Tesamorelin

A 44-amino acid synthetic GHRH analog. FDA-approved (Egrifta) for HIV-associated lipodystrophy with proven 15–20% reduction in visceral adipose tissue. Increasingly used off-label for general visceral fat reduction in older adults.

Stimulates the pituitary to release growth hormone in physiological pulses. Unlike exogenous HGH, preserves natural pulsatile rhythm and feedback loops. The resulting GH/IGF-1 elevation drives visceral lipolysis specifically.

Multiple Phase 3 trials show 15–20% visceral fat reduction over 26 weeks. The only GH secretagogue with FDA approval for fat loss. Preserves lean mass while reducing visceral adipose.

Sources: NEJM: Tesamorelin Phase 3 · FDA Egrifta label

Range

1–2 mg/day total

Frequency

Daily SubQ, often split AM + PM; 5 days on / 2 off

Duration

8–12 week cycles; clinical minimum effect window 26 weeks

Sources: PubMed

SubQ

~26 minutes (rapid pulsatile GH release)

Common

• Injection site reactions
• Mild fluid retention
• Joint pain
• Carpal tunnel symptoms

Serious / theoretical

• Glucose intolerance (monitor HbA1c)
• Avoid in active malignancy
• Avoid in pregnancy

Sources: FDA label

Bachmeyer's preferred GH-axis stack anchor. Stack with Retatrutide for dual visceral fat attack (Jones DC protocol). Preferred over exogenous HGH because pituitary feedback stays intact.