Since it first became available in the 1990s, highly active antiretroviral therapy (HAART) has helped save countless lives and improve quality of life in thousands of HIV patients. Unfortunately, a side-effect of the HAART therapy was a rather dramatic change in body shape with a shift of fat to the abdominal region. At first thought, it may seem like an acceptable trade-off, but the fat accumulation isn’t purely cosmetic and has negative health implications.

The associated gain in abdominal fat is largely attributed to visceral adipose tissue (VAT). This type of fat is deep in the abdomen and surrounds the organs, hence “visceral”. This is different than subcutaneous fat which can be thought of as the “jiggly” fat underneath the skin. VAT is associated with numerous disease states such as insulin resistance (leading to Type 2 diabetes), hypertriglyceridemia (high trigylcerides), metabolic syndrome and heart disease.

Enter Tesamorelin (trade name Egrifta). Approved in 2010 and developed by the Canadian pharmaceutical company Theratechnologies for the use in the treatment of HIV-associated lipodystrophy, this peptide hormone has recently gained a lot of attention from the performance enhancement and age-management community.

Tesamorelin is a synthetic growth hormone releasing factor with all 44 amino acids with the addition of trans-3-hexenoic acid. This modified format is more potent and stable than the natural peptide.

This peptide hormone stimulates the release of growth hormone (GH), with a resultant increase in insulin-like growth factor (IGF-1) after passing through the liver. The outcome is a change in body composition through a combination of anabolic and lipolytic (fat-burning) means. In addition, Tesamorelin has been show to decrease triglyceride levels.

The benefits of Tesamorelin can include the following:

  • Reduce triglycerides
  • Improve cogntition in patients over 60
  • Decrease carotid intima media thickness (cIMT) – a decrease in this measurement is associated with less atherosclerotic vascular disease
  • Decrease c-reactive protein (inflammatory blood marker
  • Decreased abdominal fat
  • Increase protein synthesis

Contraindications

  • Type II diabetes
  • Disorders of the pituitary gland
  • Cancer
  • Pregnant women
  • Children less than 18 years of age

Side Effects

  • Hypersensitivity (rash, urticaria)
  • Extremity pain
  • Hyperglycemia
  • Injection site reactions (redness, itching, pain, irritation, swelling)

Before starting Tesamorelin, it is recommended you discuss with your doctor and evaluate your blood for markers such as triglycerides, blood sugar, HbA1C, IGF-1, liver enzymes.