Tesamorelin
Tesamorelin is a synthetic growth-hormone-releasing hormone (GHRH) analog, FDA-approved as Egrifta for reducing excess abdominal (visceral) fat in people with HIV-associated lipodystrophy. It is the only peptide with approval specifically for visceral fat reduction, and it is studied off-label for body composition and cognition.
What it is
Tesamorelin is a stabilized version of the body's own GHRH. It signals the pituitary to release growth hormone in a natural, pulsatile pattern rather than supplying growth hormone directly. That pulsatility is why it produces fat loss and IGF-1 increases with fewer of the side effects associated with exogenous growth hormone. It is injected once daily, typically at night.
What the research says
Key findings:
- Pivotal phase 3 trials: about 15–18% reduction in visceral adipose tissue at 26 weeks in HIV-associated lipodystrophy, with effects reversing after discontinuation (PMID 18057337)
- Reduced liver fat in people with HIV and fatty liver disease (PMID 25004000)
- Improved some measures of cognitive function in healthy older adults and those with mild cognitive impairment in a 20-week trial (PMID 23108198)
- Increases IGF-1 without significantly raising fasting glucose in most trial participants, though glucose should be monitored
Research dosing ranges
The labeled dose is 2 mg subcutaneously once daily (Egrifta); a newer formulation uses 1.28 mg daily. Anecdotal off-label protocols commonly run 1–2 mg daily, injected in the evening on an empty stomach, for 3–6 months. Effects reverse when stopped.
Reconstitution tables
5mg vial
| Bacteriostatic water | Concentration | Units for 1 mg | Units for 2 mg | Doses per vial (2 mg) |
|---|---|---|---|---|
| 1 ml | 5 mg/ml | 20 | 40 | 2.5 |
| 2 ml | 2.5 mg/ml | 40 | 80 | 2.5 |
10mg vial
| Bacteriostatic water | Concentration | Units for 1 mg | Units for 2 mg | Doses per vial (2 mg) |
|---|---|---|---|---|
| 2 ml | 5 mg/ml | 20 | 40 | 5 |
| 1 ml | 10 mg/ml | 10 | 20 | 5 |
Because dosing is daily at 1–2 mg, a 10mg vial lasts under a week — buy accordingly. reconstitution calculator.
Storage
- Lyophilized: refrigerate (the branded product allows room temperature before reconstitution, but refrigeration is safer for research vials). Reconstituted: refrigerate and use promptly — the label says use immediately; research protocols typically use within 7–14 days. Tesamorelin is known to gel or precipitate if mishandled; if the solution is cloudy or viscous, do not use it.
Common stacks
- Tesamorelin + Ipamorelin (GHRH + GH secretagogue, to amplify the growth hormone pulse).
- Tesamorelin + a GLP-1 agonist (to target visceral fat alongside overall weight loss).
Side effects reported
Injection-site reactions (redness, itching), joint pain, fluid retention and swelling in hands, numbness or tingling, and elevated blood glucose in some users. Contraindicated with active cancer, pregnancy, and pituitary disruption. Water retention is the most common reason people reduce the dose.
Video explanation
Third-party educational video. Not affiliated with PepIQ.
Frequently asked questions
Is tesamorelin FDA-approved?
Yes, as Egrifta, for HIV-associated abdominal fat. Use for other purposes is off-label.
Does tesamorelin work for belly fat in people without HIV?
Trials were in HIV-associated lipodystrophy. Mechanism suggests similar effects in others, but controlled data in the general population is limited.
How many units is 2 mg of tesamorelin?
At 5 mg/ml, 40 units. At 10 mg/ml, 20 units.
When should it be injected?
Trials and most protocols use once daily, usually at night on an empty stomach, to align with the natural growth hormone pulse.
Does the fat loss last after stopping?
No. Trial participants regained visceral fat within months of discontinuation.
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