Many influencers and health enthusiasts make peptides sound like a magic potion. They swear peptides can reverse aging, boost energy, accelerate recovery, enhance libido, make you tan, help with weight loss and so much more.
The excitement around peptides got a boost in July when an advisory committee narrowly voted to add six peptides to the U.S. Food and Drug Administration’s compounding list, allowing licensed pharmacies to make them for patients.
As of this writing, the FDA still needs to sign off on the recommendation, though given that Robert F. Kennedy Jr., who oversees the FDA as the Health and Human Services Secretary, has expressed support for peptides, it will likely pass. The committee has faced criticism over conflicts of interest, notably that six of the eight appointed members run clinics that offer peptides.
So how much of the hype is just…hype? What is safe? What isn’t? We asked local experts to weigh in.
What are peptides?
Peptides are short chains of amino acids, essentially small bits of protein your body makes naturally. According to Harvard Medical School, peptides can control inflammation and help coordinate hormone activity, immune defense, digestion and tissue repair.
Your body makes some peptides on its own. Others are made using the amino acids found in proteins you consume, such as eggs, meat and legumes. They can also be created in a lab and used in supplements, injectables and medications. Some familiar peptides include insulin, oxytocin and weight-loss drugs such as GLP-1s.
Rachel Frank, a board-certified orthopedic surgeon and sports medicine specialist with UCHealth, often works with patients who are looking to optimize their athletic performance or recover faster from training or injuries. Lately, she’s encountered many patients who are interested in BPC-157 and TB-500, two peptides on the FDA committee’s compounding list.
“When I talk about this from the 30,000-foot view, I’m super excited about the potential,” Frank says. “Who wouldn’t want to have a better solution for aging, for bone health, for inflammation, for all the things that are so hard to treat?”
The bummer, she says, is that the research just isn’t there yet.
For example, BPC-157 is a synthetic peptide that has been shown in animal studies to accelerate healing, but it hasn’t really been tested on humans yet. Another synthetic peptide, TB-500, is based on a fragment of a naturally occurring protein in human cells that plays a role in rebuilding tissue. As of this writing, TB-500 has not undergone human trials either.
“Some peptides are well-studied, FDA-approved medications, including GLPs and insulin,” Frank says. “Others have very little human clinical evidence, are not FDA approved and may in fact be unsafe or contaminated.”
Frank doesn’t blame patients for wanting that edge in competition or wanting to recover faster when they’re hurt. But peptides may not be the easy solution that wellness influencers lead you to believe.
Facial Aesthetics
Not one size fits all
Caitlin Bump, a certified family nurse practitioner and director of wellness at Facial Aesthetics, a med spa in Fort Collins, says she became interested in peptides after she used a GLP-1 medication and lost 60 pounds.
“That sparked my interest in wanting to help make these accessible to more people because I’ve seen personally how they can change lives,” she says.
Facial Aesthetics provides tailored peptide therapies for a variety of ailments, targeting longevity, beauty, weight management, sexual wellness and hormonal balance, according to its website. The med spa offers NAD+, which is believed to boost energy levels and improve cognitive function; sermorelin to boost hormones that support muscle growth, fat loss and better sleep; and GHK-Cu, a copper peptide thought to grow hair.
Bump determines whether a peptide treatment is appropriate for patients at Facial Aesthetics. Not every peptide is one size fits all, she says.
“We have to look at the side effects, risks, benefits and interactions—all important things to take into consideration,” she says.
Bump often sees patients who think that because peptides are naturally occurring, they must be risk free. But that isn’t true.
“Take sermorelin, or any of the peptides that help increase growth factor. It can help with building muscle and things like that, but the peptides can’t tell which tissues to grow,” she says. “So if there were something like an underlying cancer, or somebody who’s had cancer in the past, sermorelin could potentially make that cancer progress.”
Confusing approvals
Frank says she knows BPC-157 is being promoted online for things like tendon, ligament and muscle recovery. Patients ask her to prescribe it, especially since it was among the six peptides recommended for approval by the FDA committee. But BPC-157 wasn’t evaluated for tendon, ligament and muscle recovery.
“What the FDA specifically evaluated it for was ulcerative colitis,” she says, which is a chronic inflammatory bowel disease. “I don’t treat ulcerative colitis. I’m not an expert in that, and that’s what it’s been approved for.”
So, Frank tells her patients no.
TB-500 was approved for wound healing, which is also appealing to many of her patients, she says, but it still isn’t a good fit for most of them.
“I don’t typically deal with wounds that need to ‘heal,’ per se,” she says. “There will probably be a good application for TB-500; it’s just not necessarily going to apply to my patients.”
She also says athletes should be wary when taking peptides, even if they do get them prescribed, as many peptides are considered doping and are prohibited.
Getting peptides safely
It can be difficult for folks to discern what’s legally available, let alone safe, especially since many wellness products are available online, Bump says.
She recommends working with qualified medical providers rather than buying from influencers or online shops that don’t involve medical professionals. Many peptides must be purchased from compounding pharmacies because they are not FDA approved, she says, but that doesn’t mean they’re unregulated.
Compounding pharmacies offer medications that aren’t commercially available by preparing them onsite, according to Harvard. Those medications are usually formulated to meet a specific need, such as providing a particular dose or strength or excluding an ingredient, like lactose or gluten, due to an allergy.
While compounded drugs are supposed to use FDA-approved ingredients, the formulations aren’t reviewed by the FDA for purity, safety or effectiveness, according to Harvard. Facial Aesthetics uses one of the top three compounding pharmacies in the country, Bump says, and they undergo rigorous checks to be an accredited pharmacy.
“The compounded peptides that we offer have to be compounded at a facility that undergoes strict regulatory checks,” she says. “Basically, it’s being checked that products are sterile, potent and effective.”
So, what are the possible red flags? Bump encourages people to ask these three things:
1. Where are the sellers sourcing peptides from?
2. Is the peptide labeled as research grade? If so, it is not meant for human consumption, is not regulated and could be contaminated.
3. Do you need to mix it yourself?
“If someone gives you a powder vial, you should run away,” she says.
Proceed with caution
Frank doesn’t claim to be an expert on peptides.
“I’m an orthopedic surgeon speaking from the sports medicine and athlete safety side of this,” she says. “But that raises the question I think is the most important: If I’m not the expert, who is?”
The FDA’s own scientific reviewers recommended against most peptides a couple of years ago, citing absent or contradictory human data, Frank says. The advisory committee then made a different recommendation.
“It reflects some real tension between patient access and caution,” she says. “The honest answer right now is that expertise on long-term human safety and efficacy for most of these compounds simply doesn’t exist.”
Still, she hopes the popularity of peptides and the public’s continued interest in them will drive further research so that healthcare providers can make more evidence-based recommendations.
“It doesn’t mean that in a year we won’t be saying these things are the greatest things since sliced bread,” she says. “It just means [the research] doesn’t exist right now.”
