Tesamorelin + Ipamorelin + MOTS-c

Where the name "Tesamorelin + Ipamorelin + MOTS-c" comes from

This is a community and market name for a three-compound combination, and it is not one Peptide Health Lab coined or endorses. The page exists because the name is being searched for and sold under, and describing what it refers to is more useful than pretending it is not.

Its origin is not documented. A PubMed search for (tesamorelin AND ipamorelin AND "MOTS-c") AND (stack OR blend OR compounded OR "combination product") on 1 September 2026 returned 0 records — no paper proposes this grouping, defines it, or records where it came from. The only published context for the practice is a 2026 narrative review of approved and unapproved peptides marketed direct to patients, which describes a parallel market of unapproved compounds operating largely outside regulatory oversight and covers these compounds as individual entries in a list.^[10] That a market exists is documented. That anyone studied this grouping is not.

The reason this page exists separately from the two-compound version of the same name is not that it has more evidence. It has less, and the arithmetic of why is the rest of the page.

What's in it and why people combine them

MOTS-c is the addition, and it is the reason the combination gets thinner rather than deeper. It is a peptide encoded in mitochondrial DNA, and the volume of work on it is real: a PubMed search for "MOTS-c" on 1 September 2026 returned 254 records. What those 254 records do not contain is a study reporting what happened when a person was given any. A search for "MOTS-c" AND "first-in-human" on the same date returned 0 records.

That is a statement about the published literature, and it needs one qualification that a flat "nobody has ever been given it" would get wrong. A ClinicalTrials.gov search on 1 September 2026 returns registration NCT07505745, a phase 2a randomized double-blind placebo-controlled study of MOTS-c in adults with prediabetes and overweight or obesity, sponsored by Hudson Biotech, with an actual start date of 2 February 2026, first posted on 1 April 2026, an estimated enrolment of 120, and a status of recruiting. Its registry record carries no posted results. So the honest position is narrower than "never administered": no published study reports giving MOTS-c to a person, and one registered trial is currently doing so and has reported nothing. A registration is a statement of intent. It is not a finding, it is not a safety profile, and it is not a reason to expect an outcome — but it is also not nothing, and a page that told a reader the question had never been asked would be wrong by six months. This comes from the registry record itself, retrieved on the date given.

What has been published is animal work. Intermittent treatment of mice raised physical capacity in young, middle-aged and old animals, and treatment started in late life raised physical capacity and healthspan measures; the same investigators report that in humans, exercise induces endogenous MOTS-c in skeletal muscle and in circulation.^[1] In the published record the animals were dosed and the people were measured. That distinction is the whole content of this section, and the registry entry above is the one place it is currently being tested.

Tesamorelin is the only component with an approval anywhere, and that approval is narrow in every respect that matters. Its FDA labelling, retrieved from the openFDA drug-label API on 1 September 2026, gives the route as subcutaneous injection, and gives the indication as the reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy, and states in its own Limitations of Use that the product is not indicated for weight loss management. Those are sentences from a label, not from a paper. A randomized double-blind placebo-controlled trial in 50 antiretroviral-treated adults with HIV and abdominal fat accumulation met both primary endpoints, reducing visceral adipose tissue and liver fat over six months, while fasting glucose rose significantly in the treated group at two weeks.^[7]

Ipamorelin sits between them, with one randomized efficacy trial in 117 adults having bowel resection whose key endpoint — time to tolerance of a standardized solid meal — showed no significant difference from placebo, and with no significant differences in the secondary efficacy analyses either.^[8]

The story told about the grouping is that two compounds act on the growth hormone axis while the third acts on mitochondrial metabolism, so the three cover different ground. Covering different ground is a description of a diagram. Nothing published has tested whether the diagram corresponds to anything in a person. Dosing and protocol ranges for each compound live on the individual compound pages, not here.

What the evidence says about the combination

A PubMed search for tesamorelin AND ipamorelin AND MOTS-c on 1 September 2026 returned 1 record. A full-synonym search for (tesamorelin OR TH9507 OR "TH-9507" OR Egrifta) AND ipamorelin AND ("MOTS-c" OR MOTSc OR "MOTS c") on the same date returned the same 1. That search narrowed with (combination OR combined OR "co-administration" OR "administered together") returned 0. Pairwise, MOTS-c AND ipamorelin returned 1 and MOTS-c AND tesamorelin returned 1 — the same record each time. A broader ("MOTS-c") AND (tesamorelin OR ipamorelin OR "growth hormone") returned 2, and the second of those is a review of mitochondrial-derived peptides that mentions growth hormone in an unrelated correlation.

So the entire published intersection of these three names is one 2026 narrative review, which lists them among the peptides being marketed direct to patients and administered none of them.^[10] One record is not a literature. A co-mention in a review's coverage list is not a co-administration, and this page's combination claim is graded anecdotal for that reason.

The specific negative that matters most here is not about the combination at all — it is about one of the parts. A PubMed search for "MOTS-c"[tiab] AND (humans[mesh] AND (randomized controlled trial[pt] OR clinical trial[pt])) on 1 September 2026 returned 5 records, and not one of them administered MOTS-c to anybody. In one, nineteen active men had two weeks of calf immobilization and were randomized to repeated heat exposure or sham; the heat treatment raised circulating MOTS-c and lowered skeletal muscle FGF21, while immobilization moved neither.^[2] In another, subjects were randomized to acute endurance exercise, resistance exercise or control, and endurance exercise raised circulating mitochondrial-derived peptides, with MOTS-c itself reaching only a trend.^[3] In a third, a sixteen-week aerobic and resistance exercise intervention in breast cancer survivors reported a significant post-exercise increase in MOTS-c in the non-Hispanic White survivors against both baseline and usual care, and reported no such increase for the Hispanic survivors.^[4]

An esummary check of all five on 1 September 2026 found four of them carrying the PubMed publication type Randomized Controlled Trial; the fifth is typed Clinical Trial; Multicenter Study. What each of the four randomized was an exercise, a heat exposure, or metformin. The peptide was the measurement in every one. Reading any of the four as a trial of MOTS-c administration is the single most likely misreading available on this subject, and it is available because the publication type says "Randomized Controlled Trial" and the abstract says "MOTS-c" in the same record.

Where the evidence is weak

Adding a component with no published human results cannot strengthen a combination. Whatever the two-compound version of this name has, this one has that minus a third unknown: no published human outcome for MOTS-c, no published human safety profile, and no published exposure data a clinician could reason from. The dated searches above are how that is known, and the one registered administration trial is recruiting rather than reporting — which means the answer does not exist yet, not that it is favourable.

The direction of the MOTS-c association is not settled, and the reassuring reading is not the only one. Plasma MOTS-c did not differ between lean and obese adults, and its correlation with insulin sensitivity surrogates held only in the lean group.^[5] A 2018 review reports mitochondrial-derived peptides, MOTS-c included, worsening the senescence-associated secretory phenotype in senescent cells by driving pro-inflammatory cytokine secretion.^[6] That is not a reason for confidence about long-term exposure, and a page reporting only the healthspan framing would be reporting half a literature.

The strongest MOTS-c result is a mouse result whose authors have a declared interest. The physical-capacity work in mice is the best thing this component has, and its conflict-of-interest statement declares two authors as consultants and shareholders of a company developing this class of peptide.^[1] That does not make the result wrong. It is a fact a reader is entitled to have next to it.

Tesamorelin's evidence does not reach the other two, and its own trial had a counter-finding. The trial cited above was run in adults with HIV on antiretroviral therapy, both primary endpoints were met in that population, and fasting glucose rose significantly in the treated group at two weeks.^[7] A glucose signal in the approved component is not cancelled by putting two unstudied compounds next to it.

Ipamorelin's contribution is a negative trial. No significant difference from placebo on the key endpoint, none on the secondary analyses, and nothing published since to replace it.^[8]

Questions to bring to a provider

The productive version of this conversation is not "which of the three is doing the work". It is "what am I actually trying to change, and what has been shown to change it in a person".

• What is the target — body composition, energy, a metabolic marker, recovery — and what does standard-of-care evidence offer for it?
• The published administration data for MOTS-c are mouse data: intermittent treatment raised physical capacity in mice, while the same paper's human component measured what exercise did to a person's own circulating MOTS-c.^[1] Given that no published study reports what happened when MOTS-c was given to a person, and that the one registered trial doing so has posted no results, what is the basis for expecting it to do anything in one?
• If the reasoning rests on human MOTS-c studies, which studies, and did they give the peptide or measure it? In the acute-exercise study, what was randomized was the exercise and the mitochondrial-derived peptides were the measurement.^[3]
• What would be monitored in someone raising growth hormone exposure, given that a glucose rise appeared early in the approved component's own randomized trial?^[7]
• Is there a testing obligation in play, and who would be asked before rather than after?

Anti-doping status

All three components of this combination are named individually on the World Anti-Doping Agency Prohibited List in force for 2026. This was read from the published International Standard PDF on 1 September 2026, reached from the USADA prohibited list page, which returned HTTP 200 with a browser user agent and links the WADA-hosted 2026 PDF, which also returned HTTP 200. It is stated from that document and from no paper.

• Tesamorelin: section S2.2.4, growth hormone releasing factors. The List names "growth hormone-releasing hormone (GHRH) and its analogues (e.g. CJC-1293, CJC-1295, sermorelin and tesamorelin)".
• Ipamorelin: section S2.2.4, growth hormone releasing factors. The same subsection names "growth hormone secretagogues (GHS) and their mimetics" and lists ipamorelin among its examples.
• MOTS-c: section S4.4.1, metabolic modulators. The List names activators of AMP-activated protein kinase and gives "mitochondrial open reading frame of the 12S rRNA-c (MOTS-c)" as an example.

The three are prohibited for two different reasons, and the split matters. Tesamorelin and ipamorelin sit in S2, Peptide Hormones, Growth Factors, Related Substances, and Mimetics, because of what they do to the growth hormone axis. MOTS-c sits in S4, Hormone and Metabolic Modulators, because of what it is proposed to do to cellular energy metabolism — an entirely separate class, reached by an entirely separate rationale. A reader who has satisfied themselves about one section has learned nothing about the other. The List marks both classes prohibited at all times, in and out of competition, and marks S2 substances and S4.4 substances alike as non-Specified Substances.

Section S0 does not arise for any of the three. S0, non-approved substances, reaches a pharmacological substance only when it is not addressed by any of the subsequent sections of the List and has no current approval by any governmental regulatory health authority for human therapeutic use. All three compounds on this page are addressed by a subsequent section — two of them at S2.2.4 and one at S4.4.1 — so S0's first condition fails before the approval question is ever reached, and no S0 reasoning is required here. That is worth naming, because the S0 question is usually settled by reasoning about a substance's approval status, and on this page it is settled earlier and more simply — by the List naming each of the three in a section of its own.

MOTS-c did not arrive on anti-doping science's radar recently. A 2016 paper from a doping-control laboratory surveyed emerging compounds affecting skeletal muscle function and mitochondrial biogenesis, named MOTS-c among the substances that might become relevant for doping controls in future, and presented mass spectra of representative compounds and of in-vitro-derived phase-I metabolites to support future test methods; PubMed types it as a journal article rather than a review, and its own data are those spectra rather than a synthesis of trials.^[9] That is a source for what anti-doping scientists were watching, and building assays for, ten years ago. The section number above comes from the List and carries no citation.

That said, a substance's absence from the List is never a statement that it is permitted, and the List is reissued annually with sections that renumber between editions. A competing athlete should confirm the current year's list and their own national anti-doping organization's guidance rather than relying on this page.