Tesamorelin / Ipamorelin

Tesamorelin and ipamorelin are two peptides that work on different parts of the same system. Tesamorelin is a stabilized analog of growth-hormone-releasing hormone (GHRH), the molecule your hypothalamus already uses to ask the pituitary for growth hormone. Ipamorelin is a selective ghrelin-receptor (GHS-R1a) agonist that acts on a parallel pathway on the same pituitary cells.

Pairing them activates two receptors on the same cell at the same time. Published pituitary work suggests this dual stimulation produces a larger, sharper pulse of growth hormone than either peptide on its own.

Tesamorelin has an FDA-approved version (Egrifta WR) for HIV-associated lipodystrophy. The combination with ipamorelin at wellness doses is used as an individualized protocol, not a labeled indication.

Growth hormone is naturally pulsatile, with the largest pulses happening overnight in deep sleep. Dosing at bedtime works with that rhythm rather than against it. The 5-on / 2-off pattern gives the pituitary regular off-days, which we and most outpatient protocols favor over continuous daily dosing.

The 12-on / 4-off cycle is similar. The aim is to keep the GH axis responsive, not to drive it constantly. Sustained, non-pulsatile GH elevation is a different physiologic state than what this protocol is trying to mimic.

Dose adjustments are based on what you’re noticing in sleep, training, and recovery. The cycle structure itself is the main lever; we adjust if a cycle isn’t doing what you expected, not on a fixed schedule.

Body composition is rarely about a single lever. This protocol is often used to supplement other services like medical weight management and hormone optimization, where the underlying drivers tend to live.