Tesamorelin is a GHRH analog developed and approved for HIV-associated lipodystrophy — specifically, reduction of visceral adipose tissue (VAT). In self-experimenter circles, it's used off-label for general visceral-fat reduction, anti-aging, and sleep effects. Tracking is unusually clean here because there is a published clinical endpoint (VAT change) and a measurable proxy (waist circumference) that correlates well with it.
What it does
Tesamorelin stimulates pulsatile growth hormone release. Downstream, GH and IGF-1 effects include lipolysis of visceral fat depots. Trial data show meaningful VAT reduction over 26 weeks at standard dosing, with effects plateauing if the protocol is discontinued.
Typical protocol shape
- Frequency: daily SC, usually evening or pre-bed
- Dose: trial standard is 2 mg/day
- Duration: meaningful changes appear at 8–12 weeks; full clinical effect by ~26 weeks
- Cycle length: longer than most peptide protocols — months, not weeks
This is a slow peptide. If you're impatient, you'll quit at week 4 and conclude it doesn't work.
What to track daily
- Dose (yes/no, time)
- Sleep quality (1–10)
- Energy on waking
- Subjective recovery
- Joint pain / fluid retention — common with GH-related peptides
- Glucose if you measure (GH can transiently raise glucose)
What to track weekly
- Waist circumference at the navel — the single most useful proxy for VAT in self-experimenters without DEXA access
- Weight (less informative — VAT loss can occur with stable weight)
- Body photos
- Workout performance
What to test in bloodwork
- IGF-1 — the canonical marker that tesamorelin is engaging the GH axis
- Fasting glucose, HbA1c — important
- Lipids
- Liver enzymes if running long
A baseline before week 1 and follow-ups at weeks 8, 16, 24 give you a real dataset.
What "working" looks like
In trial populations, expected change at 26 weeks:
- Meaningful VAT reduction (often ~15–20% from baseline)
- Modest waist reduction (1–3 cm typical)
- IGF-1 elevation within high-normal range
- Often improved sleep quality and recovery
In a single individual, results vary. What you're looking for: a downtrend in waist circumference over months, paired with an IGF-1 elevation that confirms the protocol is biologically active.
Common mistakes
- Stopping at week 4. This is the most common reason "tesamorelin didn't work" — it was barely getting started.
- Daily weigh-ins instead of weekly waist. Weight is noise for visceral fat; waist is signal.
- No IGF-1 baseline. Without it, an IGF-1 of 240 at week 8 means nothing — was it 240 before?
- Stacking too many things. A clean tesamorelin cycle is one variable. Add cardarine, change diet, and start a new training block, and you'll never know what did what.
A 16-week tracking template
- Week 0: baseline panel + waist + photos.
- Weeks 1–16: daily dose, daily sleep/energy/glucose log, weekly waist + photo.
- Week 8: mid-cycle bloodwork. Note IGF-1, glucose.
- Week 16: end-cycle panel, full photo and waist comparison.
If at week 16 the waist trend is flat and IGF-1 didn't move, the protocol is not working in you — that's real data.
Side-effect notes
- Fluid retention is common in the first month and usually self-resolves
- Joint stiffness in the morning, related to GH effects
- Hyperglycaemia in glucose-sensitive individuals
- Injection site reactions — rotate sites
After the cycle
Tesamorelin effects don't fully persist after stopping. Plan a maintenance protocol before you finish if continuation matters to you — and consult a physician about indefinite-use questions.
Peptide IA is an educational and self-tracking tool. Nothing in this post is medical advice. Doses mentioned reflect what is commonly reported in research literature — they are not recommendations. Always consult a qualified physician before starting, changing, or stopping any protocol.