Fat loss
Tesamorelin
FDA-approved GHRH analog specifically approved for reducing visceral fat in HIV-associated lipodystrophy, used off-label more broadly for visceral fat reduction and as a growth-hormone secretagogue.
FDA-approved Fat loss Fitness & muscle
- Full name
- Tesamorelin (a growth hormone releasing hormone / GHRH analog)
- Also known as
- Egrifta
- Regulatory status
- FDA-approved prescription drug (Egrifta) for reduction of excess visceral fat in HIV-associated lipodystrophy. Used off-label for general visceral fat reduction and GH-axis support.
Origin
A synthetic analog of GHRH, stabilized against enzymatic breakdown to extend its action compared to native GHRH.
Mechanism
Stimulates the pituitary to release the body's own growth hormone in a pulsatile, physiological pattern rather than injecting synthetic HGH directly. That raises IGF-1 and has been shown to reduce visceral adipose tissue, the metabolically dangerous fat around internal organs, more than subcutaneous fat.
Research summary
Evidence
The pivotal trials supporting FDA approval were conducted in HIV-associated lipodystrophy patients and showed a statistically significant reduction in visceral adipose tissue (measured by CT scan) versus placebo, along with improved triglycerides. Since the mechanism (raising endogenous GH/IGF-1) isn't HIV-specific, tesamorelin is used off-label in the general population for visceral fat reduction, and by some in longevity/performance medicine as a 'cleaner' GH-axis stimulator than exogenous HGH, since it preserves the pituitary's natural pulsatile release and negative feedback control.
Evidence tier: FDA-approved — see the methodology note for how this is assessed.
Citations
- Effects of tesamorelin (TH9507), a growth hormone-releasing factor analog, in human immunodeficiency virus-infected patients with excess abdominal fat: a pooled analysis of two multicenter, double-blind placebo-controlled phase 3 trials with safety extension data — Falutz et al. 2010
- Long-term safety and effects of tesamorelin, a growth hormone-releasing factor analogue, in HIV patients with abdominal fat accumulation — Falutz et al. 2008
- Reduction in visceral adiposity is associated with an improved metabolic profile in HIV-infected patients receiving tesamorelin — Stanley et al. 2012
Reported benefits
- Clinically demonstrated visceral fat reduction (in its approved indication population)
- Reported improvements in sleep quality and body composition among off-label users
- Considered by some GH-axis-focused practitioners to be gentler/more physiological than direct HGH injection because it preserves the body's own feedback regulation
Dosing protocols reported in the literature & community
These are protocols reported by compounding pharmacies, published trials, or self-experimentation communities — not a prescription. Start low, especially for anything new.
| Route | Reported protocol |
|---|---|
| Subcutaneous injection, daily | The FDA-approved dose is 2 mg once daily, injected subcutaneously in the abdomen, typically at bedtime; this is also the dose most commonly used off-label. |
Side effects
- Injection-site reactions
- Joint pain, swelling or fluid retention (edema) — a known class effect of raising GH/IGF-1
- Increased blood glucose has been observed in trials — caution advised for people with insulin resistance or diabetes
- Contraindicated in active malignancy given IGF-1's growth-promoting effects
Safety notes
Community & reddit notes (anecdotal — not clinical evidence)
Popular in longevity and physique-focused communities specifically for visceral fat reduction, often discussed as a more evidence-backed alternative to peptide-only GH secretagogue stacks (CJC-1295/Ipamorelin) because it has actual placebo-controlled human trial data behind it, even though that data comes from a specific patient population rather than healthy adults.
Related peptides
Used in stacks
Community combinations that include Tesamorelin — see each stack page for the combination-specific rationale and evidence.
Mixing compatibility
Pulled from a community-charted mixing-compatibility reference (anecdotal, clinic-use, and community-reported signals) — not a safety guarantee. Verify independently before combining anything.