I have been a board-certified urologist specializing in men’s health for the past two decades. The focus of our practice is men’s health, andrology and human performance in that order of priority. Our primary concern is patient care and longevity. If that requires hormonal therapies like testosterone, we are all for it. We also strive to help men perform at their best: mentally, physically and sexually. If medical interventions are warranted to improve performance, we discuss the risks and benefits in grueling detail. 

On an almost daily basis, I am inundated by patients with questions regarding “peptides”. The “peptide craze” as I like to call it, has exploded over the past few years. Largely, this phenomenon has been fueled by social media health influencers with no legitimate medical training and profiteers capitalizing on the hopes and dreams of society. It is largely hype-based, not evidence-based. Most recently, I saw a patient taking a “stack” of peptides recommended by an “expert physician” with over a million followers on YouTube. That expert was a chiropractor. 

Peptides are nothing new. Many drugs are peptides including insulin, GLP-1 agonists, Lupron and human growth hormone to name a few. But these drugs have been well studied in humans and they are FDA approved for specific medical indications. They are synthesized meticulously using exacting scientific methodology.

For the purposes of this article, when I use the term “peptides” I’m referring to the drugs being propagated online by health influencers and medical quacks that have little to no human data to support their use. They are often sold directly to patients without a prescription by telling would-be users that they are for “research” or “lab use” only. Dosing and peptide “stacks” are guided by self proclaimed peptide experts who are quite literally, morons. 

BPC-157 is perhaps the poster child peptide when it comes to lack of human data and scam artistry. BPC-157 (Body Protection Compound-157) is a synthetic pentadecapeptide derived from human gastric juice that has shown promising tissue-healing effects in preclinical ANIMAL studies, but it is not FDA-approved and lacks sufficient human clinical evidence to support its use.

Proposed mechanisms of action include enhancement of growth hormone receptor expression, upregulation of pathways involved in cell growth and angiogenesis (including VEGF), reduction of inflammatory cytokines, and modulation of the nitric oxide system. Interestingly, most of the existing data on BPC-157 (animal studies mind you) comes from a single group of researchers in Croatia. To put it lightly, this Croatian lab is not a hotbed of Nobel prize winning scientists which is why most of their “published” results do not appear in peer reviewed journals. 

Regardless, as I am writing this article, there is only ONE human trial in the scientific literature on BPC-157 and it involved intra-articular injection of the drug into 12 patients.That’s not a typo. Twelve patients. Despite this complete and total paucity of quality human data, BPC-157 is being used widely by my patients. And it’s being used systemically. That is absolute stupidity, plain and simple.

The complete lack of human safety and efficacy data is why the FDA has warned compounding pharmacies to NOT produce BPC-157. Pharmacies who disregard that warning and physicians who prescribe BPC-157 risk serious legal repercussions. A popular online source of BPC-157 was just shut down by regulators. 

Most of the BPC-157 being sold to my patients comes from the online grey market. The majority is produced in China. The US based companies claiming that they produce a high quality product stateside are using Chinese sourced materials. They are typically labeled “research only” or “for lab use only” in order to get around the need for a physician’s prescription. I can assure you that these companies are not employing billion dollar pharmaceutical labs equipped with the latest drug synthesizing technology. These products are down right dangerous. Don’t believe the hype and website claims from their “experts” that their peptides are “third party tested” or “endotoxin-free”. High quality drug synthesis doesn’t work that way.

Most reputable compounding pharmacies won’t produce BPC-157 due to regulatory oversight and the risk of legal repercussions. But the potential financial gain doesn’t prevent all of them from producing BPC-157. When big money is at stake, there will be plenty of “longevity” and “anti-aging” physicians willing to prescribe it as well. Legit compounding pharmacies do not manufacture and real physicians do not prescribe a drug that has been studied in twelve human beings. 

The argument I hear from patients who have used BPC-157 is that it works. Perhaps it’s a placebo effect. Maybe it does work. Perhaps it's the next wonder drug and Big Pharma won’t develop it because they want to keep us all sick (another common statement made by users). Anecdotal evidence is simply not enough, so sorry. If it does actually work to promote wound healing or angiogenesis, perhaps it also promotes cardiovascular disease and cancer. That is an absolute scientific possibility that has not been explored in humans. 

Long story short, I’m not against the use of all peptides. But there has to be at the very least, reasonable human safety data. There certainly are some peptides that have shown modest benefits in human studies. For example, some of the growth hormone secretagogues would fall into this category. We know they have benefits in terms of improving body composition. We also know they have potentially severe side effects. Furthermore, most of the human data we have suggests that increasing growth hormone likely shortens lifespan. If a patient still wants to use it, then perhaps it's reasonable in the eyes of some medical practitioners. 

BPC-157 is NOT the same. If you value your health to any degree, you should NOT take drugs that are devoid of legit human data. You should not trust a physician willing to prescribe a drug that has only shown promise in rats. Chinese grey market research compounds being sold by health influencers are dangerous. But, if you want to believe the body builder lecturing us on gym bro science and the Croatian rat scientists, it’s your body.