Tesamorelin — the visceral fat protocol.

Tesamorelin is a stabilized analog of growth-hormone-releasing hormone. The FDA-approved indication (as the brand-name Egrifta) is reduction of visceral adipose tissue (VAT) in adults with HIV-associated lipodystrophy. The clinical trial data showing ~15% VAT reduction over 26 weeks is what drives the off-label metabolic-medicine interest.

Compounded forms are available through 503A pharmacies for off-label use under physician supervision. Brand Egrifta is available but cash-pay price is significantly higher.

Like Sermorelin, Tesamorelin binds the GHRH receptor on the pituitary. The structural modifications give it greater stability and potency — more sustained GH pulses, more pronounced IGF-1 elevation. The metabolic effect on visceral fat appears to come from this sustained GH/IGF-1 axis activation driving lipolysis preferentially in visceral depots.

Tesamorelin tends to fit:

• Patients with elevated visceral fat and metabolic markers (high A1C, elevated triglycerides, low HDL)
• Patients who've plateaued on Sermorelin or CJC/Ipa and want stronger GH response
• Patients prioritizing body recomposition over generalized recovery
• Patients with HIV-associated lipodystrophy (FDA-approved indication)

Often paired with GLP-1 medications for patients with significant metabolic dysfunction — the two work on different pathways (Tesamorelin on GH/lipolysis, GLP-1 on satiety/insulin sensitivity).

FDA-approved Egrifta dosing is 2mg subcutaneous injection daily. Off-label compounded protocols vary; common starting dose is 1mg/day for 12-week cycles, increasing if labs show inadequate response and tolerability is good.

Like other GHRH peptides, dosing is at bedtime on an empty stomach. Cycle 12–26 weeks; some patients use maintenance dosing thereafter.

Most patients see meaningful visceral fat reduction (measured by DEXA scan or waist circumference) at 12–26 weeks. Glycemic markers (A1C, fasting insulin) typically improve in parallel. Energy and sleep improvements similar to other GHRH peptides start at 2–4 weeks.

IGF-1 re-tested at 6–8 weeks and 12 weeks. DEXA or measurement at baseline and 12 weeks for body composition tracking.

Vektor prescribes Tesamorelin through our 503A pharmacy partner — standard format is 3mg/mL in a 5mL vial. For patients who prefer the FDA-approved branded option, we can prescribe Egrifta directly (cash-pay; insurance varies).

Tesamorelin is often the right protocol for the patient who's done their reading on metabolic medicine and wants the stronger GH analog. We require baseline lipid + A1C + insulin labs before prescribing.