Fat loss
GH / Body Comp Stack
Tesamorelin pushes the gas, ipamorelin releases the brake. A GHRH analog signals the pituitary to release growth hormone while a ghrelin mimetic suppresses somatostatin, producing a larger pulse than either alone.
At a glance
- Sold as
- Separate vials
- The evidence
- Tesamorelin alone has FDA approval and Phase 3 data showing 15–18% visceral fat reduction over 26 weeks. Ipamorelin has Phase 2 studies confirming selective GH release without cortisol or prolactin, and remains a 503B Category 2 substance. FDA cites literature reports of serious adverse events including death when it was given intravenously for gastric motility. The combination itself has no trial. The rationale is pharmacologic, not proven.Combination-specific research is limited. Treat each compound’s evidence as separate unless a study of the combination itself is named here, and review the complete plan with a qualified clinician.
Running this stack, with the schedule, the vials it takes and a log of what you took, happens in the app: Claritide for iPhone.
Why people explore it
Common reasons for exploring it
- Adults 35+ with stubborn midsection fat despite consistent training and nutrition
- People who want GH optimisation without exogenous growth hormone
- Anyone whose primary target is visceral fat specifically rather than scale weight
- People willing to measure by DEXA, CT or waist circumference rather than the bathroom scale
Where clinician input matters
- Anyone with active cancer or a cancer history
- Pituitary pathology, including prior pituitary surgery or irradiation. This is a label contraindication, not a caution
- Anyone acutely critically ill
- Diabetic retinopathy
- Pregnant or nursing
- Anyone already taking exogenous GH or another GH secretagogue
The science
Read the compound mechanisms
Tesamorelin is a secretagogue, not a hormone replacement. It binds GHRH receptors on the anterior pituitary and tells the gland to produce and release your own growth hormone, which then travels to the liver and tissues and drives IGF-1 production. Because it works through the pituitary, the body's natural pulsatile release pattern and its somatostatin feedback brake stay intact, which is the central difference from injecting growth hormone directly, and the reason the insulin resistance risk is lower. The fat-loss effect runs through GH-mediated lipolysis: growth hormone activates hormone-sensitive lipase in fat cells, breaking stored triglycerides into free fatty acids. Visceral fat responds preferentially because those cells carry a higher density of beta-adrenergic receptors and are more metabolically active than subcutaneous fat. GH production declines roughly 14% per decade after age 30, which is the rationale for off-label use.
Ipamorelin activates the ghrelin receptor (GHS-R) on the pituitary. Ghrelin is the hunger hormone, and its receptor also sits on the GH release pathway, which is why this class works at all. The functional effect is suppression of somatostatin, the hormone that normally brakes GH release. Pairing it with a GHRH analog produces a larger pulse than either alone, because one compound is signalling for release while the other removes the restraint. Ipamorelin's distinguishing feature is selectivity: it hits the GH pathway without the cortisol, prolactin and appetite effects that older ghrelin mimetics produce.
Commonly researched ranges
- Tesamorelin1.28–1.4 mgPrescription
- Ipamorelin100–300 mcg
| Compound | Amount | Frequency | Timing |
|---|---|---|---|
| TesamorelinPrescription | 1.28–1.4 mg | Once daily | Bedtime, fasted at least 2–3 hours |
| Ipamorelin | 100–300 mcg | Once daily | Bedtime, same injection window as tesamorelin |
- Tesamorelin: Label doses, and they differ by formulation. EGRIFTA SV: 2 mg vial reconstituted with 0.5 mL STERILE water, dose 1.4 mg = 0.35 mL subcutaneously daily, use immediately and discard the remainder. EGRIFTA WR: 11.6 mg vial reconstituted with 1.3 mL BACTERIOSTATIC water, dose 1.28 mg = 0.16 mL daily, one vial lasts 7 days. Both labels state the formulations are not substitutable. The fasted window is not optional. Insulin blunts the GH response.
- Ipamorelin: Our weight-loss guide describes an alternative schedule of 200–300 mcg two to three times daily. A pre-blended tesamorelin/ipamorelin vial at 10 mg / 3 mg is sold for convenience: 10 mg / 3 mg reconstituted with 2 mL bacteriostatic water gives tesamorelin 5 mg/mL and ipamorelin 1.5 mg/mL, so 20 units draws 1 mg tesamorelin plus 300 mcg ipamorelin in one shot. The unit arithmetic is worth learning; the cadence sold with it (once daily evening, 5 on / 2 off, 8 weeks on / 8 off) is vendor-tier.
- Duration
- 8–12 weeks on, 4 weeks off. The Playbook tesamorelin protocol runs 12–26 weeks, matching the trial duration.
Mixing each compound
Not established in available literature. Use the figures printed on your own vial.
Week by week
Tesamorelin
- Week 1–2
Adaptation. Possible mild joint stiffness or water retention, signs the GH axis is responding. These typically resolve by week 3.
- Week 3–4
Sleep quality and recovery begin to improve, usually the first noticeable effect. Some report better skin quality.
- Month 2–3
Measurable visceral fat reduction begins. Body composition shifts become visible; waist circumference drops. Total scale weight may not move much, since fat loss is offset by lean tissue gain.
- Week 16–26
Full clinical effect as demonstrated in trials: maximum visceral fat reduction by week 26, around 15–18%. Bloodwork may show improved fasting glucose and lipids.
- Beyond 26 weeks
Benefits maintained with continued use. LIPO-011 showed fat reduction maintained through 52 weeks.
- After stopping
In LIPO-011, patients switched to placebo at week 26 saw visceral fat return to baseline. Ongoing treatment is needed to maintain the reduction.
Ipamorelin
- Early weeks
Improved sleep and recovery are the first effects our sources describe, driven by amplified GH pulses during deep sleep.
- Week 4–8
Our tesamorelin page describes stack users reporting significant fat reduction beginning in this window.
What it costs
- Tesamorelin: $300–500 per month
- Ipamorelin: Not established in available literature
The combined figure excludes Ipamorelin, for which our sources publish no price.
Cautions
- The tesamorelin label contraindications are hard, not cautions: disruption of the hypothalamic-pituitary axis (hypophysectomy, hypopituitarism, pituitary tumour or surgery, head irradiation, head trauma), active malignancy, hypersensitivity, and pregnancy.
- Both labels state plainly: not indicated for weight loss management. Long-term cardiovascular safety is not established.
- The quantified label numbers are worth reading before starting. At 26 weeks, 47% of patients had IGF-1 above 2 standard deviations and 36% above 3. HbA1c reached 6.5% or higher in 5% of patients versus 1% on placebo. The intention-to-treat hazard odds ratio for developing diabetes was 3.3 (95% CI 1.4–9.6).
- Growth-hormone-induced fluid retention is on the label: oedema, arthralgia and carpal tunnel syndrome.
- Increased mortality has been reported in patients with acute critical illness. This is a reason to stop, not a reason to monitor.
- On glucocorticoid replacement for adrenal insufficiency, growth hormone inhibits 11β-HSD-1 and maintenance or stress doses may need increasing. Cortisone acetate and prednisone are the most affected. This is the opposite direction from the "corticosteroids blunt tesamorelin" story that used to sit here.
- This is two GH-axis compounds running at once. The Playbook warns explicitly against combining GH-modulating peptides without medical guidance.
- Monitor IGF-1, fasting glucose and a lipid panel at baseline and mid-cycle.
- Tesamorelin is a prescription compound. Work with your prescriber.
- Visceral fat returns to baseline after stopping. LIPO-011 demonstrated this directly.
Absence from this list does NOT mean safety. It means lack of research.
Every stack here is free to read, and it stays free. Your own schedule, vials and log live in the app: Claritide for iPhone.