The FDA-approved GHRH analog that specifically reduces visceral (belly) fat — originally developed for HIV patients and now widely used off-label for body composition.
Tesamorelin is a synthetic GHRH (Growth Hormone Releasing Hormone) analog. It stimulates your own pituitary to produce more growth hormone — specifically in a way that preferentially reduces visceral adipose tissue (VAT), the deep belly fat most linked to metabolic disease.
It is FDA approved as Egrifta SV (current daily formulation, 2019) and Egrifta WR (weekly-reconstitution formulation, March 2025) for the reduction of excess abdominal fat in HIV-infected adults with lipodystrophy. Phase 3 trials showed roughly 15–18% reductions in visceral fat over 26 weeks (Falutz 2007 NEJM, PMID 18057338; Falutz 2010 JCEM pooled extension, PMID 20554713). Off-label use in non-HIV adults for body recomposition and longevity has no comparable RCT evidence base.
FDA approved (Egrifta SV / WR). Prescription-only. WADA prohibited (S2). Available through compounding pharmacies and research suppliers; compounded availability is increasingly contested as Theratechnologies pursues FDA enforcement.
Binds the GHRH receptor on anterior-pituitary somatotrophs, producing a robust GH pulse with a longer-acting, more stable molecule than native GHRH. SC elimination half-life is ~26 minutes (FDA Egrifta SV label); the trans-3-hexenoic acid N-terminal modification stabilizes against DPP-IV cleavage (native GHRH t½ ~7 min).
Raises IGF-1 by roughly 50% on average; nearly half of subjects in pivotal trials reached IGF-1 SDS >2, the label-recommended threshold to consider dose reduction or discontinuation (Falutz 2007 NEJM, PMID 18057338).
Unlike GLP-1s which produce general weight loss, tesamorelin preferentially mobilizes visceral adipose tissue via IGF-1-mediated lipolysis — while preserving or increasing lean mass.
As a GHRH analog it keeps natural pituitary feedback intact — unlike exogenous HGH which shuts down endogenous production.
Tesamorelin has more Phase 3 clinical data than any other growth-hormone-releasing peptide. The original HIV lipodystrophy program is the gold standard.
| Benefit | Evidence |
|---|---|
| Visceral fat reduction | Phase 3 (Falutz 2007 NEJM, PMID 18057338; Falutz 2010 JCEM pooled, PMID 20554713): 15–18% VAT reduction at 26 weeks on 2 mg/day (the historical F1 trial dose) |
| Triglyceride improvement | Falutz 2007 (PMID 18057338): triglycerides −50 mg/dL (tesamorelin) vs +9 mg/dL (placebo), P<0.001 |
| Liver fat (HIV-NAFLD) | Stanley 2014 JAMA (PMID 25038357) and Stanley 2019 Lancet HIV (PMID 31611038): tesamorelin reduced hepatic fat and prevented fibrosis progression on biopsy at 12 months in HIV-infected patients with abdominal fat accumulation |
| Cognitive function | Baker 2012 Arch Neurol (PMID 22869065; n=152, 20 weeks of 1 mg/day): improved executive function and verbal memory in healthy older adults and MCI. Follow-up RCT in HIV-associated neurocognitive disorder did not replicate. Single-trial signal — not yet replicated. |
| Lean mass preservation | Falutz 2007 (PMID 18057338): lean body mass preserved or slightly increased over 26 weeks |
| Glucose tolerance | Neutral to slightly elevated fasting glucose; ~5% incidence of new or worsened glucose dysregulation in pooled phase 3 data — monitor in T2DM and IGT |
Build your protocol, log every dose, monitor your body's response, and get reminders so you never miss a dose.
Start Tracking FreeOff-label / research-grade vial users typically dose to 2 mg/day to match the published trial regimen.
Tesamorelin is particularly sensitive to handling — it’s fragile compared to other peptides. Branded Egrifta ships with a dedicated diluent; research vials use bacteriostatic water.
5 mg vial + 2 mL BAC water = 2.5 mg/mL
| Dose | Volume | Syringe Units |
|---|---|---|
| 1 mg | 0.40 mL | 40 units |
| 2 mg | 0.80 mL | 80 units |
5 mg vial at 2 mg/day = ~2.5 days per vial. Plan purchases accordingly.
Storage rules differ between branded products and research-grade vials. Follow your specific product's instructions.
Pre-filled with a typical Tesamorelin setup. Edit any field — the draw updates live.
Dose requires 3.000 ml but your 0.5 ml syringe can't hold that much. Use a larger syringe or add more BAC water.
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Elevated GH and IGF-1 may promote growth of existing tumors — the concern is real for active disease; for past history, discuss with your oncologist rather than assuming automatic exclusion.
Tesamorelin vs. CJC-1295?
Tesamorelin has more clinical data, FDA approval, and produces a larger and more reliable GH pulse. CJC-1295 (especially with ipamorelin) is cheaper and more flexible for multi-pulse dosing. Tesamorelin is preferred for visceral fat reduction and NAFLD.
Do I need to cycle?
Continuous use is well tolerated in trials, but many users cycle 3–6 months on, 1–3 months off to let IGF-1 normalize and reduce side effects.
How long before I see fat loss?
Visible changes typically appear at 8–12 weeks, with peak effect at 26 weeks in clinical trials. Earlier changes (energy, sleep, skin) often noticed within 2–4 weeks. Expectation-setter: the Phase 3 data (Falutz 2007 NEJM, PMID 18057338; Falutz 2010 JCEM pooled, PMID 20554713) specifically show reductions in visceral adipose tissue — subcutaneous fat is not reduced to a clinically significant extent. Tesamorelin reshapes the midsection more than it drops scale weight, and its approved evidence base is HIV-associated lipodystrophy.
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Build your protocol, log every dose, monitor your body's response, and get reminders so you never miss a dose.
Start Tracking FreeYes — for one specific indication. Tesamorelin is FDA approved under the brand name Egrifta (first approved Nov 2010), Egrifta SV (2019, the lower-volume daily-reconstitution formulation), and Egrifta WR (March 2025, weekly-reconstitution formulation). All three are approved only for reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy. Use for general anti-aging, body composition, or growth-hormone supplementation is off-label.
The currently FDA-approved doses are: Egrifta SV — 1.4 mg subcutaneously once daily; Egrifta WR — 1.28 mg subcutaneously once daily. The original Egrifta (F1, 2010) was 2 mg/day — that "2 mg" figure is what pervades off-label and research-chemical sources, but it does not match currently marketed labeled products. Community off-label dosing typically uses 1–2 mg/day.
For a 5 mg lyophilized vial, a typical reconstitution is 5 mg + 2 mL of bacteriostatic water, yielding 2.5 mg/mL. A 2 mg dose draws to 0.80 mL (80 units on a 100-unit insulin syringe). FDA-approved Egrifta SV uses its own diluent and reconstitution procedure per its package label — vial-reconstitution instructions below apply to research-grade lyophilized tesamorelin.
Sermorelin is the bare GHRH(1-29) fragment — short plasma half-life (~10–20 min), not FDA approved. Tesamorelin is a modified full-length GHRH(1-44) with a trans-3-hexenoic acid N-terminal group that resists DPP-4 cleavage — longer half-life (~26 min), once-daily dosing viable, and FDA approved (for HIV lipodystrophy). Both act on the GHRH receptor. Tesamorelin is the more clinically validated molecule.
In the Falutz 2007 NEJM and Stanley 2014 JAMA trials in HIV lipodystrophy, statistically significant visceral adipose tissue reduction was observed at 26 weeks of 2 mg/day. IGF-1 elevation is observable within days; observable body-composition change in mainstream trials takes 12–26 weeks of continuous daily dosing.
Yes. Tesamorelin is prohibited at all times under WADA S2.2 (Growth Hormone-Releasing Factors). No therapeutic-use exemption is available for athletes.
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