#403 ‒ Peptides: separating scientific promise from marketing hype

“And most that end up showing clinical benefit do have that. With BPC-157, we do not have a clear mechanism as well. Okay, so what's the second question? Is there evidence of meaningful benefit in humans?”

“Now, of course, that doesn't prove that BPC 157 causes cancer, and I'm not saying that. But if proponents claim that it meaningfully stimulates healing through those pathways, they should also take seriously the possibility of stimulating biology you may not want overstimulated.”

“Fifth, is there a better characterized way to get the same result? Well, for BPC-157, you do not need a perfect named alternative to reject it. You're being asked to take an uncharacterized molecule on faith. For tendon injuries, ligament injuries, pain, inflammation, gut symptoms, or recovery, there are better characterized ways to evaluate and manage the specific underlying problem.”

“Many peptides come with a powerful story around them. That's true for something like Retatrutide, and it's also true for something like BPC-157. The difference is that for some peptides, controlled human trials help separate the effect of the molecule from the expectation surrounding it.”

“For others, like BPC-157, the story is powerful and the human outcome data are thin. Even when a peptide is biologically active, the perceived benefit can still be shaped by expectation, behavioral change, and the ritual of treatment, along with the broader story attached to it.”

“into the weeds of the history of this peptide and all those other things. But suffice it to say, CJC 1295 can raise growth hormone and IGF-1. But one of the biggest mistakes people make is assuming that's because a molecule changes biology and therefore it's going to improve health.”

“That distinction matters a lot for CJC1295 because its appeal rests on stimulating the growth hormone pathway. And we already have a much more direct way to interrogate that pathway, giving growth hormone itself.”

“For CJC 1295, I think that case has yet to be made. And, Peter, I think, given what we talked about, one of the common follow-up questions, and we see it a lot, is going to be: you know, the amount of people who will write or ask us who insist they've been on one of these peptides and it's worked, or they have friends who have tried it and it's worked for them.”

“BPC 157, CJC 1295, or some other peptide stack is just one part of a sea of variables, and yet it always seems to be the thing that gets the credit.”

“These molecules came from inside the industry very often. CJC 1295 is actually named after the pharma company that abandoned it, ConjiChem. The gray market isn't an alternative to pharma. It's the salvage yard for the drugs pharma tested and walked away from.”

“So, for example, how do you think about gray market GLP1 agonists? I think one of the biggest misconceptions people have about these so-called research-only or gray market peptides is that they assume the molecule is the drug.”

“We've already seen exactly this dynamic play out. A whole field of companies is racing to develop drugs built on synthetic variations of the same GLP-1 peptide biology, a drug based on a peptide found in nature.”

“Peptides are a legitimate and powerful class of drugs. As I gave examples of before, insulin and GLP-1s are the obvious examples of what is possible when you understand the biology, dosing, manufacturing, benefits, and risks.”

“That distinction matters a lot for CJC1295 because its appeal rests on stimulating the growth hormone pathway. And we already have a much more direct way to interrogate that pathway, giving growth hormone itself.”

“But in growth hormone-replete adults, i.e., virtually everybody listening to this podcast, including me, the results have been surprisingly underwhelming.”

“We already know what happens when we push this pathway more directly. If directly administering growth hormone has largely failed to produce meaningful functional benefits in growth hormone-replete adults, the burden of proof is high for claiming that an indirect growth hormone-releasing hormone will produce dramatically different results.”

“With many non-approved peptides, they are virtually all unanswered. An important point: FDA approval does not automatically mean the drug is safed.”

“And that's why I would just have a hard time recommending non-approved peptides. Not because FDA approval is infallible and final, but because bypassing that system usually means giving up the information and oversight that you would need to make a defensible risk-benefit decision for yourself.”

“Many peptides come with a powerful story around them. That's true for something like Retatrutide, and it's also true for something like BPC-157. The difference is that for some peptides, controlled human trials help separate the effect of the molecule from the expectation surrounding it.”

“This is, I would say, a not obvious point. Take Retatrutideas an example. Retatrutide is not just the amino acid sequence.”

“dosing, manufacturing, benefits, and risks. The pipeline also supports this. Roughly 100 peptide drugs are already approved, and about 150 more are in clinical trials, and 600 to 700 more are in preclinical development.”

“The cleanest illustration of this is CJC 1295 versus Tesamorelin. Same underlying biology developed around the same time. CJC 1295 reached phase two but was abandoned. Tesamorelin advanced to phase three and received full FDA approval.”

“And there is no denying this photo, there was an enormous improvement. And I said, this looks amazing, there's no denying it. What else was he doing? He said, well, he also started exercising and he was taking Tirzepatide. And he changed his diet of course because of the Tirzepatide. And I think he was taking testosterone.”

“In fact, something a lot of people don't realize is that many of these wellness peptides are drugs that started in the pharmaceutical pipeline but stopped being pursued for one reason or another.”