No injectable "muscle peptide" has a human trial showing hypertrophy or strength gains in trained adults. The best-evidenced items on this page are creatine and adequate protein. Every research compound below is prohibited at all times under WADA's 2026 list. And MK-677, which every roundup files under peptides, is not one.
That is the ledger in four sentences. The rest is the receipts: one row per compound, scored against the published rubric, each naming the study that would change its score.
Criteria / reviewed 2026-09-05. Scores follow the site's four rules, applied identically to research compounds and supermarket supplements: human trials over animal models; trained subjects over untrained; independent replication over single labs; performance endpoints (strength, power, work capacity) over biomarkers (hormone levels, lean-mass estimates). Regulatory status uses three labels: not FDA-approved for any use, FDA-approved for a different indication, or dietary supplement. WADA status is quoted by section from the 2026 Prohibited List and updated when the list moves.
How to read this ledger
A 5 means several independent human trials, trained people included, with a strength or performance endpoint that moved. A 4 is replicated human data that is mostly body composition or untrained subjects. A 3 is a few human RCTs from one research cluster or a narrow population. A 2 is a single human trial, or an approved drug's label data in patients, with no strength gain. A 1 is no human muscle data at all: animal studies, cell work, or hormone levels only.
The score does not measure safety — a 1 is not "harmless" — nor the volume of the marketing; some of the loudest compounds sit at the bottom.
One disambiguation first. Search results mix two products that share a word: powdered "growth peptide" dietary supplements on retail sites, and injectable research compounds sold as "not for human use." The collagen row is the only food-derived peptide with human muscle data; every secretagogue, growth-factor and myostatin row is an injectable research compound.
The benchmark rows: legal supplements set the scale
The best-evidenced entries on this rubric are the two things most lifters already own, so they go first and set the scale.
Creatine monohydrate — evidence score 5
| Evidence score | Regulatory status | WADA 2026 | What would change this score |
|---|---|---|---|
| 5 / 5 | Dietary supplement | Not listed (full-text search of the 2026 list returns no match) | Nothing upward; a large independent female-only trial with strength endpoints would close the one open question |
Creatine is what the rest of the page is measured against. In adults under 50 who resistance-trained, a 2024 meta-analysis of 12 RCTs found creatine added 1.14 kg of lean body mass over training alone (95% CI 0.69–1.59) and lowered body-fat percentage by 0.88 points, with no difference between trained and untrained subgroups (Desai 2024). In older adults, 22 RCTs with 721 men and women found lean tissue mass up 1.37 kg plus small but significant chest-press and leg-press strength gains (Chilibeck 2017). A 2025 analysis of 69 RCTs and 1,937 adults put numbers on performance: bench press +1.43 kg, squat +5.64 kg, vertical jump +1.48 cm, Wingate peak power +47.8 W versus placebo with training (Kazeminasab 2025). A 100-study meta-analysis from 1994–2003 found a small but significant body-composition effect with no difference between men and women or between trained and untrained subjects (Branch 2003).
Four independent meta-analyses, trained subjects included, performance endpoints that moved. That is what a 5 looks like.
The limitations ride with the number. Kazeminasab's lower-body and power gains were significant in male subgroups "but this was not observed in females," and the authors call for trials in women. That paper's co-author, and the authors of the International Society of Sports Nutrition position stand calling creatine "safe and well-tolerated in healthy individuals," disclose creatine-industry ties. The effect holds in labs without such ties; the reader should still know who wrote which sentence.
Protein intake — evidence score 5
| Evidence score | Regulatory status | WADA 2026 | What would change this score |
|---|---|---|---|
| 5 / 5 | Dietary supplement (food) | Not listed | Nothing upward; the absolute fat-free-mass effect is small and the score reflects replication and endpoints, not magnitude |
The largest meta-analysis on the page: 49 RCTs, 1,863 participants, all training for at least six weeks (Morton 2018). Protein supplementation added 2.49 kg to one-rep-max strength (95% CI 0.64–4.33), 0.30 kg of fat-free mass (0.09–0.52), and 310 µm² of muscle-fiber cross-sectional area. The fat-free-mass effect was larger in resistance-trained people (+0.75 kg) and shrank with age. The analysis also found a ceiling: no further fat-free-mass gain once total protein intake passed about 1.6 g per kg of body weight per day — a finding of the meta-analysis, not a recommendation from this page.
Cons: the absolute lean-mass number is small, and the senior author discloses grant support and honoraria from the US National Dairy Council, which supported some included trials. The strength endpoint and the trained-subject effect are why this row scores 5 rather than 4.
Collagen peptides — evidence score 3
| Evidence score | Regulatory status | WADA 2026 | What would change this score |
|---|---|---|---|
| 3 / 5 | Dietary supplement | Not listed | An independent replication outside the Freiburg research cluster, and a trial where fat-free-mass gains are matched by fiber hypertrophy |
The only "peptide" on the page with human muscle data, and it is a food product. Three 12-week RCTs, all pairing collagen peptides with resistance training: in 53 sarcopenic men, mean age 72, fat-free mass rose 4.2 kg versus 2.9 kg on placebo and isokinetic quadriceps strength 16.5 versus 7.3 Nm (Zdzieblik 2015); in 77 premenopausal women, the collagen group gained more fat-free mass and hand-grip strength than training plus placebo (Jendricke 2019); in 57 recreationally active young men, fat-free mass rose more with collagen but type II fiber cross-sectional area increased equally in both groups, which the authors read as "passive connective tissue adaptations," not hypertrophy (Kirmse 2019).
Why 3 and not 4: all three trials come from one research cluster, Zdzieblik has a co-author at the Collagen Research Institute in Kiel, and the Kirmse funders "were allowed to make suggestions in phrasing." A 2021 Nutrients review with no external funding says most of this evidence comes from non-athletic populations and calls the conclusions preliminary.
The ceiling row: growth hormone itself — evidence score 2
| Evidence score | Regulatory status | WADA 2026 | What would change this score |
|---|---|---|---|
| 2 / 5 | FDA-approved for different indications (somatropin labels such as Humatrope: pediatric growth failure, adult GH-deficiency replacement); no muscle-growth indication | S2.2.3, prohibited at all times | A trial in trained adults where lean-mass gains are matched by strength or hypertrophy — the existing trials looked and did not find it |
Every secretagogue on this page has the same proposed mechanism: make the body release more growth hormone. So the ceiling on what any of them could do is what growth hormone itself does in healthy, fit people, and that has been measured.
A systematic review of 27 study samples with 303 GH recipients found lean body mass up 2.1 kg (95% CI 1.3–2.9), "but strength and exercise capacity did not seem to improve," with more soft-tissue edema and fatigue in the GH groups (Liu 2008).
Then WADA funded the trial that should have settled it: 96 recreationally trained athletes, 63 men and 33 women, eight weeks, randomized (Meinhardt 2010). Growth hormone raised sprint capacity 3.9% (95% CI 0.0–7.7). Dead-lift strength, jump power and VO2max did not change. Lean mass rose "through an increase in extracellular water," and the sprint effect was gone six weeks after stopping.
Water-weight lean mass, no strength: the best-case result for the whole secretagogue category, from the hormone itself, in an RCT with a performance endpoint. A compound that merely nudges GH cannot score above the thing it nudges.
Growth-hormone secretagogue rows
The category the search results call "the best peptides for muscle growth." Google's AI Overview for this query recommends two of them together; they act on different receptors (a GHRH analogue versus a ghrelin-receptor agonist), which is why they are separate rows, and no human trial has tested them together for a muscle outcome. A 2018 review of the class found "few long-term, rigorously controlled studies" of secretagogue efficacy or safety, flagged rising blood glucose from reduced insulin sensitivity, and called for long-term cancer-incidence and mortality data (Sigalos 2018, no conflicts reported). Here is what the human literature contains for each.
CJC-1295 — evidence score 1
| Evidence score | Regulatory status | WADA 2026 | What would change this score |
|---|---|---|---|
| 1 / 5 | Not FDA-approved for any use | S2.2.4, named, prohibited at all times | Any human RCT with a lean-mass or strength endpoint; none exists |
The human data are a 2006 pharmacology study in healthy adults aged 21–61 whose stated outcome measures were GH and IGF-1 concentrations (Teichman 2006): mean plasma GH rose two- to ten-fold for six or more days and IGF-1 1.5- to three-fold for nine to eleven days. No muscle mass. No strength. The first author's affiliation is a consulting firm and the sponsor is not named in the abstract. Hormone levels are a biomarker; biomarkers-only is a 1. FDA's compounding page lists CJC-1295 under substances "nominated but withdrawn," noting "serious adverse events... including increased heart rate and systemic vasodilatory reaction."
Ipamorelin — evidence score 1
| Evidence score | Regulatory status | WADA 2026 | What would change this score |
|---|---|---|---|
| 1 / 5 | Not FDA-approved for any use (ipamorelin acetate is in FDA 503B compounding category 2) | S2.2.4, named, prohibited at all times | A human trial that measures muscle; the only human RCT measured bowel recovery and was negative |
The only randomized human trial of ipamorelin in PubMed is a phase 2 study of postoperative ileus in 117 bowel-resection patients (Beck 2014): median time to first tolerated meal 25.3 hours versus 32.6 on placebo, p = 0.15, no significant difference on any key or secondary efficacy analysis. A PubMed search restricted to human studies with muscle-mass or strength terms returns one 2026 narrative review and no trial. This is the compound the AI Overview recommends.
GHRP-2 and GHRP-6 — evidence score 1
| Evidence score | Regulatory status | WADA 2026 | What would change this score |
|---|---|---|---|
| 1 / 5 | Not FDA-approved for any use (both in FDA 503B compounding category 2 as of September 29, 2023) | S2.2.4, named ("GHRP-2 (pralmorelin)... and GHRP-6"), prohibited at all times | Any prospective human trial with a muscle endpoint |
The only published human data on these compounds "for lean body mass" is a retrospective chart review of men on testosterone therapy (Sigalos 2017). Of 105 charts, 14 met inclusion; IGF-1 rose from 159.5 to 239.0 ng/mL; muscle mass and strength were not measured. A biomarker, from 14 charts, in men already on testosterone.
Sermorelin — evidence score 1
| Evidence score | Regulatory status | WADA 2026 | What would change this score |
|---|---|---|---|
| 1 / 5 | Formerly approved (pediatric GH deficiency); approval withdrawn effective June 18, 2009, not for safety or effectiveness; no currently approved product | S2.2.4, named, prohibited at all times | Any human muscle-outcome trial; none exists in athletes or healthy adults |
Clinic pages, and some of the AI Overview's sources, call sermorelin FDA-approved. The Federal Register record says otherwise: GEREF (sermorelin acetate) was approved in 1990 as a diagnostic and in 1997 for idiopathic growth-hormone deficiency in children with growth failure; EMD Serono discontinued it in 2008, FDA withdrew both approvals effective June 18, 2009, and determined in 2013 the withdrawal was not for safety or effectiveness. No approved sermorelin product exists today, and there was never a muscle-growth indication.
Tesamorelin — evidence score 2
| Evidence score | Regulatory status | WADA 2026 | What would change this score |
|---|---|---|---|
| 2 / 5 | FDA-approved for a different indication: reduction of excess abdominal fat in HIV-infected adults with lipodystrophy | S2.2.4, named, prohibited at all times | A trial in healthy or trained adults with a strength endpoint; the label data are patient-population body composition only |
The one secretagogue with an FDA label, so the numbers come from the label. EGRIFTA WR prescribing information (revised March 2025) limits the indication to abdominal fat in HIV lipodystrophy and states that long-term cardiovascular safety is not established and it is not indicated for weight loss. In the two 26-week trials, lean body mass changed +1.3 kg and +1.2 kg versus −0.2 kg and −0.03 kg on placebo, alongside visceral-fat reductions. Patients, not athletes; composition, not strength. An approved drug that is still prohibited at all times; whether a Therapeutic Use Exemption applies is a question for an athlete's anti-doping organization, not this page.
MK-677 (ibutamoren) — evidence score 2, and not a peptide
| Evidence score | Regulatory status | WADA 2026 | What would change this score |
|---|---|---|---|
| 2 / 5 | Not FDA-approved for any use; FDA 503A and 503B compounding category 2 | S2.2.4, named as "ibutamoren (MK-677)," prohibited at all times | A trial in younger or trained adults where fat-free-mass gain comes with strength; the existing RCT found the opposite |
It appears here because every roundup and the AI Overview list it as a peptide. It is not one. Ibutamoren is a spiro-indoline small molecule, C27H36N4O5S, molecular weight 528.7 (PubChem CID 178024), not a chain of amino acids.
Its evidence is better than any actual peptide in this section, which says more about the section. A one-year RCT in 65 healthy adults aged 60–81 found fat-free mass up 1.1 kg versus −0.5 kg on placebo, and in the same abstract: "Increased fat-free mass did not result in changes in strength or function" (Nass 2008). Fasting glucose rose about 5 mg/dL, insulin sensitivity fell, and limb fat rose more than placebo. Older, untrained, composition without function: a 2.
And a specific safety fact: FDA's compounding page places ibutamoren mesylate in category 2 for both 503A and 503B pharmacies because a randomized hip-fracture trial "was terminated early due to a potential safety signal of congestive heart failure."
IGF-1 LR3 — evidence score 1
| Evidence score | Regulatory status | WADA 2026 | What would change this score |
|---|---|---|---|
| 1 / 5 | Not FDA-approved for any use (the approved IGF-1 is mecasermin, a different molecule, for pediatric deficiency) | S2.3, "IGF-1 (mecasermin) and its analogues," prohibited at all times | Any human study at all; as of September 5, 2026 there is none |
A PubMed title/abstract search for "Long R3 IGF-I," "LR3-IGF-1" and "IGF-1 LR3" returns five records, none human: rat, fetal sheep, mouse, a yeast-expression paper, and a 2026 narrative review that tiers peptides "from regulatory-grade randomized trial data to a complete absence of human studies" and notes online self-administration despite "the absence of regulatory approval for physique- or performance-related indications" (Dominikowski 2026, no commercial funding). Zero human studies is a 1 with no asterisk.
The approved IGF-1 product is a different molecule with a sobering label. INCRELEX (mecasermin) is indicated only for growth failure in children two and older with severe primary IGF-1 deficiency or a GH gene deletion with neutralizing antibodies; warnings include severe hypoglycemia leading to seizures and several cases of malignant neoplasia in treated children. That is the pathway the LR3 analogue is sold to activate.
"Recovery" peptides with no growth data
Two compounds dominate the recovery conversation and drift into muscle-growth roundups by association. Healing is not hypertrophy, and neither compound has human data for either.
BPC-157 — evidence score 1
| Evidence score | Regulatory status | WADA 2026 | What would change this score |
|---|---|---|---|
| 1 / 5 | Not FDA-approved for any use; FDA lists it as "nominated but withdrawn" from compounding review, with "no, or only limited, safety-related information" | S0 (non-approved substances), named, prohibited at all times | A single human clinical trial; as of September 5, 2026 PubMed has none |
On September 5, 2026, a PubMed search for BPC-157 limited to clinical-trial or RCT publication types returned zero records; the human-tagged hits are narrative reviews and doping-laboratory analytical papers. What exists is animal work, which scores 1 by design; this row says nothing about what the compound does in a person because nobody has measured it.
WADA's 2026 list names it in the very first class: S0 "covers many different substances including but not limited to BPC-157," prohibited at all times. A 2026 Sports Medicine review of approved and unapproved peptides sums up the category: favorable tissue-repair outcomes in animal models, but "rigorous human safety data are scarce, and there is potential for serious harm" (Mendias 2026; authors at a performance-medicine clinic, one disclosing unrelated consulting fees).
TB-500 / thymosin beta-4 — evidence score 1
| Evidence score | Regulatory status | WADA 2026 | What would change this score |
|---|---|---|---|
| 1 / 5 | Not FDA-approved for any use; FDA states it "has not identified any human exposure data" for the LKKTETQ fragment sold as TB-500 | S2.3, "Thymosin-ß4 and its derivatives e.g. TB-500," prohibited at all times | Any human trial with a muscle or tendon endpoint |
Human trials of thymosin beta-4 exist, for other things: a safety study in 40 healthy volunteers whose authors suggested further development for cardiac ischemia (Ruff 2010, contract-research author) and a topical phase 2 in 73 patients with venous leg ulcers (Guarnera 2010). A PubMed search for human trials of thymosin beta-4 or TB-500 returns those and one unrelated record; no muscle endpoint anywhere. The JBJS Reviews 2026 structured review of injectable peptides in sports medicine grades the category, thymosin derivatives included, as Level V evidence that "remain[s] investigational, with uncertain safety profiles, product quality concerns, and widespread antidoping restrictions."
Myostatin-pathway rows
The one place on the ledger where a human muscle signal exists for a pathway drug, and the clearest demonstration of why the rubric weighs replication and program status.
ACE-031 — evidence score 2
| Evidence score | Regulatory status | WADA 2026 | What would change this score |
|---|---|---|---|
| 2 / 5 | Not FDA-approved for any use; development program halted | S4.3, "decoy activin receptors (e.g. ACE-031)," prohibited at all times | Independent replication by a non-sponsor lab with a strength endpoint; the drug is no longer in development, so this is unlikely |
In a single-administration study of 48 healthy postmenopausal women, the highest of the tested groups showed total-body lean mass up 3.3% by DXA and thigh muscle volume up 5.1% by MRI at day 29 (Attie 2013). One administration, sponsor-authored (Acceleron Pharma), no strength measurement. Then the follow-on trial in ambulatory boys with Duchenne muscular dystrophy was stopped "due to potential safety concerns of epistaxis and telangiectasias," with lean-mass and walk-distance effects reported as trends only (Campbell 2017, Acceleron co-authors). The strongest human muscle-growth number on this page belongs to a discontinued drug, from one study, in one population, unreplicated. That is the exception that proves the rubric, not evidence that a "myostatin peptide" works.
Follistatin — evidence score 1
| Evidence score | Regulatory status | WADA 2026 | What would change this score |
|---|---|---|---|
| 1 / 5 | Not FDA-approved for any use | S4.3, "myostatin-binding proteins (e.g. follistatin)," prohibited at all times | A human trial of the protein product itself; the only human data are gene therapy in a disease population |
The only human follistatin data are a phase 1/2a gene-therapy trial in six men with Becker muscular dystrophy, using a viral vector carrying the follistatin gene (Mendell 2015). Four of six improved six-minute-walk distance (58, 125, 108 and 29 meters); two showed no change. Gene transfer, in a muscular dystrophy population, six patients. That is not the "follistatin" vial sold online, and it supports no muscle-growth claim in healthy people.
What the data say about women
Most numbers on this page were generated in men, and the field knows it. Across 5,261 publications and 12.5 million participants in six major sport and exercise science journals from 2014 to 2020, 34% of participants were female; 31% of studies enrolled men only and 6% women only (Cowley 2021).
The female-specific data that exist, row by row. For creatine, a 2026 meta-analysis of seven RCTs in 608 postmenopausal women found lean mass up 0.37 kg (95% CI 0.05–0.69) and leg-press one-rep max up 7.5 kg, with benefits seen alongside resistance training and adverse events similar to placebo (Naddafha 2026; the authors lead creatine-industry-funded organizations and the publication fee was industry-supported). A lifespan review notes women carry 70–80% lower endogenous creatine stores than men and that premenopausal women appear to gain strength and performance from supplementation (Smith-Ryan 2021; two authors advise a creatine maker). Against that, the largest strength meta-analysis found the male-subgroup gains were not observed in female subgroups. Creatine has measured effects in women; how large, and on which endpoints, is under-studied.
For research compounds, the female-only human data on this page consist of one study: Attie 2013's 48 postmenopausal women, in a drug that was then halted. Meinhardt's GH trial included 33 women and found no strength gain in the combined group; Jendricke's 77 premenopausal women are the collagen row's female data. No secretagogue has been tested for muscle in women, because none has been tested for muscle in anyone.
Regulatory status, plainly
Three labels, and nothing on this page is approved for muscle growth.
Not FDA-approved for any use: BPC-157, CJC-1295, ipamorelin, GHRP-2, GHRP-6, IGF-1 LR3, TB-500, ACE-031, follistatin, and MK-677. Several were added to FDA's compounding category 2 on September 29, 2023 "because FDA has identified significant safety risks," per FDA's 503A categories notice; FDA's current page keeps ibutamoren, GHRP-2, GHRP-6 and ipamorelin (503B) there, while BPC-157, CJC-1295, ipamorelin (503A) and TB-500 now sit under "nominated but withdrawn." That is compounding eligibility, not approval and not a ban; whichever way the list moves, the accurate phrase is "not FDA-approved for any indication."
FDA-approved for a different indication: growth hormone (somatropin), tesamorelin (abdominal fat in HIV lipodystrophy) and mecasermin (pediatric IGF-1 deficiency; not the LR3 molecule sold as IGF-1 LR3). Sermorelin was approved for pediatric GH deficiency until 2009 and has no current approved product.
Dietary supplement: creatine monohydrate, protein, collagen peptides.
WADA 2026 status
From the 2026 Prohibited List, effective January 1, 2026. Every compound below is prohibited at all times, in and out of competition. This table is updated when the list moves.
| Compound | WADA 2026 section | Named in the list text? |
|---|---|---|
| BPC-157 | S0 Non-approved substances | Yes ("including but not limited to BPC-157") |
| CJC-1295 | S2.2.4 Growth hormone releasing factors (GHRH analogues) | Yes |
| Sermorelin | S2.2.4 (GHRH analogues) | Yes |
| Tesamorelin | S2.2.4 (GHRH analogues) | Yes |
| Ipamorelin | S2.2.4 (growth hormone secretagogues) | Yes |
| MK-677 (ibutamoren) | S2.2.4 (growth hormone secretagogues) | Yes ("ibutamoren (MK-677)") |
| GHRP-2, GHRP-6 | S2.2.4 (GH-releasing peptides) | Yes ("GHRP-2 (pralmorelin)... GHRP-6") |
| IGF-1 LR3 | S2.3 Growth factors ("IGF-1 (mecasermin) and its analogues") | As an analogue |
| TB-500 / thymosin beta-4 | S2.3 Growth factors | Yes ("Thymosin-ß4 and its derivatives e.g. TB-500") |
| ACE-031 | S4.3 Agents preventing activin receptor IIB activation | Yes |
| Follistatin | S4.3 (myostatin-binding proteins) | Yes |
| Growth hormone | S2.2.3 Growth hormone, its analogues and fragments | Yes |
| Creatine monohydrate | Not listed | No (full-text search: zero matches) |
| Protein, collagen peptides | Not listed | No |
Two clarifications the clinic pages get wrong. Myostatin-pathway agents are S4.3 in the 2026 list, not S4.4 (S4.4 is metabolic modulators). And "prohibited at all times" means an out-of-competition test counts; there is no in-competition-only window for anything in S0, S2 or S4.3. This page does not discuss detection windows.
The full ledger at a glance
| Row | Score | Best human evidence | Endpoint class | Regulatory | WADA 2026 |
|---|---|---|---|---|---|
| Creatine monohydrate | 5 | 4 independent meta-analyses incl. 69-RCT strength analysis | Performance + composition | Dietary supplement | Not listed |
| Protein intake | 5 | 49 RCTs / 1,863 participants | Performance + composition | Dietary supplement | Not listed |
| Collagen peptides | 3 | 3 RCTs, one research cluster | Composition; strength in 2 of 3 | Dietary supplement | Not listed |
| Growth hormone (ceiling) | 2 | 27-sample review; 96-athlete WADA RCT | Composition (water); sprint only | Approved, other indications | S2.2.3 |
| Tesamorelin | 2 | Label trials in HIV lipodystrophy | Composition | Approved, other indication | S2.2.4 |
| MK-677 (not a peptide) | 2 | 1-year RCT, 65 older adults | Composition, no strength | Not approved; 503A/503B cat. 2 | S2.2.4 |
| ACE-031 | 2 | Single-administration study, 48 postmenopausal women; program halted | Composition | Not approved; discontinued | S4.3 |
| CJC-1295 | 1 | Hormone-level pharmacology study | Biomarker | Not approved | S2.2.4 |
| Ipamorelin | 1 | 1 RCT, postoperative ileus, negative | Non-muscle | Not approved; 503B cat. 2 | S2.2.4 |
| GHRP-2 / GHRP-6 | 1 | 14-chart retrospective IGF-1 review | Biomarker | Not approved; 503B cat. 2 | S2.2.4 |
| Sermorelin | 1 | None for muscle | — | Approval withdrawn 2009 | S2.2.4 |
| IGF-1 LR3 | 1 | None in humans | — | Not approved | S2.3 |
| BPC-157 | 1 | None (zero clinical trials in PubMed) | — | Not approved | S0 |
| TB-500 / Tβ4 | 1 | Human trials for ulcers and volunteer safety only | Non-muscle | Not approved | S2.3 |
| Follistatin | 1 | Gene therapy in 6 BMD patients | Disease population | Not approved | S4.3 |
What would change these scores
Every row names its missing study, and the pattern is plain. For every secretagogue it is the same trial nobody has run — randomized, in trained adults, with DXA lean mass and a one-rep-max endpoint — and even a positive result would be capped by the growth-hormone ceiling row. For IGF-1 LR3 and BPC-157 it is any human trial at all; their 1s mean the literature is empty, not negative. For creatine and protein, it is the female-only trials the meta-analysts keep asking for.
The gap between the supplement rows and the compound rows is not opinion. It is the difference between 1,937 participants in randomized strength trials and zero. The ranked version of this ledger, same scores in comparison-table form, is at best peptides for muscle growth; how the scores are built, and who publishes them, is on the editorial standards and about pages.
Sources
Reviewed 2026-09-05. Every number above traces to one of these.
- WADA, The 2026 Prohibited List, effective January 1, 2026 (PDF via the International Testing Agency mirror of WADA's document; sections S0, S2.2.3, S2.2.4, S2.3, S4.3 quoted).
- Liu H et al. Systematic review: the effects of growth hormone on athletic performance. Ann Intern Med 2008. PMID 18347346.
- Meinhardt U et al. The effects of growth hormone on body composition and physical performance in recreational athletes. Ann Intern Med 2010. PMID 20439575. Funded by WADA.
- Teichman SL et al. Prolonged stimulation of GH and IGF-I secretion by CJC-1295 in healthy adults. J Clin Endocrinol Metab 2006. PMID 16352683.
- Beck DE et al. Randomized, controlled, proof-of-concept study of ipamorelin for postoperative ileus. Int J Colorectal Dis 2014. PMID 25331030.
- Sigalos JT et al. Growth hormone secretagogue treatment in hypogonadal men raises serum IGF-1. Am J Mens Health 2017. PMID 28830317.
- Sigalos JT, Pastuszak AW. The safety and efficacy of growth hormone secretagogues. Sex Med Rev 2018. PMID 28400207.
- Federal Register, March 4, 2013 (78 FR 14095): determination that GEREF (sermorelin acetate) was not withdrawn for reasons of safety or effectiveness.
- EGRIFTA WR (tesamorelin) prescribing information, DailyMed, revised March 2025, set ID 839334d3-8c1d-4c26-9036-2ab524a6ea75.
- INCRELEX (mecasermin) prescribing information, DailyMed, revised July 2025, set ID a8b27a1b-a611-4f91-ad22-76d4b390c3ae.
- Nass R et al. Effects of an oral ghrelin mimetic on body composition and clinical outcomes in healthy older adults. Ann Intern Med 2008. PMID 18981485.
- PubChem compound record CID 178024, ibutamoren.
- FDA, Certain bulk drug substances for use in compounding that may present significant safety risks (page as read 2026-09-05); FDA 503A categories update, September 29, 2023.
- Dominikowski A et al. The emerging landscape of performance-enhancing peptides modulating the GH-IGF1 axis. Front Endocrinol 2026. PMID 42395176.
- PubMed search, BPC-157 limited to clinical-trial and RCT publication types, run 2026-09-05 (zero records).
- Mendias CL, Awan TM. Safety and efficacy of approved and unapproved peptide therapies for musculoskeletal injuries and athletic performance. Sports Med 2026. PMID 41966639.
- Villegas Meza AD et al. Injectable peptides in sports medicine: a structured narrative review. JBJS Rev 2026. PMID 42160466.
- Ruff D et al. Intravenous thymosin beta4 in healthy volunteers. Ann N Y Acad Sci 2010. PMID 20536472. Guarnera G et al., same volume, PMID 20536470.
- Attie KM et al. A single ascending-dose study of ACE-031 in healthy volunteers. Muscle Nerve 2013. PMID 23169607. Acceleron Pharma authors.
- Campbell C et al. ACE-031 treatment of ambulatory boys with Duchenne muscular dystrophy. Muscle Nerve 2017. PMID 27462804.
- Mendell JR et al. A phase 1/2a follistatin gene therapy trial for Becker muscular dystrophy. Mol Ther 2015. PMID 25322757.
- Morton RW et al. Protein supplementation and resistance training-induced gains in muscle mass and strength. Br J Sports Med 2018. PMID 28698222. Senior author discloses National Dairy Council support.
- Desai I et al. Creatine supplementation and resistance training-based changes to body composition. J Strength Cond Res 2024. PMID 39074168.
- Chilibeck PD et al. Creatine during resistance training in older adults: a meta-analysis. Open Access J Sports Med 2017. PMID 29138605.
- Kazeminasab F et al. Creatine supplementation and upper- and lower-body strength and power. Nutrients 2025. PMID 40944139. Co-author discloses creatine-industry ties.
- Branch JD. Creatine supplementation, body composition and performance: a meta-analysis. Int J Sport Nutr Exerc Metab 2003. PMID 12945830.
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