Compounded Tesamorelin & NAD+ Longevity Stack

The stack is two separately compounded, physician-prescribed injectables shipped together: one vial of compounded tesamorelin for targeted visceral fat loss, lean-muscle support, and sleep, and one vial of NAD+ for cellular energy, focus, and recovery. There is a single formulation of each — no dosage tiers to pick from. Your physician provides the per-injection instructions for both.

Tesamorelin prompts your pituitary to release growth hormone in its natural night-time rhythm, which raises IGF-1, preferentially breaks down visceral fat, supports muscle, and deepens sleep. NAD+ works inside your cells, powering mitochondrial energy production, DNA repair, and the sirtuin pathways tied to healthy aging. One restores the hormonal signal, the other restores the cellular fuel — and they target the two declines that define midlife.

Yes, under medical supervision. They act on completely different systems (the growth hormone axis vs. cellular coenzyme metabolism) and have no known direct interaction. Because growth hormone can slightly reduce insulin sensitivity, your physician monitors fasting glucose and IGF-1 with periodic bloodwork. Both are prescribed together only after a licensed physician reviews your health history.

Separately, on different schedules. Tesamorelin is one subcutaneous injection into the abdomen each night at bedtime, ideally on an empty stomach, to work with your body's natural night-time growth hormone pulse. NAD+ is one subcutaneous injection per week (belly, thigh, or upper arm). On your weekly NAD+ day you simply do both.

Visceral fat is the deep fat packed around your liver and other organs. It is more metabolically active and more strongly linked to insulin resistance, fatty liver, and cardiovascular risk than the fat under your skin. Tesamorelin reduced visceral fat by about 18% in 26 weeks in its FDA-reviewed trials — a selectivity that diet and exercise alone do not have.

That is what NAD+ is for. NAD+ levels fall by roughly half between your 40s and 60s, and that cellular shortfall is a major driver of flat energy and mental fog. Injectable NAD+ bypasses digestion to replenish levels directly; most patients notice steadier energy and clearer focus within 2–4 weeks, and GHRH signalling from tesamorelin has shown favorable effects on memory in older adults.

Many patients report deeper, more restorative sleep within the first few weeks. Tesamorelin is taken at bedtime specifically to amplify the growth hormone pulse that occurs during deep sleep, and better cellular energy from NAD+ tends to steady the day-night rhythm rather than disrupt it.

Energy, focus, and sleep changes typically come first, within 2–4 weeks. IGF-1 rises measurably within the first month. Waist and body-composition changes usually become visible at 6–8 weeks, and visceral fat reductions in tesamorelin trials peaked at 26 weeks.

Yes, that is one of tesamorelin's core effects: growth hormone signalling supports muscle protein synthesis and recovery, so resistance training in your 40s and 50s produces results the way it used to. NAD+ supports the energy and recovery needed to train consistently.

Tesamorelin: injection-site redness or itching, temporary joint aches, mild fluid retention, or tingling in the hands. NAD+: brief flushing, warmth, or mild injection-site tenderness. Serious side effects are rare; your physician reviews warnings with you before prescribing.

Tesamorelin is FDA-approved (as Egrifta, 2010) for reducing excess abdominal fat in HIV-associated lipodystrophy; its use here is off-label. Compounded tesamorelin and compounded NAD+ are prepared by a licensed U.S. pharmacy and are not FDA-approved products; the FDA does not evaluate compounded drugs for safety, effectiveness, or quality. Information about NAD+ is limited. Discuss the risks and benefits with your physician.

Anyone who is pregnant, breastfeeding, or planning pregnancy; anyone with active cancer or a history of malignancy; anyone with a pituitary disorder or prior pituitary surgery; anyone with known hypersensitivity to tesamorelin or mannitol; and anyone with uncontrolled diabetes. Your physician screens for these during your assessment.

Tesamorelin can interact with glucocorticoids and other hormone therapies and may affect how some medications are metabolized. NAD+ has no well-documented drug interactions. Your physician reviews everything you take and orders baseline and follow-up labs (fasting glucose or A1c, IGF-1, lipids) to keep the stack safe.

Keep both vials refrigerated at 36-46°F (2-8°C), protected from light, and never frozen. Once a tesamorelin vial is reconstituted, use it within the window stated in your in-use guidance. Follow the instructions that ship with your order.

Growth hormone output and NAD+ levels gradually return to their age-related baseline after stopping; in tesamorelin trials visceral fat slowly returned once treatment was withdrawn, so many patients continue long-term or cycle under physician guidance. Compared with alternatives: oral NMN/NR and OTC "GH boosters" are largely broken down in digestion and do nothing for visceral fat; IV NAD+ clinics deliver NAD+ but at far higher cost and with no growth hormone component; synthetic HGH adds muscle support but overrides your pituitary's natural regulation. The Longevity Stack delivers both signals directly, at home, in rhythm with your own biology.