Visceral Fat, Reduced
Randomized trials found meaningful reductions in visceral fat.
Prescription · Clinical Monograph
Tesamorelin
FDA-approved for a complication of HIV treatment. Prologue prescribes it off-label, and it raises blood sugar.
Tesamorelin is a growth hormone releasing hormone analog. The FDA approved it in 2010 as Egrifta, to reduce excess visceral abdominal fat in people with HIV-associated lipodystrophy. Prologue prescribes it off-label.
It prompts the pituitary to release growth hormone in its natural rhythm, which raises IGF-1. Growth hormone influences how the body stores fat, which is where the body-composition interest comes from.
Two effects need checking before your physician will prescribe it: it raises blood sugar, and it raises IGF-1.
Straight Past the Gut
Daily subcutaneous injection.
Off-Label, Stated Plainly
FDA-approved for a complication of HIV treatment. Prologue prescribes it off-label.
What getting it involves
A consultation
A consultation with a Prologue physician.
A physician reads it
Your A1c, your fasting glucose, and your cancer history.
Prescribed off-label
FDA-approved for a complication of HIV treatment. Prologue prescribes it off-label.
Dispensed
Daily subcutaneous injection, compounded by a licensed pharmacy partner.
Where the evidence stands
Approved
The evidence comes from randomized trials in people with HIV-associated lipodystrophy, which found meaningful reductions in visceral fat.
Egrifta · FDA-approved 2010
Unknown
No trial has been run on healthy adults taking it for body composition. The mechanism should work the same way. Whether it works as well is unknown.
The visceral fat returns when you stop taking it.
What your physician screens for
Blood sugar
Growth hormone raises glucose, and tesamorelin raises growth hormone. In the approved trials it worsened glucose control in some people. Your physician checks your A1c and fasting glucose before prescribing.
Cancer history
Growth hormone and IGF-1 are growth signals. Active malignancy is a contraindication on the approved label. Whether long-term IGF-1 elevation affects cancer risk over decades remains an open question in the literature, and your physician will weigh your family history against it.
These two risks are specific to tesamorelin. The consultation also covers your full medical history, and your physician may ask for recent lab results depending on what they find.
How it's prescribed
Daily subcutaneous injection.
There's no established dose for the off-label use. Your physician sets it against your lab results, including IGF-1, and adjusts.
Compounded by a licensed pharmacy partner and tested for potency, sterility, and endotoxin levels before shipment.
PotencySterilityEndotoxin
Disclosures
Tesamorelin is FDA-approved as Egrifta for the reduction of excess visceral abdominal fat in patients with HIV-associated lipodystrophy. Prologue prescribes it off-label for longevity indications. It is compounded by a licensed pharmacy partner and tested for potency, sterility, and endotoxin levels before shipment. Treatment is not appropriate for every patient, and outcomes vary. Talk with your physician about whether this fits your situation.
Begin
How to get it.
Tesamorelin requires a consultation with a Prologue physician.
Everyone else starts by joining the practice.
Members can bring it up at their next consultation.
Questions
Nothing is charged when you join. Billing begins only after a physician has approved your plan. If they decide treatment isn't appropriate for you, you are not charged.
It is gentler than most people expect. The needle is the size of an insulin pen — thin and short, designed for subcutaneous tissue rather than muscle. Your physician can walk you through the technique at your consultation, and most patients are comfortable with the routine by the end of the first week.
NAD+ and sermorelin are compounded by a licensed pharmacy partner and shipped monthly with everything you need — vials, syringes, alcohol swabs, sharps disposal. Your physician adjusts dosing based on how you're responding.
It's a subcutaneous injection, given at home. Your physician sets the schedule, so the frequency is decided for you rather than fixed in advance.
The first dose takes about a minute. Your physician can walk you through the technique at your consultation, and you'll have everything you need in the first shipment.
Tell your physician at your intake. The needle is short and fine, and most people settle into the routine within the first couple of weeks — but if self-injection isn't workable for you, say so and your physician will talk through the alternatives.
For anything urgent, call 911 or your primary care physician — Prologue is not an emergency service. For everything else, write to the care team. Clinical questions get a reply within 24 hours.
Standard shipping for oral medications. Cold-chain shipping for injectables.
Protocol adjustments happen as your response shows up. If the dose or cadence changes, your next shipment reflects the change. There is no additional fee for protocol adjustments within your existing protocol.
Refills go out on the cadence your physician sets, without you having to ask.
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