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How it works: GHRH receptor binding: Sermorelin binds pituitary somatotroph GHRH receptors, activating adenylyl cyclase and increasing intracellular cAMP to trigger synthesis and pulsatile release of endogenous GH IGF-1 upregulation: elevated GH drives hepatic IGF-1 production, which mediates the downstream anabolic effects including lean mass accretion, bone density support, and tissue remodeling Preserved feedback regulation: because sermorelin works through the hypothalamic-pituitary axis rather than bypassing it, natural somatostatin-mediated negative feedback remains intact, reducing the risk of GH excess seen with exogenous HGH Extracellular matrix support: preclinical models suggest GH axis stimulation may reduce inflammatory cytokine signaling and promote extracellular matrix remodeling, contributing to faster soft tissue recovery Administration: Subcutaneous injection (intramuscular also used) Typical dosing range: 200-500 mcg once daily, most protocols use 300 mcg nightly

DOI: 10.1007/s00441-019-03016-8

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