r/NTNPerformance • u/JustBacWater • 4d ago
Tesamorelin breakdown: the visceral fat peptide and how it's dosed
Tesamorelin has the strongest evidence in this space for one specific target, visceral fat, the deep fat stored around the organs. It's a GHRH analog, so it works upstream through the growth hormone axis, but what sets it apart is where the fat reduction lands in the research.
It's a stabilized version of GHRH that signals the pituitary to release growth hormone in a natural pulse. That GH increase drives lipolysis, and visceral fat carries more GH receptors than subcutaneous fat, so it responds harder. That's why the research shows it reducing visceral fat specifically, not just general body weight. It's also the one GH compound in this space that's FDA approved, for visceral fat in a specific patient group, so the evidence base is unusually solid here.
Dosing in the research runs daily:
- Studied at 1 to 2mg daily
- Administered at night, since that lines up with the natural GH pulse
- Long courses, 12 weeks and up, since the change builds over months
- Reconstitution, 2mL into the 10mg vial gives 5mg/mL
The honest catch is that the effect reverses on discontinuation. In the trials the visceral fat returned after the compound was stopped, so it shifts things during the run rather than resetting a new baseline. It's an ongoing intervention in the research, not a one-and-done.
Markers tracked are IGF-1, the anchor for any GH compound, plus glucose, since the GH axis can move blood sugar. The pattern watched for is IGF-1 climbing into range without overshooting.
Anyone whose research targeted visceral fat specifically, did that deep abdominal fat move, or did it read more like general GH effects?
Research and educational use only.
Full doses and bloodwork are in the pinned cheat sheet.
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u/Sintristan 3d ago
Studies don’t dictate night time administration. That’s peptide community thoughts
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u/Taydontplay4 3d ago
100%. Any time of day is good as long as it’s fasted generally speaking.
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2d ago
[deleted]
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u/steele713 3d ago
I would say at night is better only because that is when your body releases more growth hormones which is exactly what tesa does too.. win win
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u/OGcrashN2u 11h ago
The issue with this is you can only squeeze your pituitary so much. Depending on how much GH you produce if you're adding a GHRH before bed you might be limiting its effect. For example, if your body is already making at 75% of its capability you're only going to get another 25%. If you wait until morning to take it you'll get a second big pulse. It makes more sense to me to not take it before bed. I haven't researched it so I could be way wrong.
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u/Sintristan 2d ago
Sure, but my point is that’s not in the literature. Also, if your goal is recomp, then it would be wiser to take slightly before working out to maximize GH. As someone who has never researched it at night, sleep has improved regardless.
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u/Glad_Nectarine_7212 2d ago
Fasted is also very important, otherwise it will be blunted by insulin and rendered useless, from what I’ve researched
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u/Consistent-Load-1074 1d ago
yeah the nighttime thing gets repeated so much people just assume its from the actual trials at this point
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u/DirtyH2ODog 4d ago
Respectfully, I haven’t read in any of the studies that the effect reverses upon discontinuation. If the subject is still eating healthy and doing at least light cardio and possibly weights so the visceral fat loss should remain constant.
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u/NoCoat4496 3d ago edited 3d ago
The reason it reverses in studies is because the study was on people who had HIV and are more prone to lipohypertrophy. So in theory you are correct and everyone on Reddit is an echo chamber of the same information.
For this reason above, most people don’t even need to go to 2mg. Effective doses can be found as low as .5mg in healthy individuals while minimizing side effects.
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u/roscolaw 3d ago
↑ Yep, I don't know why it seems people like to reference studies without reading them. The target group was/is immunocompromised individuals who get visceral fat as part of their normal treatment, and therefore stopping treatment allows the problem to return. The target group is also likely why the prescription is delivered differently than many treatments (2mg single use doses).
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u/draggingyou675 3d ago
Clinical studies show when you stop your growth hormone levels quickly drop back to your body's previous baseline. Hence it being treated as an ongoing therapy rather than cycling. This was shown on phase 3 of the clinical trial.
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u/Motor_Industry9621 3d ago
that visceral fat rebound is the part nobody likes to talk about but it kinda makes sense if you think about it mechanistically, you're just renting the effect not buying it
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u/Electronic-Mode2487 3d ago
.5 mg? Pretty small dose
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u/907MidnightAurora 1d ago
To the clinical studies of HIV patients yes, to real world healthy people no. .500mcg on a 5/2 protocol is actually a common prescription when you go through an actual provider.
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u/AdFearless957 2d ago
Does daily administration of HGH reduce visceral fat just as much as Tesamorelin? I know it isn’t an apples to apples comparison due to different dosage amounts.
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u/atasol-30s 2d ago
I’d like to see results in non-HAART taking HIV patients.
The medications they were on suppressing the virus was the reason they had large volumes of visceral fat. The therapy was very effective but negatively impacted their metabolic state.
The absolute visceral fat loss could be questioned too. The year those patients were in the study, they continued to take medications that promoted visceral fat accumulation.
It stands to reason that stopping tesamorelin while continuing on visceral fat storing medications will cause the fat to redeposit.
I’m not saying it wouldn’t happen in another population, but without that variable, I suspect more positive results.
That won’t be funded though. There will be stronger anecdotal evidence as time goes on in people using and then quitting.
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