01 — Identity

What Is Tesamorelin?

2010

FDA APPROVED

GHRH

RECEPTOR TARGET

~26 min

HALF-LIFE

Egrifta

BRAND NAME

Origin

Developed by Theratechnologies Inc. (Canada). Synthetic analog of endogenous GHRH with a trans-3-hexenoic acid group at the N-terminus for enhanced stability and prolonged receptor binding vs. native GHRH.

Chemical Class

44-amino acid GHRH analog. Identical to endogenous GHRH(1-44) except for the N-terminal fatty acid modification that increases plasma stability.

FDA Indication

Approved for HIV-associated lipodystrophy — reduction of excess visceral fat in HIV patients on antiretroviral therapy. The only FDA-approved GHRH analog for visceral fat reduction.

Administration

Subcutaneous injection. Nightly before bed — FASTED. Available in 10mg and 20mg vials — reconstitution math differs by vial size.

Tesamorelin is the most clinically proven GHRH analog for visceral adipose tissue (VAT) reduction. ENCORE and ENCORE2 Phase III trials demonstrated 15–18% reduction in VAT vs. placebo over 26 weeks. Off-label use in non-HIV populations for visceral fat reduction and GH optimization is well-supported by the mechanism.

02 — Research History

Discovery & Research Timeline

1982

GHRH(1-44) is isolated and sequenced. Theratechnologies identifies the N-terminal fatty acid modification strategy to extend GHRH half-life beyond the ~2-minute plasma half-life of the native hormone.

1990s

TH9507 (Tesamorelin) synthesized and characterized by Theratechnologies. Initial studies confirm superior stability and pituitary GH stimulation vs. native GHRH. Development pivots toward HIV lipodystrophy as a clinical indication.

2004–2008

ENCORE Phase II and III clinical trials conducted. Tesamorelin at 2mg daily demonstrates statistically significant 15–18% reduction in visceral adipose tissue vs. placebo with an excellent safety profile over 26–52 weeks.

2010

FDA approves Tesamorelin (Egrifta) for HIV-associated lipodystrophy — the first and only FDA-approved GHRH analog for visceral fat reduction. European approval follows in subsequent years.

2015–Present

Off-label use expands in functional medicine and anti-aging clinics for visceral fat reduction, GH optimization, and NAFLD improvement in non-HIV populations. Cognitive function studies in MCI patients underway. Research peptide community widely adopts Tesamorelin as the gold-standard GHRH analog.

03 — Primary Benefits

Documented Effects

01

Visceral Fat Reduction

The most clinically proven peptide for visceral adipose tissue (VAT) reduction. Phase III trials: 15–18% VAT reduction vs. placebo over 26 weeks at 2mg daily. Targets the dangerous visceral fat depot associated with metabolic syndrome and cardiovascular risk.

02

IGF-1 Elevation

Stimulates pituitary GH secretion → liver IGF-1 production. IGF-1 rises proportionally to GH output, driving body composition changes, tissue repair, and metabolic improvement.

03

Liver Fat Reduction

NAFLD studies show Tesamorelin reduces hepatic steatosis (liver fat) alongside visceral fat reduction. GH promotes hepatic fatty acid oxidation and reduces lipogenic enzyme activity in the liver.

04

Lean Mass Preservation

GH-driven IGF-1 supports lean muscle mass during fat loss. Unlike caloric restriction alone, Tesamorelin preferentially reduces fat while preserving lean tissue — improving body composition ratio.

05

Triglyceride Reduction

Clinical trials showed significant reduction in triglycerides associated with visceral fat syndrome. GH drives lipolysis in visceral adipose and reduces hepatic VLDL production.

06

Cognitive Support

Ongoing studies in mild cognitive impairment (MCI) — GH receptors are expressed throughout the brain; IGF-1 is neurotrophic. Preliminary data suggests Tesamorelin may slow cognitive decline in at-risk populations.

07

FDA-Validated Safety Profile

Extensive Phase III safety data — the most thoroughly studied GHRH analog. Well-characterized side effect profile: fluid retention, joint pain (dose-dependent), and glucose monitoring requirements are the primary considerations.

04 — Reconstitution

Mixing & Storage — Two Vial Sizes

▸ 10mg Vial + 2.0mL BAC Water

10mg + 200u BAC water = 50 mcg/unit

10,000 mcg total
300mcg dose = 6 units
500mcg dose = 10 units
800mcg dose = 16 units
1mg dose = 20 units

▸ 10mg Vial + 3.0mL BAC Water

10mg + 300u BAC water = 33.3 mcg/unit

10,000 mcg total
300mcg dose = 9 units
500mcg dose = 15 units
800mcg dose = 24 units
1mg dose = 30 units

Use 2.0mL BAC water for a cleaner 50mcg/unit concentration — easier unit math at all three dose levels. The tracker defaults to 2.0mL. Adjust BAC volume in the tracker if your vial was reconstituted differently.

UNRECONSTITUTED

Refrigerate at 36–46°F / 2–8°C. Stable at room temp for shipping. Do not freeze lyophilized powder.

RECONSTITUTED

Refrigerate at 36–46°F / 2–8°C. Use within 4–6 weeks. Protect from light. Do not freeze.

05 — Dosing Protocol

Dose Levels & Unit Draws (10mg Vial / 2.0mL BAC = 50mcg/unit)

Level	Dose	10mg Vial Draw	Description
LOW	300mcg Daily nightly	6 units	Conservative starting dose. Ideal for first-time GH optimization or users with glucose sensitivity.
STANDARD	500–800mcg Daily nightly	10–16 units	Most common research dose range. Nightly, fasted, SC injection. Titrate up from 500mcg based on response and tolerance.
HIGH	1mg Daily nightly	20 units	Upper research dose. Monitor glucose and IGF-1 closely. Higher doses increase side effect risk.

⚠ Monitor glucose on higher doses. GH elevation can reduce insulin sensitivity. Inject fasted (2–3 hrs no food) for maximum GH output — insulin from recent meals blunts pituitary response.

06 — Timing & Frequency

When & How Often

Variable	Recommendation	Why
Timing	Nightly — 30–60 min before sleep	GH pulses naturally during slow-wave sleep. Nightly injection primes the pituitary at sleep onset, amplifying the natural nocturnal GH pulse for maximal IGF-1 production and fat mobilization during sleep.
Fed State	FASTED — 2–3 hrs no food	Elevated insulin from recent meals inhibits GH release at the pituitary level. Fasted injection is critical for maximizing GH output. No carbohydrates after dinner if dosing at bedtime.
Frequency	Daily (7×/week)	Daily nightly dosing mirrors the Phase III protocol. Consistent daily stimulation is required for the 15–18% VAT reduction observed in trials. Unlike once-weekly peptides, Tesamorelin requires daily administration.
Injection Site	SC abdomen — rotate daily	Abdominal SC injection is standard. Rotate within the abdominal quadrants to prevent lipohypertrophy at injection sites.

07 — Biomarker Monitoring

Lab Tests & Optimal Ranges

▸ GH Axis & Efficacy

Biomarker	Lab Test	Clinical Range	Optimal Range
IGF-1 Primary GH output marker	Serum IGF-1	CLINICALAge-dependent	OPTIMALUpper third of age range
Visceral Adipose Tissue	DEXA scan or CT abdomen	CLINICALBaseline measurement	OPTIMAL10–18% reduction from baseline at 6 months

▸ Metabolic Safety

Biomarker	Lab Test	Clinical Range	Optimal Range
Fasting Glucose	Fasting plasma glucose	CLINICAL70–100 mg/dL	OPTIMAL75–90 mg/dL
Fasting Insulin	Serum insulin	CLINICAL2–25 µIU/mL	OPTIMAL2–6 µIU/mL
HbA1c	Hemoglobin A1c	CLINICAL<5.7%	OPTIMAL4.6–5.3%
Triglycerides	Lipid panel	CLINICAL<150 mg/dL	OPTIMAL<80 mg/dL
AST / ALT	CMP	CLINICALAST 10–40 / ALT 7–56 U/L	OPTIMALAST <26 / ALT <26 U/L
CBC	Complete Blood Count	CLINICALStandard ranges	OPTIMALMid-range

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⚠ Tesamorelin (Egrifta) is FDA-approved for HIV-associated lipodystrophy. Off-label use for visceral fat reduction in non-HIV populations is not FDA-approved but is mechanistically supported and widely practiced. Monitor glucose carefully — GH can reduce insulin sensitivity. Do not use in active malignancy. GH axis stimulation is contraindicated with pituitary tumor or active pituitary pathology.

08 — Cycle Protocol

Cycle Length, Frequency & Timing

STANDARD CYCLE

26 Weeks

FDA-approved protocol duration. 2mg nightly for 6 months produces the maximum documented 15–18% VAT reduction. Measurable IGF-1 rise typically seen by week 4–8.

BREAK

4–8 Weeks

Off period allows pituitary receptor recovery. Clinical data shows VAT returns partially during off period — repeat cycles are common in off-label longevity protocols.

PROTOCOL SUMMARY

26 wk

CYCLE LENGTH

Nightly

FREQUENCY

500–800mcg

STANDARD DOSE

Fasted

FED STATE

SC

ROUTE

4–8 wk

BREAK