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Lab work and peptide therapy

Why patients who add it to baseline before sermorelin, why IGF-1 is the marker, and what it means that a result is allowed to end the conversation.

Medically reviewed by the Kesbury Health physician · Last updated 2026-09-02

Quick answer

At Kesbury Health, the Longevity Lab Panel is optional; when you add it, it is ordered after approval and drawn at a Quest Diagnostics location. The $129 Longevity Lab Panel is a choice rather than a gate: skip it now and you can add it anytime, and your physician can still request labs in an individual case. Adding it gives your physician baseline context for monitoring and ongoing care. Its centrepiece is IGF-1, the practical laboratory marker of growth hormone axis activity, because growth hormone itself is released in pulses and a single random measurement of it carries almost no information. The panel provides a baseline for follow-up and can identify findings that may lead your physician to stop, change, or further evaluate therapy. When appropriate, later dose adjustments can be considered in the context of those results. When the panel is run, results that argue against therapy mean therapy is not prescribed, and that possible outcome is part of the point.

What a baseline adds, and why it is your choice

The panel is optional because the program does not need a lab result to justify itself: a licensed physician reviews every completed evaluation and can decline, with or without labs. What the panel adds is precision. A later result only means something when there is a baseline to compare it against, and, when appropriate, a physician can consider dose adjustments in the context of your own IGF-1 rather than a population average. That is what the panel is for, and it is why the panel is priced as its own visible line rather than folded into a subscription: the decision is yours, and you should be able to see it before you pay.

The practical consequence is worth stating plainly: when the panel is run, the answer can be no. A physician reviews the results and can decline or adjust therapy, which is what separates a lab step from a lab formality.

Why IGF-1 rather than growth hormone

Growth hormone is secreted in bursts, and the largest bursts are tied to early sleep, so a blood sample taken at an arbitrary moment may show almost nothing in a completely healthy person. IGF-1, produced by the liver in response to growth hormone, is far more stable across the day, which makes it the workable readout of the axis.

The marker also moves enough to be worth measuring. In a 2012 controlled trial, treatment with GHRH increased IGF-1 levels by 117% (P < .001) [5], which is why a baseline value taken before therapy is what makes a later value interpretable.

One technical caveat is important if you bring outside results. IGF-1 assays differ between laboratories, and a 2011 consensus statement in Clinical Chemistry was written to address the standardization and evaluation of growth hormone and IGF assays [2]. Comparing a value from one laboratory against another laboratory's reference interval is a well-recognised route to a wrong conclusion, which is why the same pathway is used for baseline and follow-up wherever possible.

What the panel is looking for

  • A baseline IGF-1 for later comparison and, when appropriate, dose adjustments.
  • Findings that make therapy inappropriate for you specifically.
  • Metabolic context, because growth hormone influences glucose handling.
  • Anything that argues for a different workup first, since fatigue, poor sleep and low motivation have causes that are more common than a hormone axis problem.

What happens after the result

Three outcomes are possible, and a process that only produces the first one is not measuring anything:

  1. Therapy is appropriate. The physician sets an individualized protocol against your baseline, and the medication is compounded by a licensed U.S. pharmacy and shipped to you.
  2. Therapy is not appropriate. Sermorelin is not prescribed. That is a real outcome of this step, not a hypothetical one.
  3. Something else comes first. The result points at a question that deserves its own workup before any peptide is considered.

Monitoring is part of the therapy

The principle is not specific to sermorelin. The 2011 Endocrine Society clinical practice guideline for adult growth hormone deficiency describes dose titration against clinical response and IGF-1, with monitoring built into the therapy rather than added to it [1]. The published GHRH research protocols were themselves measurement exercises: a 1992 study dosed for 14 days and measured [3], and a 1997 study ran six weeks of nightly home injections in eleven men aged 64 to 76 with low baseline IGF-1, selected on the basis of that measurement [4]. The sermorelin program here builds in a 90-day re-evaluation for the same reason.

How physician-directed sermorelin works at Kesbury Health

  1. Complete a short online assessment about your goals, symptoms and health history. It takes about 60 seconds to begin.
  2. A licensed Kesbury Health physician reviews what you submitted and decides whether therapy is a reasonable fit for you, or whether something else should be looked at first.
  3. Optional baseline labs. The $129 Longevity Lab Panel is optional. If you add it, it is ordered after approval and gives your physician a baseline for monitoring and, when appropriate, later dose adjustments. You can skip it now and add it later. If the results show a reason to stop, change, or further evaluate therapy, your physician will let you know. When it is run, the results can still end the conversation rather than continue it.
  4. If therapy is appropriate, the medication is compounded by a licensed U.S. pharmacy and shipped to your door, with dosing set to you rather than to a chart.
  5. Ongoing physician oversight follows the protocol set at approval: a check-in questionnaire about every 30 days and a physician reassessment about every 90 days determine whether treatment continues or changes.

Care is delivered by telehealth to residents of the ten states where your Kesbury Health physician is licensed: Alabama, District of Columbia, Delaware, Florida, Maryland, Michigan, New Jersey, Ohio, Pennsylvania and Texas. Eligibility is confirmed during the assessment.

Frequently asked questions

Do you need labs before starting sermorelin?

No. The $129 Longevity Lab Panel is optional at Kesbury Health, not a prerequisite. Adding it gives your physician baseline context for monitoring and ongoing care. Your physician can still request labs in an individual case, and the panel is no formality: when it is run, results that argue against therapy mean therapy is not prescribed.

What does the Longevity Lab Panel look at?

Its centrepiece is IGF-1, the practical laboratory marker of growth hormone axis activity, together with the general health markers a prescribing physician needs before starting an endocrine medication. IGF-1 is used because growth hormone itself is released in pulses and a single random measurement of it says very little.

Why can a result end the conversation?

Because some results make therapy inappropriate, and a process that cannot say no is not a clinical process. That is the difference between a lab step and a lab formality, and it is the reason the panel is billed as its own visible line rather than buried in a monthly price.

Can I use labs from my own doctor?

Bring them, and expect your physician to weigh them carefully. IGF-1 assays are not perfectly interchangeable between laboratories, which a 2011 consensus statement in Clinical Chemistry addressed directly [2], so a result from one lab compared against another lab's reference range can mislead. Your physician may still want a panel run through the same pathway your follow-up will use.

Are labs repeated later?

Follow-up measurement is part of the therapy rather than an extra. Endocrine Society guidance for growth hormone therapy describes titration against clinical response and IGF-1 rather than a fixed schedule [1], and the sermorelin program here builds in a 90-day re-evaluation.

Is a lab panel required for NAD+ as well?

No lab panel is required for either therapy. The optional Longevity Lab Panel can be added on any plan. Both NAD+ and sermorelin require a physician evaluation, and your physician can order labs where your history indicates them.

Start with the measurement, if you choose it

Start the Kesbury Health evaluation. Where sermorelin is under consideration, add the optional $129 Longevity Lab Panel if you want a baseline your physician can use during follow-up and, when appropriate, later dose adjustments.

Start your evaluation →

Kesbury Health is a LegitScript-certified (#51875982) telehealth longevity practice licensed in ten states. Sermorelin and NAD+ are compounded medications prescribed by a licensed physician after review. Compounded medications are not FDA-approved. This page is educational and is not individualized medical advice. Statements on this page have not been evaluated by the FDA. Individual results vary.

References (primary sources)

Every reference below was checked against its PubMed record on 2026-09-02. Links open the abstract.

  1. Molitch ME, Clemmons DR, Malozowski S, Merriam GR, Vance ML. Evaluation and treatment of adult growth hormone deficiency: an Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism. 2011;96(6):1587-1609. doi:10.1210/jc.2011-0179. PMID 21602453.
  2. Clemmons DR. Consensus statement on the standardization and evaluation of growth hormone and insulin-like growth factor assays. Clinical Chemistry. 2011;57(4):555-559. doi:10.1373/clinchem.2010.150631. PMID 21285256.
  3. Corpas E, Harman SM, Pineyro MA, Roberson R, Blackman MR. Growth hormone (GH)-releasing hormone-(1-29) twice daily reverses the decreased GH and insulin-like growth factor-I levels in old men. Journal of Clinical Endocrinology and Metabolism. 1992;75(2):530-535. doi:10.1210/jcem.75.2.1379256. PMID 1379256.
  4. Vittone J, Blackman MR, Busby-Whitehead J, Tsiao C, et al. Effects of single nightly injections of growth hormone-releasing hormone (GHRH 1-29) in healthy elderly men. Metabolism. 1997;46(1):89-96. doi:10.1016/s0026-0495(97)90174-8. PMID 9005976.
  5. Baker LD, Barsness SM, Borson S, Merriam GR, et al. Effects of growth hormone-releasing hormone on cognitive function in adults with mild cognitive impairment and healthy older adults: results of a controlled trial. Archives of Neurology. 2012;69(11):1420-1429. doi:10.1001/archneurol.2012.1970. PMID 22869065.

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