.

Indications

  • Investigational: GH deficiency — Phase 2
  • Investigational: Heart failure (cardioprotective effects) — Phase 2
  • Unapproved: GH release and body composition (research/anti-aging)

Mechanism of Action

Hexarelin activates the growth hormone secretagogue receptor (ghrelin receptor) on pituitary somatotrophs, triggering intracellular calcium release and GH secretion

Dosing

CompoundDoseFrequencyNotes
Hexarelin100-200 mcg1-3 times dailyCommon research dose; cycle to prevent desensitization
Hexarelin1-2 mcg/kgOnce dailyClinical trial dose range

Evidence Grade

GRADE C

Safety & Contraindications

  • Cortisol elevation — more pronounced than ipamorelin
  • Prolactin elevation — monitor for symptoms
  • Rapid desensitization with chronic daily use (2-4 weeks)
  • Hunger stimulation (less than GHRP-6, more than ipamorelin)
  • Injection site reactions
  • Not FDA-approved — research peptide