Tesamorelin

Tesamorelin is a synthetic GHRH analogue with a trans-3-hexenoic acid modification at the N-terminus, which enhances stability against dipeptidyl peptidase IV (DPP-IV) degradation while preserving GHRH receptor binding. It stimulates endogenous GH secretion with preserved physiological pulsatility — a key distinction from exogenous GH administration, which suppresses the HPG axis feedback.

FDA approval: Tesamorelin (Egrifta) approved for HIV-associated lipodystrophy — significant visceral fat reduction in controlled trials.

VAT: ~15–18% reduction in visceral fat observed over 26 weeks in clinical research.

Cognitive: Emerging research on GHRH/GH axis and working memory function in older adults.

Lipid effects: Improvements in triglycerides and trunk fat distribution observed in multiple studies.

HPG preservation: Does not suppress the hypothalamic-pituitary-GH axis feedback, unlike exogenous GH.