I'm 55 should I take Tesamorelin or just go for hgh and trt?

[lessthanhalf]

The standard HGH is HGH191aa or somatropin, HGH fragment 176-191 is not the same at all, the research is all old, whether it has effects on fat metabolism or not is disputed.
Effects of HGH on muscle and fat to muscle ratio and visceral fat take many months to develop, and at non extreme doses are not very large. Side effects are very common, and much more likely at doses higher than replacement doses, anything above about 1iu/day for someone in their 50's.
The long term effects of HGH in older persons are not really well known, apart from the side effects like increased blood sugar and increased risks of diabetes, carpal tunnel syndrome , fluid retention etc.. Effects on longevity are also not known, but in animal studies, those with hgh deficiency live longer , which is a bit concerning. It could increase risks of cancer.

 

[Omxxl]

gemini info:

Understanding the difference between Standard HGH (Somatropin) and HGH Fragment 176-191 is crucial because, while the latter is derived from the former, they behave very differently once they enter your system.
Here is the breakdown of the most important differences:

---

Key Differences: HGH 191aa vs. HGH Fragment 176-191​

Feature	Standard HGH (191aa)	HGH Fragment 176-191
Structure	Full 191-amino acid chain.	Only the tail end (amino acids 176–191).
Primary Goal	Systemic growth, cell repair, and metabolism.	Targeted fat loss (Lipolysis).
IGF-1 Effect	High (stimulates tissue growth).	Virtually zero.
Muscle Mass	Highly anabolic (helps build muscle).	Non-anabolic (does not build muscle).
Blood Glucose	Can cause insulin resistance.	No effect on blood sugar levels.
Side Effects	Water retention, joint pain, carpal tunnel.	Generally just redness at the injection site.

---

1. Scope of Action​

HGH 191aa is the complete hormone. Think of it as a "master key" that opens many doors: it improves injury recovery, increases bone density, promotes protein synthesis (muscle growth), and also burns fat.
HGH Fragment 176-191, on the other hand, is just the specific part of the hormone responsible for lipolysis (fat burning). It is often called the "lipolytic fragment" because it isolates the weight-loss benefits while discarding the parts of the hormone that cause organ growth or water retention.

2. Impact on Insulin and IGF-1​

This is the most significant health-related distinction:

• Standard HGH: It can raise blood sugar levels and, over time, decrease insulin sensitivity. It also raises IGF-1 (Insulin-like Growth Factor 1), which is what makes muscles and other tissues grow.
• Fragment 176-191: It does not compete for insulin receptors. This means it doesn't mess with your glucose levels, making it a much "friendlier" option for those solely focused on aesthetics without wanting to alter their metabolic profile.

3. Expected Results​

• Use HGH 191aa if: You are looking for a total body transformation, including faster recovery from workouts/injuries, lean muscle gain, and anti-aging benefits.
• Use Fragment 176-191 if: Your only goal is oxidizing stubborn body fat without the risk of the systemic side effects associated with the full hormone.

Safety Note: While the fragment is more targeted, both substances influence hormonal processes. Professional supervision is essential, and it’s important to remember that diet is the deciding factor in whether Fragment 176-191 actually delivers results.

 

[lessthanhalf]

From a version of chatgpt 5.3 research / factual with added strong proscience and anti hallucination prompting. This is parts of its answer as it is pretty long.
This is in no way intended as personal criticism of the poster, but the basic fast versions of AI's and in my experience the base version of gemini is awful, have a strong tendency to agree with you and make a convincing story, whether it is true or not. It has most definitely not got that information from scientific literature, more likely a peptide site, that may or may not be trying to sell peptides. It is easy to get very bad answers from AI's, and if the issue relates to health or medication , then that is a major problem. It is not very hard to get very good, very accurate answers from AI's, there will always be some risks of it making stuff up, but I know for certain which answer I would trust for medical or medication related advice. The absolute minimum prompt is "do not agree with me without evidence and provide evidence for your answers". The general research scholar versions are also pretty good in the default state, but I would still add that prompt.
I would interpret this answer as being the quality of the evidence is very low that hgh fragment 176-191 is useful and safe in humans.
Short answer:
👉 There is no good-quality evidence that HGH Fragment 176-191 produces meaningful fat loss or metabolic benefit in humans.
Animal data shows some lipolytic effects, but it’s limited, inconsistent, and not clearly translatable.

B. Real-world / clinical outcomes​

There is no convincing evidence for:
sustained weight loss
clinically meaningful fat reduction
improved metabolic health
compared to:
diet
GLP-1–based therapies

5. Comparison to real therapies​

Compared to:
Tirzepatide
Semaglutide
HGH fragment:
has orders of magnitude less evidence
unclear efficacy
no long-term safety data

9. Bottom line​

HGH Fragment 176–191 has:
weak human evidence
modest and uncertain animal evidence
No strong proof of meaningful fat loss in humans
No high-quality trials demonstrating clinical benefit
Far less effective (and less understood) than established therapies

 

[Researcher6076]

I am 71, gym rat, scientist, yoga teacher, lol. I alternate days of 2mg Tesa fasting in the mornings, with 200mcg Ipamorelin + 200mcg CJC-1295 NODAC fasted before bed. And one day a week off. It's more conservative than all Tesa, so no side effects. And cheaper. And mechanisticly Tesa 3 days at 2mg is more effective than 6 days are 1mg. The ipamorelin + CJC-1295 NODAC is giving me the flushing tingles, so it is probably doing a little.

 

[Calm Logic]

HGH Fragment 176–191 has:
weak human evidence
modest and uncertain animal evidence
No strong proof of meaningful fat loss in humans
No high-quality trials demonstrating clinical benefit
Far less effective (and less understood) than established therapies

Exactly. HGH Fragment 176-191 is just another form of arguably worthless AOD.

Regarding HGH vs. tesa, tesa is less illicit and has less variable dosing, and HGH (though cheaper) seems to require more frequent testing, including ideally ApoB testing now and then.

I just read a small 1996 study where high-dose HGH can lower LDL but raise Lp(a). Lp(a) is more likely to cause clots and plaque than standard LDL. So that's another blood test to order, along with ApoB.

Tesa would probably be neutral for both LDL and Lp(a).

For HGH, median increase in Lp(a) was 33% after 12 weeks of a high dose of HGH (0.05 IU/kg/d; about 4.5 IU per day for someone at 200 pounds):

The effect of growth hormone on low-density lipoprotein cholesterol and lipoprotein (a) levels in familial hypercholesterolemia - PubMed

Severe elevations of low-density lipoprotein (LDL) cholesterol are not always normalized with conventional drugs. Growth hormone decreases LDL cholesterol levels, in part by augmenting liver LDL receptor activity. This increase may be on the order of magnitude of the increase induced by statins...

pubmed.ncbi.nlm.nih.gov

No changes occurred in the levels of other lipids, lipoprotein particles, or apolipoproteins, with the exception of lipoprotein(a) [Lp(a)]. The median changes in Lp(a) were 33% (interquartile range, 2% to 53%) and -15% (interquartile range, -22% to 18%) in the growth hormone and placebo groups, respectively (P = .02). We conclude that the effect of growth hormone on LDL cholesterol levels in FH is less than expected, based on its LDL-catabolic effects, and is counteracted by profound increases in Lp(a) levels, resulting in unchanged levels of apolipoprotein B. Thus, growth hormone is probably not useful as adjunctive therapy in FH.

On the positive side, the decrease in LDL was about 18 points (-0.46 mmol/L). And Lp(a) tends to rise less on HGH if LDL is already high. But in the study above of HGH for familial hypercholesterolemia, the baseline LDL was probably higher already.

Tesa is likely neutral for Lp(a) given its positive cardiovascular profile:

https://academic.oup.com/ofid/article/12/Supplement_1/ofae631.633/7988201

In an obesity study though, tesa was neutral for LDL too, only lowering triglycerides:

Metabolic Effects of a Growth Hormone-Releasing Factor in Obese Subjects with Reduced Growth Hormone Secretion: A Randomized Controlled Trial - PMC

Obesity is associated with reduced GH secretion and increased cardiovascular disease risk. We performed this study to determine the effects of augmenting endogenous GH secretion on body composition and cardiovascular disease risk indices in obese ...

pmc.ncbi.nlm.nih.gov

 

[foffspam111]

I am 71, gym rat, scientist, yoga teacher, lol. I alternate days of 2mg Tesa fasting in the mornings, with 200mcg Ipamorelin + 200mcg CJC-1295 NODAC fasted before bed. And one day a week off. It's more conservative than all Tesa, so no side effects. And cheaper. And mechanisticly Tesa 3 days at 2mg is more effective than 6 days are 1mg. The ipamorelin + CJC-1295 NODAC is giving me the flushing tingles, so it is probably doing a little.

Thank you for the information. I am doing 2mg of Tesa daily on a 5x2 schedule. It is working great. I take it before bed after 3hrs of no food. I started with CJC/IPA but right away side effect, I switched to tesa after a month. No side effects, great sleep, muscle tone, energy, and fat burn have been great. I may try your schedule and see if there is any difference but probably won’t do CJC/IPA anytime soon though.

 

[wulf00777]

I've read a lot of people stating Tesa didn't do anything for them. That's why with the price tag I'm looking for other ways to gain muscle and lose the last fat after I lose my majority of weight, just planning ahead.

 

[foffspam111]

I've read a lot of people stating Tesa didn't do anything for them. That's why with the price tag I'm looking for other ways to gain muscle and lose the last fat after I lose my majority of weight, just planning ahead.

Everyone is different. Some also depends on age. If you’re younger the hgh secretagogues won’t move the needle much if at all. But that really applies to most peptides in my opinion. When you’re younger the body is more efficient at all things. As you age, body needs a little help getting there and the signals from peptides can make a difference.
Hgh will give faster improvements but at a cost. I wish you success on your goals!

 

[Calm Logic]

For the GH secretagogues like tesa, age seems less important than biological sex, with males having greater response thanks to less estrogen but more "hepatic sensitivity." Same with HGH:

Gender difference in insulin-like growth factor I response to growth hormone (GH) treatment in GH-deficient adults: role of sex hormone replacement - PubMed

GH production in healthy women is about thrice that in men. Yet insulin-like growth factor I (IGF-I) levels are similar, suggesting a lower responsivity to GH in women. In untreated GH-deficient adults, basal IGF-I levels are reportedly lower in females than in males, and the therapeutic...

pubmed.ncbi.nlm.nih.gov

The IGF-I increase (delta) per IU GH/day x kg over the 24-month period was about twice higher in men than in women

So women may need 2 mg of tesa to get to the same IGF-1 (and visceral fat loss) of men on 1 mg of tesa (or 2 IU of HGH instead of 1 IU). And even with younger guys, response may be quite variable, since they have less to gain. (And women generally live longer, so they have the last laugh.)

 

[DrPEPr]

The ipamorelin + CJC-1295 NODAC is giving me the flushing tingles, so it is probably doing a little.

The 'flushing tingles' is only the histamine response of the body. Unfortunately this says nothing about the effectiveness of the compound.

 

[Researcher6076]

The 'flushing tingles' is only the histamine response of the body. Unfortunately this says nothing about the effectiveness of the compound.

Ty

 

[bogardbilla]

I've read a lot of people stating Tesa didn't do anything for them. That's why with the price tag I'm looking for other ways to gain muscle and lose the last fat after I lose my majority of weight, just planning ahead.

Well I'll chime in with an opposite statement then 🙂

Tesa 2mg + Ipa 300mcg every day for about 3 months did wonders for my mid section. I've lost almost all fat in the love handles area and the sides of the mid section, an area which used to be extremely stubborn during my previous attempts at weight loss.

 

[Quatroskin]

Thank you for the information. I am doing 2mg of Tesa daily on a 5x2 schedule. It is working great. I take it before bed after 3hrs of no food. I started with CJC/IPA but right away side effect, I switched to tesa after a month. No side effects, great sleep, muscle tone, energy, and fat burn have been great. I may try your schedule and see if there is any difference but probably won’t do CJC/IPA anytime soon though.

Great feedback. I’m going to give Tesa a try here soon. I’m thinking of dropping my weekly Reta to 2mg or even 1mg a week and add the 2mg Tesa. Any side effects with the Tesa ? What’s the cycle for Tesa? 6-8 weeks? And I also will be following the 5x2 schedule.

 

[foffspam111]

Great feedback. I’m going to give Tesa a try here soon. I’m thinking of dropping my weekly Reta to 2mg or even 1mg a week and add the 2mg Tesa. Any side effects with the Tesa ? What’s the cycle for Tesa? 6-8 weeks? And I also will be following the 5x2 schedule.

I have been running a 5x2 weekly schedule and will for 90 days (I am in the last 2 weeks now) then take 2-4 weeks off. From there I may try Cjc/ipa again but it’s tough to not just run tesa again with the results I’ve gotten. Only side effects were some water retention the first 2 weeks but after that no. All positive so far.

 

[bogardbilla]

Any side effects with the Tesa ? What’s the cycle for Tesa? 6-8 weeks? And I also will be following the 5x2 schedule.

No side effects for me, except maybe better sleep. There's no cycle for Tesamorelin, you're supposed to take 2mg every day until you reach your desired goal.

 

[lessthanhalf]

Just in case others are interested, I thought I was being quite conservative with my HGH dose of 1.5iu/day. Finally got around to getting IGF-1 tested and result was 50 micromol/l mean 20 standard deviation 5 to 7 . ( at age 58 ), which is quite high , ( US units may be different ) more than 3 standard deviations above the mean. Unfortunately never got tested beforehand. Aim was any help I can get with keeping 54% weight off. Given I have some assymptomatic evidence of early cardiac failure on echo, overdoing it on HGH is probably not a good idea. Will be dropping the dose and getting retested. I did lose extra cm off my waist circumference from it.

 

[wulf00777]

Just in case others are interested, I thought I was being quite conservative with my HGH dose of 1.5iu/day. Finally got around to getting IGF-1 tested and result was 50 micromol/l mean 20 standard deviation 5 to 7 . ( at age 58 ), which is quite high , ( US units may be different ) more than 3 standard deviations above the mean. Unfortunately never got tested beforehand. Aim was any help I can get with keeping 54% weight off. Given I have some assymptomatic evidence of early cardiac failure on echo, overdoing it on HGH is probably not a good idea. Will be dropping the dose and getting retested. I did lose extra cm off my waist circumference from it.

Be careful with test too if you are taking it.

 

[Calm Logic]

Just in case others are interested, I thought I was being quite conservative with my HGH dose of 1.5iu/day. Finally got around to getting IGF-1 tested and result was 50 micromol/l mean 20 standard deviation 5 to 7 . ( at age 58 ), which is quite high , ( US units may be different ) more than 3 standard deviations above the mean. Unfortunately never got tested beforehand. Aim was any help I can get with keeping 54% weight off. Given I have some assymptomatic evidence of early cardiac failure on echo, overdoing it on HGH is probably not a good idea. Will be dropping the dose and getting retested. I did lose extra cm off my waist circumference from it.

So an IGF-1 getting close to 400:

382.5 ng/mL

 

[lessthanhalf]

On medically prescribed testosterone gel at low doses, was 8 pretreatment now 13-16 nmol/l ref range 10-30 - total, so not high at all, at those doses there is no evidence of negative cardiovascular outcomes. Again units used in the states tend to be different. After checking with chatgpt the igf-1 level is more like 5 standard deviations above normal.

 

[wulf00777]

Well I'll chime in with an opposite statement then 🙂

Tesa 2mg + Ipa 300mcg every day for about 3 months did wonders for my mid section. I've lost almost all fat in the love handles area and the sides of the mid section, an area which used to be extremely stubborn during my previous attempts at weight loss.

Awesome, thanks for the feedback. That reinforces my plans to use Tesa and ipa for fine tuning.

 

[Calm Logic]

On medically prescribed testosterone gel at low doses, was 8 pretreatment now 13-16 nmol/l ref range 10-30 - total, so not high at all, at those doses there is no evidence of negative cardiovascular outcomes. Again units used in the states tend to be different. After checking with chatgpt the igf-1 level is more like 5 standard deviations above normal.

I guess you will be checking the velocity of any expected PSA increase.

 

[lessthanhalf]

I had blood tests done last week and requested the PSA not be tested, but it was anyway and was a tiny bit high. From a quick look at the research I do not see a lot of advantage in screening for prostate cancer, given it does not improve long term outcomes much for a whole lot of investigations and treatment. I do not think I will be able to convince my GP or endocrinologist not to test it anyway, and still prescribe testosterone. Not really interested in the slippery slope of a few more tests and then a biopsy or MRI when most cancers found are not going to do anything much.

 

[Aussiegreenmachine]

I am 71, gym rat, scientist, yoga teacher, lol. I alternate days of 2mg Tesa fasting in the mornings, with 200mcg Ipamorelin + 200mcg CJC-1295 NODAC fasted before bed. And one day a week off. It's more conservative than all Tesa, so no side effects. And cheaper. And mechanisticly Tesa 3 days at 2mg is more effective than 6 days are 1mg. The ipamorelin + CJC-1295 NODAC is giving me the flushing tingles, so it is probably doing a little

How is your sleep on this protocol and how was your sleep before you commenced?

 

[latviantower]

No side effects for me, except maybe better sleep. There's no cycle for Tesamorelin, you're supposed to take 2mg every day until you reach your desired goal.

Just an FYI , prescription tesa (brand name Egrifta) has a prescribed run time of 6 months, 2 mg 5&2. Target demographic HIV patients with diagnosed excessive visceral fat.

 

[TheEngineer]

Here is a great example of a panel to specifically request. This is in addition to a bunch of all the standard stuff ie... Hematocrit, hba1c, fasted glucose, glomerular filtration etc...

 

[Calm Logic]

From a quick look at the research I do not see a lot of advantage in screening for prostate cancer, given it does not improve long term outcomes much for a whole lot of investigations and treatment.

But PSA is commonly checked on TRT since it can elevate PSA. TRT with HGH can be like Miracle-Grow for the prostate:

https://academic.oup.com/jcem/article-abstract/88/1/88/2846008

The percentage increase in prostate volume was greater in hypoandrogenemic patients receiving both GH and testosterone replacement (51 ± 11%) than in those receiving GH replacement alone (15 ± 3%; P < 0.0009)

Personally, I am more concerned about BPH than cancer:

https://glp1forum.com/threads/best-for-bph.12458/post-130765

 

[Researcher6076]

How is your sleep on this protocol and how was your sleep before you commenced?

My sleep is better, but I'm doing other thing so I cannot attribute sleep improvementsto this.

 

[Tbagger]

I am a huge fan of tesa/ipa. I'm currently on TRT, Reta, and Tesa/ipa and it has been a life changer! Lost 100 lbs of fat and gained 10lbs of lean muscle. My Igf-1 went from approx 150 up to 300. Not quite super-physiological level, but pretty high for a 42 year old. The reta is easily able to overcome the insulin resistance from the tesa/ipa. My fasted glucose is always in the low 80's and I have even tried to see if I can spike it with donuts but the highest I have been able to get it was 105. And my visceral fat levels went from a 19 on the index to a 6 over the last year while bringing my ALT and AST levels into the normal range. The only thing left on my blood work that is a problem is my HDL is a little low. I am taking 2mg tesa and 250mcg ipa fasted before bed 7 days a week. As an added bonus it gives me great sleep and recovery. I do 12week on, 4 week off and I hate doing my off cycle, but I worry about receptor downregulation so I suck it up and do it anyway.

 

[latviantower]

I am a huge fan of tesa/ipa. I'm currently on TRT, Reta, and Tesa/ipa and it has been a life changer! Lost 100 lbs of fat and gained 10lbs of lean muscle. My Igf-1 went from approx 150 up to 300. Not quite super-physiological level, but pretty high for a 42 year old. The reta is easily able to overcome the insulin resistance from the tesa/ipa. My fasted glucose is always in the low 80's and I have even tried to see if I can spike it with donuts but the highest I have been able to get it was 105. And my visceral fat levels went from a 19 on the index to a 6 over the last year while bringing my ALT and AST levels into the normal range. The only thing left on my blood work that is a problem is my HDL is a little low. I am taking 2mg tesa and 250mcg ipa fasted before bed 7 days a week. As an added bonus it gives me great sleep and recovery. I do 12week on, 4 week off and I hate doing my off cycle, but I worry about receptor downregulation so I suck it up and do it anyway.

You can reset receptors using the Mon-Fri tesa 2 mg protocol, take the weekends off. Do that for 26 weeks. Added bonus, easy math. 10 mg vial lasts one week, 20 mg vial - two weeks.

 

[Tbagger]

You can reset receptors using the Mon-Fri tesa 2 mg protocol, take the weekends off. Do that for 26 weeks. Added bonus, easy math. 10 mg vial lasts one week, 20 mg vial - two weeks.

That's what some people say, but there has been no studies done on it. The general consensus has been that it was either the wellness clinics that started the 5 on 2 off protocol because they are closed on weekends, or people started doing it to save some money. Either way, I don't think it's enough time to prevent downregulation so I give it 4 weeks off. My results are showing that it's working, so I'm gonna stick to it. But the trials and prescription protocol for Egrifta is daily injections for up to a year without any breaks. So I might just be overly cautious about it.