Tesamorelin
Egrifta, Egrifta SV, Egrifta WR, TH9507
The only FDA-approved growth hormone releasing factor analogue, and the only compound with trial evidence that it preferentially strips visceral fat.
FDA-approved
FDA-approved (2010) for reduction of excess visceral abdominal fat in adults with HIV-associated lipodystrophy. Use for general body composition in healthy adults is off-label and unstudied.
What it is
Tesamorelin is a stabilised analogue of growth hormone releasing hormone. It binds the GHRH receptor on the pituitary and stimulates the pituitary to make and release your own growth hormone - as opposed to injecting exogenous HGH, which suppresses the axis.
Because it works through the pituitary, GH release stays pulsatile and subject to normal negative feedback from somatostatin. That is the main safety argument for secretagogues over HGH.
What the evidence shows
The registration trials in HIV-associated lipodystrophy demonstrated roughly 15-18% reduction in visceral adipose tissue over 26 weeks, and the effect reversed when treatment stopped.
The important detail: the fat loss was preferentially visceral, not subcutaneous, and largely without change in total body weight. Visceral fat is the metabolically dangerous compartment, so this is a meaningful distinction rather than a technicality - but it also means the scale will not move much, which surprises people using it off-label.
There is separate exploratory work on tesamorelin in cognition and in liver fat, with less definitive results.
The gap: none of the approval evidence comes from healthy adults using it for body composition. That population has not been studied at all.
Practical notes
- Night-time, empty stomach. Elevated insulin blunts GH release, so food near the injection reduces the effect.
- IGF-1 is the monitoring lever. If you are using a GH secretagogue seriously, tracking IGF-1 is how you know whether anything is happening and whether it has gone too far.
- Glucose gets worse before body composition gets better. GH antagonises insulin. Anyone with pre-existing insulin resistance should watch fasting glucose closely.
- Effect stops when you stop. Visceral fat returned in the trials after discontinuation.
Versus the ipamorelin/CJC route
Tesamorelin is the approved, trial-backed GHRH analogue with a real safety database. Ipamorelin and CJC-1295 are unapproved, cheaper and act on complementary parts of the same axis. If the goal is visceral fat specifically, tesamorelin is the only one of the three with evidence for it.
Side effects and warning signs
Commonly reported
- Injection-site erythema, itching and swelling - the most common complaint by a wide margin
- Joint pain and peripheral oedema, both classic GH-axis effects
- Carpal tunnel-type symptoms and paraesthesia
- Reduced insulin sensitivity and raised fasting glucose
- Muscle aches
Stop and get medical help
- Progressive numbness or hand weakness - GH-driven fluid retention compressing the median nerve
- Rising fasting glucose or HbA1c, particularly with existing insulin resistance
- Any active malignancy - GH and IGF-1 elevation is contraindicated
Sources
From the community
Discussion for this compound concentrates in r/Peptidesource and r/PeptideForum.
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