Compound family

Bone and endocrine peptide medicines

In one sentenceSettled peptide medicines, included as reference points: two that build bone, one that switches growth hormone off, one retired by its own safety data, one banned in sport as a masking agent, and the original: insulin.
Compounds6
Best gradeA Teriparatide
Approved medicines6 of 6
Prohibited in sport2 of 6

What this family is

This family exists to show what a peptide medicine looks like when the evidence is settled. Teriparatide is the first 34 amino acids of parathyroid hormone, approved since 2002 for severe osteoporosis, and abaloparatide is its 2017 successor with less high calcium; octreotide is an eight-residue analogue of somatostatin, approved since 1988 for acromegaly and hormone-secreting neuroendocrine tumours. Salmon calcitonin was an osteoporosis nasal spray for thirty years until a 2012 review found a marginal fracture benefit and a small cancer excess. Desmopressin, a nine-residue vasopressin analogue, has treated diabetes insipidus and bedwetting since the 1970s. Insulin, the 51-residue original from 1922, is the reference for everything else here — and the one member that is misused outside medicine. All are prescription-only and all have decades of use.

The evidence is of a different order from most of this site. Teriparatide's approval trial randomised 1,637 women and cut new spinal fractures from 14% to 5%; a later head-to-head beat the standard bisphosphonate. Octreotide's PROMID trial more than doubled the time before midgut neuroendocrine tumours progressed, from 6 to 14.3 months. Abaloparatide's ACTIVE trial did the same for 2,463 women. These are hard endpoints in large trials, and they are why the grades are A. Calcitonin and desmopressin show the other side of settled evidence: certainty about a small effect (33% fewer spinal fractures at one dose and none at the others; under one fewer night-time void) and about the harm (a cancer signal; low sodium in 7.6% of older adults).

Octreotide has one more role on this site: it is the approved medicine for having too much growth hormone — the mirror image of the secretagogues and releasing hormones sold to make more of it. Where those pages describe unproven ways to push growth hormone up, this one describes the proven way to push it down when the body makes too much.

Grade counts across the family: 6 × A · 0 × B · 0 × C · 0 × D. The best grade here, A, means established in humans. How LYO grades →

The compounds, graded

Every member with its best-supported outcome grade, human-trial count and regulatory status. Each opens the full evidence page.

Teriparatide

A

The first medicine that builds bone rather than slowing its loss. Approved since 2002 on a trial that cut spinal fractures by two-thirds.

Human trialsFracture Prevention Trial (n=1,637) + head-to-head VERO trial
StatusApproved (Rx)

Abaloparatide

A

The second bone-building peptide. An 18-month trial of 2,463 women cut new spinal fractures by more than 80%, with less high calcium than teriparatide.

Human trialsACTIVE RCT (n=2,463) + extension
StatusApproved (Rx)

Octreotide

A

A synthetic version of the hormone that switches growth hormone off. Approved since 1988 for acromegaly and hormone-secreting tumours — and it slows those tumours' growth.

Human trialsPROMID RCT (n=85) + approval programmes + decades of use
StatusApproved (Rx)

Calcitonin (salmon)

A

A 32-amino-acid hormone that was an osteoporosis medicine for thirty years — until a cancer signal and a marginal fracture trial ended most of that use.

Human trialsPROOF RCT (n=1,255, 5 yr) + regulatory meta-analyses
StatusApproved (Rx, restricted)

Desmopressin

A

A nine-residue vasopressin analogue in use since the 1970s. Cuts night-time urination modestly; causes dangerous low sodium in about one older adult in thirteen. Banned in sport as a masking agent.

Human trialsCochrane review (14 RCTs, n=2,966) + decades of use
StatusApproved (Rx)

Insulin

A

The original peptide medicine, in use since 1922. Included as the reference point: what a century of evidence looks like, and what the sharpest peptide side effect looks like.

Human trialsDCCT (n=1,441), UKPDS (n=3,867) and a century of use
StatusApproved (Rx)

Comparisons

Questions

Why are these on a site about grey-market peptides?
Because they are peptides people search for, and because a reference should show what settled evidence looks like. A reader who has only seen grade D pages should see what an A means.
Why was calcitonin withdrawn?
Pooled trials showed a small excess of cancers and the osteoporosis benefit was marginal. The EMA ended long-term use in 2012; short-term injection remains.
Why is desmopressin banned in sport?
It concentrates urine, so an athlete can drink to dilute a sample. WADA lists it as a masking agent (S5).
Is teriparatide anabolic?
It builds bone — that is what 'anabolic' means here. It has nothing to do with anabolic steroids and no effect on muscle.
Does octreotide relate to growth hormone peptides?
It is their opposite: the approved treatment for growth-hormone excess. The secretagogues raise growth hormone; octreotide suppresses it.

Written and maintained by LYO Research — how pages are written and checked. Reviewed 23 September 2026. Grades count human evidence only. Not medical advice. Correct this page →