Tesamorelin — 20mg

Tesamorelin is a synthetic 44-amino acid analog of growth hormone-releasing hormone (GHRH 1-44) modified at its N-terminus with a trans-3-hexenoyl fatty acid group that protects against dipeptidyl peptidase IV cleavage. The compound was developed by Theratechnologies and approved by the FDA in 2010 as Egrifta for the treatment of HIV-associated lipodystrophy — a condition characterized by excessive visceral (abdominal) adipose tissue accumulation in patients on antiretroviral therapy. This approval established tesamorelin as the first pharmacotherapy with demonstrated visceral-fat-specific reduction in humans.

Mechanistically, tesamorelin binds GHRH receptors on anterior pituitary somatotropes to increase pulsatile growth hormone (GH) release, which in turn elevates IGF-1 and drives lipolysis. The visceral adipose specificity observed in clinical trials — a reduction of approximately 18% in visceral adipose tissue at 26 weeks — reflects the preferential lipolytic effect of GH on deep visceral fat depots over subcutaneous fat. Beyond the primary indication, randomized placebo-controlled trials have demonstrated meaningful reductions in hepatic fat content in HIV-associated NAFLD, with improvements in liver stiffness and biochemical markers of hepatic inflammation.

Beyond body composition, tesamorelin has been investigated in a 20-week randomized trial of older adults with mild cognitive impairment, where GHRH administration produced modest improvements in executive function and verbal memory. Parallel research has examined its role in non-HIV NAFLD, metabolic syndrome-associated visceral adiposity, and as a research tool for studying the GHRH/GH/IGF-1 axis in aging. Its trans-3-hexenoyl modification and 44-amino acid length distinguish it from shorter GHRH fragments like CJC-1295 (30-AA) or sermorelin (29-AA), and the half-life (~30 minutes after subcutaneous injection) supports once-daily dosing in clinical protocols.