Tesamorelin: for the fat I couldn’t pinch

This is one of the three peptides I’m running right now, and it has one job. It’s for visceral fat — the fat that sits deep around the organs, under the muscle, where you can’t pinch it. Below is why I tried it, what changed, how I know it changed, and the list I was given before I started. You won’t find doses or how-to here. That’s a conversation for a doctor, not a web page.

Why I tried it

I had visceral fat that would not move. I’d done the obvious things first: I watched what I ate, I trained, and I tried the older weight-loss injections as each one came out. That fat barely shifted.

The rule I work by is that we don’t offer anything we haven’t tried on ourselves first. So this one went through me too.

The explanation I was given

The explanation I was given is that Tesamorelin is a growth hormone-releasing hormone (GHRH) analogue. It doesn’t put growth hormone into the body. It acts on the pituitary gland, binding the same receptors as the GHRH your body already makes, with similar strength, so the body makes more of its own. That lifts IGF-1 into a normal physiological range, working with the body’s own rhythms rather than overriding its negative feedback loops. That, I was told, is the difference between this and taking growth hormone itself. I won’t go further than that, because the biology isn’t mine to explain.

What actually happened

It wasn’t quick. It was around two to three months before I could see a change.

How I know. Visceral fat is the kind you can’t see in a mirror, so I went by three things:

Body composition. The visceral fat reading on the body-composition scan went down.
My waist. My waist came in and my clothes fit differently.
My blood tests. My blood fats, including triglycerides, and my blood sugar both improved.

What I can’t tell you

I was on Retatrutide through the same stretch. So I can’t honestly hand the credit to one or the other. What I can say is that the fat that hadn’t moved for anything else did move while this was part of what I was using.

The same goes for the biggest number I have. Across the whole time I’ve been doing this — peptides plus changing how I live — my body-composition score went from 80 to 95. That’s everything together, not this one on its own.

Where I am now

I still use it, in cycles, with breaks in between. It sits alongside Retatrutide and Epithalon. For me that’s the limit: two or three at a time, never twelve.

What I was told it does

None of this is my own experience. It’s what was explained to me, passed on as it was given.

Visceral fat. In the clinical studies, deep abdominal fat went down by about 18% over 52 weeks of treatment, and by 15–18% across the trials. Those trials were in people living with HIV who had built up abdominal fat, not in the general population.
Blood fats. Triglycerides came down by an average of 51 mg/dl.
How it uses fat. I was told it steps up beta-oxidation, the breakdown of fatty acids, and promotes the release of fat from the abdomen.
Mitochondria. I was told it supports the making of new mitochondria through PGC-1α, oxidative phosphorylation and the NRF pathways, helping the body produce energy and use fat as fuel.
Antioxidant balance. I was told it activates Nrf2, PPAR-gamma and the body’s antioxidant systems.
Heart and blood vessels. I was told it helps reduce artery wall thickness (carotid intima-media thickness), CRP — a marker of inflammation — and triglycerides, and improves the overall lipid profile. The figure I was given was a 0.40% reduction in cardiovascular (ASCVD) risk over 26 weeks.
The brain. Research showed improved cognitive function in healthy older adults and in people with mild cognitive impairment.
Muscle and bone. It supports healthy muscle metabolism and bone mineral density.

On cycles, what I was told is that it’s usually used for about 6 to 12 weeks, followed by a break, to keep the body’s cells responsive to it and to help the metabolism adapt. That’s broadly how I use it.

Questions people ask me

Is it just growth hormone by another name?

That’s not how it was explained to me. As above, it prompts the body to make more of its own growth hormone rather than supplying it from outside, and it leaves the body’s own brakes in place.

How long before anything happens?

For me it was around two to three months before I could see it. That’s one body. “I was fine” is not the same sentence as “you’ll be fine,” and the same goes for timing.

Can it be used with Retatrutide?

I do. That’s exactly why I can’t tell you which one did what. Before I started, everything I was taking went on the table first — that’s the question a doctor asks, not me.

Is it approved?

I was told it’s approved in the US for one use only: abdominal fat build-up in people living with HIV. That isn’t why I use it, and I’d rather say so than let the word “approved” do more work than it should.

Can I just buy the powder and mix it myself?

I mix my own. Every vial I’ve used gets mixed before it’s injected. What I don’t do is use a vial I can’t check: what’s actually in it, whether it’s clean, and whether it stayed cold the whole way. I’ve written about those three questions on my peptides page. None of them are about the drug. They’re about whoever handed you the vial. That’s where I landed. I’m not telling you where to land.

The list I was given before I started

Before I used it, a doctor went through this with me.

Who it isn’t for

Anyone who is pregnant or breastfeeding
Anyone with active cancer, or a history of a hormone-sensitive cancer
Anyone with a pituitary disorder
Anyone whose diabetes isn’t under control
Anyone known to react to peptide products

Other medicines

I was told there are no well-established studies on how Tesamorelin interacts with other drugs, so these get raised first:

Insulin or other diabetes medicines
Growth hormone or IGF-1 therapies
Corticosteroids
Other injectable peptides, or anything that works on hormones

Side effects I was told about

I was told it’s generally well tolerated, and the one listed was mild irritation where it’s injected — redness or itching. I’ve had none. That’s one person.

Where this comes from

Falutz J, et al. Metabolic effects of a growth hormone–releasing factor in patients with HIV. New England Journal of Medicine, 2007.
Falutz J, et al. Long-term safety and effects of tesamorelin, a growth hormone-releasing factor analogue, in HIV patients with abdominal fat accumulation. AIDS, 2008.
Falutz J, et al. Effects of tesamorelin (TH9507), a growth hormone-releasing factor analog, in HIV-infected patients with excess abdominal fat: a pooled analysis of two multicenter, double-blind placebo-controlled phase 3 trials with safety extension data. Journal of Clinical Endocrinology & Metabolism, 2010.
Baker LD, et al. Effects of growth hormone–releasing hormone on cognitive function in adults with mild cognitive impairment and healthy older adults. Archives of Neurology, 2012.
Stanley TL, et al. Effect of tesamorelin on visceral fat and liver fat in HIV-infected patients with abdominal fat accumulation: a randomized clinical trial. JAMA, 2014.

It was the one part of me that wouldn’t budge. This was in the mix when it finally did.

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I’m George. Thirty years in business, then ten years trying this whole field on myself before offering it to anyone else.

This is where I write down what I use, what I stopped using, and what I’d never do again. More about me →

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