How to Time Tesamorelin on a GLP-1 (The Fasting Window)

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How to Time Tesamorelin on a GLP-1 (The Fasting Window)

The question she asks is, is a five-hour fast in the evening on RETA long enough to take tesamorelin before bed, or is morning best? Let me sit down and explain this. The short answer is morning, because a GLP-1 stretches your digestion far past the point where five hours means anything.

Okay, so when you're taking an incretin, like semaglutide, turzepatide, retatrutide, one of the core components that helps mitigate your appetite is a GLP-1 agonist. This is doing this by mostly slowing the gastric process, your stomach empties slower, things get digested, takes longer, and therefore you're not as hungry, okay? In addition to that, GLP-1 is also affecting how hungry you are, your overall appetite, but the point here is understanding that with growth hormone-related peptides, especially like tesamorelin, CJC-1295, or even growth hormone, we know that it's best for the purpose of fat loss to take those peptides when we're fasted, okay, when our insulin levels are low.

And the reason is because if you've watched my Growth Hormone Masterclass, you know that in order for your body to produce the most growth hormone of the pituitary, we need the presence of ghrelin.

And ghrelin is the hunger hormone that your body sends when you haven't eaten, that's the first piece. But the second piece is that when you have insulin present in your blood paired with growth hormone, that goes to the liver and converts it into IGF-1. That conversion is fine if you want IGF-1. It is not what you want if the goal is fat loss, because growth hormone that gets pulled into the liver is growth hormone that is no longer out in circulation working on fat cells.

I also send this signal of GHRH by way of tesamorelin to the pituitary and they meet at the pituitary and this is what's influencing the maximal size pulse of GH so that I can get the fat loss benefits that go from having the growth hormone in my bloodstream.

So what all that means is that in order for us to get the maximum fat loss benefits from growth hormone related peptides like tesamorelin, we must take them when we're fasted. And not doing that not only minimizes the size of that pulse through ghrelin and somatostatin inhibition at the pituitary, but it's also making it so that less of that growth hormone is spending time in my bloodstream doing its thing as far as lipolysis is concerned. You lose on both ends of the same dose.

So the question is, is okay, well, what does it mean to be fasted? Well, typically, rule of thumb for something like tesamorelin if you're not on a GLP-1 agonist would be like one to two hours. If you go and look at the data, what they found was that the optimal time for fasting for taking tesamorelin was about three hours.

This phase three trial did not include the GLP-1s.

So what does that mean for us? Well, if we're taking a GLP-1 and we know that that's slowing gastric emptying, then this is also going to extend the amount of time that it takes for your body to be considered fasted is kind of what we're looking at in theory. But keep in mind, there hasn't been a direct study of tesamorelin with a GLP-1. Nobody has run that trial, so the exact number is a guess built from two separate data sets.

However, what we do know about GLP-1s is that they show that it could increase the amount of time that that food spins in your stomach by up to 12 hours.

So a lot of guys, what they'll do is they'll extend their window after they eat to like six hours or even five hours. Against a 12 hour emptying time, six hours is still a stomach with food in it and a pancreas still releasing insulin.