The usual comparison sets the two up as rivals for the same job: more growth hormone. That skips the part that decides most of the answer. HGH, sold as somatropin, is an approved drug with a federal law aimed at how it is distributed [1]. Sermorelin is a once-approved drug that reaches patients today only through compounding [4].
HGH is the hormone; sermorelin is a signal to make more
Somatropin is recombinant human growth hormone. The Genotropin label calls it exactly that, "a recombinant human growth hormone" [2]. A dose adds growth hormone to your blood whether or not your pituitary is working.
Sermorelin contains no growth hormone. It is a lab-made copy of the first 29 amino acids of growth-hormone-releasing hormone (GHRH), the signal your hypothalamus sends to the pituitary [6]. Its effect depends on a pituitary that can still respond. That is also why its first approval was as a diagnostic test of pituitary function [4].
Side by side: approved replacement against a compounded signal
| Sermorelin | HGH (somatropin) | |
|---|---|---|
| What it is | GHRH(1-29), a fragment of the releasing hormone | Recombinant human growth hormone [2] |
| How it acts | Prompts the pituitary to release its own growth hormone | Replaces growth hormone directly |
| FDA status | Approved as Geref until 2009; withdrawn at the maker's request, not for safety [4] | FDA-approved; several brands, such as Genotropin |
| Labeled uses | None current; formerly a pituitary test and children with GH deficiency | Adults with adult-onset or childhood-onset GH deficiency; five pediatric growth conditions [2] |
| Distribution limits | No sermorelin-specific federal distribution rule found | 21 U.S.C. §333(e): authorized uses on a physician's order only [1] |
| Adult evidence | 11 older men, 6 weeks, no control [7] | FDA-approved for adult GH deficiency [2] |
| How patients get it | Compounded drug, by prescription | Approved brand, by prescription for a labeled condition |
| Sport | Prohibited at all times, WADA S2.2.4 [9] | Prohibited at all times, WADA S2.2.3 [9] |
What federal law says about distributing HGH
HGH has its own section in the federal drug law. Most prescription drugs can be prescribed off-label at a doctor's judgment. Growth hormone is treated differently, and the core of the statute is short enough to quote:
Whoever knowingly distributes, or possesses with intent to distribute, human growth hormone for any use in humans other than the treatment of a disease or other recognized medical condition, where such use has been authorized by the Secretary of Health and Human Services under section 355 of this title and pursuant to the order of a physician, is guilty of an offense punishable by not more than 5 years in prison, such fines as are authorized by title 18, or both.[1]
The next paragraph raises the maximum to 10 years when the offense involves someone under 18. The statute then defines its term: "human growth hormone" means "somatrem, somatropin, or an analogue of either of them" [1]. The statute authorizes the Drug Enforcement Administration to investigate violations.
In plain terms, the uses that count are the ones FDA has approved, and a physician has to order them. Anti-aging, body composition and athletic recovery are not approved uses of any somatropin product. This is a description of the statute, not legal advice. Questions about your own treatment belong with a prescriber.
What HGH is approved for, from the Genotropin label
The Genotropin label lists its uses in section 1. For adults, it is approved to treat adults with "either adult onset or childhood onset GHD", growth-hormone deficiency [2]. For children, it covers growth failure from growth-hormone deficiency, Prader-Willi syndrome, being born small for gestational age, Turner syndrome and idiopathic short stature.
The same label lists what to watch for in section 5 [2]. Those are FDA-reviewed risks of the real hormone at prescribed doses. The headings include:
- Increased mortality in patients with acute critical illness
- Tumor progression or recurrence, and second tumors in childhood cancer survivors
- Impaired glucose tolerance and diabetes
- Raised pressure inside the skull
- Serious allergic reactions
- Fluid retention, "especially in adults"
- Low adrenal or thyroid function, and pancreatitis
What sermorelin was approved for, and what has been studied since
Geref was approved in 1990 as a pituitary test and in 1997 for children with growth-hormone deficiency [4]. In the children's study, 110 untreated children with the deficiency took it for up to a year, and height velocity rose from 1.6 inches (4.1 cm) a year to 3.1 inches (8.0 cm) at 6 months [6]. The maker stopped selling it in 2008, and FDA withdrew the approvals in 2009 [5]. In 2013 FDA found the withdrawal was not for safety or effectiveness reasons [4].
Adult evidence is where sermorelin thins out. In 11 healthy men aged 64 to 76, 6 weeks raised night-time growth hormone but didn't change IGF-1, weight, or muscle and fat on DEXA scans [7]. A second study used a close analog, not sermorelin, in 19 older adults [8]. The full approval history is on is sermorelin FDA approved, and the adult evidence is weighed in does sermorelin work.
| Source | Drug | Who | What it shows |
|---|---|---|---|
| Genotropin label [2] | Somatropin | Adults with GH deficiency; 5 pediatric conditions | FDA-approved uses, with an FDA-reviewed safety section |
| Thorner 1996 [6] | Sermorelin | 110 children with GH deficiency, open-label | Height velocity 1.6 to 3.1 inches (4.1 to 8.0 cm) a year at 6 months |
| Vittone 1997 [7] | Sermorelin | 11 healthy men aged 64 to 76 | Night-time GH up; IGF-1, muscle and fat unchanged |
| Head-to-head adult trial | Both | None found | Unknown |
Is HGH better than tesamorelin? They are approved for different things
Tesamorelin is a GHRH analog, like sermorelin, sold as Egrifta. Its label approves one use: "the reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy" [3]. It also says Egrifta "is not indicated for weight loss management." Somatropin's approvals are for growth-hormone deficiency and childhood growth conditions. No trial has compared the two, because they treat different conditions. Tesamorelin against sermorelin is on tesamorelin vs sermorelin.
Side effects: HGH has an FDA-reviewed list, sermorelin has no current label
Somatropin's risks are the section 5 headings above, from fluid retention to blood-sugar changes, measured in trials and reviewed by FDA [2]. Sermorelin's small studies reported it well tolerated, with no adverse changes in routine blood tests in the children's trial [6]. Those studies were short and decades old, and with no current label there is no up-to-date official list. The known and unknown risks are on is sermorelin safe.
If your interest is growth hormone, the first step is the same for both: ask a clinician whether testing for growth-hormone deficiency fits your situation. Peptides with no pharmacy route, such as CJC-1295, don't belong in that comparison at all. How this site reads regulatory records is set out in how we check.