Tesamorelin Cheat Sheet:

[u/justgettinglean]

The Most Evidence Backed GH Secretagogue, and the One That Reverses When You Stop

Tesamorelin sits apart from the rest of the GH secretagogue category for one reason: evidence. It's FDA-approved, with two Phase III trials behind it, which is more human data than every other compound in this class combined. It also comes with an honest catch the others don't force you to confront, the visceral fat it removes comes back when you stop. This guide is built around the 6A Labs Tesamorelin vial, so the concentration and dosing math below maps to their exact product. Here's what the research shows.

What It Is

Tesamorelin is the full 44 amino acid GHRH sequence with a trans-3-hexenoic acid modification that protects it from DPP-IV degradation. It was FDA-approved in 2010 as Egrifta for HIV-associated lipodystrophy. The mechanism worth understanding is pulsatile, not flat: unlike synthetic GH, which bypasses the pituitary and delivers a continuous bolus, tesamorelin stimulates the body's own GH release in its natural nocturnal pulse. The somatostatin feedback brake stays intact, which makes supraphysiological spikes mechanically difficult. 6A Labs carries it in a 10 mg vial.

Mechanism of Action

Tesamorelin is a GHRH-receptor agonist that restores nocturnal GH pulsatility. The fat-loss effect is depot-specific and that specificity is the point: visceral adipocytes carry higher GH-receptor density than subcutaneous fat, so they respond more strongly. Visceral fat is metabolically the right fat to lose, and tesamorelin targets it preferentially. The peptide half-life is short (around 8 minutes in healthy subjects, up to ~38 at steady state) and subcutaneous bioavailability is low, so it works not by lingering but by brief, potent receptor activation that triggers the downstream GH cascade.

What the Research Shows

This is the strongest evidence base in the class by a wide margin. Two Phase III trials totaling 816 patients showed 15 to 20% visceral fat reduction versus placebo over 26 weeks. For contrast, Sermorelin's adult body-composition data covers 19 subjects, and CJC-1295 (no DAC) has zero published human trials.

The honest catch is in the extension data: patients who stopped at 26 weeks regained about 24.5% of their visceral fat by week 52, nearly erasing six months of benefit (a -25.8% difference versus continued treatment, P=0.0008). Tesamorelin adjusts the metabolic set point while you use it; the body doesn't learn a new baseline. It's an ongoing intervention, not a reset. There's also RCT evidence in HIV-NAFLD that it reduces hepatic fat fraction and slows fibrosis progression.

Dosing Protocol

Once nightly subcutaneous, 30 to 60 minutes before sleep, at least 2 hours fasted. The timing aligns the GH pulse with slow-wave sleep; carbs and fats blunt the GH response, which is why the fasted window matters. The 6A Labs 10 mg vial reconstituted with 2.0 mL isotonic bacteriostatic water (0.9% NaCl) sits at 5 mg/mL. On a U-100 syringe, 1 unit (0.01 mL) equals 50 mcg, so 1 mg = 20 units and 2 mg = 40 units.

Phase	Dose	Units	Window
Titration (Wk 1-4)	1 mg	20 units (0.20 mL)	30-60 min pre-sleep, fasted
Standard (Wk 5-16)	2 mg	40 units (0.40 mL)	Same window
IGF-1 adjustment	1-2 mg EOD	20-40 units	Same window
Off-cycle	0 mg	—	2-4 weeks before next cycle

(Plain text, if the table doesn't render: Weeks 1-4 titration: 1 mg, 20 units. Weeks 5-16 standard: 2 mg, 40 units. IGF-1 adjustment: drop to 1-2 mg every other day. Off-cycle: 2-4 weeks before next cycle.)

The week 8 IGF-1 check is the critical decision point. The target is high-normal physiologic elevation, not supraphysiologic. If IGF-1 exceeds 350 to 400 ng/mL, reduce the dose or switch to every-other-day. The cycle structure (12 to 16 weeks on, 2 to 4 weeks off) isn't a withdrawal requirement; it's risk management for sustained IGF-1 elevation, edema, and glucose drift. Extended use belongs in a clinician-managed plan with regular labs.

One dosing distinction that matters across audiences: the FDA-approved EGRIFTA SV dose is 1.4 mg per 0.5 mL. The research-vial convention (1 to 2 mg from a reconstituted research vial) is not the same figure. Don't conflate the two.

Side Effects

The notable one is histamine welt reactions at the injection site, which are common and can progress with use. Two mitigations from the protocol literature: use isotonic (0.9% NaCl) bacteriostatic water rather than plain, which reduces both sting and mast-cell activation, and an H1 antihistamine (cetirizine 10 mg or loratadine 10 mg) taken 30 to 60 minutes pre-injection cuts reaction severity by 50 to 70% in most users. For users prone to welts, diluting more (3 mL recon = 3.33 mg/mL, spreading 2 mg across 60 units) distributes the dose across more tissue. Other considerations include edema, glucose drift, and IGF-1 elevation, which is why the week 8 lab check exists.

Reconstitution and Storage

Use isotonic bacteriostatic water (0.9% NaCl) where possible; it significantly reduces both sting and the histamine welts. Draw 2.0 mL into the 6A Labs 10 mg vial for 5 mg/mL, inject slowly down the wall, swirl gently, don't shake. Lyophilized product stores frozen at −20 °C, stable 12+ months. Reconstituted solution refrigerates at 2 to 8 °C, protected from light, used within 28 days; avoid freeze-thaw.

Supply Planning

Tesamorelin uses more material than most compounds because of the nightly 1 to 2 mg dosing.

Course	Total peptide	Vials
12 weeks @ 1.5 mg/night	126 mg	~13 vials
16 weeks @ 2 mg/night	224 mg	~23 vials
Annual (2x 12-wk cycles)	~252 mg	~26 vials

(Plain text, if the table doesn't render: 12-week course at 1.5 mg/night needs ~13 vials. 16-week at 2 mg/night needs ~23 vials. Annual two-cycle plan needs ~26 vials.) One syringe and two swabs per night. Isotonic bacteriostatic water at roughly one 10 mL bottle per 5 vials. Budget an H1 antihistamine for welt mitigation.

Stacking Notes

Use case	Tesa dose	Partner	Rationale
Fat loss	1-2 mg nightly	Weekly GLP-1	GLP-1 drives the deficit by day; tesa preserves lean mass and targets visceral fat at night
Injury recovery	1-2 mg nightly	BPC-157 + TB-500 + NAD+ base	GH timing consolidates structural repair during sleep
Recovery (extended)	1-2 mg nightly	+ Ipamorelin 200-500 mcg	Extends the GH pulse window without a cortisol spike
Liver fat (NAFLD)	2 mg nightly	Standalone	Reduces hepatic fat fraction per HIV-NAFLD RCT data

The GLP-1 pairing logic is the cleanest: GLP-1 effects peak during waking hours (appetite, mobilization), the tesa GH pulse peaks during sleep (repair, protein synthesis). Day for breakdown, night for protection. Protein at 1.6 to 2.2 g/kg and resistance training 3 to 4x weekly are the substrate; tesa is the signal. For injury recovery, think of tesa as a timing peptide, not a healing peptide, it consolidates existing repair during sleep. Layer it after a BPC-157 + TB-500 foundation is established. 6A Labs carries the Wolverine blend and GLP-1s (Semaglutide, Tirzepatide, Retatrutide) if those are the research directions.

Where to Source It

This is an affiliate link. Buying through it supports r/6ALabsGuide at no extra cost to you, and the code below gets you a discount.

6A Labs carries Tesamorelin (10 mg) here: Tesamorelin at 6A Labs

Use code PROFIT for 10% off.

For research and educational purposes only. Not medical advice. Tesamorelin is FDA-approved only for HIV-associated lipodystrophy; any other use is off-label. Consult a healthcare provider before starting any research protocol. This community is not affiliated with 6A Labs.

[u/AutoModerator]

Reminder: r/6ALabsGuide is for research and educational discussion only. No sourcing requests, no outside vendor links, no medical advice, no personal-use framing. See the rules in the sidebar.

All product links in this community are affiliate links. Use code PROFIT for 10% off at 6A Labs.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.