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Tesamorelin

Growth hormone-releasing hormone (GHRH) analogue

Also known as TH9507, Egrifta, GHRH analogue

A GHRH analogue approved specifically for HIV-associated lipodystrophy. Frequently cited well outside that indication, on evidence that does not extend there.

Guide updated Sep 2, 2026Literature checked Sep 2, 20262 curated studies38 literature recordsBaseline editorial

Overview

In shortA lab-made copy of the signal that tells your pituitary to release growth hormone, so your own body produces it in a more natural rhythm than injecting growth hormone itself. Approved for one narrow use: reducing deep belly fat in adults with HIV-related fat redistribution. It gets discussed far more widely than that, usually with the approved use quietly dropped.

Tesamorelin is a synthetic analogue of human growth hormone-releasing hormone, stabilised against degradation. It stimulates the pituitary to release growth hormone in a pattern closer to physiological pulsatility than exogenous growth hormone administration.

Its approval is narrow: reduction of excess visceral adipose tissue in adults with HIV-associated lipodystrophy. It appears in general discussion far more broadly than that, usually with the indication quietly dropped, which is a good worked example of the population-transfer error.

Mechanism

In shortIt tells the pituitary to release your own growth hormone, which then raises a second hormone from the liver. Because it acts one step upstream, the body's own brakes on that system still work, which is the argument for why it might be safer than injecting growth hormone directly. Whether that holds over years is not settled.

Tesamorelin binds the GHRH receptor on pituitary somatotrophs, increasing endogenous growth hormone secretion and consequently hepatic IGF-1 production.

Because it acts upstream, negative feedback via somatostatin and IGF-1 remains intact, which is the mechanistic argument for a different safety profile than exogenous growth hormone. Whether that translates into a meaningfully different long-term risk profile is not settled by the available trial durations.

Evidence

In shortSolid for the approved use, thin to absent outside it. In late-stage trials in people with HIV-related fat redistribution, deep belly fat measured on CT scans fell against placebo, and came back after stopping. Small studies on memory and fatty liver are mixed. There is no properly sized evidence for healthy adults using it for body composition or ageing.

Adequate within the approved indication, thin to absent outside it.

Phase III trials in people with HIV-associated lipodystrophy reported statistically significant reductions in visceral adipose tissue measured by CT versus placebo, with effects reversing after discontinuation.

There is separate interest in cognition and in non-alcoholic fatty liver disease with small trials reporting mixed results, and no adequately powered evidence for use in healthy adults for body composition or ageing. The gap between what has been shown and what is claimed is unusually wide for an approved compound.

Safety

In shortJoint pain, swelling, muscle aches and injection site reactions, which is what raising growth hormone would be expected to do. Blood sugar control can get worse. Because the second hormone it raises encourages cells to grow, it is not for anyone with an active cancer. The benefit reverses when you stop.

Reported effects include arthralgia, peripheral oedema, injection site reactions, and myalgia. Broadly the pattern expected from increased GH/IGF-1 signalling.

Glucose intolerance and worsening insulin resistance are the mechanistically expected concerns and have been observed. Because IGF-1 is mitogenic, active malignancy is a contraindication. The reversal of benefit after discontinuation means it functions as continuous therapy.

Regulatory status

In shortApproved in the US and Canada for HIV-related fat redistribution. Not approved anywhere for body composition, sport, memory or anti-ageing use. Anything sold for those purposes is outside any approved route.

Approved in the United States and Canada for HIV-associated lipodystrophy. Not approved for body composition, athletic, cognitive, or anti-ageing use in any major jurisdiction. Material sold for those purposes is outside any approved pathway.

The literature

2 studies indexed. Findings and limitations get equal weight, on purpose.

Always check the primary source

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Everything above is free to read. What an account opens is the evidence underneath it: 2 studies with their limitations, and the regimen each trial actually reported.

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  • The limitations, given the same weight as the findings
  • The dose each named trial administered, where recorded
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The wider literature

16 indexed papers and 22 registered trials mentioning Tesamorelin, straight from PubMed and ClinicalTrials.gov. 22 of 22 administer it; the rest measure it. These have not been read by us. Unlike the studies above, they carry no findings and no limitations written by anyone here, because writing either would mean claiming a reading nobody has done. They are a starting point for yours.

Registered trials (22)

  1. Tesamorelin for Reduction of Liver Fat in Adults With Fatty Liver Disease (Mock Study)

    Hudson Biotech2026NCT07481734

    interventionalphase2recruitingn=120

  2. Tesamorelin as an Adjunct to Exercise for Improving Physical Function in HIV

    Massachusetts General Hospital2025NCT06554717

    interventionalphase2recruitingn=100

  3. Growth Hormone Releasing Hormone Analog to Improve Nonalcoholic Fatty Liver Disease and Associated Cardiovascular Risk

    Massachusetts General Hospital2019NCT03375788

    interventionalphase2completedn=51

  4. Tesamorelin to Improve Functional Outcomes After Peripheral Nerve Injury

    Johns Hopkins University2018NCT03150511

    interventionalphase2recruitingn=36

  5. Body Composition and Adipose Tissue in HIV

    Columbia University2018NCT03226821

    interventionalphase4terminatedn=6

  6. Phase II Trial of Tesamorelin for Cognition in Aging HIV-Infected Persons

    University of California, San Diego2017NCT02572323

    interventionalphase2completedn=73

  7. The Effect of Growth Hormone Releasing Hormone on Cognitive Function in Individuals With Mild Cognitive Impairment

    The University of Texas Medical Branch, Galveston2017NCT02553603

    interventionalphase1completedn=22

  8. Impact of GHRH on Sleep Promotion and Endocrine Regulation in Service Members Who Sustained a Traumatic Brain Injury and Have Current Insomnia

    National Institute of Nursing Research (NINR)2016NCT02931474

    interventionalphase2withdrawnn=0

  9. Tesamorelin Effects on Liver Fat and Histology in HIV

    Massachusetts General Hospital2015NCT02196831

    interventionalnacompletedn=61

  10. Abdominal Obesity, Cardiovascular Inflammation, and Effects of Growth Hormone Releasing Hormone Analogue

    Massachusetts General Hospital2014NCT01632592

    interventionalnawithdrawnn=0

  11. Long-term Observational Study in HIV Subjects Exposed to EGRIFTA®

    Theratechnologies2013NCT01579695

    observationalterminatedn=391

  12. Egrifta Replacement and Sleep Disordered Breathing

    Johns Hopkins University2012NCT01788462

    observationalwithdrawnn=0

  13. Diabetic Retinopathy in HIV Subjects Treated With EGRIFTA®

    Theratechnologies2012NCT01591902

    interventionalphase4terminatedn=129

  14. Efficacy and Safety Study of Tesamorelin in Chronic Obstructive Pulmonary Disease (COPD) Subjects With Muscle Wasting

    Theratechnologies2011NCT01388920

    interventionalphase2terminatedn=3

  15. Effects of Growth Hormone Releasing Hormone in HIV

    Massachusetts General Hospital2010NCT01263717

    interventionalnacompletedn=54

  16. Effect of Short Term Growth Hormone Releasing Hormone in Healthy Men

    Massachusetts General Hospital2009NCT00850564

    interventionalnacompletedn=15

  17. Effectiveness of Growth Hormone Releasing Hormone in Reducing Abdominal Fat in People Who Are Obese

    Massachusetts General Hospital2008NCT00675506

    interventionalphase2completedn=60

  18. Pharmacokinetic and Pharmacodynamic Study of TH9507, a Growth Hormone-Releasing Factor Analog, in HIV Positive Patients

    Theratechnologies2008NCT02012556

    interventionalphase1completedn=18

  19. TH9507 Extension Study in Patients With HIV-Associated Lipodystrophy

    Theratechnologies2007NCT00608023

    interventionalphase3completedn=263

  20. SMART: Somatotrophics, Memory, and Aging Research Trial

    University of Washington2006NCT00257712

    interventionalphase2completedn=151

  21. TH9507 in Patients With HIV-Associated Lipodystrophy

    Theratechnologies2005NCT00123253

    interventionalphase3completedn=412

  22. Safety Study of TH9507 in Subjects With Stable, Type 2 Diabetes

    Theratechnologies2002NCT01264497

    interventionalphase2completedn=55

Papers (16)

  1. Safety and Efficacy of Approved and Unapproved Peptide Therapies for Musculoskeletal Injuries and Athletic Performance.

    Mendias CL, et al.Sports medicine (Auckland, N.Z.)2026PMID 41966639

    journal articlereview

  2. Therapeutic Peptides in Orthopaedics: Applications, Challenges, and Future Directions.

    Rahman OF, et al.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews2026PMID 41490200

    journal articlereview

  3. Injectable Peptide Therapy: A Primer for Orthopaedic and Sports Medicine Physicians.

    Mayfield CK, et al.The American journal of sports medicine2026PMID 41476424

    journal articlereview

  4. Effects of Tesamorelin on Neurocognitive Impairment in Persons With HIV and Abdominal Obesity.

    Ellis RJ, et al.The Journal of infectious diseases2025PMID 39813152

    clinical trial, phase iijournal articlemulticenter studyrandomized controlled trial

  5. Renoprotective effects of GHRH agonist MR409 is associated with reduced oxidative stress and ferroptosis in diabetic mice.

    Liu Y, et al.Frontiers in pharmacology2025PMID 40926987

    journal article

  6. CROI 2024: Neuropsychiatric Complications in People With HIV.

    Corley MJ, et al.Topics in antiviral medicine2024PMID 39746672

    journal articlereview

  7. Efficacy and safety of tesamorelin in people with HIV on integrase inhibitors.

    Russo SC, et al.AIDS (London, England)2024PMID 38905488

    journal articlerandomized controlled trialresearch support, non-u.s. gov'tresearch support, n.i.h., extramural

  8. Approach to the Patient With Lipodystrophy.

    Fourman LT, et al.The Journal of clinical endocrinology and metabolism2022PMID 35137140

    case reportsjournal articleresearch support, n.i.h., extramural

  9. Advances in the detection of growth hormone releasing hormone synthetic analogs.

    Memdouh S, et al.Drug testing and analysis2021PMID 34665524

    journal articlevalidation study

  10. 2016PMID 30920787

    review

  11. 2016PMID 30896905

    review

  12. Growth hormone in the aging male.

    Sattler FRBest practice & research. Clinical endocrinology & metabolism2013PMID 24054930

    journal articleresearch support, n.i.h., extramuralresearch support, u.s. gov't, non-p.h.s.review

  13. Tesamorelin.

    2012PMID 31644039

    review

  14. Tesamorelin.

    Grunfeld C, et al.Nature reviews. Drug discovery2011PMID 21283099

    news

  15. Tesamorelin update.

    O'Neal RBETA : bulletin of experimental treatments for AIDS : a publication of the San Francisco AIDS Foundation2010PMID 21591600

    newspaper articlejournal article

  16. Tesamorelin, a human growth hormone releasing factor analogue.

    Wang Y, et al.Expert opinion on investigational drugs2009PMID 19243281

    journal articlereview

Discussion

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For Research & Educational Discussion Only. Not Medical Advice

This guide is educational reference material compiled from published literature. It is not medical advice, not a recommendation, and not a substitute for a clinician who knows your history. Nothing here should be used to make a decision about your own health without one.

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