Peptide Profile
Tesamorelin
The only FDA-approved peptide specifically designed to melt away stubborn belly fat by telling your brain to release more growth hormone naturally—working with your body's own systems rather than replacing them.
Dose Range
1-2mg
Frequency
Once daily
Route
Subcutaneous injection
Cycle Length
12+ weeks
Onset
Moderate (1-2 weeks)
Evidence
Strong
Compound Profile
Scientific & Efficacy Data
C221H366N72O67S
Molecular Formula
5135.86 g/mol
Molecular Weight
26-38 minutes
Half-Life
~100% (subcutaneous injection)
Bioavailability
218949-48-5
CAS #
16137828
PubChem ID ↗
Developed By · 2000
Theratechnologies Research Team
Theratechnologies Inc.
Primary Benefits
FDA-approved with Phase 3 trial data showing 15-18% reduction in dangerous belly fat—among the strongest evidence for any fat-targeting peptide
Significantly improves triglycerides, cholesterol ratios, and liver fat markers as visceral fat decreases
Increases IGF-1 levels by 100%+ while maintaining physiological feedback—works with your body's own systems
Amino Acid Sequence
Trans-3-hexenoic acid-Tyr-Ala-Asp-Ala-Ile-Phe-Thr-Asn-Ser-Tyr-Arg-Lys-Val-Leu-Gly-Gln-Leu-Ser-Ala-Arg-Lys-Leu-Leu-Gln-Asp-Ile-Met-Ser-Arg-Gln-Gln-Gly-Glu-Ser-Asn-Gln-Glu-Arg-Gly-Ala-Arg-Ala-Arg-Leu-NH2Dosing
How much
do I take?
Starting Dose
1 mg
Some practitioners start at the lower approved dose to assess tolerance before increasing. The standard FDA-approved dose is 2mg, but starting lower allows you to monitor for side effects like injection site reactions or joint discomfort.
Standard Dose
2 mg (or 1.4 mg Egrifta SV)
This is the FDA-approved dose shown effective in large Phase 3 trials. Clinical studies showed significant visceral fat reduction at 26 weeks with continued benefits at 52 weeks. Note: Egrifta SV uses a 1.4mg dose which is bioequivalent to the original 2mg formulation.
Advanced Dose
2 mg
Long-term use beyond the initial 26 weeks has been studied and shows maintained benefits. However, stopping treatment causes visceral fat to return. Many users continue indefinitely with periodic monitoring. Extended use requires regular IGF-1 and glucose monitoring.
Timing
Best time to take
Inject in the morning on an empty stomach, at least 30 minutes before eating. This aligns with your natural cortisol awakening response and may optimize growth hormone release patterns.
With food?
Do NOT inject with food. Tesamorelin should be given on an empty stomach for optimal absorption. Wait at least 30 minutes after injection before eating breakfast.
If stacking
If using with other growth hormone secretagogues, separate injections by several hours. Some practitioners alternate between tesamorelin and other GHRH peptides rather than using them the same day. Never combine with exogenous GH—choose one or the other.
Adjusting Your Dose
Increase if
- +You've been on the starting dose for 4+ weeks with no issues
- +IGF-1 levels haven't increased meaningfully on lower doses
- +Your physician recommends the standard FDA-approved dose
Decrease if
- -You experience significant joint pain or swelling
- -Blood glucose levels rise substantially
- -Fluid retention becomes uncomfortable
- -Injection site reactions are severe or persistent
Signs of right dose
- ✓Measurable reduction in waist circumference over 3-6 months
- ✓Improved triglyceride levels on blood work
- ✓IGF-1 levels in the upper normal range
- ✓Better body image and reduced belly appearance distress
Dosing Calculator
Calculate Your Exact Dose
Amount to Draw
10
units
Suitability
Is this
right for me?
Best For
People with Stubborn Visceral Fat
If you carry your weight around your midsection—the deep belly fat that wraps around your organs—tesamorelin is specifically designed for you. Unlike weight loss drugs, it targets visceral fat while preserving the normal subcutaneous fat that's healthy to have.
HIV Patients with Lipodystrophy
Tesamorelin is FDA-approved specifically for HIV-associated lipodystrophy—the abnormal fat accumulation in the belly that antiretroviral medications can cause. It's the only treatment proven to help this condition, reducing both the physical and psychological burden.
Those Concerned About Metabolic Health
Visceral fat isn't just cosmetic—it's metabolically dangerous, linked to heart disease, diabetes, and inflammation. By reducing visceral fat, tesamorelin also improves triglycerides, cholesterol ratios, and may help protect your liver from fatty liver disease.
Adults Wanting Natural GH Stimulation
Unlike synthetic growth hormone injections, tesamorelin works WITH your body's natural systems. It tells your pituitary to release more of YOUR OWN growth hormone, maintaining normal feedback loops and reducing the risks associated with supraphysiological GH levels.
Consider Alternatives If
Who Should Avoid
Do not use if
- ×You have active cancer or a history of malignancy—growth hormone can potentially stimulate tumor growth
- ×You have pituitary problems from surgery, radiation, or tumors affecting the hypothalamic-pituitary axis
- ×You are pregnant or planning to become pregnant
- ×You have a known allergy to tesamorelin or mannitol (a stabilizing ingredient)
- ×You have uncontrolled diabetes—tesamorelin can worsen glucose tolerance
Use with caution if
- !You have pre-diabetes or impaired glucose tolerance—monitor blood sugar closely
- !You take medications that affect blood sugar like insulin or oral diabetes drugs
- !You have a history of carpal tunnel syndrome—GH elevation can worsen symptoms
- !You have fluid retention issues or heart problems—edema can occur
- !You take glucocorticoids (steroids)—they may reduce tesamorelin's effectiveness
- !You're over 65—less clinical data exists for elderly patients
Administration
How do I
use it?
Reconstitution
What you need
- •Tesamorelin powder vial
- •Sterile water for injection (provided with prescription products)
- •Insulin syringes (29-31 gauge, 1/2 inch needle)
- •Alcohol swabs
- •Sharps disposal container
Injection
Route
Subcutaneous injection (just under the skin into fatty tissue)—this is the only approved administration route
Best sites
- •Abdomen (2 inches away from belly button)—the most common site
- •Front or outer thigh
- •Rotate sites to prevent lipodystrophy at injection locations
Technique
- 1.Wash hands thoroughly with soap and water
- 2.Clean the injection site with an alcohol swab and let dry completely
- 3.Pinch a fold of skin between thumb and forefinger
- 4.Insert needle at a 45 to 90-degree angle (90 for more tissue, 45 for lean individuals)
- 5.Inject slowly and steadily over 5-10 seconds
- 6.Wait 5 seconds before withdrawing the needle
- 7.Do not rub the injection site afterward
Storage
Signs of degradation
Sample Daily Schedule
Safety
Is it
safe?
Safety Profile
Tesamorelin has a strong safety profile backed by FDA approval and multiple large Phase 3 clinical trials involving over 800 patients. The most common issues are injection site reactions and the typical side effects of elevated growth hormone (joint pain, fluid retention). Glucose metabolism should be monitored as some patients experience increased blood sugar. Long-term cardiovascular safety data is still being collected, which is why the FDA recommends reassessing treatment if visceral fat doesn't reduce.
Safety data comes from well-designed, placebo-controlled Phase 3 trials published in peer-reviewed journals and reviewed by the FDA. Studies extended up to 52 weeks with safety monitoring. This represents some of the strongest evidence available for any peptide therapy.
Common Side Effects
Experienced by some users
Injection site reactions
Redness, itching, pain, swelling, or bruising where you inject. This is the most frequently reported side effect, affecting up to 25-30% of users.
Management: Rotate injection sites between left and right abdomen. Make sure the solution reaches room temperature before injecting. Apply a cool compress if needed. Most reactions resolve within a day or two.
Joint pain (arthralgia)
Aching in joints, particularly knees, hips, or hands. This happens because increased growth hormone affects your connective tissues.
Management: Often improves after the first few weeks as your body adjusts. Stay well-hydrated. If severe, discuss dose adjustment with your doctor. Over-the-counter pain relievers can help.
Muscle pain (myalgia)
General muscle aches or soreness, similar to what you might feel after exercise.
Management: Usually mild and transient. Gentle stretching and staying active can help. Should improve within the first month of treatment.
Peripheral edema
Swelling in your hands, feet, or ankles due to fluid retention—a known effect of growth hormone.
Management: Usually mild. Reduce salt intake and stay active. Elevate feet when resting. If swelling is significant or affects breathing, contact your doctor immediately.
Less Common
- •Carpal tunnel symptoms
- •Elevated blood glucose
These typically resolve with continued use or dose adjustment.
Stop and Seek Help If
- ×Severe allergic reaction occurs—stop immediately and seek emergency care
- ×Visceral fat has not decreased after 3 months of treatment (per FDA guidance)
- ×Blood glucose becomes uncontrolled despite adjustments
- ×Development of new or worsening malignancy
- ×Pregnancy occurs or is planned
- ×Intolerable side effects that don't resolve with dose adjustment
Tesamorelin is an FDA-approved prescription medication that should only be used under physician supervision. Never start, stop, or adjust your dose without consulting your prescribing healthcare provider. This information is educational and does not constitute medical advice.
Interactions
With other peptides
- ✓Similar mechanism (GHRH pathway). Can be used together but may be redundant. Some practitioners alternate rather than combine.
- ✓Works on different receptor (GHRP). Can complement tesamorelin for enhanced GH release. Use at different times of day.
- ✓Very similar mechanism (also GHRH analog). Generally not used together—choose one or the other.
- ✓Different mechanism entirely (healing peptide). Safe to use together if addressing different goals.
With medications
- !Insulin - Tesamorelin can increase blood glucose, potentially requiring insulin dose adjustments. Monitor closely.
- !Oral diabetes medications - May need dose adjustment as tesamorelin affects glucose metabolism. Work with your endocrinologist.
- ✓Glucocorticoids (prednisone, etc.) - Steroids may reduce tesamorelin's effectiveness and counteract fat reduction benefits.
- !Growth hormone - Do not combine. Using both would be redundant and could cause excessive GH effects.
With supplements
- ✓Arginine - May have additive GH-releasing effects. Generally safe but probably unnecessary with tesamorelin.
- ✓Glucose disposal agents (berberine, etc.) - May help counteract tesamorelin's glucose-raising effects. Discuss with your doctor.
- ✓Fish oil - Safe to combine. May complement the triglyceride-lowering effects of tesamorelin.
- ✓Chromium - Safe. May help with blood sugar regulation.
Effectiveness
Does it
work?
Evidence Level
Strong human trials
What to Expect
Weeks 1-2
What you might notice
- •Injection site reactions as your body adjusts
- •Possibly some joint stiffness or mild aching
- •May feel some fluid retention in hands or feet
- •No visible body composition changes yet
What's normal
- •Mild injection site redness or itching that resolves in 1-2 days
- •Slight puffiness in extremities, especially in the morning
- •Initial adjustment period discomfort
What's next
- →Continue with daily injections at consistent times
- →Track any side effects to discuss with your doctor
- →Side effects typically improve as your body adjusts
Weeks 3-8
What you might notice
- •Injection site reactions typically decrease significantly
- •IGF-1 levels rising on bloodwork (if tested)
- •May notice clothes fitting slightly differently around waist
- •Energy levels may improve as GH levels optimize
What's normal
- •Settling into the routine with manageable side effects
- •Subtle changes in how your midsection looks or feels
- •Better tolerance than the first couple weeks
What's next
- →Continue consistent daily dosing
- →Most practitioners recommend imaging (CT or MRI) at baseline and 12-26 weeks
- →Monitor blood glucose at regular intervals
Weeks 12-26
What you might notice
- •Measurable reduction in visceral fat (15-18% average in clinical trials)
- •Waist circumference decreasing noticeably
- •Improved triglyceride levels on bloodwork
- •Better body image and reduced belly-related distress
What's normal
- •Significant visceral fat reduction visible on imaging
- •Improved metabolic markers like triglycerides
- •Stable weight overall (tesamorelin is weight-neutral)
What's next
- →Discuss continuation with your physician
- →Benefits are maintained with continued treatment
- →Stopping treatment will cause visceral fat to return
Weeks 26-52 and beyond
What you might notice
- •Continued maintenance of reduced visceral fat
- •Sustained metabolic improvements
- •Possible continued incremental benefits
- •Long-term tolerance typically well-established
What's normal
- •Stable visceral fat reduction maintained at ~17-18% below baseline
- •Steady IGF-1 levels within normal range
- •Manageable or resolved side effects
What's next
- →Many patients continue indefinitely for maintenance
- →Regular monitoring of IGF-1 and glucose recommended
- →Reassess periodically with your healthcare provider
Signs It's Working
Body Composition
- ✓Measurable decrease in waist circumference over 3-6 months
- ✓Reduction in visceral fat on CT or MRI imaging
- ✓Clothes fitting looser around the midsection
- ✓Reduced belly appearance distress or improved body image
Metabolic Markers
- ✓Decreased triglyceride levels on blood tests
- ✓Improved cholesterol ratios (total cholesterol to HDL)
- ✓IGF-1 levels elevated into upper normal range
- ✓Stable or improved liver function tests
Subjective Well-Being
- ✓Feeling less distressed about belly appearance
- ✓Improved self-image regarding body shape
- ✓Better energy levels throughout the day
- ✓Sense of metabolic health improvement
Not Seeing Results?
Common reasons
- •Not injecting on an empty stomach—food can interfere with absorption and effectiveness
- •Inconsistent daily dosing—tesamorelin works best with consistent daily administration
- •Insufficient treatment duration—real visceral fat reduction takes 12-26 weeks to manifest
- •Unrealistic expectations—tesamorelin reduces visceral fat, not overall weight
- •Poor injection technique—ensure proper subcutaneous delivery, not intramuscular
- •Confounding medications like high-dose steroids that counteract the effects
Key Research
"Effects of tesamorelin (TH9507), a growth hormone-releasing factor analog, in HIV-infected patients with excess abdominal fat: a pooled analysis of two phase 3 trials"
Falutz J, Mamputu JC, Potvin D, et al., 2010
Finding: In this combined analysis of over 800 HIV patients, tesamorelin reduced visceral fat by an average of 15.4% compared to placebo at 26 weeks. The reduction was maintained at 52 weeks in those who continued treatment. It also improved triglycerides by 12% and significantly improved how patients felt about their belly appearance.
View Study"Reduction in visceral adiposity is associated with an improved metabolic profile in HIV-infected patients receiving tesamorelin"
Stanley TL, Falutz J, Marsolais C, et al., 2012
Finding: Patients who achieved at least 8% reduction in visceral fat (called 'responders') experienced significantly greater improvements in triglycerides, glucose control, and adiponectin levels compared to non-responders. This shows that the metabolic benefits directly correlate with how much visceral fat you lose.
View Study"Effects of growth hormone-releasing hormone on cognitive function in adults with mild cognitive impairment and healthy older adults"
Baker LD, Barsness SM, Borson S, et al., 2012
Finding: In a 20-week trial with 152 adults (some with mild cognitive impairment), tesamorelin improved executive function and showed a trend toward better verbal memory. IGF-1 levels increased 117% and body fat decreased 7.4%. This suggests tesamorelin may have brain health benefits beyond just fat reduction.
View Study"Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial"
Stanley TL, Fourman LT, Feldpausch MN, et al., 2019
Finding: In people with HIV and fatty liver disease, tesamorelin reduced liver fat by 37% relative to placebo over 12 months. Remarkably, 35% of tesamorelin patients achieved liver fat levels below 5% (essentially normal) compared to only 4% on placebo. This opens up potential new uses for liver health.
View Study"Tesamorelin: a review of its use in the management of HIV-associated lipodystrophy"
Dhillon S, 2011
Finding: This comprehensive review confirmed tesamorelin's effectiveness and safety profile. It noted that while visceral fat reduces significantly, subcutaneous fat stays stable—an important distinction because subcutaneous fat is metabolically healthier. Side effects were manageable and serious events occurred in less than 4% of patients.
View StudyFrequently Asked Questions