Tesamorelin and other GH Secretagogue dosing protocol

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Top of normal range as a raw number is useless as the raw igf1 number you get depends on the machine used, the reference range, and the measurement method. Much better to talk about igf1 levels in terms of z-score, so you can a sane way to compare across labs.
 
EAM9112 said:
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
Thank you for this! Excellent info
 
RicFlair said:
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
Skip the MOTS-c - but do add the IPA with Tesa. These work together for a higher than either alone benefit (2+2=5)

MOTS-c is unrelated and has comparatively lower level of study supporting it.

The simultaneous use of Tesamorelin and Ipamorelin leverages a biochemical synergy to optimize growth hormone (GH) therapy. While direct human trials for this exact combination remain scarce, the physiological rationale is well-established across endocrinology literature (Mayfield, 2026).

This protocol mimics the body’s natural, dual-signaling mechanism for GH release. Tesamorelin is an FDA-approved Growth Hormone-Releasing Hormone (GHRH) analogue that binds to GHRH receptors on the pituitary to kickstart a natural, pulsatile surge of GH. This specific peptide is clinically proven to dramatically decrease visceral adipose tissue and improve lean muscle mass quality (Adrian et al., 2019). Meanwhile, Ipamorelin acts via a completely separate pathway as a selective Growth Hormone Secretagogue (GHS) and ghrelin receptor agonist (Sinha et al., 2020).

When paired, these pathways act synergistically (Veldhuis & Bowers, 2009). Ipamorelin dramatically amplifies the peak amplitude of the GH pulse initiated by Tesamorelin, while simultaneously neutralizing somatostatin—the inhibitory hormone that halts GH production. This dual action triggers a highly potent, sustained elevation of natural GH and downstream Insulin-like Growth Factor 1 (IGF-1). This achieves optimized body recomposition and enhanced recovery without causing the organomegaly or systemic side effects tied to synthetic, exogenous human growth hormone injections (Sinha et al., 2020).
 
zebit0 said:
Skip the MOTS-c - but do add the IPA with Tesa. These work together for a higher than either alone benefit (2+2=5)

MOTS-c is unrelated and has comparatively lower level of study supporting it.

The simultaneous use of Tesamorelin and Ipamorelin leverages a biochemical synergy to optimize growth hormone (GH) therapy. While direct human trials for this exact combination remain scarce, the physiological rationale is well-established across endocrinology literature ( Mayfield, 2026 ).

This protocol mimics the body’s natural, dual-signaling mechanism for GH release. Tesamorelin is an FDA-approved Growth Hormone-Releasing Hormone (GHRH) analogue that binds to GHRH receptors on the pituitary to kickstart a natural, pulsatile surge of GH. This specific peptide is clinically proven to dramatically decrease visceral adipose tissue and improve lean muscle mass quality ( Adrian et al., 2019 ). Meanwhile, Ipamorelin acts via a completely separate pathway as a selective Growth Hormone Secretagogue (GHS) and ghrelin receptor agonist ( Sinha et al., 2020 ).

When paired, these pathways act synergistically ( Veldhuis & Bowers, 2009 ). Ipamorelin dramatically amplifies the peak amplitude of the GH pulse initiated by Tesamorelin, while simultaneously neutralizing somatostatin—the inhibitory hormone that halts GH production. This dual action triggers a highly potent, sustained elevation of natural GH and downstream Insulin-like Growth Factor 1 (IGF-1). This achieves optimized body recomposition and enhanced recovery without causing the organomegaly or systemic side effects tied to synthetic, exogenous human growth hormone injections ( Sinha et al., 2020 ).
Amazing work thank you for all the education and links to the studies! Great information
 
zebit0 said:
The simultaneous use of Tesamorelin and Ipamorelin leverages a biochemical synergy to optimize growth hormone (GH) therapy. While direct human trials for this exact combination remain scarce, the physiological rationale is well-established across endocrinology literature ( Mayfield, 2026 ).

Might be important to add that Tesamorelin does not require cycling, FDA study subjects used it continuously for close to a year I believe.

Ipamorelin however is recommended to be cycled, with its optimal range being between 12–16 weeks.
 
Just completed my second run of Tesamorelin. The first one was 30 days back in November 25 due to a miscalculation of the total needed. This one lasted 50 days. 2mg in the AM, fasted, and I stored it in a dark, cool space, not refrigerated. just got my bloodwork back today.

IGF-1 470 ng/ml. ( Way too high)

Z score = + 3.0 ( Way too high)

Kinda a bummer. The side effects have been really showing up over the last couple of weeks. Carpel tunnel and joint soreness in all limbs

I really did enjoy using this peptide. Waist dropped at least 2 more inches, but will discontinue due to much higher levels than anticipated. Might cycle again later this year, but at 1 mg.
 
zebit0 said:
Skip the MOTS-c - but do add the IPA with Tesa. These work together for a higher than either alone benefit (2+2=5)

MOTS-c is unrelated and has comparatively lower level of study supporting it.

The simultaneous use of Tesamorelin and Ipamorelin leverages a biochemical synergy to optimize growth hormone (GH) therapy. While direct human trials for this exact combination remain scarce, the physiological rationale is well-established across endocrinology literature ( Mayfield, 2026 ).

This protocol mimics the body’s natural, dual-signaling mechanism for GH release. Tesamorelin is an FDA-approved Growth Hormone-Releasing Hormone (GHRH) analogue that binds to GHRH receptors on the pituitary to kickstart a natural, pulsatile surge of GH. This specific peptide is clinically proven to dramatically decrease visceral adipose tissue and improve lean muscle mass quality ( Adrian et al., 2019 ). Meanwhile, Ipamorelin acts via a completely separate pathway as a selective Growth Hormone Secretagogue (GHS) and ghrelin receptor agonist ( Sinha et al., 2020 ).

When paired, these pathways act synergistically ( Veldhuis & Bowers, 2009 ). Ipamorelin dramatically amplifies the peak amplitude of the GH pulse initiated by Tesamorelin, while simultaneously neutralizing somatostatin—the inhibitory hormone that halts GH production. This dual action triggers a highly potent, sustained elevation of natural GH and downstream Insulin-like Growth Factor 1 (IGF-1). This achieves optimized body recomposition and enhanced recovery without causing the organomegaly or systemic side effects tied to synthetic, exogenous human growth hormone injections ( Sinha et al., 2020 ).
What is the correct ratio for Tesamorelin / Ipamorelun? Is it 1mg Tesa / .25mg Ipa, or ???
 
chewonmysac said:
Just completed my second run of Tesamorelin. The first one was 30 days back in November 25 due to a miscalculation of the total needed. This one lasted 50 days. 2mg in the AM, fasted, and I stored it in a dark, cool space, not refrigerated. just got my bloodwork back today.

IGF-1 470 ng/ml. ( Way too high)

Z score = + 3.0 ( Way too high)

Kinda a bummer. The side effects have been really showing up over the last couple of weeks. Carpel tunnel and joint soreness in all limbs

I really did enjoy using this peptide. Waist dropped at least 2 more inches, but will discontinue due to much higher levels than anticipated. Might cycle again later this year, but at 1 mg.
Sounds like great news to me: you don't need 2mg to get meaningful IGF1 rise, and you get to save money. Very few non-HIV people will need 2mg, IGF1 zscore should be your guide for dosage, not some arbitrary mg number.
 
chewonmysac said:
Just completed my second run of Tesamorelin. The first one was 30 days back in November 25 due to a miscalculation of the total needed. This one lasted 50 days. 2mg in the AM, fasted, and I stored it in a dark, cool space, not refrigerated. just got my bloodwork back today.

IGF-1 470 ng/ml. ( Way too high)

Z score = + 3.0 ( Way too high)

Kinda a bummer. The side effects have been really showing up over the last couple of weeks. Carpel tunnel and joint soreness in all limbs

I really did enjoy using this peptide. Waist dropped at least 2 more inches, but will discontinue due to much higher levels than anticipated. Might cycle again later this year, but at 1 mg.
IMO, this is the way to go. Get your Z-Score and adjust accordingly. I ran Tesa at 1.5mg- 2mg and my Z-score jumped way too high as well. I dropped down to 1mg and will retest later this month.
 
Commander said:
What is the correct ratio for Tesamorelin / Ipamorelun? Is it 1mg Tesa / .25mg Ipa, or ???
There’s no study to suggest a ratio or proper dose of these together. Independently there are studies suggesting Tesa at up to 2mg weekly for HIV patients. Ipa has very limited studies, maybe a 7 day human study IIRC. As others mentioned, IGF-1 and Z-score results are likely as good a guide as it gets. I’ve used up to 2mg Tesa and 290mcg IPA but then downward to get desired blood test results / ranges. And remember the GH doesn’t do a lot for us unless we’re doing some resistance training.
 
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