Summary
Secretin is a natural gut hormone that is FDA approved in synthetic form (ChiRhoStim, human secretin, approved 2004) as a diagnostic agent: it stimulates pancreatic bicarbonate secretion to test exocrine pancreatic function, provokes gastrin release to diagnose gastrinoma (Zollinger-Ellison syndrome), and helps locate the pancreatic duct during ERCP. It became famous in the late 1990s as a proposed autism treatment, but a randomized trial in 60 children and a Cochrane review of more than a dozen trials found no benefit. It is used only in hospitals and endoscopy units, not as a therapy.
What is Secretin?
Secretin is a gastrointestinal hormone (27 amino acid peptide of the secretin/glucagon family), used as a diagnostic agent. It is also known as ChiRhoStim, human secretin, synthetic human secretin, porcine secretin, SecreFlo.
How does it work?
Secretin is released by duodenal S cells when acidic chyme enters the small intestine. It binds secretin receptors on pancreatic duct cells, raising cyclic AMP and driving secretion of bicarbonate rich fluid that neutralizes gastric acid. It also inhibits gastric acid secretion and gastrin release in normal tissue, but paradoxically stimulates gastrin release from gastrinoma cells, which is the basis of the secretin stimulation test for Zollinger-Ellison syndrome.
| Cluster | Other peptides |
|---|---|
| Routes | Intravenous bolus (diagnostic use only) |
| Conditions studied | None recorded |
| Record | v3, draft, verified Sep 23, 2026 |
What does the evidence say about Secretin?
For its approved diagnostic uses, the evidence base is decades of physiology and diagnostic accuracy studies: secretin stimulated pancreatic fluid analysis remains a reference standard for exocrine pancreatic function, and a gastrin rise of 120 pg per mL or more after secretin is the accepted criterion for gastrinoma. For autism, where it was widely promoted, a double blind randomized trial (n = 60) found no benefit over placebo and a Cochrane review of randomized trials in about 900 children found no evidence of effect. The evidence grade reflects those randomized trials, which show it does not work for autism, and observational diagnostic data for approved uses.
| Evidence type | Indexed studies | Participants (human) |
|---|---|---|
| Human randomized trials | 2 | 60 |
| Human observational studies | 1 | n/a |
| Animal studies | 0 | n/a |
| All indexed studies | 3 | 60 |
Human evidence
Sandler 1999 (randomized, double blind, placebo controlled, n = 60): a single intravenous dose of synthetic human secretin produced no improvement in autism symptom scores versus placebo at 4 weeks; parents could not distinguish active drug from placebo. Williams 2012 Cochrane review: across randomized trials of single and repeated secretin doses in children with autism spectrum disorder, no significant effect on core symptoms was found and the authors concluded further trials were not justified. Stevens 2008 (crossover, endoscopic versus Dreiling tube collection): secretin stimulated endoscopic pancreatic function testing gave comparable bicarbonate results to the traditional tube method in patients evaluated for chronic pancreatitis.
Animal evidence
Secretin was the first hormone ever identified (Bayliss and Starling, 1902, in dogs). Animal physiology established its release from the duodenum, its stimulation of pancreatic bicarbonate secretion, and its receptor pharmacology. Some rodent studies report central nervous system effects, which fueled the autism hypothesis but did not translate to human benefit.
Key studies
| Study | Design and population | Outcome | Grade |
|---|---|---|---|
| Lack of benefit of a single dose of synthetic human secretin in the treatment of autism and pervasive developmental disorder1999 PMID 10588965 | Randomized, double blind, placebo controlled trial, 4 week follow upn = 60 Children aged 3 to 14 with autism or pervasive developmental disorder | No difference from placebo on the Autism Behavior Checklist or other symptom measures; parents could not identify treatment assignment | Evidence: Human RCT evidence |
| Intravenous secretin for autism spectrum disorders (ASD)2012 PMID 22513913 | Cochrane systematic review of randomized controlled trialsChildren with autism spectrum disorder given single or repeated intravenous secretin | No evidence that secretin improves core autism symptoms; authors concluded further trials are not justified | Evidence: Human RCT evidence |
| A prospective crossover study comparing secretin-stimulated endoscopic and Dreiling tube pancreatic function testing in patients evaluated for chronic pancreatitis2008 PMID 18294508 | Prospective crossover diagnostic studyPatients evaluated for chronic pancreatitis | Secretin stimulated endoscopic collection gave peak bicarbonate results comparable to the traditional Dreiling tube method | Evidence: Human observational evidence |
Is Secretin legal in the United States?
FDA and compounding status
FDA approved diagnostic drug: synthetic porcine secretin (SecreFlo) was approved in 2002 and synthetic human secretin (ChiRhoStim) in 2004; the human product is the one currently marketed. It is a hospital and endoscopy unit agent with no therapeutic indication, so there is no compounding or telehealth market and it is not on any 503A bulks list. Some research chemical sellers list secretin, but there is no evidence based human use outside diagnostic testing.
WADA status
Not WADA prohibited. Not named on the current prohibited list. Athletes should still confirm against the list in force for their season.
Regulatory timeline
No regulatory events recorded.
Secretin dose on the FDA label
Doses below are quoted from the FDA label for its approved uses, plus the doses used in the pivotal trials where noted. The prescriber sets the dose; PeptideAgent does not recommend doses or protocols.
FDA label (ChiRhoStim, DailyMed; diagnostic use only, by intravenous injection over 1 minute): 0.2 mcg/kg to stimulate pancreatic secretions, including bicarbonate, to aid in diagnosing exocrine pancreas dysfunction; 0.4 mcg/kg to stimulate gastrin secretion to aid in diagnosing gastrinoma; 0.2 mcg/kg to stimulate pancreatic secretions to help identify the ampulla of Vater and accessory papilla during ERCP. There is no labeled therapeutic dose.
Routes reported
| # | Route |
|---|---|
| 1 | Intravenous bolus (diagnostic use only) |
What are the side effects and interactions of Secretin?
Side effects
| # | Reported side effect |
|---|---|
| 1 | Flushing, nausea, vomiting, and mild abdominal discomfort during infusion |
| 2 | Transient changes in heart rate or blood pressure |
| 3 | Rare hypersensitivity reactions; a test dose is sometimes used in patients with prior exposure |
| 4 | In the autism trials, adverse effects were mild and similar to placebo |
Interactions
| # | Interaction |
|---|---|
| 1 | Anticholinergic drugs reduce the pancreatic response to secretin and can cause a false result; the label advises stopping them before testing |
| 2 | Proton pump inhibitors and H2 blockers raise baseline gastrin and complicate interpretation of the gastrinoma test; they are usually held before testing when safe to do so |
Contraindications
| # | Contraindication |
|---|---|
| 1 | Acute pancreatitis (test should be delayed until the episode resolves) |
| 2 | Known hypersensitivity to secretin |
| 3 | Not approved or effective as a treatment for any condition, including autism |
How do people access Secretin legally?
Typical cost: Unknown at the patient level; single use diagnostic vials are administered in hospital and billed as part of the endoscopy or laboratory procedure. The vial price is high enough that testing is reserved for defined indications.
Verified access options
Step 1
Administered intravenously by a gastroenterologist or endoscopist in a hospital or endoscopy unit for pancreatic function testing, gastrinoma testing, or ERCP.
Step 2
Not dispensed to patients and not available through compounding pharmacies or telehealth.
Access paths are verified against public regulatory records and prescriber licensing. We never list unlicensed vendors.
Frequently asked questions
What is secretin used for?
Three FDA approved diagnostic uses: stimulating pancreatic fluid so its bicarbonate content can be measured to assess exocrine pancreatic function (for example in chronic pancreatitis), provoking gastrin release to diagnose gastrinoma in Zollinger-Ellison syndrome, and making the pancreatic duct opening easier to find during ERCP. It is not a treatment for anything. [3] [4]
Is secretin FDA approved?
Yes, as a diagnostic agent. Synthetic porcine secretin was approved in 2002 and synthetic human secretin (ChiRhoStim) in 2004, replacing the biologically extracted product that had been used for decades. Approval covers pancreatic function testing, gastrinoma testing, and aid to ERCP cannulation only. [4]
Does secretin help autism?
No. After anecdotal reports in 1998, a double blind randomized trial in 60 children found that a single intravenous dose of synthetic human secretin was no better than placebo on autism symptom scores, and parents could not tell which their child received. A Cochrane review of randomized trials in about 900 children, including repeated dose studies, found no effect on core symptoms and concluded that further trials were not warranted. [1] [2]
What are the side effects of secretin?
Usually minor and brief because it is a single intravenous dose: flushing, nausea, mild abdominal discomfort, and transient changes in heart rate or blood pressure. Allergic reactions are rare. It should not be given during acute pancreatitis. In the autism trials, side effects were no different from placebo. [1] [4]
How is the secretin stimulation test done?
For gastrinoma, a baseline gastrin level is drawn, 0.4 mcg per kg of secretin is injected intravenously over 1 minute, and gastrin is measured at 1, 2, 5, 10, and 30 minutes; a rise of 120 pg per mL or more above baseline supports gastrinoma. For pancreatic function, 0.2 mcg per kg is given and duodenal fluid is collected by tube or endoscope over about an hour to measure bicarbonate concentration. [3] [4]
How much does secretin cost?
Patients rarely see a direct price because it is given in hospital or endoscopy units and billed with the procedure. The synthetic human product is expensive per vial, which is why the test is reserved for defined indications rather than used as a screening tool. No cash pay or outpatient channel exists. [4]
Is secretin banned by WADA?
No. Secretin is not on the WADA Prohibited List. It is a digestive hormone with no effect on performance and is used only as a single dose diagnostic agent. [5]
Decisions about starting, stopping, or combining any treatment belong with a licensed clinician who knows your history.
Sources
Numbered citations above point to these primary sources. PubMed entries link to the indexed abstract.
- [1]Sandler AD et al. Lack of benefit of a single dose of synthetic human secretin in the treatment of autism and pervasive developmental disorder. N Engl J Med 1999PubMed 10588965, 1999
- [2]Williams K et al. Intravenous secretin for autism spectrum disorders (ASD). Cochrane Database Syst Rev 2012PubMed 22513913, 2012
- [3]Stevens T et al. A prospective crossover study comparing secretin-stimulated endoscopic and Dreiling tube pancreatic function testing in patients evaluated for chronic pancreatitis. Gastrointest Endosc 2008PubMed 18294508, 2008
- [4]FDA prescribing information for ChiRhoStim (human secretin) for injection, via DailyMedFDA, 2025
- [5]WADA Prohibited ListWADA, 2026
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