Tesamorelin Added to Reta

[bogardbilla]

UpDownLeftRightAS* said:

bogardbilla said:

UpDownLeftRightAS* said:

GeraltRedhammer said:

The standard dosing for tesamorelin is 2 mg taken at night, and you should wait 2–3 hours after your final meal of the day. Research showed that using 1 mg was notably weaker. Combining tesamorelin with ipamorelin creates a synergistic effect that boosts how well it works, and that's the approach I use for dosing.

Because tesamorelin carries a high price tag, I'm considering switching to CJC (without DAC) plus Ipamorelin for my next round – from what I understand, they function through the same mechanism.

Egrifta used to follow that approach, but the tesamorelin dosing information has since been revised....1.28mg appears to be the optimal amount. https://www.egriftawr.com/about-egrifta-wr


https://www.perplexity.ai/search/egrifta-tesamorelin-1mg-dosage-47os1pwURmSeZy0aBx.lxA

That said, Egrifta WR isn't the same compound, which explains the lower dose. Per your Perplexity source:

• 1.28 mg Egrifta WR is not meant to be “weaker” in a clinical sense. It is a different formulation designed to match exposure from the older 2 mg product.
  
• The original efficacy data for tesamorelin came from the 2 mg daily dose, which reduced visceral fat in the pivotal studies cited in the prescribing information.
  
• Because the newer formulation was approved on the basis of bioequivalence/comparable exposure, the expected fat-loss benefit is considered similar, assuming it’s used as labeled.

Click to expand...

I'm with you 100% on this, nice catch! Perplexity is a favorite of mine too! But the medication itself and how much actually gets absorbed doesn't change, right? When you strip it down, it's still tesamorelin mg's and its bioavailability we're discussing. Sounds like I need to do some more reading and connect this more clearly to the standard 10mg kits I've already bought.... (purely anecdotal, but resistance training plus a stretch of 1mg daily w/ Tesa gave me solid results)

That matches my understanding: 2mg of the original Egrifta and 1.28mg of Egrifta WR deliver an equivalent quantity of Tesamorelin that the body absorbs.

 

[RadicalCrimson]

FWIW, titration isn't part of Tesa protocols, though it is for Isa, so I'm applying it to both:

• 100/1000 for 0.5 weeks
  
• 133/1000 for 0.5 weeks
  
• 200/1500 for 2 weeks
  
• After that 266/2000. 300/2000 is a possibility.

Somewhere, @Calm Logic shared a Gemini response that brought up titration as a way to reduce Tesa side effects.

On top of that, I've got a glucose monitor on, and for some reason my glucose keeps dropping lower and lower, so insulin resistance apparently isn't an issue, lol.

Right now I'm in the 1500 stage.

 

[RadicalCrimson]

According to the FDA approval document I shared earlier:

• When fasting glucose hits 110, the options are returning to 1mg or moving to 2mg taken every 2 days
  
• Should IGF-1 hit 3 standard deviations (+3.0 Z-score?), stop completely.

 

[RadicalCrimson]

Derbyshire said:

Hello everyone, I'm finding myself uncertain about this. After doing quite a bit of reading, I keep concluding that Tesa doesn't justify the risk compared with the benefits. From what I gather, Tesa can reduce fat and at a decent percentage, yet that fat sits beneath the stomach muscles rather than in the mid-section "tyre". Reta is said to handle that area very well, but Tesa's effects can also rebound fast when things like diet, sleep, and hormones remain unchanged. Tesa comes up often and gets promoted by posters as a belly fat aid, but the link below along with other studies show it targets organ fat more than the usual fat above the abs.

https://img.thebody.com/pinf/2010/tesamorelin.pdf

Right, Subcutaneous Adipose Tissue (SAT) went up marginally (+2%), yet subjects at a 27 BMI (near my own) experienced a 1.4kg (3 pounds) drop in fat (largely trunk), plus a 1.7kg (almost 4 pounds) gain in lean mass, for a total delta of 3.1kg.

Put differently, the muscle they put on outweighed the fat they shed.

Numbers for obese individuals would likely look even stronger.

Count me in.

 

[RadicalCrimson]

Keep in mind that this Phase 2 trial ran for just 12 weeks.

As for the Phase 3 trials, those lasted 52 weeks, though at the 26-week mark they pulled the nasty switcheroo with placebo (the placebo group switches to Tesa, half of the Tesa group switches to placebo, and the remaining half is the fortunate one that receives the full year).

The results from that extension are shown by the green line (T-T):

Should you discontinue Tesa at the 6-month point, you become the blue line (T-P).


Summary of Extension Phases of LIPO-010 and CTR-1011 - Clinical Review Report: Tesamorelin (Egrifta) - NCBI Bookshelf

 

[RadicalCrimson]

Keep in mind that every one of these participants is HIV-positive and has been on HIV treatment for years, and they kept using that treatment even after stopping TESA.

As far as I know, no official account has been given for why HIV medication leads to additional VAT.

Likely because no one enrolled in the trial that swapped those people over to placebo

 

[Derbyshire]

Appreciate the info. That Blue line is what concerns me the most. That said, if those individuals continued their HIV treatment—which is thought to be what drives the additional VAT—then a reversal seems very probable. It would be worth checking in people not on HIV meds to find out how that blue line would behave in that case. Based on what folks report about Tesa and the outcomes they achieve, does it look like Tesa should be chosen over CJC-1295 without DAC + IPA?

 

[UpDownLeftRightAS*]

It strikes me as somewhat odd, as a side note, that this medication remains in production with a new 2025 formulation (beyond off-label usage), considering that the HIV treatments most linked to fat redistribution are especially the early protease inhibitors going back to the late ’80s and early ’90s.

Considering the experiences of patients in that period, frequently depending on experimental therapies carrying major side effects, it really highlights the progress science has made.

Based on what I’ve observed, among them certain summaries from Perplexity, current treatments are generally linked more to slight overall weight gain instead of the marked fat redistribution patterns tied to older regimens.

https://www.perplexity.ai/search/do-modern-hiv-drugs-still-caus-EYVrnphfRjqY.7n8AJjKXQ

 

[Quatroskin]

RadicalCrimson said:

Derbyshire said:

Hello everyone, I'm finding myself uncertain about this. After doing quite a bit of reading, I keep concluding that Tesa doesn't justify the risk compared with the benefits. From what I gather, Tesa can reduce fat and at a decent percentage, yet that fat sits beneath the stomach muscles rather than in the mid-section "tyre". Reta is said to handle that area very well, but Tesa's effects can also rebound fast when things like diet, sleep, and hormones remain unchanged. Tesa comes up often and gets promoted by posters as a belly fat aid, but the link below along with other studies show it targets organ fat more than the usual fat above the abs.

https://img.thebody.com/pinf/2010/tesamorelin.pdf

Right, Subcutaneous Adipose Tissue (SAT) went up marginally (+2%), yet subjects at a 27 BMI (near my own) experienced a 1.4kg (3 pounds) drop in fat (largely trunk), plus a 1.7kg (almost 4 pounds) gain in lean mass, for a total delta of 3.1kg.

Put differently, the muscle they put on outweighed the fat they shed.

Numbers for obese individuals would likely look even stronger.

Count me in.

How did you begin dosing, and what was the schedule — 5 days on with 2 days off, or daily?

 

[RadicalCrimson]

Quatroskin said:

RadicalCrimson said:

Derbyshire said:

Hello everyone, I'm finding myself uncertain about this. After doing quite a bit of reading, I keep concluding that Tesa doesn't justify the risk compared with the benefits. From what I gather, Tesa can reduce fat and at a decent percentage, yet that fat sits beneath the stomach muscles rather than in the mid-section "tyre". Reta is said to handle that area very well, but Tesa's effects can also rebound fast when things like diet, sleep, and hormones remain unchanged. Tesa comes up often and gets promoted by posters as a belly fat aid, but the link below along with other studies show it targets organ fat more than the usual fat above the abs.

https://img.thebody.com/pinf/2010/tesamorelin.pdf

Right, Subcutaneous Adipose Tissue (SAT) went up marginally (+2%), yet subjects at a 27 BMI (near my own) experienced a 1.4kg (3 pounds) drop in fat (largely trunk), plus a 1.7kg (almost 4 pounds) gain in lean mass, for a total delta of 3.1kg.

Put differently, the muscle they put on outweighed the fat they shed.

Numbers for obese individuals would likely look even stronger.

Count me in.

How did you begin dosing, and what was the schedule — 5 days on with 2 days off, or daily?

Look at what I wrote earlier — it's been just 2 weeks since I began. I take it daily.

 

[reyqaz]

RadicalCrimson said:

Quatroskin said:

RadicalCrimson said:

Derbyshire said:

Hello everyone, I'm finding myself uncertain about this. After doing quite a bit of reading, I keep concluding that Tesa doesn't justify the risk compared with the benefits. From what I gather, Tesa can reduce fat and at a decent percentage, yet that fat sits beneath the stomach muscles rather than in the mid-section "tyre". Reta is said to handle that area very well, but Tesa's effects can also rebound fast when things like diet, sleep, and hormones remain unchanged. Tesa comes up often and gets promoted by posters as a belly fat aid, but the link below along with other studies show it targets organ fat more than the usual fat above the abs.

https://img.thebody.com/pinf/2010/tesamorelin.pdf

Right, Subcutaneous Adipose Tissue (SAT) went up marginally (+2%), yet subjects at a 27 BMI (near my own) experienced a 1.4kg (3 pounds) drop in fat (largely trunk), plus a 1.7kg (almost 4 pounds) gain in lean mass, for a total delta of 3.1kg.

Put differently, the muscle they put on outweighed the fat they shed.

Numbers for obese individuals would likely look even stronger.

Count me in.

How did you begin dosing, and what was the schedule — 5 days on with 2 days off, or daily?

Look at what I wrote earlier — it's been just 2 weeks since I began. I take it daily.

I take it daily too. Do I really need 2 days off?

 

[bogardbilla]

reyqaz said:

RadicalCrimson said:

Quatroskin said:

RadicalCrimson said:

Derbyshire said:

Hello everyone, I'm finding myself uncertain about this. After doing quite a bit of reading, I keep concluding that Tesa doesn't justify the risk compared with the benefits. From what I gather, Tesa can reduce fat and at a decent percentage, yet that fat sits beneath the stomach muscles rather than in the mid-section "tyre". Reta is said to handle that area very well, but Tesa's effects can also rebound fast when things like diet, sleep, and hormones remain unchanged. Tesa comes up often and gets promoted by posters as a belly fat aid, but the link below along with other studies show it targets organ fat more than the usual fat above the abs.

https://img.thebody.com/pinf/2010/tesamorelin.pdf

Right, Subcutaneous Adipose Tissue (SAT) went up marginally (+2%), yet subjects at a 27 BMI (near my own) experienced a 1.4kg (3 pounds) drop in fat (largely trunk), plus a 1.7kg (almost 4 pounds) gain in lean mass, for a total delta of 3.1kg.

Put differently, the muscle they put on outweighed the fat they shed.

Numbers for obese individuals would likely look even stronger.

Count me in.

How did you begin dosing, and what was the schedule — 5 days on with 2 days off, or daily?

Look at what I wrote earlier — it's been just 2 weeks since I began. I take it daily.

I take it daily too. Do I really need 2 days off?

That is false.

 

[Rickcaps]

Zydeceltico said:

jmon1977 said:

Zydeceltico said:

GeraltRedhammer said:

The standard dosing for tesamorelin is 2 mg taken at night, and you should wait 2–3 hours after your final meal of the day. Research showed that using 1 mg was notably weaker. Combining tesamorelin with ipamorelin creates a synergistic effect that boosts how well it works, and that's the approach I use for dosing.

Because tesamorelin carries a high price tag, I'm considering switching to CJC (without DAC) plus Ipamorelin for my next round – from what I understand, they function through the same mechanism.

Since tesamorelin is aimed at visceral fat in particular, swapping CJC in for tesa won't deliver the same outcome. My own stack consists of tirz, tesamorelin, CJC (No DAC), and Ipamorelin, and the results have been very, very positive. ymmv.........and the very best results - in my case - have come from using that stack as a strong tool to swap out poor lifestyle habits for positive healthy ones (i.e., food choices, exercise, and proper sleep).

The peptides don't do the work for me. They give a great assist in doing the work to get and stay fit.

At what amounts are you dosing each of the 3 secretagogues?

tesa: 2mg every day, fasted, before sleep

ipa & cjc(no dac): .5mg each per day, fasted, before sleep

Are you able to say whether you combine it with reta?

What are you aiming for with this — only building muscle, or dropping fat as well?

I came across a protocol that listed

Fasted at night

2mg tesa

200mcg cjc no dac and 200mcg ipa

Then fasted 200mcg ipa in the morning

Wondering whether that would be logical for fat loss alongside reta.

What do you think? @Calm Logic it would be nice if you could weigh in too.

 

[reyqaz]

Does Tesa need to be kept at room temperature rather than in the fridge?

 

[UpDownLeftRightAS*]

Phatmax said:

Hey everyone, I've been using reta for a while and I'm thinking about stacking Tesamorelin with it. I realize it's dosed at night, but what's the amount—1mg nightly? Anyone here who's used this combo, could you share some guidance?

From what I understand, the labeling doesn't mention needing a fasted state or a particular time of day. With GH/Sg's, timing matters more because they're so thoroughly researched, so it makes sense to optimize. My own dose goes in the morning right after waking, while fasted (usually just coffee plus some vital protein). Reta was the same story—it kept me too wired, so mornings became my only option.

 

[chewonmysac]

UpDownLeftRightAS* said:

Phatmax said:

Hey everyone, I've been using reta for a while and I'm thinking about stacking Tesamorelin with it. I realize it's dosed at night, but what's the amount—1mg nightly? Anyone here who's used this combo, could you share some guidance?

From what I understand, the labeling doesn't mention needing a fasted state or a particular time of day. With GH/Sg's, timing matters more because they're so thoroughly researched, so it makes sense to optimize. My own dose goes in the morning right after waking, while fasted (usually just coffee plus some vital protein). Reta was the same story—it kept me too wired, so mornings became my only option.

Same routine here. Currently in my 2nd run of it. My 1st run was just 4 weeks because my math was off. Still noticed a reasonable drop in waist size. Now I'm going for 8 weeks, and I'm 3 weeks in. Zero rest days. Total will be 12 vials at 10 mg each. Once mixed, I keep it at room temp. Fingers crossed I'll be able to rock my mesh half-shirt this summer.

 

[ftv10hb]

Rickcaps said:

Zydeceltico said:

jmon1977 said:

Zydeceltico said:

GeraltRedhammer said:

The standard dosing for tesamorelin is 2 mg taken at night, and you should wait 2–3 hours after your final meal of the day. Research showed that using 1 mg was notably weaker. Combining tesamorelin with ipamorelin creates a synergistic effect that boosts how well it works, and that's the approach I use for dosing.

Because tesamorelin carries a high price tag, I'm considering switching to CJC (without DAC) plus Ipamorelin for my next round – from what I understand, they function through the same mechanism.

Since tesamorelin is aimed at visceral fat in particular, swapping CJC in for tesa won't deliver the same outcome. My own stack consists of tirz, tesamorelin, CJC (No DAC), and Ipamorelin, and the results have been very, very positive. ymmv.........and the very best results - in my case - have come from using that stack as a strong tool to swap out poor lifestyle habits for positive healthy ones (i.e., food choices, exercise, and proper sleep).

The peptides don't do the work for me. They give a great assist in doing the work to get and stay fit.

At what amounts are you dosing each of the 3 secretagogues?

tesa: 2mg every day, fasted, before sleep

ipa & cjc(no dac): .5mg each per day, fasted, before sleep

Are you able to say whether you combine it with reta?

What are you aiming for with this — only building muscle, or dropping fat as well?

I came across a protocol that listed

Fasted at night

2mg tesa

200mcg cjc no dac and 200mcg ipa

Then fasted 200mcg ipa in the morning

Wondering whether that would be logical for fat loss alongside reta.

What do you think? @Calm Logic it would be nice if you could weigh in too.

Taking Tesa and CJC simultaneously means they'll compete for the same receptors. Pairing either one with Ipa produces a 1+1=3 outcome, but combining them with each other only gives a 1+1=1.5 result lol. The overall approach could still be viable if you shifted your Tesa dose to the morning alongside your first Ipa dose—that's something I plan to test myself in about a month.

 

[WYSiWYG]

After going through this thread and the info shared here, I'm now second-guessing whether to start the 2 kits that just arrived. My plan had been to stack Tesa with Reta to cut overall BF. Right now I've got a good grip on diet/nutrition and training - but after reading this, it feels like maybe that isn't the best move at the moment.

 

[boris]

chewonmysac said:

UpDownLeftRightAS* said:

Phatmax said:

Hey everyone, I've been using reta for a while and I'm thinking about stacking Tesamorelin with it. I realize it's dosed at night, but what's the amount—1mg nightly? Anyone here who's used this combo, could you share some guidance?

From what I understand, the labeling doesn't mention needing a fasted state or a particular time of day. With GH/Sg's, timing matters more because they're so thoroughly researched, so it makes sense to optimize. My own dose goes in the morning right after waking, while fasted (usually just coffee plus some vital protein). Reta was the same story—it kept me too wired, so mornings became my only option.

Same routine here. Currently in my 2nd run of it. My 1st run was just 4 weeks because my math was off. Still noticed a reasonable drop in waist size. Now I'm going for 8 weeks, and I'm 3 weeks in. Zero rest days. Total will be 12 vials at 10 mg each. Once mixed, I keep it at room temp. Fingers crossed I'll be able to rock my mesh half-shirt this summer.

So is it possible to verify the test while it sits at room temperature?

 

[chewonmysac]

boris said:

chewonmysac said:

UpDownLeftRightAS* said:

Phatmax said:

Hey everyone, I've been using reta for a while and I'm thinking about stacking Tesamorelin with it. I realize it's dosed at night, but what's the amount—1mg nightly? Anyone here who's used this combo, could you share some guidance?

From what I understand, the labeling doesn't mention needing a fasted state or a particular time of day. With GH/Sg's, timing matters more because they're so thoroughly researched, so it makes sense to optimize. My own dose goes in the morning right after waking, while fasted (usually just coffee plus some vital protein). Reta was the same story—it kept me too wired, so mornings became my only option.

Same routine here. Currently in my 2nd run of it. My 1st run was just 4 weeks because my math was off. Still noticed a reasonable drop in waist size. Now I'm going for 8 weeks, and I'm 3 weeks in. Zero rest days. Total will be 12 vials at 10 mg each. Once mixed, I keep it at room temp. Fingers crossed I'll be able to rock my mesh half-shirt this summer.

So is it possible to verify the test while it sits at room temperature?

For me it did the job, kept at room temp inside a cabinet. At 2mg per day, the vial was gone in 5 days. It performed just as expected. Since switching to HGH, the difference is far more obvious — my midsection has really gone flat and the side fat has melted away. 3iu per day. That's been going for 57 days now. Likely I'll pause it next month.