Growth hormone-releasing hormone analogue

Tesamorelin

aka tesamorelin acetate · TH9507

Evidence grade

Moderate human evidence

for visceral / abdominal fat reduction in people without HIV

User score everyone · n = 23

US FDA Approved for HIV-related belly fat only checked 2026-11-13

WADA 2026 Prohibited (S2.2.4) at all times · checked 2026-11-13

EU A centralized EU marketing application was withdrawn in 2012 after provisional benefit-risk concerns; a later EU-wide authorization was not found. · checked 2026-11-13

B belly fat in people without HIV
A HIV-associated abdominal fat (FDA-approved)

Grade note: revised from A to B on independent review. The seat graded the approved indication (excess abdominal fat in HIV-associated lipodystrophy), where A is right.

Goals: Fat loss Compare with another peptide →

User reports

approximate — combined from two independent Reddit reads

Men 45–60

2 men aged 45–60

small sample · n = 2

Outcome negative 1 of 2 · no effect 1 of 2

Side effects blood pressure 1 of 2 · heart rate up 1 of 2 · insomnia 1 of 2

Why stopped side effects 1 of 2

Stopped 1 of 2 Used with other compounds 0 of 2

All men

5 men

small sample · n = 5

Outcome positive 3 of 5 · negative 1 of 5 · no effect 1 of 5

Benefits fat loss 3 of 5 · muscle 1 of 5

Side effects blood pressure 1 of 5 · heart rate up 1 of 5 · insomnia 1 of 5

Why stopped side effects 1 of 5

Stopped 1 of 5 Used with other compounds 3 of 5

Everyone

23 people

Positive: 10 of 23 (43%)
Mixed: 4 of 23 (17%)
Negative: 6 of 23 (26%)
No effect: 1 of 23 (4%)
Unclear: 2 of 23 (9%)

Benefits reported of 23

Side effects reported of 23

Side effects reported (n = 23)
Item	Reports
Other	5 of 23 (22%)
Insomnia	2 of 23 (9%)
Anxiety	1 of 23 (4%)
Blood pressure	1 of 23 (4%)
Heart rate up	1 of 23 (4%)
Injection site	1 of 23 (4%)
Low blood sugar	1 of 23 (4%)
Tingling / numbness	1 of 23 (4%)

Why people stopped of 23

Stopped 8 of 23 (35%) Used with other compounds 9 of 23 (39%)

User reports are anecdata, not evidence: self-selected, unverified, often combined with other compounds.

In their words

“At 52M 2mg daily tesamorelin didn't move my IGF1 levels much”

no effect52M · r/Biohacking
“I'm 55 and tried tesamorelin and had horrible sides. Weird heart palpitations, high blood pressure, bad sleep so I stopped.”

negative55M · r/trt
“Within seconds of injecting it, I experienced an intense metallic taste in my mouth and severe itching over my entire body.”

side effectr/Tesamorelin
“I did an eight week cycle of tesamorelin 2mg/day on week days, weekends off, and it went really well. I definitely lost fat, gained muscle”

positiver/Peptides
“This happened to me with tesa and ipa. (All the "morelin" style peptides can do this.) I started developing allergic symptoms, which led anaphylaxis.”

side effectr/Peptides
“Never had any issue with Tesa.”

positiver/Peptides

Read summaries and method notes

Read 1. Two men aged 45–60, neither with a clear benefit: a 52M on 2 mg daily saw little IGF-1 change; a 55M stopped for palpitations, high blood pressure and poor sleep. The full 19-user set leaned favourable or mixed (smaller waist/visceral fat, better body composition, sometimes sleep), but several serious reports involved allergic/anaphylaxis-like reactions after weeks of tolerance, and one severe hypoglycaemia with an ER visit (with ipamorelin). Seven stopped for side effects; many positives were stacked with TRT, GLP-1s or ipamorelin.

Read 2. No man aged 45–60 (the "older man" thread was on excluded r/BodyHackGuide). Four users: 1 positive (8 weeks at 2 mg on weekdays, fat loss and muscle gain), 1 negative (escalating allergy to anaphylaxis on tesamorelin + ipamorelin, a reported class risk for "morelin" peptides), 2 unclear (switched from sermorelin without issues). Clinical trials need 26–52 weeks for lasting visceral-fat reduction. Reliability low.

Note 1. The two target-age men were unfavourable/no-effect despite a more favourable everyone block. Allergic reactions and hypoglycaemia were prominent severe-event reports. r/BodyHackGuide seeds excluded.

Note 2. Two seed threads were excluded as r/BodyHackGuide. Three of four reports came from sermorelin side-effect threads.

Each read counted people independently. Overlap between the two reads is estimated from shared threads and removed; counts are approximate. How we count.

Summary

GHRH analog containing a 44-amino-acid sequence with an attached hexenoyl group. FDA-approved for HIV-related lipodystrophy. Reduces visceral adipose tissue in the approved HIV-associated indication; muscle-imaging findings are exploratory and do not establish a general muscle-quality benefit. Preserves natural GH pulsatility.

Safety

Increased IGF-1 and potential neoplasm risk
Glucose intolerance and diabetes
Fluid retention, joint pain and injection-site reactions
Contraindicated in active malignancy, pregnancy, relevant hypothalamic-pituitary disruption and hypersensitivity
Long-term cardiovascular safety is not established

From labels, regulators and trials. No signal in small studies ≠ safe.

Legal status

US FDAApproved for HIV-related belly fat only

Approved for reduction of excess abdominal fat in adults with HIV-associated lipodystrophy. Not indicated for general weight-loss management; different approved formulations have different labeled doses. Tesamorelin was not on the July 2026 PCAC agenda. Source

checked 2026-11-13

WADA 2026Prohibited (S2.2.4)

Prohibited at all times, S2.2.4 GHRH analogue. Source

checked 2026-11-13

EU

A centralized EU marketing application was withdrawn in 2012 after provisional benefit-risk concerns; a later EU-wide authorization was not found. Source

checked 2026-11-13

Evidence B visceral / abdominal fat reduction in people without HIV

Changed A to B. The seat graded the approved indication (excess abdominal fat in HIV-associated lipodystrophy), where A is right. But the handbook audience uses it for belly fat without HIV, and the FDA label says it is not indicated for weight-loss management. That is the rubric's 'approval for a narrow indication' = B, supported by one smaller positive RCT in adults with obesity. Same rule as SS-31, sermorelin and rapamycin: an approval only earns A when it covers the marketed use.

Human trials · 4

PMID 180573382007Randomized double-blind placebo-controlled trial 412 people

Adults with HIV and abdominal fat accumulation

At 26 weeks visceral fat decreased 15.2% with treatment versus an increase of 5.0% with placebo. Source
PMID 201011892010Randomized double-blind placebo-controlled trial with extension 404 people

Adults with HIV and abdominal fat accumulation

Visceral fat fell 10.9% versus 0.6% with placebo at six months; benefit was lost after switching to placebo. Source
PMID 250383572014Randomized double-blind placebo-controlled trial 50 people

Adults with HIV and abdominal fat accumulation

Visceral and liver fat decreased relative to placebo over six months; long-term liver outcomes remain uncertain. Source
PMID 316110382019Randomized double-blind placebo-controlled trial 61 people

Adults with HIV and nonalcoholic fatty liver disease; 60 received study treatment

Liver fat fell and fewer participants with paired biopsies had fibrosis progression at 12 months; the study was small. Source

Bar length = trial size on a log scale.

Dose ranges

Reported ranges from labels and studies, with context. Not a recommendation.

approved label
1.28 mg subcutaneously once daily for the 11.6 mg/vial formulation Source
approved label
1.4 mg subcutaneously once daily for the 2 mg/vial formulation Source
clinical trial
2 mg subcutaneously once daily using the older 1 mg/vial formulation Source

Editorial ratings EDITORIAL

Editors’ judgement, 0–5. Opinion, not data; separate from grade and user score.

Safety 4 out of 5
Sleep 3 out of 5
Recovery 3.5 out of 5
Cognitive 3.5 out of 5

Sources

Reddit threads read · 12

Research checked 2026-11-13.

Item	Reports
Fat loss	9 of 23 (39%)
Muscle	4 of 23 (17%)
Sleep	3 of 23 (13%)
Recovery	1 of 23 (4%)