What is Tesamorelin?
Tesamorelin is a stabilized analogue of human GHRH consisting of the full 44-amino-acid GHRH sequence with a trans-3-hexenoic acid group attached to the N-terminus, which protects it from dipeptidyl peptidase IV degradation and extends its half-life compared to native GHRH. It received FDA approval (Egrifta) for the treatment of excess abdominal fat in HIV-infected adults with lipodystrophy. Researchers have also studied its metabolic effects in non-HIV populations, including reductions in visceral adipose tissue and potential cognitive benefits.
Mechanism of action
Tesamorelin binds the GHRH receptor on pituitary somatotrophs, stimulating the synthesis and pulsatile release of endogenous GH. Elevated GH subsequently increases IGF-1 levels, which drives lipolysis in visceral adipose tissue. The intact negative-feedback axis is preserved, distinguishing it from exogenous GH.
Researched benefits
- Significant reductions in visceral adipose tissue (VAT) in HIV-lipodystrophy clinical trials
- Improved triglyceride and lipid profiles in clinical studies
- Elevated IGF-1 levels consistent with enhanced GH axis activity
- Pilot data suggesting benefits in cognitive function and memory in older adults
- Lean body mass improvements noted in longer research protocols
Researched dosage
Most research protocols use 1000–2000 mcg administered 1× per day via subcutaneous injection. The FDA-approved clinical dose is 2 mg (2000 mcg) subcutaneously once daily. Some research protocols use 1 mg daily. Rotate injection sites to minimize local reactions.
A typical cycle runs 26 weeks on, then 8 weeks off before reassessment.
Use the calculator below to convert your target Tesamorelin dose into exact insulin-syringe units.
Reconstitution & storage
A standard 1 mg vial reconstituted with 2.2 mL of bacteriostatic water yields 455 mcg/mL. Store lyophilized vials at 2–8°C. Reconstituted solution should be refrigerated and used within 24 hours per manufacturer guidance; some research protocols extend this to 72 hours under strict cold-chain conditions.
Side effects & considerations
- Injection-site erythema, pruritus, and pain (most common in trials)
- Peripheral edema and joint pain from GH-mediated fluid retention
- Possible glucose intolerance with prolonged use
- Antibody formation to tesamorelin observed in a subset of trial participants
Tesamorelin stacks
- Visceral Fat & Metabolic Research — paired with Semaglutide. Complementary visceral fat and appetite regulation signals. Investigators have modeled combining GHRH-axis stimulation with GLP-1 agonism for synergistic metabolic effects. This is a research framing only.
- GH Axis Dual Stimulation — paired with Ipamorelin. GHRH + GHRP combinatorial GH release. Pairing Tesamorelin with a GHRP like Ipamorelin is studied to amplify pituitary GH output beyond what either compound achieves alone.
Selected research
- Tesamorelin, a synthetic human growth hormone-releasing factor, in HIV-infected patients with abdominal fat accumulation — AIDS, 2010
- Effects of tesamorelin on visceral fat and liver fat in HIV-infected patients with abdominal fat accumulation — Clinical Infectious Diseases, 2012
- Growth hormone-releasing factor analogue tesamorelin and cognition in older adults — Journal of the American Geriatrics Society, 2019