Peptides
Evidence: Strong (FDA-approved indication), Moderate (longevity)
Tesamorelin is an FDA-approved synthetic 44-amino acid GHRH analog with a trans-3-hexenoic acid modification at the N-terminal tyrosine that confers resistance to DPP-IV degradation. It binds GHRH receptors on anterior pituitary somatotrophs, stimulating endogenous GH production and secretion while maintaining pulsatile release patterns. Tesamorelin selectively reduces visceral adipose tissue (15-20% reduction in trials) while preserving subcutaneous fat, and markedly increases plasma GH and IGF-1 levels with once-daily dosing.
Standard: Research indicates 2 mg administered once daily via subcutaneous injection (FDA-approved dose for HIV lipodystrophy).
Maintenance: Research indicates 1-2 mg daily. Effects reverse upon discontinuation.
Administration: subcutaneous
Timing: Morning administration on empty stomach. Consistent daily timing recommended.
Duration: 26+ weeks in clinical trials. Long-term use is common; effects are not sustained after discontinuation.
Tesamorelin is the gold standard for evidence-based GH optimization — it is FDA-approved (2010) with robust Phase III data. Pivotal trials showed 15-20% visceral fat reduction in 26 weeks. It is the only GHRH analog with regulatory approval. Effects reverse upon discontinuation, suggesting continuous use is needed. The pharmaceutical cost is high; compounding pharmacy versions are more accessible. Off-label use for body composition optimization in non-HIV populations is common in the optimization community.
Pharmaceutical-grade (marketed as EGRIFTA). Also available through compounding pharmacies. The only FDA-approved GHRH analog currently on market.
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