Hexarelin (Examorelin)
Evidence: C/DGH Axis / Body Composition
Evidence Snapshot
What this grade covers
C for limited small human endocrine, pharmacology, repeated-administration, sleep, and acute cardiovascular physiology studies demonstrating biological activity and short-term surrogate effects; D for therapeutic efficacy, established cardioprotection in humans, cardiovascular clinical outcomes, body-composition improvement, muscle or strength gain, exercise performance, recovery, anti-aging or longevity effects, and long-term safety because adequate controlled clinical outcome evidence is absent.
Regulatory Context
Investigational and not FDA-approved. Human research consists mainly of small acute endocrine and cardiovascular studies; no established approved therapeutic indication or adequate long-term safety program was identified.
Research Takeaway
Hexarelin is a synthetic growth-hormone secretagogue that produces strong acute GH responses in humans.
See all 10 evidence claims →Quick Summary
Hexarelin, also called examorelin, is a synthetic growth-hormone secretagogue and ghrelin-receptor agonist. Small human studies documented strong acute GH release, accompanying prolactin/ACTH/cortisol responses, and short-lived cardiovascular effects. Longer-term cardioprotection and anti-fibrotic findings are primarily preclinical, so they should not be presented as established human benefits.
Mechanism & Research Overview
Hexarelin, also called examorelin, is a synthetic ghrelin-receptor agonist and growth-hormone secretagogue. Small human studies evaluated acute GH and other pituitary-hormone responses. CD36-related cardiac and anti-fibrotic mechanisms have largely been studied preclinically, and they do not establish long-term cardiovascular benefit in humans.
Evidence Grade Breakdown
A single letter grade can't capture how evidence quality differs across approved use, off-label use, and unsupported claims. The categories below break that down -- none of them grade this compound "overall."
Overall Research Grade
Small human studies demonstrate acute GH-axis activity, nonselective endocrine effects, repeated-administration attenuation, sleep-related endocrine effects, and short-term cardiovascular physiological changes. These findings do not establish therapeutic efficacy, human cardioprotection, improved cardiovascular outcomes, body-composition benefit, performance enhancement, recovery benefit, anti-aging effects, or long-term safety.
CHuman Endocrine/Pharmacology Evidence
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Human Endocrine/Pharmacology Evidence
Small human studies consistently demonstrate acute growth-hormone release and additional prolactin, ACTH, and cortisol effects. These studies establish short-term endocrine activity but do not establish therapeutic benefit.
CAcute Human Cardiovascular Physiology
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Acute Human Cardiovascular Physiology
Three small human studies reported short-term changes in ejection fraction, cardiac index, or cardiac output after acute administration. These are physiological or surrogate findings observed over brief periods, not evidence of improved cardiovascular clinical outcomes.
DHuman Therapeutic Outcome Efficacy
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Human Therapeutic Outcome Efficacy
No adequate controlled human trial establishes treatment efficacy for growth-hormone deficiency, fat loss, muscle or strength gain, exercise performance, injury recovery, cardiovascular disease, anti-aging, or longevity.
CDesensitization/Repeated-Administration Evidence
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Desensitization/Repeated-Administration Evidence
Repeated-administration studies show interval-dependent attenuation of the growth-hormone response. A 16-week study in 12 older participants reported progressive attenuation with partial recovery after treatment stopped.
DSafety Evidence
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Safety Evidence
Safety information is limited to small human endocrine, sleep, repeated-administration, and acute hemodynamic studies. No dedicated long-term controlled safety program, adequate pediatric evidence, or Hexarelin-specific FDA safety evaluation is present in the approved source set.
CPreclinical Cardiac/Mechanistic Evidence
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Preclinical Cardiac/Mechanistic Evidence
Animal studies support CD36-mediated cardiac effects, cardiovascular restoration in growth-hormone-deficient rats, and reduced cardiac fibrosis in hypertensive rats. These findings do not establish corresponding human cardioprotection or clinical benefit.
CRegulatory/Product-Identity Evidence
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Regulatory/Product-Identity Evidence
PubChem supports Hexarelin or examorelin identity and distinguishes it from related compounds and formulations. WADA provides contextual anti-doping status. No Hexarelin-specific FDA compounding-category or significant-safety-risk determination is present in the approved source set.
Evidence reviewed
- Regulatory documents
- 2
- Preclinical studies
- 3
- Primary sources reviewed
- 16 of 17
Study counts describe the reviewed evidence base. They do not independently determine evidence quality.
How MitoCore grades evidence
Grade definitions
- A
- Strong and directly applicable evidence, generally including regulatory support or multiple high-quality replicated human trials for the exact claim and population.
- A-
- Strong human evidence with limited uncertainty, narrower applicability, or incomplete replication.
- B+
- Moderately strong evidence with meaningful human support but important scope, duration, safety, or generalizability limitations.
- B
- Credible evidence with notable uncertainty, limited replication, or mixed results.
- C
- Preliminary or inconsistent evidence, usually limited human data or strong indirect evidence.
- D
- Weak, indirect, population-limited, or largely unsupported evidence for the specific use being graded.
- F
- No credible supporting evidence, evidence contradicting the claim, or claims based primarily on speculation or marketing.
Confidence definitions
- High
- The evidence classification is unlikely to change substantially with ordinary additional research.
- Moderate
- The classification is reasonably supported but could change with additional high-quality evidence.
- Low
- The evidence base is sparse, indirect, inconsistent, or dependent on uncertain assumptions.
- Very Low
- The evidence base is extremely limited, speculative, or unsuitable for firm conclusions.
Scope
The grade evaluates the evidence supporting the specific category or claim. A grade does not evaluate product purity, supplier quality, personal suitability, treatment appropriateness, individual outcomes, legality, or medical safety for a specific person.
These grades and confidence levels describe the research evidence itself. They are not medical recommendations, and they do not evaluate any specific product, supplier, or individual's situation.
Evidence Claims
Individual scientific statements drawn from the sources cited below, each shown with the specific evidence boundary that statement does not establish.
Supported
Hexarelin is a synthetic growth-hormone secretagogue that produces strong acute GH responses in humans.
Sources: Effects of GHRP-2 and hexarelin, two synthetic GH-releasing peptides, on GH, prolactin, ACTH and cortisol levels in man. Comparison with the effects of GHRH, TRH and hCRH; Comparison of the effects of growth hormone-releasing hormone and hexarelin on growth hormone secretion in humans with or without glucocorticoid excess
Supported
Hexarelin can also increase prolactin, ACTH, and cortisol, so it is not endocrine-selective for GH.
Supported
Small human studies reported short-lived positive inotropic or cardiac-performance effects after acute hexarelin administration.
Sources: Acute cardiovascular and hormonal effects of GH and hexarelin, a synthetic GH-releasing peptide, in humans; Effects of acute hexarelin administration on cardiac performance in patients with coronary artery disease during by-pass surgery; GH-independent cardiotropic activities of hexarelin in patients with severe left ventricular dysfunction due to dilated and ischemic cardiomyopathy
Supported
Cardioprotection, receptor-mediated cardiac effects, and anti-fibrotic findings are supported mainly by animal models.
Sources: Hexarelin, a growth hormone-releasing peptide, discloses protectant activity against cardiovascular damage in rats with isolated growth hormone deficiency; CD36 mediates the cardiovascular action of growth hormone-releasing peptides in the heart; Chronic administration of hexarelin attenuates cardiac fibrosis in the spontaneously hypertensive rat
Supported
Long-term therapeutic benefit and safety have not been established by adequate controlled outcome trials.
Sources: The cardiovascular action of hexarelin; Impact of two or three daily subcutaneous injections of hexarelin, a synthetic growth hormone (GH) secretagogue, on 24-h GH, prolactin, adrenocorticotropin and cortisol secretion in humans
Supported
Hexarelin, also called examorelin, is distinct from GHRP-2, GHRP-6, ipamorelin, ghrelin, GHRH, CJC-1295, and recombinant human GH; the free molecule, acetate, hydrochloride, TFA, and unspecified commercial material must not be treated as automatically interchangeable.
Supported
Repeated-dose experiments found interval-dependent reductions in GH response and loss of acute synergy with GHRH after repeated hexarelin administration.
Supported
A 16-week study in 12 healthy older participants found that twice-daily subcutaneous hexarelin produced a progressively attenuated GH response; the response recovered after treatment stopped, indicating partial and reversible desensitization.
Sources: Attenuation of GH Response During 16 Weeks of Hexarelin
Supported
In seven healthy volunteers, repetitive nocturnal hexarelin increased GH, ACTH, cortisol, and prolactin but decreased stage-4 sleep and EEG delta power. Hexarelin must not be described as a proven sleep-improvement peptide.
Supported
Relative potency for an acute GH peak does not establish superior therapeutic efficacy, and acute hemodynamic tolerance in small studies does not establish cardiovascular safety. No adequate controlled human evidence establishes that hexarelin treats growth-hormone deficiency, reduces fat, increases muscle or strength, improves exercise performance, accelerates injury recovery, or produces anti-aging or longevity effects.
Sources: Growth hormone-releasing activity of hexarelin in humans. A dose-response study; Attenuation of GH Response During 16 Weeks of Hexarelin
Safety & Evidence Limitations
Considerations reported in the sources cited on this page — not a complete list of every possible risk, and not medical advice.
Higher-Priority Safety Consideration
No adequate long-term controlled safety program or approved indication was identified.Safety Consideration
Human studies found increases in prolactin, ACTH, and cortisol in addition to GH.Safety Consideration
Small studies reported short-lived changes in cardiac performance; the relevance and safety of repeated exposure are uncertain.Safety Consideration
Repeated-administration studies reported attenuation of GH response, complicating extrapolation from single-dose experiments.Safety Consideration
Repetitive nocturnal hexarelin decreased stage-4 sleep and EEG delta power despite increasing GH, ACTH, cortisol, and prolactin; this is not evidence of a sleep benefit.Safety Consideration
Cardioprotection, anti-fibrotic effects, and post-injury benefits are largely preclinical and should not be promoted as established in humans.
Research Areas Being Studied
Research areas discussed on this page reflect the GH Axis / Body Composition category and the sources cited below.
Findings Reported in Studies
Educational summary only — reported in cited studies, not a claim of proven benefit.
- Effects of acute hexarelin administration on cardiac performance in patients with coronary artery disease during by-pass surgery (2002):
- GH-independent cardiotropic activities of hexarelin in patients with severe left ventricular dysfunction due to dilated and ischemic cardiomyopathy (2002):
- Impact of two or three daily subcutaneous injections of hexarelin, a synthetic growth hormone (GH) secretagogue, on 24-h GH, prolactin, adrenocorticotropin and cortisol secretion in humans (2002):
- Acute cardiovascular and hormonal effects of GH and hexarelin, a synthetic GH-releasing peptide, in humans (1999):
- Age-related variations in the neuroendocrine response to hexarelin (1997):
- Effects of GHRP-2 and hexarelin, two synthetic GH-releasing peptides, on GH, prolactin, ACTH and cortisol levels in man. Comparison with the effects of GHRH, TRH and hCRH (1997):
- Comparison of the effects of growth hormone-releasing hormone and hexarelin on growth hormone secretion in humans with or without glucocorticoid excess (1995):
- Growth hormone-releasing activity of hexarelin in humans. A dose-response study (1994):
- Attenuation of GH Response During 16 Weeks of Hexarelin ():
- Nocturnal Hexarelin Effects on Hormones and Sleep ():
- Repeated Hexarelin Administration and GH Response ():
Study Tables by Evidence Type
Human Studies & Clinical Data
| Title | Year | Population / Model | Dose / Duration / Finding | Safety Notes | Source |
|---|---|---|---|---|---|
| Effects of acute hexarelin administration on cardiac performance in patients with coronary artery disease during by-pass surgery | 2002 | 24 coronary artery disease patients undergoing bypass surgery | Prompt increase in ejection fraction, cardiac index, and cardiac output (all p<0.001), lasting up to 90 minutes, without a change in vascular resistance.
| ||
| GH-independent cardiotropic activities of hexarelin in patients with severe left ventricular dysfunction due to dilated and ischemic cardiomyopathy | 2002 | 8 dilated cardiomyopathy + 5 ischemic cardiomyopathy patients, plus healthy/GHD comparison groups | Ejection fraction increased in ischemic cardiomyopathy patients but not dilated cardiomyopathy patients, despite similar GH release in both groups — suggesting direct myocardial stimulation distinct from GH release.
| ||
| Impact of two or three daily subcutaneous injections of hexarelin, a synthetic growth hormone (GH) secretagogue, on 24-h GH, prolactin, adrenocorticotropin and cortisol secretion in humans | 2002 | Human repeated-administration endocrine study | The study evaluated how repeated daily hexarelin exposure affected 24-hour GH, prolactin, ACTH, and cortisol secretion in healthy humans. | Short-term endocrine study; it does not establish long-term clinical outcomes or long-term safety. | |
| Acute cardiovascular and hormonal effects of GH and hexarelin, a synthetic GH-releasing peptide, in humans | 1999 | 7 male volunteers | Hexarelin raised left ventricular ejection fraction from 64.0% to 70.7% (p<0.03), a GH-independent effect; rhGH alone had no cardiac effect.
| ||
| Age-related variations in the neuroendocrine response to hexarelin | 1997 | Healthy subjects across age groups | The study evaluated how age influenced hormonal responses to hexarelin. | Acute endocrine study; does not establish repeated-use safety. | |
| Effects of GHRP-2 and hexarelin, two synthetic GH-releasing peptides, on GH, prolactin, ACTH and cortisol levels in man. Comparison with the effects of GHRH, TRH and hCRH | 1997 | Six healthy young adults and six healthy elderly subjects | GHRP-2 and hexarelin produced strong GH responses and also increased prolactin, ACTH, and cortisol, demonstrating incomplete endocrine selectivity.
| Small, acute physiology study; it does not establish repeated-use safety. | |
| Comparison of the effects of growth hormone-releasing hormone and hexarelin on growth hormone secretion in humans with or without glucocorticoid excess | 1995 | 8 patients with glucocorticoid excess + 6 controls | Hexarelin produced a comparable GH response in both groups, unlike the blunted GHRH-alone response seen in glucocorticoid excess.
| ||
| Growth hormone-releasing activity of hexarelin in humans. A dose-response study | 1994 | Healthy volunteers | The study evaluated acute, dose-related growth-hormone responses to hexarelin in humans. | Small acute pharmacology study; it does not establish long-term therapeutic benefit or safety. | |
| Attenuation of GH Response During 16 Weeks of Hexarelin | 12 healthy older participants | Twice-daily subcutaneous hexarelin over 16 weeks produced a progressively attenuated GH response; the response recovered after treatment stopped, indicating partial and reversible desensitization.
| |||
| Nocturnal Hexarelin Effects on Hormones and Sleep | 7 healthy volunteers | Repetitive nocturnal hexarelin increased GH, ACTH, cortisol, and prolactin but decreased stage-4 sleep and EEG delta power. | Hexarelin must not be described as a proven sleep-improvement peptide based on this finding. | ||
| Repeated Hexarelin Administration and GH Response | Healthy adults (repeated-dose design) | Repeated-dose experiment reporting interval-dependent reductions in GH response and loss of acute synergy with GHRH after repeated hexarelin administration. |
Animal / Cell / Preclinical Data
| Title | Year | Population / Model | Dose / Duration / Finding | Safety Notes | Source |
|---|---|---|---|---|---|
| Chronic administration of hexarelin attenuates cardiac fibrosis in the spontaneously hypertensive rat | 2012 | Spontaneously hypertensive rats | Reduced myocardial collagen I/III deposition; the effect was blocked by a GHS-R antagonist, indicating a GHS-R-dependent fibrosis pathway distinct from the GH-independent CD36 pathway (both mechanisms are real and coexist).
| ||
| CD36 mediates the cardiovascular action of growth hormone-releasing peptides in the heart | 2002 | Rat cardiac membrane receptor purification; CD36-null mice | Identified CD36 (not GHS-R1a) as hexarelin's specific cardiac receptor; the cardiac effect was absent in CD36-null mice, establishing a GH-independent cardioprotective mechanism. | ||
| Hexarelin, a growth hormone-releasing peptide, discloses protectant activity against cardiovascular damage in rats with isolated growth hormone deficiency | 1997 | GHRH-antibody-induced growth-hormone-deficient rats | Fully restored somatotropic function and reversed cardiac/endothelial dysfunction.
|
Regulatory Documents & Official Trial Registries
| Title | Year | Population / Model | Dose / Duration / Finding | Safety Notes | Source |
|---|---|---|---|---|---|
| 2026 World Anti-Doping Agency Prohibited List | 2026 | Anti-doping regulatory standard | WADA lists growth-hormone-releasing factors and secretagogues, including CJC-1295, sermorelin, GHRP-2, GHRP-6, and examorelin/hexarelin, as prohibited in sport. | Anti-doping status is not a clinical safety or efficacy determination. | |
| PubChem Examorelin / Hexarelin Record | PubChem identity record for hexarelin (examorelin), a synthetic six-amino-acid peptidyl growth-hormone secretagogue and ghrelin-receptor agonist, a modified GHRP-family compound containing non-natural amino-acid residues. |
Review Articles / Secondary Sources
| Title | Year | Population / Model | Dose / Duration / Finding | Safety Notes | Source |
|---|---|---|---|---|---|
| The cardiovascular action of hexarelin | 2014 | Review of the CD36 mechanism and cardiac trial data | Synthesizes the CD36-mediated cardioprotective mechanism and the human cardiac trial data for hexarelin. |
Anecdotal Reported Patterns — Not Medical Advice
Anecdotal Reported Patterns — Not Medical Advice
Reported dosing patterns are included for educational context only. They are self-reported, unverified, not medical advice, and not instructions for human use. Community-submitted patterns are not yet available in this Phase 1 prototype; this section is a placeholder reserved for moderated, aggregated community data.
Lab Markers to Discuss With a Clinician
Educational topics only — not self-monitoring instructions.
FAQ
Disclaimer
Educational research summary only. This page does not provide medical advice, treatment guidance, product-quality assurance, or instructions for human use.
Educational use only. This content is provided for informational and research-summary purposes only. It is not medical advice, not a treatment recommendation, not a dosing guide, and not a substitute for care from a licensed medical professional. Nothing here is intended to diagnose, treat, cure, prevent, or mitigate disease. Reported dosing patterns, when shown elsewhere on the site, must be labeled either as Study / Trial Dosing or Anecdotal Reported Patterns — Not Medical Advice. Community reports are self-reported, unverified, and not scientific proof.
Community-reported experiences, once enabled, must be displayed only as moderated, anonymized, or aggregated data. They are anecdotal, self-reported, unverified, and should never be presented as proof of safety, efficacy, or expected results.
Content status: Content pending review. Last updated 2026-07-26.
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