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Peptide

Tesamorelin

Tesamorelin is a 44-amino-acid synthetic analog of growth hormone-releasing hormone (GHRH) that is FDA-approved (2010) for reducing excess abdominal fat in HIV-infected patients with lipodystrophy. It stimulates endogenous pulsatile GH secretion from the pituitary gland. Tesamorelin has demonstrated efficacy in reducing visceral adipose tissue, liver fat (NAFLD), and improving cognitive function in clinical trials.

Research notice. This page is for education and research. Peptides may not be FDA-approved for human use and may only be legally available for research. Talk to a qualified clinician before considering any peptide.

Best evidence
Grade A
Conditions studied
4
Outcomes
15
Graded outcomes
6513

Evidence by condition

  • Strong
  • Moderate
  • Limited
  • Very limited

4 conditions, plus general outcomes

Metabolic Health

Metabolic Health: outcomes studied for Tesamorelin
GradeOutcomeEffectSizeStudiesPeopleStudies list
Growth Hormone Release

Tesamorelin stimulates significant increases in endogenous pulsatile GH secretion, with preserved physiological release patterns.

Improves (the measure goes up)Large effect8 studies

Studies that measured growth hormone release

IGF-1 Levels

Treatment produces significant increases in IGF-1 levels, mediating downstream metabolic and cognitive effects.

Changes; see studiesModerate effect8 studies

Studies that measured igf-1 levels

Nonalcoholic Fatty Liver Disease (NAFLD)

Nonalcoholic Fatty Liver Disease (NAFLD): outcomes studied for Tesamorelin
GradeOutcomeEffectSizeStudiesPeopleStudies list
Liver Fat (NAFLD)

A randomized controlled trial showed 37% relative reduction in hepatic fat fraction from baseline, with 35% of tesamorelin patients achieving less than 5% liver fat versus 4% with placebo.

Improves (the measure goes down)Large effect6 studies

Studies that measured liver fat (nafld)

Liver Fibrosis Progression

Liver biopsies showed tesamorelin prevented progression of fibrosis over 12 months, with reductions in liver fat associated with reductions in fibrosis.

Improves (the measure goes down)Moderate effect6 studies

Studies that measured liver fibrosis progression

Body Composition

  • Visceral Adipose Tissue: improves
  • Waist Circumference: improves
Body Composition: outcomes studied for Tesamorelin
GradeOutcomeEffectSizeStudiesPeopleStudies list
Visceral Adipose Tissue

Two Phase 3 clinical trials demonstrated significant reduction in visceral adipose tissue in HIV patients with lipodystrophy, maintained through 52 weeks of treatment.

Improves (the measure goes down)Large effect3 studies

Studies that measured visceral adipose tissue

Waist Circumference

Clinical trials demonstrated significant reductions in waist circumference and trunk fat in patients with HIV-associated lipodystrophy.

Improves (the measure goes down)Moderate effect3 studies

Studies that measured waist circumference

General

  • Hormone Levels: improves
  • Liver Protection: improves
  • Safety/Tolerability: improves
General: outcomes studied for Tesamorelin
GradeOutcomeEffectSizeStudiesPeopleStudies list
Hormone Levels

23 human trials and systematic reviews support this finding. Evidence includes systematic reviews/meta-analyses. Human clinical trial data available.

Improves (the measure goes up)Moderate effect11 studies

Studies that measured hormone levels

and 1 more in the citations list

Liver Protection

11 human trials and systematic reviews support this finding. Evidence includes systematic reviews/meta-analyses. Human clinical trial data available.

Improves (the measure goes up)Moderate effect11 studies

Studies that measured liver protection

and 1 more in the citations list

Safety/Tolerability

9 human trials and systematic reviews support this finding. Evidence includes systematic reviews/meta-analyses. Human clinical trial data available.

Improves (the measure goes up)Moderate effect10 studies

Studies that measured safety/tolerability

Immune Function

4 human trials support this finding. Human clinical trial data available.

Improves (the measure goes up)Small effect5 studies

Studies that measured immune function

Blood Glucose Control

2 human trials support this finding. Human clinical trial data available.

Improves (the measure goes down)Small effect3 studies

Studies that measured blood glucose control

Body Weight

2 human trials support this finding. Human clinical trial data available.

Improves (the measure goes down)Small effect3 studies
Lipid Profile

2 systematic reviews and preclinical studies support this finding. Evidence includes systematic reviews/meta-analyses. Primarily preclinical evidence.

Improves (the measure goes down)Small effect3 studies

Cognitive Function

  • Executive Function: improves
  • Cognitive Function in MCI: improves
Cognitive Function: outcomes studied for Tesamorelin
GradeOutcomeEffectSizeStudiesPeopleStudies list
Executive Function

A 20-week RCT showed tesamorelin improved executive function (P=0.005) as measured by Task Switching, Stroop Color-Word Interference, Self-Ordered Pointing Test, and Word Fluency.

Improves (the measure goes up)Moderate effect6 studies

Studies that measured executive function

Cognitive Function in MCI

Treatment attenuated the expected functional decline in individuals with mild cognitive impairment and improved cognitive function in healthy older adults.

Improves (the measure goes up)Small effect6 studies

Studies that measured cognitive function in mci

Key findings

  • Growth Hormone ReleaseMetabolic HealthImproves (the measure goes up)
  • IGF-1 LevelsMetabolic HealthChanges; see studies
  • Liver Fat (NAFLD)Nonalcoholic Fatty Liver Disease (NAFLD)Improves (the measure goes down)

Studies cited

43 studies from PubMed

  1. Body composition, hepatic fat, metabolic, and safety outcomes of Tesamorelin, a GHRH analogue, in HIV-associated lipodystrophy: A meta-analysis of randomized controlled trials.Obesity research & clinical practice, 2026 · PMID 41545261
  2. Effects of Tesamorelin on Neurocognitive Impairment in Persons With HIV and Abdominal ObesityJ Acquir Immune Defic Syndr, 2025 · PMID 39813152
  3. Metabolic dysfunction-associated steatotic liver disease in people with HIV.Current opinion in HIV and AIDS, 2025 · PMID 40397552
  4. Efficacy and safety of tesamorelin in people with HIV on integrase inhibitors.AIDS (London, England), 2024 · PMID 38905488
  5. Causes and outcomes of hepatic fibrosis in persons living with HIV.Current opinion in HIV and AIDS, 2022 · PMID 36165079
  6. Clinical Predictors of Liver Fibrosis Presence and Progression in Human Immunodeficiency Virus-Associated Nonalcoholic Fatty Liver Disease.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021 · PMID 32270862
  7. Growth Hormone Releasing Hormone Reduces Circulating Markers of Immune Activation in Parallel with Effects on Hepatic Immune Pathways in Individuals with HIV-infection and Nonalcoholic Fatty Liver Disease.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021 · PMID 33852720
  8. Non-Alcoholic Steatohepatitis (NASH) - A Review of a Crowded Clinical Landscape, Driven by a Complex Disease.Drug design, development and therapy, 2021 · PMID 34588764
  9. Effects of tesamorelin on hepatic transcriptomic signatures in HIV-associated NAFLDJCI Insight, 2020 · PMID 32539271
  10. Effects of tesamorelin on hepatic transcriptomic signatures in HIV-associated NAFLD.JCI insight, 2020 · PMID 32701508
  11. Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trialLancet HIV, 2019 · PMID 31611038
  12. Tesamorelin, liver fat, and NAFLD in the setting of HIV.The lancet. HIV, 2019 · PMID 31611037
  13. Safety and metabolic effects of tesamorelin, a growth hormone-releasing factor analogue, in patients with type 2 diabetes: A randomized, placebo-controlled trial.PloS one, 2017 · PMID 28617838
  14. Growth hormone deficiency and human immunodeficiency virus.Best practice & research. Clinical endocrinology & metabolism, 2017 · PMID 28477736
  15. Visceral fat reduction with tesamorelin is associated with improved liver enzymes in HIV.AIDS (London, England), 2017 · PMID 28832410
  16. Fibroblast growth factor 21 decreases after liver fat reduction via growth hormone augmentation.Growth hormone & IGF research : official journal of the Growth Hormone Research Society and the International IGF Research Society, 2017 · PMID 29031905
  17. Cardiovascular risk and dyslipidemia among persons living with HIV: a review.BMC infectious diseases, 2017 · PMID 28793863
  18. Treatment of dyslipidemia in HIV.Current atherosclerosis reports, 2015 · PMID 25702057
  19. Effect of tesamorelin on visceral fat and liver fat in HIV-infected patients with abdominal fat accumulation: a randomized clinical trialJAMA, 2014 · PMID 24911133
  20. Effect of tesamorelin on visceral fat and liver fat in HIV-infected patients with abdominal fat accumulation: a randomized clinical trial.JAMA, 2014 · PMID 25038357
  21. Effects of growth hormone-releasing hormone on cognitive function in adults with mild cognitive impairment and healthy older adults: results of a controlled trialArch Neurol, 2012 · PMID 22869065
  22. Neuroendocrinology: Tesamorelin can improve cognitive functionNat Rev Endocrinol, 2012 · PMID 22926095
  23. Tesamorelin: a growth hormone-releasing factor analogue for HIV-associated lipodystrophyDrugs, 2011 · PMID 22298602
  24. Growth hormone and tesamorelin in the management of HIV-associated lipodystrophyHIV AIDS (Auckl), 2011 · PMID 22096409
  25. Spotlight on tesamorelin in HIV-associated lipodystrophyBioDrugs, 2011 · PMID 22050344
  26. Effects of tesamorelin on inflammatory markers in HIV patients with excess abdominal fatJ Clin Endocrinol Metab, 2011 · PMID 21471524
  27. Effects of a growth hormone-releasing hormone analog on endogenous GH pulsatility and insulin sensitivity in healthy men.The Journal of clinical endocrinology and metabolism, 2011 · PMID 20943777
  28. Growth hormone axis treatments for HIV-associated lipodystrophy: a systematic review of placebo-controlled trials.HIV medicine, 2011 · PMID 21265979
  29. Effects of tesamorelin on inflammatory markers in HIV patients with excess abdominal fat: relationship with visceral adipose reduction.AIDS (London, England), 2011 · PMID 21516030
  30. Tesamorelin: a novel therapeutic option for HIV/HAART-associated increased visceral adipose tissue.Drugs of today (Barcelona, Spain : 1998), 2011 · PMID 21695284
  31. Tesamorelin: a review of its use in the management of HIV-associated lipodystrophy.Drugs, 2011 · PMID 21668043
  32. Effects of tesamorelin, a growth hormone-releasing factor, in HIV-infected patients with abdominal fat accumulation: a randomized placebo-controlled trial with a safety extension.Journal of acquired immune deficiency syndromes (1999), 2010 · PMID 20101189
  33. Effects of tesamorelin (TH9507), a growth hormone-releasing factor analog, in human immunodeficiency virus-infected patients with excess abdominal fat: a pooled analysis of two multicenter, double-blind placebo-controlled phase 3 trials with safety extension data.The Journal of clinical endocrinology and metabolism, 2010 · PMID 20554713
  34. Tesamorelin, a human growth hormone releasing factor analogue.Expert opinion on investigational drugs, 2009 · PMID 19243281
  35. Effects of a growth hormone-releasing factor analog on abdominal visceral fat in HIV-infected patients with fat redistributionAIDS, 2008 · PMID 18784331
  36. Long-term safety and effects of tesamorelin, a growth hormone-releasing factor analogue, in HIV patients with abdominal fat accumulation.AIDS (London, England), 2008 · PMID 18690162
  37. Tesamorelin for fat accumulation. 52-week effects and safety of tesamorelin (growth hormone releasing factor) in HIV patients with fat accumulation.Positively aware : the monthly journal of the Test Positive Aware Network, 2008 · PMID 18724445
  38. The next generation of human growth hormone. How Serostim and tesamorelin measure up.Positively aware : the monthly journal of the Test Positive Aware Network, 2008 · PMID 18828236
  39. Side effects and complications. Clinical trials of tesamorelin in Canada.TreatmentUpdate, 2007 · PMID 17571443
  40. Side effects and complications. Tesamorelin--results from Phase III.TreatmentUpdate, 2007 · PMID 17575575
  41. Metabolic effects of a growth hormone-releasing factor in patients with HIV.The New England journal of medicine, 2007 · PMID 18057338
  42. Manipulation of the growth hormone axis in patients with HIV infection.The New England journal of medicine, 2007 · PMID 18057344
  43. Drug evaluation: tesamorelin, a synthetic human growth hormone releasing factorIDrugs, 2006 · PMID 17086939