Tesamorelin (Egrifta)
Also known as: Egrifta, Tesamorelin Acetate, TH9507, Tesa
The only growth hormone releasing peptide with a genuine approval — proven to reduce visceral fat, and the one substance in this group with real human trial data.
Substance family
Growth hormone itself and the peptides that prompt the body to release it. Effects build over months rather than weeks, and reduced insulin sensitivity is what limits duration.
Effects on
Which outcomes this substance acts on — descriptive, not a recommendation.
Strain profile
Where this substance is most likely to hit — a rough orientation, individually dependent on dose, duration and predisposition.
This substance causes
This substance works against
Dosing & protocols by goal
Rough orientation ranges as reported in harm-reduction literature — not an individual treatment plan. Doses are individual and open-ended; frequency depends on the ester or half-life.
HIV-associated lipodystrophy (approved indication)
MedicalDose
2 mg / day
Frequency
1× daily, subcutaneous
Cycle length
Ongoing, medically supervised
The approved dose, tested in phase 3 trials. Visceral fat reduction of roughly 15–18 percent over 26 weeks.
Visceral fat reduction (off-label)
AdvancedDose
1–2 mg / day
Frequency
1× daily, evening
Cycle length
3–6 months
The same dose range as the approved use. Effects build over months — visceral fat responds more slowly than subcutaneoussubcutaneousInjection into the fat layer under the skin rather than into muscle. fat.
Lower-dose approach
AdvancedDose
1 mg / day
Frequency
1× daily, evening
Cycle length
3–6 months
Half the approved dose, used to limit water retention and glucose effects. Correspondingly weaker effect.
Side effect & countermeasure
Typical problems and what you can do to reduce harm — at a glance. Does not replace medical monitoring.
Problem
Rising blood glucose and reduced insulin sensitivity
Countermeasure
Like all substances raising growth hormone, tesamorelin works against insulin. This appeared in the approval trials and is the reason for regular monitoring. Check fasting glucose and HbA1c before, during and after; particularly relevant with pre-existing insulin resistanceinsulin resistanceHow strongly the body responds to its own insulin — worsened by growth hormone and by some blood-pressure drugs..
Problem
Water retention, joint pain, carpal tunnel symptoms
Countermeasure
Signs of excessive GH activity. Reduce the dose; symptoms usually resolve within days. Tingling hands at night mean the dose is too high, not that it is working.
Problem
Effect reverses after stopping
Countermeasure
The approval trials showed visceral fat returning after discontinuation. This is not a one-off intervention — the effect lasts as long as the substance is used, which makes the cost a real planning factor.
Problem
Injection-site reactions
Countermeasure
Redness and irritation are common with daily injection. Rotate sites systematically; the reaction is usually local and harmless but worsens with repeated use of the same spot.
Problem
Very high price and corresponding counterfeit rate
Countermeasure
Tesamorelin is among the most expensive peptidespeptidesA short chain of amino acids — the reason this whole category has to be injected.. Grey-market products labelled as such frequently contain a cheaper GHRH analogue or nothing of substance. Only sources with an independent HPLC/MS analysis.
Problem
Accelerated growth of existing tumours
Overview
Tesamorelin occupies a position no other peptide in this field holds: it has a genuine approval, obtained through proper phase 3 trials, for a specific indication — the visceral fat accumulation that occurs in HIV patients on antiretroviral therapy.
That matters for how the substance should be judged. Where ipamorelin, CJC-1295 and MOTS-c rest on mechanism and anecdote, tesamorelin has documented human data showing what it does, how much, and over what time frame.
Its particular property, and the reason for the interest beyond the approved indication: it acts specifically on visceral fat — the fat around the organs, not under the skin.
Mechanism of Action
Tesamorelin is a stabilised analogue of GHRH, the hypothalamic signal that prompts the pituitary to release growth hormone. It differs from CJC-1295 in the type of modification but works on the same receptor.
The release remains pulsatile and stays within the body's own regulation, including the feedback loops that limit excess. This is the key difference from injected HGH, and it is why the side-effect profile is milder despite the effect being real.
Why visceral fat specifically responds is not fully resolved, but visceral adipose tissue is more metabolically active and denser in GH receptors than subcutaneous fat. The approval trials showed reductions of roughly fifteen to eighteen percent in visceral fat over twenty-six weeks, with little change in subcutaneous fat — meaning it does not do what most people using it for aesthetics are hoping for.
The trials also showed the effect reversing after discontinuation. Visceral fat returns. This is not a permanent restructuring but an ongoing intervention.
Typical Context
Off-label, tesamorelin is used for the same purpose as in its approved indication: reducing visceral fat, over three to six months at one to two milligrams daily, injected in the evening.
Two expectations deserve correcting. The first: this is not a substance for visible abdominal definition. Visceral fat sits behind the abdominal wall, and reducing it changes waist circumference and metabolic markers rather than what a lean physique looks like. The second: the effect requires months. The trials measured at twenty-six weeks, and anyone judging after six is judging too early.
The price is a genuine factor. Tesamorelin is among the most expensive peptides available, and because the effect stops when the substance does, the cost is recurring rather than one-off. That combination — high price, ongoing requirement — is also what makes it a frequent counterfeit target.
Side Effects & Risks
- Rising blood glucose and reduced insulin sensitivity
- Water retention, joint pain, carpal tunnel symptoms
- Injection-site reactions with daily use
- Effect reverses after discontinuation
- Accelerated growth of existing tumours
- Muscle pain, tingling in the extremities
- High counterfeit rate on the grey market
Blood Work & Monitoring
- IGF-1 — the practical measure of GH activity
- Fasting glucose and HbA1c — the limiting factor; appeared as a finding in the approval trials
- Waist circumference — the meaningful practical marker for visceral fat, more so than body weight
- Lipid profile (LDL, HDL, triglycerides) — improved in the trials
- Thyroid values (TSH, fT3, fT4)
Harm-Reduction Notes
- Plan in months; the trial data measured at 26 weeks, not at 6
- It targets visceral fat, not subcutaneous — it will not produce visible definition
- Check glucose and HbA1c regularly; insulin sensitivity is the limiting factor
- Carpal tunnel symptoms and water retention mean the dose is too high
- The effect reverses on stopping — factor the ongoing cost into the decision
- Only sources with an independent analysis; the price makes it a prime counterfeit target
- Existing or suspected malignancy is a contraindication
Legal status by region
Regulation differs considerably between jurisdictions and changes over time. This is a rough orientation, not legal advice — check the rules that apply where you are.
| Region | Regulatory status |
|---|---|
| United States | Prescription-only medicineApproved for defined indications; use outside them is off-label. |
| EU / UK | Prescription-only medicineApproved for defined indications. |
| Canada / Australia | Prescription-only medicine |
| Parts of Asia, Latin America & Middle East | Pharmacy availability variesSeveral countries dispense it without prescription in practice. Rules and enforcement differ and change. |
| Competitive sport | Check the current WADA listSome substances in this class are prohibited, others are not. |