PHYSIQ Blend (Tesamorelin / Ipamorelin / AOD-9604 / MOTS-c): What It Is, Where to Get It Prescribed, and What It Costs

PHYSIQ is not a single molecule. It is four independently studied peptides — tesamorelin, ipamorelin, AOD-9604 and MOTS-c — dissolved together at equal concentration in one sterile multi-dose vial by a compounding pharmacy. Each has its own literature, its own described mechanism and its own regulatory file at the FDA, and those files could hardly be more different: one is the active ingredient of an FDA-approved drug, two were voted against by an FDA advisory committee, one was voted for on a split vote. The name is a brand name for the combination; it does not appear in any journal. So "does PHYSIQ work" is four questions, because the combination has never been studied as a combination.

The rationale prescribers give is that body composition is governed by more than one signal, and each component is described as acting on a different one. Tesamorelin and ipamorelin both prompt growth-hormone release, through two different receptors — GHRH and ghrelin — described as converging on the same pituitary pulse. AOD-9604 was designed to carry the fat-metabolism region of the growth hormone molecule without the rest of it. MOTS-c is described as acting inside the cell on energy handling rather than on hormone release.

The proportions are worth noticing. PHYSIQ is an even split — 10 mg of each, 0.5 mg of each in every dose. That is a formulation choice by the pharmacy, not a ratio established by any study, and it cannot be adjusted per component. If a physician wants more tesamorelin and no AOD-9604, the components are prescribed separately.

It is not a weight-loss medication in the sense that semaglutide or tirzepatide are: no component has a randomised human trial showing weight loss in a general population, and the one with an FDA-approved product is labelled weight-neutral. It is not a substitute for a caloric deficit or for training. It is not a steroid and does not contain growth hormone. And it is not a treatment for a diagnosed endocrine condition — growth hormone deficiency, adrenal disease or diabetes are an endocrinologist's job.

Tesamorelin is growth-hormone-releasing hormone with an N-terminal modification that protects it from rapid breakdown. It binds the GHRH receptor on the pituitary and prompts a pulse of the body's own growth hormone, which acts downstream largely through IGF-1 made in the liver. Growth hormone is lipolytic, and visceral fat is described as particularly responsive to it, which is the basis for the approved indication.

This is the component with human evidence. Randomised, placebo-controlled trials in HIV-infected adults with lipodystrophy reported reductions in visceral adipose tissue on CT — a 2007 paper in the New England Journal of Medicine and a 2010 pooled analysis of two phase 3 trials in the Journal of Clinical Endocrinology and Metabolism are the core work; a 2014 randomised trial in JAMA added liver fat, and a 2019 randomised trial in Lancet HIV examined fatty liver disease in HIV. Two things need saying precisely. Those trials were in a specific population with a specific condition, using the approved product — not a general adult wanting a leaner build. And the approved label states the product is not indicated for weight-loss management because its effect on weight is neutral: the trials describe where fat is, not how much a person weighs. A fuller treatment is on the tesamorelin page.

Ipamorelin is a five-amino-acid synthetic peptide developed at Novo Nordisk in the 1990s. It stimulates growth-hormone release through the ghrelin receptor, not the GHRH receptor, which is why prescribers pair it with a GHRH analogue. The 1998 paper in the European Journal of Endocrinology that introduced it reported growth-hormone release in rat pituitary cells, rats and swine comparable to GHRP-6, and — the finding it is known for — no meaningful rise in ACTH or cortisol in swine even at doses more than 200 times the dose needed for growth-hormone release. That is what "selective" means: earlier compounds in the class raised cortisol and prolactin; ipamorelin, in those animal studies, did not.

Its human data is narrow and does not concern body composition. A 2014 phase 2 randomised, placebo-controlled trial in the International Journal of Colorectal Disease tested intravenous ipamorelin for postoperative ileus in 114 bowel-resection patients; it was well tolerated but did not differ significantly from placebo. There are no human trials of subcutaneous ipamorelin for sleep, recovery or body composition. A fuller treatment is on the ipamorelin page.

AOD-9604 is a modified fragment corresponding to amino acids 177 to 191 of human growth hormone, the region attributed with the molecule's fat-metabolism activity, designed to keep that activity while dropping the full molecule's effects on growth and insulin sensitivity. In obese mice, a 2001 paper in Endocrinology reported that chronic treatment reduced weight gain and altered lipid metabolism, and — using beta-3 adrenergic receptor knock-out mice — described the effect as partly dependent on that receptor. A 2000 paper in Hormone Research covers the early metabolic studies.

This is the component whose story has to be told carefully. It was developed for obesity by an Australian company in the early 2000s, and its phase 2 obesity programme — several placebo-controlled trials in obese adults, oral and intravenous — did not meet its endpoints: no statistically significant weight loss versus placebo, and the programme ended. The FDA's 2024 review concluded there was a lack of evidence of effectiveness for obesity by any route, and no human exposure data for the subcutaneous route at all. It is in this blend on the mechanistic rationale from the mouse work, not on human results. A fuller treatment is on the AOD-9604 page.

MOTS-c is a 16-amino-acid peptide encoded in mitochondrial DNA rather than in the nucleus — evidence that mitochondria send signals to the rest of the cell rather than only producing energy. A 2015 paper in Cell Metabolism reported that in mice it acted on skeletal muscle through the folate cycle and AMPK signalling, and that treatment prevented diet-induced obesity and age-related insulin resistance. A 2021 paper in Nature Communications reported that MOTS-c treatment improved physical capacity in young, middle-aged and old mice, and — the human part — that exercise raised endogenous MOTS-c in skeletal muscle and circulation in people. That is an observation about a peptide the body already makes, not a trial of giving it. There are no human trials of administered MOTS-c. A fuller treatment is on the MOTS-c page.

The clinical rationale is a stack of four described targets: growth-hormone release by the GHRH route (tesamorelin), growth-hormone release by the ghrelin route (ipamorelin), the fat-metabolism region of growth hormone without its growth effects (AOD-9604), and cellular energy handling in muscle (MOTS-c). It is a rationale, not a finding — no study has confirmed that the four act together, or that four are better than any one alone.

This rests entirely on tesamorelin, and it is real human evidence: randomised, placebo-controlled trials in HIV-infected adults with lipodystrophy reported visceral fat reductions on CT over 26 and 52 weeks, with the effect described as reversing after discontinuation. Three qualifications: the population had a specific fat-redistribution syndrome; the trials used the approved product, not a compounded blend; and weight did not change. Extrapolating to a general adult wanting a leaner build is an extrapolation a physician may reasonably make, but which the trials do not themselves support.

Ipamorelin's growth-hormone release is well characterised in animals, with the cortisol-sparing profile above. Tesamorelin's effect on IGF-1 is documented in the human trials. What neither establishes is that a growth-hormone pulse prompted at bedtime translates into a body-composition change in a healthy adult; that trial has not been run with either compound.

AOD-9604 is the component nominally aimed here, and the human evidence went the wrong way: the obesity trials did not show statistically significant weight loss versus placebo. The mouse work stands, but a signal that did not produce weight loss in obese people over twelve weeks should not be presented as a fat-loss agent, and this page does not. MOTS-c's obesity and insulin-resistance findings are in mice only.

This is the honest part, and the part worth understanding before starting.

There are no randomised controlled trials of PHYSIQ, or of any four-peptide combination of these components, in humans. The blend has never been studied as a blend. Evidence is per component, and it is very uneven:

• Tesamorelin has randomised, placebo-controlled phase 3 trials — in HIV-infected adults with lipodystrophy, measuring visceral fat, with the approved product. They describe fat distribution, not weight.
• Ipamorelin has one phase 2 randomised trial, for postoperative ileus by intravenous infusion, which did not separate from placebo. None for body composition, sleep or recovery.
• AOD-9604 has human obesity trials, and they did not meet their endpoints. No human data for the subcutaneous route.
• MOTS-c has no human trials of any kind; its human data is observational.

Much of medicine rests on mechanism plus clinical experience, and that is the basis physicians prescribe PHYSIQ on. But the accurate framing is "one component with human trials in a different population, three described in preclinical research" — not "proven in people."

• That four peptides together do more than any one alone. No study has compared the blend with its components.
• Weight loss. No component has a randomised trial showing it in a general population; the one designed for obesity did not meet its endpoints.
• An effect size or a timeline for body composition in healthy adults. Timelines given by prescribers are clinical experience, not trial endpoints.
• Long-term safety over years of continuous use — the tesamorelin label itself states long-term cardiovascular safety has not been established.
• Efficacy for any condition as an FDA-approved treatment. PHYSIQ is not approved for anything, and compounded tesamorelin is not the approved product.

Egrifta (tesamorelin acetate) was approved on 10 November 2010 for the reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy; the current formulation, Egrifta WR, was approved on 25 March 2025 and is dosed at 1.28 mg once daily. Its label carries three limitations of use: long-term cardiovascular safety has not been established, it is not indicated for weight-loss management because its effect on weight is neutral, and there are no data that it improves antiretroviral adherence. As the active ingredient of an approved drug it was never nominated to the 503A bulk substances list and does not appear on it; its status did not move in the 2026 peptide changes. Compounded tesamorelin has not been reviewed by the FDA as a finished product, and prescribing it for anything other than HIV-associated lipodystrophy is off-label.

Ipamorelin acetate was placed in Category 2 of the FDA's interim 503A list — the category for nominated substances with identified safety concerns — in 2023, and left it in September 2024 when the nomination behind it was withdrawn; the FDA's safety-risks page, current as of 22 April 2026, lists it under substances nominated but withdrawn. On 29 October 2024 the FDA's Pharmacy Compounding Advisory Committee voted 0 in favour, 12 against, with 1 abstention, on adding ipamorelin (free base) and ipamorelin acetate to the 503A Bulks List. The uses evaluated were growth hormone deficiency and postoperative ileus, and the stated reason was a lack of safety and efficacy data for those uses. That is an advisory recommendation, not a rule. On the FDA's 503A category list updated 14 May 2026, ipamorelin appears in no category — Category 2 is down to six substances, none in this blend — and no final determination has been issued. It is not on the July 2026 or February 2027 advisory dockets.

AOD-9604 was placed in Category 2 in 2023 and also left it in September 2024 on withdrawal of its nominations; the FDA's safety-risks page lists it under nominated but withdrawn. On 4 December 2024 the Pharmacy Compounding Advisory Committee voted 0 in favour and 12 against adding AOD-9604 (free base) and AOD-9604 acetate to the 503A Bulks List, the use evaluated being obesity. The FDA's briefing document concluded there was no evidence of effectiveness for obesity by any route and no human data for the subcutaneous route. It appears in no category on the 14 May 2026 list and is not on the July 2026 or February 2027 dockets. No final rule has been issued.

MOTS-c was in Category 2 from 2023. On 15 April 2026 the FDA announced the removal of twelve peptides from Category 2, effective about a week later, and MOTS-c was among them, alongside BPC-157, KPV, TB-500, injectable GHK-Cu, Semax, epitalon, DSIP, dihexa, LL-37, PEG-MGF and melanotan II. On 23 July 2026 the Pharmacy Compounding Advisory Committee reviewed MOTS-c (free base and acetate) for the nominated uses of obesity and osteoporosis and voted 7–5, with two abstentions, to recommend adding it to the 503A Bulks List. The FDA's own reviewers had recommended against; the committee voted the other way by the narrowest margin of the peptides it recommended. The FDA's final determination is still pending as of September 2026.

None of the four components is currently in Category 2 or otherwise restricted. One is the active ingredient of an approved drug; two carry negative advisory-committee recommendations, with no final rule; one carries a positive recommendation awaiting final FDA action. All four are prescribed by physicians and compounded by licensed pharmacies. None of it makes PHYSIQ an FDA-approved drug product, and compounded medications never are.

Most people notice little. Injection-site tenderness is the most commonly reported observation. Some describe deeper sleep, which prescribers attribute to the bedtime growth-hormone pulse; some describe nothing, which is normal and is not a sign the course is not working.

The window one vial covers on a weekday schedule. Prescribers describe it mostly in terms of recovery from training and sleep quality rather than anything visible. Water retention or mild joint stiffness, both known effects of raised growth-hormone signalling, are sometimes reported here.

Where body-composition change happens, this is where prescribers describe it becoming noticeable — typically as a change in how clothes fit around the midsection rather than on the scale. The tesamorelin trials measured visceral fat at 26 weeks: the one component with human data was assessed over six months, not six weeks. It takes a second and third vial to reach this window.

There is no withdrawal described. In the tesamorelin trials, visceral fat returned toward baseline after the drug was stopped, which is the honest answer to "does it last": the effect is present while the signal is present. Whether anything persists depends on the training and diet the course ran alongside.

The directions are written in millilitres and in insulin-syringe units because that is what you can actually read off the barrel. 0.25 mL is 25 units on a U-100 syringe. You are not calculating anything — the number is printed on your medication. Because the four are in fixed, equal proportion, every dose delivers 0.5 mg of each component; you cannot take more of one and less of another.

The body's largest natural growth-hormone pulse occurs in the first hours of sleep, and prescribers time the two secretagogues to sit alongside it. That is a prescribing convention, not a trial-established requirement. Subcutaneous means into the fat layer, not the muscle. Abdomen and thigh are the usual sites, rotated so the same spot is not used repeatedly. Your directions will say.

20 doses at five per week is four weeks of weekday dosing, which is why refills run on a monthly cycle. Weekends off is part of the schedule, not a missed dose. One vial per fill, always — not a stockpile.

Refrigerated, and it ships that way in insulated packaging with ice packs. Beyond-use dating runs from first puncture and is on the label; a four-peptide vial is not something to keep past it.

One component differs. SHRED is AOD-9604, CJC-1295, ipamorelin and MOTS-c; PHYSIQ swaps CJC-1295 for tesamorelin. Tesamorelin is the GHRH analogue with an approved product and human visceral-fat trials; CJC-1295 is the longer-acting one more commonly stacked with ipamorelin. Which a physician prefers usually turns on whether visceral fat is the specific target.

The two-peptide preparation is the secretagogue half of PHYSIQ without AOD-9604 or MOTS-c. Given that AOD-9604's obesity trials did not meet their endpoints and MOTS-c has no human trials, a physician may reasonably decide the two components with the stronger evidence are the prescription and the other two are not adding enough to justify a fixed ratio. It is a legitimate, and common, narrowing.

Not the same job. Semaglutide and tirzepatide act on appetite and have randomised trial evidence for weight loss in adults with obesity. PHYSIQ acts on growth-hormone signalling and cellular energy handling and has no weight-loss evidence. Some patients use a body-composition blend alongside a GLP-1; whether that is appropriate is a physician's decision.