OnePin Peptide Library · Growth Hormone
Tesamorelin
Egrifta
Tesamorelin is a synthetic analog of human growth hormone-releasing hormone (GHRH), consisting of the full 44 amino acid sequence of endogenous GHRH with a trans-3-hexenoic acid modification at the N-terminus that enhances stability against enzymatic degradation. It is the only GHRH analog with FDA approval (marketed as EGRIFTA SV) for reducing excess abdominal visceral adipose tissue in adults with HIV-associated lipodystrophy. Tesamorelin stimulates the pituitary to release growth hormone in a physiologically patterned, pulsatile manner, preserving the body's natural feedback mechanisms. It is discussed in performance and longevity contexts for body composition optimization, visceral fat reduction, improved sleep architecture, cognitive support, and liver health.
Evening dosing recommended, fasted 2+ hours. FDA label recommends rotating abdominal injection sites. Best before bed.
Start here. Every protocol below is ordered lowest-first. Begin at the smallest effective dose, hold about a week to assess tolerance, and step up only if needed.
How it works
Tesamorelin binds to GHRH receptors (GHRH-R) on somatotroph cells in the anterior pituitary gland, triggering a signaling cascade through cyclic AMP (cAMP) and protein kinase A (PKA). This stimulates both synthesis and pulsatile release of stored growth hormone granules. Unlike exogenous GH injection, tesamorelin preserves the body's natural somatostatin feedback loop, maintaining physiologic GH pulsatility rather than creating continuous supraphysiologic elevation. Downstream effects include increased hepatic production of insulin-like growth factor 1 (IGF-1), which mediates many of the anabolic and metabolic effects. The trans-3-hexenoic acid modification protects the N-terminus from DPP-IV degradation, extending the effective signaling window compared to endogenous GHRH.
Tesamorelin binds to GHRH receptors (GHRH-R) on somatotroph cells in the anterior pituitary gland, triggering a signaling cascade through cyclic AMP (cAMP) and protein kinase A (PKA). This stimulates both synthesis and pulsatile release of stored growth hormone granules. Unlike exogenous GH injection, tesamorelin preserves the body's natural somatostatin feedback loop, maintaining physiologic GH pulsatility rather than creating continuous supraphysiologic elevation. Downstream effects include increased hepatic production of insulin-like growth factor 1 (IGF-1), which mediates many of the anabolic and metabolic effects. The trans-3-hexenoic acid modification protects the N-terminus from DPP-IV degradation, extending the effective signaling window compared to endogenous GHRH.
What to expect
Weeks 1-2: Improved sleep quality is typically the first noticeable effect. Some users report vivid dreams. Mild water retention or joint stiffness may occur as GH and IGF-1 levels rise. Energy levels may improve.
Weeks 4-8: Body composition changes begin to become visible. Visceral fat starts to decrease. Recovery from workouts improves noticeably. Skin quality improvements begin. Lab work should show elevated IGF-1.
Weeks 8-16: Significant body composition improvements. Clinical trials showed 15-18% visceral fat reduction at 26 weeks. Lean mass preservation or increase. Cognitive benefits become apparent. Lab monitoring of IGF-1, fasting glucose, and HbA1c recommended.
Evidence
The honest take
Visceral fat reduction
FDA-approved for this indication in HIV lipodystrophy. Phase 3 trials demonstrated 15-18% reduction. Strongest evidence of any peptide for this specific claim.
Clinical studies show significant reduction in hepatic fat fraction and improved liver inflammation markers. Promising but not FDA-approved for this indication.
Published study in older adults showed improvements in executive function and verbal memory. Mechanism likely related to GH/IGF-1 effects on hippocampal function. Preliminary but encouraging data.
Interactions & stacking
What's safe to combine, and what belongs in a separate pin.
Safe & synergistic
Keep separate
Side effects & safety
Commonly reported
- Injection site reactions (redness, itching, swelling) in approximately 20-30% of users
- Joint pain or arthralgia (related to GH/IGF-1 elevation)
- Peripheral edema (water retention, typically mild and transient)
- Numbness or tingling in hands (carpal tunnel-like symptoms from fluid retention)
Less common & notes
- Anti-tesamorelin antibodies develop in approximately 50% of patients by 26 weeks but do not appear to affect efficacy.
- Glucose intolerance may develop (monitor fasting glucose and HbA1c).
- Rare hypersensitivity reactions reported.
- Contraindicated in active malignancy due to IGF-1 elevation.
- Contraindicated in pregnancy.
- Discontinue if persistent IGF-1 elevation above 3 SDS.
Pharmacokinetics
Storage. EGRIFTA SV label (sterile water): Use immediately after reconstitution, single use vial, do not store. With BAC water: 2-4 weeks refrigerated at 2-8C. Up to 4-6 weeks per some compounding pharmacy guidance with strict temperature control. The difference is the diluent: sterile water has no preservative and supports bacterial growth after reconstitution, BAC water (0.9% benzyl alcohol) provides antimicrobial protection. Unreconstituted vials store at room temperature (20-25C). Protect from light.
Regulatory status
FDA-approved as EGRIFTA SV for reduction of excess abdominal fat in HIV-associated lipodystrophy. Off-label use for other indications is at physician discretion. WADA prohibits tesamorelin under S2 Peptide Hormones, Growth Factors, Related Substances and Mimetics. Available by prescription and through compounding pharmacies.
Put it to work
Calculate, log & track
Open Tesamorelin straight into OnePin with your vial and dose pre-filled, then let it handle the syringe math and remind you before the vial runs out.
Open Tesamorelin in the app →Go deeper
The guide & community
The complete Tesamorelin walkthrough, real protocol discussion and coaching live inside the BlessUp community on Skool.
Join the community ↗