Tesamorelin
A GHRH analogue FDA-approved for HIV-associated lipodystrophy. It is potent for reducing visceral abdominal fat.
Common Dosage
1mg - 2mg daily
Category
Fat Loss
- Visceral fat reduction
- Increased IGF-1
- Improved lipids
Tesamorelin is a GHRH analogue developed by Theratechnologies and FDA-approved in 2010 under the brand name Egrifta for treatment of excess abdominal fat in HIV-infected patients with lipodystrophy — a metabolic complication of antiretroviral therapy characterized by abnormal fat redistribution. It is notable for being the only FDA-approved GHRH analogue and one of the few peptides with a clear regulatory approval pathway. Its approval for HIV lipodystrophy opened significant interest in broader visceral fat reduction applications.
Tesamorelin binds to pituitary GHRH receptors to stimulate GH release in a physiologically appropriate pulsatile pattern. The resulting GH elevation drives IGF-1 production in the liver and peripheral tissues. The specific effect on visceral adipose tissue (VAT) appears disproportionate to its general GH-releasing effect — visceral fat is particularly sensitive to GH-induced lipolysis because of its high density of GH receptors and sensitivity to lipolytic signals.
- HIV-associated lipodystrophy — FDA-approved indication
- Visceral abdominal fat reduction in metabolic syndrome
- Non-alcoholic fatty liver disease (NAFLD) improvement
- Cognitive function in older adults (MCI research)
- Body composition optimization in aging populations
- Lipid profile improvement — reducing triglycerides and LDL
LADI and LADI-2 Clinical Trials
The pivotal trials in HIV patients demonstrated approximately 20% reduction in visceral adipose tissue area measured by CT scan after 6 months of tesamorelin 2mg daily — a statistically and clinically significant result that supported FDA approval. Lipid profiles also improved meaningfully.
Cognitive Protection in Older Adults
A landmark trial by the University of Wisconsin group showed that tesamorelin improved executive function and verbal memory in older adults with mild cognitive impairment, correlated with elevated IGF-1 levels — suggesting that GH axis restoration may protect brain function during aging.
Metabolic Syndrome Application
Off-label use in individuals without HIV but with significant visceral obesity has shown consistent results in clinical practice — reductions in waist circumference, visceral fat, and triglycerides over 3–6 month courses, consistent with its mechanism.
- Elevated IGF-1 — requires monitoring; potential proliferative risk in pre-malignant states
- Joint pain and edema are common dose-dependent side effects
- Contraindicated in active malignancy, pituitary disorders, or pregnancy
- Cost is significant if obtained pharmaceutically; research-grade versions lack FDA quality controls
- Glucose metabolism effects — monitor fasting glucose, particularly in those with pre-diabetes
- Injection site reactions are common with daily administration
- Joint pain
- Injection site reaction