# Hexarelin

Most potent GHRP; fast desensitisation, acute cortisol/prolactin rise and direct CD36 heart effects.

- Page: https://peprank.xyz/peptides/hexarelin
- Category: Hormones & libido (Research peptide)
- Also known as: examorelin; 'hex'
- Routes: Injection
- Safety tier: Strict: Avoid · Balanced: Caution · Evidence only: Caution
- Risk axes (0 none to 3 severe): Seen harm 0, Mechanism 2, Data gap 2, Silent harm 3, Product 3
- Positive: 45% of 5 graded reports glowing or positive, shrunk toward the 49% all-report average by 8 reports' weight
- Rank: #42 of 61 research peptides
- Graded reports: 5 (Positive 2, Mixed 2, Negative 1)
- Evidence: Small human studies — Acute dosing in volunteers and patients; one 16-week trial in 12 elderly adults; developed in the 1990s, never approved
- Access: Grey market
- Onset: Within the hour: the GH pulse and, in studies, the rise in heart contractility (peaking at 30 minutes after IV dosing).
- Lasts: Short-acting: each dose gives a GH pulse of a couple of hours; the cardiac effect lasted up to an hour after IV dosing.
- Cost per month: ≈ €27–110 (researchers' estimate)
- Updated: 2026-10-30

**Why Avoid under the strict bar:** GH/IGF-1 axis elevation, acute cortisol and prolactin release, and GH-independent actions on heart and coronary vessels via CD36.

## What users report

Only five first-hand reports, too few to judge. Users describe it as the strongest GHRP ('powerful', 'awesome but strong'), cycled a month on and a month off because the response 'burns out'. One user felt better than ever but watched his resting heart rate climb; another gets a flu-like, tired, sore feeling at 100 mcg a day. One raised the dose expecting prolactin or cortisol side effects and got only strong hunger. Most replies to hexarelin threads advise switching to ipamorelin or plain GH, and warn about gynecomastia from prolactin, though no first-hand case appears. Felt nothing: None of the 5 reports felt nothing, but there are too few to say..

**Effects:** largest acute GH pulse of the GHRPs; strong hunger; acute rise in heart contractility (in studies)

**Downsides:** response fades within weeks of daily use; flu-like tiredness and soreness for some; resting heart rate increase (one report); hunger

**Risks:** GH/IGF-1 axis elevation (glucose, theoretical neoplasm promotion); Acute ACTH, cortisol and prolactin release after each dose (Arvat 1997; Maccario 2002); Binds CD36 in heart and vessels: raised coronary perfusion pressure (vasoconstriction) in perfused rodent hearts; Acute positive inotropic effect in humans; long-term cardiac effects of repeated dosing unstudied

**Caveat:** The prolactin and cortisol rises are well documented after single IV doses but did not persist with modest twice-daily subq dosing over 16 weeks; community doses are often higher. The cardiac findings are acute and partly in heart patients, so they say little about months of use either way.

**Typical use:** Users: 100-200 mcg subq 1-2x/day, fasted, 4 weeks on and 4 off. Trials used 1-2 mcg/kg IV or 1.5 mcg/kg subq twice daily.

**Getting it:** Research-peptide vials (2-5 mg) and blends with GHRP-6 and mod-GRF. Never approved anywhere; WADA-prohibited as examorelin.

**Stacked with:** Tesamorelin or CJC-1295 (Run together for a bigger GH pulse; users pair a GHRH in the morning with hexarelin before training.); Ipamorelin (Rotated in during hexarelin's off-months to avoid desensitisation.); Cabergoline (Commenters tell hexarelin users to keep it on hand against prolactin; no first-hand report shows it was needed.)

## Risk profile

- **Seen harm 0/3:** No published case reports, label warnings or trial SAE signals in the human studies, which include a 16-week trial in 12 elderly adults and acute IV dosing in heart-failure and bypass-surgery patients. Reddit adds one rising resting heart rate and one flu-like reaction, neither serious. The zero reflects small documented exposure, not reassurance.
- **Mechanism 2/3:** Two credible pathways. Hormone axis: the strongest GH release of the GHRPs plus acute prolactin, ACTH and cortisol rises comparable to a CRH challenge (though these did not persist at 1.5 mcg/kg twice daily over 16 weeks). Heart: it binds CD36, raised coronary perfusion pressure (vasoconstriction) in perfused rodent hearts and acutely raises ejection fraction in people independently of GH. No in-vivo demonstration of serious harm, so 2.
- **Data gap 2/3:** Never approved. Human data are small studies: acute IV challenges in groups of 6-20, one 16-week subq trial in 12 elderly adults, and 6-10 months of intranasal dosing in 7 children. No controlled trial of repeated subcutaneous use in healthy adults.
- **Silent harm 3/3:** The feared harms are theoretical IGF-1-driven tumour promotion and unknown long-term effects of repeated CD36 and inotropic stimulation on the heart and coronary vessels, both silent and delayed (3). Glucose effects would show on a blood test; hunger and flu-like feelings are immediate.
- **Product 3/3:** Bought as grey-market injectable vials (2-5 mg) or premixed 'gaining blends' with GHRP-6 and mod-GRF, reconstituted at home and injected daily.
- **Never if:** Pregnancy or breastfeeding (no human reproductive data); Active or past cancer; Coronary artery disease, heart failure or arrhythmia (direct cardiac and coronary CD36 effects); Diabetes or prediabetes; Pituitary tumours, including prolactinoma; Under 18

## Top reports

- Positive, recovery: “Hexarelin is awesome as a ghrp but strong. If you run it treat it like igf1-lr3. Month on then a month off. Hexarelin will burn out your receptors.” — [r/BodyHackGuide](https://www.reddit.com/r/BodyHackGuide/comments/1nxy3c1/ghrhghrp_cycling_question/nhsb490/)
- Positive, recovery, 10 mg over 14 days, 14 off, repeated: “The protocol was 10mg (2mL dilution) over 14 days. 14 days off. Then 10mg over 14 days. He was pleased with the outcome. He said it is powerful, so note all changes and stay aware.” — [r/Peptidesource](https://www.reddit.com/r/Peptidesource/comments/1tuhcin/hexarelin/op9lxpn/)
- Mixed, recovery: “i genuinely have never felt better. but realised my resting HR is increasing after taking Hexarelin” — [r/BiohackingU](https://www.reddit.com/r/BiohackingU/comments/1toh1io/should_i_drop_all_gh_secretagogues_and_just/)
- Mixed, recovery: “I was waiting for some prolactin/cortisol side effects as I upped the dose a decent bit but all I got was hungry as fuck” — [r/DrWillPowers](https://www.reddit.com/r/DrWillPowers/comments/1mrgijf/pioglitazone_and_hexarelin_with_hrt_feminization/n9r22ii/)
- Negative, recovery, 100 mcg/day: “That Hexarelin gone have you tired and sore. I take 100 mcg a day and feels like I got the flu.” — [r/BodyHackGuide](https://www.reddit.com/r/BodyHackGuide/comments/1nxy3c1/ghrhghrp_cycling_question/nic251j/)

## Studies

- [Rahim et al. 1998: GH status during long-term hexarelin therapy](https://pubmed.ncbi.nlm.nih.gov/9589671/) (open-label, n=12, 1998): 16 weeks of 1.5 mcg/kg subq twice daily in healthy elderly adults: the GH response fell by about a third within a week and by 45% at week 16, recovered 4 weeks after stopping; IGF-1, lean mass, fat and bone density did not change.
- [Rahim et al. 1999: effect of chronic hexarelin on the pituitary-adrenal axis and prolactin](https://pubmed.ncbi.nlm.nih.gov/10341859/) (open-label, n=12, 1999): In the same 16-week trial, the cortisol response to each dose shrank rather than grew and prolactin responses did not change; no sustained over-stimulation at this dose.
- [Maccario et al. 2002: two or three daily subq hexarelin injections and 24-h GH, prolactin, ACTH and cortisol](https://pubmed.ncbi.nlm.nih.gov/11888836/) (controlled, n=6, 2002): Two or three daily injections raised 24-hour GH equally without changing 24-hour prolactin, ACTH or cortisol, though an IV challenge still raised all four.
- [Arvat et al. 1997: GHRP-2 and hexarelin effects on GH, prolactin, ACTH and cortisol in man](https://pubmed.ncbi.nlm.nih.gov/9285939/) (controlled, n=12, 1997): IV hexarelin released more GH than GHRH and raised prolactin, ACTH and cortisol, the cortisol rise matching a CRH challenge.
- [Bisi et al. 1999: acute cardiovascular and hormonal effects of GH and hexarelin in humans](https://pubmed.ncbi.nlm.nih.gov/10342360/) (controlled, n=7, 1999): IV hexarelin raised left-ventricular ejection fraction from 64% to 71% for up to an hour while equal GH from injected rhGH did not; hexarelin also raised cortisol.
- [Bisi et al. 1999: cardiac effects of hexarelin in hypopituitary adults](https://pubmed.ncbi.nlm.nih.gov/10528131/) (controlled, n=16, 1999): Ejection fraction rose even in GH-deficient men who released almost no GH, pointing to a direct heart receptor.
- [Bodart et al. 2002: CD36 mediates the cardiovascular action of GHRPs in the heart](https://pubmed.ncbi.nlm.nih.gov/11988484/) (animal, 2002): Hexarelin binds CD36 on cardiomyocytes and microvascular endothelium and dose-dependently raised coronary perfusion pressure in perfused hearts, absent in CD36-null mice.
- [Klinger et al. 1996: desensitisation from long-term intranasal hexarelin in short children](https://pubmed.ncbi.nlm.nih.gov/8766941/) (open-label, n=7, 1996): The GH response halved after 7 days of three-times-daily dosing and stayed low for 6 months, recovering 3 months after stopping.

## Sources

- [Mao 2014: the cardiovascular action of hexarelin (review)](https://pmc.ncbi.nlm.nih.gov/articles/PMC4178518/)
- [Rahim & Shalet 1998: does desensitization to hexarelin occur?](https://pubmed.ncbi.nlm.nih.gov/10990150/)
- [WADA 2026 Prohibited List, S2.2.4 (examorelin/hexarelin)](https://www.wada-ama.org/sites/default/files/2025-09/2026list_en_final_clean_september_2025.pdf)
- [Renehan et al. 2004: circulating IGF-I and cancer risk, systematic review and meta-regression](https://pubmed.ncbi.nlm.nih.gov/15110491/)