Strut Health Review: The NAD+ Page That Calls a Coenzyme a Peptide

Sermorelin: eight promises, and nineteen trials that tested none of them

Sermorelin is Strut's longevity line — $119 for a 9 mg injectable vial, $99 for thirty lozenges. Both pages carry the same sentence:

"A modern therapy designed to help your body naturally boost growth hormone. May support deeper sleep, faster recovery, mental clarity, fat metabolism, lean muscle mass, energy, mood, and metabolic health."

Eight outcomes. Here is what the registry holds for the molecule delivering them.

A ClinicalTrials.gov search for sermorelin as an intervention returns twenty-seven studies, and not one of them names sermorelin as the intervention. ¹ Every hit is a different molecule that the registry's synonym expansion has swept in: tesamorelin — sold as Egrifta, a genuinely approved GHRH analog — or GHRH(1-44), or an unspecified "GHRH" used as a diagnostic stimulation agent for pituitary testing. Sermorelin is GHRH(1-29). It is not any of those.

The search was tried six ways: "sermorelin", "sermorelin acetate", "GHRH(1-29)", "GHRH 1-29", "growth hormone releasing hormone 1-29", and "Geref", the brand name under which sermorelin was once approved and has since been withdrawn. A free-text search across every field in every record was run as well. Zero.

The obvious worry with a finding like that is a broken search. So the same queries were run for three molecules that should be there. Tirzepatide returns 158 records naming it as the intervention. Tesamorelin returns 17. Bremelanotide returns 10. The instrument works.

PubMed does not agree, and this review originally said it did. "Sermorelin" appears in twenty-four titles or abstracts and zero of those carry a trial publication type — but that restriction is the whole error. The trial literature files the molecule as GHRH(1-29)-NH₂, so searching without it returns 19 randomized controlled trials. ² They ran between 1986 and 2005, on growth-hormone stimulation, dose-response pharmacology and growth in children with growth hormone deficiency. The single paper that pairs sermorelin with aging or body composition is still a narrative review in Translational Andrology and Urology, not a trial — which is the actual point: the trials exist, and none of them is about what is being sold.

None of that is Strut's fault. It is a fact about the molecule, and it is equally true of every other company in this category selling sermorelin — which is most of them. What belongs to Strut is the decision to promise eight specific outcomes from it, on two products, at two prices, with no qualification anywhere on either page.

The lozenge compounds the problem. It carries the injectable's sentence verbatim, for a delivery route with no absorption study behind it. Peptides are cleaved by peptidases; getting one across the oral mucosa intact and in useful quantity is the hard part. Strut's own FAQ half-concedes this, advising patients to take the lozenge "on an empty stomach" and to avoid eating or drinking afterwards "to allow for better absorption" — a workaround for a difficulty the product page never raises.

"Apomorphine OR PT-141"

Super Strut is sold as "the world's first and only 4-in-1 ED tablet", $79 a month for ten tablets, "fast-acting" and "active for up to 36 hours". Its active ingredients are listed as:

"Tadalafil. Vardenafil. Apomorphine OR PT-141. Oxytocin."

Two of those four are uncontroversial. Tadalafil and vardenafil are approved PDE5 inhibitors with large trial programs, and nothing here questions them.

The third slot is the problem, twice over.

PT-141 is bremelanotide, and the evidence for it runs in a direction the page does not acknowledge. Its two phase 3 registration trials, RECONNECT 1 and 2, enrolled 723 and 714 premenopausal women with hypoactive sexual desire disorder. ⁷ The approval that followed is Vyleesi, and the Vyleesi label carries two Limitations of Use in consecutive sentences: "VYLEESI is not indicated for the treatment of HSDD in postmenopausal women or in men. VYLEESI is not indicated to enhance sexual performance." ⁶ Strut sells it to men, for performance.

That is not ordinary off-label prescribing, which is lawful and often good medicine. Off-label use rests on evidence the label has not caught up with. Here the label is describing the absence of evidence, and the registry agrees with the label.

And then there is the "OR". Apomorphine is a dopamine agonist. Bremelanotide is a melanocortin receptor agonist. They are different drug classes with different mechanisms, different adverse-effect profiles and different interactions — apomorphine in particular is associated with nausea and with orthostatic hypotension. The page offers no way to find out which one is in the tablet you are prescribed. For a product taken sublingually alongside two PDE5 inhibitors, that is not a formulation detail.

What Strut does better than its neighbors

It would be easy to read the above as a company being careless, and the rest of the site does not support that reading.

Strut publishes real safety labeling. Its sermorelin pages carry a warning that sermorelin and growth hormones "may have a negative effect on tumor growth" and should not be used by anyone with cancerous or benign tumors; that it may raise blood glucose and worsen insulin resistance; that it may interfere with thyroid function. The NAD+ page names cancer treatment, liver disease, kidney disease and uncontrolled diabetes as things to disclose. Most sellers in this category publish nothing of the kind, and Strut's blocks are written to be acted on.

It prints, on the product page rather than in the terms, that "Compounded medications are not FDA-approved. This compound has not been evaluated by the FDA for safety or efficacy."

It names the state it cannot serve — Arkansas — rather than claiming all fifty and qualifying it in a document nobody opens.

And it publishes who it is: Strut Health, LLC, 701 Commerce Street, Dallas, with Dr. Simal Patel, MD as founder and CEO.

The letter, and what it was actually about

On 20 February 2026 FDA issued warning letter 721448 to Strut Health, LLC dba Strut. ⁸ It cites two things under FD&C Act 502(a) and 502(bb). The first is that the compounded products "displayed on your website identify 'Strut' on the pictured label, suggesting Strut is the compounder of those drugs when in fact it is not." The second is website language including "Generic Zepbound, Mounjaro."

Both are labeling and advertising findings. The letter alleges nothing about sterility, potency, contamination or product quality, and this review does not treat it as though it did.

Strut acted on it. All three cited phrases are gone from the live site, and the compounding disclaimer now leads the weight-loss pages. What has not happened is a close-out — FDA has issued none, so nearly six months on the letter stands open.

There is an unresolved thread, though, and it is the reason the letter belongs in a review about evidence rather than only in one about marketing. FDA's finding was that the site implies Strut is the compounder when it is not. Strut still does not name who the compounder is — across all 132 pages of its own site, there is no pharmacy name, only "partner pharmacy" and "pharmacy network". And its footer displays ACHC and PCAB badges, both of which are pharmacy accreditations, with no entity, no certificate number and no link. A reader cannot tell whether those badges belong to Strut, to the unnamed pharmacy, or to nobody on the page.

What this means if you are buying

For semaglutide or tirzepatide, Strut is a reasonable place to look and the claims on the pages are broadly supported — appetite suppression and glycemic control are established at phase 3 for both. ^{4 5} Check the arithmetic before you agree to anything: the tirzepatide page advertises "as low as $199", its own 30-day card says $325, and the "Just $6.63" printed beneath the $325 is the per-day rate for $199. Thirty days at $325 is $10.83 a day. That card sits under a heading reading "Transparent Pricing".

For sermorelin, understand what you are buying: a molecule whose randomized trials all predate 2005 and measured pituitary hormone output, sold on eight promised outcomes none of them tested, at $119 a month injectable or $99 for the lozenge — and the lozenge adds an absorption question on top of the evidence question.

For NAD+, the page that is selling it does not appear to know what it is.

For Super Strut, ask which of apomorphine or PT-141 you are being prescribed before you take it, and know that if the answer is PT-141, the approved label for that molecule says it is not indicated for men and not indicated to enhance performance.