Tesamorelin

Tesamorelin is a synthetic peptide derived from growth hormone-releasing hormone. It consists of 44 amino acids and is designed to stimulate the body’s natural production of growth hormone. Its structure closely mimics the endogenous hormone to trigger specific physiological responses.

Tesamorelin is primarily used to reduce excess abdominal fat, particularly in individuals with certain metabolic conditions. It may also support improved body composition and metabolic health by enhancing growth hormone levels. Overall, it is promoted for its ability to influence fat distribution and related metabolic processes.

Tesamorelin has been shown in multiple human clinical trials to significantly reduce visceral fat. In a randomized, placebo‑controlled 6‑month study in HIV‑positive patients, tesamorelin reduced visceral adipose tissue by around 42 cm² compared to placebo ¹. In that same trial, it also decreased liver fat modestly, indicating a potential impact on ectopic fat stores beyond the abdomen ². Longer‑term studies (up to 12 months) confirmed that reductions in visceral fat were maintained with continued treatment ³.

Beyond fat reduction, tesamorelin has been linked to improvements in metabolic markers and quality of life. Phase 3 trials found that it lowers triglyceride levels and improves body‑image distress in people with HIV‑associated lipodystrophy ⁴. One smaller study also suggested a trend toward better neurocognitive performance in abdominally obese HIV‑positive individuals, though it was not statistically conclusive ⁵. Overall, tesamorelin appears to improve body composition and metabolic health by specifically reducing deep abdominal fat while positively influencing lipid profiles and patient well‑being.

Tesamorelin’s most common negative side effects reported in clinical studies include injection‑site reactions, arthralgia (joint pain), myalgia (muscle pain), and edema (swelling) in the limbs ⁶. In longer human trials, elevated levels of IGF‑1 (which is stimulated by tesamorelin) raise concerns about potential tumor growth, though no clear malignancy risk has been established ⁷.

In some studies, tesamorelin impaired glucose metabolism: in a 6-month randomized trial, fasting glucose increased early on, and hemoglobin A1c rose modestly ⁸. Also, in a longer 12‑month liver‑fat study, more patients in the tesamorelin group reported injection‑site complaints than in the placebo group ⁹. These findings indicate that tesamorelin’s side effects are generally manageable but require monitoring of glucose levels and injection‑site reactions.

Tesamorelin is a synthetic analogue of human growth‑hormone releasing hormone (GHRH) that binds to receptors on somatotrophs in the anterior pituitary, stimulating pulsatile release of endogenous growth hormone (GH) ⁹. The released GH acts on peripheral tissues, especially the liver, to increase production of insulin‑like growth factor‑1 (IGF‑1) ¹⁰. GH and IGF‑1 then promote lipolysis in visceral fat and support anabolic processes in tissues such as muscle ¹¹. This coordinated action allows Tesamorelin to reduce visceral fat while enhancing overall metabolic and tissue growth activity.

Tesamorelin is an FDA‑approved prescription drug in the United States, marketed under the brand name EGRIFTA WR™ for the reduction of excess visceral fat in HIV‑infected adults with lipodystrophy. Its use is regulated and limited to the approved formulation, and compounding pharmacies are not permitted to produce it because it is classified as a biologic. In terms of athletic regulation, tesamorelin is classified as a growth‑hormone–releasing hormone analogue and is explicitly prohibited by the World Anti-Doping Agency (WADA) both in-competition and out-of-competition. Consequently, while tesamorelin is legal for therapeutic use under prescription, it is considered a performance-enhancing substance and is banned in competitive sports.