List of Peptides, Their Use, and Common Dosages

List of peptides and other molecules, their uses, and commonly used dosages.

Adipotide (FTPP) - Targets blood vessels in fat tissue to promote fat loss by cutting off blood supply to adipose tissue. Dose: Highly experimental, no established safe dosing.

AICAR - Activates cellular energy pathways to enhance endurance and potentially promote fat burning. Dose: Research doses 150-500mg, but safety unclear.

AOD9604 - A growth hormone fragment designed to promote fat loss while avoiding muscle-building effects. Dose: 250-500mcg daily.

ARA-290 - Provides tissue protection and promotes healing through erythropoietin receptor activation. Dose: 2-8mg daily.

B7-33 - A relaxin derivative that may help with heart failure and fibrosis reduction. Dose: Experimental, no established dosing.

BPC-157 - Promotes healing of various tissues including tendons, muscles, and digestive tract. Dose: 200-500mcg daily.

Bronchogen - Used as a bronchodilator to help with respiratory conditions. Dose: Varies by condition.

Cagrisema - A combination therapy for weight management and diabetes control. Dose: Clinical trials ongoing.

Cagrilintides - Dual-acting peptides that regulate blood sugar and promote weight loss. Dose: Under clinical investigation.

Cardiogen - Supports cardiovascular health and heart muscle function. Dose: 10-20 drops or equivalent.
Cartalax - Targets cartilage health and may help with joint-related issues. Dose: 10-20 drops or equivalent.

Cerebrolysin - A brain-derived peptide mixture used for neurological conditions and cognitive enhancement. Dose: 10-30ml IV (medical supervision required).

Chonluten - Supports respiratory system health and lung function. Dose: 10-20 drops or equivalent.
CJC-1295 DAC - Long-acting growth hormone releasing hormone that stimulates natural GH production. Dose: 1-2mg weekly.

list of peptides their use and dosages.webp


Cortagen - Supports brain and nervous system health. Dose: 10-20 drops or equivalent.

DSIP - Delta sleep-inducing peptide that promotes deep, restorative sleep. Dose: 25-100mcg before bed.

Epithalon (Epitalon) - May have anti-aging effects by potentially influencing telomerase activity. Dose: 5-10mg daily for 10-20 days.

Follistatin-315 - Blocks myostatin to promote muscle growth and strength. Dose: 100mcg daily.

Follistatin-344 - Inhibits myostatin for muscle development. Dose: 100mcg daily.

FOXO4-DRI - Targets senescent cells to potentially slow aging processes. Dose: Highly experimental.

GHK-Cu (Copper Peptide) - Promotes skin healing, wound repair, and anti-aging effects. Dose: 1-3mg daily or topical application.

GHK Basic - Tissue repair and anti-aging without copper. Dose: 1-3mg daily.

GHRP-2 - Stimulates natural growth hormone release for muscle growth and recovery. Dose: 100-300mcg 2-3x daily.

GHRP-6 - Growth hormone releasing peptide that also stimulates appetite. Dose: 100-300mcg 2-3x daily.

GHRH - Directly stimulates pituitary to release growth hormone. Dose: Varies by specific analog.

Glutathione - Powerful antioxidant supporting detoxification and cellular protection. Dose: 500-2000mg daily or IV.

Gonadorelin (GnRH) - Regulates reproductive hormones and restores natural testosterone. Dose: 75-150mcg daily.

hGH Fragment 176-191 - Growth hormone fragment for fat loss without other GH effects. Dose: 250-500mcg daily.

Hexarelin - Potent growth hormone releasing peptide with cardioprotective effects. Dose: 100mcg 2-3x daily.

Humanin - Protects cells from damage with anti-aging and neuroprotective properties. Dose: Research stage.

Ipamorelin - Selective growth hormone releasing peptide with minimal side effects. Dose: 200-300mcg 2-3x daily.

Kisspeptin-10 - Regulates reproductive hormones and puberty onset. Dose: Research varies widely.

KPV - Anti-inflammatory peptide derived from melanocortin. Dose: 200-500mcg daily.

Liraglutide - Manages diabetes and promotes weight loss by regulating blood sugar. Dose: 0.6-3mg daily (prescription).

Livagen - Supports liver health and function. Dose: 10-20 drops or equivalent.

LL-37 - Antimicrobial peptide that fights infections and supports immune function. Dose: Topical or research doses vary.

Melanotan 2 - Stimulates melanin production for tanning and may affect libido. Dose: 250-500mcg daily.

Mezdutide - Newer peptide for weight management and metabolic health. Dose: Clinical trials ongoing.

MGF C-terminal - Promotes muscle repair and growth after exercise. Dose: 200mcg post-workout.

ModGRF 1-29 - Shorter-acting growth hormone releasing hormone. Dose: 100-300mcg 2-3x daily.

MK-677 - Stimulates growth hormone and IGF-1 while increasing appetite. Dose: 10-25mg daily.

MOTS-c - Mitochondrial peptide enhancing metabolism and exercise performance. Dose: 5-15mg weekly.

N-Acetyl Epithalon Amidate - Modified Epithalon with enhanced stability. Dose: Similar to Epithalon.

N-Acetyl Selank Amidate - Anxiolytic peptide reducing anxiety and stress. Dose: 250-750mcg daily.

N-Acetyl Semax Amidate - Enhances cognitive function and provides neuroprotection. Dose: 300-600mcg daily.


NAD+ - Supports cellular energy production with potential anti-aging effects. Dose: 250-750mg IV or sublingual.

Ovagen - Supports ovarian health and female reproductive function. Dose: 10-20 drops or equivalent.

Oxytocin - Promotes bonding, social behavior, and may aid recovery. Dose: 10-40 IU nasal spray.

Pancragen - Supports pancreatic health and function. Dose: 10-20 drops or equivalent.

PE-22-28 - May have anti-inflammatory and tissue protective effects. Dose: Research stage.

PEG-MGF - Longer-acting MGF for sustained muscle growth and repair. Dose: 200mcg 2-3x weekly.

Pinealon - Supports brain health and cognitive function. Dose: 10-20 drops or equivalent.

PNC-27 - Experimental anti-cancer peptide. Dose: Highly experimental.

Prostamax - Supports prostate health in men. Dose: 10-20 drops or equivalent.

PT-141 - Enhances sexual arousal and libido in both men and women. Dose: 0.75-2mg as needed.

P21 - Cognitive enhancer improving memory and learning. Dose: Research varies.

Retatrutide - Triple-acting peptide for significant weight loss and metabolic improvement. Dose: Clinical trials ongoing.

Selank - Anxiolytic peptide reducing anxiety while improving cognition. Dose: 250-750mcg daily.

Semaglutide - Highly effective for diabetes management and weight loss. Dose: 0.25-2.4mg weekly (prescription).

Semax - Enhances cognitive performance with neuroprotective benefits. Dose: 300-600mcg daily.

Sermorelin - Stimulates natural growth hormone production for anti-aging. Dose: 200-500mcg daily.

SS-31 - Targets mitochondria to improve cellular energy and slow aging. Dose: 2.5-5mg daily.

Survodutide - Dual-acting peptide for weight management and metabolic health. Dose: Clinical development.

TB-500 - Promotes healing of muscles, tendons, and soft tissues. Dose: 2-10mg weekly.

Tesamorelin - Specifically reduces visceral fat, particularly in HIV patients. Dose: 2mg daily (prescription).

Testagon - Supports natural testosterone production and male reproductive health. Dose: 10-20 drops or equivalent.

Thymagen - Supports immune system function and thymus gland health. Dose: 10-20 drops or equivalent.

Thyrotropin-TRH - Regulates thyroid function and metabolism. Dose: Medical supervision required.

Tirzepatide - Dual-acting peptide for diabetes and significant weight loss. Dose: 2.5-15mg weekly (prescription).

Triptorelin - Regulates reproductive hormones in hormone therapy. Dose: Varies by indication (prescription).

Vesigen - Supports blood vessel health and circulation. Dose: 10-20 drops or equivalent.

Vesilute - Supports bladder and urinary system health. Dose: 10-20 drops or equivalent.

Vilon - Supports immune system function with potential anti-aging properties. Dose: 10-20 drops or equivalent.

VIP - Regulates digestion, circulation, and immune response. Dose: Varies by application.

CRITICAL WARNING: Many of these peptides are experimental, not FDA-approved for human use, or require medical supervision. Always consult with a qualified healthcare provider before considering any peptide therapy.
 
Last edited:
Nelson Vergel

Nelson Vergel

List of peptides and other molecules, their uses, and commonly used dosages.

Adipotide (FTPP) - Targets blood vessels in fat tissue to promote fat loss by cutting off blood supply to adipose tissue. Dose: Highly experimental, no established safe dosing.

AICAR - Activates cellular energy pathways to enhance endurance and potentially promote fat burning. Dose: Research doses 150-500mg, but safety unclear.

AOD9604 - A growth hormone fragment designed to promote fat loss while avoiding muscle-building effects. Dose: 250-500mcg daily.

ARA-290 - Provides tissue protection and promotes healing through erythropoietin receptor activation. Dose: 2-8mg daily.

B7-33 - A relaxin derivative that may help with heart failure and fibrosis reduction. Dose: Experimental, no established dosing.

BPC-157 - Promotes healing of various tissues including tendons, muscles, and digestive tract. Dose: 200-500mcg daily.

Bronchogen - Used as a bronchodilator to help with respiratory conditions. Dose: Varies by condition.

Cagrisema - A combination therapy for weight management and diabetes control. Dose: Clinical trials ongoing.

Cagrilintides - Dual-acting peptides that regulate blood sugar and promote weight loss. Dose: Under clinical investigation.

Cardiogen - Supports cardiovascular health and heart muscle function. Dose: 10-20 drops or equivalent.
Cartalax - Targets cartilage health and may help with joint-related issues. Dose: 10-20 drops or equivalent.

Cerebrolysin - A brain-derived peptide mixture used for neurological conditions and cognitive enhancement. Dose: 10-30ml IV (medical supervision required).

Chonluten - Supports respiratory system health and lung function. Dose: 10-20 drops or equivalent.
CJC-1295 DAC - Long-acting growth hormone releasing hormone that stimulates natural GH production. Dose: 1-2mg weekly.

View attachment 52822

Cortagen - Supports brain and nervous system health. Dose: 10-20 drops or equivalent.

DSIP - Delta sleep-inducing peptide that promotes deep, restorative sleep. Dose: 25-100mcg before bed.

Epithalon (Epitalon) - May have anti-aging effects by potentially influencing telomerase activity. Dose: 5-10mg daily for 10-20 days.

Follistatin-315 - Blocks myostatin to promote muscle growth and strength. Dose: 100mcg daily.

Follistatin-344 - Inhibits myostatin for muscle development. Dose: 100mcg daily.

FOXO4-DRI - Targets senescent cells to potentially slow aging processes. Dose: Highly experimental.

GHK-Cu (Copper Peptide) - Promotes skin healing, wound repair, and anti-aging effects. Dose: 1-3mg daily or topical application.

GHK Basic - Tissue repair and anti-aging without copper. Dose: 1-3mg daily.

GHRP-2 - Stimulates natural growth hormone release for muscle growth and recovery. Dose: 100-300mcg 2-3x daily.

GHRP-6 - Growth hormone releasing peptide that also stimulates appetite. Dose: 100-300mcg 2-3x daily.

GHRH - Directly stimulates pituitary to release growth hormone. Dose: Varies by specific analog.

Glutathione - Powerful antioxidant supporting detoxification and cellular protection. Dose: 500-2000mg daily or IV.

Gonadorelin (GnRH) - Regulates reproductive hormones and restores natural testosterone. Dose: 75-150mcg daily.

hGH Fragment 176-191 - Growth hormone fragment for fat loss without other GH effects. Dose: 250-500mcg daily.

Hexarelin - Potent growth hormone releasing peptide with cardioprotective effects. Dose: 100mcg 2-3x daily.

Humanin - Protects cells from damage with anti-aging and neuroprotective properties. Dose: Research stage.

Ipamorelin - Selective growth hormone releasing peptide with minimal side effects. Dose: 200-300mcg 2-3x daily.

Kisspeptin-10 - Regulates reproductive hormones and puberty onset. Dose: Research varies widely.

KPV - Anti-inflammatory peptide derived from melanocortin. Dose: 200-500mcg daily.

Liraglutide - Manages diabetes and promotes weight loss by regulating blood sugar. Dose: 0.6-3mg daily (prescription).

Livagen - Supports liver health and function. Dose: 10-20 drops or equivalent.

LL-37 - Antimicrobial peptide that fights infections and supports immune function. Dose: Topical or research doses vary.

Melanotan 2 - Stimulates melanin production for tanning and may affect libido. Dose: 250-500mcg daily.

Mezdutide - Newer peptide for weight management and metabolic health. Dose: Clinical trials ongoing.

MGF C-terminal - Promotes muscle repair and growth after exercise. Dose: 200mcg post-workout.

ModGRF 1-29 - Shorter-acting growth hormone releasing hormone. Dose: 100-300mcg 2-3x daily.

MK-677 - Stimulates growth hormone and IGF-1 while increasing appetite. Dose: 10-25mg daily.

MOTS-c - Mitochondrial peptide enhancing metabolism and exercise performance. Dose: 5-15mg weekly.

N-Acetyl Epithalon Amidate - Modified Epithalon with enhanced stability. Dose: Similar to Epithalon.

N-Acetyl Selank Amidate - Anxiolytic peptide reducing anxiety and stress. Dose: 250-750mcg daily.

N-Acetyl Semax Amidate - Enhances cognitive function and provides neuroprotection. Dose: 300-600mcg daily.


NAD+ - Supports cellular energy production with potential anti-aging effects. Dose: 250-750mg IV or sublingual.

Ovagen - Supports ovarian health and female reproductive function. Dose: 10-20 drops or equivalent.

Oxytocin - Promotes bonding, social behavior, and may aid recovery. Dose: 10-40 IU nasal spray.

Pancragen - Supports pancreatic health and function. Dose: 10-20 drops or equivalent.

PE-22-28 - May have anti-inflammatory and tissue protective effects. Dose: Research stage.

PEG-MGF - Longer-acting MGF for sustained muscle growth and repair. Dose: 200mcg 2-3x weekly.

Pinealon - Supports brain health and cognitive function. Dose: 10-20 drops or equivalent.

PNC-27 - Experimental anti-cancer peptide. Dose: Highly experimental.

Prostamax - Supports prostate health in men. Dose: 10-20 drops or equivalent.

PT-141 - Enhances sexual arousal and libido in both men and women. Dose: 0.75-2mg as needed.

P21 - Cognitive enhancer improving memory and learning. Dose: Research varies.

Retatrutide - Triple-acting peptide for significant weight loss and metabolic improvement. Dose: Clinical trials ongoing.

Selank - Anxiolytic peptide reducing anxiety while improving cognition. Dose: 250-750mcg daily.

Semaglutide - Highly effective for diabetes management and weight loss. Dose: 0.25-2.4mg weekly (prescription).

Semax - Enhances cognitive performance with neuroprotective benefits. Dose: 300-600mcg daily.

Sermorelin - Stimulates natural growth hormone production for anti-aging. Dose: 200-500mcg daily.

SS-31 - Targets mitochondria to improve cellular energy and slow aging. Dose: 2.5-5mg daily.

Survodutide - Dual-acting peptide for weight management and metabolic health. Dose: Clinical development.

TB-500 - Promotes healing of muscles, tendons, and soft tissues. Dose: 2-10mg weekly.

Tesamorelin - Specifically reduces visceral fat, particularly in HIV patients. Dose: 2mg daily (prescription).

Testagon - Supports natural testosterone production and male reproductive health. Dose: 10-20 drops or equivalent.

Thymagen - Supports immune system function and thymus gland health. Dose: 10-20 drops or equivalent.

Thyrotropin-TRH - Regulates thyroid function and metabolism. Dose: Medical supervision required.

Tirzepatide - Dual-acting peptide for diabetes and significant weight loss. Dose: 2.5-15mg weekly (prescription).

Triptorelin - Regulates reproductive hormones in hormone therapy. Dose: Varies by indication (prescription).

Vesigen - Supports blood vessel health and circulation. Dose: 10-20 drops or equivalent.

Vesilute - Supports bladder and urinary system health. Dose: 10-20 drops or equivalent.

Vilon - Supports immune system function with potential anti-aging properties. Dose: 10-20 drops or equivalent.

VIP - Regulates digestion, circulation, and immune response. Dose: Varies by application.

CRITICAL WARNING: Many of these peptides are experimental, not FDA-approved for human use, or require medical supervision. Always consult with a qualified healthcare provider before considering any peptide therapy.
why does tesamorelin reduce visceral fat in HIV patients more than a patient with only fatty liver?
 
To be honest, I think tirzepatide plus TRT would be better for fatty liver. But try tesamorelin. I hope it’s not too expensive.

How is Lipshultz going to measure your fatty liver progress ?
Thanks for the honest recommendation Nelson. I am not sure how he is going to manage it as I see Nurse Amy because she is more accessible. Liver enzymes are in range (mid) but for my next appointment I think Ill book it with the man Lipshultz himself to see how we can measure. Ultrasound I'd imagine..

With me I am learning to eat less and "better" and not be so afraid to lose muscle mass as I cut weight. I know at 226lbs if I get down to 210 my liver and body will be much healthier.
 
why does tesamorelin reduce visceral fat in HIV patients more than a patient with only fatty liver?

Tesamorelin vs. Ipamorelin: Properties

Tesamorelin is approved for the treatment of HIV-associated lipodystrophy. This very narrow approval belies the peptide's wider use as an agent for altering body composition. Research indicates that Tesamorelin can reduce fat mass, boost muscle and bone mass, improve peripheral nerve regeneration, and may even be useful in the treatment of mild cognitive impairment.

Ipamorelin, which underwent phase II clinical trials for the treatment of postoperative ileus, is known to be the most selective ghrelin receptor (aka growth hormone secretagogue receptor/GHSR) agonist yet discovered. It increases plasma growth hormone levels in animals but has no effect on prolactin, follicle-stimulating hormone, luteinizing hormone, thyroid-stimulating hormone, or adrenocorticotropic hormone levels. The astounding specificity of Ipamorelin makes it a highly useful peptide for studying the effects of increased GH levels with confounding results by elevating levels of other hormones.



Tesamorelin vs Ipamorelin: Mechanism of Action

What is so interesting about these two peptides is the fact that they both raise GH levels by binding to different receptors. Ipamorelin works by binding to and activating the ghrelin receptor, which is located in the brain and the pituitary gland. Activation of this receptor leads to an increase in GH release. It does not interact directly with the growth hormone-releasing hormone (GHRH) receptor like some other GHRPs.

Tesamorelin acts as a synthetic analog of human GHRH, which is a hormone that stimulates the release of GH from the pituitary gland. By binding to the GHRH receptor, Tesamorelin activates the receptor, leading to a cascade of intracellular signaling events. This results in an increase in the synthesis and secretion of growth hormone. Tesamorelin promotes the release of growth hormone in a pulsatile manner, similar to the body's natural pattern of GH secretion. This pulsatile release is important for maintaining the normal physiological functions associated with growth hormone.

Growth hormone stimulates the liver and other tissues to produce insulin-like growth factor-1 (IGF-1). Both Tesamorelin and Ipamorelin's action of increasing growth hormone levels consequently leads to an increase in IGF-1 levels. Ipamorelin has a relatively short duration of action and leads to temporary but large increases in GH and IGF-1 levels. Tesamorelin also has a relatively short duration of action. For both peptides, levels of GH and IGF-1 return to baseline after just a few hours. Tesamorelin, which is administered once daily, has a slightly greater effect on GH levels. Ipamorelin is generally considered to have a more moderate and controlled effect, mimicking the body's natural pattern of secretion. Both peptides preserve the body's natural pulsatile release of GH, a factor that is associated with a lower risk of desensitization and unwanted effects compared to continuous stimulation of GH release.



Tesamorelin vs Ipamorelin: Fat Loss

The most obvious comparison to make between Tesamorelin and Ipamorelin is in the ability of these two peptides to promote fat loss and alter body composition. While Tesamorelin is specifically approved for the reduction of adiposity, both peptides are relatively similar in their stimulation of GH release and should therefore produce somewhat similar results on body composition. Here is what the science says.

Tesamorelin has been shown to reduce adiposity by approximately 20% in a year[1]. It is known to be particularly effective in reducing visceral fat. Visceral fat is the fat that wraps around abdominal organs and is different from the subcutaneous fat that sits below the skin. A little bit of visceral fat is good for protecting organs, but too much of it can lead to dangerous health consequences including high levels of lipids and triglycerides in the bloodstream. In fact, research shows that administration of Tesamorelin can reduce triglyceride levels by approximately 25% over just 26 weeks. This may not seem like a lot, but it is similar to other common "cholesterol" drugs like niacin, atorvastatin, and simvastatin.

Tesamorelin has been shown to have positive effects on muscle mass, although its primary indication is for reducing excess abdominal fat in individuals with HIV-associated lipodystrophy. While most clinical studies of Tesamorelin have focused on its effects on reducing visceral adipose tissue (VAT) or abdominal fat, some studies have reported secondary improvements in body composition, including an increase in lean body mass or muscle mass. Combining Tesamorelin treatment with regular exercise, particularly resistance training, may have synergistic effects on muscle growth and maintenance. Exercise can further stimulate protein synthesis and enhance the anabolic response to Tesamorelin.

Research in mice shows that Ipamorelin can significantly increase growth hormone (GH) levels, with reported increases ranging from 3-fold to 13-fold above baseline levels. The impact of increased GH levels resulting from Ipamorelin administration on body composition has been studied in animal models. Studies suggest that if the diet is kept consistent, Ipamorelin treatment can lead to an increase of approximately 9% in muscle mass and a decrease of around 14% in fat mass, even without changes in exercise volume[2], [3].

The effects of Ipamorelin on triglyceride levels have not been extensively studied in human clinical trials. Therefore, the specific impact of Ipamorelin on triglyceride levels in humans is not well-established. However, as Ipamorelin stimulates the release of growth hormone (GH), it is important to note that GH can have potential effects on lipid metabolism, including triglyceride levels. GH has been shown to increase lipolysis (breakdown of fat) and improve lipid profiles in some individuals. In animal studies, Ipamorelin has been shown to reduce fat mass, which could potentially have an indirect effect on triglyceride levels.



Tesamorelin vs Ipamorelin: Fat Quality

It may sound odd to talk about the quality of fat, but research has revealed over the last several decades that all adipose tissue is not created the same. While there has been a great deal of emphasis on fat quantity from mainstream sources, there has been decidedly less discussion about fat quality and why it matters.

Adipose tissue (AT) is not just a passive energy storage depot but is increasingly being recognized as an active endocrine and inflammatory organ. In fact, thinking of adipose tissue as "fat" isn't entirely accurate. It consists of adipocytes (fat cells), connective tissue, nerves, blood vessels, and immune cells, all working together as a single unit. AT responds to hormonal and neuronal signals and plays a crucial role in maintaining metabolic homeostasis.

One of the ways AT exerts its effects on the body is through the secretion of various factors, including leptin and adiponectin. These factors, along with others, regulate metabolic processes and influence overall metabolic health. Research has primarily focused on the quantity of two types of AT: visceral adipose tissue (VAT), which surrounds internal organs, and subcutaneous adipose tissue (SAT), which is located just beneath the skin. It was originally assumed that changes in AT quantity are directly related to changes in AT quality or function. It was similarly assumed that SAT and VAT tissue were generally the same.

Careful observation has revealed that the above assumptions cannot be accurate. For instance, it has been observed that increases in AT quantity, such as in cases of metabolically healthy obesity, are not always accompanied by obvious cardiometabolic consequences. Similarly, AT quality can vary even at the same AT quantity, suggesting that AT quality may independently contribute to metabolic health. Evaluating AT quality is typically done through computed tomography (CT) scanning, where denser AT is associated with smaller, better-quality adipocytes, while lower density indicates larger, more lipid-engorged, poorer quality adipocytes.

Observational studies in the general population, such as the Framingham Heart Study, have indicated that lower VAT and SAT density are associated with lower levels of adiponectin (a beneficial adipokine) and increased cardiovascular disease risk. So, what is low-quality fat? Basically, low-quality fat is fat that is made up of large fat cells, is producing inflammatory cytokines, and which is metabolically inflexible[4]. Thus, there are both healthy fat and unhealthy fat, with the latter consisting of hypertrophic adipose cells.

Research indicates that Tesamorelin can improve the quality of fat by improving its function. In subjects given Tesamorelin, lipid and triglyceride profiles improved, adipocytes became smaller and more dense, and adiponectin concentrations increased[5]. Thus, Tesamorelin appears to not only reduce fat mass and help with weight loss, but it also helps to improve the function of existing fat tissue and thus improve overall health.

The same studies have not been performed with Ipamorelin, but it seems reasonable to believe that the peptide might have similar effects on fat quality given that both Ipamorelin and Tesamorelin are GH secretagogues. The research remains to be done but will certainly provide valuable insight into the regulation of adipose tissue health and conditions like diabetes and cardiovascular disease that are associated with it.

As a final note, do not take the discussion of fat quality to be any kind of endorsement of the “fit-fat” mentality or the idea that being lean is not desirable. Less is generally more when it comes to fat, although a body fat percentage that is too low can lead to problems. The point is not to say that carrying excess body fat is healthy, that would be a misinterpretation. The point is that lean bodies still carry fat (and should carry fat) and that fat can be either healthy or unhealthy. Future research in this area will likely reveal that fat quality is something that even relatively lean people need to pay attention to and methods for addressing fat quality will likely enhance lifespans and healthspans as well.



Tesamorelin vs Ipamorelin: Muscle Density

It is well known that GH secretagogues can help to build muscle mass and bone mass while reducing fat mass. However, these peptides do not simply increase and decrease the quantity of these tissues. As the section above describes, GH secretagogues also appear to increase the quality of fat tissue. Researchers naturally wondered if they might also affect the quality of other tissues in addition to affecting quantity.

It has long been known that Ipamorelin is of major benefit to bone health. In fact, the peptide has undergone clinical trials to determine its usefulness in the treatment of bone-wasting conditions like osteoporosis and corticosteroid-induced bone loss.

Of course, treatments for bone loss already exist in medications like bisphosphonates, and so it begs the question why reinvent the wheel? As it turns out, while bisphosphonates and existing medications are useful in stopping bone loss and improving bone density, they don't do a whole lot to improve the quality of bone itself. It would be much like shoring up the foundation of a house so that it doesn't continue to sink by doing nothing to address the cracks that are letting in water and making the home unlivable.

As it turns out, Ipamorelin doesn't simply boost bone mineral content and thus make bones denser. Rather, Ipamorelin stimulates the growth and proliferation of the cells responsible for maintaining bone structure and function. The result is that Ipamorelin can increase bone formation in certain settings by as much as 400%, helping increase bone mineral density in a systematic and meaningful way. The result is that bones aren't just denser, they are healthier and more functional. This can help to thwart some of the side effects, such as osteonecrosis of the jaw, associated with existing treatments. Remarkably, Ipamorelin does all of this while being less expensive than existing treatments.

Given the benefit of Ipamorelin on bone quality, scientists wondered if other GH secretagogues might have similar effects but on other tissues. Naturally, they turned to Tesamorelin to test because it already has FDA approval for use in humans. What they found is that Tesamorelin reduces adipose tissue within muscle, vastly increasing muscle density[6]. This may not seem like a big deal, but the deposition of adipose tissue in muscle has been linked to physical function limitations, particularly those associated with age. In fact, increased levels of fat in muscle have even been linked to falls[7].

Similarly, Tesamorelin leads to an increase in the total areas of muscle. These findings suggest that Tesamorelin is increasing overall muscle fiber growth, which is to say that Tesamorelin leads to myofibrillar hypertrophy. Muscle fiber density is directly related to muscle strength as well as muscle stamina and its ability to recover following stress. Muscle density is associated with increased athleticism and is a primary factor in aging. The denser muscles are, the more resilient they are to the ravages of aging.



Tesamorelin vs Ipamorelin: Pain and Inflammation

Previous research has revealed anti-nociceptive (anti-pain) effects of ghrelin mimetics in models of inflammatory, neuropathic, and acute pain. Some of these studies demonstrated that ghrelin mimetics reduced the release of pro-inflammatory cytokines and overall inflammation. In a neuropathic pain model, ghrelin administration in the spinal cord inhibited the activation of signaling pathways associated with pro-inflammatory cytokine upregulation. In an acute pain model, the anti-nociceptive effects of ghrelin were attenuated by an opioid receptor antagonist, suggesting the involvement of the central opioid receptor system in mediating these effects. In short, research has shown that ghrelin mimetics are effective at controlling pain associated with inflammation. To this point, it was thought that the main anti-nociceptive effects of ghrelin mimetics were, in fact, due to their ability to reduce inflammatory signals. New research, however, suggests that this may be only part of the story.

In a new study, a hypersensitivity model was used that did not involve active inflammation. Instead, the researchers induced transient visceral hypersensitivity without active colonic inflammation using a low concentration of acetic acid. In this model, the ghrelin mimetics were able to attenuate both visceral and somatic hypersensitivity. The anti-nociceptive effects were specifically mediated through the ghrelin receptors, as blocking these receptors prevented the improvement of hypersensitivity.

These findings suggest that ghrelin mimetics, like Ipamorelin, have anti-nociceptive properties and can alleviate both visceral and somatic hypersensitivity, even in the absence of active inflammation. The interaction between ghrelin and the ghrelin receptors, as well as the potential involvement of the opioid receptor system, may contribute to the mechanisms underlying these effects. Further research is needed to fully understand the therapeutic potential of ghrelin mimetics in the treatment of pain conditions, but there is a great deal of interest in using these peptides to address abdominal and GI-related pain.

Tesamorelin has not been directly tested for an ability to mitigate pain. Furthermore, as a GHRH mimetic rather than a ghrelin mimetic, the ability of Tesamorelin to influence pain cannot be inferred from the same ability of Ipamorelin. After all, Ipamorelin binds to the ghrelin receptor, and Tesamorelin, as far as we know, does not. Tesamorelin has, however, been associated with the ability to reduce inflammation, albeit modestly. In some studies, Tesamorelin led to a decrease in interconnected proteins associated with cytotoxic T-cell and monocyte activation. Specifically, the circulating concentrations of 13 proteins were significantly reduced by Tesamorelin, while no proteins showed an increase. These proteins included four chemokines (CCL3, CCL4, CCL13 [MCP4], IL8 [CXCL8]), two cytokines (IL-10 and CSF-1), and four T-cell associated molecules (CD8A, CRTAM, GZMA, ADGRG1), as well as ARG1, Gal-9, and HGF. Several of these chemokines are associated with neuropathic pain and may play a role in the propagation of pain neurodegenerative and autoimmune disorders as well as virus-based diseases that have a neuropathic pain component (e.g., herpes zoster/shingles). These findings suggest that Tesamorelin has the ability to modulate immune activation pathways and reduce the levels of specific proteins associated with cytotoxic T-cell and monocyte activation[8]. The down-regulation of these immune pathways may have implications for various types of pain.



Tesamorelin vs Ipamorelin: Research Notes

It might seem that Tesamorelin would be the easier peptide to work with in the research setting. Ipamorelin is not without advantages, though. The peptide is roughly two orders of magnitude cheaper than Tesamorelin, making it very attractive for research on a limited budget. Additionally, Ipamorelin has undergone at least phase II clinical trials and has a very long track record of use in animal research as well. Getting approval for the use of either of these peptides in research should not cause any undue burden.



Tesamorelin vs Ipamorelin: Summary

Tesamorelin and Ipamorelin are more similar than they are different, but their differences are still dramatic. In the Tesamorelin vs Ipamorelin debate, Tesamorelin appears to have a slight advantage in terms of fat loss. It also shows potential for superior cardiovascular properties, although more research is needed to establish this claim conclusively. On the other hand, Ipamorelin demonstrates advantages in improving bone mass and has shown potential benefits in sleep and general cognition. Both peptides are still under investigation for potential therapeutic applications in various disease conditions.

The biggest differences between these two peptides are in their abilities to influence muscle density and pain perception. Tesamorelin appears to be particularly useful at improving muscle density by increasing muscle fiber growth. This makes Tesamorelin of interest in treating muscle wasting and dysfunction associated with aging. Muscle dysfunction is associated with falls and a general decline in physical well-being.

Ipamorelin has been shown to be a highly effective modulator of both inflammatory and non-inflammatory pain. These properties are mediated through action at the ghrelin receptor, and thus it is not immediately clear that Tesamorelin would share any of these pain-relieving benefits. There is interest in using Ipamorelin to explore the treatment of GI pain.

So, more research is needed to fully understand the benefits and limitations of both Tesamorelin and Ipamorelin. What is clear is that the myriad benefits associated with these peptides make them of interest to research circles beyond those dedicated to fat loss. But even where fat loss is concerned, these peptides are helping to open new doors to understanding the role of fat quality in the development of diseases like diabetes. Together, Ipamorelin and Tesamorelin are helping to advance our scientific understanding of the complex control of metabolism, body composition, and energy balance. They have helped to add nuance to existing theories about energy balance and have opened new pathways to understanding the physiology and pathophysiology of adipose tissue. There is a great deal of promise in the future research of both Tesamorelin and Ipamorelin.



Resources

[1] Clinical Review Report: Tesamorelin (Egrifta). in CADTH Common Drug Reviews. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health, 2016. Accessed: Apr. 06, 2022. [Online]. Available: Clinical Review Report: Tesamorelin (Egrifta) - NCBI Bookshelf

[2] P. B. Johansen, Y. Segev, D. Landau, M. Phillip, and A. Flyvbjerg, “Growth hormone (GH) hypersecretion and GH receptor resistance in streptozotocin diabetic mice in response to a GH secretagogue,” Exp. Diabesity Res., vol. 4, no. 2, pp. 73–81, Jun. 2003, doi: 10.1155/EDR.2003.73.

[3] J. V. Gobburu, H. Agersø, W. J. Jusko, and L. Ynddal, “Pharmacokinetic-pharmacodynamic modeling of ipamorelin, a growth hormone releasing peptide, in human volunteers,” Pharm. Res., vol. 16, no. 9, Art. no. 9, Sep. 1999, doi: 10.1023/a:1018955126402.

[4] F. G. De Carvalho, J. N. Justice, E. C. de Freitas, E. E. Kershaw, and L. M. Sparks, “Adipose Tissue Quality in Aging: How Structural and Functional Aspects of Adipose Tissue Impact Skeletal Muscle Quality,” Nutrients, vol. 11, no. 11, p. 2553, Oct. 2019, doi: 10.3390/nu11112553.

[5] J. E. Lake et al., “Tesamorelin improves fat quality independent of changes in fat quantity,” AIDS Lond. Engl., vol. 35, no. 9, pp. 1395–1402, Jul. 2021, doi: 10.1097/QAD.0000000000002897.

[6] S. Adrian et al., “The Growth Hormone Releasing Hormone Analogue, Tesamorelin, Decreases Muscle Fat and Increases Muscle Area in Adults with HIV,” J. Frailty Aging, vol. 8, no. 3, pp. 154–159, 2019, doi: 10.14283/jfa.2018.45.

[7] O. Addison, R. L. Marcus, P. C. Lastayo, and A. S. Ryan, “Intermuscular fat: a review of the consequences and causes,” Int. J. Endocrinol., vol. 2014, p. 309570, 2014, doi: 10.1155/2014/309570.

[8] F. A. White, H. Jung, and R. J. Miller, “Chemokines and the pathophysiology of neuropathic pain,” Proc. Natl. Acad. Sci., vol. 104, no. 51, pp. 20151–20158, Dec. 2007, doi: 10.1073/pnas.0709250104.
 
why does tesamorelin reduce visceral fat in HIV patients more than a patient with only fatty liver?
The main reason is that they actually took Tesamorelin, a new peptide to the finish line with an FDA approval. Since Ipamorelin was already in use and readily available, there was no money in it. Ipam will give you the same results sans the FDA approved label. For a lot less money ;)
 

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