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.
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.
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.
Each reference below was re-fetched from its PubMed record, and the quoted sentence was confirmed to appear in that abstract and to support the claim it sits under. Follow any of them to read the source.
Exact-molecule evidence boundary: the live abstract reports the quoted finding for Tesamorelin; no broader inference is made.
A growth hormone-releasing factor, tesamorelin, may selectively reduce visceral fat in this population.
Evidence scope. Exact molecule wording appears in the quoted live sentence. Only the population/model, formulation, route, and outcome expressly stated there are supported.
Claims we could not support
No abstract we checked supports these for this molecule at this route. That is not the same as saying they are false — it marks where the evidence is missing.
Dose/route: 1 to 2 mg daily; SubQ injection, typically in the abdominal area; Once daily. No selected live abstract sentence verified this complete regimen.
Mechanism as written in source JSON. No selected live abstract sentence verified the complete mechanism at the card formulation/route and relevant population/model.
Primary safety claim as written in source JSON. No selected live abstract sentence verified the complete safety claim for this exact formulation and route.
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.
Two different questions: what is documented about running these together, and what is documented about drawing them into the same syringe. A good pharmacological partner can still have to be pinned separately.
Check any specific pair in the Stack & Interaction Checker, which answers both questions separately. Absence of a documented conflict is not evidence of safety.
SubQ
GH pulse lasts 2-4 hours despite short plasma t1/2
Enzymatic degradation (DPP-IV and endopeptidases); trans-3-hexenoic acid modification slows N-terminal degradation
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.
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.
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