I had a teen patient who was found to have purchased KLOW and IGF-1 LR3 online to bulk up, which led me down a path to learn more about these and write about them to warn parents and alert other physicians. I was disgusted how these companies can sell things online that are clearly not FDA approved and marked "not for human consumption." Our current FDA and public health are a risk to humans! It's frustrating as a physician to learn about these things well after they've gone mainstream. Thank you for helping to spread the word about the reality vs the hype!
I feel like inflammation is the new boogeyman. Everyone seems to think they have it, and all the voodoo potions are out there on social media to fix it. Isn't a blood test the only way to test for chronic inflammation?
Thank you so much for writing this. I had a patient come in the other day talking about this, and I had no idea what she was talking about! Thank you again. Extremely well written and very, very helpful. From an infectious disease physician in Colorado!
This is one of the most balanced takes on peptides I have read from a physician. The distinction between FDA approved peptides and the gray market is critical and rarely made this clearly. The sourcing and purity problem alone should give anyone pause before ordering research chemicals online. Appreciate you framing it as a risk tolerance conversation rather than a blanket dismissal.
This is a very well balanced post thank you. I would add two other things to what drives people to the gray market. One is insurance denial where there is physician approved recommendations for a peptide. When the medication is denied routinely and the cost of the FDA approved version is exorbitant, it leaves people with no other options. This has to be fixed. Secondarily the lack of sufficient paid sick leave in this country is insane. For example, I had a minor hand surgery last year and the surgery recovery and weekly physical therapy ate up all the sick leave I had accumulated in 10 years in my job. I’m not the only person this has happened to, and when someone has an injury that could require ongoing therapy and there is no way to do it then they are absolutely going to look for some alternative and a small shot every morning before work looks extremely appealing. As to Research though are we looking at only US based research? I’ve read articles about research on peptides in Russia going back decades.
Nice article ! You and I share clinical perspectives and writing style. Thanks for sharing about a topic I get asked about every day. I really love how you handle the curious patient. Am just venturing into Substack and welcome any guidance. Xoxo
I haven’t tried them yet but I am interested. I wish it was only that I need relief from pain from exercise and trying to remain very active. There is part of me that is wary and frustrated of big Pharma’s motives and the physicians on their payroll. They’ve promoted drugs that have harmed me. They’ve dismissed real concerns I’ve had about treating symptoms instead of causes. Possibly for their financial gain. They’ve limited access to pain relief aggressively even when I have no risk of addiction. While I’ve been in chronic pain for over fifteen years. So when peptides (which are difficult to patent and for them to exploit) are dismissed, and funding at the NIH plummets, and estradiol production is limited and now, even MHT is once again vilified, in the face of significant meaningful data on its health benefits- I thought, maybe.. BPC-157 may indeed be risky but think about this. They promote SSRIs that can cause SUICIDE. Just turn on the TV and watch the endless drug ads and a laundry list of side effects that are comical to hear. So if it helps in the short term I’m not certain that they’re any riskier than the options they push on people for THEIR FINANCIAL GAIN. Not to mention that there is a stranglehold on access to real options. I’m a grown adult- let me accept risk. You’ve crammed very harmful options down my throat for years to line your pocket. Let me live my life as optimally as possible despite you.
Thanks. I am not inclined toward magical thinking. But I surrounded by people who are and this helps me better understand them and what I might say should the topic come up.
Recently started an oral peptide called "SLU-PP-332" to hopefully help with muscle weight gain (63 year old lean female here, 15+ years post-menopause and denied HRT due to lack of "symptoms"). Would love any feedback here on safety? Prescribed by a facility that I've also started weekly estradiol/testosterone injections & oral progesterone from.
Re the peptide you are taking - this is exactly what I’m talking about in my piece. :) No evidence to show benefit. Risks not clear. Re menopausal HRT or “MHT”: the evidence is clear that the majority of women benefit from it when estrogen and progesterone are started in the first 10 yrs after menopause. However even if HRT is started after 10 yrs many women can benefit! You just need a good doctor to help you understand tradeoffs and risk/benefit for YOU and only you. Last thing: injectable forms of estrogen and testosterone are totally off the wall / not standard of care. So please be careful about who you are trusting w your precious health!
This is an excellent example of why people are less than confident in "FDA approved" treatment plans. As of today, HRT for perimenopausal and menopausal women is a good thing, 20 years ago it was not. Testosterone is being prescribed with the caveat that it's not approved for women but that it's probably beneficial. And still a debate of whether injectable or topical is the better route.
I agree that there are plenty of uninformed consumers. There are likely a similar proportion of apathetic providers who dismiss anything that isn't already in the algorithm.
The shift in menopause care (as example) did not just happen because there were five providers that were willing to talk about it online, rather the millions of women that talked to their friends about their own experiences, pointed to the validation provided by Dr Mary Haver Clare and others, and then facilitated their own treatment through remote providers like Alloy. We were willing to be our own guinea pigs (rat models). Most of us already had a relationship with a primary care physician who wasn't the least bit interested in exploring anything other than SSRI or diet and exercise.
Pediatrician here, so not qualified to treat adults for aging related issues, but able to look up research. I'm curious about your comment because I'm a few years behind you in my own menopausal journey, so looked things up and wanted to share what I found. SLU-PP-332 is an experimental research compound that has never been tested in humans and is not FDA-approved for any use. SLU-PP-332's safety profile, appropriate dosing, drug interactions, and long-term effects in humans are completely unknown. Evidence also does not support testosterone therapy for improving lean body mass or muscle strength in postmenopausal women. If estrogen is used for a medical indication, patches have fewer (but still substantial) risks than injections. The description of the facility prescribing these treatments raises red flags in my mind. You mentioned that you're 15 years post-menopause, which is outside the typical window for initiating hormone therapy. The risks of hormone therapy generally increase with age and time since menopause, particularly for cardiovascular events like stroke and heart attack, but also cancer. Talk to your physician again if you think an approved treatment would help you - they may not have fully explained the risks of why they don't think they're right for you, but at least those are known risks that can be monitored. Non-FDA monitored supplements have not been evaluated for safety or effectiveness, are not monitored for quality, and show significant variability in dosing, so you could get a lot more or less than what they say they're administering.
I had a teen patient who was found to have purchased KLOW and IGF-1 LR3 online to bulk up, which led me down a path to learn more about these and write about them to warn parents and alert other physicians. I was disgusted how these companies can sell things online that are clearly not FDA approved and marked "not for human consumption." Our current FDA and public health are a risk to humans! It's frustrating as a physician to learn about these things well after they've gone mainstream. Thank you for helping to spread the word about the reality vs the hype!
Totally. It’s terrifying.
I feel like inflammation is the new boogeyman. Everyone seems to think they have it, and all the voodoo potions are out there on social media to fix it. Isn't a blood test the only way to test for chronic inflammation?
inflammation is indeed the new boogeyman - a single blood test cannot capture the nuances of inflammation - if only it were that easy!
:)
Thank you so much for writing this. I had a patient come in the other day talking about this, and I had no idea what she was talking about! Thank you again. Extremely well written and very, very helpful. From an infectious disease physician in Colorado!
Go glad!!
This is one of the most balanced takes on peptides I have read from a physician. The distinction between FDA approved peptides and the gray market is critical and rarely made this clearly. The sourcing and purity problem alone should give anyone pause before ordering research chemicals online. Appreciate you framing it as a risk tolerance conversation rather than a blanket dismissal.
Thank you! 🙏
you…have….got….to….be….kidding…..me. this is insane
This is a very well balanced post thank you. I would add two other things to what drives people to the gray market. One is insurance denial where there is physician approved recommendations for a peptide. When the medication is denied routinely and the cost of the FDA approved version is exorbitant, it leaves people with no other options. This has to be fixed. Secondarily the lack of sufficient paid sick leave in this country is insane. For example, I had a minor hand surgery last year and the surgery recovery and weekly physical therapy ate up all the sick leave I had accumulated in 10 years in my job. I’m not the only person this has happened to, and when someone has an injury that could require ongoing therapy and there is no way to do it then they are absolutely going to look for some alternative and a small shot every morning before work looks extremely appealing. As to Research though are we looking at only US based research? I’ve read articles about research on peptides in Russia going back decades.
Thank you for this valuable information.
Nice article ! You and I share clinical perspectives and writing style. Thanks for sharing about a topic I get asked about every day. I really love how you handle the curious patient. Am just venturing into Substack and welcome any guidance. Xoxo
@mariasophoclesmd
It’s all this “wellness” stuff that’s pushed and marketed. And poorly regulated.
Yep
I haven’t tried them yet but I am interested. I wish it was only that I need relief from pain from exercise and trying to remain very active. There is part of me that is wary and frustrated of big Pharma’s motives and the physicians on their payroll. They’ve promoted drugs that have harmed me. They’ve dismissed real concerns I’ve had about treating symptoms instead of causes. Possibly for their financial gain. They’ve limited access to pain relief aggressively even when I have no risk of addiction. While I’ve been in chronic pain for over fifteen years. So when peptides (which are difficult to patent and for them to exploit) are dismissed, and funding at the NIH plummets, and estradiol production is limited and now, even MHT is once again vilified, in the face of significant meaningful data on its health benefits- I thought, maybe.. BPC-157 may indeed be risky but think about this. They promote SSRIs that can cause SUICIDE. Just turn on the TV and watch the endless drug ads and a laundry list of side effects that are comical to hear. So if it helps in the short term I’m not certain that they’re any riskier than the options they push on people for THEIR FINANCIAL GAIN. Not to mention that there is a stranglehold on access to real options. I’m a grown adult- let me accept risk. You’ve crammed very harmful options down my throat for years to line your pocket. Let me live my life as optimally as possible despite you.
Im just beginning my education on peptides.....I have had 2 back surgeries, a broken back and chronic pain. Is there one specific i should research?
Thanks. I am not inclined toward magical thinking. But I surrounded by people who are and this helps me better understand them and what I might say should the topic come up.
Thank you for doing this deep dive into a wild unregulated world...
Just a thought. The pep in peptides may have the analogue of a pep band in lieu of a full orchestra.
Recently started an oral peptide called "SLU-PP-332" to hopefully help with muscle weight gain (63 year old lean female here, 15+ years post-menopause and denied HRT due to lack of "symptoms"). Would love any feedback here on safety? Prescribed by a facility that I've also started weekly estradiol/testosterone injections & oral progesterone from.
Re the peptide you are taking - this is exactly what I’m talking about in my piece. :) No evidence to show benefit. Risks not clear. Re menopausal HRT or “MHT”: the evidence is clear that the majority of women benefit from it when estrogen and progesterone are started in the first 10 yrs after menopause. However even if HRT is started after 10 yrs many women can benefit! You just need a good doctor to help you understand tradeoffs and risk/benefit for YOU and only you. Last thing: injectable forms of estrogen and testosterone are totally off the wall / not standard of care. So please be careful about who you are trusting w your precious health!
This is an excellent example of why people are less than confident in "FDA approved" treatment plans. As of today, HRT for perimenopausal and menopausal women is a good thing, 20 years ago it was not. Testosterone is being prescribed with the caveat that it's not approved for women but that it's probably beneficial. And still a debate of whether injectable or topical is the better route.
I agree that there are plenty of uninformed consumers. There are likely a similar proportion of apathetic providers who dismiss anything that isn't already in the algorithm.
The shift in menopause care (as example) did not just happen because there were five providers that were willing to talk about it online, rather the millions of women that talked to their friends about their own experiences, pointed to the validation provided by Dr Mary Haver Clare and others, and then facilitated their own treatment through remote providers like Alloy. We were willing to be our own guinea pigs (rat models). Most of us already had a relationship with a primary care physician who wasn't the least bit interested in exploring anything other than SSRI or diet and exercise.
Pediatrician here, so not qualified to treat adults for aging related issues, but able to look up research. I'm curious about your comment because I'm a few years behind you in my own menopausal journey, so looked things up and wanted to share what I found. SLU-PP-332 is an experimental research compound that has never been tested in humans and is not FDA-approved for any use. SLU-PP-332's safety profile, appropriate dosing, drug interactions, and long-term effects in humans are completely unknown. Evidence also does not support testosterone therapy for improving lean body mass or muscle strength in postmenopausal women. If estrogen is used for a medical indication, patches have fewer (but still substantial) risks than injections. The description of the facility prescribing these treatments raises red flags in my mind. You mentioned that you're 15 years post-menopause, which is outside the typical window for initiating hormone therapy. The risks of hormone therapy generally increase with age and time since menopause, particularly for cardiovascular events like stroke and heart attack, but also cancer. Talk to your physician again if you think an approved treatment would help you - they may not have fully explained the risks of why they don't think they're right for you, but at least those are known risks that can be monitored. Non-FDA monitored supplements have not been evaluated for safety or effectiveness, are not monitored for quality, and show significant variability in dosing, so you could get a lot more or less than what they say they're administering.