New — Free Peptide Starter Guide (2026): 13 chapters, 34 cited studies

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Growth Hormone PeptidesFat Loss & Metabolic

Tesamorelin

Also known as: Egrifta, TH9507

Tesamorelin is an FDA-approved synthetic GHRH analog specifically indicated for reduction of excess abdominal (visceral) fat in HIV patients with lipodystrophy. It is the only GHRH peptide with FDA approval for a fat-reduction indication and is studied off-label for metabolic syndrome and cognitive function.

Half-Life

~26 minutes

Route

SubQ

Category

Growth Hormone Peptides, Fat Loss & Metabolic

Studies

50 references

Key Benefits

  • FDA-approved for visceral fat reduction in HIV lipodystrophy
  • Significant reduction in trunk/visceral fat (average 15–20% in trials)
  • Improved triglyceride and lipid profiles
  • Potential cognitive benefits and memory improvement
  • Preserves lean mass while reducing fat
  • Natural pulsatile GH stimulation

Mechanism of Action

Tesamorelin is a stabilized synthetic analog of GHRH that binds GHRH receptors in the anterior pituitary, stimulating GH secretion. Its stabilization (addition of a trans-3-hexenoic acid group) extends its half-life compared to native GHRH. GH-mediated effects include preferential mobilization of visceral adipose tissue, improved lipid profiles, and emerging evidence of cognitive benefits through IGF-1 signaling in the brain.

Dosing Protocols

FDA-Approved Protocol (HIV Lipodystrophy)

Dose
2 mg
Frequency
Once daily
Timing
Before bedtime, subcutaneous into abdomen
Cycle
Ongoing while benefit persists; reassess at 26 weeks

Rotate injection sites within the abdomen. FDA-approved dose is 2 mg/day. Do not inject into scar tissue or bruised areas.

Off-Label Metabolic / Cognitive Protocol

Dose
1–2 mg
Frequency
Once daily
Timing
Before bed
Cycle
12–26 week cycles

Off-label use for metabolic syndrome and cognitive enhancement. Some protocols use lower 1 mg/day dose.

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Side Effects

  • Injection site reactions (redness, irritation)
  • Arthralgia and joint pain
  • Peripheral edema
  • Carpal tunnel syndrome
  • Elevated blood glucose / insulin resistance
  • Nausea

Contraindications

Active malignancy. Disruption of hypothalamic-pituitary axis (tumors, trauma, radiation). Pregnancy or breastfeeding. Hypersensitivity to mannitol (used in formulation).

Storage

Refrigerate at 2–8°C. Protect from light. Reconstitute with diluent provided. Use within 3 hours of reconstitution at room temperature.

Featured In Stacks

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Fat LossIntermediate

Body Recomposition: Fat Loss + Lean Mass

Simultaneously reduce body fat and build lean muscle using complementary GH axis peptides and targeted lipolytic compounds. The gold standard body recomposition stack.

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HIV Lipodystrophy & Visceral Fat Reduction Protocol

A clinically-validated protocol for HIV-associated lipodystrophy using Tesamorelin alongside complementary peptides to reduce visceral adiposity, improve metabolic parameters, and support immune function in HIV-positive individuals on antiretroviral therapy.

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Insulin Resistance & Metabolic Syndrome Reversal Protocol

Comprehensive metabolic peptide protocol targeting insulin resistance, visceral adiposity, mitochondrial dysfunction, and chronic inflammation underlying metabolic syndrome.

Clinical Research

50 studies
  1. 1.
    Pharmacologic Treatments for the Preservation of Lean Body Mass During Weight Loss

    Arora G, Conde KR, Desouza CV · Journal of clinical medicine · 2026ReviewPubMed Verified

  2. 2.
    Body composition, hepatic fat, metabolic, and safety outcomes of Tesamorelin, a GHRH analogue, in HIV-associated lipodystrophy: A meta-analysis of randomized controlled trials

    Badran AS, Helal A, Shata KS, Ayesh H · Obesity research & clinical practice · 2026Meta-AnalysisPubMed Verified

  3. 3.
    Therapeutic Peptides in Orthopaedics: Applications, Challenges, and Future Directions

    Rahman OF, Lee SJ, Seeds WA · Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2026ReviewPubMed Verified

  4. 4.
    Injectable Peptide Therapy: A Primer for Orthopaedic and Sports Medicine Physicians

    Mayfield CK, Bolia IK, Feingold CL, Lin EH, Liu JN, Rick Hatch GF et al. · The American journal of sports medicine · 2026ReviewPubMed Verified

  5. 5.
    Analysis of growth hormone releasing hormone and its analogs in urine using nano liquid chromatography coupled with quadrupole/orbitrap mass spectrometry

    Uçaktürk E, Nemutlu E · Journal of pharmaceutical and biomedical analysis · 2026PubMed Verified

  6. 6.
    Carpal Tunnel Syndrome Attributed to Medication Use: A Pharmacovigilance Study

    Mihalache A, Volfson E, Huang R, Zuo K, Persitz J · Cureus · 2025PubMed Verified

  7. 7.
    Metabolic dysfunction-associated steatotic liver disease in people with HIV

    Gattu AK, Fourman LT · Current opinion in HIV and AIDS · 2025ReviewPubMed Verified

  8. 8.
    Effects of Tesamorelin on Neurocognitive Impairment in Persons With HIV and Abdominal Obesity

    Ellis RJ, Vaida F, Hu K, Dube M, Henry B, Chow F et al. · The Journal of infectious diseases · 2025RCTPubMed Verified

  9. 9.
    CROI 2024: Neuropsychiatric Complications in People With HIV

    Corley MJ, Letendre SL, Nightingale S · Topics in antiviral medicine · 2024ReviewPubMed Verified

  10. 10.
    Efficacy and safety of tesamorelin in people with HIV on integrase inhibitors

    Russo SC, Ockene MW, Arpante AK, Johnson JE, Lee H, Toribio M et al. · AIDS (London, England) · 2024RCTPubMed Verified

  11. 11.
    Dietary regimens appear to possess significant effects on the development of combined antiretroviral therapy (cART)-associated metabolic syndrome

    Chege BM, Mwangi PW, Githinji CG, Bukachi F · PloS one · 2024PubMed Verified

  12. 12.
    Chromatographic-mass spectrometric analysis of peptidic analytes (2-10 kDa) in doping control urine samples

    Thomas A, Walpurgis K, Thevis M · Journal of mass spectrometry : JMS · 2024PubMed Verified

  13. 13.
    Cationic exchange SPE combined with triple quadrupole UHPLC-MS/MS for detection of GHRHs in urine samples

    Cristea CD, Radu M, Toboc A, Stan C, David V · Analytical biochemistry · 2023PubMed Verified

  14. 14.
    Effect of tesamorelin in people with HIV with and without dorsocervical fat: Post hoc analysis of phase III double-blind placebo-controlled trial

    Rahman F, McLaughlin T, Mesquita P, Morin J, Potvin D, De Chantal M et al. · Journal of clinical and translational science · 2023PubMed Verified

  15. 15.
    Proteomic Analysis of Hepatic Fibrosis in Human Immunodeficiency Virus-Associated Nonalcoholic Fatty Liver Disease Demonstrates Up-regulation of Immune Response and Tissue Repair Pathways

    Fourman LT, Stanley TL, Ockene MW, McClure CM, Toribio M, Corey KE et al. · The Journal of infectious diseases · 2023PubMed Verified

  16. 16.
    Causes and outcomes of hepatic fibrosis in persons living with HIV

    Yen DW, Sherman KE · Current opinion in HIV and AIDS · 2022ReviewPubMed Verified

  17. 17.
    Probing for peptidic drugs (2-10 kDa) in doping control blood samples

    Thomas A, Thilmany S, Hofmann A, Thevis M · Analytical science advances · 2022PubMed Verified

  18. 18.
    An antibody-free, ultrafiltration-based assay for the detection of growth hormone-releasing hormones in urine at low pg/mL concentrations using nanoLC-HRMS/MS

    Coppieters G, Deventer K, Polet M, Van Eenoo P, Judák P · Journal of pharmaceutical and biomedical analysis · 2022PubMed Verified

  19. 19.
    Approach to the Patient With Lipodystrophy

    Fourman LT, Grinspoon SK · The Journal of clinical endocrinology and metabolism · 2022Case ReportPubMed Verified

  20. 20.
    Advances in the detection of growth hormone releasing hormone synthetic analogs

    Memdouh S, Gavrilović I, Ng K, Cowan D, Abbate V · Drug testing and analysis · 2021PubMed Verified

  21. 21.
    Non-Alcoholic Steatohepatitis (NASH) - A Review of a Crowded Clinical Landscape, Driven by a Complex Disease

    Fraile JM, Palliyil S, Barelle C, Porter AJ, Kovaleva M · Drug design, development and therapy · 2021ReviewPubMed Verified

  22. 22.
    Delineating tesamorelin response pathways in HIV-associated NAFLD using a targeted proteomic and transcriptomic approach

    Fourman LT, Stanley TL, Billingsley JM, Sui SJH, Feldpausch MN, Boutin A et al. · Scientific reports · 2021PubMed Verified

  23. 23.
    Growth Hormone Releasing Hormone Reduces Circulating Markers of Immune Activation in Parallel with Effects on Hepatic Immune Pathways in Individuals with HIV-infection and Nonalcoholic Fatty Liver Disease

    Stanley TL, Fourman LT, Wong LP, Sadreyev R, Billingsley JM, Feldpausch MN et al. · Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021RCTPubMed Verified

  24. 24.
    Tesamorelin improves fat quality independent of changes in fat quantity

    Lake JE, La K, Erlandson KM, Adrian S, Yenokyan G, Scherzinger A et al. · AIDS (London, England) · 2021PubMed Verified

  25. 25.
    Relationship of IGF-1 and IGF-Binding Proteins to Disease Severity and Glycemia in Nonalcoholic Fatty Liver Disease

    Stanley TL, Fourman LT, Zheng I, McClure CM, Feldpausch MN, Torriani M et al. · The Journal of clinical endocrinology and metabolism · 2021RCTPubMed Verified

  26. 26.
    Comparison of magnetic bead surface functionalities for the immunopurification of growth hormone-releasing hormones prior to liquid chromatography-high resolution mass spectrometry

    Pont L, Alechaga É, Terrero A, Monfort N, Ventura R · Journal of chromatography. A · 2020PubMed Verified

  27. 27.
    Effects of tesamorelin on hepatic transcriptomic signatures in HIV-associated NAFLD

    Fourman LT, Billingsley JM, Agyapong G, Ho Sui SJ, Feldpausch MN, Purdy J et al. · JCI insight · 2020RCTPubMed Verified

  28. 28.
    Clinical Predictors of Liver Fibrosis Presence and Progression in Human Immunodeficiency Virus-Associated Nonalcoholic Fatty Liver Disease

    Fourman LT, Stanley TL, Zheng I, Pan CS, Feldpausch MN, Purdy J et al. · Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021RCTPubMed Verified

  29. 29.
    Peptide Ligation at High Dilution via Reductive Diselenide-Selenoester Ligation

    Chisholm TS, Kulkarni SS, Hossain KR, Cornelius F, Clarke RJ, Payne RJ · Journal of the American Chemical Society · 2020PubMed Verified

  30. 30.
    Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial

    Stanley TL, Fourman LT, Feldpausch MN, Purdy J, Zheng I, Pan CS et al. · The lancet. HIV · 2019RCTPubMed Verified

  31. 31.
    Tesamorelin, liver fat, and NAFLD in the setting of HIV

    Audsley J, Sasadeusz J, Lewin SR · The lancet. HIV · 2019PubMed Verified

  32. 32.
    The Growth Hormone Releasing Hormone Analogue, Tesamorelin, Decreases Muscle Fat and Increases Muscle Area in Adults with HIV

    Adrian S, Scherzinger A, Sanyal A, Lake JE, Falutz J, Dubé MP et al. · The Journal of frailty & aging · 2019RCTPubMed Verified

  33. 33.
    Comparison of visceral fat measurement by dual-energy X-ray absorptiometry to computed tomography in HIV and non-HIV

    Fourman LT, Kileel EM, Hubbard J, Holmes T, Anderson EJ, Looby SE et al. · Nutrition & diabetes · 2019PubMed Verified

  34. 34.
    Tesamorelin

    2012ReviewPubMed Verified

  35. 35.
    Fibroblast growth factor 21 decreases after liver fat reduction via growth hormone augmentation

    Braun LR, Feldpausch MN, Czerwonka N, Torriani M, Grinspoon SK, Stanley TL · Growth hormone & IGF research : official journal of the Growth Hormone Research Society and the International IGF Research Society · 2017RCTPubMed Verified

  36. 36.
    Visceral fat reduction with tesamorelin is associated with improved liver enzymes in HIV

    Fourman LT, Czerwonka N, Feldpausch MN, Weiss J, Mamputu JC, Falutz J et al. · AIDS (London, England) · 2017PubMed Verified

  37. 37.
    Cardiovascular risk and dyslipidemia among persons living with HIV: a review

    Maggi P, Di Biagio A, Rusconi S, Cicalini S, D'Abbraccio M, d'Ettorre G et al. · BMC infectious diseases · 2017ReviewPubMed Verified

  38. 38.
    Safety and metabolic effects of tesamorelin, a growth hormone-releasing factor analogue, in patients with type 2 diabetes: A randomized, placebo-controlled trial

    Clemmons DR, Miller S, Mamputu JC · PloS one · 2017RCTPubMed Verified

  39. 39.
    Growth hormone deficiency and human immunodeficiency virus

    Rochira V, Guaraldi G · Best practice & research. Clinical endocrinology & metabolism · 2017ReviewPubMed Verified

  40. 40.
    PubMed PMID 30920787

    2016ReviewPubMed Verified

  41. 41.
    PubMed PMID 30896908

    2016ReviewPubMed Verified

  42. 42.
    PubMed PMID 30896905

    2016ReviewPubMed Verified

  43. 43.
    Therapeutic augmentation of the growth hormone axis to improve outcomes following peripheral nerve injury

    Tuffaha SH, Singh P, Budihardjo JD, Means KR, Higgins JP, Shores JT et al. · Expert opinion on therapeutic targets · 2016ReviewPubMed Verified

  44. 44.
    Qualitative identification of growth hormone-releasing hormones in human plasma by means of immunoaffinity purification and LC-HRMS/MS

    Knoop A, Thomas A, Fichant E, Delahaut P, Schänzer W, Thevis M · Analytical and bioanalytical chemistry · 2016PubMed Verified

  45. 45.
    Predictors of Treatment Response to Tesamorelin, a Growth Hormone-Releasing Factor Analog, in HIV-Infected Patients with Excess Abdominal Fat

    Mangili A, Falutz J, Mamputu JC, Stepanians M, Hayward B · PloS one · 2015RCTPubMed Verified

  46. 46.
    Expanded test method for peptides >2 kDa employing immunoaffinity purification and LC-HRMS/MS

    Thomas A, Walpurgis K, Tretzel L, Brinkkötter P, Fichant E, Delahaut P et al. · Drug testing and analysis · 2015PubMed Verified

  47. 47.
    Population pharmacokinetic and pharmacodynamic analysis of tesamorelin in HIV-infected patients and healthy subjects

    González-Sales M, Barrière O, Tremblay PO, Nekka F, Mamputu JC, Boudreault S et al. · Journal of pharmacokinetics and pharmacodynamics · 2015Clinical TrialPubMed Verified

  48. 48.
    Treatment of dyslipidemia in HIV

    Sekhar RV · Current atherosclerosis reports · 2015ReviewPubMed Verified

  49. 49.
    Population pharmacokinetic analysis of tesamorelin in HIV-infected patients and healthy subjects

    González-Sales M, Barrière O, Tremblay PO, Nekka F, Mamputu JC, Boudreault S et al. · Clinical pharmacokinetics · 2015RCTPubMed Verified

  50. 50.
    Effect of tesamorelin on visceral fat and liver fat in HIV-infected patients with abdominal fat accumulation: a randomized clinical trial

    Stanley TL, Feldpausch MN, Oh J, Branch KL, Lee H, Torriani M et al. · JAMA · 2014RCTPubMed Verified

Medical disclaimer: This information is for educational purposes only and does not constitute medical advice. Many compounds listed are research chemicals not approved for human use. Always consult a qualified healthcare professional before starting any protocol.

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