Labs · Protocol

Lab work and peptide therapy

Q: Do you need labs before starting sermorelin?

At Kesbury Health, yes. The $179 Sermorelin Baseline Panel is a prerequisite for sermorelin therapy, and the signed sermorelin consent states the panel is required. It is not an optional add-on and it is not a formality: results that argue against therapy mean therapy is not prescribed.

Q: 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.

Q: 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.

Q: 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.

Q: Is a lab panel required for NAD+ as well?

No. The required panel is specific to sermorelin. NAD+ therapy still requires a physician evaluation, and your physician can order labs where your history indicates them.

Why the baseline panel is a prerequisite rather than an upsell, 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 Clinical Team · Last updated 2026-09-02

Quick answer

At Kesbury Health, a baseline lab panel is required before sermorelin therapy, not offered alongside it. The $179 Sermorelin Baseline Panel is a prerequisite: the signed sermorelin consent states the panel is required, and the prescription follows the result rather than the other way round. 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 does two jobs. It checks that nothing in your current biology argues against therapy, and it establishes the reference point that your individualized dose is set against and later compared to. Results that argue against therapy mean therapy is not prescribed, and that possible outcome is the point of the step.

Why the panel is required rather than recommended

A lab step that can be skipped when the patient is keen is a marketing step wearing a lab coat. The requirement here is written into the sermorelin consent a patient signs, which is a stronger commitment than a sentence on a marketing page, and it is priced as its own visible line rather than folded into a subscription so that the decision point is visible before you pay.

The practical consequence is worth stating plainly: when the panel is run, the answer can be no. Comparing telehealth providers on this single question separates a clinical process from a fulfilment pipeline more reliably than any other question you can ask.

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 to anchor dosing and later comparison.
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:

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.
Therapy is not appropriate. Sermorelin is not prescribed. That is a real outcome of this step, not a hypothetical one.
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

Complete a short online assessment about your goals, symptoms and health history. It takes about 60 seconds to begin.
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.
Baseline labs where they apply. The $179 Sermorelin Baseline Panel is a prerequisite for sermorelin therapy, and the results can end the conversation rather than continue it.
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.
Ongoing physician oversight adjusts the protocol over time, with a 90-day re-evaluation built into the sermorelin program.

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?

At Kesbury Health, yes. The $179 Sermorelin Baseline Panel is a prerequisite for sermorelin therapy, and the signed sermorelin consent states the panel is required. It is not an optional add-on and it is not a formality: results that argue against therapy mean therapy is not prescribed.

What does the baseline 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. The required panel is specific to sermorelin. NAD+ therapy still requires a physician evaluation, and your physician can order labs where your history indicates them.

Start with the measurement

Take the free 60-second Kesbury Health assessment. Where sermorelin is under consideration, the required baseline panel comes before any prescription, and the result is allowed to end the conversation.

Start your free 60-second assessment →

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.

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.
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.
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.
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.
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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