Tesamorelin
Tesamorelin is a man-made version of growth hormone-releasing hormone. In the US it is approved to reduce excess abdominal fat in adults with HIV who have lipodystrophy.
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What it is
Tesamorelin is a synthetic analogue of growth hormone-releasing hormone (GHRH), sold in the US as Egrifta [1]. It was first approved by the US Food and Drug Administration (FDA) in 2010 [1, 2]. It is a specialist medicine for one condition: excess abdominal fat in adults with HIV who have lipodystrophy, a change in how body fat is distributed that affects some people with HIV [1].
How it works
Tesamorelin acts on GHRH receptors in the pituitary gland. This stimulates the body's own production and pulsed release of growth hormone, which in turn raises levels of insulin-like growth factor 1 (IGF-1) and its binding protein IGFBP-3 [1]. Unlike growth hormone injections, it works through the pituitary, and it is not used in people whose hypothalamic-pituitary axis has been damaged or removed [1]. It is cleared from the blood within minutes [1].
Approved medical uses
In the US, tesamorelin is approved to reduce excess abdominal fat in adults with HIV and lipodystrophy [1]. The label states that it is not a weight-loss medicine, that its long-term effects on heart disease are not known, and that it has not been shown to improve adherence to HIV treatment [1].
It is not approved in the EU. The company withdrew its EU application in 2012, when the European Medicines Agency's medicines committee was of the provisional view that its benefits did not outweigh its risks [3]. It should only be used under medical supervision.
What the research shows
- Visceral fat: in two 26-week placebo-controlled trials in people with HIV and abdominal fat build-up, tesamorelin reduced visceral (deep abdominal) fat by about 18% and 14% compared with baseline, while it rose or stayed about the same with placebo [1].
- Other measures: trunk fat and waist size fell modestly, and participants reported less distress about the appearance of their abdomen than with placebo [1].
- After stopping: in an extension study, people switched to placebo after 26 weeks had their trunk fat increase again, while those who continued treatment kept their reduction [2].
- Clinical relevance: the European Medicines Agency's committee was not convinced that the fat reduction led to real health benefits, noted a lack of long-term safety data, and was concerned that the study participants were not representative of European patients [3].
- Long-term cardiovascular safety and benefit have not been studied [1, 2].
Known risks and side effects
- Joint pain (13%), injection-site reactions, muscle pain, swelling of the limbs, tingling or numbness and rash were more common than with placebo [1].
- Fluid retention, including carpal tunnel syndrome [1].
- Raised blood sugar and new diabetes. Over 26 weeks, 5% of people on tesamorelin developed an HbA1c of 6.5% or higher, compared with 1% on placebo [1].
- High IGF-1 levels. At 26 weeks, 47% of treated people had IGF-1 more than 2 standard deviations above normal for their age [1]. High IGF-1 may be linked to cancer risk and worsening diabetic eye disease [3].
- Possible increased risk of tumours: it must not be used with active cancer [1].
- Allergic (hypersensitivity) reactions in about 4% of people. About half of treated people developed antibodies to tesamorelin [1].
- It must not be used in pregnancy or in people with a damaged hypothalamic-pituitary axis [1].
- GHRH analogues, including tesamorelin, are prohibited at all times in sport under the WADA Prohibited List [4].
Blood tests commonly monitored
- IGF-1, with stopping considered if levels stay well above normal [1].
- Blood glucose and HbA1c before treatment and from time to time during it [1].
- Eye checks for diabetic retinopathy in people with diabetes [1].
If you and your doctor are monitoring treatment, Enhanced Training Studio keeps a private log on your phone: what you take and when, your blood test results over time, and how you feel. How tracking works.
Sources
- US Food and Drug Administration. Egrifta WR (tesamorelin for injection): prescribing information. Revised March 2025. FDA label (PDF)
- US Food and Drug Administration. Egrifta (tesamorelin for injection): prescribing information. 2010. FDA label (PDF)
- European Medicines Agency. Questions and answers on the withdrawal of the marketing authorisation application for Egrifta (tesamorelin). 2012. EMA (PDF)
- World Anti-Doping Agency. Prohibited List 2026, class S2: peptide hormones, growth factors, related substances and mimetics (English text as reproduced by the German Sport University Cologne). DSHS Cologne
Related
Last reviewed 7 October 2026. General information, not medical advice. Found a mistake? Email [email protected].