# Tesamorelin

FDA-approved GHRH analogue for visceral fat; raises IGF-1, anaphylaxis reports.

- Page: https://peprank.xyz/peptides/tesamorelin
- Category: Metabolic & weight (Research peptide)
- Also known as: Egrifta; Egrifta WR; tesa
- Routes: Injection
- Sequence: YADAIFTNSYRKVLGQLSARKLLQDIMSRQQGESNQERGARARL (GHRH(1-44), N-trans-3-hexenoyl, C-amide)
- Safety tier: Strict: Avoid · Balanced: Avoid · Evidence only: Avoid
- Risk axes (0 none to 3 severe): Seen harm 2, Mechanism 2, Data gap 0, Silent harm 3, Product 3
- Positive: 42% of 30 graded reports glowing or positive, shrunk toward the 49% all-report average by 8 reports' weight
- Rank: #52 of 61 research peptides
- Graded reports: 30 (Glowing 4, Positive 8, Mixed 3, Nothing 3, Negative 5, Bad reaction 7)
- Evidence: Approved drug — in the US (HIV-associated lipodystrophy)
- Access: Grey market
- Onset: Sleep changes within days; visible visceral or waist change usually after 4-8 weeks. Trials measured the full effect at 26 weeks.
- Lasts: Short half-life (minutes) but nightly dosing keeps IGF-1 raised. Visceral fat returns over months after stopping; many users also drop several pounds of water within a week of stopping.
- Cost per month: ≈ €240–480 (at 1–2 mg/day, Semax Polska at €7.94/mg)
- Dose users report: 1–1.4 mg/day (median 1.4 mg, n=5)
- Updated: 2026-10-30

**Why Avoid under the strict bar:** GH/IGF-1 axis elevation (neoplasm and glucose warnings on label) plus anaphylaxis reports.

## What users report

Gradual visceral-fat loss (several DEXA-confirmed, 40%+ in one case), much better sleep and muscle retention during GLP-1 cuts, with results taking 4-8+ weeks. Sceptics note that most visible results come from retatrutide, and a minority see nothing, especially when already lean. Water retention (sometimes numb or tingling hands), joint pain, disturbed sleep or a raised night heart rate, and itchy injection-site welts are common. Anaphylaxis accounts recur throughout 2026, typically after months of use and often after weeks of worsening welts. They include ER and hospital visits, loss of consciousness, and one reaction masked by daily antihistamines. A separate account describes a week in hospital with reactive hypoglycaemia (glucose below 40) on tesamorelin plus ipamorelin.

**Effects:** visceral fat reduction; better sleep; muscle preservation in a deficit; IGF-1 rise without shutting down endogenous GH

**Downsides:** water retention / swollen ankles; flushing, palpitations; joint aches; injection-site reactions

**Risks:** Raises GH/IGF-1: label warns on neoplasm (contraindicated with active malignancy); Glucose intolerance / diabetes risk; Hypersensitivity incl. anaphylaxis (label + multiple user reports)

**Typical use:** 1-2 mg/day subQ at night, 5 days on / 2 off for 12 weeks.

**Getting it:** FDA-approved as Egrifta WR (and SV) only for HIV-associated abdominal fat; some US clinics prescribe it off-label or compounded. Most Reddit users buy research-peptide vials.

**Stacked with:** Retatrutide or tirzepatide (The dominant pairing, meant to protect muscle and target visceral fat during a GLP-1 cut. Sceptics say the GLP-1 does most of the visible work.); Ipamorelin (Sold as a premixed tesa/ipa blend for sleep and recovery. Several anaphylaxis posters later reacted to CJC/ipamorelin or sermorelin too.); HGH (A common next step after tesamorelin, chosen for cost or after an allergic reaction.)

## Risk profile

- **Seen harm 2/3:** The Egrifta label carries warnings for neoplasm, IGF-1 elevation, fluid retention, glucose intolerance (HbA1c 6.5% or above in 5% vs 1%) and hypersensitivity in 4%; at least four independent first-hand reports describe anaphylaxis after weeks or months of use, some with loss of consciousness or hospital care.
- **Mechanism 2/3:** A GHRH analogue that raises IGF-1, above 2 SDS in 47% of patients at 26 weeks; the label states the effects of prolonged IGF-1 elevation are unknown and requires any malignancy to be inactive.
- **Data gap 0/3:** FDA-approved since 2010 for HIV lipodystrophy on placebo-controlled trials in over 800 patients, with 16 years of post-marketing use.
- **Silent harm 3/3:** Tumour promotion from sustained IGF-1 elevation would be silent and delayed; IGF-1 and glucose can be watched on blood tests, but the cancer risk cannot.
- **Product 3/3:** Biohackers mostly inject grey-market vials rather than the expensive pharmacy product; tesamorelin was among the compounds in the 6,441-sample quality study.
- **Never if:** Active cancer or a history of cancer; Disrupted hypothalamic-pituitary axis (hypophysectomy, pituitary tumour or surgery, head irradiation) (label); Diabetes or impaired glucose tolerance; Pregnancy (label)

## Top reports

- Glowing, metabolic: “Tesamorelin has completely melted away my midsection fat over the past 12 weeks and I swear by it.” — [r/Peptidesource](https://www.reddit.com/r/Peptidesource/comments/1rmcyjo/tesamorelin_effects/o8yv749/)
- Glowing, metabolic: “Finished my 12 week cycle and had awesome results. My sleep is ridiculous good. I lost 5% visceral fat and had zero complications.” — [r/Biohackers](https://www.reddit.com/r/Biohackers/comments/1rxgb9e/tesamorelin_experience/ob6ystf/)
- Glowing, metabolic, 2 mg at bedtime, 5 on/2 off: “I’m on the same protocol, 2mg at bedtime, 5/2. I’m on Reta also, so after a 6pm dinner I no longer snack. 7 months in, 4 inches off my waist. Love handles and back fat greatly reduced.” — [r/Peptidesource](https://www.reddit.com/r/Peptidesource/comments/1o9pexm/has_anyone_here_used_tesamorelin_longterm_and/nkcakzv/)
- Glowing, metabolic, 2 mg nightly fasted, 5 days a week: “I had a Dexa scan before and after my first cycle of Tesa. I took 2MG a night (fasted), 5 days a week for 3 months. I cut my visceral fat by 42%” — [r/BodyHackGuide](https://www.reddit.com/r/BodyHackGuide/comments/1usa76h/measurable_results_on_tesamorelin/owmi4qx/)
- Positive, sleep, 1 mg at night, fasted: “Biggest thing I’ve noticed is my sleep has improved significantly. I can fall asleep fast without the help of sleep supplements.” — [r/BodyHackGuide](https://www.reddit.com/r/BodyHackGuide/comments/1tndrci/2_weeks_on_tesamorelin_amazing_sleep_but/)

## Cheapest in Europe

- [Europa-Peptide](https://europa-peptide.de/en/shop/tesamorelin/) (PL): Tesamorelin 10mg, €60, €5.99/mg
- [Europa-Peptide](https://europa-peptide.de/en/shop/tesamorelin/) (PL): Tesamorelin 5mg, €33, €6.58/mg
- [Semax Polska](https://semaxpolska.com/en/tesamorelin-10mg/) (PL): Tesamorelin 10 mg + bacteriostatic water 3 ml, €79, €7.94/mg
- [Modern Peptides EU](https://modernpeptides.eu/product/tesamorelin/) (DE): Tesamorelin 10mg, €95, €9.50/mg

## Studies

- [Falutz et al. 2007: metabolic effects of a growth hormone-releasing factor in patients with HIV (NEJM)](https://pubmed.ncbi.nlm.nih.gov/18057338/) (rct, n=412, 2007): 2 mg daily for 26 weeks cut CT-measured visceral fat by 15.2% (placebo +5.0%) and lowered triglycerides, while IGF-1 rose 81%; more tesamorelin patients withdrew for adverse events.
- [Falutz et al. 2010: tesamorelin in HIV patients with excess abdominal fat, pooled phase 3 with 52-week extension](https://pubmed.ncbi.nlm.nih.gov/20554713/) (rct, n=806, 2010): Visceral fat fell 15.4% versus placebo at 26 weeks with no change in subcutaneous fat; the loss held to week 52 on drug, and glucose measures did not differ between groups.
- [Stanley et al. 2014: effect of tesamorelin on visceral fat and liver fat in HIV-infected patients (JAMA)](https://pubmed.ncbi.nlm.nih.gov/25038357/) (rct, n=50, 2014): Six months cut visceral fat (net -42 cm²) and liver fat (net -2.9 percentage points); fasting glucose rose at 2 weeks but was back to placebo levels by 6 months.
- [Stanley et al. 2019: tesamorelin for non-alcoholic fatty liver disease in HIV (Lancet HIV)](https://pubmed.ncbi.nlm.nih.gov/31611038/) (rct, n=61, 2019): One year reduced hepatic fat fraction by 37% relative to baseline, and 35% versus 4% on placebo got below the 5% NAFLD threshold.
- [Makimura et al. 2012: tesamorelin in obese subjects with reduced GH secretion (no HIV)](https://pubmed.ncbi.nlm.nih.gov/23015655/) (rct, n=60, 2012): The only trial outside HIV. A year of 2 mg daily cut visceral fat (net -35 cm²), carotid wall thickness and triglycerides, with no effect on subcutaneous fat, glucose or HbA1c.

## Sources

- [Egrifta WR prescribing information (DailyMed)](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=839334d3-8c1d-4c26-9036-2ab524a6ea75)
- [r/Biohackers: Anaphylaxis after 7 months of tesamorelin](https://www.reddit.com/r/Biohackers/comments/1xehn9e/anaphylaxis_after_7_months_of_tesamorelin_my/)