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The Peptide Effect
preclinicalGrowth Hormone

Hexarelin

Also known as: Examorelin, HEX, Hexarelin Acetate, EP-23905

Hexarelin is a synthetic hexapeptide growth hormone secretagogue and one of the most potent members of the GHRP (Growth Hormone Releasing Peptide) family. It acts on the ghrelin/GHS receptor to stimulate robust GH release from the pituitary. Beyond its GH-releasing properties, hexarelin has demonstrated unique cardioprotective effects that appear to be independent of GH, acting directly on cardiac tissue through the CD36 scavenger receptor.

Key Facts

Mechanism
Hexarelin binds to the growth hormone secretagogue receptor (GHS-R1a) on pituitary somatotrophs, triggering a potent GH release pulse. It is structurally based on GHRP-6 with modifications that enhance its GH-releasing potency. Unlike ipamorelin, hexarelin is not selective — it also stimulates ACTH, cortisol, and prolactin release. Its cardioprotective effects are mediated through binding to the CD36 scavenger receptor on cardiomyocytes, which activates peroxisome proliferator-activated receptor gamma (PPARgamma) signaling, reduces oxidative stress, and protects against ischemia-reperfusion injury. Notably, hexarelin is prone to rapid tachyphylaxis (receptor desensitization) with continuous use.
Research Status
preclinical
Half-Life
~70 minutes
Molecular Formula
C₄₇H₅₈N₁₂O₆
Primary Use
Growth Hormone
Table of Contents

Benefits

  • One of the most potent GH-releasing peptides, producing a strong acute GH surgestrong
  • Cardioprotective effects independent of GH release, mediated through the CD36 receptormoderate
  • May protect cardiac tissue from ischemia-reperfusion injurypreliminary
  • Joint and connective tissue healing support through GH/IGF-1 elevationpreliminary
  • Supports lean body mass and improved body composition during GH elevationmoderate

Dosage Protocols

RouteDosage RangeFrequencyNotes
Subcutaneous injection200 mcg2–3× dailyInject on an empty stomach; avoid continuous daily use beyond 4–8 weeks due to desensitization
Subcutaneous injection100–200 mcgOnce daily at bedtimeLower-dose protocol used to minimize cortisol/prolactin effects while still enhancing nocturnal GH pulse
Subcutaneous injection200 mcg2× daily, 5 days on / 2 days offIntermittent cycling protocol designed to reduce receptor desensitization while maintaining GH benefits

Medical disclaimer

Dosage information is provided for educational reference only. Always follow your prescriber's instructions and consult a qualified healthcare provider before starting any peptide protocol.

Side Effects

  • Elevated cortisol and prolactin levels (non-selective GH secretagogue)common
  • Increased appetite and hunger from ghrelin pathway activationcommon
  • Water retention and bloatingcommon
  • Rapid desensitization (tachyphylaxis) with continuous daily use — diminishing GH responsecommon
  • Tingling or numbness in extremitiesrare

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Frequently Asked Questions

How does hexarelin compare to ipamorelin?
Hexarelin produces a more potent acute GH release than ipamorelin, but at the cost of selectivity. Hexarelin significantly elevates cortisol, prolactin, and appetite, while ipamorelin does not. Hexarelin also desensitizes quickly with continuous use, whereas ipamorelin can be used for longer periods. For most users seeking clean GH elevation, ipamorelin is preferred. Hexarelin may be chosen when maximum GH output is the primary goal, or when its cardioprotective properties are desired.
Why does hexarelin cause desensitization and how can it be avoided?
Hexarelin causes rapid desensitization (tachyphylaxis) of the GHS-R1a receptor with continuous daily use, typically within 4–8 weeks. The GH response progressively diminishes even at higher doses. Strategies to mitigate desensitization include intermittent cycling (e.g., 5 days on / 2 days off), limiting cycles to 4–8 weeks with equal off periods, or rotating with other GH secretagogues. Complete receptor sensitivity typically returns after 2–4 weeks off.
How does the cardioprotective effect of hexarelin work?
Hexarelin binds to the CD36 scavenger receptor on cardiomyocytes, independent of GHS-R1a. This activates PPARgamma signaling, reduces reactive oxygen species, decreases apoptosis in cardiac cells, and protects against ischemia-reperfusion injury. These effects have been demonstrated in animal models and isolated human cardiac tissue. Importantly, these cardioprotective effects are not shared by all GHRPs — they appear specific to hexarelin and are independent of its GH-releasing activity.
Is hexarelin suitable for long-term anti-aging use?
Hexarelin is generally not the best choice for long-term anti-aging protocols due to its rapid desensitization, cortisol/prolactin elevation, and appetite-stimulating effects. Ipamorelin or CJC-1295 + ipamorelin are typically preferred for sustained, long-term GH optimization. Hexarelin may be useful in short-term, high-output cycles or when specifically targeting its cardioprotective benefits. Always consult a healthcare provider for personalized protocol design.
Can hexarelin be stacked with a GHRH analog?
Yes. Like other GHRPs, hexarelin can be combined with GHRH analogs such as CJC-1295 or sermorelin for synergistic GH release. The GHRH analog amplifies the pulse initiated by hexarelin, potentially producing a greater total GH output. However, the cortisol and prolactin elevation from hexarelin will still occur, and desensitization remains a concern. Monitor hormone levels with blood work when using this combination.

References

  1. 1
    Hexarelin, a synthetic growth hormone secretagogue, and cardiac function(1996)PubMed ↗
  2. 2
    Cardiac effects of hexarelin in GH-deficient and healthy subjects: mediation through a specific cardiac receptor(2000)PubMed ↗
  3. 3
    Hexarelin protects the heart from ischemia-reperfusion injury via the CD36 scavenger receptor(2005)PubMed ↗
  4. 4
    Growth hormone secretagogues: cardiovascular effects and therapeutic potential(2007)PubMed ↗

Last updated: 2026-02-14