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V-Series Protocol

V-03#1 Most AllocatedPopular · GLP-1 + Lean Mass

Metabolic - Weight & Blood Sugar

Visceral fat reduction with lean mass and dermal preservation

Quick Takeaways
Dual-receptor metabolic action (GLP-1 / GIP via Tirzepatide)
Targets visceral lipid reduction (Tesamorelin)
Structural recovery support during active fat loss (BPC-157)
TargetsAesthetic Optimization · Metabolic Health
Duration12–16 week titration protocol
Cohort184 active members
Core Compounds
TirzepatideTesamorelin
Batch 001 Allocation
28 of 30 reserved2 open
Monthly
$360 USD/mo
Founding-Member Savings
Standard (Monthly)$360/mo
6-Month Founding Tier$325/mo
Annual savings$420
◇ Physician-Evaluated Adjuncts
BPC-157
+$38/mo
Purpose: GI protection during titration
Indication: For patients with GI sensitivity history, low body mass, first-time GLP-1 exposure, or breakthrough symptoms during titration
Adjuncts are selected based on your specific profile - they are not default purchases. Your audit consultation will determine if any adjunct applies.
Janoshik Verified
HPLC + MS purity, every batch
Independent third-party lab
COA Per Batch
Lot-level certificates published
Labeled vs actual mg disclosed
Protocol Reviewed
Clinical reasoning per stack
Phase 1 supervision onboarding
V-03 · Gold · Metabolic
Composition

Each compound, and what it does

Every component is individually sourced, third-party verified, and dispensed within physician supervision. Tap any compound for its full clinical reference.

Clinical Overview
V-03 Explainer · 90 seconds
Video Coming Soon
Clinical explainer · ~90s · Authored by Vivre Labs Medical Board
Patient Selection
Who This Protocol Is For

A metabolic protocol for patients pursuing significant weight reduction while preserving lean mass and dermal architecture. Combines incretin-driven fat loss with growth-hormone secretagogue activity to address what monotherapy GLP-1 protocols often produce: facial volumetric loss, dermal sagging, and accelerated skin laxity. BPC-157 is available as a physician-evaluated adjunct for patients sensitive to GI side effects during titration.

CLINICAL INDICATION: Patients pursuing aesthetic-conscious weight management, metabolic syndrome, refractory obesity

Cohort Outcomes · V-03
What members on Metabolic - Weight & Blood Sugar report.
n=162 members completing Week 12 of V-03 · Population medians, individual results vary
HbA1c reduction
-12%
Median, baseline → wk 12
Fasting insulin reduction
-50%
Insulin sensitivity restoration
IGF-1 increase
+37%
Lean mass preservation marker
Triglycerides reduction
-45%
Cardiometabolic risk
Member VL-2026-0089 (M, 51): HbA1c 5.9 → 5.4, fasting insulin 16.1 → 7.1, -8.2kg loss with maintained lean mass per DEXA. No facial volumetric loss reported.
Outcomes shown reflect cohort medians from members completing 12 weeks on protocol. Individual outcomes depend on baseline biomarkers, adherence, and physician-directed adjustments. Past cohort performance does not guarantee future results.
Mechanism
How V-03 Works

Advanced metabolic protocol engineered to address Incretin-Induced Facial Volumetric Loss. Tirzepatide drives GLP-1/GIP dual agonism for visceral fat reduction; Tesamorelin amplifies growth hormone pulses to preserve lean mass and dermal collagen. BPC-157 may be added by physician evaluation for patients with GI sensitivity history, low body mass, or first-time GLP-1 exposure during the titration window.

Monotherapy Tirzepatide reduces fat indiscriminately, including facial fat pads and dermal support structures. V-03 addresses this clinically: Tesamorelin's GHRH analog activity preserves subcutaneous tissue and skin elasticity during weight loss. For patients who experience significant GI tolerability burden during titration, BPC-157 is available as an adjunct - assessed by your physician based on your specific profile rather than bundled as a default.

Formulation
What arrives each month
◇ Multi-Vial Stack
3 separate vials · Separate injections per physician schedule
Tirzepatide follows its own weekly schedule per the approved-class regimen. Tesamorelin and BPC-157 are administered per the physician's integrated protocol. Pre-blending is not appropriate because the approved-class Tirzepatide has fixed weekly cadence distinct from the adjunct peptides.
What's in the boxSpecificationPer month
Tirzepatide10mg vial · once-weekly administration covers ~4 weeks
Tesamorelin10mg vial · typical monthly allocation
BPC-1575mg vial · 2 vials typical monthly supply for adjunct support
V-03 cohort tracks each compound's contribution separately. Pre-blending would prevent compound-level monitoring this stack requires.
Vial counts shown are operational transparency - what arrives in the monthly allocation box. Administration frequency, per-administration amounts, and reconstitution method are physician-determined at consultation, not on this page.
Components
Core Compounds in V-03
Weight loss · once weekly
Tirzepatide
Base Form · 10mg
GLP-1 / GIP Dual Agonist
Growth hormone support
Tesamorelin
GHRH Analog · 10mg
GHRH Receptor Agonism
Protocol Timeline
Titration Schedule
Wk 1–4
Tirzepatide 2.5mg/wk
Loading. Tolerability baseline. BPC-157 adjunct (500mcg/day) if prescribed.
Wk 5–8
Tirzepatide 5mg/wk + Tesamorelin 1mg/day
GH secretagogue activation
Wk 9–12
Tirzepatide 7.5–10mg/wk + Tesamorelin 2mg/day
Therapeutic dose - DEXA at wk 12
Wk 13–16
Maintenance or escalation per physician
HbA1c trend-guided
Clinical Oversight
Monitoring & Safety
Lab Monitoring
Fasting insulin, HbA1c, lipid panel, DEXA scan, IGF-1 at baseline + wk 6, 12
Contraindications
Personal/family history of MTC, MEN2, pancreatitis, severe GI motility disorders
Patient Bloodwork Guide
Bloodwork for Metabolic & Weight Protocols

GLP-1 class - Tirzepatide, Retatrutide, Semaglutide, Cagrilintide, V-03, V-M2

These protocols work on appetite, insulin sensitivity, and how your body stores fat. Monitoring tracks both the metabolic benefit and the things that change quickly during weight loss - blood sugar, lipids, and lean-mass markers.

Incremental approach. Doses are titrated upward slowly from a low starting point. Maintenance is typically a moderate dose - pushing higher rarely adds benefit and adds side effects. Monitoring guides where you settle.

Blood sugar & insulin
Fasting insulinTracks insulin sensitivity - usually the first thing to improve.
HbA1cYour 3-month average blood sugar.
Fasting glucoseRoutine blood-sugar tracking.
Heart & lipids
Full lipid panelLDL, HDL, triglycerides, ApoB - these shift meaningfully during weight loss.
Resting heart rate & BPSimple checks tracked through the protocol.
Muscle & body composition
IGF-1Helps your physician protect lean mass during rapid weight loss.
DEXA / body compositionConfirms you are losing fat, not muscle - the goal of pairing with resistance training.
Overall safety
CMP & liver enzymesKidney and liver function (AST/ALT), watched especially when compounds are combined.
ThyroidBaseline check, as thyroid influences metabolic rate.
When the tests happen
BaselineCMP, HbA1c, fasting insulin, full lipids, liver, thyroid, IGF-1, DEXA.
Weeks 4 / 8 / 12 / 16Weight, resting HR, BP, symptom check.
QuarterlyCMP, HbA1c, fasting insulin, lipids, liver, IGF-1, body composition.

Educational only - not medical advice or a dosing instruction. Your physician orders the tests, sets your dose, interprets results, and decides if a protocol is right for you. See the Informed Consent & Disclaimer for full terms.

Lean-Mass Support During Weight Loss
A related option - discuss with your physician

Rapid GLP-1/GIP weight loss reduces fat and lean muscle. The foundation for preserving muscle is resistance training and adequate protein (roughly 1.2–1.6 g/kg/day for most people losing weight) - these do most of the work and come first.

As an adjunct, some patients discuss a GH-axis secretagogue protocol with their physician, on the rationale that supporting the growth-hormone / IGF-1 axis may help protect lean mass during a caloric deficit. This is mechanistically reasonable but not established by combination-outcome trials - there is no study showing it preserves more muscle than training and protein alone. Whether it is appropriate is a physician decision.

Educational only - not a recommendation to combine compounds or a dosing instruction. Any protocol decision is made by your supervising physician.

Clinical Monitoring Reference
What Your Physician Tracks - and Why
V-03 supports metabolic recomposition with structural preservation. The reference set below is what a Vivre physician tracks during supervised use - monitoring practice, not a self-administration guide.
Dosing & Frequency
Physician-supervised titration with review checkpoints. Dose and frequency are physician-determined by response and GI tolerability - never self-adjusted.
BiomarkerWhy It's MonitoredBaselineCadence
HbA1cGlycemic control and efficacy signalYesWk 6, 12
Fasting insulinInsulin-sensitivity trendYesWk 6, 12
Lipid panelMetabolic recomposition surveillanceYesWk 6, 12
Lean mass (DEXA)Confirm lean-mass preservationYesWk 6, 12
IGF-1Growth-axis surveillance when pairedYesWk 6, 12
GI tolerability logGuides titration paceYesOngoing
Monitoring practice shown for education. Allocation and titration are physician-directed after consultation.
This reference describes physician monitoring practice for educational purposes. It is not a prescription, a dosing instruction, or medical advice. Treatment, dosing, and frequency are determined only by a licensed physician in consultation.
§
Clinical Literature
Evidence Behind The Stack
V-03 combines Tirzepatide, Tesamorelin, and BPC-157. Tirzepatide and Tesamorelin have substantial controlled human evidence in their respective indications; BPC-157 is preclinical-only and used adjunctively under supervision.
Tirzepatide

Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1)

Jastreboff AM, Aronne LJ, Ahmad NN, et al. · 2022 · New England Journal of Medicine 2022;387:205–216

Findings

Phase 3 RCT over 72 weeks. Mean weight reduction was 16.0%, 21.4%, and 22.5% at 5, 10, and 15 mg respectively, versus 2.4% on placebo. Body-composition analysis showed approximately 3-fold greater fat-mass reduction than lean-mass reduction. Three-year extension data have since shown durable maintenance of weight loss when therapy is continued under supervision.

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Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes (SURPASS-2)

Frías JP, Davies MJ, Rosenstock J, et al. · 2021 · New England Journal of Medicine 2021;385:503–515

Findings

Head-to-head Phase 3 RCT in adults with type 2 diabetes inadequately controlled on metformin. Tirzepatide produced superior reductions in HbA1c and body weight compared with semaglutide 1 mg at 40 weeks. Patients on tirzepatide 15 mg had approximately twice the weight loss of those on semaglutide 1 mg, with a comparable gastrointestinal adverse-event profile. First major head-to-head incretin-class trial.

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Tirzepatide as Compared with Semaglutide for the Treatment of Obesity (SURMOUNT-5)

Aronne LJ, Horn DB, le Roux CW, et al. · 2025 · New England Journal of Medicine 2025;393:26–36

Findings

Phase 3b open-label, controlled, head-to-head trial over 72 weeks in adults with obesity but without type 2 diabetes. Tirzepatide produced superior reductions in body weight and waist circumference versus semaglutide 2.4 mg (the approved obesity dose). Gastrointestinal adverse events leading to discontinuation occurred more often with semaglutide than tirzepatide. First direct comparative obesity trial between the two agents.

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Tirzepatide is an approved-class dual agonist with a substantial human evidence base spanning monotherapy efficacy (SURMOUNT-1), head-to-head superiority in type 2 diabetes (SURPASS-2), and head-to-head superiority in obesity (SURMOUNT-5). Use at Vivre is physician-supervised; suitability, dosing, and titration are determined in consultation, not by the patient.
Tesamorelin

Metabolic Effects of a Growth Hormone–Releasing Factor in Patients with HIV

Falutz J, Allas S, Blot K, et al. · 2007 · New England Journal of Medicine 2007;357:2359–2370

Findings

Pivotal Phase 3 RCT in HIV-associated lipodystrophy over 26 weeks. Tesamorelin produced selective reduction in visceral adipose tissue versus placebo, with improvements in lipid profile and no significant glycaemic worsening at the studied dose. This trial supported the FDA approval for the lipodystrophy indication. Use outside this indication is off-label.

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Tesamorelin has well-characterised evidence for visceral adipose reduction in its approved indication. Use in healthy adults for body composition is off-label and conducted under physician supervision with explicit consent.
BPC-157

Oral Peptide BPC-157 - An Emerging Adjunct to Inflammatory Bowel Disease Therapy: A Systematic Review

Joshi N, Patel S, et al. · 2025 · American Journal of Gastroenterology 2025;120(10S):Abstract S808

Findings

PRISMA-compliant systematic review (36 studies, 1993–2025) summarising the BPC-157 evidence base. The authors documented BPC-157's mechanistic profile (growth hormone receptor enhancement, angiogenesis modulation, anti-inflammatory pathways) across preclinical IBD, GI ulcer, NSAID-induced injury, fistula, and anastomotic models. Critically, the review states: "No clinical safety data is available to date" - i.e. despite extensive preclinical activity, controlled human safety and efficacy data remain absent in the modern peer-reviewed literature.

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Pentadecapeptide BPC 157 in Clinical Trials as a Therapy for Inflammatory Bowel Disease (PL14736)

Sikirić P, Petek M, Ručman R, et al. (originating group; multiple publications) · 2003–2024 · Multiple publications; see Inflammopharmacology 2024;32:3119–3161 (review)

Findings

Early Croatian Phase I/II clinical trials (PL10, PL14736) explored BPC-157 in mild-to-moderate ulcerative colitis, reporting safety and tolerability signals in small cohorts. Important caveats: these trials were conducted primarily by BPC-157's discoverers and have not been independently replicated in Western peer-reviewed RCTs at scale; detailed trial reports have not appeared in major Western journals despite frequent reference in subsequent reviews. The 2024 Sikiric et al. review summarises three decades of work but is from the originating group. Independent confirmatory trials remain absent.

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Pentadecapeptide BPC 157 Enhances the Growth Hormone Receptor Expression in Tendon Fibroblasts

Chang CH, Tsai WC, Hsu YH, Pang JS · 2014 · Molecules 2014;19:19066–19077

Findings

In-vitro study on isolated Achilles tendon fibroblasts. BPC-157 produced time- and dose-dependent upregulation of Growth Hormone Receptor expression at the mRNA and protein level, with increased fibroblast proliferation markers. Mechanistic and preclinical; does not constitute evidence of efficacy in human tissue repair.

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The promoting effect of pentadecapeptide BPC 157 on tendon healing involves tendon outgrowth, cell survival, and cell migration

Chang CH, Tsai WC, Lin MS, Hsu YH, Pang JS · 2011 · Journal of Applied Physiology 2011;110:774–780

Findings

Preclinical study mapping cellular pathways. Identified BPC-157 activity on the FAK–paxillin migration pathway, with enhanced cell outgrowth and survival in tendon-explant models. Cellular/animal level; human controlled trial evidence remains absent.

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Stable Gastric Pentadecapeptide BPC 157 and Wound Healing

Seiwerth S, Milavic M, Vukojevic J, … Sikirić P (originating group) · 2021 · Frontiers in Pharmacology 2021;12:627533 (review)

Findings

Comprehensive narrative review of BPC-157 wound-healing data across skin wounds, burns, diabetic ulcers, alkali burns, and a distinctive body of fistula-healing work (colocutaneous, gastrocutaneous, esophagocutaneous, duodenocutaneous, vesicovaginal, rectovaginal). Documents the angiogenic mechanism - BPC-157 upregulates VEGF-a and promotes endothelial proliferation and vascular tube formation, with an angiogenic effect exceeding standard agents in the sponge assay. Two important caveats: (1) the evidence is almost entirely animal (rat/mouse, some pig) - not human outcome data; (2) it is a review by the originating Zagreb group, and most primary citations are that group's own work, so it has not been independently replicated at scale. Note also that the same pro-angiogenic/VEGF action that drives healing is the basis for the theoretical oncologic caution discussed for any angiogenic compound.

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BPC157 as Potential Agent Rescuing from Cancer Cachexia

Kang EA, Han YM, An JM, … Sikiric P, Hahm KB · 2018 · Current Pharmaceutical Design 2018;24(18):1947–1956

Findings

Review proposing BPC-157 as a candidate for cancer cachexia (cancer-related muscle/fat wasting). In a C-26 colon-adenocarcinoma mouse model the peptide antagonised TNF-α and IL-6, cytokines central to cachexia. Preclinical and pre-clinical-trial - a proposal, not an outcome study - and from the originating (Sikiric) group.

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BPC 157 inhibits cell growth and VEGF signalling via the MAPK kinase pathway in the human melanoma cell line

Radeljak S, Seiwerth S, Sikiric P · 2004 · Melanoma Research 2004;14(4):A14–A15 (conference abstract)

Findings

In vitro: BPC-157 (2–10 ng) reduced human melanoma cell S-phase fraction by up to ~55% and decreased ERK phosphorylation - i.e. it acted as an antimitogenic agent INHIBITING the VEGF-MAPK proliferative signal in melanoma cells. A conference abstract (no full text), from the originating group; counterintuitive against the “BPC promotes angiogenesis” healing literature, which is why both directions matter.

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Stable Gastric Pentadecapeptide BPC 157 as a Therapy and Safety Key: … Controlling and Modulating Angiogenesis and the NO-System

Sikiric P, Seiwerth S, Skrtic A, et al. · 2025 · Pharmaceuticals (Basel) 2025;18(6):928 (PMC12195719)

Findings

A 2025 review in which the originating group directly addresses the tumour-risk speculation: it argues BPC-157 CONTROLS/MODULATES angiogenesis rather than driving tumorigenesis (e.g. it opposes corneal neovascularisation - “angiogenic privilege”), reports anti-tumour potential in vitro and in vivo per Folkman’s concept, and notes LD1 not achieved with no reported adverse effects. Important read: this is a defence authored by the compound’s originating group, so it answers but does not independently close the theoretical tumour-risk question.

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BPC-157 has an extensive preclinical literature spanning thirty years and early Croatian Phase I/II trials in ulcerative colitis from the discovering group - but no independently-replicated controlled human RCTs at scale, and no current FDA or EMA approval for any indication. The 2025 ACG systematic review explicitly notes that no modern clinical safety data exists. Important disclosure for competitive athletes: BPC-157 has been on the World Anti-Doping Agency Prohibited List since 2022 (S0 - non-approved substances). At Vivre, BPC-157 is allocated under physician supervision with the evidence limitations and WADA status explicitly disclosed in informed consent.
Studies cited are real peer-reviewed publications. Summaries reflect what each source actually concluded. Educational only - not medical advice, a prescription, or a dosing instruction.
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