Quick summary
Tesamorelin is an FDA-approved GHRH analog (brand: Egrifta) that reduces visceral fat in HIV-associated lipodystrophy and has shown cognitive benefits in aging adults. It is one of the few peptides with full FDA approval and robust Phase III data.
Overview
Tesamorelin is a synthetic GHRH analog that is FDA-approved (as Egrifta) for the treatment of HIV-associated lipodystrophy (excess abdominal fat). It is one of the few peptides with full FDA approval and robust clinical trial data. It is increasingly used off-label for body composition optimization and anti-aging.
Mechanism of action
Tesamorelin is a modified GHRH(1-44) with a trans-3-hexenoic acid group attached to the tyrosine at position 1, which increases its potency and stability. It stimulates the pituitary gland to produce and release growth hormone in a pulsatile, physiological pattern. It specifically reduces visceral adipose tissue (VAT) without significantly affecting subcutaneous fat.
Dosing protocols
| Purpose | Route | Dosage | Frequency | Notes |
|---|---|---|---|---|
| visceral fat reduction | subcutaneous | 1–2 mg | daily | Inject in abdomen. FDA-approved dose is 2mg daily. Cycle length varies; clinical trials ran 26-52 weeks. |
Dosing information is for educational purposes only. Consult a qualified healthcare professional before using any peptide.
Research summary
Phase III clinical trials (LIPO-010, LIPO-011) demonstrated significant reductions in trunk fat (-15.2%) and visceral adipose tissue in HIV patients. Also shown to reduce liver fat, improve cognitive function in older adults with mild cognitive impairment (2020 study), and reduce carotid intima-media thickness (cardiovascular marker). GH and IGF-1 increases are dose-dependent and clinically meaningful.[1][2][3][4][5]
Evidence grading
Each claimed benefit is graded by the strength of available evidence. Grades reflect study quality, not effect size.
Strong = multiple RCTs · Moderate = limited trials or observational · Preliminary = animal or in vitro only · Insufficient = anecdotal or no published data
Side effects
Side effects vary by individual. This is not an exhaustive list. Report unusual symptoms to a healthcare professional.
Common stacks
Peptides commonly paired with Tesamorelin for synergistic effects.
Legal status
FDA-approved as Egrifta for HIV-associated lipodystrophy. Available by prescription. Also available through compounding pharmacies for off-label use.
Sourcing & access
Prescription required
Tesamorelin is an FDA-approved prescription medication available through licensed healthcare providers, telehealth platforms, and 503A/503B compounding pharmacies.
Frequently asked questions
Tesamorelin (brand name Egrifta) received FDA approval in 2010 for the reduction of excess abdominal fat (lipodystrophy) in HIV-positive patients on antiretroviral therapy. This remains its only approved indication. Off-label research has explored its use for general body composition improvement, visceral adiposity reduction in non-HIV populations, and cognitive function.
Tesamorelin is a synthetic analogue of GHRH(1-44) stabilized with a trans-3-hexenoic acid moiety at the N-terminus, which protects it from rapid dipeptidyl peptidase IV (DPP-IV) degradation. It stimulates pulsatile GH secretion from the pituitary, which elevates IGF-1 and promotes lipolysis specifically in visceral adipose tissue through IGF-1 and direct GH receptor signaling in fat cells.
A 2020 randomized controlled trial showed tesamorelin improved cognitive performance in adults with mild cognitive impairment (MCI) and reduced liver fat and carotid intima-media thickness (IMT) as secondary outcomes. These findings are preliminary and were not the basis for FDA approval. Cognitive benefits are thought to be mediated by increased IGF-1 and improvements in metabolic health.
The FDA-approved dose for HIV lipodystrophy is 2 mg administered by subcutaneous injection into the abdomen once daily. Clinical trials supporting approval ran 26 to 52 weeks, demonstrating approximately 15 percent reduction in trunk fat. Off-label use typically follows this protocol, though treatment duration and monitoring differ outside the approved indication.
The most common side effects observed in clinical trials are injection site reactions (pain, redness, bruising), peripheral edema, joint pain (arthralgia), nausea, and muscle pain. Fluid retention can occur, particularly at initiation. Glucose metabolism should be monitored as GH elevation may reduce insulin sensitivity. Tesamorelin is contraindicated in active malignancy due to IGF-1 elevation.
Research references
- Effects of tesamorelin, a growth hormone-releasing factor, in HIV-infected patients with abdominal fat accumulation: a randomized placebo-controlled trial with a safety extensionPubMed
- Effect of tesamorelin on visceral fat and liver fat in HIV-infected patients with abdominal fat accumulation: a randomized clinical trialPubMed
- Reduction in visceral adiposity is associated with an improved metabolic profile in HIV-infected patients receiving tesamorelinPubMed
- The Growth Hormone Releasing Hormone Analogue, Tesamorelin, Decreases Muscle Fat and Increases Muscle Area in Adults with HIVPubMed
- Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trialPubMed