GLP-1 Protocol: Advanced
Full Recomposition with Anabolic Protection
Who This Is For
Experienced users who want:
- Maximum fat loss while preserving or building lean mass.
- Targeted visceral fat reduction.
- Deep recomposition: looking bigger while weighing less.
- Sustained energy and recovery despite aggressive deficit.
This tier adds Tesamorelin for anabolic signaling and visceral fat targeting. Optional additions—AOD-9604 and Ipamorelin—provide further lipolytic and GH support for those who need it.
The Stack
| Compound | Role |
|---|---|
| Retatrutide | Metabolic controller: intake, partitioning, oxidative drive |
| NAD+ | Energy infrastructure: redox balance, ATP production |
| L-Carnitine | Fat transport: shuttles fatty acids into mitochondria |
| MOTS-c | Mitochondrial expansion: biogenesis, metabolic flexibility |
| Tesamorelin | Anabolic preservation: GH pulsatility, visceral fat targeting, recovery |
Optional additions:
| Compound | Role |
|---|---|
| AOD-9604 | Lipolytic amplifier: accelerates stubborn subcutaneous fat loss |
| Ipamorelin | GH secretagogue: supports natural GH pulse; gentler alternative to Tesamorelin |
Dosing Protocol
Core Stack
Retatrutide
| Parameter | Specification |
|---|---|
| Dose | 3–4 mg weekly (some respond to 5–6 mg) |
| Route | Subcutaneous |
| Frequency | Weekly or split |
| Note | If escalating from Intermediate, allow 4+ weeks before increasing |
NAD+
| Parameter | Specification |
|---|---|
| Dose | 200–300 mg per injection |
| Frequency | 5–6×/week or EOD |
| Route | IM preferred |
| Timing | Morning; may split AM/PM on heavy training days |
L-Carnitine
| Parameter | Specification |
|---|---|
| Dose | 500–1000 mg per injection |
| Frequency | Daily or 5–6 days/week |
| Timing | Fasted morning or 30–45 min pre-workout |
| Route | IM |
MOTS-c
| Parameter | Specification |
|---|---|
| Dose | 5–10 mg per injection |
| Frequency | 2–3×/week |
| Timing | Morning or pre-training, fasted |
| Route | Subcutaneous |
| Cycle | 6–8 weeks on, 2–4 weeks off |
Tesamorelin
| Parameter | Specification |
|---|---|
| Dose | 1–2 mg nightly |
| Timing | 30–60 min before sleep, at least 2 hours after last meal |
| Route | Subcutaneous |
| Monitoring | Check IGF-1 at week 4–6 and monthly thereafter |
Optional Additions
AOD-9604
| Parameter | Specification |
|---|---|
| Dose | 250–500 mcg per injection |
| Frequency | Daily (5–6 days/week) |
| Timing | Morning, fasted |
| Route | Subcutaneous; optional site-specific injection near problem areas |
| When to add | Stubborn subcutaneous fat that isn't responding to core stack |
Ipamorelin
| Parameter | Specification |
|---|---|
| Dose | 100–300 mcg per injection |
| Frequency | 1–2× daily (commonly before bed and/or AM) |
| Route | Subcutaneous |
| When to add | Alternative to Tesamorelin if seeking gentler GH support; can combine at lower doses |
Why This Combination
The Intermediate stack—Retatrutide, NAD+, L-Carnitine, MOTS-c—maximizes fat oxidation capacity. But deep recomposition requires one more element: an anabolic signal that tells the body what to preserve while fat burns.
Tesamorelin provides that signal. It's a GHRH analog that triggers natural, pulsatile growth hormone release during sleep. This matters because:
- GH → IGF-1 sustains mTOR signaling in muscle, maintaining protein synthesis even in caloric deficit.
- GH-driven lipolysis targets visceral fat specifically—the deep, inflammatory depot most resistant to change.
- Collagen synthesis increases, strengthening tendons, ligaments, and connective tissue.
- Sleep architecture deepens, anchoring recovery to the hours when GH peaks.
The combination creates a metabolic environment where fat is the preferred fuel and muscle is the protected asset. Users describe looking "bigger while weighing less"—the hallmark of true recomposition.
AOD-9604 adds peripheral lipolytic support. It increases fatty acid release from stubborn subcutaneous depots without systemic GH effects. Useful when certain areas (lower abdomen, flanks) resist the core stack.
Ipamorelin offers a gentler GH secretagogue option. It produces reliable GH pulses without the cortisol or prolactin elevation seen with some other secretagogues. Can be combined with Tesamorelin at reduced doses or used as a standalone alternative.
Weekly Schedule (Example)
| Day | Retatrutide | NAD+ | L-Carnitine | MOTS-c | Tesamorelin | AOD-9604 (opt) |
|---|---|---|---|---|---|---|
| Mon | — | 250 mg AM | 500 mg fasted | 10 mg AM | 2 mg bedtime | 300 mcg fasted |
| Tue | — | 250 mg AM | 500 mg pre-WO | — | 2 mg bedtime | 300 mcg fasted |
| Wed | Weekly dose | 250 mg AM | 500 mg fasted | 10 mg AM | 2 mg bedtime | 300 mcg fasted |
| Thu | — | 250 mg AM | 500 mg pre-WO | — | 2 mg bedtime | 300 mcg fasted |
| Fri | — | 250 mg AM | 500 mg fasted | 10 mg AM | 2 mg bedtime | 300 mcg fasted |
| Sat | — | Rest or 250 mg | Optional | — | 2 mg bedtime | Optional |
| Sun | — | Rest | Rest | — | 2 mg bedtime | Optional |
Timeline: What to Expect
Weeks 1–4
| Focus | Expected Changes |
|---|---|
| GH adaptation | Sleep deepens within first week; vivid dreams common |
| Fat loss | Accelerates to 2–3 lb/week |
| Recovery | Training recovery noticeably faster |
| Water | Transient GH-related water retention may occur; resolves by week 3–4 |
| Muscle | Fullness maintained despite deficit |
Weeks 5–8
| Focus | Expected Changes |
|---|---|
| Recomposition | Visible transformation: waist drops, limbs hold or gain size |
| Performance | Strength maintained or improved; endurance up |
| Visceral fat | Belt notches move; trunk tightens |
| Energy | Higher than pre-protocol baseline despite lower calories |
| Sleep | Deep, restorative; morning alertness high |
Weeks 9–12
| Focus | Expected Changes |
|---|---|
| Definition | Muscle separation apparent; stubborn areas finally yielding |
| Cumulative | 20–30 lb fat loss typical; lean mass preserved or slightly gained |
| Metabolic markers | Significant improvements in glucose, TG, HDL, liver enzymes |
| Physical | "Photoshoot ready" look achievable for many |
| State | Metabolism feels self-sustaining, not effortful |
Lifestyle Foundation
| Component | Target |
|---|---|
| Protein | 1.0–1.2 g/lb body weight; anchor each meal at 30–40 g |
| Training | 4–5 days/week; power + hypertrophy hybrid |
| Cardio | Zone 2 predominates (20–40 min, 3–4×/week); HIIT optional if recovery permits |
| Sleep | 7–9 hours; Tesamorelin timing is critical—consistent bedtime matters |
| Hydration | 3–4 liters daily; higher with GH-related water shifts |
Managing Side Effects
GH-Related (Tesamorelin/Ipamorelin)
| Issue | Management |
|---|---|
| Water retention (weeks 1–3) | Transient; ensure adequate potassium (4–5 g/day from diet) |
| Joint stiffness / hand paresthesia | Improves with movement and hydration; reduce dose temporarily if persistent |
| Blood glucose elevation | Monitor if diabetic; GH can transiently raise fasting glucose |
Retatrutide-Related
| Issue | Management |
|---|---|
| Nausea/early satiety | Smaller protein-first meals; hold dose until resolved |
| Constipation | Fiber + fluids → magnesium citrate at bedtime |
MOTS-c/L-Carnitine
| Issue | Management |
|---|---|
| Early fatigue (MOTS-c) | Resolves within 1 week; ensure sleep and electrolytes |
| Injection site soreness | Rotate sites; use appropriate needle length for IM |
Monitoring
| Timepoint | What to Track |
|---|---|
| Baseline | Full panel: CBC, CMP, lipids, fasting glucose/insulin, HbA1c, thyroid, IGF-1 |
| Week 4–6 | IGF-1 (target 50–100% above baseline, not supraphysiologic), fasting glucose |
| Monthly | IGF-1 while on Tesamorelin |
| Week 12 | Full panel; expect: ↓ glucose, ↓ TG, ↑ HDL, ↑ IGF-1, improved liver enzymes |
IGF-1 guidance: Target physiologic elevation (upper normal to moderately elevated). If IGF-1 exceeds 350–400 ng/mL, reduce Tesamorelin dose.
What Comes Next
Maintenance:
- Reduce Retatrutide to 2–3 mg/week.
- Tesamorelin to 1 mg nightly for ongoing sleep/connective tissue support.
- NAD+ at 100–150 mg on training or high-stress days.
- L-Carnitine as needed pre-training.
Lean-gain phase:
- Discontinue Retatrutide.
- Maintain Tesamorelin.
- Increase calories to slight surplus.
- Continue NAD+ and L-Carnitine to support performance.
- Goal: slow, clean accrual of lean mass.
Advanced cycling:
- MOTS-c: 6–8 weeks on, 2–4 weeks off.
- Tesamorelin can be run continuously with IGF-1 monitoring.
- Consider periodizing AOD-9604 around stubborn fat phases.
Contraindications
- Personal or family history of medullary thyroid carcinoma or MEN2 syndrome (Retatrutide).
- Active malignancy (GH/IGF-1 axis; MOTS-c).
- Proliferative diabetic retinopathy (GH can worsen).
- Pregnancy or breastfeeding.
- Uncontrolled diabetes (requires close monitoring and medication adjustment).