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Peptide Guide · Growth hormone and muscle

Tesamorelin

Egrifta, TH9507, GHRH(1-44) analog

Tesamorelin was built to shrink one kind of fat, the deep belly fat that builds up in some people on HIV treatment. It carries a current FDA approval for exactly that use.

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Studied for
Visceral fat, liver fat and lipids in HIV-associated lipodystrophy
Evidence
FDA-approved
Taken as
Daily injection under the skin, per the label
Studied for
Visceral fat, liver fat and lipids in HIV-associated lipodystrophy
Evidence
FDA-approved
Taken as
Daily injection under the skin, per the label
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Tesamorelin, in short

Tesamorelin (Egrifta) is an FDA-approved growth hormone releasing factor analog. Its label states it is indicated for the reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy. It prompts the pituitary to release growth hormone, which breaks down fat. In phase 3 trials it cut visceral fat by about 15%. It is not indicated for weight loss.

Medically reviewed by Robert Lufkin, MD (opens in a new tab)

Chief Medical Officer, Vitals Vault · Updated October 29, 2026 · 14 sources

At a glance

FDA-approved
Type
Synthetic growth hormone releasing factor (GHRH) analog1
Brand
Egrifta SV (Theratechnologies)1
FDA-approved for
Reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy1
Not indicated for
Weight loss management1
First approved
November 10, 20103
Taken as
Daily injection under the skin, per the label1
Sport
Growth hormone releasing factors are prohibited by WADA14

Before you consider Tesamorelin

  • Safety

    The label lists warnings for raised IGF-1, fluid retention and higher blood sugar. Long-term heart safety has not been established.1

    Side effects and safety
  • Legal status

    FDA approved it as Egrifta in 2010, only for extra belly fat in adults with HIV and lipodystrophy. Other uses are off-label.13

    FDA status
  • How it’s taken

    A daily injection under the skin of the abdomen, with sites rotated. The label sets the dose and a prescriber decides on use.1

    Forms and dosage

How does Tesamorelin work?

Tesamorelin copies the body’s own signal to make growth hormone.

  • Copies a natural signal

    It is a lab-made version of the brain signal that tells the pituitary gland to make growth hormone.1

  • Growth hormone is released

    The pituitary releases growth hormone in pulses, and growth hormone helps the body break down fat.1

  • Growth factor levels rise

    Growth hormone makes the liver produce more IGF-1. It rose 81% in the main trial, so doctors monitor it.41

Tesamorelin benefits: what it is studied for

All of this comes from human trials in adults with HIV and extra belly fat. Results may differ in people without HIV.

  1. Human study01

    Less visceral fat

    In a 26-week trial of 412 people with HIV, visceral fat fell 15.2% on tesamorelin and rose 5.0% on placebo. A pooled analysis found it held for 52 weeks.45

  2. Human study02

    Better blood fats

    Triglycerides fell by 50 mg per deciliter on tesamorelin and rose by 9 on placebo, and the ratio of total to HDL cholesterol improved.4

  3. Human study03

    Less liver fat

    In a 50-person randomized trial, tesamorelin reduced both visceral fat and liver fat over 6 months. The authors called the finding preliminary.11

  4. Human study04

    Better body image

    In the pooled analysis of two phase 3 trials with 806 people, body image improved alongside the drop in visceral fat.5

What the research shows

FDA-approved
  1. 1 · Cells in a labNot cited

    This guide cites no findings at this level.

    Shows a mechanism

  2. 2 · AnimalsNot cited

    This guide cites no findings at this level.

    Shows an effect in a body

  3. 3 · People Studied

    Placebo-controlled phase 3 trials in 806 adults with HIV cut visceral fat by about 15%, with the loss holding to 52 weeks.45

    Shows it works in people

Tesamorelin has the strongest evidence in this library: placebo-controlled phase 3 trials, a regulatory approval and a long safety extension. All of it is in adults with HIV and abdominal fat. Using it for general fat loss, anti-aging or sport is outside the trial evidence and the label.451

The full guide to Tesamorelin

8 min read · Medically reviewed by Robert Lufkin, MD

In this guide

  1. 1A belly that HIV medicine left behind
  2. 2How tesamorelin works
  3. 3Tesamorelin benefits for visceral fat: the phase 3 trials
  4. 4Responders, non-responders and what happens when you stop
  5. 5Tesamorelin and liver fat
  6. 6Beyond HIV: tesamorelin and the aging brain
  7. 7Tesamorelin vs sermorelin and CJC-1295
  8. 8Tesamorelin side effects and safety
  9. 9The labs that track tesamorelin
  10. 10Tesamorelin’s FDA approval and label
  11. 11What this means for you
  12. 12What to expect
  13. 13Key studies
  14. 14Myths and evidence

01 / 11

A belly that HIV medicine left behind

By the 2000s, antiretroviral therapy had turned HIV into a condition people could live with for decades. Many of them then noticed something their doctors could see on a CT scan: fat collecting deep inside the abdomen, around the organs. Researchers call it visceral adipose tissue, and in people on HIV treatment it was linked to higher cardiovascular risk.

The change also weighed on how people felt about their bodies. A team led by Julian Falutz at McGill University in Montreal, with Steven Grinspoon at Harvard, set out to test whether a growth hormone signal could shrink it, since growth hormone breaks down fat.

The molecule they used traces back to 1982, when Roger Guillemin’s lab read the full 44-amino-acid sequence of growth hormone releasing hormone, GHRH, from a pancreatic tumor that had caused acromegaly. Tesamorelin is a synthetic analog built on that full-length sequence, developed by Theratechnologies.

That makes tesamorelin unusual in the peptide world. It was developed for a narrow, measurable problem, tested in large placebo-controlled trials, and judged on a CT scan. The story of what it does well, and where it stops, is unusually clear as a result.4581

02 / 11

How tesamorelin works

Tesamorelin speaks the same language as your own hypothalamus. In laboratory tests, it binds and stimulates human GHRH receptors with potency similar to the natural hormone. Those receptors sit on growth hormone cells in the pituitary, which respond by making and releasing growth hormone in pulses.

Growth hormone does two jobs that matter here. It is anabolic, supporting protein building, and it is lipolytic, meaning it breaks stored fat down into fatty acids the body can burn. It also signals the liver to make IGF-1. In the 2007 trial, IGF-1 rose 81% on tesamorelin and fell 5% on placebo, which is why the label tells prescribers to monitor it.

Because tesamorelin works through the pituitary, the body’s feedback stays in the loop. It asks for growth hormone and leaves the gland to decide how much to release. The same pathway also explains the watch points on the label: growth hormone changes how tissues respond to insulin and how the body holds water, so glucose and fluid retention are monitored.14

In the 2007 trial, IGF-1 rose 81% on tesamorelin and fell 5% on placebo, which is why the label tells prescribers to monitor it.

03 / 11

Tesamorelin benefits for visceral fat: the phase 3 trials

The landmark trial appeared in the New England Journal of Medicine in 2007. It enrolled 412 people with HIV and excess abdominal fat, 86% of them men, and randomly assigned them to a daily injection of tesamorelin or placebo for 26 weeks. The main outcome was the change in visceral fat measured by CT.

Visceral fat fell 15.2% on tesamorelin and rose 5.0% on placebo. Triglycerides fell by 50 milligrams per deciliter on tesamorelin and rose by 9 on placebo, and the ratio of total to HDL cholesterol improved. Glucose and insulin measures were not significantly different between groups at 26 weeks.

A second phase 3 trial followed, and in 2010 the two were pooled: 806 people in total. The visceral fat result held, the fat just under the skin of the belly barely changed, and people reported less distress about how their bellies looked. Their physicians rated the belly profile as improved too.

At 26 weeks, people on tesamorelin were randomly assigned to keep going or switch to placebo for another 26 weeks. Those who kept going maintained the drop in visceral fat at 52 weeks, along with smaller waists and lower triglycerides. The overall pattern was a targeted effect on the deep fat, while the fat under the skin was largely spared.45

04 / 11

Responders, non-responders and what happens when you stop

Averages hide something important about tesamorelin. Before the phase 3 data were analyzed, the trial plan defined a responder as someone whose visceral fat fell by at least 8%. Most people on tesamorelin met that bar. Some did not. In 2012, researchers asked what separated the two groups, and the answer is practical.

Among 402 participants initially assigned to tesamorelin and kept in the per-protocol analysis, responders saw triglycerides fall, while non-responders saw little change. Responders’ fasting glucose and HbA1c stayed essentially flat over 52 weeks. Non-responders’ glucose and HbA1c drifted upward. Adiponectin, a protective hormone made by fat tissue, improved more in responders. Changes in lipids and glucose tracked the percentage of visceral fat lost.

Put plainly, greater visceral fat loss went along with better triglycerides and steadier glucose. One way to read this is that shrinking visceral fat offsets growth hormone’s tendency to nudge glucose up, so people whose fat did not shrink got the hormonal push without the payoff. These were post hoc analyses, so they show association and cannot say why the groups differed. They are still the most practical insight in the tesamorelin literature.

The 2017 follow-up adds the second half of the story. Among people with raised liver enzymes at the start, responders saw ALT and AST fall over 26 weeks. When some were switched to placebo, visceral fat partly came back, though the liver enzyme improvement held through 52 weeks. The fat effect depends on staying on the drug, which is one reason a clinician tracks how someone is responding.1213

05 / 11

Tesamorelin and liver fat

Visceral fat and liver fat travel together, so the next question was obvious. In a 2014 JAMA trial at Massachusetts General Hospital, 50 people with HIV and abdominal fat were randomly assigned to tesamorelin or placebo for six months. Tesamorelin reduced visceral fat and, more modestly, liver fat.

Fasting glucose rose slightly on tesamorelin at two weeks, then settled, with no significant difference from placebo across the six months. The authors called the study preliminary and asked for longer trials to understand what the liver changes meant clinically.

They ran one. A 2019 trial in The Lancet HIV enrolled 61 people with HIV and fatty liver disease for 12 months. Liver fat fell by 4.1 percentage points more on tesamorelin than on placebo, a 37% relative reduction, and 35% of people on tesamorelin ended with liver fat below 5%, the study’s entry threshold, against 4% on placebo. Glucose and HbA1c did not differ between groups at 12 months.

Fatty liver is not part of the approved indication, and these were mid-sized trials. They do suggest that the visceral fat effect extends to the organ where fat does some of its quietest damage.116

In a 2014 JAMA trial at Massachusetts General Hospital, 50 people with HIV and abdominal fat were randomly assigned to tesamorelin or placebo for six months.

06 / 11

Beyond HIV: tesamorelin and the aging brain

The most intriguing tesamorelin study had nothing to do with HIV. At the University of Washington, 152 adults aged 55 to 87, 66 of them with mild cognitive impairment, used daily tesamorelin or placebo injections for 20 weeks. The researchers wanted to know whether a growth hormone releasing signal could help the aging brain, since GHRH, growth hormone and IGF-1 all fall with age.

Cognition improved on tesamorelin compared with placebo, in people with mild cognitive impairment and in healthy older adults alike. The clearest effect was on executive function, the skills of planning, focusing and switching between tasks, with a trend for verbal memory. IGF-1 rose 117% but stayed within the normal range, and percent body fat fell 7.4% from baseline.

There were trade-offs. Fasting insulin rose 35% in the people with mild cognitive impairment, though within the normal range, and mild adverse events were reported by 68% on tesamorelin against 36% on placebo. The authors called for longer trials. This is a single study, cognition is not an approved use, and it remains one of the more interesting open threads in growth hormone research.7

Know your baseline before any peptide

120+ lab tests at Quest Diagnostics, every result reviewed by a licensed clinician. Most results in 3–5 business days. A baseline today gives your clinician something to compare against if you start Tesamorelin later.

Start with 120+ lab tests · $99Get early access to peptide care

Full refund before your blood draw · No membership

07 / 11

Tesamorelin vs sermorelin and CJC-1295

All three peptides are versions of GHRH. Sermorelin is the first 29 amino acids, the shortest fully active fragment, and was once sold as Geref. CJC-1295 is a long-acting GHRH analog with an estimated half-life of 5.8 to 8.1 days in its human trials. Tesamorelin is built on the full 44-amino-acid sequence.

The real difference is the evidence. Tesamorelin has placebo-controlled phase 3 trials with CT-measured outcomes, a 52-week extension and a current approval. Sermorelin’s record is mostly pediatric. CJC-1295 has small, short trials measuring hormone levels in healthy adults.

That does not make tesamorelin the right choice for everyone curious about growth hormone. Its phase 3 evidence for shrinking abdominal fat comes from adults with HIV-associated abdominal fat, and use outside that group is off-label and a prescriber’s decision.51910

08 / 11

Tesamorelin side effects and safety

Tesamorelin has a full prescribing label, which makes its safety picture clearer than that of most peptides. The most common adverse reactions, each in more than 5% of people in trials, were joint pain, redness and itching at the injection site, pain in the arms or legs, swelling in the lower limbs and muscle pain.

The label also carries warnings for raised IGF-1, fluid retention, glucose intolerance or diabetes, hypersensitivity reactions, injection site reactions, an increased risk of neoplasms and increased mortality in people with acute critical illness. In the label’s trials, HbA1c of 6.5% or higher developed in 5% of people on tesamorelin against 1% on placebo.

It is contraindicated in people with disruption of the hypothalamic-pituitary axis from surgery, tumor, head irradiation or head trauma, in active malignancy, in known hypersensitivity and in pregnancy. The label also says long-term cardiovascular safety has not been established.

In the 2007 trial, overall adverse events did not differ significantly from placebo, though more people on tesamorelin stopped because of one. Taken together, it is generally tolerated, with real metabolic watch points that call for monitoring.14

The most common adverse reactions, each in more than 5% of people in trials, were joint pain, redness and itching at the injection site, pain in the arms or legs, swelling in the lower limbs and muscle pain.

09 / 11

The labs that track tesamorelin

The label asks for glucose checks before and during treatment, so fasting glucose is the starting point. HbA1c, the three-month average of blood sugar, catches the slower drift the trials watched for, such as the 5% versus 1% rate of new HbA1c readings at or above 6.5%.

ALT, a liver enzyme, has a special place here. In the phase 3 data, among people whose ALT or AST was raised at the start, visceral fat responders saw larger falls in liver enzymes than non-responders, and liver fat itself dropped in later trials. Triglycerides, a blood fat, fell sharply in the 2007 trial and fell further in responders, so they help track metabolic change, though no blood marker can tell you whether your own visceral fat has shrunk.

IGF-1 sits alongside them as the drug’s own fingerprint. It rose 81% in the 2007 trial and 117% in the older-adult cognition study, and the label tells prescribers to monitor it, since persistently high IGF-1 is one of the warnings. It shows that the pituitary is answering, while the four markers above show whether the body is better for it.

Together these markers give a clinician both sides of the ledger: how metabolism is moving and whether blood sugar is holding. Vitals Vault starts with a blood panel, a licensed clinician reviews it with your history, and the same markers are retested to show which way you are moving.1412137

10 / 11

Tesamorelin’s FDA approval and label

FDA first approved tesamorelin as Egrifta on November 10, 2010. The current Egrifta SV label states that it is indicated for the reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy. The label adds that it is not indicated for weight loss management, that long-term cardiovascular safety has not been established, and that there are no data supporting improved adherence to antiretroviral therapy.

In sport, the World Anti-Doping Agency prohibits growth hormone releasing factors, including tesamorelin, in and out of competition.3114

11 / 11

What this means for you

Tesamorelin has two placebo-controlled phase 3 trials behind it and a current FDA approval. In adults with HIV and excess abdominal fat, it reliably shrank the deep fat around the organs, improved triglycerides and, in later trials, liver fat. The benefit lasted while people took it and partly faded when they stopped, and the metabolic gains were associated with how much visceral fat actually came off.

If you are wondering about it, start with whether visceral fat is really your problem, and how you would know if it was responding. Your waist, your triglycerides, your ALT and your blood sugar give a clinician context, while imaging is what actually measures visceral fat.51213

Tesamorelin has two placebo-controlled phase 3 trials behind it and a current FDA approval.

Know your baseline before any peptide

120+ lab tests at Quest Diagnostics, every result reviewed by a licensed clinician. Most results in 3–5 business days. A baseline today gives your clinician something to compare against if you start Tesamorelin later.

Start with 120+ lab tests · $99Get early access to peptide care

Full refund before your blood draw · No membership

What to expect with Tesamorelin

The phase 3 trials judged tesamorelin at 26 weeks, when visceral fat was measured by CT, and the reduction held to 52 weeks in people who continued. In the liver fat trials, changes were measured at 6 and 12 months. IGF-1 rises earlier, which is one reason the label asks for it to be monitored.

Because responses vary, follow-up matters. Triglycerides, waist size, ALT and blood sugar help a clinician see how metabolism is moving and whether glucose is holding steady, though only imaging measures visceral fat directly.45116121

Key Tesamorelin studies

  • Falutz et al., 2007 (NEJM)4

    Randomized, double-blind, placebo-controlled, 26 weeks · 412 adults with HIV and abdominal fat (86% men)

    Visceral fat down 15.2% vs up 5.0% on placebo; triglycerides and cholesterol ratio improved

    Limits: HIV population only; more withdrawals for adverse events

  • Falutz et al., 20105

    Pooled analysis of two phase 3 trials with 26-week extension · 806 adults with HIV and abdominal fat

    Visceral fat reduction held to 52 weeks on continued treatment; belly fat under the skin unchanged; body image improved

    Limits: HIV population only

  • Stanley et al., 201212

    Post hoc responder analysis · 402 tesamorelin-assigned participants in the per-protocol analysis

    Responders had better triglycerides, adiponectin and stable glucose; benefits were associated with fat lost

    Limits: Post hoc; association, not proof

  • Stanley et al., 2019 (Lancet HIV)6

    Randomized, double-blind, placebo-controlled, 12 months · 61 adults with HIV and fatty liver disease

    Liver fat down 37% relative to baseline; 35% vs 4% fell below the fatty liver threshold

    Limits: Mid-sized; long-term liver outcomes unknown

  • Baker et al., 20127

    Randomized, double-blind, placebo-controlled, 20 weeks · 152 adults aged 55 to 87, 66 with mild cognitive impairment

    Better executive function; IGF-1 up 117%; percent body fat down 7.4% from baseline

    Limits: Single trial; more mild adverse events; not an approved use

Key studies on Tesamorelin
StudyDesignWhoWhat it foundLimits
Falutz et al., 2007 (NEJM)4Randomized, double-blind, placebo-controlled, 26 weeks412 adults with HIV and abdominal fat (86% men)Visceral fat down 15.2% vs up 5.0% on placebo; triglycerides and cholesterol ratio improvedHIV population only; more withdrawals for adverse events
Falutz et al., 20105Pooled analysis of two phase 3 trials with 26-week extension806 adults with HIV and abdominal fatVisceral fat reduction held to 52 weeks on continued treatment; belly fat under the skin unchanged; body image improvedHIV population only
Stanley et al., 201212Post hoc responder analysis402 tesamorelin-assigned participants in the per-protocol analysisResponders had better triglycerides, adiponectin and stable glucose; benefits were associated with fat lostPost hoc; association, not proof
Stanley et al., 2019 (Lancet HIV)6Randomized, double-blind, placebo-controlled, 12 months61 adults with HIV and fatty liver diseaseLiver fat down 37% relative to baseline; 35% vs 4% fell below the fatty liver thresholdMid-sized; long-term liver outcomes unknown
Baker et al., 20127Randomized, double-blind, placebo-controlled, 20 weeks152 adults aged 55 to 87, 66 with mild cognitive impairmentBetter executive function; IGF-1 up 117%; percent body fat down 7.4% from baselineSingle trial; more mild adverse events; not an approved use

Tesamorelin myths and evidence

  • Tesamorelin is a weight loss drug

    Its label says it is not indicated for weight loss management. In trials it targeted visceral fat around the organs, while fat under the skin of the belly barely changed.15

  • Once the belly fat is gone, it stays gone

    In the phase 3 extension, people switched to placebo saw visceral fat partly come back. The reduction held in those who continued treatment.135

  • Everyone on tesamorelin gets the same result

    Most people met the 8% visceral fat response bar, but some did not. Non-responders saw glucose and HbA1c drift up without the metabolic benefits.1213

  • Tesamorelin is approved for anti-aging and fat loss in anyone

    The approval covers the reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy. Other uses, including cognition or general aging, are off-label.1

On this page

  1. A belly that HIV medicine left behind
  2. How tesamorelin works
  3. Tesamorelin benefits for visceral fat: the phase 3 trials
  4. Responders, non-responders and what happens when you stop
  5. Tesamorelin and liver fat
  6. Beyond HIV: tesamorelin and the aging brain
  7. Tesamorelin vs sermorelin and CJC-1295
  8. Tesamorelin side effects and safety
  9. The labs that track tesamorelin
  10. Tesamorelin’s FDA approval and label
  11. What this means for you
  12. What to expect
  13. Key studies
  14. Myths and evidence

Know your baseline first

120+ lab tests at Quest, every result reviewed by a licensed clinician. Most results in 3–5 business days.

Start with 120+ lab tests · $99

How is Tesamorelin taken?

Egrifta SV is a prescription medicine injected under the skin once a day in the abdomen, with injection sites rotated, according to its label. The label sets the dose, and a prescriber decides on use.1

Tesamorelin dosage

For its approved use, reducing excess abdominal fat in adults with HIV and lipodystrophy, the label sets one injection under the skin of the abdomen once daily. The amount differs between Egrifta SV and Egrifta WR, which are not interchangeable; the dosage table lists both, plus the dose used in the first phase 3 trial. No dose is established for other uses, and your clinician sets your dose.124

Typical Tesamorelin dosage

Tesamorelin is FDA-approved to reduce excess abdominal fat in adults with HIV and lipodystrophy. The label dose is one injection under the skin of the abdomen once daily, and the amount depends on the formulation (Egrifta SV or Egrifta WR, which are not interchangeable). No dose is established for other uses, and a clinician sets the actual dose.

These are reference doses from FDA labels, studies in people and clinical practice reports, shown for education. They are not a recommendation or a prescription. Your dose, form and schedule should be set by a licensed clinician who knows your history and lab results.

Already have a prescribed dose? The peptide dosage calculator turns it into the units to draw on an insulin syringe.

  • FDA label · Injection under the skin of the abdomen

    1.4 mg

    Once daily1

    Egrifta SV; adults with HIV and lipodystrophy

  • FDA label · Injection under the skin of the abdomen

    1.28 mg

    Once daily2

    Egrifta WR; adults with HIV and lipodystrophy. Not interchangeable with Egrifta SV

  • Human trial · Injection under the skin

    2 mg

    Once daily for 26 weeks4

    Adults with HIV and excess abdominal fat; original formulation used in the phase 3 trial

Typical Tesamorelin doses in people, by source
SourceFormAmountHow oftenNotes
FDA label1Injection under the skin of the abdomen1.4 mgOnce dailyEgrifta SV; adults with HIV and lipodystrophy
FDA label2Injection under the skin of the abdomen1.28 mgOnce dailyEgrifta WR; adults with HIV and lipodystrophy. Not interchangeable with Egrifta SV
Human trial4Injection under the skin2 mgOnce daily for 26 weeksAdults with HIV and excess abdominal fat; original formulation used in the phase 3 trial

Is Tesamorelin right for you?

A clinician makes the call. These are the questions they will ask first.

It may suit

  • Adults with HIV and lipodystrophy with excess abdominal fat, as the label describes, under a prescriber’s care
  • People willing to have glucose, HbA1c and IGF-1 checked before and during treatment

Talk to a clinician first if you are

  • Active malignancy (a contraindication on the label); prior cancer needs careful review
  • Pituitary disease, hypophysectomy, pituitary tumor, head irradiation or head trauma (contraindicated)
  • Pregnancy (contraindicated on the label); breastfeeding should be discussed with a prescriber
  • Diabetes or prediabetes, since glucose intolerance can develop
  • Critical illness
  • Tested athletes (WADA prohibits growth hormone releasing factors)

Vitals Vault peptide care starts with a blood panel and a licensed clinician, and ends with a retest.

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Tesamorelin vs sermorelin

Tesamorelin vs sermorelin
AttributeTesamorelinSermorelin
Based onFull 44-amino-acid GHRH, modifiedFirst 29 amino acids of GHRH
FDA statusApproved (Egrifta SV)Geref discontinued; no approved product
Approved useExcess abdominal fat in HIV-infected adults with lipodystrophyPreviously diagnostic use and pediatric growth hormone deficiency
EvidencePhase 3 trials with 52-week extensionMostly older pediatric studies and small adult studies

Visceral fat is a hormone organ

Visceral fat is the fat packed around the organs. In some people on HIV treatment it builds up out of proportion to body weight. Growth hormone breaks fat down.

In these trials, losing visceral fat went along with better liver enzymes and a better metabolic profile. The label watches blood sugar, IGF-1 and fluid retention, since growth hormone also affects insulin and water balance.411213

What else moves the same system

  1. 01Resistance and aerobic trainingBoth reduce visceral fat and raise insulin sensitivity.
  2. 02Protein and fiber-rich mealsThey protect muscle and steady glucose and insulin.
  3. 03SleepShort sleep raises visceral fat and blunts growth hormone pulses.
  4. 04Track liver and glucose labsALT and HbA1c show how liver fat and blood sugar are moving.

Labs to check with Tesamorelin

A blood test before you start and a retest after shows what actually changed for you. It is how Vitals Vault approaches every treatment.

  1. TestA baseline panel at Quest Diagnostics.
  2. DecideA licensed clinician reviews your history and results.
  3. RetestThe same markers again, side by side.
Start with 120+ lab tests · $99
  • Fasting glucoseA simple metabolic marker to retest.
  • HbA1cYour average blood sugar over about three months.
  • Liver enzymes (ALT)Part of a metabolic panel. Checks the liver before and during any new prescription.
  • TriglyceridesA blood fat that fell on tesamorelin in the 2007 trial.

Is Tesamorelin FDA approved?

Yes, for one use. FDA approved Egrifta (tesamorelin) on November 10, 2010. The current label states that Egrifta SV is indicated for the reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy. The label adds that long-term cardiovascular safety has not been established, that it is not indicated for weight loss management, and that there are no data supporting improved adherence to antiretroviral therapy. Use outside that indication is off-label.13

Tesamorelin timeline

  1. 2007

    Phase 3 trial in 412 people with HIV shows a 15.2% drop in visceral fat on tesamorelin.4

  2. November 10, 2010

    FDA approves Egrifta (tesamorelin) for reduction of excess abdominal fat in HIV-infected patients with lipodystrophy.3

  3. 2010

    Pooled analysis of two phase 3 trials shows the visceral fat reduction held for 52 weeks.5

  4. 2014

    Randomized trial in 50 people shows reductions in visceral and liver fat.11

A Latina woman, 57, medium build, dark-brown bob with a grey streak, round glasses reads on a tiled patio

Tesamorelin questions

What is tesamorelin used for?

Tesamorelin (Egrifta SV) is FDA-approved for the reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy. It is not indicated for weight loss management.

What are the benefits of tesamorelin?

In HIV trials it reduced visceral fat by 15.2% against a 5.0% rise on placebo, improved triglycerides, and in a smaller trial reduced liver fat. These benefits were shown in adults with HIV.

How does tesamorelin work?

It binds the GHRH receptor on the pituitary, which releases growth hormone in pulses. Growth hormone breaks down fat and raises IGF-1.

What are the side effects of tesamorelin?

The most common are joint pain, injection site reactions, pain in the extremities, swelling and muscle pain. The label also warns of raised IGF-1, glucose intolerance or diabetes, fluid retention, hypersensitivity and neoplasm risk.

What is the tesamorelin dosage?

For adults with HIV and excess abdominal fat, the label dose is one injection under the skin of the abdomen once daily, with the amount set by the formulation. There is no established dose for other uses. Your clinician sets your dose.

Is tesamorelin FDA approved?

Yes, for the reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy. FDA first approved Egrifta on November 10, 2010. Other uses are off-label.

Tesamorelin vs sermorelin: what is the difference?

Both are GHRH analogs. Tesamorelin is a modified full-length 44-amino-acid analog and is FDA-approved today. Sermorelin is the first 29 amino acids, and its Geref products were discontinued.

Can people without HIV use tesamorelin?

The label covers HIV-infected adults with lipodystrophy. Trials in other groups are limited. Any other use is off-label and a prescriber’s decision.

Is tesamorelin banned in sports?

Yes. The World Anti-Doping Agency prohibits growth hormone releasing factors in and out of competition.

Can I get tesamorelin through Vitals Vault?

Vitals Vault is opening clinician-led peptide care that starts with a blood test. Join the peptides waitlist to hear first. A licensed clinician reviews your history and labs and decides whether tesamorelin is right for you.

Peptides, prescribed and measured

Vitals Vault is opening peptide care that starts with your blood work, is prescribed by licensed US clinicians and ends with a retest. Join the waitlist to hear first.

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Keep reading

Full Peptide Guide
  • SermorelinA 29-amino-acid fragment of growth hormone releasing hormone, once FDA-approved as Geref and since discontinued.
  • CJC-1295A long-acting growth hormone releasing hormone analog, studied for raising growth hormone and IGF-1.
  • IpamorelinA five-amino-acid growth hormone secretagogue that mimics ghrelin, studied for its selective release of growth hormone.
  • AOD-9604A fragment of human growth hormone designed to break down fat. It reached human obesity trials but did not beat placebo.

Sources

  1. 1. DailyMed. EGRIFTA SV (tesamorelin for injection) prescribing information (opens in a new tab)
  2. 2. DailyMed. EGRIFTA WR (tesamorelin for injection) prescribing information (opens in a new tab)
  3. 3. Drugs@FDA. Egrifta (tesamorelin), BLA 022505, original approval November 10, 2010 (opens in a new tab)
  4. 4. Falutz J, et al. Metabolic effects of a growth hormone-releasing factor in patients with HIV. N Engl J Med. 2007 (opens in a new tab)
  5. 5. Falutz J, et al. 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. J Clin Endocrinol Metab. 2010 (opens in a new tab)
  6. 6. Stanley TL, et al. Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial. Lancet HIV. 2019 (opens in a new tab)
  7. 7. Baker LD, et al. Effects of growth hormone-releasing hormone on cognitive function in adults with mild cognitive impairment and healthy older adults: results of a controlled trial. Arch Neurol. 2012 (opens in a new tab)
  8. 8. Guillemin R, et al. Growth hormone-releasing factor from a human pancreatic tumor that caused acromegaly. Science. 1982 (opens in a new tab)
  9. 9. Prakash A, et al. Sermorelin: a review of its use in the diagnosis and treatment of children with idiopathic growth hormone deficiency. BioDrugs. 1999 (opens in a new tab)
  10. 10. Teichman SL, et al. Prolonged stimulation of growth hormone (GH) and insulin-like growth factor I secretion by CJC-1295, a long-acting analog of GH-releasing hormone, in healthy adults. J Clin Endocrinol Metab. 2006 (opens in a new tab)
  11. 11. Stanley TL, 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 (opens in a new tab)
  12. 12. Stanley TL, et al. Reduction in visceral adiposity is associated with an improved metabolic profile in HIV-infected patients receiving tesamorelin. Clin Infect Dis. 2012 (opens in a new tab)
  13. 13. Fourman LT, et al. Visceral fat reduction with tesamorelin is associated with improved liver enzymes in HIV. AIDS. 2017 (opens in a new tab)
  14. 14. World Anti-Doping Agency. Prohibited List (opens in a new tab)

Written by the Vitals Vault editorial team, medically reviewed by Robert Lufkin, MD, and updated October 29, 2026. This is general education, not medical advice. None of these peptides is FDA-approved to diagnose, treat, cure or prevent any disease, and compounded medicines are not FDA-reviewed for safety, effectiveness or quality. Talk to a licensed clinician before starting any treatment.

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