What it is
This is one vial holding two peptides in equal amounts: CJC-1295 without DAC and Ipamorelin. The usual vial holds 10 mg in total — 5 mg of each. A larger 10 mg / 10 mg version holding 20 mg in total is sold under the nickname "The Hulk".
Both peptides make your body release more of its own growth hormone, the hormone that drives repair, muscle building, and fat burning, but they do it through different doors.
CJC-1295 copies growth hormone releasing hormone, the signal your brain sends to the pituitary gland (a pea-sized gland at the base of the brain) telling it to make and release growth hormone. Ipamorelin copies ghrelin, the hunger hormone made in your gut, which tells the same gland to release the growth hormone it has already stored. Ipamorelin also lifts the brake on the system. Because they work through separate signals, together they produce a much bigger release than either on its own.
The version used here is CJC-1295 without DAC, also called Mod GRF 1-29. DAC is a modification that keeps the peptide in the blood for about a week. Without it, the peptide clears within minutes, so the release comes in a sharp pulse, which is how the body naturally does it.
Ipamorelin is a clean choice for this pairing because it does not meaningfully raise cortisol (the stress hormone), prolactin, or ACTH, even at doses more than 200 times the dose needed for growth hormone release.
Neither peptide is approved by the FDA for human use. They come as a freeze-dried powder in a sealed glass vial. You add bacteriostatic water (sterile water with a preservative that lets it keep for weeks), then inject it just under the skin — a subcutaneous injection.
A fixed 1:1 co-formulation of a GHRH analogue and a GHRP: CJC-1295 without DAC (Mod GRF 1-29) plus Ipamorelin. The standard presentation is 10 mg total peptide, 5 mg of each; a 10 mg / 10 mg presentation giving 20 mg total is marketed as "The Hulk".
CJC-1295 is a synthetic GHRH analogue that binds GHRH receptors on the anterior pituitary and drives GH synthesis and release. The DAC (Drug Affinity Complex) modification binds albumin and extends the half-life to roughly a week — 5.8 to 8.1 days in the published trials — whereas the no-DAC version clears within minutes, preserving pulsatile secretion. Ipamorelin is a pentapeptide selective GHS-R1a (ghrelin receptor) agonist with a half-life of approximately 2 hours; it triggers immediate release of stored GH and suppresses somatostatin tone. Its selectivity is the reason it became the standard pairing compound: no significant ACTH, cortisol, or prolactin elevation at doses more than 200 times the effective GH-releasing dose, unlike GHRP-2 and GHRP-6.
The rationale for co-formulation is synergy through independent pathways: GHRH increases the number of somatotrophs secreting GH, ghrelin agonism increases the amount released per cell, and somatostatin withdrawal removes the inhibitory brake. Neither compound is FDA-approved for human use, and no published RCT has tested the combination in healthy adults.
Interactions worth knowing. Do not combine with exogenous GH or IGF-1: the resulting somatostatin elevation blocks the secretagogue signal at the pituitary; allow 2 to 3 days for exogenous IGF-1 to clear before switching. GH secretagogues alter insulin sensitivity and may require adjustment of insulin or oral hypoglycaemics. Glucocorticoids blunt GH response. Thyroid medication may need adjustment because GH influences T4 to T3 conversion. GH-induced fluid retention may reduce diuretic effectiveness or complicate blood pressure control on beta-blockers, ACE inhibitors, ARBs, or calcium channel blockers. Oestrogen can reduce IGF-1 levels. Concurrent testosterone, anabolic steroids, or SARMs act synergistically on muscle growth, water retention, and joint stress. Dizziness or fatigue may compound with sedatives, alcohol, or sleep medication.
How it works
Your pituitary gland releases growth hormone in bursts through the day and night. The biggest burst happens in deep sleep, roughly between 10 p.m. and 2 a.m. Smaller ones follow hard training and periods without food.
Two signals control those bursts. One is growth hormone releasing hormone, from the brain, which tells the gland to make and release the hormone. The other is ghrelin, from the gut, which triggers release of what is already stored. There is also a brake, called somatostatin, which slows things down when growth hormone and IGF-1 rise. The biggest natural bursts happen when both signals fire at once — which is exactly what happens in deep sleep, when you are fasted.
CJC-1295 copies the first signal. Ipamorelin copies the second and, at the same time, eases off the brake. Firing both together produces a far larger release than either alone. The research on this pairing shows submaximal doses of the two together raise growth hormone synergistically, meaning the result is bigger than adding the two effects up.
Growth hormone does not build muscle or burn fat by itself. It travels to your liver, which turns it into IGF-1 (insulin-like growth factor 1). IGF-1 is the worker: it drives muscle protein synthesis, fat mobilisation, tissue repair, and collagen production.
There is a timing puzzle here. Growth hormone releases best when you are fasted and insulin is low, but the liver needs insulin present to convert it into IGF-1 efficiently. Your body solves this naturally: you fast overnight, get a big pulse, then eat in the morning and the conversion happens.
One important difference from injecting growth hormone itself: these peptides work through your own signalling system, so your body still controls the response and the feedback loop stays intact. Injected growth hormone bypasses that system and eventually shuts down your own production.
GH secretion is pulsatile, with the dominant pulse in slow-wave sleep between 10 p.m. and 2 a.m. and secondary pulses after intense training and in fasted, low-insulin, high-ghrelin states. Two stimulatory inputs govern it — hypothalamic GHRH and gut-derived ghrelin — against somatostatin as the inhibitory arm.
CJC-1295 occupies the GHRH receptor on pituitary somatotrophs, driving synthesis and release. Clinical trials of the DAC version showed mean plasma GH concentrations rose 2 to 10 fold above baseline after a single subcutaneous injection, with elevation lasting 6 or more days, and IGF-1 up 1.5 to 3 fold for 9 to 11 days; the estimated half-life was 5.8 to 8.1 days. Repeated weekly dosing kept IGF-1 above baseline for up to 28 days with evidence of cumulative effect. A separate study confirmed pulsatility is preserved during continuous stimulation: pulse frequency and magnitude were unchanged while basal trough GH rose 7.5 fold, mean GH rose 46%, and IGF-1 rose 45%. The no-DAC analogue used in the blend shares the mechanism but produces sharper, shorter pulses.
Ipamorelin binds GHS-R1a, producing an immediate GH burst that peaks around 40 minutes post-injection before exponential decline, with a half-life of approximately 2 hours, and concurrently withdraws somatostatin inhibition.
The synergy has three components: GHRH recruits more secreting somatotrophs, ghrelin agonism raises output per cell, and somatostatin suppression removes the brake on the GHRH signal. A human study in 18 normal men showed submaximal doses of a ghrelin receptor agonist plus GHRH stimulated GH release synergistically, confirming independent pathways.
Downstream, hepatic conversion of GH to IGF-1 is the effector step for muscle protein synthesis, lipolysis, tissue repair, and collagen synthesis. The physiological tension is that GH release is best in the fasted, low-insulin state while hepatic IGF-1 conversion is insulin-dependent.
Because secretagogues act upstream, the somatostatin feedback loop remains intact and endogenous regulation is retained — a fundamental difference from exogenous GH, which overrides the axis entirely.
What it does
Sleep: this is usually the first thing people notice. The blend amplifies the natural growth hormone burst that happens in deep sleep, so sleep tends to get deeper and more restful.
Recovery: higher growth hormone and IGF-1 support protein synthesis and tissue repair, so soreness drops and training sessions recover faster.
Fat: growth hormone promotes lipolysis — the breakdown of stored fat. It switches on an enzyme called hormone-sensitive lipase, which breaks stored fat down into fatty acids the body can burn.
Muscle: it supports lean muscle, both keeping what you have and building more. It does not replace testosterone for building muscle.
Healing: it speeds the repair of muscle, tendon, and ligament, and helps recovery from the small tears training creates.
Skin and joints: it improves collagen production, which improves skin elasticity, joint comfort, and tendon resilience. Cosmetic and anti-ageing uses are studied in peptide medicine.
Mind and mood: growth hormone receptors are found throughout the brain, and some people report clearer thinking, better focus, and steadier mood. The research here is thinner than the body composition research.
Endocrine: higher GH output through amplified pulsatile release, with downstream IGF-1 elevation as the effector.
Sleep: the most consistently reported effect, driven by amplification of the slow-wave-sleep GH pulse; vivid dreaming is frequently reported alongside it.
Regenerative: accelerated repair of muscle, tendon, and ligament, and faster recovery from training microtrauma via IGF-1-mediated protein synthesis.
Metabolic: GH-driven lipolysis via activation of hormone-sensitive lipase, liberating free fatty acids from stored triglyceride. The effect is progressive rather than acute and is most visible when training and nutrition are already controlled.
Anabolic: supports lean mass preservation and growth, but does not substitute for testosterone as a driver of hypertrophy.
Dermal and connective tissue: IGF-1-mediated collagen synthesis, reported as improved skin elasticity, reduced joint stiffness, and better tendon comfort over months 3 to 6; cosmetic and anti-ageing applications are studied in peptide medicine.
Cognitive: GH receptors are distributed throughout the brain and some users report improved clarity, focus, and mood stability, though published cognitive data on secretagogue therapy is less robust than the body composition data.
The mechanistic point of the pairing is that GHRH-receptor stimulation raises pulse amplitude while GHS-R1a agonism increases per-cell output and suppresses somatostatin tone — different arms of one axis, so combined output exceeds either alone.
Benefits
Evidence grades: what the labels mean
- Human trials Supported by randomised or placebo-controlled human trials.
- Limited human data Some human evidence, such as pilot studies, case reports or observational data, but no controlled trials.
- Animal or lab only Shown in animal or cell studies only; not yet tested in people.
- Anecdotal No published studies; based on user reports or theory.
Each grade reflects the strongest published support for that specific claim, not for the compound as a whole.
- Raises your body's own growth hormone and IGF-1 output.Limited human data
- Improves sleep quality — usually the first change people notice, within 1 to 2 weeks.Anecdotal
- Speeds recovery between sessions and reduces soreness, typically within 2 to 4 weeks.Anecdotal
- Promotes the breakdown of body fat, usually noticeable around weeks 8 to 12.Anecdotal
- Supports keeping and building lean muscle.Anecdotal
- Speeds healing of muscle, tendon, and ligament.Anecdotal
- Improves recovery from the small tears training causes.Anecdotal
- Improves collagen production for skin elasticity, joint comfort, and tendon resilience over months 3 to 6.Anecdotal
- Has cosmetic and anti-ageing applications studied in peptide medicine.Anecdotal
- Some people report better mental clarity, focus, and mood stability.Anecdotal
- May improve energy and recovery from fatigue.Anecdotal
- Amplified pulsatile GH release with downstream IGF-1 elevation; CJC-1295 trials showed IGF-1 above baseline for up to 28 days on repeated weekly dosing, with cumulative effect.Limited human data
- Improved sleep quality, the most consistently reported benefit, typically within 1 to 2 weeks.Anecdotal
- Faster recovery and reduced soreness within 2 to 4 weeks, particularly relevant for adults over 35 with declining endogenous GH.Anecdotal
- Promotes lipolysis via hormone-sensitive lipase activation; visible around weeks 8 to 12.Anecdotal
- Supports lean muscle preservation and growth.Anecdotal
- Accelerates tissue healing across muscle, tendon, and ligament.Anecdotal
- Enhances exercise recovery and repair of microtrauma.Anecdotal
- IGF-1-mediated collagen synthesis for skin elasticity, joint comfort, and tendon resilience over months 3 to 6.Anecdotal
- Cosmetic and anti-ageing applications studied in peptide medicine.Anecdotal
- Possible improvements in mental clarity, focus, mood stability, energy, and recovery from fatigue.Anecdotal
- Preserves the somatostatin feedback loop, unlike exogenous GH.Limited human data
What to expect
No published trial has tracked the timeline of this combination in healthy adults. What follows comes from the data on each peptide separately and from consistent user reports.
Weeks 1 to 2: sleep. Most people fall asleep faster, sleep deeper, and wake more rested. Vivid and sometimes intense dreams are common early on. Some people get the opposite at first — broken sleep, waking 2 to 3 times a night — while the body adjusts to the bigger pulses. That usually settles by week 4 to 6.
Weeks 2 to 4: recovery. Less soreness after training, more energy through the day, and the ability to train harder without dragging.
Weeks 8 to 12: fat loss becomes more apparent. It is not a fat burner. It amplifies what your diet and training are already doing.
Months 3 to 6: skin quality, joint comfort, and tendon health improve. This is the long play and it needs consistency.
Side effects tend to be mild and mostly settle within the first 2 weeks: injection site redness, mild water retention, brief tingling or numbness in the hands, flushing after injecting.
Managing expectations. These are long-term tools. You will not take a shot tonight and wake up transformed. Growth hormone peptides do not replace testosterone replacement therapy or anabolic steroids for building muscle, and expecting steroid-level growth will leave you disappointed. In practice, those who run it for 16 to 24 weeks report better sleep and more efficient fat loss, with the fat loss often only showing up toward the end of the cycle. Users who run 16 weeks or longer report gradual improvements in body composition, particularly less abdominal fat and better definition — subtle and progressive, not dramatic. Most people who are disappointed stopped too early. The value is in recovery, sleep, body composition over months, and connective tissue health.
No published RCT tracks the timeline of the combination in healthy adults; the sequence below is inferred from the individual compound data and consistent user reporting.
Weeks 1 to 2: sleep changes dominate — faster onset, deeper sleep, more rested waking, frequently with vivid dreams attributed to enhanced slow-wave phases. A minority report transient disruption in the first 3 to 4 weeks, including waking 2 to 3 times per night, typically stabilising by week 4 to 6 as the axis adapts to larger pulses.
Weeks 2 to 4: recovery. Reduced post-training soreness, improved daily energy, higher tolerable training frequency. This is the effect users already on TRT or other hormone protocols report most clearly, since elevated GH complements the existing anabolic environment.
Weeks 8 to 12: body composition changes become apparent, most pronounced when nutrition and training are already controlled. The compound amplifies an existing stimulus rather than substituting for one.
Months 3 to 6: connective tissue, skin quality, and joint health. Reported less often than sleep and recovery, largely because most users do not run long enough to reach this window.
Commonly reported side effects are mild and mostly resolve within 2 weeks: injection site redness or irritation, mild water retention, transient tingling or numbness in the fingers or hands, post-injection flushing, and mild lightheadedness at higher doses. Persistent numbness, carpal tunnel symptoms, joint swelling, or facial puffiness indicate the dose is too high and should prompt a reduction or a temporary stop.
Expectation management matters. Users running 16 weeks or longer report gradual, progressive improvements in body composition — reduced abdominal fat, improved definition — rather than dramatic change, and in practice fat loss is often only evident toward the end of a 16 to 24 week run. Secretagogues do not replace testosterone or anabolic steroids as drivers of hypertrophy; the return is in sleep, recovery, connective tissue, and slow body recomposition.
Reconstitution and dosing
The blend comes as a dry powder. The standard vial holds 10 mg in total — 5 mg of CJC-1295 No DAC and 5 mg of Ipamorelin. Mix it with 2 mL of bacteriostatic water: draw the water up, inject it slowly against the inside wall of the vial rather than straight onto the powder, then let it dissolve on its own and swirl gently after a few minutes. Do not shake. At that strength, 10 units on an insulin syringe give 250 mcg of each peptide, and at 250 mcg of each per day one vial lasts about 20 days.
The usual dose is 100 to 300 mcg of each peptide per day, injected just under the skin, once a day, every day. Push the plunger slowly — injecting fast is what causes the hot, flushed, pins-and-needles feeling.
Body weight is the usual guide: under 150 lbs, 100 to 150 mcg of each; 150 to 200 lbs, 200 mcg of each; 200 to 250 lbs, 250 to 300 mcg of each; over 250 lbs, 300 mcg of each.
Dose fasted, at least 2 hours after eating. Insulin from a meal blocks the pituitary from releasing growth hormone, so eating first means pressing the accelerator and the brake together. Before bed on an empty stomach is the preferred time and suits fat loss best. If muscle is the main goal, consider injecting in the morning about 30 minutes before food, so the meal afterwards supplies the insulin your liver needs to convert growth hormone into IGF-1. An advanced option is to split the dose: 100 to 150 mcg of each in the morning fasted and the same again before bed, giving two pulses a day.
Run it daily for 12 to 16 weeks, then take 4 weeks off. The old 5 days on, 2 days off rule has no scientific basis. Dosing 5 days a week saves about 30% on cost, but that is a budget choice, not a desensitisation one.
After mixing, keep it refrigerated at 2 to 8 degrees C, do not freeze, and use within 4 to 6 weeks.
Standard vial: 10 mg total peptide (5 mg CJC-1295 no DAC + 5 mg Ipamorelin), reconstituted with 2 mL of bacteriostatic water. That yields 250 mcg of each peptide per 10 insulin units, i.e. 25 mcg of each — 50 mcg of blend — per unit. At 250 mcg of each per day a vial lasts approximately 20 days. Add diluent down the vial wall, do not spray directly onto the cake, let it dissolve and swirl gently; do not shake.
Practical dosing is 100 to 300 mcg of each peptide per day, subcutaneously, once daily. Administer slowly: the flushing and paraesthesia are rate-dependent rather than dose-dependent. Body-weight tiering: under 150 lbs, 100 to 150 mcg of each; 150 to 200 lbs, 200 mcg of each; 200 to 250 lbs, 250 to 300 mcg of each; over 250 lbs, 300 mcg of each.
Fasting is non-negotiable — insulin acts directly on somatotrophs to suppress GH release, so dose at least 2 hours after the last meal. Pre-bed fasted is the default and the better choice for fat loss, since GH mobilises adipose tissue directly overnight without requiring IGF-1 conversion. For hypertrophy, morning dosing roughly 30 minutes before the first meal preserves the fasted release while supplying postprandial insulin for hepatic IGF-1 conversion. Advanced split dosing: 100 to 150 mcg of each in the fasted morning and again pre-bed, producing two discrete pulses per day.
Cycle daily for 12 to 16 weeks, then 4 weeks off. The 5 on / 2 off convention addresses neither form of desensitisation: acute desensitisation resolves in approximately 60 minutes, as shown in perifused rat pituitary cells with GHRP-6, while chronic desensitisation develops after roughly 16 weeks and requires about 4 weeks to reverse — 12 elderly subjects on twice-daily hexarelin for 16 weeks showed declining GH response that returned to baseline after 4 weeks off. Tesamorelin trials dosed daily for 26 weeks and MK-677 trials for two years with sustained GH and IGF-1 elevation. Dosing 5 days per week saves about 30% on product cost and is a valid budget strategy only.
Monitor IGF-1, fasting glucose, and HbA1c. Refrigerate after reconstitution at 2 to 8 degrees C, do not freeze, use within 4 to 6 weeks.
A 10/10 mg presentation (20 mg total, "The Hulk") is also sold; reconstituted with 2.5 mL it runs at 80 mcg of blend per unit, 40 mcg of each component, so draws are half those of the 10 mg vial for the same dose.
Standard, 10 mg vial
Mix with 2 mL (200 units) of bacteriostatic water.
5 mg/mL · 50 mcg per unit
Cycle: 12 to 16 weeks, then 4 weeks off · Frequency: 1×/day, daily; fasted at least 2 hours after eating; before bed on an empty stomach preferred
| When | Dose | Draw | How often |
|---|---|---|---|
| Starting — 100 mcg of each peptide (200 mcg total blend) | 200 mcg | 4 units | 1×/day |
| Full — 300 mcg of each peptide (600 mcg total blend) | 600 mcg | 12 units | 1×/day |
Alternative protocols
Alternative protocols reflect older community practice and are kept for reference.
Alternative, 5/5 mg blend vial (10 mg total peptide) — standard protocol
Mix with 2.5 mL (250 units) of bacteriostatic water.
4 mg/mL · 40 mcg per unit
Cycle: 12–16 weeks, then an 8–16 week washout · Frequency: 1×/day, 5–7 days per week; pre-bed, fasted 2+ hours; inject slowly
| When | Dose | Draw | How often |
|---|---|---|---|
| Initial dose (6 units) — hold, then titrate up gradually | 240 mcg | 6 units | 1×/day |
| Top of range (15 units) | 600 mcg | 15 units | 1×/day |
Alternative, 5/5 mg blend vial (10 mg total peptide) — maximum protocol
Mix with 2.5 mL (250 units) of bacteriostatic water.
4 mg/mL · 40 mcg per unit
Cycle: 12–16 weeks, then an 8–16 week washout · Frequency: 1×/day, 5–7 days per week; pre-bed, fasted 2+ hours; inject slowly
| When | Dose | Draw | How often |
|---|---|---|---|
| Initial dose (12 units) — hold, then titrate up gradually | 480 mcg | 12 units | 1×/day |
| Top of range (30 units) | 1.2 mg | 30 units | 1×/day |
Alternative, 10/10 mg blend vial (20 mg total peptide) — "The Hulk", 8–12 week titration
Mix with 2.5 mL (250 units) of bacteriostatic water, giving 8 mg/mL — 80 mcg of blend per insulin unit, which is 40 mcg of each component. A unit column of 3, 4, 5, 6, 8, 9 units is wrong for this vial: those are the 5/5 vial's draws rounded up, and following them would deliver roughly double the stated dose. The draws here are computed from the microgram figures. Inject as slowly as possible to avoid the hot, flushed, prickly sensation.
8 mg/mL · 80 mcg per unit
Cycle: 8–12 weeks, then a 6–8 week washout · Frequency: 1×/day; 7 days per week on an 8-week cycle, 5 days per week on a 12-week cycle; bedtime preferred, or immediately on waking; subcutaneous
| When | Dose | Draw | How often |
|---|---|---|---|
| Weeks 1–2 (1.25 units; not 3, which is incorrect for this vial) | 100 mcg | 1.25 units | 1×/day, 5–7 days per week |
| Weeks 3–4 (1.88 units, not 4) | 150 mcg | 1.88 units | 1×/day, 5–7 days per week |
| Weeks 5–6 (2.5 units, not 5) | 200 mcg | 2.5 units | 1×/day, 5–7 days per week |
| Weeks 7–8 (3.12 units, not 6) | 250 mcg | 3.13 units | 1×/day, 5–7 days per week |
| Weeks 9–10 (3.75 units, not 8) | 300 mcg | 3.75 units | 1×/day, 5–7 days per week |
| Weeks 11–12 (4.38 units, not 9) | 350 mcg | 4.38 units | 1×/day, 5–7 days per week |
Alternative, 10/10 mg blend vial (20 mg total peptide) — "The Hulk", 12–16 week low-dose anti-ageing titration
Mix with 2.5 mL (250 units) of bacteriostatic water, giving 8 mg/mL — 80 mcg of blend per insulin unit, 40 mcg of each component. Rounding to whole units because half-units cannot be measured accurately gives draws (1, 2, 3, 4, 5 units) that run from 20% below the correct draw at the first step to 33% above it at the last; the draws here are the exact computed values. Use a 30 or 50 unit syringe, where every unit has its own graduation. Drawing up 20–30 extra units of bacteriostatic water after the dose makes slow injection easier and reduces flushing.
8 mg/mL · 80 mcg per unit
Cycle: 12–16 weeks, then an 8–16 week washout · Frequency: 1×/day, daily; immediately before bed, fasted 2+ hours, or on waking before food; subcutaneous, injected slowly
| When | Dose | Draw | How often |
|---|---|---|---|
| Weeks 1–2 (1.25 units, not 1) | 100 mcg | 1.25 units | 1×/day, daily |
| Weeks 3–4 (1.88 units, not 2) | 150 mcg | 1.88 units | 1×/day, daily |
| Weeks 5–6 (2.5 units, not 3) | 200 mcg | 2.5 units | 1×/day, daily |
| Weeks 7–12 (3.12 units, not 4). Overlaps the optional weeks 12–16 step at week 12 | 250 mcg | 3.13 units | 1×/day, daily |
| Weeks 12–16, optional (3.75 units, not 5) | 300 mcg | 3.75 units | 1×/day, daily |
10 mg of blend in 2 mL is 5 mg/mL, or 50 mcg per unit. Draw 4 units (0.04 mL) for 200 mcg of blend.
- CJC-1295 No DAC100 mcg
- Ipamorelin100 mcg
Who should avoid it
- Anyone pregnant or breastfeeding.
- Anyone with an active cancer or tumour, including a pituitary adenoma — a tumour of the pituitary gland. Growth hormone and **IGF-1** (insulin-like growth factor 1, the hormone the liver makes in response to growth hormone) can speed tumour growth. Anyone with any history of cancer should not use these compounds without clearance from an oncologist.
- Anyone with diabetic retinopathy — damage to the blood vessels at the back of the eye caused by diabetes.
- Anyone with uncontrolled diabetes.
- Anyone with an underactive thyroid that has not been treated, or an unstable thyroid disorder.
- Anyone who already has high growth hormone or high IGF-1, or acromegaly — a condition of excess growth hormone — where more stimulation would be unsafe.
- Anyone with advanced chronic kidney disease.
- Anyone who is critically ill.
- Anyone allergic to mannitol or the other peptide components.
- Stop if you find you are hypersensitive to the peptide.
- Take care with type 2 diabetes or prediabetes — growth hormone can affect how well your body handles sugar, so monitor blood sugar closely.
- Take care if you have had carpal tunnel syndrome before.
- Take care with heart disease, high blood pressure, or kidney or liver disease. There is a risk of fluid overload, high blood pressure, or swelling if you have severe heart or blood vessel disease.
- Do not combine with injected growth hormone (HGH) or IGF-1 — they shut down the signal these peptides rely on.
- Talk to a doctor before combining with insulin or diabetes tablets, as doses may need adjusting. Steroid tablets such as prednisone can blunt the effect.
- Pregnancy and lactation.
- Active malignancy or tumours, including pituitary adenoma — GH and IGF-1 can accelerate tumour growth; any cancer history requires oncologist clearance.
- Diabetic retinopathy.
- Uncontrolled diabetes mellitus.
- Untreated hypothyroidism or unstable thyroid disorder.
- Pre-existing elevated GH/IGF-1 or acromegaly making further stimulation unsafe.
- Advanced chronic kidney disease.
- Critical illness.
- Allergy to mannitol or other peptide components; discontinue on established hypersensitivity.
- Caution in type 2 diabetes or prediabetes — GH is counter-regulatory to insulin; monitor glycaemia.
- Caution with a history of carpal tunnel syndrome.
- Caution in cardiovascular disease or hypertension, and in kidney or liver disease; risk of fluid overload, hypertension, or oedema in severe cardiovascular disease.
- Do not combine with exogenous growth hormone or IGF-1: rising IGF-1 drives somatostatin release, which blocks pituitary responsiveness to GHRH and blunts the ghrelin arm. Allow 2 to 3 days after stopping exogenous IGF-1 for clearance and reversal of negative feedback.
- Insulin and oral hypoglycaemics may require adjustment; glucocorticoids such as prednisone blunt the GH response. Thyroid medication may need adjustment because GH influences T4 to T3 conversion.
- GH-induced fluid retention may reduce diuretic effectiveness or worsen blood pressure control — monitor on beta-blockers, ACE inhibitors, ARBs, or calcium channel blockers. Oestrogen can reduce IGF-1 levels and dampen benefit. Concurrent anabolic steroids, testosterone, SARMs, or other hormone therapies may act synergistically on muscle growth, water retention, and joint stress. Dizziness or fatigue may compound with sedatives, alcohol, or sleep medication.
- Monitor IGF-1, fasting glucose and HbA1c, and a standard metabolic panel.
Side effects
- Reaction where you inject — redness, irritation, swelling, and/or itching.
- Mild water retention. Magnesium supplements may help.
- Bloating.
- Tingling or numbness in the fingers or hands, usually temporary.
- Flushing, heat, and/or a pins-and-needles feeling shortly after dosing — inject as slowly as you can to reduce it.
- Vivid dreams, especially in the first few weeks.
- Mild lightheadedness or dizziness, more common at higher doses.
- Headaches.
- Mild increase in hunger.
- Tiredness while your body adapts.
- Temporary blood sugar swings.
- Nausea.
- Hives.
- Dry mouth.
- Feeling wired or overactive.
- Uncommon: joint pain or stiffness.
- Rare: an allergic reaction, rash, or difficulty breathing.
- Rare: features resembling acromegaly, a condition caused by too much growth hormone — only with very high doses or prolonged misuse.
- Most side effects settle within the first 2 weeks. Persistent numbness or tingling in the hands, carpal tunnel symptoms, joint swelling, or a puffy face mean the dose is too high — reduce it or stop for a while.
- Injection site reactions: redness, irritation, swelling, and/or itching.
- Mild water retention — magnesium supplementation may reduce it.
- Bloating.
- Transient paraesthesia or numbness in the fingers and hands.
- Flushing/heat post-injection — rate-dependent, mitigated by injecting as slowly as possible.
- Vivid dreams, associated with enhanced deep sleep phases.
- Mild lightheadedness, more common at higher doses.
- Headache.
- Mild appetite stimulation.
- Fatigue during initial adaptation.
- Temporary blood glucose fluctuations.
- Nausea, urticaria, dry mouth, hyperactivity.
- Uncommon: joint pain or stiffness.
- Rare: hypersensitivity/allergic reactions, rash, difficulty breathing.
- Rare: acromegaly-like features from excess GH — only with very high doses or prolonged misuse.
- CJC-1295 was well tolerated in clinical trials at 30 to 60 mcg/kg with no serious adverse reactions; common effects were transient injection site reactions, mild flushing, and headache. Ipamorelin showed no significant elevation in cortisol, prolactin, or ACTH even at supraphysiological doses.
- Dose-excess signals: persistent hand paraesthesia, carpal tunnel symptoms, joint swelling, or facial puffiness. Reduce or temporarily discontinue.
What the evidence shows
Both peptides have been tested in people, but separately. No published randomised trial has tested the blend itself in healthy adults for body composition or performance.
For CJC-1295, two randomised, placebo-controlled, double-blind trials enrolled healthy adults aged 21 to 61. After one injection under the skin, growth hormone rose 2 to 10 fold above starting levels and stayed high for 6 or more days. IGF-1 — the hormone the liver makes in response to growth hormone — rose 1.5 to 3 fold for 9 to 11 days. The compound stayed in the body for roughly 5.8 to 8.1 days. With repeated weekly doses, IGF-1 stayed above baseline for up to 28 days and built up over time. No serious problems were reported at 30 or 60 mcg/kg. Important caveat: that study used the long-acting DAC version, not the no-DAC version in this blend.
A second study showed CJC-1295 keeps the body's natural pulse pattern of growth hormone release intact. Pulse frequency and size did not change, but the baseline level between pulses rose 7.5 fold, average growth hormone rose 46%, and IGF-1 rose 45%.
For Ipamorelin, a dose-escalation trial in 40 healthy male volunteers found it stays active for about 2 hours, with growth hormone peaking around 40 minutes after injection and then falling back. The original selectivity study showed Ipamorelin released no ACTH or cortisol at any dose tested, even at more than 200 times the dose needed for growth hormone release.
For the pairing itself, a human study in 18 normal men showed that submaximal doses of a ghrelin-type peptide plus GHRH raised growth hormone more than either alone, confirming two separate routes.
On days off: one study in perifused rat pituitary cells found sensitivity fully recovered after 60 minutes. A human study gave 12 elderly subjects twice-daily hexarelin for 16 weeks; response dropped by week 16 but returned to normal after 4 weeks off.
Both compounds have human trial data, tested separately. No published RCT has assessed the combination in healthy adults for body composition or performance outcomes.
CJC-1295: two randomised, placebo-controlled, double-blind trials in healthy adults aged 21 to 61 (Teichman et al., 2006). A single subcutaneous injection raised mean plasma GH 2 to 10 fold above baseline with elevation lasting 6 or more days; IGF-1 rose 1.5 to 3 fold for 9 to 11 days; estimated half-life 5.8 to 8.1 days. Repeated weekly dosing kept IGF-1 above baseline for up to 28 days with evidence of cumulative effect. No serious adverse reactions at 30 or 60 mcg/kg. Critically, this was CJC-1295 with DAC; pituitary stimulation is mechanistically identical but the pharmacokinetics differ from the no-DAC analogue used here.
Ionescu and Frohman (2006) confirmed pulsatility is preserved during continuous stimulation: pulse frequency and magnitude unchanged, basal trough GH up 7.5 fold, mean GH up 46%, IGF-1 up 45%.
Ipamorelin: a dose-escalation trial in 40 healthy male volunteers (Gobburu et al., 1999) established a half-life of approximately 2 hours with GH peaking around 40 minutes post-injection, dose-dependent across all tested doses, followed by exponential decline. Raun et al. (1998) established Ipamorelin as the first selective GH secretagogue, releasing no ACTH or cortisol at any dose tested, including doses more than 200 times the GH-effective dose — the finding that separated it from GHRP-2 and GHRP-6.
Synergy: Bowers et al. (1990), 18 normal men, showed submaximal GHRP plus GHRH stimulated GH release synergistically, indicating independent pathways. GHRH raises the number of somatotrophs secreting; ghrelin agonism raises output per cell and suppresses somatostatin tone.
Desensitisation: Blake and Smith (1991) found receptor sensitivity in perifused rat pituitary cells fully recovered after 60 minutes. Rahim and Shalet (1998) dosed 12 elderly subjects with twice-daily hexarelin for 16 weeks; GH response declined significantly by week 16 and returned to baseline after 4 weeks off. Tesamorelin trials that gained FDA approval used daily dosing for 26 weeks; MK-677 trials used daily dosing for two years, with GH and IGF-1 elevated throughout.
The downstream outcomes — fat loss, recovery, connective tissue — are inferred from established GH/IGF-1 effects rather than directly measured for the blend.
User reports
From public forums
These notes come from Reddit, peptide forums, and clinic testimonials. They are anecdotal and do not carry the weight of published research.
Sleep is the most universally reported benefit. Users describe deeper sleep and falling asleep faster within the first 1 to 2 weeks. Some report temporary sleep disruption in the first 3 to 4 weeks, including waking 2 to 3 times a night, which usually settles around week 4 to 6 as the body adjusts to bigger growth hormone pulses. Vivid and sometimes intense dreams are frequently reported, especially early on.
Body composition changes are slow. Users who run it for 16 weeks or longer report gradual reduction in belly fat and better muscle definition. Almost everyone describes the results as subtle and progressive, not dramatic. People who expect fast visible changes are usually disappointed. The best outcomes come from those who stay consistent for 4 to 6 months with their food and training already sorted.
Recovery improves for most people within the first month — less soreness and the ability to train more often. Users already on testosterone replacement notice this most, since the extra growth hormone adds to an already anabolic setting.
Users who run it for 3 months or longer report better skin elasticity, less joint stiffness, and more comfortable tendons. These reports are less common simply because most people do not stay on long enough.
Side effects users report most often are mild: injection site redness, mild water retention, occasional tingling or numbness in the hands, and temporary flushing after injection. Most clear up within the first 2 weeks. Those who push the dose too high report more water retention, carpal tunnel symptoms, and joint swelling.
On the blend versus tesamorelin: users favour this blend for overall optimisation because it hits two pathways, and sometimes prefer tesamorelin for targeted visceral fat because that is what its trials measured.
Aggregated from external platforms including Reddit, peptide forums, and clinic testimonials. Anecdotal and not equivalent to published data.
Sleep is the most consistently reported effect, with deeper sleep onset within the first 1 to 2 weeks. A subset report transient sleep disruption over the first 3 to 4 weeks, including 2 to 3 nocturnal awakenings, generally stabilising by week 4 to 6 as the system adapts to larger GH pulses. Vivid, sometimes intense dreams are frequently described, attributed to enhanced slow-wave phases.
Body composition: users running 16 weeks or longer report gradual reductions in abdominal fat and improved definition. Users report that changes are subtle and progressive. Those expecting rapid visible change report disappointment; best outcomes come from 4 to 6 months of consistency with nutrition and training already controlled.
Recovery: reduced post-training soreness and increased training frequency are commonly reported within the first month, and are noticed most by users on TRT or other hormone protocols, where elevated GH complements the existing anabolic environment.
Skin and connective tissue: at 3 months or longer, users report improved skin elasticity, reduced joint stiffness, and better tendon comfort. These reports are less frequent simply because most users do not run the blend long enough.
Reported adverse effects skew mild — injection site redness, mild water retention, transient hand paraesthesia, post-injection flushing — with most resolving inside 2 weeks. Dose-pushers report more pronounced fluid retention, carpal tunnel symptoms, and joint swelling.
On the tesamorelin comparison, reported preference tracks the mechanism: this blend recruits both GHRH and ghrelin arms while tesamorelin acts on GHRH alone, so users favour the blend for general optimisation and sometimes favour tesamorelin for visceral adiposity because that is the outcome its trials measured.
Reports from practice describe roughly 3 months of use producing a clear improvement in sleep quality with negligible muscle and strength change in an already TRT-optimised user, while longer runs of 16 to 24 weeks produced better sleep and more efficient fat loss, with fat loss appearing only towards the end of the cycle.
User reports are individual experiences submitted by site visitors. They are not medical advice, are not verified for accuracy, and do not reflect Amino Reference's views. Read the evidence section above and talk to a clinician. Full disclaimer.
Stacking
- L-Carnitine
It supports the transport and burning of fatty acids while you are changing body composition.
Supports fatty-acid transport into mitochondria and subsequent oxidation during recomposition.
It supports fat burning without affecting blood sugar — useful here, since growth hormone itself can push blood sugar up.
Lipolysis support without glycaemic impact — a relevant property given the blend's own insulin-counter-regulatory effect.
Adds connective tissue, tendon, and joint recovery alongside the growth hormone repair effect. No interaction concerns. It does not need to be taken fasted, so inject it whenever suits and keep the blend on its own fasted schedule.
Connective-tissue, tendon, and joint recovery alongside GH-mediated repair; also upregulates GH receptor expression in tendon fibroblasts. No interaction concerns, but different timing requirements: BPC-157 has no fasting requirement, so the blend keeps its own fasted window.
The other suggestion for connective tissue, tendon, and joint recovery. No interaction concerns, and it does not need to be taken fasted.
Grouped with BPC-157 for connective-tissue, tendon, and joint recovery alongside GH-mediated repair. No interaction concerns; no fasting requirement, so it can be timed independently of the blend.
One of the two peptides in this vial, sold on its own. Use the standalone version when you want to control the two doses separately rather than at a fixed 1:1 ratio.
One half of this blend. Running the components separately trades the convenience of a single injection for independent titration of the GHRH and GHRP arms — worth it if one component is dose-limiting.
The other peptide in this vial, sold on its own. Also known as Mod GRF 1-29. Using it alone still raises growth hormone, but not as much as the pair.
The other half of this blend, identical to Mod GRF 1-29. Solo use recruits the GHRH arm only and forfeits the synergy; also the component whose usual 2-3×/day schedule the once-daily blend protocol does not follow.
No interaction concerns — completely different mechanisms, so they can be run at the same time. One thing to watch: appetite suppression from a GLP-1 can cut food intake enough to reduce the insulin needed to convert growth hormone into IGF-1. Eat enough to fuel recovery.
No interaction concerns; entirely separate mechanisms and can be run concurrently. The GLP-1 handles appetite regulation and metabolic signalling while the blend drives the GH axis. Practical caveat: significant appetite suppression may limit the postprandial insulin required for efficient hepatic GH-to-IGF-1 conversion.
Another GLP-1 type compound named as having no interaction concerns with this blend. Same caveat about eating enough to support IGF-1 conversion.
Named alongside the semaglutide- and tirzepatide-class agents as having no interaction concerns and being safe to run concurrently, with the same caveat on appetite suppression limiting insulin availability for IGF-1 conversion.
No interaction concerns. It works on the energy factories inside cells, which is a completely different target from the growth hormone system.
No interaction concerns. Mitochondrial target versus the somatotropic axis — different mechanisms, can be run concurrently.
No interaction concerns. Like MOTS-C, it targets the cell's energy factories rather than the growth hormone system.
No interaction concerns. Mitochondrial-targeted, mechanistically distinct from the GH axis; concurrent use is unproblematic.
- HGH 191AA — do not stack
Do not combine. Injecting growth hormone directly raises IGF-1, which makes the brain release somatostatin — the brake on the system — and that blocks the signal these peptides send. If switching from injected IGF-1, allow 2 to 3 days for it to clear first.
Contraindicated as a stack. Exogenous GH raises IGF-1, triggering hypothalamic somatostatin release that blocks pituitary responsiveness to GHRH and blunts the ghrelin arm; after a single injection of exogenous GH the GHRH pathway was substantially inhibited. Secretagogues work within the intact feedback loop; exogenous GH bypasses it. Allow 2 to 3 days after stopping exogenous IGF-1 for clearance and reversal of negative feedback.
An alternative rather than an add-on. Tesamorelin works on one pathway only, while this blend works on two. Users pick tesamorelin when the main goal is targeted belly fat, because that is what its trials measured.
Positioned as an alternative, not an adjunct: tesamorelin is GHRH-only while this blend recruits GHRH plus ghrelin signalling. Tesamorelin carries the specific clinical trial data for visceral adiposity; the blend is favoured for dual-pathway synergy across sleep, recovery, and muscle support.
Common questions
Is CJC-1295 without DAC the same as Mod GRF 1-29?
Yes. They are two names for the same compound — a modified copy of the natural signal the brain sends to the pituitary gland. The original CJC-1295 was made with DAC to last about a week. The no-DAC version is used in this blend because it clears quickly and keeps the body's natural pulse pattern.
Yes — identical compounds. CJC-1295 without DAC and Mod GRF 1-29 are two names for the same modified GHRH analogue. The original CJC-1295 incorporated the Drug Affinity Complex for extended duration via albumin binding; the no-DAC form is used here because rapid clearance preserves pulsatile GH release.
Should the dose be split or taken all at once?
Once daily works. Splitting it gives better results because you catch two natural growth hormone peaks. If you pick one time, bedtime on an empty stomach is best, because it amplifies the biggest natural pulse, which happens in deep sleep.
Once-daily dosing is effective, but split dosing produces better results by capturing two endogenous GH peaks. If restricted to a single administration, fasted pre-bed is optimal because it amplifies the largest physiological pulse, which occurs during slow-wave sleep between 10:00 p.m. and 2:00 a.m.
Can CJC-1295 be used on its own without Ipamorelin?
It can, but results are left on the table. CJC alone works through one door only. Adding Ipamorelin opens a second door at the same time, which is where the extra effect comes from. CJC alone still raises growth hormone, just not as much as the pair.
Yes, but at a cost. CJC alone recruits the GHRH receptor pathway only. Adding Ipamorelin engages GHS-R1a simultaneously, which is the source of the synergy: GHRH increases the number of somatotrophs secreting while ghrelin agonism increases output per cell and suppresses somatostatin. Solo CJC still elevates GH, but not to the same degree.
Why does the injection need to be taken fasted?
Eating raises blood sugar, which makes the body release insulin. Insulin attaches to the growth hormone cells in the pituitary gland and suppresses their ability to release it. Injecting while insulin is around is like pressing the accelerator and the brake together. Wait at least 2 hours after eating so insulin has cleared.
Postprandial insulin binds directly to pituitary somatotrophs and suppresses GH release, so administering a secretagogue while insulin is elevated works against the signal. A minimum 2-hour post-meal window is required for insulin clearance. Note the physiological paradox: optimal GH release needs low insulin, but efficient hepatic conversion of GH to IGF-1 needs insulin present — the body resolves this by pulsing overnight and converting after the first meal.
Does the timing change depending on the goal?
Yes. For fat loss, inject before bed. Growth hormone sits in your system overnight and mobilises fat directly, without needing IGF-1 for that job, and you sleep fasted. For building muscle, consider injecting in the morning about 30 minutes before eating: you are fasted so you get the full release, and then the meal supplies the insulin needed to convert it into IGF-1 for muscle protein synthesis. The fasting rule stays the same either way — only what happens afterwards changes.
Yes. For fat loss, pre-bed administration is preferable: GH circulates overnight and mobilises adipose tissue directly without requiring IGF-1 conversion, and the overnight fast is maintained. For muscle accrual, morning dosing roughly 30 minutes before the first meal captures the full fasted GH release and then supplies postprandial insulin for efficient hepatic IGF-1 conversion driving muscle protein synthesis. The fasting requirement is unchanged; only the post-injection feeding state differs.
Is 5 days on, 2 days off necessary to prevent desensitisation?
No. That protocol has no scientific support and does not address either real form of desensitisation. The short-term kind resolves on its own within about 60 minutes of each dose, so two days off does nothing for it. The longer-term kind develops after roughly 16 weeks of continuous use and needs about 4 weeks off to reverse, so two days is far too short. Daily dosing is the evidence-based approach: run for up to 16 weeks, then take 4 weeks off. Dosing 5 days a week saves about 30% on product cost, which is a valid budget choice — but it has nothing to do with desensitisation.
No. The 5-on/2-off pattern sits in a useless middle ground. Acute desensitisation occurs within minutes of each dose and resolves in approximately 60 minutes — Blake and Smith (1991) found full recovery of receptor sensitivity in perifused rat pituitary cells after 60 minutes — so two days off is redundant. Chronic desensitisation develops after roughly 16 weeks of continuous use and needs about 4 weeks to reverse; Rahim and Shalet (1998) gave 12 elderly subjects twice-daily hexarelin for 16 weeks, with GH response declining significantly by week 16 and returning to baseline after 4 weeks off — so two days is far too short. Tesamorelin trials used daily dosing for 26 weeks and MK-677 trials for two years with GH and IGF-1 elevated throughout. Daily dosing is the evidence-based approach; 5 days weekly is a budget strategy saving roughly 30% on product cost, not a desensitisation strategy.
This blend or tesamorelin?
It depends on the goal. Both work through the same brain-to-pituitary signal, but this blend also works through a second route. For overall optimisation including sleep, recovery, and muscle support, the blend is the better choice because of the two-pathway effect. Tesamorelin has trial data specifically for reducing deep belly fat, so if that is the main concern it is worth considering.
Goal-dependent. Both act on the GHRH pathway; the blend additionally recruits GHS-R1a, giving dual-pathway synergy that favours it for sleep, recovery, and muscle support. Tesamorelin holds clinical trial data specific to visceral fat reduction, so it is worth considering where visceral adiposity is the primary target — though mechanistically it covers the same GHRH pathway CJC already addresses.
How long does it take to see results, and will it replace TRT for building muscle?
Expect sleep improvements in weeks 1 to 2, recovery improvements in weeks 2 to 4, body composition changes around weeks 8 to 12, and connective tissue benefits at months 3 to 6. Most people who are disappointed stopped too early. It will not replace testosterone for building muscle — these are recovery and optimisation tools. Do not expect steroid-level growth.
Reported timeline: sleep at weeks 1 to 2, recovery at weeks 2 to 4, body composition around weeks 8 to 12, connective tissue and skin at months 3 to 6. Premature discontinuation is the most common reason for dissatisfaction. GH secretagogues do not substitute for testosterone replacement or anabolic steroids for hypertrophy; testosterone remains the primary anabolic driver and the blend supports rather than replaces it. The value sits in recovery, sleep, gradual body composition change, and connective tissue health.
References
- Teichman SL, Neale A, Lawrence B, Gagnon C, Castaigne JP, Frohman LA. Prolonged stimulation of growth hormone (GH) and insulin-like growth factor I secretion by CJC-1295, a long-acting analog of GH-releasing hormone, in healthy adults. J Clin Endocrinol Metab. 2006;91(3):799-805.
- Raun K, Hansen BS, Johansen NL, Thogersen H, Madsen K, Ankersen M, Andersen PH. Ipamorelin, the first selective growth hormone secretagogue. Eur J Endocrinol. 1998;139(5):552-561.
- Gobburu JV, Agerso H, Jusko WJ, Ynddal L. Pharmacokinetic-pharmacodynamic modeling of ipamorelin, a growth hormone releasing peptide, in human volunteers. Pharm Res. 1999;16(9):1412-1416.
- Ionescu M, Frohman LA. Pulsatile secretion of growth hormone (GH) persists during continuous stimulation by CJC-1295, a long-acting GH-releasing hormone analog. J Clin Endocrinol Metab. 2006;91(12):4792-4797.
- Bowers CY, Reynolds GA, Durham D, Barrera CM, Pezzoli SS, Thorner MO. Growth hormone (GH)-releasing peptide stimulates GH release in normal men and acts synergistically with GH-releasing hormone. J Clin Endocrinol Metab. 1990;70(4):975-982.
- Laron Z. Insulin-like growth factor 1 (IGF-1): a growth hormone. Mol Pathol. 2001;54(5):311-316.
- Blake AD, Smith RG. Desensitization studies using perifused rat pituitary cells show that growth hormone-releasing hormone and His-D-Trp-Ala-Trp-D-Phe-Lys-NH2 stimulate growth hormone release through distinct receptor sites. J Endocrinol. 1991;129(1):11-19.
- Rahim A, Shalet SM. Does desensitization to hexarelin occur? Growth Horm IGF Res. 1998;8 Suppl B:141-143.
- Jenkins PJ, Mukherjee A, Shalet SM. Does growth hormone cause cancer? Clin Endocrinol. 2006;64(2):115-121.
- Ishida J, Saitoh M, Ebner N, Springer J, Anker SD, von Haehling S. Growth hormone secretagogues: history, mechanism of action, and clinical development. JCSM Rapid Commun. 2020;3(1):25-37.
- Ho KY, Evans WS, Blizzard RM, et al. Effects of sex and age on the 24-hour profile of growth hormone secretion in man: importance of endogenous estradiol concentrations. J Clin Endocrinol Metab. 1987;64(1):51-58.
This entry has been reviewed and expanded with additional reference material. Units are recomputed from the stated protocol.