Tesamorelin
The GH peptide with real trial data on deep belly fat. 1 to 2 mg at bedtime, nothing to eat 90 minutes either side, 120 days max.
What it is
Tesamorelin is the one growth hormone peptide with human trials showing it strips visceral fat, the deep fat around your organs that makes a waist hard. People run it nightly for up to 120 days for a tighter midsection and a leaner liver, and it is the most aggressive option in this class.
The tesamorelin user is someone whose problem is specifically the midsection: a hard, round belly that diet has not touched, often with a fatty liver on a scan, usually past forty. It was approved (as Egrifta) to reduce exactly that fat in HIV patients, and that is where its data comes from. It is the standout secretagogue for this job and also the most aggressive, roughly doubling IGF-1, so it is not the gentle sleep-and-recovery choice; that is CJC-1295 + ipamorelin. Anyone with diabetes, prediabetes or a cancer history belongs on a different page.
The first week can be odd: an early-morning wake-up, alert and rested at 5 am, from a cortisol bump that settles within a week. Sleep then usually improves. Water retention and some joint stiffness come in the first two to three weeks for some people. The belly change is slow and then obvious: most people see the waist move at six to eight weeks and the clearest results at the end of a full 12 to 16 week run, with liver fat following. It will not change the scale much; the fat it removes is deep and dense, and total weight moves little. It is not a general fat burner for someone already lean.
Women take 0.5 to 1 mg, men 1 to 2 mg, subQ, right before bed, with nothing to eat in the 90 minutes before or after; food, especially carbs and fat, blunts the GH pulse that does the work. Run it up to 120 days, then take 2 to 4 months off. That ceiling is our caution, not a sign it stops working (the approved version was studied for a year): it raises IGF-1 and blood sugar, so the 2 to 4 month break lets both settle and is when you recheck them. Some of the belly-fat result comes back during the 2 to 4 month break, which is why you plan the next run if you are doing one or two a year. It is finicky to mix: use room-temperature water (it hates cold), always 2 ml per 10 mg (1 ml per 5 mg), and skip 20 mg vials, which are very hard to get into solution. Once mixed it arguably does not even need the fridge. A 10 mg vial is five doses at 2 mg, so a four-month run at 2 mg is about 24 vials (half that at 1 mg), which is the cost reality. The named mistakes are a bedtime snack and the first-week wake-ups scaring people off before it has started.
Animal 4, human 3: tesamorelin has an FDA-approved version with controlled trials showing visceral fat reduction, which puts it ahead of every other GH peptide here. Using it for general belly fat in healthy adults is outside that approved use, so the numbers you see are from a specific patient group, and the effect in you will be smaller if you have less visceral fat to lose. Blood sugar rises on GH, and that is the one thing the trials were careful about.
If you want sleep, recovery and a slow lean-out, CJC-1295 + ipamorelin is cheaper, gentler and plenty. If you are already lean and want abs, this will disappoint; it works on deep fat, not the last layer under the skin. If your fasting glucose is already creeping up, do not add a GH pusher. Tesamorelin earns its cost when the problem is a hard visceral belly and you can commit to the fasted bedtime routine for three or four months.
What people use it for
Deep belly fat
Most evidenceIn the trials behind its approval, tesamorelin reduced visceral fat by roughly 14 to 18 percent over 26 weeks in people with HIV-related fat buildup, with the fat returning after stopping. That is controlled human data, rare on this site. In healthy adults with a smaller visceral store the effect is real but smaller.
Liver fat
Some evidenceFollow-on trials in the same population showed less liver fat and slower progression of fatty liver on tesamorelin. This is why people with a fatty-liver diagnosis reach for it. Still a specific patient group, but the mechanism (less visceral fat, more fat burning) carries over.
Body composition and IGF-1
Some evidenceTesamorelin roughly doubles IGF-1 and raises GH, which over months favors a bit more lean mass and less fat overall. The lean-mass effect is modest and the trials measured belly fat, not muscle. It is a shape tool more than a size tool.
Blood sugar
Some evidenceGH pushes blood sugar up, and the approval trials tracked this carefully; glucose rose slightly in some people and settled, but anyone near the diabetic line is the group to watch. A fasting glucose before and at six weeks is cheap insurance. This is the real safety story, not the injection.
How it works
Where Tesamorelin sits among GHRH peptides
- Best known for reducing deep belly (visceral) fat
- One of the few in this class with an FDA-approved version
- A stronger track record than most GH peptides
- Still best used with medical guidance
How people use it
Safety, in brief
Things people sometimes notice
- Waking early and alert the first week, which settles
- Puffy hands or ankles and a little water weight in the first weeks
- Stiff or achy joints, especially mornings
- Redness or itch at the injection site
The full picture — stop signs and who should talk to a doctor first — is on the dosing guide.
Sources
The labels and studies behind this page. Each link opens the original on PubMed, DailyMed or ClinicalTrials.gov.
- Egrifta WR (tesamorelin) prescribing information
- Metabolic effects of a growth hormone-releasing factor in patients with HIV
- Effects of tesamorelin (TH9507), a growth hormone-releasing factor analog, in human immunodeficiency virus-infected patients with excess abdominal fat: a pooled analysis of two multicenter, double-blind placebo-controlled phase 3 trials with safety extension data
- Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial