What blood work comes before peptide therapy?
Peptide therapy at Ultimate Male starts with blood work that includes IGF-1 plus metabolic and hormone markers, and the exact list depends on which peptide is on the table. Your provider sets the exact list, but for the growth-hormone-releasing peptides, sermorelin and tesamorelin, these are the markers that typically matter:
| Marker | Why it is checked before starting |
|---|---|
| IGF-1 | Baseline for growth hormone activity, so the response can be measured |
| Fasting glucose and A1c | Growth hormone can reduce insulin sensitivity and raise blood sugar |
| Lipid panel | Metabolic baseline for the body composition goals these peptides target |
| Kidney and liver function | General safety baseline before any injectable |
| Hormone markers such as testosterone | Many men asking about peptides also have hormone questions worth answering together |
Reference ranges for each marker vary between laboratories, and IGF-1 in particular is reported against age-specific ranges, so results are read against your own report.
Why do glucose and A1c sit next to IGF-1?
Glucose and A1c are there because pushing growth hormone up can push blood sugar up with it. The EGRIFTA SV label for tesamorelin warns that it can cause glucose intolerance. In its clinical trials, 5% of people on tesamorelin developed an A1c of 6.5% or higher by week 26, compared with 1% on placebo, and the label tells clinicians to evaluate glucose status before starting and to monitor it periodically.
The same pattern appears with growth hormone itself. The Genotropin (somatropin) label states that treatment may decrease insulin sensitivity, particularly at higher doses, and can unmask impaired glucose tolerance or diabetes, especially in people with obesity or a family history of diabetes. Sermorelin works by prompting your own pituitary to release growth hormone, so the same caution applies.
A baseline A1c of 5.4% and one of 6.2% lead to different conversations. The second man is already in the prediabetes range, so a peptide that can nudge glucose upward needs a closer watch, or a different plan. Our HbA1c test for men page explains the cutoffs, and our answer on peptide therapy with diabetes covers men who already have the diagnosis.
Why do lipids belong in the baseline?
Lipids belong in the baseline because growth hormone acts directly on fat metabolism. The Genotropin label describes growth hormone mobilizing fat, shrinking fat stores and raising plasma fatty acids, and tesamorelin is approved specifically to reduce excess abdominal fat in people with HIV-associated lipodystrophy. A lipid panel before you start gives a fixed point to compare against when your provider reviews how your body is responding.
It also catches problems that deserve attention for their own sake. A high LDL or triglyceride level found at a peptide consult is still a heart-risk finding, whatever you decide about the peptide.
Why does the baseline IGF-1 matter?
The baseline IGF-1 is the yardstick for everything that follows. Growth hormone itself rises and falls through the day, while MedlinePlus explains that IGF-1 is more stable, which makes it the practical way to track growth hormone activity. Without a starting value, a later result cannot show whether the peptide did anything.
The starting number also shapes the plan. A man already near the top of his age range has little room to rise, and an IGF-1 well above the range raises the separate question of growth hormone excess, which needs its own workup. Our page on the IGF-1 blood test for men explains the age-adjusted ranges, and IGF-1 levels on sermorelin or tesamorelin covers what happens after you start.
Who may be steered away from growth-hormone peptides?
Some histories rule these peptides out regardless of the labs. The tesamorelin label lists active cancer, disruption of the hypothalamic-pituitary axis from pituitary surgery, tumors, head radiation or head trauma, and pregnancy as contraindications. For men with a treated and stable cancer, it calls for weighing the benefit carefully against the risk of reactivating it, since growth hormone acts as a growth factor.
Tesamorelin is FDA-approved, as Egrifta, for reducing abdominal fat in HIV-associated lipodystrophy; using it for body composition in other men is off-label. Sermorelin was once approved as Geref and is now compounded, and the FDA notes that compounded drugs are not FDA-approved or reviewed for safety, effectiveness or quality before they are sold. Our answer on whether peptides increase cancer risk goes deeper on the cancer question.
What about BPC-157, TB-500 and NAD+?
These peptides do not act through growth hormone, so the IGF-1 and glucose logic above is less central. Labs still give a baseline of kidney, liver and metabolic health before an injectable. BPC-157 and TB-500 carry their own caveats: their compounding status is unsettled after the FDA’s 2026 advisory committee vote, with no final rule, and both are on the World Anti-Doping Agency prohibited list, which matters if you compete in tested sport.
How Ultimate Male runs peptide labs
The peptide therapy process starts with a free phone call, then blood work that includes IGF-1 and metabolic and hormone markers, drawn on site at San Gabriel or Downey with results in 24 to 48 hours. At a one-on-one consultation, a PA-C or MD reads those results with your history and goals and tells you whether a peptide fits, and which one.
If you go ahead, follow-up labs and a check-in come at six to eight weeks, so the IGF-1 and glucose numbers you started with become the comparison point. Our guide to the first peptide therapy consultation walks through that visit, and the tesamorelin page covers the FDA-approved option in detail.
