Tesamorelin (10mg)

Tesamorelin is a **synthetic 44-amino acid analogue** of human GHRH. It binds to GHRH receptors on the somatotroph cells of the **anterior pituitary gland**, stimulating pulsatile GH secretion. This increases circulating levels of **IGF-1**, which mediates lipolysis — particularly in **visceral adipose tissue**. Unlike exogenous GH, Tesamorelin **preserves the negative feedback mechanism** via somatostatin, avoiding supraphysiological levels. Clinical studies also highlight **neuroprotective action** through the reduction of cerebral amyloid-beta deposition.

• Typical dose: 1–2mg subcutaneously, daily
• Frequency: Daily, 30–60 minutes before bed, on an empty stomach
• Storage: 2–8°C after reconstitution, use within 21 days
• Advantage: 5 full doses per vial — fewer reconstitutions

1. Clean the vial and BAC water stoppers with an alcohol wipe.
2. Draw 2mL of bacteriostatic water (BAC water).
3. Inject slowly down the side of the vial — do not spray directly onto the powder.
4. Gently swirl until fully dissolved — do not shake.
5. Mark the reconstitution date on the vial.
6. Store immediately in the refrigerator (2–8°C).

• FDA-approved (2010) for visceral fat reduction — the only GHRH compound with clinical approval.
• Natural pulsatile GH secretion without suppression of the GH-IGF-1 axis.
• The 10mg vial is the optimal price per mg for long-term protocols.
• Phase III clinical studies: average visceral fat reduction of ~18% over 26 weeks.
• Clinical tolerance data in long-term studies (up to 2 years).

• Weeks 1–2: 1mg/day — introductory phase to assess tolerability.
• Weeks 3+: 2mg/day — clinically used dose corresponding to the FDA dose.
• Administer before bed on an empty stomach (≥2 hours fasting).
• Cycle: 3–6 months active, followed by a 4–8 week washout.
• Evaluate data at 12 weeks — if no change, reassess.
• Break between cycles: After the cycle (3–6 months), a 4–8 week pause is recommended. Tesamorelin stimulates endogenous GHRH receptors — the pause prevents tolerance (down-regulation) and allows for sensitivity to be restored. Maintain exercise and diet during the washout.

• Lyophilized powder: room temperature (up to 25°C) or refrigerator.
• Reconstituted solution: 2–8°C required, use within 21 days.
• Do not freeze after reconstitution.
• Avoid exposure to direct light or temperatures >25°C.

• Monitor IGF-1 every 4–6 weeks and fasting glucose monthly.
• Contraindicated in active neoplasia or history of GH-dependent malignancies.
• Report immediately: persistent edema, severe arthralgias, or carpal tunnel syndrome.
• The use of this protocol is for informational purposes only.

1. FDA Approval — Tesamorelin — Dhillon S. Tesamorelin: a review of its use in the management of HIV-associated lipodystrophy. Drugs. 2011;71(8):1071-1091.
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2. Visceral Fat Reduction RCT — Falutz J, et al. Effects of tesamorelin on body composition and visceral fat in HIV-infected patients. JAMA. 2007;298(7):761-769.
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3. Long-term Safety — Falutz J, et al. Long-term safety and efficacy of tesamorelin in HIV patients. AIDS. 2008;22(14):1719-1728.
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4. Neuroprotective Effects — Stanley TL, et al. Effects of tesamorelin on neuroimaging markers of brain aging. Ann Neurol. 2023;93(4):808-816.
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5. Metabolic Effects Review — Stanley TL, Grinspoon SK. Effects of GHRH on visceral fat, metabolic, and cardiovascular indices. Growth Horm IGF Res. 2015;25(2):59-65.
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