Follow-up: Tesamorelin has an approved indication — what that changes about the evidence posts 61–69

What a well-designed human trial of a secretagogue would look like: randomised, placebo-controlled, adequate sample size, IGF-1 as primary outcome, muscle and strength as secondary outcomes, adequate follow-up duration. Very few secretagogue trials meet that description.

Flagging that the sources on this are thinner than the confidence in the thread suggests.

An update on my earlier Tesamorelin post: the pattern held for another six weeks and then stopped, which I did not predict and cannot explain.

Distinguishing three things in the Tesamorelin discussion that keep getting used interchangeably: the observation, the proposed mechanism, and the recommendation that gets attached to both.

A mass result for a short peptide is more discriminating than for a long one, because a single residue difference is a larger proportion of the total. That makes identity confirmation genuinely useful here.

If this contradicts something upthread, the upthread version may well be the better one.

Where I would push back on the Tesamorelin consensus is the confidence, not the direction. The direction looks right. The confidence is borrowed.

An honest declaration on Tesamorelin: I have a prior here and it is strong enough that you should weight what I say downward. Stating it rather than hiding it.

I had written a reply contradicting post #64 and deleted it. Here is what survived.

Storage: these are lyophilised short peptides and are generally reasonably stable dry and considerably less so in solution. Reconstituting only what will be used within the period the supplier's own data covers is the conservative approach.

Tesamorelin would be much easier to settle if anyone reported the denominator. Almost nobody reports the denominator.