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For competitive athletes, hexarelin (also called examorelin) is explicitly named as a prohibited growth-hormone-releasing peptide under WADA's Prohibited List in category S2 (Peptide Hormones, Growth Factors, Related Substances and Mimetics), banned at all times as a non-specified substance carrying a default four-year sanction

Future research efforts should therefore prioritize longitudinal, immune-stratified cohort studies, harmonize analytical methodologies, and integrate peripheral immune markers into adaptive clinical trial designs