Chances are, if you work in healthcare or spend any time on social media, you’ve heard various athletes, “wellness influencers,” and even some medical professionals lauding the benefits of peptides. The explosion of post-pandemic longevity and wellness initiatives has pushed peptides into the healthcare zeitgeist, but what does “peptide” actually mean, and what do we need to know to counsel our patients?
What are peptides?
A peptide is simply a short chain of amino acids, but peptide-based medications can mean a variety of things and are by no means new to medicine. Insulin, semaglutide, EPO, and oxytocin are all peptides commonly used in medicine for decades. In the last decade, peptide drug development has exploded, with 33 non-insulin peptide drugs approved by the FDA since the year 2000.
This growth has been driven by both advances in development technology and a surge of public interest, driven in no small part by the explosion of the wellness and self-optimization movement that has emerged in the post-COVID-19 pandemic world. The blockbuster success of GLP-1 medications like semaglutide (Ozempic, Wegovy) and tirzepatide for type 2 diabetes and obesity has only sharpened public curiosity about what peptides can do.
Medical breakthrough or modern snake oil?
While many FDA-approved peptide therapeutics are on the market and backed by a wealth of clinical trials, they are not the ones your patients are likely asking about. The emerging peptide craze centers primarily around non-FDA-approved substances with limited data and few clinical trials to back up their benefit claims.
One such peptide is BPC-157, which has gained immense popularity through social media and podcasts, heralded as a miracle injection for injury recovery. It is not FDA-approved for any clinical use and is on the USADA list of banned substances. Very little clinical research exists to substantiate the many anecdotal claims made by those who swear by it. Only time will tell whether BPC-157 gets proper clinical trials to evaluate its efficacy, but for now, patients should use extreme caution if considering it, primarily because of unregulated formulation and production standards for an injectable medication.
Another peptide gaining serious popularity and headlines is TB-500, a synthetic derivative of thymosin beta-4, a naturally occurring peptide involved in cell migration and tissue repair. While thymosin beta-4 has undergone some human studies, TB-500 is a different molecule and has little evidence supporting its claims. These two peptides are often marketed together as the “Wolverine Stack,” a marketing ploy that compares the peptides' effects to the Marvel character “Wolverine,” known for his superhuman regenerative ability. It should be noted that both of these substances are also currently banned by organizations such as USADA.
Marketed as a “growth hormone” peptide stack, CJC-1295 and ipamorelin are often marketed together with claims of increased muscle mass, fat loss, and anti-aging effects. While some small randomized studies provide good evidence that CJC-1295 and ipamorelin can raise growth hormone levels, little to no evidence shows they improve outcomes such as muscle gain and fat loss. In addition, the FDA has noted that there may be significant adverse effects associated with its use, such as increased heart rate and systemic vasodilatory reactions. The FDA has also stated general concerns about potential impurities in unregulated compounded products.
Navigating the gray
The truth is, we don’t know enough about these substances to make true evidence-based recommendations about their safety and efficacy, because the evidence doesn’t exist at the level needed to draw meaningful conclusions.
Further clouding the picture is the fact that many of the patients looking into these substances are also people who are living generally healthy lifestyles. That makes it difficult to pin down how much of the perceived benefit comes from the peptides versus the placebo effect in a patient who is already living a healthy life at baseline.
We have been down this road before. I remember a few years ago when high-dose vitamin C infusions were going to be the magic medication to help resuscitate patients with sepsis. People got overly hyped about early data, but the follow-up studies just didn’t hold up.
Now I don’t think we should be totally dismissive of patients with a genuine interest in peptides, but we should be realistic in our message: We don’t know what we don’t know. They might be helpful, they might be harmful, or they might do nothing. But patients should be cautious about shelling out hundreds of dollars per month for subscription services that offer questionable peptide injections sold in a legal gray area and produced in unregulated facilities with no health and safety standards to hold themselves to.
I try to write these blog posts about topics that align with our collective experiences as clinicians and the common issues we all face, regardless of clinical location. I welcome your feedback, stories, and suggestions. Shoot me an email at NP@hippoeducation.com; I would love to hear from you!
Check out this clip from a September 2026 episode of Primary Care RAP for a preview of a great discussion between Dr. Michael Baca-Atlas and Dr. Michaela Bowers about BPC-157.
