Three primary synthetic peptides, sirmirellan, tessumarelin, and CJC 1295, play significant roles in growth hormone release. Another category, including ipromerellin and hexarelin, stimulates growth hormone through ghrelin, which can increase hunger and anxiety. While hexarelin offers the strongest growth hormone pulses, it also carries risks such as receptor desensitization and increased prolactin levels, potentially leading to libido suppression.