Unregulated Peptides

Say what you will about death during the regular season; I’m still not betting against mortality in the playoffs.

Let’s talk about unregulated peptides.

Two points for context:

First, I have no moral reservations about unregulated medication use. I’m an addiction specialist. Some of my patients have injected terrifying things into their bodies. My starting point is non-judgmental understanding. The same approach applies to peptides.

Second, peptides are not a new or magical class of medications. The first peptide drug was insulin, and it’s been used clinically for over 100 years. Moreover, drugs that mimic peptides have been used by humans for thousands of years. The biotechnology driving new peptide development is a wonderful achievement. But our understanding of pharmacology has not changed.

Here’s how I think about peptides (and every other medication) as a physician:

In medicine, we understand that there are no risk-free treatments. Medical decisions are a chance to exchange one form of risk for another. Sometimes, these decisions are easy. For example, untreated type 1 diabetes is fatal. The risks of insulin are small in comparison.

Many other decisions are not so simple. When should prostate cancer screening and treatment occur? Which types of back pain are best managed with surgery? These are hard questions with a mountain of nuance. We work with the data we have to make individualized, shared decisions with patients.

Regulated peptides have been thoroughly tested in humans. They have known risks and benefits. We continue to research them, and so we’ll continue to know more about their advantages and disadvantages.

In contrast, no one can accurately quantify the pros and cons of unregulated peptides. Almost every other drug candidate we’ve invented is ineffective or harmful in humans. (That’s why we require extensive clinical testing before marketing drugs.) There’s no reason to believe that peptides are different. Clinical research in humans is the foundation of good medicine. Animal studies and advertising claims are not good enough.

But the risks don’t stop there. You cannot readily verify that an unregulated medication is the molecule you think it is. You have no assurance that it was created using Good Manufacturing Practices. Contaminants in an oral medication are cause for concern. Injected contaminants carry even greater risk.

If the potential rewards were higher, I might be more open to unregulated peptide use. Reversal of aging might be the only claim I’ve seen that qualifies as truly high reward. But I’m skeptical. Say what you will about death during the regular season; I’m still not betting against mortality in the playoffs. A crack squad of molecules is trying to succeed when no other combination of medication, supplement, diet, or exercise has ever forced a game 5. We might beat death one day, but I suspect it’ll be a coalition of scientists (and not the peptide sellers) who pull it off.

Unfortunately, the advertised benefits of unregulated peptides are rarely worth the risk. There is almost always a safer, more effective way to reach the promised goal. When there isn’t, what proof do you have that the outcome you’re being sold is real?

But hey, you do you. I’ll wait for rock-solid data and rigorous quality control before adding these medications to my toolkit.