01 · 11 referencesHuman trials + laboratory research
Retatrutide
GLP-3 (RT) · LY3437943
Phase 1b through phase 3, plus metabolic substudies
The reading list covers glucose and weight endpoints, liver fat measured by MRI, body composition, kidney markers, appetite questionnaires and receptor structures. TRANSCEND-T2D-1 provides published phase 3 diabetes results; the TRIUMPH design paper explains the obesity, sleep-apnoea and knee-osteoarthritis programme.
Limit of this evidenceSubstudies reuse participants from the parent trials. Biomarker changes do not establish prevention of kidney failure or cardiovascular events. A trial formulation is not evidence that a commercial research vial is equivalent.
Clinical trials · 4+
TRANSCEND-T2D-1: phase 3 diabetes monotherapy ↗ (opens in a new tab)Bajaj HS et al. · Lancet (London, England) · 2026 · PMID 42250575537 adults · 40 weeks · placebo controlled
HbA1c fell 1.69–1.94 percentage points across the study arms versus 0.81 with placebo. Mean weight change was −11.5% to −15.3% versus −2.6% (treatment-regimen analysis).
Keep in mind: Participants had diabetes inadequately controlled with diet and exercise. Gastrointestinal events were most frequent; adverse-event discontinuation was 2–5% versus 0%. Two deaths were judged unrelated to treatment.
Phase 2 obesity trial: 24- and 48-week outcomes ↗ (opens in a new tab)Jastreboff AM et al. · The New England journal of medicine · 2023 · PMID 37366315338 adults · 48 weeks · placebo controlled
At 48 weeks, mean weight change ranged from −8.7% to −24.2% across retatrutide arms, compared with −2.1% with placebo. The primary endpoint was at 24 weeks; 48-week weight change was secondary.
Keep in mind: Gastrointestinal events were dose related. Heart-rate increases peaked at 24 weeks and then declined. This was a phase 2 trial, not a long-term cardiovascular-outcomes study.
Phase 2 diabetes: glucose and weight endpoints ↗ (opens in a new tab)Rosenstock J et al. · Lancet (London, England) · 2023 · PMID 37385280281 randomized · 36 weeks · placebo and dulaglutide comparators
At week 24, HbA1c change reached −2.02 percentage points in the highest study arm versus −0.01 with placebo and −1.41 with dulaglutide. At week 36, weight change reached −16.94% versus −3.00% and −2.02%, respectively.
Keep in mind: 275 participants entered efficacy analyses. Gastrointestinal events occurred in 35% of retatrutide recipients overall, 13% on placebo and 35% on dulaglutide. Comparisons depend on the specific study arm.
Phase 1b: early pharmacology and tolerability ↗ (opens in a new tab)Urva S et al. · Lancet (London, England) · 2022 · PMID 3635404072 participants · 12 weeks · small ascending-dose cohorts
The study measured pharmacokinetics, glucose, HbA1c and weight. The estimated half-life was about six days; higher-exposure cohorts showed reductions in glucose and weight.
Keep in mind: 29 participants discontinued early. Safety and tolerability were the primary purpose; small cohorts and short follow-up limit conclusions. Gastrointestinal disorders were the most frequent adverse events.
Secondary analyses · 5+
Liver-fat MRI substudy ↗ (opens in a new tab)Sanyal AJ et al. · Nature medicine · 2024 · PMID 3885852398 participants from the phase 2 obesity trial · 48 weeks
At week 24, relative liver-fat change ranged from −42.9% to −82.4% across retatrutide arms versus +0.3% on placebo. Participants entered with liver fat of at least 10%.
Keep in mind: This is a subset of the obesity trial, not an independent trial. MRI fat measurements do not establish histological fibrosis reversal or prevention of liver complications.
DXA body-composition substudy ↗ (opens in a new tab)Coskun T et al. · The lancet. Diabetes & endocrinology · 2025 · PMID 40609566189 enrolled in substudy · 36 weeks
Total fat mass fell by 15.2%, 26.1% and 23.2% in the pooled 4, pooled 8 and 12 mg study arms, versus 4.5% with placebo. The paper also assessed lean-mass loss.
Keep in mind: Only 103 participants completed treatment with both baseline and week-36 scans. Lean mass also fell; these findings do not support a “no muscle loss” claim.
Kidney markers: albuminuria and estimated filtration ↗ (opens in a new tab)Heerspink HJL et al. · Kidney international reports · 2025 · PMID 40630318Post-hoc analysis of two phase 2 trials · 36 and 48 weeks
Higher study arms reduced urine albumin-to-creatinine ratio. Estimated filtration increased in the obesity cohort but was unchanged versus placebo in the diabetes cohort.
Keep in mind: Most participants had normal albuminuria, so absolute reductions were modest. These were laboratory markers, not kidney-failure outcomes; this is not a new independent trial.
Appetite and eating-behaviour questionnaires ↗ (opens in a new tab)Kanu C et al. · Diabetes, obesity & metabolism · 2025 · PMID 40916752275 adults with diabetes · exploratory analysis · 24 and 36 weeks
Higher study arms reduced self-reported hunger and disinhibition compared with placebo. Differences versus dulaglutide were less consistent. Questionnaire changes correlated with weight change.
Keep in mind: Self-reported appetite is not a direct measurement of energy intake. Participants came from the same phase 2 diabetes trial.
Lipidomics and metabolomics ↗ (opens in a new tab)Pearson MJ et al. · The Journal of clinical endocrinology and metabolism · 2026 · PMID 42135195282 obesity and 213 diabetes participants · post-hoc analysis
Fasting samples showed changes in metabolites related to fatty-acid oxidation and insulin resistance, including acylcarnitines, branched-chain amino-acid products and selected triglycerides.
Keep in mind: Associations and mediation models do not establish causation or fewer cardiovascular events. Both populations were drawn from the existing phase 2 trials.
Trial design · 1+
TRIUMPH programme: what the phase 3 trials measure ↗ (opens in a new tab)Giblin K et al. · Diabetes, obesity & metabolism · 2026 · PMID 41090431Four placebo-controlled trials · planned programme over 5,800 participants
The design includes weight management, sleep-apnoea and knee-osteoarthritis assessments. Endpoints include percentage weight change, apnoea–hypopnoea index and WOMAC knee-pain score.
Keep in mind: This publication describes trial design; it is not a results report and does not give current recruitment status.
Foundational references · 1+
02 · 25 referencesPhase 3 trials + laboratory research
Tirzepatide
GLP-2 (TZ) · LY3298176
Compound identity · PubChem
SURMOUNT, SURPASS, sleep apnoea, heart failure and liver disease
SURMOUNT studies examine weight management and maintenance. SURPASS studies examine diabetes, with different background treatments and comparators. Separate trials assess sleep apnoea, heart failure and liver histology. Each result below belongs to its stated population and endpoint.
Limit of this evidenceDo not compare percentages across different trials as if participants and study designs were identical. Primary trials, extensions and post-hoc analyses are labelled separately. Clinical results do not certify research-product identity, quality or human suitability.
Weight-management trials · 7+
SURMOUNT-1: obesity without diabetes ↗ (opens in a new tab)Jastreboff AM et al. · The New England journal of medicine · 2022 · PMID 356580242,539 participants · 72 weeks · placebo controlled
Mean weight change was −15.0%, −19.5% and −20.9% across the three study arms versus −3.1% with placebo.
Keep in mind: Participants did not have diabetes. Gastrointestinal events predominated; adverse-event discontinuation ranged from 4.3–7.1% with tirzepatide versus 2.6% with placebo.
SURMOUNT-1 extension: three-year follow-up ↗ (opens in a new tab)Jastreboff AM et al. · The New England journal of medicine · 2025 · PMID 395362381,032 participants with prediabetes · 176 weeks plus 17 weeks off treatment
Diabetes was diagnosed in 1.3% of tirzepatide recipients versus 13.3% of placebo recipients by week 176. After 17 weeks off treatment, proportions were 2.4% and 13.7%.
Keep in mind: This is the prediabetes subgroup of SURMOUNT-1, not another independent trial. Gastrointestinal events were most common during escalation. It does not show permanent prevention after treatment stops.
SURMOUNT-2: obesity with type 2 diabetes ↗ (opens in a new tab)Garvey WT et al. · Lancet (London, England) · 2023 · PMID 37385275938 participants · 72 weeks · placebo controlled
Mean weight change was −12.8% and −14.7% in the two tirzepatide arms versus −3.2% with placebo in the treatment-regimen analysis.
Keep in mind: The population had both obesity/overweight and diabetes; results are not interchangeable with SURMOUNT-1. Gastrointestinal adverse events were most common.
SURMOUNT-3: after intensive lifestyle intervention ↗ (opens in a new tab)Wadden TA et al. · Nature medicine · 2023 · PMID 37840095579 randomized after a 12-week lead-in · 72 additional weeks
Following initial lifestyle-associated loss, weight changed a further −18.4% with tirzepatide versus +2.5% with placebo.
Keep in mind: Only participants who first lost at least 5% entered randomization. The reported change starts after that lead-in. Most common adverse events were gastrointestinal.
SURMOUNT-4: continuation versus withdrawal ↗ (opens in a new tab)Aronne LJ et al. · JAMA · 2024 · PMID 38078870670 randomized after a 36-week lead-in · 52-week comparison
From randomization to week 88, continuing tirzepatide produced a further −5.5% weight change; switching to placebo produced +14.0%.
Keep in mind: All randomized participants had already completed the tirzepatide lead-in. These percentages describe change from week 36, not from the original baseline.
SURMOUNT-5: direct comparison with semaglutide ↗ (opens in a new tab)Aronne LJ et al. · The New England journal of medicine · 2025 · PMID 40353578751 participants without diabetes · 72 weeks · open label
Mean weight change was −20.2% with tirzepatide versus −13.7% with semaglutide. Both groups used their maximum tolerated study dose.
Keep in mind: The trial was open label. Semaglutide arms used 1.7 or 2.4 mg, unlike SURPASS-2. Gastrointestinal events were the most common adverse events in both groups.
SURMOUNT-MAINTAIN: maintenance after initial weight loss ↗ (opens in a new tab)Horn DB et al. · Lancet (London, England) · 2026 · PMID 42119587378 randomized after 60-week lead-in · 112 weeks total
From original baseline to week 112, modelled weight change was −21.9% with continued maximum-tolerated treatment, −16.6% with the reduced study dose and −9.9% after switching to placebo.
Keep in mind: This selected participants who completed the lead-in. Rescue treatment was permitted after substantial regain and was handled in the primary analysis. Gastrointestinal events were most common.
Diabetes trials · 6+
SURPASS-1: diabetes monotherapy ↗ (opens in a new tab)Rosenstock J et al. · Lancet (London, England) · 2021 · PMID 34186022478 participants · 40 weeks · placebo controlled
HbA1c fell 1.87–2.07 percentage points across tirzepatide arms versus a 0.04-point rise on placebo.
Keep in mind: This was a monotherapy setting. Nausea, diarrhoea and vomiting were more frequent with tirzepatide; results do not describe add-on insulin therapy.
SURPASS-2: comparison with semaglutide in diabetes ↗ (opens in a new tab)Frías JP et al. · The New England journal of medicine · 2021 · PMID 341706471,879 participants · 40 weeks · open label
HbA1c fell 2.01–2.30 percentage points with tirzepatide versus 1.86 with semaglutide. All three tirzepatide arms met noninferiority and superiority criteria for this endpoint.
Keep in mind: The semaglutide comparator was 1 mg. This study cannot stand in for an obesity-dose comparison; gastrointestinal adverse events occurred in both groups.
SURPASS-3: comparison with insulin degludec ↗ (opens in a new tab)Ludvik B et al. · Lancet (London, England) · 2021 · PMID 343709701,444 randomized; 1,437 treated · 52 weeks · open label
HbA1c fell 1.93–2.37 percentage points with tirzepatide versus 1.34 with degludec. Weight fell 7.5–12.9 kg with tirzepatide and rose 2.3 kg with degludec.
Keep in mind: Participants used metformin with or without an SGLT2 inhibitor. Gastrointestinal events and adverse-event discontinuation were more common with tirzepatide; hypoglycaemia was less common.
SURPASS-4: diabetes with high cardiovascular risk ↗ (opens in a new tab)Del Prato S et al. · Lancet (London, England) · 2021 · PMID 346729672,002 randomized · 52-week primary endpoint · insulin glargine comparator
HbA1c fell 2.43 and 2.58 percentage points in the 10 and 15 mg study arms versus 1.44 with glargine.
Keep in mind: This glycaemic trial is distinct from SURPASS-CVOT. Gastrointestinal events were more frequent with tirzepatide; cardiovascular-outcomes claims require the dedicated outcomes trial.
SURPASS-5: added to basal insulin ↗ (opens in a new tab)Dahl D et al. · JAMA · 2022 · PMID 35133415475 participants · 40 weeks · placebo controlled
With background insulin glargine, HbA1c fell 2.11–2.40 percentage points across tirzepatide arms versus 0.86 with placebo. Weight fell 5.4–8.8 kg versus a 1.6 kg rise.
Keep in mind: Both groups continued insulin therapy. Nausea occurred in 13–18% versus 3%, and diarrhoea in 12–21% versus 10%.
SURPASS-6: comparison with mealtime insulin ↗ (opens in a new tab)Rosenstock J et al. · JAMA · 2023 · PMID 377863961,428 randomized · 52 weeks · open label
Added to basal insulin, pooled tirzepatide reduced HbA1c by 2.1 percentage points versus 1.1 with insulin lispro. Weight changed −9.0 kg versus +3.2 kg.
Keep in mind: Hypoglycaemia rates were 0.4 versus 4.4 events per patient-year. Gastrointestinal symptoms were common with tirzepatide. Results concern this particular insulin-treated population.
Organ-specific trials · 4+
SURPASS-CVOT: cardiovascular outcomes ↗ (opens in a new tab)Nicholls SJ et al. · The New England journal of medicine · 2025 · PMID 4140644413,299 randomized; 13,165 in modified analysis · active comparator
Cardiovascular death, myocardial infarction or stroke occurred in 12.2% with tirzepatide versus 13.1% with dulaglutide: hazard ratio 0.92, 95.3% confidence interval 0.83–1.01.
Keep in mind: Noninferiority was met; superiority was not (P=0.09). Participants had diabetes and established atherosclerotic cardiovascular disease. Gastrointestinal events were more frequent with tirzepatide.
SURMOUNT-OSA: obstructive sleep apnoea ↗ (opens in a new tab)Malhotra A et al. · The New England journal of medicine · 2024 · PMID 38912654Two randomized trials · 52 weeks · placebo controlled
The apnoea–hypopnoea index fell 25.3 versus 5.3 events/hour in trial 1, and 29.3 versus 5.5 in trial 2.
Keep in mind: One trial enrolled people not using positive airway pressure; the other enrolled users. All had obesity and moderate-to-severe sleep apnoea. Gastrointestinal events predominated.
SUMMIT: heart failure with preserved ejection fraction ↗ (opens in a new tab)Packer M et al. · The New England journal of medicine · 2025 · PMID 39555826731 participants · median follow-up 104 weeks · placebo controlled
Cardiovascular death or worsening heart failure occurred in 9.9% versus 15.3% (hazard ratio 0.62; 95% CI 0.41–0.95). Health-status scores also improved.
Keep in mind: The composite difference was mainly from fewer worsening-heart-failure events; cardiovascular mortality alone was not established as reduced. Adverse-event discontinuation was 6.3% versus 1.4%.
SYNERGY-NASH: liver-biopsy outcomes ↗ (opens in a new tab)Loomba R et al. · The New England journal of medicine · 2024 · PMID 38856224190 randomized · 52 weeks · phase 2
Resolution of MASH without worsening fibrosis occurred in 44–62% across tirzepatide arms versus 10% with placebo. One-stage fibrosis improvement without worsening MASH occurred in 51–55% versus 30%.
Keep in mind: 157 participants had evaluable paired biopsies. These are histological endpoints, not liver-failure or survival outcomes. Gastrointestinal events were most common.
Secondary analyses · 3+
SURPASS-4 kidney analysis ↗ (opens in a new tab)Heerspink HJL et al. · The lancet. Diabetes & endocrinology · 2022 · PMID 36152639Post-hoc analysis of SURPASS-4
The analysis evaluated estimated filtration, urine albumin and a composite kidney endpoint including new macroalbuminuria, comparing tirzepatide with insulin glargine.
Keep in mind: This reuses SURPASS-4 participants. The composite includes albuminuria; it should not be described simply as fewer cases of kidney failure.
SURMOUNT-1: fat mass and lean mass by DXA ↗ (opens in a new tab)Look M et al. · Diabetes, obesity & metabolism · 2025 · PMID 39996356160 participants with paired scans · 72 weeks
Pooled tirzepatide participants had −33.9% fat-mass and −10.9% lean-mass change, versus −8.2% and −2.6% with placebo. Approximately 75% of weight lost was fat and 25% lean mass in both groups.
Keep in mind: A substudy of SURMOUNT-1, not an independent trial. Lean mass includes more than skeletal muscle, and these averages do not predict an individual’s body-composition changes.
SURMOUNT-CN: follow-up after treatment stopped ↗ (opens in a new tab)Chen C et al. · Life metabolism · 2025 · PMID 42058132152 completers · 26-week observational follow-up
After cessation, mean weight rose 9.1% and 12.3% in the previous tirzepatide groups versus 1.8% in the previous placebo group. All groups remained below their original trial baseline on average.
Keep in mind: The follow-up was observational and excluded subsequent anti-obesity medicines or bariatric procedures. Regain figures start at treatment cessation, not the original baseline.
Regional trials · 2+
SURMOUNT-CN: Chinese adults without diabetes ↗ (opens in a new tab)Zhao L et al. · JAMA · 2024 · PMID 38819983210 participants · 52 weeks · randomized placebo control
Mean weight change was −13.6% and −17.5% in the two tirzepatide arms versus −2.3% with placebo.
Keep in mind: Eligibility used Chinese BMI thresholds and excluded diabetes. Gastrointestinal events were most common; the population and duration differ from the global SURMOUNT trials.
SURMOUNT-J: Japanese adults with obesity disease ↗ (opens in a new tab)Kadowaki T et al. · The lancet. Diabetes & endocrinology · 2025 · PMID 40031941267 randomized; 225 in modified analysis · 72 weeks
Weight-change differences relative to placebo were −16.1 and −21.1 percentage points in the two study arms.
Keep in mind: These figures are placebo-adjusted differences, not within-arm weight loss. One site was excluded from the modified analysis. Gastrointestinal symptoms were the most common adverse events.
Trial design · 2+
SURMOUNT-MMO: morbidity and mortality trial design ↗ (opens in a new tab)Lam CSP et al. · Obesity (Silver Spring, Md.) · 2025 · PMID 40545827Event-driven trial · approximately 15,000 planned participants
The primary composite includes myocardial infarction, stroke, coronary revascularization, heart-failure events and death from any cause in adults with obesity/overweight without diabetes.
Keep in mind: A rationale-and-design publication. It does not report a reduction in any of these outcomes or establish current recruitment status.
SURMOUNT-REAL UK: pragmatic trial design ↗ (opens in a new tab)Rutter MK et al. · Obesity (Silver Spring, Md.) · 2026 · PMID 42297568Approximately 3,000 planned participants · five-year study
The planned comparison is tirzepatide plus standard care versus standard care alone. The primary endpoint is weight change at 24 months; a key secondary endpoint is diabetes onset through month 60.
Keep in mind: This publication describes planned methods and endpoints, not results. It focuses on UK primary care and class I obesity without diabetes.
Foundational references · 1+
03 · 6 referencesIngredient studies
BPC-157 / TB-500
Two-component blend
Compound identity · PubChem
Component records for the blend.
TB-500 fragment · CID 62707662 ↗ (opens in a new tab)- Formula
- C38H68N10O14
- Also called
- TB500
- Sequence
- Ac-LKKTETQ-OH
This record is the acetylated seven-residue fragment. Full-length thymosin beta-4 is a different molecule; the TB-500 name alone does not establish which form was supplied.
Two ingredients need separate evidence
BPC-157 increased growth-hormone receptor expression in rat tendon fibroblasts at both mRNA and protein levels. A separate analytical paper identified an acetylated thymosin beta-4 fragment in a product labelled TB-500.
Limit of this evidenceThese studies do not establish the performance or safety of the combined vial. TB-500 fragment research and full-length thymosin beta-4 research require separate sequence matching.
Analytical and preclinical studies · 3+
TB-500 metabolism and fibroblast assays ↗ (opens in a new tab)Rahaman KA et al. · Journal of chromatography. B, Analytical technologies in the biomedical and life sciences · 2024 · PMID 38382158In-vitro systems and rats · mass spectrometry
Researchers quantified TB-500 and metabolites. Ac-LKKTE, rather than the parent peptide, showed significant wound-healing activity in the reported fibroblast assay.
Keep in mind: This paper defines TB-500 as Ac-LKKTETQ. Check the exact sequence before applying it to a differently labelled material. No BPC-157 combination was tested.
TB-500 detection in equine samples ↗ (opens in a new tab)Ho EN et al. · Journal of chromatography. A · 2012 · PMID 23084823Equine urine and plasma · LC–MS
The validated method detected N-acetylated LKKTETQ and metabolites after administration to horses, using retention times and product-ion patterns.
Keep in mind: Analytical detection is not evidence of clinical benefit. Full-length thymosin beta-4 and this fragment are different materials.
Peptide loss to laboratory surfaces ↗ (opens in a new tab)Judák P et al. · Analytical biochemistry · 2017 · PMID 28887173Recovery from glassware and plasticware
TB-500 was one of four peptides used to compare adsorption. More expensive low-binding consumables did not consistently give better recovery.
Keep in mind: This concerns analytical sample handling, not a verified shelf life or storage rule for our vial.
Evidence review · 1+
BPC-157: scope of the orthopaedic literature ↗ (opens in a new tab)Vasireddi N et al. · HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2025 · PMID 40756949Systematic review · search through 3 June 2024
The authors included 36 studies: 35 preclinical studies and one clinical study. They found no clinical safety data within the included evidence.
Keep in mind: This is a review, not a new experiment. Its search cutoff matters; it should not be presented as a complete account of all later research.
Foundational references · 2+
04 · 5 referencesIngredient evidence · blend gap
KLOW
KPV + GHK-Cu + BPC-157 + TB-500
Compound identity · PubChem
KLOW combines KPV, GHK-Cu, BPC-157 and TB-500. These are component references, not a single blend identifier.
TB-500 fragment · CID 62707662 ↗ (opens in a new tab)- Formula
- C38H68N10O14
- Also called
- TB500
- Sequence
- Ac-LKKTETQ-OH
This record is the acetylated seven-residue fragment. Full-length thymosin beta-4 is a different molecule; the TB-500 name alone does not establish which form was supplied.
Four ingredients, with separate research histories
KLOW combines KPV, GHK-Cu, BPC-157 and TB-500. KPV papers focus on inflammatory signalling and delivery; GHK-Cu on extracellular matrix biology; BPC-157 on cell and animal models; and TB-500 on peptide identity, metabolism and analytical detection.
Limit of this evidenceThe papers below studied individual ingredients or different formulations. No study of this exact four-ingredient KLOW blend was verified. They do not establish additive effects, synergy, stability or clinical safety of the combination.
Ingredient studies · 5+
KPV: PepT1 transport and inflammatory signalling ↗ (opens in a new tab)Dalmasso G et al. · Gastroenterology · 2008 · PMID 18061177Human cell lines and two mouse colitis models
KPV uptake involved the PepT1 transporter. Experiments measured reduced NF-κB/MAPK signalling and cytokine secretion, followed by findings in DSS- and TNBS-induced mouse colitis.
Keep in mind: Human-derived cells are not a human clinical trial. No GHK-Cu, BPC-157 or TB-500 blend was tested.
KPV: targeted nanoparticle delivery ↗ (opens in a new tab)Xiao B et al. · Molecular therapy : the journal of the American Society of Gene Therapy · 2017 · PMID 28143741Cell experiments and mouse colitis model
Hyaluronic-acid-functionalized nanoparticles delivered KPV to epithelial cells and macrophages. The nanoparticle/hydrogel formulation reduced TNF-α and mucosal damage in the mouse model.
Keep in mind: The carrier and oral delivery system are part of the experiment. Results cannot be assigned to a plain mixed peptide vial.
GHK-Cu: extracellular matrix in rat wound chambers ↗ (opens in a new tab)Maquart FX et al. · The Journal of clinical investigation · 1993 · PMID 8227353Individual-ingredient preclinical research
The study measured collagen and extracellular-matrix accumulation in experimental rat wounds. It did not test the KLOW blend.
Keep in mind: Ingredient findings do not demonstrate the performance or safety of KLOW.
TB-500: parent peptide and metabolite activity ↗ (opens in a new tab)Rahaman KA et al. · Journal of chromatography. B, Analytical technologies in the biomedical and life sciences · 2024 · PMID 38382158Individual-ingredient preclinical research
In fibroblast assays, a metabolite showed a significant wound-healing signal while the parent did not. The work also studied rat metabolism; it was not a human blend trial.
Keep in mind: Ingredient findings do not demonstrate the performance or safety of KLOW.
05 · 5 referencesCell and animal studies
GHK-Cu
Copper tripeptide complex
Compound identity · PubChem
Collagen, matrix remodelling and wound models
The papers examine collagen production, proteoglycans and matrix-remodelling enzymes in fibroblasts and rat wounds. Findings vary by model: a study of irradiated rat flaps did not show significant improvement with topical GHK-Cu.
Limit of this evidenceA cell-culture measurement is not a demonstrated skin outcome or a test of this product. GHK and its copper complex must be distinguished when selecting papers.
Laboratory and animal studies · 4+
GHK-Cu in experimental rat wounds ↗ (opens in a new tab)Maquart FX et al. · The Journal of clinical investigation · 1993 · PMID 8227353Animal model / tissue assays
Rat wound chambers showed increased collagen and other extracellular-matrix components after GHK-Cu exposure.
Keep in mind: An implanted rat wound chamber does not establish human cosmetic or healing outcomes.
Proteoglycans and matrix composition ↗ (opens in a new tab)Siméon A et al. · The Journal of investigative dermatology · 2000 · PMID 11121126Animal model / tissue assays
Rat wound tissue and fibroblast cultures showed altered decorin, biglycan and glycosaminoglycan expression. Different matrix components responded differently.
Keep in mind: These are molecular and tissue measurements, not evidence for a universal collagen or skin claim.
Matrix metalloproteinases during remodelling ↗ (opens in a new tab)Siméon A et al. · The Journal of investigative dermatology · 1999 · PMID 10383745Animal model / tissue assays
Rat wound experiments found time-dependent changes in MMP-2 and MMP-9 expression or activity. Interstitial collagenase activity was not altered.
Keep in mind: The response depended on the enzyme and sampling time; the study did not test human treatment.
Irradiated rat wounds: no significant improvement ↗ (opens in a new tab)Parker NP et al. · Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2013 · PMID 23744835Animal model / tissue assays
Topical GHK-Cu gel did not significantly improve flap ischaemia, vessel number, vessel area or VEGF expression at the study’s significance threshold.
Keep in mind: This negative result used irradiated rat flaps and a topical gel. It shows why positive findings cannot be generalized across wound models.
Foundational references · 1+
06 · 3 referencesPreclinical + observational research
MOTS-C
Mitochondrial-derived peptide
Compound identity · PubChem
Mitochondrial signalling and metabolism
The 2015 discovery paper investigated a peptide encoded within mitochondrial DNA. It linked MOTS-c to the folate cycle and AMPK signalling in experiments using cells and mice.
Limit of this evidenceThe paper combines cell experiments and mouse models. These findings do not establish the same metabolic response in humans.
Animal and human observational research · 2+
Exercise, ageing and muscle homeostasis ↗ (opens in a new tab)Reynolds JC et al. · Nature communications · 2021 · PMID 33473109Mice, muscle cells and human exercise measurements
MOTS-c administration improved physical performance in mice. In the human part, exercise increased naturally occurring MOTS-c in muscle and circulation.
Keep in mind: The human participants were not a clinical trial of administered MOTS-c. Mouse performance findings cannot be relabelled as human anti-ageing results.
Circulating MOTS-c and strength ↗ (opens in a new tab)Domin R et al. · International journal of molecular sciences · 2023 · PMID 3783439920 physically active volunteers · observational
Resting MOTS-c correlated with some jump-force, power and muscle-mass measures, but not peak oxygen uptake.
Keep in mind: Small cross-sectional association; no peptide treatment and no evidence that raising MOTS-c causes greater strength.
Foundational references · 1+
07 · 4 referencesIngredient trials · blend gap
CJC-1295 / Ipamorelin
No DAC · Two-component blend
Compound identity · PubChem
Ipamorelin is linked below. An exact PubChem record for the no-DAC CJC component has not been verified; a different CJC form is not substituted.
Ipamorelin evidence is not blend evidence
A 1998 study tested ipamorelin in rat pituitary cells, rats and swine. It measured growth-hormone release and compared selectivity with other secretagogues.
Limit of this evidenceIt did not test a CJC-1295/Ipamorelin blend. Papers on long-acting CJC-1295 with DAC cannot be treated as studies of the No DAC material.
Related formulation · 1+
Long-acting CJC-1295: human GH and IGF-I study ↗ (opens in a new tab)Teichman SL et al. · The Journal of clinical endocrinology and metabolism · 2006 · PMID 16352683Two short randomized studies · healthy adults
The long-acting CJC-1295 formulation increased GH and IGF-I; estimated half-life was 5.8–8.1 days.
Keep in mind: This is the albumin-binding, long-acting formulation associated with DAC. It is not evidence for CJC-1295 without DAC or the CJC/ipamorelin blend.
Clinical trial of one ingredient · 1+
Ipamorelin: postoperative ileus trial ↗ (opens in a new tab)Beck DE et al. · International journal of colorectal disease · 2014 · PMID 25331030117 enrolled; 114 analysed · phase 2 · placebo controlled
Median time to the first tolerated meal was 25.3 hours with ipamorelin versus 32.6 hours with placebo. The difference was not statistically significant (P=0.15).
Keep in mind: The primary result does not establish benefit. This short postoperative study tested ipamorelin alone, not a CJC-1295 combination.
Laboratory and animal studies · 1+
Ipamorelin: postoperative transit in rats ↗ (opens in a new tab)Venkova K et al. · The Journal of pharmacology and experimental therapeutics · 2009 · PMID 19289567Rat postoperative-ileus model
Ipamorelin shortened time to first bowel movement. Repeated exposure also changed food intake and faecal output.
Keep in mind: The later human trial did not demonstrate a significant primary-endpoint benefit. Animal findings and human results are shown separately.
Foundational references · 1+
08 · 3 referencesHuman study
Tesamorelin
GHRH analogue
Compound identity · PubChem
GH physiology and HIV-associated fat-distribution trials
The references cover GH pulsatility in a small physiology study and randomized trials measuring visceral or liver fat in adults with HIV. Those are different populations and endpoints.
Limit of this evidenceThe clinical trials studied defined HIV-associated conditions and clinical preparations. They do not establish general weight-management effects or equivalence to a research vial.
Clinical trials · 2+
Abdominal and liver fat in adults with HIV ↗ (opens in a new tab)Stanley TL et al. · JAMA · 2014 · PMID 2503835750 participants · six months · randomized placebo control
Visceral fat changed −34 cm² with tesamorelin versus +8 cm² with placebo. The net liver lipid-to-water ratio difference was −2.9 percentage points.
Keep in mind: Specific HIV/antiretroviral-treated population. These outcomes do not establish benefit for general weight management.
Liver fat in HIV-associated fatty liver disease ↗ (opens in a new tab)Stanley TL et al. · The lancet. HIV · 2019 · PMID 3161103861 enrolled; 60 treated · 12-month randomized phase
The absolute between-group hepatic-fat-fraction effect was −4.1 percentage points. At 12 months, 35% versus 4% had hepatic fat below 5%.
Keep in mind: Localized injection-site complaints were more frequent. Longer-term liver-histology outcomes remained uncertain; the population had HIV and fatty liver disease.
Foundational references · 1+
09 · 4 referencesLimited clinical + laboratory studies
Selank
Synthetic heptapeptide
Compound identity · PubChem
Neurotransmission-related gene expression
Researchers measured 84 neurotransmission-related genes in rat frontal cortex at one and three hours after Selank or GABA exposure. They observed changes in gene expression.
Limit of this evidenceGene-expression changes do not by themselves establish a behavioural effect, human benefit or direct receptor binding.
Limited clinical reports · 2+
Selank versus medazepam ↗ (opens in a new tab)Zozulia AA et al. · Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova · 2008 · PMID 1845409662 patients · comparative clinical report
The report compared anxiety scales in 30 Selank and 32 medazepam recipients and described similar anxiolytic effects.
Keep in mind: English abstract of a Russian-language publication. Randomization, blinding and adequate safety detail are not established by the abstract; do not call it a large placebo-controlled trial.
Selank versus phenazepam ↗ (opens in a new tab)Medvedev VE et al. · Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova · 2014 · PMID 2517626160 patients · comparative clinical report
The authors assessed symptom scales, tolerability and quality of life in anxiety and somatoform disorders.
Keep in mind: The abstract provides no robust numerical effect estimate or clear blinding description. Its conclusions are not proof of long-term safety.
Laboratory studies · 1+
GABA-related gene expression in cultured cells ↗ (opens in a new tab)Filatova E et al. · Frontiers in pharmacology · 2017 · PMID 28293190IMR-32 neuroblastoma cells · 84-gene panel
Selank alone produced no changes in the tested mRNA levels. In combination with GABA or olanzapine, expression responses differed.
Keep in mind: A cell-line interaction study does not establish clinical synergy or a reason to combine substances.
Foundational references · 1+
10 · 4 referencesLimited clinical + animal studies
Semax
ACTH-derived peptide
Compound identity · PubChem
Gene expression in an experimental brain model
A genome-wide analysis compared rat brain tissue after experimental focal ischemia, with and without Semax. The paper reported changes in immune- and vascular-related gene expression.
Limit of this evidenceAn induced animal model cannot establish cognitive effects in healthy people. The results apply to the peptide and model studied, not to Adamax.
Laboratory studies · 2+
Neurotrophin transcription after cerebral ischaemia ↗ (opens in a new tab)Dmitrieva VG et al. · Cellular and molecular neurobiology · 2010 · PMID 19633950Rat middle-cerebral-artery occlusion
Semax changed transcription of selected neurotrophins and receptors at 3, 24 and 72 hours; the timing and genes affected differed.
Keep in mind: Changes in rat mRNA are not proof of improved cognition in healthy humans.
Protein markers after ischaemia–reperfusion ↗ (opens in a new tab)Sudarkina OY et al. · International journal of molecular sciences · 2021 · PMID 34201112Rat model · brain proteins at 24 hours
The study measured changes in CREB, MMP-9, c-Fos and JNK in different brain regions.
Keep in mind: Protein-marker findings in an induced stroke model do not establish clinical efficacy or general nootropic effects.
Limited clinical report · 1+
Rehabilitation after ischaemic stroke ↗ (opens in a new tab)Gusev EI et al. · Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova · 2018 · PMID 29798983110 patients · clinical report
The authors compared BDNF levels, motor performance and Barthel scores in early/late rehabilitation groups with and without Semax; they reported better recovery measures in Semax groups.
Keep in mind: The English abstract does not establish blinded randomized allocation or detailed safety outcomes. Rehabilitation timing is an important co-intervention.
Foundational references · 1+
11 · 5 referencesHuman trials + receptor research
Cagrilintide
Amylin analogue
Compound identity · PubChem
Amylin-receptor research, monotherapy and CagriSema
Cagrilintide has its own phase 2 weight-management trial. CagriSema studies test cagrilintide plus semaglutide; those combination results are labelled separately below. Structural work examines activation of both amylin and calcitonin receptors.
Limit of this evidenceCagriSema results cannot be attributed to cagrilintide alone. The clinical formulations and study populations differ from laboratory research products.
Clinical trials · 1+
Cagrilintide alone: phase 2 dose-finding trial ↗ (opens in a new tab)Lau DCW et al. · Lancet (London, England) · 2021 · PMID 34798060706 participants · 26 weeks · placebo and liraglutide comparators
Under the trial-product analysis, mean weight reduction was 6.0–10.8% across cagrilintide arms versus 3.0% with placebo. The highest arm reached 10.8% versus 9.0% with liraglutide.
Keep in mind: Trial-product estimates assume adherence. Gastrointestinal events affected 41–63% with cagrilintide versus 32% with placebo.
Combination trials · 2+
Cagrilintide + semaglutide: phase 1b ↗ (opens in a new tab)Enebo LB et al. · Lancet (London, England) · 2021 · PMID 3389483896 randomized; 95 treated · 20 weeks
The study primarily assessed adverse events and pharmacokinetics. Most adverse events were mild/moderate; gastrointestinal disorders accounted for 37% of reported events.
Keep in mind: All groups also received semaglutide. Exploratory weight findings are not results for cagrilintide monotherapy; cohorts were small.
REDEFINE 1: CagriSema phase 3 ↗ (opens in a new tab)Garvey WT et al. · The New England journal of medicine · 2025 · PMID 405444333,417 randomized · 68 weeks · four treatment groups
The combination produced −20.4% mean weight change versus −3.0% with placebo in the treatment-policy analysis. The study also included separate semaglutide and cagrilintide arms.
Keep in mind: The −20.4% figure is for the combination. Gastrointestinal events affected 79.6% with the combination versus 39.9% with placebo.
Laboratory studies · 1+
Amylin and calcitonin receptor structures ↗ (opens in a new tab)Gu YM et al. · Acta pharmacologica Sinica · 2026 · PMID 40847076Cryo-EM and cell-signalling assays
Structures of cagrilintide bound to AMY1 and calcitonin receptors, supported by functional assays, identified contacts involved in dual activation.
Keep in mind: Molecular binding and signalling do not measure clinical outcomes.
Foundational references · 1+
12 · 3 referencesMetabolism pilot + laboratory studies
NAD+ (Buffered)
Nicotinamide adenine dinucleotide
Compound identity · PubChem
The record describes NAD+ itself. Buffer ingredients and salts belong to the formulation and are not represented by this formula.
Where NAD+ sits inside a cell matters
In HEK293 cells, researchers redistributed NAD+ toward mitochondria using an introduced transporter. The cells shifted toward glycolysis despite higher mitochondrial NAD+ levels.
Limit of this evidenceThis was a genetically modified cell model, not a test of added buffered NAD+. Buffer ingredients, pH and assay compatibility still need separate assessment.
Human pilot · 1+
Direct NAD+ infusion: metabolite pilot ↗ (opens in a new tab)Grant R et al. · Frontiers in aging neuroscience · 2019 · PMID 31572171Six-hour infusion · plasma and urine measurements
Plasma NAD+ and measured metabolites did not rise during the first two hours. Urinary NAD+ and methylnicotinamide increased by six hours.
Keep in mind: This is a small metabolism study, not an anti-ageing or disease-treatment efficacy trial. It does not validate the formulation or tolerability of our buffered product.
Laboratory and animal studies · 1+
More muscle NAD did not improve oxidative metabolism ↗ (opens in a new tab)Frederick DW et al. · The Journal of biological chemistry · 2015 · PMID 25411251Muscle-specific NAMPT overexpression in mice
Muscle NAD rose by about 50%, but mitochondrial function and biogenesis did not improve, and susceptibility to high-fat-feeding effects remained.
Keep in mind: This genetically altered mouse model is not direct NAD+ administration. It challenges the assumption that a higher NAD level automatically improves function.
Foundational references · 1+
13 · 3 referencesOral trial + analytical methods
Glutathione
GSH · Redox research
Compound identity · PubChem
Checking whether an assay measures GSH reliably
A study of six cell lines compared an enzymatic glutathione assay with HPLC and a fluorescence method. In two lines, sample interference sometimes prevented the enzymatic assay from detecting glutathione.
Limit of this evidenceThe sample matrix can affect the result. This method comparison does not establish the purity or reduced-to-oxidised glutathione ratio of a supplied vial.
Human trial · oral formulation · 1+
Oral glutathione and body stores ↗ (opens in a new tab)Richie JP et al. · European journal of nutrition · 2015 · PMID 2479175254 healthy nonsmokers · six months · randomized placebo control
Glutathione stores increased in several measured compartments. In the higher study arm, erythrocyte, plasma and lymphocyte levels rose approximately 30–35% versus baseline at six months.
Keep in mind: Oral formulation and biomarker endpoints. This does not establish results for a lyophilized vial or broad clinical benefit; measured levels returned to baseline after washout.
Analytical methods · 1+
Measuring reduced and oxidized glutathione ↗ (opens in a new tab)Tipple TE et al. · Methods in molecular biology (Clifton, N.J.) · 2012 · PMID 22669674Enzymatic recycling and HPLC protocols
The methods chapter explains glutathione measurement and sample-processing considerations, including distinguishing reduced and oxidized forms.
Keep in mind: An assay protocol is not a product stability study. Sample handling can affect the measured redox state.
Foundational references · 1+
14 · 0 referencesEvidence gap
Adamax (1032 Grade)
Identity requires confirmation
Compound identity · PubChem
No exact PubChem identity verified for Adamax (1032 Grade). A Semax record would not identify this material.
A product name is not a scientific identifier
We have not verified a PubMed paper for the exact material sold under this name and grade. A confirmed chemical identity is needed before attaching a research summary.
Limit of this evidenceNo exact-product publication was verified for the stated Adamax 1032 identity. Semax papers are listed under Semax and are not evidence for Adamax. A verified sequence or chemical identifier is needed to match the literature.
Product specifications → — Adamax (1032 Grade)
15 · 1 referenceManufacturer reference
BAC Water
Bacteriostatic water · Laboratory diluent
Compound identity · PubChem
Ingredient reference for the preservative. The finished water formulation has no single compound identity.
Check the preservative, not just the water
Pfizer’s label lists benzyl alcohol at 0.9% (9 mg/mL) or 1.1% (11 mg/mL), depending on the presentation. Both are called bacteriostatic water; the name alone does not specify the concentration.
Limit of this evidenceThat label applies to Pfizer products. It does not establish Morris Peppy batch sterility, expiry or compatibility with a particular laboratory assay.
Foundational references · 1+
