← The Hunter Williams Podcast
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Hunter Williams
Hey everybody, this is Hunter Williams. I hope you're doing amazing wherever you might be in the world today I have the Tessa Morellin Masterclass. I'm really excited for this one. I love the Peptide Tessa Morellin. I think this masterclass is going to be really cool because you're probably if you're in the peptide world, you're familiar with Tessella and you may have even used it. And today we're going to be doing just going over the masterclass of one, just the background of how it works and everything like that, but then also to the best practices that I would recommend for for using it. This is one that definitely I've seen move the needle probably more in people's health and fitness journey than a lot of the other Peptides. So we're going to go through all of that everything you need to know related to tesmorellon so that at the end of this video you can either take this yourself or share it with a friend and family member and basically have all of the tools in order to use TESS and intelligently to get the results you would want, which is usually obviously better body composition better sleep better and all the other things that we are looking forward to using with Peptide. So that's we're going to cover in this one. As always, thank you guys so much for supporting me and being there. Whether you're on the email list, use my code at places, whatever it is. Thank you guys so much. The link will be to will always be in the description of the videos. There's one link now there now that is kind of like a link tree that you can click on and then go use to opt into the email list or join the private group or whatever it is. So thank you guys so much and without further ado, I enjoyed you hope to share my screen and today we are going to cover tessamorelin. All right, let's get into it. Today I'm going to cover TESS and this will be the user's guide as it stands today in 2026 as of the filming of this video. So what is tess? Today we're going to cover Tessin. It's the only FDA approved peptide for visceral fat reduction. We'll go over the foundations, dosing and cycling, protocol stacking and then also just some troubleshooting and FAQs, because this is one that I say has a decent amount of side effects or issues that come up when people are using it. Now, TESS is not growth hormone itself. I personally am a fan of growth hormone, but I am also a fan of Tesslin and I think you can use both of them intelligently in the right protocol. But TESS is a synthetic analog of growth hormone releasing hormone. It's gonna be a very important distinction as you go along on your peptide journey to understand the difference between a GHRH and a ghrp, which is a growth hormone releasing peptide. TESSIN sits on the side of a ghrh. Now, what does that mean? It's an upstream signal your hypothalamus uses to tell your pituitary to release your own GH and natural pulsatile burst. So what we're doing when we're using Tesamorelin is increasing endogenous growth hormone production. You inject tesrelin, your pituitary releases growth hormone, your liver makes IGF1, and then we get all of these wonderful benefits and the negative feedback loops that keep the system system balance stay intact. Unlike introducing exogenous growth hormone which can impair that feedback loop and have a negative impact on it. TESS Marlin does not do that. So then we come off, basically we're just right back where we were before and there's no downtime like you would have with hgh, although I do think that with HGH is overblown. But again, different topic for a different video. Now let's look at the headline numbers. In clinical studies, we see 15% visceral fat reduction. So not just fat reduction, but visceral fat reduction over 26 weeks. And that was from a 2007 trial. 37% liver fat reduction over 12 months in a 2019 study that was in HIV patients with fatty liver disease and then it was approved by the FDA in 2010. So this is an FDA approved peptide, meaning that you can get this compounded from compounding pharmacies to use off label from your doctor. Again, a peptide is just a short chain amino acids. Again we all know the popular peptides. Let's look at specifically though the molecular structure of tesrellin. Tessa is a 44amino acid peptide with a sequence identical to native human growth hormone releasing hormone plus one critical addition. It has a trans 3 hexanoic acid moiety on the alpha amino group of the first amino acid which is tyrosine. Again don't get confused with that. Just know that this is about as close to native human growth hormone releasing hormone that we can get in the form of a peptide. And what this means that the modification physically blocks the enzyme DPP4. From cleaving the molecule extends the half life from around seven minutes, which is what native G R, G H R H is, to around 26 to 38 minutes, which is long enough to drive a meaningful GH pulse from a single daily injection. And again when we get that, that 26 to 38 minute half life, it's more about the downstream effects of tesrellin. So obviously extending it from seven to 26 minutes has an impact on what it's doing, but it's going to have a cumulative effect over time. And again when we look at names, the brand name is a Grifta or a Grifta SV or a Grifta WR also has been called Tesrel and Acetate TH9507 or just mostly Teslin. There's not a ton of different names around this one. Let's look at the growth hormone haxis and how it actually works in the body. So one, we have the hypothalamus and then that is signaling to the pituitary and then the pituitary makes growth hormone and and then that goes to liver which is then metabolized into IGF1 and then we have a feedback loop. So again think of this as a F thermostat. The hypothalamus is the dial, the pituitary is the furnace, the GH is the heat and the IGF one is the room temperature. And so the ultimate goal with all of this is to have the right temperature, right, which is to have the right IGF one to create the environment in the body that ends up getting us the fat loss, the sleep benefits, and everything we have, but the hypothalamus again is tuning the dialogue. The pituitary is the actual furnace that is creating the temperature. In this case it would be the heat if you had a furnace. And then the GH is the actual heat and then ultimately the IGF one is the temperature, which is the end result. And then we have a feedback loop to where we can turn that up or down. And that's what we're using TESS to do. When we look at clinically important effects, obviously the biggest one is reduction in visceral fat. Growth hormone driven lipolysis targets the dangerous fat fat behind the abdominal wall and that's primarily what people are going to use it for. Secondarily we have a reduction in liver fat. So direct growth hormone effects plus reduced fatty acid delivery from shrinking visceral fat end up in reduced liver fat. We obviously have the increase in IGF1, which restores levels typical of a healthy young adult, which can be very, very beneficial to someone in their 50s or 60s. Lipids improve, so triglycerides fall significantly and think cholesterol modestly improves. But more importantly, we get drops in triglyceride, which can be huge for someone's metabolic health that ends up dictating later risk for cardiovascular disease. And then what's cool, I think very few people talk about this and very few people realize it, but we actually get an improvement in cognition with Tessellin that's driven by this increase in GH and IGF1. Executive function improves in older adults, and that was in a 2012 trial. So very cool things there. Let's look at Tessellin, comparing it to some of these other GH peptides because there are many. These are the popular ones when we look at Tess, it works on the GHRH receptor, serumorelin and CJC. 1295 DAC or no DAC, both work on the GHRH receptor as well. I would say Tessamorelin ultimately is probably the superior peptide for most people when it comes to a GHRH analog. The half life is 26 to 38 minutes, whereas with those it's around 30 minutes. Obviously the CJC with DAC has a half life of six to eight days, which I actually don't like and I won't talk about that in this video, but I'll cover that in the CJC video. Then we have iPirelin and MK677. These are Ghrelin receptors or GHRP analogs. So they're growth hormone releasing peptide. The Half life can be around 2 hours to 24 hours. In the case of MK677 IPinelin, closer to a 2 hour half life.
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Hunter Williams
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Hunter Williams
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Hunter Williams
You can watch the record breaking phenomenon at home. You're clearly working at Zootopia 2 now available on Disney plus, rated PG. Those are not FDA approved, whereas TESS is. There is visceral fat RCT data around tesmorellon and not around the other ones. And. And then is it stackable? Tesmorellon? I would recommend people not to stack serumorelin and CJC with tess, whereas you can stack tesmorellon with ipamorelin. Although I'll talk about this a little bit later when we get into the stacking section. There are times where you may want to do that and there are times where you may not want to do that. Now who's the peptide for? I think for people in their 40s and 50s that have creeping visceral fat, training and diet is reasonable, but the midsection won't respond. This is the strongest evidence base obviously for people with fatty liver and have people that have elevated liver enzymes or imaging diagnosis, this is gonna work really well for them. And then people that have low to normal IGF1, which most people after 40 will have, or even people that have had concussions or brain trauma. The bottom third of age specific range. For people with poor recovery, drifting body composition. Tesla is typically gonna raise IGF1 by 80 to 110% in a lot of cases. So it can be very beneficial to those people that have like an IGF one of 150 or under. And then for people with cognitive concerns, there are WOR that have word retrieval problems, memory issues, slower executive function. It does show moderate improvement over a 20 week period for people with cognitive issues. So for all the people out there that are trying to do everything they can to stop cognitive decline, TESS can be a huge, huge player to help improve that. Also for people, I think, you know, when we look at the GH peptides, younger people stand to benefit really well from them. So for the biohacker that's optimized on trt, I really love the combination of TRT with either growth hormone testament, ipamilin, anything along the growth hormone axis, you Just get this one plus one equals three effect that you cannot get with either alone. And I say that to the people. There are so many people out there, you might be one of them watching this. That will take testamorelan, but you will do nothing about your testosterone levels. And again, it's not to say that it's not gonna work, but it's just gonna be one of those things that ends up not getting the results that you probably want if you're not optimizing both of them. So the biohacker on trt, it's gonna get. They're gonna get muscle protein synthesis from the testosterone. Testament's gonna amplify the GH axis and handle visceral fat. And then they're gonna get two different signals with a clean complimentary effect. And also too, for people that are post bariatric surgery or post GLP1 or post GLP1 active phases where they're on higher doses of a GLP1 from those things, they're going to get significant weight loss. But disproportionate visceral fat remains in a lot of cases. And tesrel and targets that residual depot specifically, once stable on the primary intervention. And I always like to remind people tesrelin is a body composition tool, not a direct weight loss tool. The FDA splits specifically notes a weight neutral effect in a lot of people. So if significant weight reduction is a goal, GLP1s are usually the right tool. I love them synergistically together, especially for the muscle muscle maintenance and muscle just keeping muscle on over time. On a GLP1. Everyone's on a GLP1 that is struggling with muscle loss. There's no reason they shouldn't be on a peptide like Tess. And again, there, there is typically a weight neutral effect, but we do get this reduction in visceral fat. But then you pair that with the GLP1 and then you pair it with testosterone. It's amazing. And so you often hear people talk about ttt. So trt, teslin and terzepatide, you could obviously do trt. You could do retatrutide and you could do testamen. You could do anything in those category, buckets. But that's just a very, very good stack that a lot of people can use to transform their body pretty rapidly. Who should skip it? Anyone with cancer? Again, we just don't know when it comes to growth hormone and cancer. So at the end of the day, I could go into different diatribes on both sides of the fence to growth hormone cancer. But if you do have an active or recent malignancy. We just think it's probably best at this point to not use it. People that are pregnant or lactating just don't do it. People have had HPA axis disruption, so a pituitary tumor surgery, irradiation or hypopituitarism, the signal has no functional target. I want to talk about this for a second because I am someone that has a partially empty sell up, which is most likely come from the fact that I've had a lot of concussions in my lifetime from playing football at a very high level for a very long time. When you talk about growth hormone peptides like Teslarillin Lin, for people like that, it's not that they won't work. However, a lot of those people like myself don't get the results that I would get from growth hormone itself because we're relying on that HBA axis, which in a lot of times doesn't work that well because our pituitary doesn't work that well. So does it mean it's absolutely worthless? No, but the peptide tends to work better in someone that does not have that. And so for me, the first time I took growth hormone, it was like it was one of the best things I had ever experienced for sleep because even though I had used Tesremellin and they did make my sleep better, even just one IUA growth hormone was just so far beyond how well I responded to any of the peptides. So that's kind of up to you. You have to, you have to use own discretion around those things. But for people that have had head trauma in the past, they tend to do better. And then also too, for people with uncontrolled diabetes, you really want to stabilize metabolic foundations first and then tesrellin can mildly worsen glucose tolerance if you're not training, if your hormones are not optimized, and especially if you're not living the proper lifestyle and eating properly and everything like that. For people with uncontrolled diabetes, I like using a GLP1 first and then once things get under control, you're just going to be in a better spot to take testament. Again, you got to use discretion around that. How severe is the diabetes and how, how much do you want to use Tesrellin? But we do know that there can be this mildly worsening effect on glucose tolerance, so it's always better to just cover your bases. Let's talk about dosing. I kind of have a, a three tier dosing ladder, one milligram, a Day, I think is going to be the general optimization sweet spot for a lot of people, especially women. Two milligrams per day is the clinical FDA approved dose. But when we look at dosing, I don't think a lot of people need to go to 2mg 1 because you might just get too much water retention. So it just might not be the best dose for you. But then also too, I think you're just wasting your, wasting your money where you're taking double the dose and you could get a lot of the Same results at 1mg per day. For some weave women, even a lot of tinier women, they even do better on 500 micrograms per day. One milligram is usually safe, but sometimes women just do better on half a milligram instead of one milligram. But again, this is the general optimization. Cognitive support, sleep and gradual body composition dose. IGF is typically going to raise around 40 to 70% for those people. And then this is going to be the best starting dose just for people that are looking to optimize. When we talk about the next dose, which is 2 milligrams per day, this is the FDA approved dose. It's used in all the trials. IGF typically raises between 80 to 110. And again, this is going to be the workhorse for visceral fat, liver fat, and substantive body composition change. I will say this. For someone like me that sits around 10% body fat most of the year, I lean towards the 1mg per day because I'm not trying to aggressively change my body composition. And if I go to that 2 milligram per day range, I actually tend to get a lot of water retention, which is which even though I may be burning fat, it does not look pleasant. So it kind of like blows my face up, makes my midsection look a little bit more bloated than it actually is because of the water retention at that higher dose. The same way if I would take six IUs or eight IUs of growth hormone, I know it can rapidly transform my body. But then I'm also going to get this layer of water that just is not for me, comfortable to deal with. And even sometimes, we'll talk about the side effects later. Sometimes you get carpal tunnel, you get edema in your ankles and everything. And when I do those higher doses in 14 days, I'm like, man, I look like a water balloon. Even though I know I'm burning fat in the process, which I know is, is counterintuitive. Contrast that you have a guy that's like 25% body fat or a woman that's 35 or 40% body fat, when they're doing 2 milligrams a day, they're really not going to notice in most cases that much more water retention because they're already holding a good amount of fat and more than they probably should. Take that person and then put them on 2 milligrams of testament, they don't notice it. And then all of a sudden, within 16, 24 weeks, they've rapidly transformed their body. They've gotten rid of a ton of visceral fat because they may need to lose 50 to 75 pounds. And it does really well in those cases. And so for someone that is closer to that like 10% body fat as a man, maybe 15 to 20% body fat as a woman, a lot of those people gravitate towards using human growth hormone just because there's a little bit more of. It's an aesthetic appeal where they look better when. Whereas the person that needs to drop a lot of body fat, tessin is gonna do really well for them and they're not gonna notice that much water retention in a lot of cases because they're already holding on to excess fat. That's how I kind of frame that for people. Whether that's right or wrong, I don't know, but it's just my own personal experience and I know having worked with a lot of people that need to lose a lot of weight and then people that are optimized to the hilt, people that need to lose a lot of weight tend to do really good at this 2 milligram dose. Whereas other people that are, that are already like very fit may already have a six pack kind of that. That lean type person, the 1 milligram a day dose is usually enough for them to get the results they want. And then we look at tier 3. Is 2mg per day extended, meaning that the established fatty liver or lipo hypertrophy type people, they usually do well on a 12 month continuous course per the 2019 Lancet study on it. And again, we'll get to cycling. But when we talk about this, I think those are the people that need to stay on the extended dose in order to really get those markers, whether it's fatty liver or or severe visceral fat, into the range that they want them to be in. Just looking at dosing by purpose, we have longevity and anti Aging. That's 1 milligram per day, 8 to 12 weeks. On 4 to 6 weeks off, 5 days a week at bedtime for visceral fat reduction again, for Those heavier people, 2 milligrams a day, 6 to 9 months. On 2 to 3 months off, 26 weeks is the minimum for the full response to get that visceral fat reduction. For those people that have a lot of visceral fat for liver fat, again, 2 milligrams a day for 12 months. In order to get the liver fat reduction for athletic performance, I think you could lean on the 1mg per day, play around with it, maybe even go to one and a half milligrams per day, anchor to a training block and again just understand that it's banned by water cognitive support. Definitely 1mg a day, er on the lower side for 20 weeks and you could do bedtime dosing and then post illness recovery just to have an IGF base after a severe chronic illness or something like that, Lyme disease, mold exposure, things like that. One milligram per day for eight to 12 weeks to help there. Let's talk about timing because this is one of the big things that people get hung up on or confused or just. There's a lot of information out there. Here is I, I will give you what the best practices are and then kind of a framework to operate within. We have standard timing which is once daily at bedtime, one to two hours after the last meal. This amplifies the natural GH pulse of the day which occurs during slow wave se for almost everyone. This is going to be the best thing to do with tesmeral. Now let's talk about fasting and insulin levels and how that affects so facet injection matters. Carbohydrates and fat suppress GH release. If you inject on an empty stomach, you're going to get the maximum pulse amplitude. Now if for whatever reason you have to eat at 9 o' clock and then go to bed at 9:30 and let's say you have a 30 minute gap between you're eating and when you're taking Testament, does that mean it's completely worthless? No, I will say you will probably impair some of the absorption of it, but it's not completely worthless. But in a perfect world we will have low insulin levels and normal blood sugar levels which usually takes about one to two hours after the last meal. Because we will want to get the body to where it's more receptive, to where it can cross the blood brain barrier better and do what it does. There's this kind of meme Going around about if you're on a glp, does it matter how long if you take tessellin, meaning that because GLP is slow gastric emptying, that it would be better to take it three to four hours after? Well, I think probably, yeah, the longer you give yourself fasting, the more effective it's going to be. However, I don't think we have to be so anal retentative that you have to say, oh I can, I can only do it four hours after eating, meaning that I have to eat at 7pm and then wait till 11pm to take it. Or if you're going to bed before 11pm, wake up and then take it. I don't really think that matters as much. Obviously in a perfect world that's what we do, right? We'd be fasted for 24 hours before we take it, just to cover all our bases. But understand that life gets in the way and there are practical considerations and so I'm not so, so gung ho on doing that. Although I do agree that the, the slowing of gastric emptying with a GLP probably has some effect. But how much? Maybe 5%, I don't know. Now let's talk about morning dosing. I think it, it's, it's acceptable for visceral fat reduction if bedtime interferes with sleeps onset. But bedtime is preferred in this case, especially with the Tesrellin. I always tell people too, sometimes people like breaking it up. So if they're doing 2 milligrams they like 1 milligram in the morning and then 1 milligram in the evening, I think that's totally fine. Also some people you see this less with TESREL and I would say more with CJC that you see this, but some people actually get their sleep disturbed and so sometimes it can be too stimulating or too wake promoting or wakefulness promoting and so those people just do better in the morning with it and that's totally fine. Although I prefer the nighttime. Talk about the 5 on 2 off schedule. This is the most common optimization pattern. Whether this, it's hard to really say whether this is rooted in science, but practically speaking I've done five days on, two days off and I've done every day. I really like the five days on, two days off. The two day break gives the GHRH receptor a brief recovery window and reduces cumulative IGF1 burden across the week. I really like that because it's almost like a mini cycle and I think it allows you to sustain a longer cumulative cycle by taking those two days off just because you maintain more receptor sensitivity to the peptide. Again, whether that's right or not, who knows? Practically speaking, I just respond really well to taking those two days off. And obviously you could do Monday through Friday, take Saturday, Sunday off, or you can take Monday, Tuesday off and do Wednesday through Sunday. Whatever works for you. And again, if doing intermittent fasting, inject at the end of the fasting window before the first meal of the eating window, usually within an hour or two before that eating window if you are doing it in the morning. But again, that's going to be such more rare that people end up doing that. Let's look at some expectations. Within 15 to 30 minutes of injecting the peptide, GHL's peak GH pulse peaks around 15 to 30 minutes post injection. Then we look at two to four weeks after cumulative dosing that five days on, two days off. After two to four weeks, IGF1 reaches a new steady state. The sleep death usually improves by this point. And then mild puffiness is possible, especially in some of those leaner people. Week six to 12, you usually see waist circumference start dropping, recomposition phase begins, and then the water retention usually settles in for most people. And again, that's where it's weird because it sucks for maybe those first six to 12 weeks that you feel puffy. And then a lot of times that will start to go away as the body acclimates to it. Then we see weeks 16 to 26. This is where we get really the full visceral fat response. So 15 to 18% reduction in phase three trials, liver fat follows through 12 months. If you get no meaningful change by 16 weeks at 2 milligrams a day, you are likely a non responder. In phase 3 trials, around 1/3 of phase 3 patients did not achieve significant visceral fat reduction. Now, just because you're a non responder to this doesn't mean it can't work. Meaning that there's always the devil's in the details. And we don't know out of those one third of people, were they exercising? Were they hormonally optimized? Probably not. And so a lot of times when we look at these clinical trials, people are responding without even doing the foundational things right. And again, when we look at 1/3, I think it's just one of those things. Tess is not going to be so powerful like a GLP that it's going to move beyond or work through those lifestyle things that are not being addressed. And again, just Understand that there are people that seem to be non responders in the clinical trials. How to know if you're working or how to know if it's working. We have subjective markers. Is your sleep better, is your recovery better? Do you have sharper executive function? Do you have a drop in waist circumference? Do you have better training capacity and do you have improved skin quality? Because that will be something that will happen. Then we can look at objective markers. If you're getting blood work done, you can look at IGF1. That should rise around 50 to 110% depending on the dose, usually within 8 to 12 weeks. So you know it's working. Then waist circumference, people will typically get a drop of 1-3 cm at 12 weeks. You can get a dexadine to measure visceral fat specifically. I would do that about 24 weeks out. Triglycerides you can measure on your blood work to see if they improve. And then your ALT and AST liver enzymes, they should modestly improve as well. If elevated baseline, obviously the liver enzymes can be a little bit more transient, so just take that with a grain of salt. Now the question is why cycle it all? So why can't you just stay on TESS all the time? One, we don't have an evidence gap or we, we have an evidence gap, we don't have evidence beyond 18 months. The longest published continuous use trial is 12 months and there was a lope open label extension at 18 months. Again, long term I just think it's best with peptides because we don't know what we don't know to just always cycle these things because it keeps the body in a state where we're not chronically exposed to it. And if there are any issues, not that I worry about that, but if there are any issues, we just cycle through. It also allows us to assess real durability. Off cycle blood work reveals whether gains are durable or entirely peptide driven. Hopefully lifestyle is an adjunct to that. And then more, more importantly, when we look at cycling have this idea of antibody formation. The cool thing about FDA or Tesrelin being FDA approved is that we have this study around antibodies. Anti tesrelin IgG antibodies develop in around 50% of patients after 26 weeks. It's non neutralizing trials but cycling breaks the exposure pattern. Basically what that means is the body is having this immune response to tesmorelin where it will stop working. Basically it's saying hey, this is being introduced to me, I don't like it anymore. The immune system Has a response and it stops working. Why do we cycle? Because in a lot of people, one out of two people are gonna have that pattern of an immune tolerance buildup to it. Thus it allows them to decrease those antibodies and then cycle back on. And so that's the real reason I think we will see that with more and more peptides that become FDA approved that we see this. And that's again why we go back to cycling. Now I'm all for using it for as long as is needed to get where you wanna go. But just understand you may have this immune response, which is why it's smart to cycle. Now does that mean you have to cycle off at eight weeks? No, you can use it for 16 weeks, 26 weeks. That's been used in clinical trials to get the results people have. But I think the more optimized a person is, the more they're going to want to want to cycle it. Because we deal with this antibody buildup. Because you may not need to lose 50 pounds of visceral fat, Whereas someone that does, it's going to be better for them to stay on it long term and then be less of the mindset of having to cycle very abruptly or very acutely. Whereas the optimized person, they have less visceral fat to lose. They don't need to cycle or they don't need to go as long with cycles. Here's some standard cycling patterns. You can do a short cycle of eight weeks on four weeks off again. General optimization beginners, this is good for them. We have middle ground. You can do 12 weeks on four weeks off again. Most common general purpose pattern, again 12 weeks, that's three months. You can usually get pretty good results in three months. Visceral fat protocol again, 16 to 24 weeks, which is four to six months. And you can take eight to 12 weeks off again. This is the full visceral visceral fat response from phase three trials. The fatty liver people stayed on for 12 months and then after that I would take at least three months off. If you've run it for 12 months and then low dose maintenance, you could do 1 milligram a day continuous. And then I would just kind of assess when you need to whether 12 weeks, 16 weeks, whatever. But I do think doing the five days on two days off allows us to sustain some of these longer if you want to. And just a caveat, continuous use beyond 18 months in optimization context is operating in an evidence free zone. Just take regular breaks until long term data clarifies the picture which we'll hint at in a little bit. Now off cycle expectations. Cuz everyone is always afraid what happens when I stop. Obviously it's a big thing with GLPs, but people love the results they get with Tessellin and then they get afraid of what happens when I stop. Let's just look at what's happening first. IGF1 usually returns a baseline within two to three weeks. Sleep and recovery for a lot of people will begin to regress within a few weeks. And then the visceral fat usually holds four to eight, eight weeks. And then for a lot of people if they don't change their lifestyle is going to drift back over 8 to 16 weeks. Which again to go back to that conversation about testosterone and then a glp. Those are going to help sustain the momentum that is created by Tessellin. And again the peptide is not a cure. The visceral fat benefit is treatment dependent. And the off cycle period is where lifestyle work matters the most. And again I cannot stress that enough. I know that's not the sexy thing to talk about all the time, but it's so important we talk about getting to where we want to go just to motivate, maintain that momentum. It's huge. Let's look at stacking with some other peptides. I love stacking this with BPC and TB500. Obviously the BPC and TB500 are gonna help with growth hormone receptor sensitivity. So you even get that much better of a response from Testamen when you're using them. I love KPV obviously just helping with inflammation. And SS31 again to go back to, to my favorite stack which is testosterone, thyroid, a growth hormone peptide like Tessamorelin, a GLP and a mitochondrial player. I love SS31 with it. Again completely different systems that really work well. And then we have ipamorelin which is a different receptor. We get an additive GH release and monitor. We want to monitor glucose more carefully. I will say stacking Tessamorelin with ipamorelin is the most powerful peptide stack to increase growth hormone. For someone that wants to really put on size, I would say Tesrel and Epamin are where you want to go. That is the ultimate muscle building size, mass accruing peptide stack. When we talk about growth hormone peptides, however, just be aware that because it's so powerful you will get bigger, meaning that you will get a lot more water retention. Sometimes to me when I've stacked those together it feels like I'm taking almost like 5 or 6 IUs of growth hormone which for Those of you don't know that is a lot of growth hormone compared to an optimization dose. Just be cautious when you are doing that. You can do that, it's the strongest that we have out there. But you need to know what you're doing. And I would always recommend using both of those in isolation. What I recommend not stacking is similar in our cjc. Again they compete for the same GHRH receptor and this can lead to an unpredictable combined signal. I know people do that. I know companies are making blends. I personally just don't, don't want to do it. When we're talking about using Tesrellin for visceral fat. I don't necessarily like stacking HGH with it. I do like that in other contexts however. And so for someone that is on a maintenance dose of HH year long, I do like using Tessamorelin to just periodically stimulate the pituitary, maybe for eight week cycles, one to two times per year. But when you talk about continuous cycling, always doing testament with hgh, I don't really like that. And I think you end up creating just an excess of growth hormone that probably is doing more harm than good. And, and also too, I do not like stacking Tess with MK677. It just drives super, super physiologic IGF with amplified side effects. And most people, it's just, it's just really too much. In the case of stacking those two together, I mean, hey, if you're, if you were really skinny, you could probably benefit a lot from doing that if you need to put on like 30 or 40 pounds. But I would say for most people I would just avoid doing that. But I would say long term, the reason I put that about the growth hormone on there is long term I'm, I'm not a fan of doing that. But short term you definitely could do it just one to two times per year. But ultimately I would say just choose between one when you're doing it. Let's look at SE sequencing. I really like having insulin sensitivity, mitochondrial function, sleep and hormone status all dialed in weeks one to eight. So before you even start test Marlin. I really like fixing hormones first. That's always gonna be. The conversation I have with people is like, hey, I know you Wanna Start Test, MD but where are our sex hormones? Where are our thyroid hormones? Because those are gonna be so much more important. What does sleep look like? What does training look like? What does nutrition look like? It's not so much like the GLP that you can Just take it and it's a miracle cure, right? GLPs are the closest thing we have. A miracle cure test Merlin is not that. Then weeks nine through 16, let's run some mitochondria support, kind of use SS31 to get everything in in a good place so that the body responds well. And then week 17 through 44, 1 to 2 milligrams per day, you choose the dose. And then weeks 45 plus maintenance. And so if you were looking over the course of the year, I really like that kind of sequencing is take four months to get all of the hormones and mitochondrial diet in and then bring in tesl because then it's gonna do the work that we really want it to do well, while the reverse order fails, glucose goes the wrong way. If you have an insulin resistant client or you're insulin resistant, GH axis amplification can push a 1C higher rather than producing the expected improvement. And again, non responders in the 2012 study saw worse glucose homeostasis. The side effects can be amplified in those people that are not exercising and dieting. They can get water retention, joint discomfort and paresthesias. And they're more prominent clients with poor baseline metabolic health. And then there's no clean diagnostic. Here's a little bit about reconstitution. Super simple this way. I have the peptide cheat sheet. 5 milligram vial. You put 2 milliliters of bacteriocyc water, 1 milligram is gonna be 40 units. If you have a 10 milligram bio and you put 2 milliliters of bacteria static water, 1 milligram is Gonna be 20 units. Obviously 2 milligram would be 40 units. There, you can screen that, screenshot that slide there. I always use back water when I'm doing it. Again, reconstitution, just do everything sterile and clean. Add the back water into the vial with a bigger syringe, let it dissolve, label and store it. Some people talk about using it within 14 to 28 days. Honestly, I've used it at three months and it's usually fine. But if you're doing the dosing and the bile's 10 milligram, you're usually going to go through it in 14 to 28 days anyway. Again, I like sub Q injections. I will say the one instance into which I don't recommend people have a sub Q injection is if they are having an immune response, meaning they're getting welts or hives from the injection, sometimes injecting into the muscle intramuscular because there are less mcast cells. I meant to say mass cells, not mcas. But unless there are fewer mass cells in the muscle they can inject into the muscle and not have as bad of a response. Personally I don't keep tesamorelin at room temperature. I know the the clinical guidelines for the pharmaceutical version say to keep it at room temperature but I've always refrigerated my tessellin. Now if you keep it really really really really really cold, basically so cold that it's not freezing but like as close to freezing you can get sometimes that results in it gelling. But I've always refrigerated mine and it's always done well for me and I knew it was testament. I knew it wasn't another peptide because I had it tested again. There's a bait about there out that hey if you want to keep it at room temperature by all means go do it. I personally just decide to keep mine refrigerated and I've never had issues with mine gelling. Some people have though and if that's you, hey do room temperature. To each their own. What to track biomarkers. I like IGF1, fasting glucose, fasting insulin, your homa, IR, A1C lipid panel, HSCRP, ALT, AST and TSH body composition. I like getting a Dexa or a BOD pod in body if that's what you can do. You can get a fiber scan to detect liver fat and then your waist circumference and then performance. Definitely look at HRV deep sleep percentage, REM sleep, resting heart rate, grip strength and how ready you feel. I will say over time most people have an improvement in HRV and resting heart rate. You may have a transient increase in resting heart rate and decrease in HRV when you first start, but usually that normalizes and then it improves over time and again. Just rate your sleep depth, morning energy, cognitive sharpness, joint discomfort, things like that. And then labs. You could get labs done every three to six months and just see how you are doing. When we look at stacking, I think testosterone is the first and most important thing when we talk about it. It's the foundational pairing when we stack testosterone with a GH modifier like Tessellin, TRT again drives muscle protein synthesis, TESS handles visceral fat and recovery and we can usually run those for pretty long periods of time and get amazing results. Then throw a GLP like tirzepatide or retatrutide on top of it. The GLP will drive overall weight loss and then Tess Marlin is going to target visceral fat specifically. Again, just make sure you're monitoring your glucose. But usually it works really well alongside of Tess Moralen because it's modulating glucose and improving insulin levels. Again, BPC 157, TB 500 helps with injury recovery and repair. And then also two, we're gonna get a really good anabolic effect. So if you are weight training, you will have much better muscle maintenance and muscle recovery and potentially muscle growth when you use BPC and TB500 with the Tesmorelin. And then like I always say, SS31 is amazing complimentary. A SS31 stabilizes mitochondrial membrane function and then tessellin working on growth hormone. And again, there's a very synergistic combo there. Some additional stacking notes. Again, just make sure you're not stacking with S&CJC or MK677. I do like it with KPV, I do like it with NAD and NAD precursors or 5Amino. I do like it with epitalin and thymalon especially for people that do not sleep well. That usually is a really good stack. And again, it can pair well with ipamorelin because of the mechanisms. They're complimentary. But just know this is gonna have the highest IGF elevation which can increase the side effect burden. So just make sure you're managing that pretty well. I think for people I didn't say this earlier. For people that are stacking them together, I like cutting the dose down of Tesrellin. So I would do closer to like a 600 micrograms of tesrellin with 200 micrograms of ipamorelin rather than the full 1 milligram dose of tessin and 300 microgram gross dose of ipamrelin. All right, let's do some troubleshooting. What about for the people that I don't feel anything? The we all know these. If you work with clients, the people, nothing works for them. They're the I don't, I, it doesn't work for me type people. One, let's look at some of these things. We have timeline. The effects emerge over four to 16 weeks. Nothing is going to happen day one. The dose could be too low. So for some people, especially if they need a lot of fat or have a lot of fat to lose, 1mg might not be enough with them. So you could titrate that up to 2 milligrams within that initial period. Could be a source quality thing. If you want to cover Your bases. You can get it from a 503A pharmacy or just have a legitimate source that you're getting it from. Again, foundation could be missing. So they could have broken sleep, poor nutrition, unaddressed testosterone deficiency. And again, test marlin can potentially amplify a very bad baseline. And then again, there's those non responders for the people. Again, how much of that is lifestyle and diet? We don't know. But we do know in trials that there was a significant cohort of people that just didn't respond. When we look at side effect management, injection site reactions, again, this can be ongoing. Rotate sites that typically helps with the immune buildup in the site, so make sure that you're rotating the sites. Skip reactive spots in week one. You could also potentially inject intramuscularly if it doesn't work. Sub Q. But I always default to injecting sub Q. I will say I've seen people that take testamerelin for six months a year, they do totally fine on it. Then one day out of the blue they inject and they have an anaphylactic shock reaction to it and they have to go to the emergency room or get an EpiPen. I don't know what's going on there. Obviously it's probably some sort of immune modulated or immune mediated thing. But I would tell those people, please just avoid Tesla in the future if that's you. And again, I think that goes back to cycling because the people that I've seen do that in almost all cases. There are people that were on it for a very long period of time without coming off. And then we talk about those, those anti drug antibody buildups. Is that person's immune system interacting with those ADAs to potentially have that issue? Maybe, maybe not. But again, that's why I think it's very important to cycle. Water retention and puffiness usually resolves by week 12. Again, if, if you are getting that, you can go down on the dose. Joint comfort or joint discomfort and stiffness can improve as the system stabilizes. People that get tingling again, this is probably from their IGF levels being too high. You could bring down the dose, but it usually will go away. And then mild glucose elevation, just monitor it and make sure you're doing everything. I would say for everyone that lives a healthy lifestyle and is hormonally optimized, they almost never have issues with glucose. It's usually just people that have very low testosterone and are sedentary that will get issues from the test. Morelin and then sleep onset Interference. This usually goes away within the first one to two weeks, but you can always move it to the morning time if that is an issue or just move it up. When to discontinue Obviously you have if you have a malignancy or cancer diagnosis, if you're pregnant, if you have one of those immune reactions like I talk talked about just a second ago and if your liver enzymes are extremely elevated, I would probably not be the first thing that I would use. And then if your IGFD score is above two standard deviations despite dose reduction and then strong reconsideration signals, if your A1C rises more than half a percent without body composition response, persistent worsening edema and swelling, persistent neuropathic symptoms with the tingling and then 16 weeks with no measurable response at 2mg a day I would just say maybe switch to something else and get on a GLP. Let's look at some FAQs. Can you take it orally or intranasally? No. I know there are people that sell this but I have not seen Tesrellin in an oral formulation or a nasal formulation. Will it make me gain weight? No. There's a net neutral effect on weight. In clinical studies there could be a transient one to three pound water retention in those first six weeks, but it usually resolves. Does it affect ketosis? Not directly. GH dry lipolysis which complements a ketogenic diet if that's for you. Although I think it would be smarter to use carbs. Does it interact with trt, metformin or other type of medications? There are no clinically significant interactions with any of these, no. Do dose adjustment needed but monitor glucose when adding Tesrellin to metformin. Should you use TESSA with CJC plus ipamrelin? I would say no. And then I would say tessellin has the strongest evidence, cleaner mechanisms and best for visceral fat. CJC and IPA are gonna be better for just overall anti aging, milder side effects, lower cost and for visceral fat specifically Tesrellin is gonna be better. What happens when you stop? We Talked about that. IGF1 usually returns within two to three weeks. Visceral fat drifts back over eight to 24 weeks without other interventions. And again it is not a panacea or cure all. What about cancer history? I think it's just one of those things. Err on the side of caution. If you have a history or act of cancer would not be the first thing that I add in. And then how much does it cost? Typically if you're getting compounded or research grade, somewhere between 50 to 100 or maybe even on the the higher end. 500 per month. I do know if you get the the brand name as a prescription could be up to 2,500 to $5,000 per month. Let's look at future outlook. So there are active programs. We have this one trial that is looking at non HIV fatty liver. It was last updated September 2024. Primary results are pending as of today in 2026. Positive results would significantly expand the off label rationale. We do have a 10 year malignancy cohort being studied. There's an FDA mandated post marketing study. The results are not yet published but hopefully this substantially clarifies the long term question around cancer. And then there is a cognition child register but no primary publication yet. When we look at where it's heading, Tessellin remains FDA approved. GHRH analog of choice. I would say as far as that goes, right now it's the gold standard for FDA approved things. It's increasingly a complimentary tool layered onto GLP1 protocols. I hope in the future that Tesmorellon becomes very, very, very commonly prescribed off label with a GLP1 to help with muscle maintenance and visceral fat reduction for someone on GLP1 and also to help preserve lean mass. I think this will be kind of the advanced body composition protocol obviously with HRT going forward. And there are oral GHRH receptor agonists in early research, none in clinical trials as of mid-2026 in humans. But again we have a very strong evidence base. Just to sum up. 15 to 18% visceral fat reduction in 26 weeks, 37% liver fat reduction in 12 months, 80 to 110% increase in IGF1 elevation at 2 milligrams per day and we have substantial executive function improvement in older adults. Where are some of the gaps? We have nothing longer than 12 to 18 months. The non HIV fatty liver cohort hasn't been reported. We don't know about the cancer question, at least from a clinical data standpoint. And again, the cognitive evidence isn't overwhelming, but it's still there. And again, no RCT data in long Covid or chronic fatigue syndrome in those cohorts. But for the right client, I think test rolling can be the right tool. It works best when foundation work is done first. The dose is matched to the goal, cycling is done intelligently like we've talked about today and monitoring is honest. And for the right indications, I think the the biggest one is for those people that get their DEXA scan done and they have a dangerous level of visceral fat. Tessellin can be very superior to every other intervention except a glp. Meaning that it's gonna be better than ippa, it's gonna be better than growth hormone, it's gonna be better than those things. I will give that to Tesmorellon. It is going to be the best thing for those people with lots of visceral fat. And then just understand that it's not a panacea, it's not a weight loss drug, it's not a continuous intervention requiring monitoring and cycling. Although you can use it in perpetuity. You could use it in perpetuity when you are cycling on and off. It would not be something that I say on five days, on two days off for perpetuity without cycling. And then just some takeaways. It's the only FDA approved peptide for visceral fat upstream. It's going to work in a pulsatile fashion that mimics our body's natural gh. Pulsing foundations are so important for starting before starting this peptide. Much more so than even things like a GLP or testosterone or SS31. And again, just be smart. When you talk about cycling, there's a lot of different use cases and you have to use your own discretion for those. It's not a magic wand, but done right in the right client for the right person is one of the most useful peptides that we have available today, particularly among the cohort of growth hormone peptides. And that is it for the slides. And that is my masterclass for Tessa Moralen. I did my best job to cover everything I could, whether it's from the clinical literature just to the coaching that I do and hearing all the different feedback things from people. I will say this would be probably if I was ranking peptides just overall, this would be in my top 10. I wouldn't say top five, but definitely top 10 because of the visceral fat and just what getting visceral fat off of the body does for so many people. When we talk about long term health, long term cardio, metabolic outcomes, long term brain health and those things. Again, when I talk about long term, I am still a fan of growth hormone itself, but I do think Tessin in the right instance can be superior to growth hormone long term with someone that's completely optimized. I think 1 to 2 IUs of growth hormone are perfect. But I will say Tesla can be used in the right situation. To get superior results to growth hormone. And one thing I didn't mention in the slides, but I did want to say before I close down the video, I think the older someone is, the better they respond to growth hormone. Because of this feedback loop that we talked about today. It just doesn't seem to work as well as we get older. However, I think if you had some guy or some woman that was 65 and they had 70 pounds of visceral fat to lose, I would still say use Tess first to get rid of that visceral fat. Contrast that if you have a 65 year old guy that's a bodybuilder and is 10% body fat and trains five days a week and is really healthy, I think long term he's going to do better with 1 to 2 IUs of growth hormone. And maybe you can use Tesamorelin just to get some pituitary stimulation here or there a couple times per year. But I know that's kind of one of the questions people have and ultimately there's no right answer. Depends on the person. But that being said, I still love Testamorelin. It does so many amazing things and I still use it personally in those one to two cycles per year alongside my growth hormone just to maintain some pituitary function. Because we do have that. I kind of think about Tessamorelin is like the HCG to my testosterone as it would be to growth hormone. Meaning that the same way we'd use HCG with testosterone, I like using Testament occasionally with my growth hormone just to have some pituitary stimulation of that, that feedback loop. But that's it for this one. I would love to hear your feedback on this. Whether it was helpful or there was anything that I left out that I could cover in future videos. That's also very helpful to me too. But just in closing, I always like to say I have the best audience in the world. Thank you guys so much for the amazing support that you send to me. Whether it's using my coded places, sharing this with friends and family, being on the email list, being in my private group, or now using the AI chat, just because that helps build the database of questions that need to be answered the most. So thank you guys so much for all of the amazing support that you have sent me. I love you guys. This is a dream come true that I get to do this and I just always want to close out to make sure that you know that. Because it's very important to me to I reciprocate the same amazing love and support that I receive from you guys. So thank you so much. Looking forward to the next one. And I will talk to you later. Peace.