Tesamorelin and other GH Secretagogue dosing protocol

[RicFlair]

Why does every protocol that I see for Tesa and other GH secretagogues mention a 5 day on and 2 days off sort of dosing schedule? Would this not be counter productive as boosting your GH production should be everyday? Ive seen many people say this is a myth and your dosing protocol should be tailored to yourself so im wondering if I should just be taking it everyday. Any other thoughts on this?

 

[woundcarping]

The best reasoning I've seen for the 5/2 split is bro science, taking the idea from somewhere else and applying it elsewhere.

 

[wildweasel]

Why does every protocol that I see for Tesa and other GH secretagogues mention a 5 day on and 2 days off sort of dosing schedule? Would this not be counter productive as boosting your GH production should be everyday? Ive seen many people say this is a myth and your dosing protocol should be tailored to yourself so im wondering if I should just be taking it everyday. Any other thoughts on this?

as woundcarping said, mostly bro science.

you can follow medical protocols for these two honestly. tesa is medically dosed at 2mg daily. gh dose is variable, daily.

there is medical literature about gh specifically suggesting that dosing EOD is as effective as dosing ED, but this study was performed on children who already release loads of endogenous GH, and its not necessarily true that what holds for them with respect for GH is also true for adult populations.

not sure whjat your plans are but you dont need both tesa and gh at the same time. Tesa is a GH secretagogue, it releases GH, specifically it makes your natural pulses stronger. if you are taking endogenous GH, the effect from that is going to be so much more than what any GH secretagogue would ever realy provide, you'd really just be wasting $$ using the Tesa. Stick with only GH if you are thinking of taking both at once, theres just no need/benefit to take both.

 

[RicFlair]

as woundcarping said, mostly bro science.

you can follow medical protocols for these two honestly. tesa is medically dosed at 2mg daily. gh dose is variable, daily.

there is medical literature about gh specifically suggesting that dosing EOD is as effective as dosing ED, but this study was performed on children who already release loads of endogenous GH, and its not necessarily true that what holds for them with respect for GH is also true for adult populations.

not sure whjat your plans are but you dont need both tesa and gh at the same time. Tesa is a GH secretagogue, it releases GH, specifically it makes your natural pulses stronger. if you are taking endogenous GH, the effect from that is going to be so much more than what any GH secretagogue would ever realy provide, you'd really just be wasting $$ using the Tesa. Stick with only GH if you are thinking of taking both at once, theres just no need/benefit to take both.

Yea sorry i should have been more clear but im only taking Tesa right now and looking to also add some other peps to my stack like Mots-C and maybe Ipamorelin too as ive read that these 3 go very well together. I currently dont take any pure HGH at all cause i think Tesa should be enough for me

 

[wildweasel]

Yea sorry i should have been more clear but im only taking Tesa right now and looking to also add some other peps to my stack like Mots-C and maybe Ipamorelin too as ive read that these 3 go very well together. I currently dont take any pure HGH at all cause i think Tesa should be enough for me

GH is less expensive than Tesa and works better.

Ipa would be a good mix with Tesa if you want to go that route, but you are probably going to be paying 20-35% more for the both than just GH, and have less effects.

What is your reasoning for increasing GH output? weight loss? muscle building? healing?

 

[RicFlair]

GH is less expensive than Tesa and works better.

Ipa would be a good mix with Tesa if you want to go that route, but you are probably going to be paying 20-35% more for the both than just GH, and have less effects.

What is your reasoning for increasing GH output? weight loss? muscle building? healing?

Weight loss and building muscle, i guess the only other reason for not taking GH straight up is cause i was worried that by taking it id be messing with my ability to produce it naturally

 

[Cannonball72]

The best reasoning I've seen for the 5/2 split is bro science, taking the idea from somewhere else and applying it elsewhere.

Was the medical protocol in tests. Also belief in brief resets.

I do it because it doesn’t seem to be any less effective and it reduces cost.

 

[wildweasel]

Weight loss and building muscle, i guess the only other reason for not taking GH straight up is cause i was worried that by taking it id be messing with my ability to produce it naturally

exogenous GH will suppress endogenous GH release, true. It turns down your natural GH production via negative feedback, and secretagogues increase that natural production.

nearly all return to normal levels after GH treatment https://ouci.dntb.gov.ua/works/4kwMDwW4 although this is a study on children (not adults, so interpret as you will, children grow alot)

 

[Researcher6076]

Why does every protocol that I see for Tesa and other GH secretagogues mention a 5 day on and 2 days off sort of dosing schedule? Would this not be counter productive as boosting your GH production should be everyday? Ive seen many people say this is a myth and your dosing protocol should be tailored to yourself so im wondering if I should just be taking it everyday. Any other thoughts on this?

Science says daily is fine as long as you don't have side effects. If you have sides on Tesamorelin don't reduce the dose, reduce the number of days per week. Science says the minimum effective dose is 2mg. It's ok to start low to be sure you don't react badly, but if you want the effective dose it is 2 mg.

Science also says cycle it. Receptor desensitization is a real thing. So is developing antibodies. If you only ever want to run one cycle science says you can get away with 26 week.

I run tesamorelin with 250 mcg Ipamorelin more or less 7 days a week. I cycle off at 12 weeks, for more or less 6 weeks. The more or less are just to accommodate travel and stuff going on in my life.

 

[DustAndDignity]

Science says daily is fine as long as you don't have side effects. If you have sides on Tesamorelin don't reduce the dose, reduce the number of days per week. Science says the minimum effective dose is 2mg. It's ok to start low to be sure you don't react badly, but if you want the effective dose it is 2 mg.

Science also says cycle it. Receptor desensitization is a real thing. So is developing antibodies. If you only ever want to run one cycle science says you can get away with 26 week.

I run tesamorelin with 250 mcg Ipamorelin more or less 7 days a week. I cycle off at 12 weeks, for more or less 6 weeks. The more or less are just to accommodate travel and stuff going on in my life.

I think a few things here are getting overstated as “what science says.”

• The clinical studies on tesamorelin didn’t require cycling. They ran participants continuously for months, so there isn’t strong evidence that cycling is necessary from a research standpoint.
• The idea that 2 mg is the “minimum effective dose” isn’t quite accurate either. That was the standard study dose, but there’s evidence and real-world use showing effects at lower doses like 1 mg. It’s just not what was formally tested as the primary protocol.
• Adjusting frequency vs dose for side effects is more of a practical strategy, not something clearly defined in the literature as a rule.

Not saying your approach is wrong. It just that a lot of this falls into “common practice” rather than established science.

From my personal experience my IGF-1 shot through the rough after running 1mg Tesa for 6w eeks before bumping it up 1.5mg for another 8 weeks.

 

[Habibibi]

Science says daily is fine as long as you don't have side effects. If you have sides on Tesamorelin don't reduce the dose, reduce the number of days per week. Science says the minimum effective dose is 2mg. It's ok to start low to be sure you don't react badly, but if you want the effective dose it is 2 mg.

Science also says cycle it. Receptor desensitization is a real thing. So is developing antibodies. If you only ever want to run one cycle science says you can get away with 26 week.

I run tesamorelin with 250 mcg Ipamorelin more or less 7 days a week. I cycle off at 12 weeks, for more or less 6 weeks. The more or less are just to accommodate travel and stuff going on in my life.

Going to need links to papers for those science quotes. Science says 2mg is the dose for HIV patients, and nothing about a healthy population. Desentization after 26 weeks in healthy patients doesnt mean that drug stopped working. VAT fat reduction was maintained after 52 weeks.

And of course, anyone talking about dosage without mentioning IGF1 levels or zscore has little idea how these substances work. 2mg of tesamorelin could put your IGF1 zscore at +0.5, or +4. This is something you want to monitor, since at +3, you start running into acromegaly territory. Dose doesn't matter, only your response to it does.

 

[Researcher6076]

I think a few things here are getting overstated as “what science says.”

• The clinical studies on tesamorelin didn’t require cycling. They ran participants continuously for months, so there isn’t strong evidence that cycling is necessary from a research standpoint.
• The idea that 2 mg is the “minimum effective dose” isn’t quite accurate either. That was the standard study dose, but there’s evidence and real-world use showing effects at lower doses like 1 mg. It’s just not what was formally tested as the primary protocol.
• Adjusting frequency vs dose for side effects is more of a practical strategy, not something clearly defined in the literature as a rule.

Not saying your approach is wrong. It just that a lot of this falls into “common practice” rather than established science.

From my personal experience my IGF-1 shot through the rough after running 1mg Tesa for 6w eeks before bumping it up 1.5mg for another 8 weeks.

I thought they tried 1 mg daily and said it was no more effective than placebo for reducing visceral fat. Of course, many here are using tesamorelin for body recomp, but the legitimate approved purpose is reducing the visceral fat so that's what the human trials were measuring.

And your absolutely right, the was no discussion about reducing side effects in the published papers. Just the discussion about the 2 mg dose. And that is still confusing to some because it was 2 mg of tesamorelin acetate, which is also what is available on the gray market, but the actual thing you would get from a pharmacy if a Dr prescribed it is a slight different version of tesamorelin with a slightly smaller dose.

Thanks for advancing the discussion

 

[Commander]

I take 1mg Tesa / .3mg Ipa every night. Had my igf level tested before I started (5 weeks ago) and going to get it tested today. I think the test results actually dictate how much you can take

 

[Twowheelr2]

I take 1mg Tesa / .3mg Ipa every night. Had my igf level tested before I started (5 weeks ago) and going to get it tested today. I think the test results actually dictate how much you can take

I just cycled off a daily Tesa/Ipa blend (2mg/545mcg) after 37 days. The fluid retention was causing carpal tunnel sensations. tingling, burning, and a little pain. Had IGF-1 levels checked prior to start and had a blood draw today. Will see how things are going. I intend to start a new cycle with Tesa. This time If I encounter the fluid retention, I plan to decrease the dosage instead of cycling off. I’d like to go 12 weeks or more.

 

[mamallama]

This thread actually answered several questions for me. Thank you. How long would it be for Tesa to have a visual effect either my scale that gives body composition, weight, or by tape measure. I'm interested in it for decreasing visceral fat. I understand the medication itself feels spicy, any comments about that? Would any of these things indicate that the vial actually contains Tesa? All your knowledge is appreciated, but the science article links are chef’s kiss 🤌

 

[Celestar62]

Here's a good overview by Jay Campbell.

Tesamorelin and Ipamorelin Blend: Benefits, Risks and Dosing

The Tesamorelin and Ipamorelin blend benefits result from using two powerful GH pathways for superior fat loss and body composition. Here's what the science has to say, and how to use it.

jaycampbell.com

My Recommended Protocol
Based on my personal experience, my work with thousands of clients, and the protocols published in my Peptide Cheat Sheet, here’s exactly how I recommend running this stack.

Tesamorelin/Ipamorelin Blend (taken directly from the Peptide Cheat Sheet):

The BioLongevity Labs blend comes as a 6mg/2mg vial (tesamorelin/ipamorelin).
Reconstitute with 2ml of bacteriostatic water.
Dose at 300mcg tesamorelin / 100mcg ipamorelin per injection (10 units on your insulin syringe).
Inject AM/PM.
5 days on, 2 days off.
8 weeks on, 8 weeks off.
If running them separately:

Tesamorelin: 1mg injected subcutaneously at night before bed (at least 90 minutes after your last meal), and 1mg upon waking in the morning (ideally before fasted cardio).
Ipamorelin: 100mcg injected subcutaneously first thing in the morning and 100mcg right before bed.
Same cycling: 5 days on, 2 days off weekly, for 8 weeks before taking 8 weeks off.
If you’re going to inject Ipamorelin only once per day, inject it before your workout… its rapid onset (GH peak at ~40 minutes post-injection) makes it ideal as a pre-workout GH secretagogue.
For women, Monica recommends the Tesamorelin/Ipamorelin blend at 150/50 mcg, in the PM while fasted, 5x per week, 8 weeks on then 6-8 weeks off.

 

[tubby]

Science says.... Science says...

Science also says...If you only ever want to run one cycle science says you can get away with 26 week.

Is this "science" in the room with us now? Are they speaking to you? Do they speak through you? 🤣

I think you meant to say that a particular research paper studied and documented its use under certain conditions. That doesn't mean those are the only valid conditions for use, just that those are the ones that are well established and if one ventures outside of that, they're operating in less certain territory. "Off label" use is a fairly common thing (both inside and outside of the prescription system).

 

[DustAndDignity]

This thread actually answered several questions for me. Thank you. How long would it be for Tesa to have a visual effect either my scale that gives body composition, weight, or by tape measure. I'm interested in it for decreasing visceral fat. I understand the medication itself feels spicy, any comments about that? Would any of these things indicate that the vial actually contains Tesa? All your knowledge is appreciated, but the science article links are chef’s kiss 🤌

I’ve never heard of Tesa being spicy. In my personal experience I never experienced any spice.

You’re looking at 8-12 weeks before you see the visual changes.

The more unexpected change for me was an increase in my lifts at the gym. I found Tesa to help me maintain and even build lean muscle mass.

 

[lessthanhalf]

All of the human clinical trials of tesamorelin were done in people with HIV lipodystrophy, and if I am remembering correctly all at 2mg/day. To the best of my knowledge, no studies have ever been done in humans in any other state, so none in any kind of general population. None for obesity either.

So it can be said that it has been shown to reduce visceral fat in persons with HIV lipodystropy, and there did not seem to be any concerning effects on cardiovascular risk markers in that group, apart from blood sugar. This does not mean it is tested or known to be safe in the general population, but has much better evidence than anything else that messes with the GH system. And it can obviously cause GH related side effects like increased sugars and insulin resistance, fluid retention and carpal tunnel syndrome. And may or may not increase cancer risks, and reduce lifespan.

Any claims beyond this by pretty much anyone are bro science, not science. There is no scientific basis for days on /off treatment, but there is no scientific base for its use outside of HIV lipodystropy. As far as I am concerned anyone using the term protocol is making stuff up, I have yet to ever see one that is actually consistent with human trial evidence.

Given there is some evidence at least of being tested in humans, and most people taking it are going to be on GLP's reducing the negative effects on blood sugars, it is probably the safest option, ( if you have to use something that messes with HGH ) but getting sugars, lipids, blood pressure and IGF-1 tested is still a good idea. Just because the studies only used 2mg , does not mean 1mg is a problem. But it is quite a lot more expensive than HGH.

 

[Calm Logic]

Speaking of bro science, the marketing genius Dr. William Seeds on GH peptides:

View: https://www.youtube.com/watch?v=804mwP1mx8w&t=1329s

YouTube's AI summary:

During this segment, Dr. William Seeds explains the function of these secretagogues, which signal the anterior pituitary to release physiological growth hormone, leading to downstream IGF-1 production. He highlights that unlike exogenous growth hormone, these peptides facilitate a pulsed release, mimicking the body's natural processes.

Key compounds mentioned include Tesamorelin, CJC-1295, GHRP-2, GHRP-6, and Hexarelin. Dr. Seeds discusses the importance of rotating these compounds to prevent receptor tolerance and describes how they improve cellular metabolic efficiency, mitochondrial biogenesis, and the availability of NAD. He also touches upon the relationship between certain GHRPs and ghrelin, noting that some, like GHRP-6, can stimulate hunger as a result.

Gemini's rebuttal:

Claim	Skeptical Perspective
Pulsed Release	"Natural" timing doesn't automatically mean "zero long-term risk" to the pituitary gland's health.
Metabolic Efficiency	Often based on animal data; can paradoxically cause insulin resistance and elevated blood sugar in humans.
IGF-1 Downstream	Elevated IGF-1 is a potent growth signal for both healthy tissue and potentially cancerous cells.
Mitochondrial Biogenesis	The link between GH secretagogues and NAD+ levels is largely speculative and lacks direct human evidence.

 

[tubby]

All of the human clinical trials of tesamorelin were done in people with HIV lipodystrophy, and if I am remembering correctly all at 2mg/day. To the best of my knowledge, no studies have ever been done in humans in any other state, so none in any kind of general population. None for obesity either.

So it can be said that it has been shown to reduce visceral fat in persons with HIV lipodystropy, and there did not seem to be any concerning effects on cardiovascular risk markers in that group, apart from blood sugar. This does not mean it is tested or known to be safe in the general population, but has much better evidence than anything else that messes with the GH system. And it can obviously cause GH related side effects like increased sugars and insulin resistance, fluid retention and carpal tunnel syndrome. And may or may not increase cancer risks, and reduce lifespan.

Any claims beyond this by pretty much anyone are bro science, not science. There is no scientific basis for days on /off treatment, but there is no scientific base for its use outside of HIV lipodystropy. As far as I am concerned anyone using the term protocol is making stuff up, I have yet to ever see one that is actually consistent with human trial evidence.

Given there is some evidence at least of being tested in humans, and most people taking it are going to be on GLP's reducing the negative effects on blood sugars, it is probably the safest option, ( if you have to use something that messes with HGH ) but getting sugars, lipids, blood pressure and IGF-1 tested is still a good idea. Just because the studies only used 2mg , does not mean 1mg is a problem. But it is quite a lot more expensive than HGH.

I'd generally agree and well said.

Might be worth adding that tesa isn't the only one that's well studied (sermorelin also gained FDA approval).

I might disagree a bit on the "bro science" angle, but that's more of a subjective difference of opinion. Although not clinically validated, the common protocols are what most others will have tried using and often represent best guesses based on an educated mechanistic understanding. Certainly inferior to a clinically researched approach (if one were available), but more likely to encorporate some degree of trial and error in being arrived at and probably better than reinventing the wheel yourself.

 

[Calm Logic]

An article on GH peptides for older adults, saying it is currently "not warranted" for anti-aging purposes:

Growth Hormone and Aging - Endotext - NCBI Bookshelf

Several short-term studies aiming to increase GH in older adults using a variety of interventions, including exercise, GH administration, or GH secretagogues, have demonstrated consistent effects on body composition but inconsistent effects on physical and cognitive function...

Long-term studies using hard clinical endpoints, such as falls and fracture rates, functional measures, quality of life, and morbidity and mortality from vascular disease, are needed to establish the potential role, if any, of GH and GHS treatment in normal aging. In the meantime, GH use for anti-aging purposes is not warranted

And even the guys/bros at Meso can't agree that HGH is worthwhile (at least at relatively safe dosages):

https://thinksteroids.com/community/threads/morning-vs-night-hgh-pin.134433988/post-3664416

Honestly, GH is the cherry on top. And if we are being real, it is probably the most overrated thing I have used.

I did not notice a massive difference on GH versus off GH. If anything, I actually felt leaner and better without it.

The typical bro science there:

https://www.thinksteroids.com/community/threads/when-is-gh-detrimental-to-ones-look.134418451/post-3142074

Skin, hair, nails, sleep, body comp, all drastically better.

https://thinksteroids.com/community/threads/loving-my-first-go-at-tesamorelin.134430817/post-3635545

On another note, I just read a medical journal article about the fact “abdominal obesity”, 25% percent of “normal BMI” people have is a major under recognized cardiovascular and all cause mortality risk factor. More men than women have it, and general weight loss isn’t really effective, even with a GLP, because in many cases you’d become underweight everywhere else before the abdomen (and it’s stubborn visceral fat, “dad gut” common as GH levels drop with age) gets to a healthy size.

They mentioned Tesamorelin as a possible way to treat this, since it’s so effective at blasting visceral fat and shrinking the gut, even without weight loss, by redistributing that fat elsewhere, like subQ where it’s essentially harmless. Restoring a “youthful” body composition type and away from middle age “spread”.

ChatGPT to clear up the Meso science:

2002 study cited by ChatGPT (with almost 700 citations at Google Scholar):

Growth Hormone and Sex Steroid Administration in Healthy Aged Women and Men

 

[Habibibi]

Agreed, low igf1 is associated with longevity.

Most of the meso crowd is doing gh at a supra physiological doses anyway, which disqualifies them from the gh for longevity question.

 

[Calm Logic]

Exactly. At Meso, they are arguably working on "brospan" or "hotspan" or something other than health span:

Too well to die; too ill to live: an update on the lifespan versus health span debate - PMC

Since the dawn of human civilisation, the pursuit of immortality has been a perennial quest. Over the past century, unprecedented advancements in medical science, public health initiatives, and social policies have significantly increased the global ...

pmc.ncbi.nlm.nih.gov

"The debate between lifespan (the total number of years a person lives) and health span (the period of life free from chronic disease or disability) has gained considerable attention in both scientific and public discourse, with global focus now gradually shifting from merely living longer to living better."

..."The most well-known framework for describing successful ageing by Rowe and Kahn in 1998, where they included the following three components for a disease-free, healthy ageing [23]:

1. Avoiding disease.
2. Maintaining cognitive and physical function.
3. Preserving engagement."

 

[lessthanhalf]

From the post above by Calm logic
Long-term studies using hard clinical endpoints, such as falls and fracture rates, functional measures, quality of life, and morbidity and mortality from vascular disease, are needed to establish the potential role, if any, of GH and GHS treatment in normal aging. In the meantime, GH use for anti-aging purposes is not warranted.

This unfortunately is the case for GH , secretagogues, androgen treatment and SARMs . There are lots of studies showing some improvement in various different measurable characteristics, like lean mass or muscle mass, or visceral fat but the studies consistently fail to show real world measurable benefits like improved strength or mobility , or less cardiovascular disease which is what matters in the end . It does seem odd that you can get a measured increase in muscle mass, but no actual performance increase, but it has been shown over and over again, in studies of these agents for sarcopenia due to age or cancer or in older persons.

Weirdly GLP's do the opposite, reducing muscle mass, but increasing muscle efficiency , and do produce significant real world gains in mobility and cardiovascular disease risk.

 

[tubby]

This unfortunately is the case for GH , secretagogues, androgen treatment and SARMs . There are lots of studies showing some improvement in various different measurable characteristics, like lean mass or muscle mass, or visceral fat but the studies consistently fail to show real world measurable benefits like improved strength or mobility , or less cardiovascular disease which is what matters in the end . It does seem odd that you can get a measured increase in muscle mass, but no actual performance increase, but it has been shown over and over again, in studies of these agents for sarcopenia due to age or cancer or in older persons.

Weirdly GLP's do the opposite, reducing muscle mass, but increasing muscle efficiency , and do produce significant real world gains in mobility and cardiovascular disease risk.

Agree on GLPs being much more lopsided (at present the pros list seems to greatly outweigh the cons list).

I also agree that we lack hard endpoints data for GH (and related compounds), but that in itself is a fairly weak criticism. Nearly all attempts to expand cardiology and related drugs from secondary prevention to primary prevention are similarly based on drugs and treatments with strong intermediate marker results and with weak endpoint data. A lack of good endpoint data is quite common in pharma overall.

 

[EAM9112]

Why does every protocol that I see for Tesa and other GH secretagogues mention a 5 day on and 2 days off sort of dosing schedule? Would this not be counter productive as boosting your GH production should be everyday? Ive seen many people say this is a myth and your dosing protocol should be tailored to yourself so im wondering if I should just be taking it everyday. Any other thoughts on this?

This is just a cost cutting strategy to save 2 doses per week. Read the FDA guidelines on Tesamorelin. It was administered every day for up to 26 weeks at a dosage of 2mg.

https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/022505s020lbl.pdf

 

[Commander]

Was that 2mg once a day or was it 1mg twice a day?

 

[wildweasel]

From the post above by Calm logic
...
It does seem odd that you can get a measured increase in muscle mass, but no actual performance increase, but it has been shown over and over again, in studies of these agents for sarcopenia due to age or cancer or in older persons.

honestly makes sense when considered

for strength/performance purposes, neurological recruitment of muscle fibers matters as much or maybe even more than raw muscle mass... same as how body builders or athletes train for max strength vs hypertrophy.. solely training for max strength output results in far less muscular protein accretion than training for muscle hypertrophy, and conversely, training for hypertrophy is not very effective at increases strength, but it does lead to significant increases in overall muscle mass.

GH/GHS/IGF1/etc.. result in new cellular muscle growth, but dont replace the ability to recruit and coordinate muscle fibers effectively through the nervous system.

 

[Ascojoerg]

This is just a cost cutting strategy to save 2 doses per week. Read the FDA guidelines on Tesamorelin. It was administered every day for up to 26 weeks at a dosage of 2mg.

https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/022505s020lbl.pdf

Thanks for that. Yeah the whole 2 day break just keeps on coming back to bro science. But I guess I am going off of my interpretation of similar studies which in itself would also be my own bro science... 😅

In the end, until a proper peer reviewed, placebo controlled blind test is done, it is all speculation.