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Explore  /  Thymosin Alpha-1 (Thymalfasin / Zadaxin)
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Thymosin Alpha-1 (Thymalfasin / Zadaxin)

B
best evidence
Peptide
also called — Thymosin Alpha-1 · Tα1 · INN thymalfasin · brand Zadaxin · a thymic immune peptide. INCI: none
immune modulationantiviral (hepatitis)vaccine adjuvant(studied:) sepsis, cancer, COVID-19

Reference entry — not sold here. The strong-evidence immune peptide and a deliberate contrast to DSIP (#45): where DSIP is "50 years, still unproven," Thymosin Alpha-1 is approved in ~35 countries with a large clinical database. A prescription/compounded drug, not a wellness supplement. No dosing pu

In brief

Thymosin Alpha-1 (thymalfasin / Zadaxin) is a 28-amino-acid thymic immune-modulating peptide and one of the most clinically validated peptides in this register — approved in ~35 countries, with a 2024 review documenting >30 clinical trials in >11,000 people. Its strongest evidence is chronic hepatitis B and immune modulation. It is not FDA-approved for marketing in the US (orphan designations and Phase 3 that stalled commercially, not on safety), and its US compounding status has been unsettled. The general "immune-boosting" wellness use is extrapolated. It is distinct from the tissue-repair peptide TB-500 (#12) despite the shared "thymosin" name.

Legal standing, by region
European Union
not EMA-centrally approved (used in some countries' clinical

not EMA-centrally approved (used in some countries' clinical practice/trials).

United States · your region
Not FDA-approved (under review)

not FDA-approved for marketing (orphan designations + stalled Phase 3). Historically dispensed via 503A/503B compounding; its compounding status has been in flux through the 2023–2026 FDA peptide review — confirm current status.

Evidence, by outcome

An honest grade per outcome — drawn from the evidence, not any catalogue. Hype and undemonstrated marketing claims grade low.

OutcomeEvidence base · effectGrade
Chronic hepatitis B (approved indication)
Strongest use; approved widely but not FDA-approved (US)
Pivotal trials; approved in ~35 countries; part of a >30-trial / >11,000-subject database · Antiviral / immune benefit
B
Immune modulation / vaccine response (elderly, immunocompromised)
Benefit clearest in immunocompromised; context-dependent
RCTs (co-administration with influenza, hep B, COVID vaccines) · Improved antibody titres / durability
B
Sepsis
Aggregate evidence re-evaluated; context-dependent
Multiple RCTs + systematic review/meta-analysis · Suggestive / mixed
C
Cancer immunotherapy adjunct
Adjuvant use; results mixed across cancers
>40 adjuvant trials (melanoma, HCC, NSCLC); 2006 NSCLC (n=95, +21% 12-mo survival) · Mixed
C
COVID-19 (severe/hospitalised)
Observational/pilot; not definitive
Zhang 2020 (China); Shehadeh 2023 US pilot (hypoxemia + lymphocytopenia) · Encouraging but preliminary
C
General "immune boosting" (healthy people / wellness)
Not proven for healthy-person immune enhancement
Extrapolated from mechanism + age-related decline · Plausible
D
Safety
Very well tolerated; minimal side effects
Millions treated; approved-drug record · Excellent

Identity a 28-amino-acid, N-terminally acetylated peptide (~3,108 Da; < 40 aa → peptide), a fragment of prothymosin alpha, produced by thymic epithelial and peripheral immune cells. Serum levels decline ~40–60% with age (thymic involution). Discovered by Allan Goldstein's lab at George Washington University (Goldstein et al., 1977) — the same lab associated with thymosin beta-4 / TB-500 (#12) — but Tα1 and Tβ4 have fundamentally different biology (Tα1 = immune modulator; Tβ4 = actin-sequestering tissue repair). ## Development & history - Isolated by Goldstein's group in the 1970s from thymic tissue (thymosin fraction 5) — one of the first demonstrations that the thymus secretes soluble immune-modulating factors. Synthetic Tα1 was made by solid-phase synthesis in the early 1980s, freeing production from tissue extraction.

  • SciClone Pharmaceuticals developed the synthetic version as Zadaxin and pursued international approvals: China approved it for hepatitis B in 1996, and it went on to marketing authorisation in ~35–37 countries across Asia, South America, the Middle East and parts of Europe.
  • US: the FDA granted orphan-drug designations (hepatitis B in 1991, plus melanoma, DiGeorge anomaly, hepatocellular carcinoma), and SciClone ran US Phase 3 trials (hepatitis C, melanoma) — but these did not lead to US marketing approval. (Widely attributed to commercial/regulatory economics, not a safety signal.) ## Mechanism (as proposed) an immune modulator acting largely through Toll-like receptors TLR2 and TLR9 on dendritic and myeloid antigen-presenting cells → activates T-cell / cell-mediated immunity. It promotes T-cell maturation (upregulating CD3/CD4/CD8), dendritic-cell maturation and Th1 polarisation, and enhances NK-cell function, helping restore immune competence in immunosuppressed states while also contributing to control of inflammation and tolerance.
Sources — 5 cited
01Goldstein AL, Low TL, et al. (Isolation and characterisation of thymosin alpha-1.) 1977.
02Romani L, et al. (Dendritic-cell maturation / Th1 polarisation; TLR mechanism.) 2004.
03Zadaxin (thymalfasin) pivotal hepatitis-B / hepatitis-C trials; sepsis RCT meta-analysis.
04Shehadeh F, et al. A pilot trial of thymalfasin (thymosin-alpha-1) in hospitalised COVID-19 patients with hypoxemia and lymphocytopenia. J Infect Dis. 2023.
05Comprehensive review (2024) — >30 clinical trials, >11,000 subjects; PMC7747025 (literature review).
Review status
Not yet reviewed

A credentialed reviewer (PharmD / PhD / MD) will be named before this entry is finalised. Until then, treat it as a working draft. Last updated July 2026 (US compounding status evolving — re-check).

Grades reflect the published evidence, not our interest. No dosing, reconstitution, or administration is published for research compounds — that restraint is deliberate.

Related compounds
TB-500 (Thymosin Beta-4 fragment)C
Peptide
BPC-157B
Peptide
Explore by goal
Immune & thymic
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Thymosin Alpha-1 (thymalfasin / Zadaxin) — evidence & status · Vallydia