At a glance

What is tesamorelin?

Tesamorelin is a synthetic analog of growth-hormone-releasing hormone (GHRH). It is FDA-approved and sold as Egrifta for reducing excess visceral (abdominal) fat in people with HIV-associated lipodystrophy. In wellness settings it is used off-label for body composition and anti-aging in people without HIV; that use is the subject of this entry and is not an approved indication.

How does it work?

Tesamorelin binds pituitary GHRH receptors and stimulates the body's own growth hormone release, which raises IGF-1 and, in its approved population, reduces visceral fat. This mechanism is well established and underlies the approved use. This describes how it works, separate from whether the off-label wellness use is supported.

The label describes growth hormone released this way as both anabolic and lipolytic¹, meaning it also drives fat breakdown, and visceral fat is the depot the HIV trials measured. Visceral fat changed as follows in the largest trial²:

Is it FDA-approved?

Yes, for one specific use. Tesamorelin is FDA-approved as Egrifta for excess abdominal fat in HIV-associated lipodystrophy, and it is now marketed as Egrifta SV¹ and Egrifta WR³. The label says it is not indicated for weight loss management¹, and it lists these contraindications¹:

• Pregnancy
• Active malignancy
• Disruption of the hypothalamic-pituitary axis

Any other use, including general body-composition or anti-aging use in people without HIV, is off-label and not an approved indication; compounded tesamorelin for non-approved uses falls in the unsettled peptide-compounding space. In sport, tesamorelin is banned at all times, and WADA explicitly lists it among prohibited GHRH analogs.

What does the research show?

For the approved use, the evidence is strong; for the wellness use, it is extrapolated. According to PubMed, a randomized, placebo-controlled trial² of 404 people with HIV-associated fat accumulation found tesamorelin significantly reduced visceral fat and raised IGF-1, with no change in glucose parameters. A 52-week extension⁴ found it generally well tolerated, and the lost visceral fat returned once treatment stopped.

However, there are no dedicated controlled trials of the off-label body-composition or anti-aging use in people without HIV; that use is an extrapolation from the HIV population, and growth hormone-axis stimulation carries class considerations such as IGF-1 elevation and effects on glucose.

Also in the library

• TesamorelinGHRH analog

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