Growth hormone · FDA-approved reduction of HIV-associated visceral fat (Egrifta)
Tesamorelin
TH9507, Egrifta, trans-3-hexenoyl-GHRH(1-44)-NH2
A GHRH analog. The approved drug is Egrifta: it stimulates pituitary GH to reduce visceral adipose tissue in HIV-associated lipodystrophy. That is not a general fat-loss licence.
- Visceral fat reduction
- GH release
- Metabolic
- Catalog fill
- 10 mg
- Typical water
- 2 mL
- Route
- Subcutaneous, abdomen
- Cycle
- 8–12 weeks, then reassess. Not typically pulsed like Ipamorelin.
- Approval
- FDA-approved as Egrifta for HIV-associated lipodystrophy.
- Status
- Prescription only.
- Evidence
- FDA-approved product with a labelled indication.
- Research score
- 90 / 100
Mechanism
GHRH-receptor binding on somatotrophs, GH then IGF-1, with relatively visceral lipolysis in the labelled population.
Safety file
Injection-site reactions, hypersensitivity, glucose intolerance/diabetes risk, IGF-1 rise (cancer monitoring on the label).
- Injection-site reactions
- Joint pain
- Muscle pain
- Numbness
- Nausea
- Sleep change
Reconstitution
2 mL bacteriostatic water into 10 mg gives 5 mg/mL. A 1 mg amount is 20 units; 2 mg is 40 units.
Research amounts
Once daily, evening, away from food if the protocol requires a fasted window.
| Step | Amount | Frequency | Notes |
|---|---|---|---|
| Lower research amount | 1 mg | Once daily | 20 units from a 2 mL reconstitution |
| Common research amount | 2 mg | Once daily | 40 units |
Storage
- Lyophilized
- −20 °C freezer preferred; a refrigerator is also acceptable. Do not open a cold vial — wait 15–30 minutes so it does not sweat. Avoid freeze–thaw cycling.
- After water
- 2–8 °C, dark, up to 45 days when mixed with bacteriostatic water. Mixed vials stay in their box. Sterile water (no preservative) is single-use.
Worksheet notes
- Sometimes paired with a secretagogue (Ipamorelin) rather than another GHRH analog.
- GHRH analogs are not interchangeable milligram-for-milligram with CJC-1295.
- Bacteriostatic water: 20–25 °C. Do not refrigerate the diluent.
- Amounts on this sheet are reconstitution math for the vial, not a recommendation.
Full protocol
Titration, schedule, and handling
The complete protocol for Tesamorelin. Where it differs from the worksheet amounts above, the worksheet reflects the NovaEvum vial.
Reconstitution
| Vial | 2 mL water | 3 mL water |
|---|---|---|
| 10 mg | 5 mg/mL | 3.33 mg/mL |
| 20 mg | 10 mg/mL | 6.67 mg/mL |
Reconstitutes with standard bacteriostatic water. Add the water slowly down the wall and roll the vial gently between your palms for about 30 seconds until the powder dissolves. It foams easily, so never shake it. If a stubborn lot will not clear with bac water alone, a known workaround is adding about 0.1 mL of acetic acid first, then topping up with bac water to the target volume. Most vials never need this.
- Use bacteriostatic water as the diluent.
- Add the water slowly, letting it run down the inside wall of the vial rather than onto the powder.
- Swirl gently to mix, then leave it to dissolve. Do not shake.
- Give it a few minutes. The finished solution should be clear and colourless.
- Roll the vial gently between your palms for about 30 seconds. Do not shake, since it foams readily.
- A little foaming on mixing is normal. Let it settle for a minute.
- Only if it will not fully dissolve in bac water alone: add about 0.1 mL of acetic acid first, swirl until clear, then add bac water to reach your target volume.
Protocol
Route: Subcutaneous
Standard protocol (subcutaneous)
- 2 mg once daily, injected at night
- This is the studied clinical dose for reducing visceral fat
- Inject on an empty stomach to work with your overnight GH release
Dosing detail
- Standard dose is 2 mg once daily at night. Some run 1 mg daily as a lighter approach.
- Inject on an empty stomach for the cleanest GH pulse.
- Visceral fat reduction is gradual, measured over months, not weeks.
- Mild water retention or joint achiness can appear early and usually settles.
Duration
- Run for at least 3 months given how gradually it works. Many keep it going longer while tracking how they look and feel.
Notes
- A GHRH analogue used mainly for reducing visceral fat.
- Inject subcutaneously and rotate sites.
- Mild water retention or joint achiness can show up early and usually settles.
Storage and handling
- Keep the powdered (lyophilized) vial in a cool, dark place. Refrigerate it for longer-term storage before mixing.
- Once reconstituted and refrigerated at 2–8 °C away from light, use the vial within 90 days.
- Do not freeze a reconstituted vial, and keep it away from heat and sunlight.
- If the solution turns cloudy, develops floating particles, or shows any other sign of degradation, stop using that vial.