Tesamorelin
The Growth Hormone Peptide Aimed at Visceral Fat
Tesamorelin is a synthetic version of the body's own growth-hormone-releasing hormone, built to last longer in the bloodstream. It prompts the pituitary to send out natural pulses of growth hormone, and its signature effect is on visceral fat, the deep fat packed around the organs.
It carries a distinction almost no other peptide in this directory has: it is an approved medicine. In 2010 the FDA approved tesamorelin to reduce excess abdominal fat in people with HIV-associated lipodystrophy, and it remains the only drug approved for that purpose.
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What we've seen in practice
Tesamorelin is our visceral-fat peptide. Dr. Koniver groups it with the growth-hormone family but sets it apart by what it does: where ipamorelin leans toward subcutaneous fat and all-around support, tesamorelin goes after the deep fat around the organs. He often frames it as a fat-loss option that many women in particular do well with, and it is one of the tools we reach for when body composition is the goal.
It has one built-in advantage over most of its cousins. The growth-hormone-releasing peptides like ipamorelin, GHRP-6 and hexarelin are usually paired with a second agent, CJC-1295, to hold the signal in the system. Tesamorelin already carries that releasing-hormone signal inside it, so it stands on its own without the pairing. Dr. Koniver rates it stronger than sermorelin, and notes it tends to protect lean muscle while it works on visceral fat. We also pair it at times with BPC-157, which makes growth-hormone receptors more receptive, so the pulse lands better.
Most often we use it inside a fat-loss combination: tesamorelin with AOD-9604 and MOTS-c, three peptides that come at body composition from different directions. Dr. Koniver is candid that this combination is not as fast or as powerful as a GLP-1 medication, where the practice leans mostly on tirzepatide. The peptide route is the slow-and-steady one, and it works best next to clean eating, walking, and good sleep.
Tesamorelin at a glance
A stabilized synthetic analogue of the body's own growth-hormone-releasing hormone, the full 44-amino-acid form, with a modification that helps it resist breakdown
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Visceral (deep abdominal) fat reduction; the approved medical use is HIV-associated lipodystrophy; wider body-composition and liver-fat interest is off-label
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Genuine randomized human trials, but conducted in HIV populations; general-wellness use rests on growth-hormone physiology, smaller studies, and clinical experience [1, 2, 3, 4]
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By subcutaneous injection
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44-amino-acid GHRH analogue with an N-terminal trans-3-hexenoyl group; formula C221H366N72O67S, about 5,136 g/mol; half-life roughly 26 to 38 minutes [5]
FDA-approved since 2010 for HIV-associated lipodystrophy (only that use); prohibited in tested sport (WADA S2, named directly). Details below
Our visceral-fat growth-hormone peptide; part of the fat-loss combination with AOD-9604 and MOTS-c. See what we have seen in practice above
All 44 amino acids of human growth-hormone-releasing hormone, capped at the front (pink) with a small fatty-acid group (trans-3-hexenoyl) that shields the peptide from the enzymes that break down the natural hormone. Compare its length with the four-bead SS-31 or the three-bead tripeptides elsewhere in the directory.
Molecular data on this page matches the reference. For most entries in this directory the chemistry had to be corrected; not here. Tesamorelin is C221H366N72O67S at about 5,136 g/mol, confirmed against the primary chemical databases. The one place this page parts ways with the reference is sport status, in the regulatory section.
Where Tesamorelin comes from
Your body already makes growth-hormone-releasing hormone, a 44-amino-acid messenger sent from the hypothalamus to tell the pituitary to release growth hormone. The trouble with using that natural messenger as a medicine is that enzymes break it down within minutes. Tesamorelin is the natural sequence rebuilt to survive: the same 44 amino acids, capped at one end with a small fatty-acid group (a trans-3-hexenoyl modification) that shields it from those enzymes.
It was developed by the company Theratechnologies and studied through the 2000s in people with HIV who, on antiretroviral therapy, accumulate deep abdominal fat. That research led to its 2010 FDA approval under the brand Egrifta. It sits in the same broad family as sermorelin and CJC-1295, all of them analogues of growth-hormone-releasing hormone, but tesamorelin is the one that became an approved drug.
How Tesamorelin works
Tesamorelin binds the growth-hormone-releasing-hormone receptor on the pituitary, raising cyclic AMP and triggering a natural, pulsed release of your own growth hormone. The feedback controls stay intact, so the rhythm looks like the body's own.
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The growth-hormone pulse prompts the liver to make more IGF-1, the downstream messenger that carries much of growth hormone's effect through the body.
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Growth-hormone signaling turns on fat breakdown, and tesamorelin's clinical signature is a preference for visceral fat around the organs rather than fat under the skin. That selectivity is why it earned a specific indication instead of being a general weight-loss drug.
Pituitary GHRH receptor
Growth hormone
IGF-1
Visceral fat loss
Evidence at a glance - real trials, in one population
A genuine randomized-trial record, concentrated in HIV-associated lipodystrophy; broader wellness use rests on physiology and experience.
What the research shows
Tesamorelin has something most research peptides lack: a real record of randomized, placebo-controlled human trials. The honest caveat sits right next to it. Those trials were run in people with HIV-associated fat accumulation, the approved population, not in the general wellness population, so the strongest evidence speaks most directly to that group.
In the pivotal work, a 2007 trial in the New England Journal of Medicine randomized 412 patients and found visceral fat fell about 15 percent with tesamorelin while it rose on placebo, alongside better triglycerides and a large rise in IGF-1. A 12-month follow-up trial confirmed a roughly 18 percent visceral-fat reduction in those who stayed on it, and showed something worth remembering: the benefit faded quickly once the peptide stopped. Later academic trials led from Massachusetts General Hospital extended the picture to the liver, with a 2014 JAMA study showing reductions in both visceral fat and liver fat, and a 2019 trial reporting a meaningful drop in liver-fat fraction in people with HIV and fatty liver.
Outside that HIV-specific evidence, the case for tesamorelin in general body composition and healthy aging rests on growth-hormone physiology, smaller studies, and clinical experience rather than large trials in otherwise healthy adults. That is the honest boundary, and it is where our own observations live.
Visceral fat in HIV-associated lipodystrophy
Multiple randomized placebo-controlled trials
Consistent visceral-fat reduction; the basis of FDA approval
Strong human evidence (in this population) [1,2]
Liver fat (NAFLD) in HIV
Randomized trials
Reduced liver-fat fraction
Well-supported (in this population) [3,4]
General body composition and healthy aging
Growth-hormone physiology, smaller studies, practice experience
Plausible support; not settled by large trials in healthy adults
Clinical observation territory
Glucose effects
Trial safety data
A transient early rise in fasting glucose in one trial, not sustained
Worth monitoring [3]
How strong is the evidence
Tier words only, never scores or percentages. The key nuance: strong human evidence, but in one specific population.
Tesamorelin has been through a full drug-approval safety review, so its tolerability is better characterized than almost any research peptide here. Across the trials it was generally well tolerated, and the most consistent issue was a local reaction at the injection site.
The one thing we always flag first
In practice, roughly a third of people who use tesamorelin get a histamine-type reaction where they inject: redness, an itchy raised patch, sometimes a little swelling. It is self-limiting, most people are not bothered by it, and for many it settles with continued use. But some people simply do not like the feeling and choose to stop, which is a perfectly reasonable call. This is tesamorelin's characteristic tolerability note, and we would rather you hear it from us first.
Because growth-hormone signaling can nudge blood sugar, we keep an eye on glucose. Standing rules apply: physician screening rules out active or prior cancer, we avoid it in pregnancy and breastfeeding, and because an approved branded product exists while the wellness market runs on compounded material, product quality and sourcing matter.
Regulatory status
Regulatory information current as of 13 August 2026. This is a summary, not legal or medical advice, and status can change.
FDA approves Egrifta, the first and only drug for HIV-associated lipodystrophy
Egrifta SV, a more concentrated once-daily version (confirm year at publish)
Egrifta WR approved, a weekly-reconstitution version set to replace SV
United States
FDA-APPROVED - HIV LIPODYSTROPHY (2010)
Approved to reduce excess abdominal fat in people with HIV-associated lipodystrophy, and still the only drug approved for it. Every other use, including body composition and healthy aging, is off-label. Wellness-market tesamorelin is typically compounded rather than the branded drug, and as a copy of an approved medicine it is subject to the associated restrictions. Never on the 2023 restricted compounding list. Verify current status.
Sport (WADA)
Prohibited - S2, named
WADA S2 - prohibited at all times
WADA names growth-hormone-releasing hormone and its analogues directly, listing tesamorelin by name under class S2, prohibited at all times, in and out of competition. Athletes should treat it as off-limits and confirm current status with their governing body.
Everywhere else,
in general
Approval varies by country, and tesamorelin is not broadly marketed outside the United States. Prescription-medicine frameworks differ, and products sold outside licensed channels carry the quality risks described in the safety section.
Regulatory information current as of 13 August 2026. Confirm the Egrifta SV date and the current WADA list wording at publication.
Common questions
Its approved medical use is to reduce excess deep abdominal fat in people with HIV-associated lipodystrophy. More broadly, it is a growth-hormone-releasing peptide, and it is used off-label for body composition and visceral-fat goals. In our practice it is the visceral-fat member of the growth-hormone family.
All three raise your own growth hormone, but by slightly different routes. Sermorelin and tesamorelin are both analogues of growth-hormone-releasing hormone; ipamorelin works through a different receptor and is usually paired with CJC-1295. Dr. Koniver rates tesamorelin stronger than sermorelin, aimed more specifically at visceral fat, and it does not need the CJC-1295 pairing because the releasing-hormone signal is built in.
Yes, for one thing: since 2010 it has been approved to reduce excess abdominal fat in HIV-associated lipodystrophy, and it remains the only drug approved for that. Any other use is off-label. The regulatory section above has the detail.
Yes. Tesamorelin is named directly on the WADA Prohibited List under class S2 and is prohibited at all times. Athletes should treat it as off-limits and confirm current status with their governing body.
Related in this directory
References
- Falutz J, Allas S, Blot K, et al. Metabolic effects of a growth hormone-releasing factor in patients with HIV. N Engl J Med. 2007;357(23):2359-2370. PMID 18057338.
- Falutz J, Potvin D, Mamputu JC, et al. Effects of tesamorelin, a growth hormone-releasing factor, in HIV-infected patients with abdominal fat accumulation: a randomized placebo-controlled trial with a safety extension. J Acquir Immune Defic Syndr. 2010;53(3):311-322. PMID 20101189.
- Stanley TL, Feldpausch MN, Oh J, et al. Effect of tesamorelin on visceral fat and liver fat in HIV-infected patients with abdominal fat accumulation: a randomized clinical trial. JAMA. 2014;312(4):380-389. PMID 25038357.
- Stanley TL, Fourman LT, Feldpausch MN, et al. Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial. Lancet HIV. 2019;6(12):e821-e830. PMID 31611038.
- US Food and Drug Administration. EGRIFTA (tesamorelin) BLA 022505; EGRIFTA WR approval, 25 March 2025. Molecular data: tesamorelin, PubChem CID 16137828, formula C221H366N72O67S, molecular weight ~5,136 g/mol, CAS 218949-48-5.
- World Anti-Doping Agency. Prohibited List, class S2 (peptide hormones, growth factors, related substances and mimetics), current edition.
This page is for informational and educational purposes and does not constitute medical advice, diagnosis, or treatment. Tesamorelin is FDA-approved only for the reduction of excess abdominal fat in people with HIV-associated lipodystrophy; all other uses are off-label, and wellness-market tesamorelin is typically compounded rather than the approved branded product. Statements describing how Dr. Koniver and the Koniver Wellness team use tesamorelin reflect clinical experience and judgment, which is not the same as controlled clinical evidence. Nothing here is a substitute for consultation with a qualified healthcare provider. Peptide therapy at Koniver Wellness is provided under physician supervision after appropriate screening, and the availability of any given peptide depends on its regulatory and supply status. Regulatory information is current as of the date shown and may have changed; verify with official sources or a licensed practitioner in your jurisdiction.
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