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Growth HormoneModerate Evidence

Hexarelin (Examorelin)

Hexarelin is a synthetic hexapeptide GH secretagogue with a unique dual mechanism: it activates both the ghrelin receptor (GHS-R1a) for GH release and CD36 cardiac receptors for heart protection. Post-MI mortality dropped from 50% to 6.7% in hexarelin-treated mice. It's roughly 10x more potent than endogenous ghrelin but causes the fastest receptor desensitization of any GHRP.

FormBlends Peptide Context

Reviewed May 14, 2026

Read Hexarelin peptide guide with the practical follow-up in mind. If the topic involves peptide therapy, the next useful step is usually to verify evidence strength, access rules, pharmacy pathway, total cost, and the personal safety details that only a clinician can review.

  • Confirm whether the page is discussing approved care, compounded access, off-label use, or research-only context.
  • Check the date, evidence quality, safety limits, and whether newer clinical or regulatory updates may change the answer.
  • Ask a licensed clinician how the information applies to your history, medications, labs, goals, and risk profile.

Clinical decision snapshot

Hexarelin authority snapshot

Hexarelin is evaluated by mechanism, evidence quality, regulatory status, practical access, and safety questions a licensed clinician would need to review before use.

Age-related GH declineCardiac protection researchPost-MI recovery (preclinical)Sarcopenia

Evidence signal

Meaningful evidence with limits

Regulatory reality

Not on Category 2 list; not affected by 2026 reclassification

Safety screen

Cortisol elevation (dose-dependent, more pronounced than GHRP-6 at comparable doses), Prolactin elevation (dose-dependent), Receptor desensitization (documented decline in GH response by week 4) should be reviewed in context.

This page currently connects to 6 source-backed evidence items through visible references or structured citation data.

Decision path

What is the supervised-review path for Hexarelin?

Hexarelin should be evaluated by evidence quality, safety status, source quality, dosing context, and whether the goal fits a legitimate clinical pathway. This page is a research and decision aid, not a self-prescribing guide.

Peptide
Hexarelin
Category
Growth Hormone
Evidence
Meaningful evidence with limits
FDA status
Not FDA approved

Step 1

Check evidence level

Hexarelin's cardiac mechanism is well-characterized. Bodart et al. (Circulation Research 2002, PMID: 11988484) identified CD36 as the cardiac receptor with dose-dependent coronary perfusion effects confirmed in CD36-null mice. Mao et al. (PMID: 28321024) showed cardiomyocyte protection from ischemia/reperfusion through IL-1 signaling. GH release kinetics studied extensively by Arvat/Ghigo group (JCEM 1994, PMID: 7962341).

Review evidence

Step 2

Screen safety context

Cortisol elevation (dose-dependent, more pronounced than GHRP-6 at comparable doses), Prolactin elevation (dose-dependent), Receptor desensitization (documented decline in GH response by week 4) should be discussed in light of history, dose, and source.

Check side effects

Step 3

Confirm access route

If FormBlends offers access, review the product page and provider pathway before deciding.

Review product access

Last updated: April 6, 2026

Typical Dosage

100 mcg subcutaneous (flat dose for ~80 kg adult), 1-2x daily. Weight-based: 1.0-2.0 mcg/kg. Cycle 12-16 weeks on, 4-6 weeks off mandatory (receptor desensitization documented by week 4).

Administration

Subcutaneous injection, Intranasal (lower bioavailability)

Typical Cost

$40-80 per 2 mg vial (research); $150-300/month if clinic-sourced

FDA Status

Not FDA Approved

Half-Life

55-76 minutes in plasma. GH peaks at approximately 30 minutes and returns to baseline by 240 minutes.

Onset of Action

Peak GH release at 30 minutes post-injection. Cardiac perfusion effects are dose-dependent and immediate. Receptor desensitization begins by week 4 of continuous use.

Bioavailability

High subcutaneous. Lower intranasal and oral (detectable GH response but reduced magnitude).

About Hexarelin

Hexarelin is a synthetic hexapeptide with the sequence His-D-2-MeTrp-Ala-Trp-D-Phe-Lys-NH2. CAS number: 140703-51-1. Molecular weight: 887.04 Da. Also known by its INN name examorelin. Every GHRP releases growth hormone through the ghrelin receptor. What makes hexarelin different is the CD36 story. In 2002, Bodart et al. published in Circulation Research (PMID: 11988484) that they'd identified CD36 as a specific cardiac binding target for hexarelin. Using a radioactive photoactivatable hexarelin derivative on rat cardiac membranes, they showed that CD36 activation increases coronary perfusion pressure in a dose-dependent manner. The effect was completely absent in CD36-null mice, confirming the receptor specificity. The cardiac data that followed is hard to dismiss. In a mouse MI model, post-infarction mortality was 6.7% in the hexarelin group versus 50% in vehicle controls. Hexarelin-treated animals showed superior cardiac output, ejection fraction, and diastolic function. Mao et al. (PMID: 28321024) later showed the protection mechanism involves IL-1 signaling pathway activation that inhibits cardiomyocyte apoptosis during ischemia/reperfusion. No other GHRP has this cardiac mechanism. GHRP-6 has some cytoprotective data (also through CD36), but hexarelin's cardiac binding is the most characterized. This makes hexarelin uniquely relevant for cardiac research despite its other drawbacks. And there are drawbacks. Hexarelin causes the most cortisol and prolactin elevation of any GHRP and desensitizes its receptor faster than any of them. The University of Turin group (Ghigo/Arvat) documented declining GH response by week 4 of continuous use, with further decline by week 16. Recovery requires a 4-6 week washout period. This mandatory cycling makes hexarelin impractical for sustained GH optimization compared to ipamorelin (which shows minimal desensitization). GH response is age-dependent. Arvat et al. (JCEM 1994, PMID: 7962341) showed that hexarelin's GH-releasing effect is blunted in elderly subjects (65-84 years) compared to young adults (24-30 years). However, co-administration of arginine fully restored the blunted response, suggesting the age-related decline is functional rather than structural. The standard dose is 100 mcg subcutaneous, 1-2x daily. The ED50 is 0.50 mcg/kg, and 1.0 mcg/kg reaches about 95% of maximum GH output. Going higher than that adds more side effects without more GH.

How Hexarelin Works

Hexarelin binds two distinct receptors. At GHS-R1a on pituitary somatotrophs, it activates adenylyl cyclase and PKC/IP3 pathways to trigger GH release (about 10x more potent than native ghrelin). At CD36 scavenger receptors on cardiomyocytes and microvascular endothelial cells, it increases coronary perfusion pressure in a dose-dependent manner. This cardiac effect was confirmed in CD36-null mice, where it was completely absent. The CD36 mechanism is what separates hexarelin from every other GHRP.

Receptor targets:

GHS-R1a (pituitary/hypothalamus, GH release)CD36 (cardiac, coronary perfusion)

Benefits

  • Strongest GH release of any GHRP (~10x endogenous ghrelin potency)
  • Unique cardiac protection through CD36 receptor (no other GHRP has this)
  • Post-MI mortality: 6.7% hexarelin vs 50% vehicle in mouse model
  • Protects cardiomyocytes from ischemia/reperfusion injury via IL-1 signaling
  • GH response can be restored in elderly by adding arginine

What Does the Research Say?

Hexarelin's cardiac mechanism is well-characterized. Bodart et al. (Circulation Research 2002, PMID: 11988484) identified CD36 as the cardiac receptor with dose-dependent coronary perfusion effects confirmed in CD36-null mice. Mao et al. (PMID: 28321024) showed cardiomyocyte protection from ischemia/reperfusion through IL-1 signaling. GH release kinetics studied extensively by Arvat/Ghigo group (JCEM 1994, PMID: 7962341).

CD36 mediates the cardiovascular action of growth hormone-releasing peptides in the heart

Circulation Research, 2002 · DOI · PubMed

Identified CD36 as the specific cardiac receptor for hexarelin with dose-dependent coronary perfusion effects; absent in CD36-null mice

Arginine and GHRH restore the blunted GH-releasing activity of hexarelin in elderly subjects

Journal of Clinical Endocrinology and Metabolism, 1994 · DOI · PubMed

Hexarelin GH response is age-dependent and blunted in elderly (65-84 yr), but arginine co-administration fully restores the response

Hexarelin protects rat cardiomyocytes from in vivo ischemia/reperfusion injury through interleukin-1 signaling pathway

Regulatory Peptides, 2014 · PubMed

Hexarelin protects cardiomyocytes from ischemia/reperfusion injury by inhibiting apoptosis through IL-1 signaling pathway

PubMed evidence trail

Research sources used to frame this page

For Hexarelin, FormBlends checks the page topic against primary trials, systematic reviews, guidelines, and current PubMed-indexed literature where available. These citations are context, not a claim that every study applies to every patient.

Potential Side Effects

  • Cortisol elevation (dose-dependent, more pronounced than GHRP-6 at comparable doses)
  • Prolactin elevation (dose-dependent)
  • Receptor desensitization (documented decline in GH response by week 4)
  • Hunger spikes (temporary, ghrelin-related)
  • Water retention (mild)
  • Tingling in extremities
  • Risk of Cushing's-like symptoms at sustained high doses

Drug Interactions

CompoundInteractionSeverity
Glucocorticoids/corticosteroidsMay compound cortisol elevation effects from hexarelin.moderate
Other GHRPs (ipamorelin, GHRP-2, GHRP-6)Stacking adds no benefit due to shared GHS-R1a receptor competition. Accelerates desensitization.moderate
Insulin and diabetes medicationsGH antagonizes insulin action. Hexarelin-induced GH may worsen glycemic control.moderate

Who Is Hexarelin For?

Women

GH release occurs in both sexes. Women may have slightly higher GH response due to estrogen's potentiating effect. Prolactin elevation may be more clinically relevant in women (monitor for galactorrhea).

Adults Over 50

GH response is blunted in elderly (65-84 yr) but can be fully restored by adding arginine (Arvat et al., JCEM 1994). Cardiac benefits through CD36 may be particularly relevant for this age group. Mandatory cycling is especially important due to faster desensitization.

Athletes

Prohibited at all times by WADA under S2. Detectable in anti-doping tests. No exceptions.

Regulatory Status

FDA Approved

No

Compounding Legal

No

2026 HHS Status

Not on Category 2 list; not affected by 2026 reclassification

Hexarelin was not specifically placed on the FDA Category 2 restricted list (that list targeted BPC-157, TB-500, GHK-Cu, ipamorelin, GHRP-2, GHRP-6, etc.). However, it is not available through standard compounding pharmacy channels for human use.

Last verified: 2026-04-06

Stacking Options

Hexarelin is commonly stacked with the following peptides for enhanced results:

Conditions Addressed

Age-related GH declineCardiac protection researchPost-MI recovery (preclinical)Sarcopenia

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Frequently Asked Questions

What is Hexarelin?
Hexarelin is a synthetic hexapeptide GH secretagogue with a unique dual mechanism: it activates both the ghrelin receptor (GHS-R1a) for GH release and CD36 cardiac receptors for heart protection. Post-MI mortality dropped from 50% to 6.7% in hexarelin-treated mice. It's roughly 10x more potent than endogenous ghrelin but causes the fastest receptor desensitization of any GHRP.
What are the benefits of Hexarelin?
Strongest GH release of any GHRP (~10x endogenous ghrelin potency). Unique cardiac protection through CD36 receptor (no other GHRP has this). Post-MI mortality: 6.7% hexarelin vs 50% vehicle in mouse model. Protects cardiomyocytes from ischemia/reperfusion injury via IL-1 signaling. GH response can be restored in elderly by adding arginine.
What is the typical dosage for Hexarelin?
100 mcg subcutaneous (flat dose for ~80 kg adult), 1-2x daily. Weight-based: 1.0-2.0 mcg/kg. Cycle 12-16 weeks on, 4-6 weeks off mandatory (receptor desensitization documented by week 4).
What are the side effects of Hexarelin?
Common side effects include Cortisol elevation (dose-dependent, more pronounced than GHRP-6 at comparable doses), Prolactin elevation (dose-dependent), Receptor desensitization (documented decline in GH response by week 4), Hunger spikes (temporary, ghrelin-related), Water retention (mild), Tingling in extremities, Risk of Cushing's-like symptoms at sustained high doses.
How much does Hexarelin cost?
$40-80 per 2 mg vial from research suppliers; $150-300/month from specialty clinics.
Is Hexarelin FDA approved?
Not FDA approved. Hexarelin was not specifically placed on the FDA Category 2 restricted list (that list targeted BPC-157, TB-500, GHK-Cu, ipamorelin, GHRP-2, GHRP-6, etc.). However, it is not available through standard compounding pharmacy channels for human use.
How strong is the evidence for Hexarelin?
Hexarelin's cardiac mechanism is well-characterized. Bodart et al. (Circulation Research 2002, PMID: 11988484) identified CD36 as the cardiac receptor with dose-dependent coronary perfusion effects confirmed in CD36-null mice. Mao et al. (PMID: 28321024) showed cardiomyocyte protection from ischemia/reperfusion through IL-1 signaling. GH release kinetics studied extensively by Arvat/Ghigo group (JCEM 1994, PMID: 7962341).