What’s legal, what’s not, and who actually offers it

5-Amino-1MQ

5-Amino-1MQ is a small molecule inhibitor of the enzyme NNMT (nicotinamide N-methyltransferase), which plays a central role in metabolic regulation and fat cell differentiation. By blocking NNMT it raises cellular NAD+ levels, activates SIRT1, and reduces adipogenesis — a novel mechanism for fat loss. Animal studies show significant reduction in body weight and adipose tissue mass. It is used in optimization medicine for metabolic health and fat loss.

Actovegin

Actovegin is a deproteinized hemodialysate of calf blood containing low-molecular-weight peptides, nucleosides, amino acids, and oligosaccharides that improve cellular oxygen utilization and glucose uptake. It is approved and widely used in Europe, Russia, and Asia for ischemic conditions, diabetic neuropathy, wound healing, and stroke recovery. Athletes and biohackers use it off-label for enhanced recovery and cognitive performance.

Alpha Lipoic Acid IV

Intravenous alpha-lipoic acid (ALA) is a both fat- and water-soluble antioxidant with clinically proven efficacy for diabetic neuropathy approved in Germany, used off-label in optimization medicine for neuropathy, metabolic syndrome, heavy metal chelation support, and anti-aging applications. IV delivery achieves plasma concentrations 10–50x higher than oral dosing, enabling therapeutic effects not attainable orally. It regenerates vitamins C, E, and glutathione.

Amycretin

Amycretin is a unimolecular fusion peptide combining GLP-1 receptor agonism with amylin receptor agonism in a single molecule, developed by Novo Nordisk as the next evolution beyond semaglutide. Phase I data showed extraordinary weight loss of approximately 13% over just 12 weeks — suggesting potential for 25%+ reductions at full treatment duration. It represents the first clinically advanced GLP-1/amylin combination in a single molecular entity.

ARA-290

ARA-290 is a synthetic 11-amino-acid peptide that selectively activates the innate repair receptor (a heterodimer of the EPO receptor and beta common receptor) without erythropoietic effects, providing neuroprotection, anti-inflammatory, and tissue-repair actions. It has completed Phase II trials for neuropathic pain in sarcoidosis and is being studied for small fiber neuropathy, diabetic neuropathy, and inflammatory conditions. It represents a novel approach to harnessing erythropoietin's tissue-protective properties without its blood-thickening risks.

Armour Thyroid

Armour Thyroid is a desiccated thyroid extract (DTE) derived from porcine thyroid glands, containing both T4 and T3 in a naturally occurring ratio of approximately 4:1. It is FDA-approved for hypothyroidism and preferred by some patients and practitioners for its dual-hormone content and natural origin. Studies suggest some patients achieve better symptom control on DTE compared to T4 monotherapy, particularly those with impaired T4-to-T3 conversion.

Bimagrumab

Bimagrumab is a human monoclonal antibody that blocks activin type II receptors (ActRII), inhibiting myostatin and related ligands to simultaneously increase muscle mass and reduce fat mass — a unique dual body composition effect. In a Phase II trial of diabetic patients, bimagrumab reduced fat mass by 20.5% and increased lean mass by 3.6% over 48 weeks. It is being studied in combination with semaglutide to preserve muscle during GLP-1-driven weight loss.

BPC-157

A synthetic 15-amino-acid peptide derived from human gastric juice proteins, BPC-157 (Body Protection Compound-157) demonstrates cytoprotective and regenerative properties in preclinical studies. Research in animal models suggests it may accelerate healing of tendons, ligaments, muscle, and gastrointestinal tissue through mechanisms involving angiogenesis, growth factor modulation, and nitric oxide pathway regulation. While extensively studied in rodent injury models, human clinical trial data remains limited, and the compound is not currently approved for therapeutic use by major regulatory agencies.

Cagrilintide

Cagrilintide is a long-acting amylin analog being developed in combination with semaglutide (as CagriSema) for obesity and type 2 diabetes. The CagriSema combination has shown weight loss exceeding 22% in early trials, rivaling surgical outcomes. Amylin complements GLP-1 action through independent satiety pathways. It is not yet approved but represents the next frontier in pharmacological obesity treatment.

CJC-1295

A synthetic analog of growth hormone-releasing hormone (GHRH), this 30-amino acid peptide is modified with a drug affinity complex (DAC) that extends its half-life by binding to serum albumin. It stimulates pulsatile growth hormone secretion from the anterior pituitary by activating GHRH receptors. The compound has been investigated in clinical research for growth hormone deficiency and conditions associated with impaired GH/IGF-1 axis function.

CoQ10 IV

Intravenous coenzyme Q10 (ubiquinol/ubiquinone) bypasses the limited oral bioavailability of CoQ10 to achieve therapeutic plasma and tissue concentrations for mitochondrial support, cardioprotection, and neurological applications. IV CoQ10 has been used in clinical settings for heart failure, Parkinson's disease, and mitochondrial disorders. It is a key component of comprehensive longevity IV drip protocols.

CT-996

CT-996 is Structure Therapeutics' oral small-molecule GLP-1 receptor agonist in early clinical development, designed for once-daily oral dosing with minimal food restrictions. Phase Ib data showed up to 6% weight loss over 28 days, promising for an early-stage program. It competes in the oral GLP-1 space with orforglipron and danuglipron, differentiated by its distinct chemical scaffold and once-daily convenience.

Dasatinib

Dasatinib is an FDA-approved BCR-ABL/Src kinase inhibitor used in chronic myeloid leukemia that has emerged as the most potent senolytic agent identified to date, used in combination with quercetin (D+Q) in clinical longevity trials. The Mayo Clinic's AFFIRM-LITE and similar trials have shown improvements in physical function, biomarkers of senescence, and quality of life in older adults. It represents the leading pharmaceutical approach to eliminating senescent cells.

DHEA

Dehydroepiandrosterone (DHEA) is the most abundant steroid hormone in the human body and serves as a precursor to both androgens and estrogens. Serum DHEA declines sharply with age, reaching 20% of peak levels by age 70. Supplementation is used to support hormone balance, energy, immune function, and bone density. It is available over the counter in the US as a supplement.

Ecnoglutide

Ecnoglutide is a once-weekly GLP-1 receptor agonist developed by Sciwind Biosciences, with Phase III trials ongoing in China and international markets. It has shown efficacy and tolerability comparable to semaglutide in head-to-head Phase II comparisons. It represents the expanding pipeline of GLP-1 agents that may increase global access and competitive pricing in the obesity treatment landscape.

Epitalon

Epitalon (epithalamin) is a synthetic tetrapeptide developed by the St. Petersburg Institute of Bioregulation and Gerontology, with decades of Russian research suggesting telomere lengthening, pineal gland regulation, and lifespan extension in animal models. It stimulates telomerase activity — a rare property among known compounds. Human data is limited but promising for longevity applications. It is widely used in anti-aging clinics.

Estradiol

Estradiol is the primary biologically active estrogen and is the cornerstone of female hormone replacement therapy for menopause management. It protects against cardiovascular disease, osteoporosis, cognitive decline, and urogenital atrophy. Transdermal delivery avoids first-pass metabolism and provides more stable levels than oral estrogen. It is used in optimization medicine to maintain youthful estradiol levels in perimenopausal and postmenopausal women.

Exosomes

Exosomes are nanoscale extracellular vesicles (30–150 nm) secreted by cells that carry proteins, lipids, mRNA, and microRNA for intercellular communication, with profound regenerative and immunomodulatory properties in emerging clinical applications. Mesenchymal stem cell-derived exosomes are used off-label for orthopedic regeneration, hair restoration, skin rejuvenation, and anti-inflammatory conditions. They offer many stem cell benefits without the risks of live cell therapies. Regulatory status is evolving rapidly.

FOXO4-DRI

FOXO4-DRI (FOXO4-D-Retro-Inverso) is a synthetic stapled peptide senolytic developed by de Keizer et al. (Nature Medicine, 2017). It disrupts the FOXO4–p53 interaction that keeps senescent cells alive, triggering apoptosis selectively in senescent cells. In mice, systemic administration reversed doxorubicin-induced liver damage, restored hair density in naturally aged mice, and improved fitness metrics. It has no FDA approval for human use and has not entered human clinical trials. It may be sold online as a research chemical without quality controls, purity verification, or dosing standards.

GHK-Cu

A naturally occurring copper-binding tripeptide found in human plasma, GHK-Cu (glycyl-L-histidyl-L-lysine copper complex) functions as a signaling molecule that modulates gene expression related to tissue remodeling, collagen synthesis, and wound healing. Research demonstrates its capacity to stimulate fibroblast activity, promote angiogenesis, and exhibit anti-inflammatory and antioxidant properties. Primary applications include dermatological research for wound repair and skin aging, with emerging investigation into its potential roles in tissue regeneration and fibrosis modulation.

Glutathione IV

Intravenous glutathione is the reduced form of the body's master antioxidant tripeptide (gamma-glutamylcysteinylglycine), administered directly to bypass limited oral bioavailability. It is used in longevity and functional medicine for detoxification support, neurological conditions (including Parkinson's), immune enhancement, and skin brightening. IV delivery produces immediate plasma level elevation compared to oral or liposomal forms.

Gonadorelin

Gonadorelin is a synthetic version of gonadotropin-releasing hormone (GnRH) used in optimization medicine to maintain pituitary-gonadal axis function during TRT, replacing HCG in protocols that require gonadal stimulation. When used as pulsatile injections, it mimics the natural hypothalamic GnRH pulse pattern to maintain LH/FSH secretion and testicular function. It is available through compounding pharmacies as a preferred alternative to HCG.

HCG

Human chorionic gonadotropin (HCG) is an LH-mimicking hormone used in TRT to maintain testicular function, prevent atrophy, and preserve fertility during exogenous testosterone therapy. It is also used in male hypogonadism as a monotherapy to stimulate endogenous testosterone production. Compounded HCG remains available after FDA discontinued most branded injectable formulations. It is an essential component of fertility-preserving TRT protocols.

HGH

Human growth hormone (somatropin) is a 191-amino acid protein produced by the pituitary gland that declines significantly with age. FDA-approved for GH deficiency, Turner syndrome, and other indications, it is used off-label in optimization medicine for body composition, recovery, and anti-aging applications. Direct HGH administration bypasses the natural pulsatile release pattern and requires careful dosing to avoid side effects. It is a Schedule III controlled substance precursor in some jurisdictions.

IGF-1

Insulin-like growth factor 1 (IGF-1) is the primary mediator of GH anabolic effects and is produced mainly in the liver. Recombinant IGF-1 (mecasermin) is FDA-approved for severe primary IGF-1 deficiency. In optimization medicine, lr3-IGF-1 (a longer-acting analog) is used off-label for muscle growth, recovery, and neuroprotection. It is a potent anabolic compound requiring careful titration.

Ipamorelin

A synthetic pentapeptide growth hormone secretagogue, ipamorelin selectively stimulates pituitary release of growth hormone by mimicking ghrelin and binding to the growth hormone secretagogue receptor (GHS-R). Unlike earlier secretagogues, it demonstrates high selectivity for GH release with minimal effect on cortisol, prolactin, or appetite-regulating hormones. Research applications have focused on its potential use in growth hormone deficiency, age-related muscle loss, and bone metabolism studies.

Kisspeptin

Kisspeptin is an endogenous neuropeptide produced in the hypothalamus that acts as the master regulator of the reproductive axis by directly stimulating GnRH neurons. It is being studied for hypogonadism, sexual dysfunction, and fertility applications where upstream HPG axis stimulation is desired. In men, kisspeptin-10 injections produce significant LH and testosterone surges. It represents a more upstream intervention than HCG or gonadorelin.

Klotho

Klotho (alpha-Klotho) is an aging-suppressor protein primarily expressed in the kidney and choroid plexus. It circulates as a soluble form shed by ADAM10/17 proteases and declines sharply with age. Preclinical studies in mice show that klotho overexpression extends lifespan by 20–30%, while klotho deficiency produces an accelerated-aging phenotype including vascular calcification, muscle wasting, and cognitive decline. Klotho has no FDA approval for human use and is not available through US pharmacies. It has not completed the human clinical trials required for FDA approval. It may be sold online as a research reagent without quality controls or dosing standards.

KPV

KPV is a tripeptide derived from the C-terminus of alpha-MSH (Lys-Pro-Val) with potent anti-inflammatory properties and direct antimicrobial activity. It is studied for inflammatory bowel disease, skin inflammation, and wound healing. Oral formulations show efficacy in gut inflammation by acting directly on intestinal epithelial cells and immune cells. It has a favorable safety profile.

Liraglutide

Liraglutide is a once-daily GLP-1 receptor agonist marketed as Victoza for type 2 diabetes and Saxenda for chronic weight management. It was one of the first GLP-1 agents to demonstrate meaningful weight loss in clinical trials, producing 5–8% body weight reduction on average. Though largely superseded by weekly agents, it remains a clinically validated option. Compounded liraglutide is available through select pharmacies.

LL-37

LL-37 is the only member of the cathelicidin family of human antimicrobial peptides, with broad-spectrum activity against bacteria, viruses, and fungi. Beyond its antimicrobial role it is a potent immunomodulator and wound-healing agent with emerging anti-cancer properties. It is studied for chronic infections, biofilm disruption, and inflammatory conditions. Available as a compounded peptide.

MariTide

MariTide (AMG 133) is a GIP receptor antagonist / GLP-1 receptor agonist fusion molecule developed by Amgen with a monthly dosing interval — the longest injection interval of any obesity therapeutic in development. Phase II data showed 20% weight loss at 52 weeks. Its monthly convenience and potent efficacy position it as a potential market disruptor if Phase III results confirm Phase II findings.

Mazdutide

Mazdutide is a once-weekly GLP-1/glucagon dual receptor agonist in late-stage clinical development showing compelling weight loss data in trials conducted primarily in Asia. It targets both energy intake (via GLP-1) and energy expenditure (via glucagon), a mechanistically differentiated approach from semaglutide. Phase III trials report 15–18% body weight reduction. It is not yet FDA-approved but may reach Western markets by 2026–2027.

Melanotan II

Melanotan II (MT-II) is a synthetic analog of alpha-MSH that stimulates melanogenesis, causing skin tanning, and also acts as a potent sexual arousal agent. It was the precursor compound from which PT-141 (bremelanotide) was derived. While PT-141 is now FDA-approved for HSDD, MT-II remains an unregulated research peptide. Side effects include nausea, spontaneous erections, and potentially uneven pigmentation.

Methylene Blue

Methylene blue is a century-old compound originally used as an antimalarial and antidote for methemoglobinemia, now studied for cognitive enhancement, mitochondrial support, and neuroprotection. At low doses it acts as a mitochondrial electron carrier, improving cellular energy production. It has shown promise in early Alzheimer's research and is used off-label by biohackers for focus and memory. Pharmaceutical-grade formulations are essential for safety.

MK-677

MK-677 (ibutamoren) is an orally active, non-peptide ghrelin mimetic that elevates GH and IGF-1 levels for 24 hours with a single daily dose. It is uniquely convenient among GH secretagogues due to its oral bioavailability. Common uses include muscle mass preservation, sleep improvement, and anti-aging applications. It is classified as a research chemical and not FDA-approved.

MOTS-c

A mitochondrial-derived peptide encoded by the 12S rRNA gene, MOTS-c functions as a signaling molecule that regulates metabolic homeostasis by activating AMPK and influencing glucose uptake, insulin sensitivity, and fatty acid oxidation. This peptide has demonstrated effects on cellular metabolism and exercise mimetic properties in preclinical studies. Current research focuses on its potential applications in metabolic dysfunction, age-related decline, and insulin resistance.

NAD+

A coenzyme present in all living cells, nicotinamide adenine dinucleotide (NAD+) functions as a critical electron carrier in cellular metabolism and serves as a substrate for enzymes involved in DNA repair, cellular signaling, and epigenetic regulation. Cellular NAD+ levels decline with age, which has been associated with metabolic dysfunction and age-related pathologies. Research focuses on NAD+ precursor supplementation (such as nicotinamide riboside and nicotinamide mononucleotide) to investigate potential therapeutic applications in metabolic disorders, neurodegeneration, and aging-related conditions.

NAD+ IV

Intravenous NAD+ administration bypasses gut absorption limitations to directly elevate systemic NAD+ levels, producing rapid improvements in energy, clarity, and cellular function reported by patients within hours of infusion. It is widely used in longevity clinics, addiction medicine (for withdrawal management), and neurological rehabilitation. IV NAD+ produces a faster and more dramatic acute effect than oral precursors like NMN or NR, though its long-term superiority over oral forms remains debated.

NADH

NADH (nicotinamide adenine dinucleotide + hydrogen) is the reduced form of NAD+, functioning directly in cellular energy production and as an electron donor in the mitochondrial electron transport chain. Oral NADH supplements (as stabilized ENADA) have shown efficacy in clinical trials for chronic fatigue syndrome and Parkinson's disease, with effects on cognitive performance and energy. Unlike NAD+ precursors, NADH delivers the reduced coenzyme directly.

Navitoclax

Navitoclax (ABT-263) is a BCL-2/BCL-xL inhibitor originally developed as a cancer therapeutic that has demonstrated potent senolytic activity in preclinical aging models, extending lifespan and improving physical function in aged mice. Its clinical use in oncology is limited by platelet toxicity, but intermittent low-dose longevity protocols are being investigated to harness senolytic benefits while minimizing hematological side effects.

NMN

Nicotinamide mononucleotide (NMN) is a direct precursor to NAD+ and is rapidly absorbed and converted to NAD+ in tissues. It has gained significant attention from longevity researchers including David Sinclair for its potential to reverse aspects of cellular aging. Animal studies show improvements in energy metabolism, mitochondrial function, and lifespan. Human trials are ongoing with encouraging preliminary data.

NMN Liposomal

Liposomal NMN (nicotinamide mononucleotide) encapsulates NMN in phospholipid vesicles to improve cellular delivery and bioavailability compared to standard oral NMN. The liposomal formulation is designed to protect NMN from digestive degradation and enhance absorption through the intestinal epithelium and direct cellular uptake. It is marketed as a premium NAD+ precursor supplement with potentially superior pharmacokinetics to standard NMN powder or capsules.

NR

Nicotinamide riboside (NR) is an NAD+ precursor and vitamin B3 analog commercially available as Tru Niagen and other supplements. It effectively raises blood NAD+ levels in humans with a well-established safety profile. Clinical trials demonstrate improved muscle function in older adults and metabolic benefits in specific populations. It is one of the most studied NAD+ precursors in human clinical research.

Orforglipron

Orforglipron is a small-molecule, non-peptide GLP-1 receptor agonist taken as a once-daily oral pill, representing the first oral GLP-1 agent that does not require food-timing restrictions unlike semaglutide tablets. Phase III trials show approximately 9% weight loss at 36 weeks with a favorable tolerability profile. Developed by Eli Lilly, it may offer broader accessibility due to its oral bioavailability and lack of cold-chain requirements.

Oxytocin

Oxytocin is a neuropeptide hormone produced in the hypothalamus with roles in social bonding, stress response, and metabolic regulation. In optimization medicine it is used off-label for anxiety reduction, libido support, and gut motility improvement. Research suggests it may also reduce food intake and improve body composition in some populations. Compounded intranasal and subcutaneous formulations are available through licensed providers.

Pemvidutide

Pemvidutide is a GLP-1/glucagon dual receptor agonist being developed by Altimmune, showing Phase II weight loss of approximately 15% over 48 weeks with a notable advantage of preserving lean muscle mass — a key differentiator versus pure GLP-1 agents. Its glucagon component increases energy expenditure and fat oxidation while the GLP-1 component manages appetite and glucose. Early data suggests a favorable body composition profile compared to semaglutide.

Phosphatidylcholine IV

Intravenous phosphatidylcholine (PC) is a phospholipid essential for cell membrane integrity used in integrative medicine for hepatoprotection, cognitive enhancement, and lipid metabolism support. Originally developed for fatty liver disease treatment (approved in some European countries as Essentiale forte), it is used off-label in optimization medicine for liver regeneration, atherosclerosis, and neurological support. The PC exchange reaction can restore aged cell membranes.

Pregnenolone

Pregnenolone is the master precursor steroid synthesized from cholesterol and is the upstream substrate for all steroid hormones including cortisol, DHEA, progesterone, and sex hormones. It has documented neurosteroid activity and is studied for cognitive enhancement, mood stabilization, and neuroprotection. Levels decline with age and are frequently low in those with adrenal dysfunction. Available as an over-the-counter supplement.

Progesterone

Bioidentical progesterone is FDA-approved for use in women and is a key component of female hormone replacement therapy, balancing estrogen's proliferative effects on the uterus and breast. It also has calming, sleep-promoting, and neuroprotective properties via its neurosteroid metabolite allopregnanolone. In optimization medicine it is used in both women and some men for hormonal balance and sleep improvement. Oral micronized progesterone (Prometrium) is the gold standard.

PT-141

A synthetic cyclic heptapeptide melanocortin receptor agonist, bremelanotide (PT-141) acts primarily on MC4 receptors in the central nervous system to modulate sexual arousal pathways. The compound increases sexual desire through direct neurological mechanisms rather than peripheral vascular effects. Its primary clinical application is the treatment of hypoactive sexual desire disorder in premenopausal women.

Rapamycin

Rapamycin (sirolimus) is an FDA-approved immunosuppressant that is the most robust longevity-extending drug identified in animal models, extending lifespan in mice by 9–14% even when started late in life. It works by inhibiting mTORC1, a central nutrient-sensing pathway. Low-dose, intermittent protocols are being studied and self-administered by longevity researchers for healthspan extension. It carries meaningful immunosuppression risks requiring physician oversight.

Retatrutide

Retatrutide is a triple agonist targeting GLP-1, GIP, and glucagon receptors simultaneously, representing the most mechanistically advanced anti-obesity peptide in late-stage clinical development. Phase II trials reported mean body weight reductions of 24% over 48 weeks — the largest pharmacological weight loss ever recorded in a randomized controlled trial. It is being developed by Eli Lilly and is expected to enter Phase III trials in 2025–2026.

Semaglutide

A synthetic glucagon-like peptide-1 (GLP-1) receptor agonist, semaglutide mimics the incretin hormone GLP-1 to stimulate glucose-dependent insulin secretion, suppress glucagon release, and slow gastric emptying. The compound also acts on hypothalamic receptors to reduce appetite and food intake. Primary clinical applications include the management of type 2 diabetes mellitus and chronic weight management in individuals with obesity or overweight with weight-related comorbidities.

Sermorelin

A synthetic analog of growth hormone-releasing hormone (GHRH), this 29-amino acid peptide stimulates the pituitary gland to produce and secrete endogenous growth hormone through binding to GHRH receptors. It functions by mimicking the N-terminal bioactive portion of native GHRH, promoting pulsatile GH release while preserving the body's natural feedback mechanisms. Primary applications include diagnostic testing of pituitary function and therapeutic use in growth hormone deficiency.

SS-31

A mitochondria-targeted tetrapeptide, SS-31 (elamipretide) selectively concentrates in the inner mitochondrial membrane where it stabilizes cardiolipin and optimizes electron transport chain function. This mechanism reduces reactive oxygen species production and improves ATP synthesis in cells under metabolic stress. The compound has been investigated primarily for mitochondrial myopathies, heart failure with reduced ejection fraction, and other conditions characterized by mitochondrial dysfunction.

Survodutide

Survodutide is a GLP-1/glucagon dual agonist developed by Boehringer Ingelheim and Zealand Pharma, in Phase III trials for obesity and non-alcoholic steatohepatitis (NASH). It has shown 18–19% weight loss in Phase II with particularly strong effects on liver fat reduction, making it a leading candidate for MASH/NASH treatment beyond weight loss. The glucagon component drives hepatic fat clearance while GLP-1 handles appetite and glycemic control.

T3 Cytomel

Liothyronine (T3) is the biologically active thyroid hormone that directly activates thyroid hormone receptors in cells, in contrast to T4 which requires conversion. It is FDA-approved for hypothyroidism and is used off-label in optimization medicine to address tissue hypothyroidism, low T3 syndrome, and refractory depression. Its short half-life requires multiple daily doses but provides more direct cellular thyroid activity than T4 alone.

T4 Levothyroxine

Levothyroxine is the synthetic form of T4 and the most prescribed thyroid medication in the US, used as first-line treatment for hypothyroidism. It is a prodrug converted peripherally to active T3 by deiodinase enzymes, making conversion efficiency a critical variable in individual response. Many optimization-oriented physicians supplement T4 therapy with T3 to address conversion impairment and residual hypothyroid symptoms.

TB-500

A synthetic peptide fragment derived from Thymosin Beta-4, this compound functions as an actin-sequestering protein that promotes cell migration, angiogenesis, and tissue repair. Its mechanism involves upregulating cell-building proteins and reducing inflammation at injury sites. Research applications have focused primarily on wound healing, cardiac tissue repair following ischemic injury, and musculoskeletal recovery in preclinical models.

Tesamorelin

Tesamorelin is an FDA-approved GHRH analog indicated for HIV-associated lipodystrophy and is used off-label in optimization medicine for visceral fat reduction and cognitive enhancement. Clinical data shows significant reductions in visceral adipose tissue and emerging evidence suggests neuroprotective benefits in older adults. It produces stronger and more sustained GH elevation than sermorelin. Compounded versions are available through licensed pharmacies.

Testosterone Cypionate

A synthetic ester of testosterone, testosterone cypionate is an intramuscularly or subcutaneously administered androgen that provides sustained release of the hormone over approximately one to two weeks. It binds to androgen receptors throughout the body, promoting protein synthesis, muscle development, bone density maintenance, and secondary sex characteristics. The compound is primarily used in the treatment of male hypogonadism and as a component of gender-affirming hormone therapy.

Testosterone Enanthate

Testosterone enanthate is a long-acting esterified form of testosterone with a half-life of 4–5 days, making weekly or twice-weekly injections standard. It is FDA-approved for hypogonadism and is one of the most prescribed TRT formulations in the US. In optimization medicine it is used to restore and maintain testosterone to youthful physiologic levels. It requires injection but offers stable serum levels with proper dosing frequency.

Thymosin Alpha-1

Thymosin Alpha-1 (Tα1) is an endogenous thymic peptide with potent immunomodulatory and antiviral properties, approved in 37 countries for hepatitis B, hepatitis C, and as an immune adjuvant in cancer care. It is used in optimization medicine for immune restoration, chronic infection management, and as an adjunct in post-COVID recovery. Compounded Tα1 is available through US pharmacies. It has an exceptional safety profile with decades of clinical use.

Tirzepatide

A synthetic dual agonist peptide, tirzepatide activates both glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptors to enhance insulin secretion, suppress glucagon, slow gastric emptying, and reduce appetite. The compound produces significant improvements in glycemic control and body weight reduction. Primary clinical applications include treatment of type 2 diabetes mellitus and chronic weight management in adults with obesity.