What to know about peptides as popularity in the U.S. booms
COLUMBIA, Mo. (KMIZ)
Foster McCormick, of Columbia, has had five shoulder surgeries since 2015. His first was due to a high school football injury, and he says recovery took about nine to 10 months before he could lift weights again.
"I've had four labrum surgeries, two on this arm, two on that arm, and then I shattered this shoulder socket," McCormick said.
The shattered socket required extensive surgery. He had to get a cadaver bone to replace the bottom part that had chipped off. He wanted to get back into mixed martial arts training and coaching faster.
McCormick turned to the peptides BPC-157, TB-500, GHK-Cu and KPV in January.
"I was just looking for anything to get over that and to get back to my sport and get back to myself quicker, so that's how I found out about all that stuff [peptides] through the internet and just recommendations from other people," said McCormick.
His doctors told him it would be anywhere between nine and 13 months to recover, but with the help of peptides, he says he was feeling great earlier than expected.
"Six months after my surgery, I was able to start walking on my hands again, doing handstand walks," said McCormick. "I just felt myself every day getting stronger; things I was scared to death to try, my body was able to overcome ... things that I knew from my past, like, 'hey, you're putting yourself in an area to get injured again,' was a walk in the park for me."
He gets his peptides from a Columbia business that he trusts, not just anywhere off the internet.
He still uses peptides like retitrutide, a GLP-3 that changes the way the body breaks down fat and uses energy while preserving muscle, to continue getting back into better shape without putting his body through the stress of intensive MMA training and other physical activity.
Stories like McCormick's are becoming more common as the peptide business continues to boom.
While he believes peptides played a role in his recovery, his experience is not the same as clinical proof, which is at the center of this growing debate over the compounds.
But how did this category of biological compounds become a booming consumer health trend on social media?
What are peptides?
Peptides are short chains of amino acids, the building blocks of proteins. The body makes them naturally and they can have a wide range of effects on hormonal changes, immune defense, tissue repair, growth, inflammation control and more.
"So there's actually a lot of these occurring naturally in your body, such as insulin, which regulates our blood sugar, and oxytocin, which regulates our mood and other things," said MU Health Care family medicine physician Dr. Regina DePietro.
The most common peptides the body makes include insulin, endorphins and growth hormones. GLP-1 (glucagon-like peptide-1) medications are not natural in the body and are used to treat obesity and Type 2 diabetes. Examples include semaglutide (Ozempic, Wegovy) and tirzepatide (Zepbound, Mounjaro). These peptides are FDA-approved and have gone through rigorous clinical studies to prove their safety and efficacy.
“The first GLP-1 receptor agonists were studied and started being marketed about 20 years ago. And then they've made them more and more effective, different types of them,” said DiPeitro. “And then they go through multiple rounds of studies to get approved.”
Injectable or oral peptides act as biological signals that speed up the body's natural peptide production.
GLP boom births peptide trend
"Over the last two years, they've kind of morphed into the med spa world, and we've gotten quite a bit of traffic recently, I think specifically because of social media influencers and the GLPs," said Dr. Phillip Rohde, medical director at Retuva Medical Spa in Columbia. "They're all over social media, all over Facebook."
GLP-1s were developed to treat diabetes. Rohde thinks that when people noticed they were losing weight and feeling better, it led to a market for non-diabetic weight loss patients.
These peptides have been researched and clinically proven through extensive clinical trials and are FDA-approved. Rohde says weight loss peptides are still his spa’s most common and popular peptide administered.
And due to their success, the door to more peptide options has busted wide open.
"If you have a desired outcome, whether it's hair growth, skin health, energy increase, better sleep, better libido, all of those things, there's a peptide for them," said Rohde. "Other peptides that are common for us are muscle recovery and anti-inflammatory. We sell a lot of those peptides to people wanting to get back on their game, wanting to get back into shape, athletes that want to reduce their recovery time."
THINKING HERE I CAN HAVE A PIC OF ALL THE PEPTIDES ROHDE'S CLINIC SHOWED ME WITH POP-UPS SO WHEN YOU HOVER OVER ONE IT TELLS YOU WHAT IT DOES.
Lots of questions remain about the non-GLP-1 peptides, with few human studies on their long-term side effects.
"When things are approved by the FDA, we know what kind of adverse effects they have," said DiPietro. "We also know if the benefits outweigh the risks."
Long-term safety cannot be guaranteed without studies, though Rohde says the lack of evidence of adverse effects gives him some confidence.
"We don't have ten, 20, 30, 40-year studies yet," said Rohde. "I can't guarantee that they're completely safe and without side effects without some additional studies, but peptides have been around in the bodybuilding world for decades and used by sports enthusiasts, triathletes and boxers, and they've demonstrated pretty good safety."
Not all peptides are created equal or studied equally. Peptides like MT-1 and MT-2, which promote skin tanning, for example, have far less human evidence compared to GLP-1s. Almost all peptides sold online are marketed as "research use only."
For McCormick, aesthetics wasn’t the original goal. He wanted to get better faster, like many other people looking to try peptides.
"It's not life-changing overnight," said McCormick. "Now, for me and my injuries, that was a short, life-changing experience for sure, but I think people need to do a lot of research on these things before they really start getting involved in them."
He looked at medical studies, merchant websites, figured out where the substances were coming from, where they were tested and the results, and made sure they were at either 100% or 99% purity. He also consulted other people he knew who had used peptides.
Rohde says that at his medical spa, every peptide is third-party tested before being sold. McCormick also says the peptides he uses personally are third-party tested.
"If you're going to get peptides from us, they have to be made in the United States, they have to be made by a pharmacy that also makes other medications, so they're regulated by the FDA, and they've done inspections, and they have to be third-party tested," said Rohde. "They have to be sent off, and then I get a report that says, 'yes, this peptide is pure, it's not contaminated, and it's appropriate for human use.'
"I don't want to prescribe peptides that are only made for test animals. So that's why it's really important to go through a rigorous process to make sure your peptides are made for humans and for professional use only."
Caution urged when buying peptides
Some people can have unrealistic expectations when starting peptides, and for those buying them online from places like TikTok, there can be consequences.
While McCormick is pro-peptides, he has had some negative experiences with them.
"There are side effects of some of them from overdosing and doing other things, and they're not very fun at all," said McCormick.
He says if you take too much of certain ones, you can experience nausea, lightheadedness and other symptoms. "It wasn't anything detrimental; it was just like, 'hey, this is not a joke, let's be serious about this and treat it like a medical procedure,'" McCormick said.
Rohde recommends his patients create regimens of about five to six weeks with two weeks off.
"People don't like to cycle off because they feel really good when they're on their peptides, but just for safety's sake," said Rohde. "Say that you do have some abnormal cells circulating that the peptide has kind of driven up a little bit; that time off helps the body to reset, clear any abnormal cells before we start another peptide round."
Peptides are not a one-stop solution. And users must follow the steps carefully for the substances to be effective.
"Peptides are pieces of this pyramid; the base of the pyramid is your lifestyle factors: your sleep, your hydration, your protein, your gym regimen, your hormone levels," said Rohde. "People think peptides are kind of a one-hit wonder, and in a lot of ways they are ... but if you're not doing all the other things that we want you to, you'll lose muscle mass, your skin will sag, you'll be fatigued, your hair will fall out."
While there is a peptide for almost everything, not everyone should be on peptides.
Rohde says he goes through an in-depth history and physical exam to make sure the peptides are appropriate for each patient. People with certain medical conditions or a history of cancer should not be on peptides because they stimulate new cell growth.
Rohde says he starts his newer peptide patients with a low dose to see how they react.
"They're really small and very, very, very concentrated and so most people only need a very, very small amount, so we start people at five units," said Rohde.
Who's watching what goes into the vials?
Shabbir Safdar is the executive director and certified fraud examiner for Partnership with Safe Medicines. His nonprofit studies drug and supply chain safety.
In July, the Pharmacy Compounding Advisory Committee for the Food and Drug Administration recommended adding six peptides to a drug compounding list: BPC-157, KPV, TB-500, MOTS-c, Epitalon and Semax. The change allows specialty pharmacies to make and sell custom medications using those peptied.
Safdar wrote that the vote was a serious setback for patient safety.
“The Pharmaceutical Compounding Advisory Committee voted to advance substances that FDA's own scientists flagged as lacking adequate evidence of safety, efficacy, or quality, Safdar wrote. "The Committee's recommendation will inevitably be interpreted by many as an endorsement of broader clinical use. It is not. Patients won't read the fine print. They will hear one thing: the FDA said yes."
His concerns are not that people are interested in peptides; it's how the products are being made and studied before a person decides to inject them into their bodies.
Peptide labels say "research use only" or "not for human consumption" because these products are not regulated as medications. They are sold as chemical compounds for experimental purposes.
"Americans are sort of not familiar with the complicated and thorough process medicine goes through to be deemed safe and effective and receive FDA approval," Safdar said. "We don't know if you shouldn't take them, if you have, for example, a heart condition or if you have a skin melanoma that might be growing; there's all sorts of danger, and we don't know if they're effective."
Peptides are widely sold online, and it can be difficult to know if you are getting pure, quality compounds. Some come from unknown supply chains and manufacturing conditions, raising the risk for contamination.
"You don't know the sterility of the place that made it, if it grows bacteria or if there's chlorine or formaldehyde left over on the machine that they used when they clean it," said Safdar. "That's going to end up in the vial, and then that's going to end up in your veins."
Safdar says even the smallest impurity can have massive, irreversible consequences.
Earlier this year, a federal judge sentenced the owner of Paradigm Peptides to 70 months in prison after the company sold unapproved drugs containing testosterone imported from Asia. Matthew Kawa admitted to forging lab certificates to establish the credibility of the peptides they were selling.
"We have to be careful about anything that we put into our bodies," DiPietro said. "I don't think we have the evidence yet to know if the benefits outweigh the risks with the unregulated peptides."
Rohde agrees that buying peptides online can be risky and that people should be hesitant if they plan to inject them into their bodies.
"The quality of the peptide may not be what we expect here in the United States, and there may be some safety issues," said Rohde. "Some people are getting online peptides for a long time and do completely fine, but it just makes me a little nervous that you're injecting substances in your body that haven't been tested, and so that's why ours are pretty stringently tested."
Rohde, a traditionally trained medical doctor, can be skeptical of new treatments, so before he started administering peptides, he did robust peptide training and research.
"Peptides are used ubiquitously in other countries," said Rohde. "I think the United States will get there at some point as we get more and more approved by the FDA."
McCormick says that getting FDA approval for more peptides can be a positive and a negative, especially when it comes to prices and accessibility.
"We just have to see where that goes, but prices, I promise you, will skyrocket. It's just going to happen," said McCormick.
Regulators in the United States are now having to grapple with a market that's already moving faster than the traditional evidence and approval system.
A booming business
The peptide industry is booming.
A subreddit community, r/Peptides, has 62,000 weekly visitors and around 1,500 contributors from all over the world. A related community, r/biohackers, which also discusses peptides and DIY biology, has 511,000 weekly visitors.
Looking up "buy peptides" on the internet yields results including multiple suppliers. On social media platforms like TikTok, you can even learn about and buy them straight off the app.
"The 'looksmaxxing' community is interested; you've seen for a long time the bodybuilder community, men and women taking peptides," said Safdar.
Young people are more vulnerable to the marketing of these unregulated peptides, Safdar said.
"You don't have as much worldly experience. Your prefrontal cortex is not fully grown out yet. And I think it's a real risk at that age to be experimenting with things that may have long-term life-changing effects," said Safdar.
McCormick, who works in the fitness community, says there is a divide between whether to use peptides.
"A lot of people in the fitness community are looking for direct and extreme results; they'd almost rather support testosterone and anabolic steroids than something like this," said McCormick.
What to consider before starting peptides
It's recommended you consult a medical professional in the field before starting peptides.
“If you are taking these, you should discuss them with your doctor so that we know, as your physician, how it could be affecting your other medications or other health conditions,” DiPietro said. “And then actually, that can create evidence with these medications of how they work and how they could potentially have risks as well.”
It's also important to ask the right questions.
What exactly am I taking? What is its intended use? Is this FDA-approved? What human evidence exists for this peptide? Where is this product coming from? Are there any known or unknown risks? What happens if I experience side effects?
"That's why it's important to really go to a provider that's familiar with peptides, and not peptide shopping online," said Rohde. "You should go to a provider that's willing to tell you, 'this is where we get our peptides, this is how we dose our peptides, these are the processes we go through to make sure that they're safe for you.' If you're going somewhere and they're pressuring you into getting peptides or pressuring you to get multiple peptides all at once, that's not somewhere you want to get your peptides from."
Research, but make sure it is quality research.
"Do as much research as you can; talk to your medical provider but be careful, because there are a lot of clinics out there that are overcharging people for peptides," said McCormick.
McCormick says he has spent about $400 on peptides over six months.
Rohde says it costs patients about $300 for a five-to-six-week regimen with taking two weeks off.
As for Safdar, before these compounds hit the market, he wants to see more proof through human trials to know their safety and efficacy.
"I'm glad you're excited, but you need to wait a little longer to know that it's not going to cause worse problems than it fixes for you," said Safdar.
