Fat Loss & Metabolism

Tesamorelin

Egrifta · TH9507 · stabilized GHRH

FDA-approved popular subQ injection

What it is

Tesamorelin is a stabilized analog of growth hormone-releasing hormone (GHRH), the natural signal your hypothalamus sends to the pituitary gland to release growth hormone. It's modified with one extra amino acid that protects it from being chewed up by enzymes in the bloodstream, giving it a much longer functional half-life than natural GHRH. FDA-approved in 2010 for HIV-related fat redistribution.

How it works

Tesamorelin tells your own pituitary to release growth hormone in a natural, pulsatile pattern — rather than dumping synthetic HGH into your system. This gives you a more physiological GH response.

The remarkable thing about Tesamorelin compared to other GHRH analogs is its specific effect on visceral adipose tissue — the deep belly fat wrapped around your organs that's the most metabolically dangerous kind. Multiple clinical trials have shown selective visceral fat reduction without affecting subcutaneous fat much.

Benefits

Significant reduction in visceral (deep belly) fat — clinical trials show ~15–20% reduction in 6 months
Reduced liver fat (improvement in NAFLD/MAFLD markers)
Improved cardiovascular markers (triglycerides, adiponectin)
Lean muscle preservation and modest gains
Better sleep quality (deeper REM stages)
Improved skin quality and recovery
Increased IGF-1 levels into the upper-normal range

Timeline

Week 1–2: Improved sleep quality — usually the first noticeable change.
Week 4: Body composition starting to shift; better recovery from training.
Week 8–12: Visible visceral fat reduction; waist circumference shrinks; clearer face.
Week 12–26: Peak visceral fat reduction (per clinical trial data — 6 months for max effect).

Dosing & titration

FDA-approved dose2 mg subQ daily (HIV indication)

Off-label range1–2 mg subQ daily

TimingBedtime, on an empty stomach (aligns with natural GH pulse)

Cycle length3–6 months on, then 1–2 months off to reset receptor sensitivity

Common stackOften combined with Ipamorelin ("Tesa-IPA") for cleaner GH pulse

When to titrateStart at 1 mg for the first 2 weeks to assess tolerance, then move to 2 mg if no significant water retention or carpal-tunnel symptoms.

Side effects & risks

Injection site redness or itching (most common)
Joint pain or stiffness, especially in hands/wrists
Mild water retention
Carpal tunnel-like symptoms at higher doses
Modest increase in fasting blood glucose — monitor if pre-diabetic
Headache

Contraindications: Active malignancy (raises IGF-1), pregnancy, severe diabetic retinopathy, hypopituitarism. Get baseline IGF-1, fasting glucose, and HbA1c. Re-test at 3 months.

Typical price

$300–$600/mo From a 503A compounding pharmacy. The branded Egrifta (FDA-approved version) is closer to $5,000+/mo retail.

Studies

Metabolic Effects of a Growth Hormone-Releasing Factor in Patients with HIV — Original NEJM paper establishing visceral fat reduction. NEJM New England Journal of Medicine, 2007
Effect of tesamorelin on visceral fat and liver fat in HIV-infected patients with abdominal fat accumulation: a randomized clinical trial — Showed 42 cm² visceral fat reduction and significant liver fat reduction. PubMed JAMA, 2014
Reduction in visceral adiposity is associated with an improved metabolic profile in HIV-infected patients receiving tesamorelin — Linked visceral fat loss to improved triglycerides and glucose markers. PubMed Clinical Infectious Diseases, 2012
Tesamorelin Improves Fat Quality Independent of Changes in Fat Quantity — Showed improvements in fat tissue characteristics beyond just amount. PubMed Central Journal of Clinical Endocrinology & Metabolism, 2021
The Growth Hormone Releasing Hormone Analogue, Tesamorelin, Decreases Muscle Fat and Increases Muscle Area — Confirmed muscle quality improvements. PubMed Journal of Frailty & Aging, 2019

Educational reference only. Not medical advice. Tesamorelin is FDA-approved for HIV lipodystrophy; off-label use should be supervised by a licensed prescriber.