ONE THING TO know about the six popular peptides that have been in the news lately: While the FDA advisory committee recommended broadening access to them, that doesn’t mean they’re FDA approved. It doesn’t even mean they’re safe.
But we know that a lot of people are taking them, anyway.
Ideally, your doctor would know something about these peptides (even though there has been barely any human research) and could get you a prescription for them from a quality compounding pharmacy and would monitor you before, during, and after taking them.
That’s not the way most of this has been going. There is no single test to see if your peptide is working. The same goes for whether it’s doing any harm to your body.
With the ever-growing peptide-curious population, we asked experts what people can do to at least be safer about it. The general consensus was to keep tabs on how peptides are affecting your body roughly every 6 to 12 months.
Here’s what docs say you need to know about your health before you inject buzzy peptides into your body and what you should keep an eye on while you’re taking them.
What to Monitor While Taking a Peptide
WORK WITH A doctor to get a baseline read on how your metabolism and organs are functioning. That’s going to be essential because some of the popular peptides that are currently not on the approved compounding list carry endocrine-metabolic risks, says emergency room physician and MH advisor Robert Glatter, MD. “The products themselves are unregulated ‘research compounds’ of uncertain purity, dose, and composition,” he adds.
It can be difficult to know what kind of expert to consult with to take peptides safely. Though there is no board certification for peptide therapy, there are certification programs that help clinicians learn when and how peptides should be used, says Jonathann Kuo, MD, founder and CEO of Extension Health in New York City. “There are credentials in this space now: longevity medicine certification through the Longevity Docs network and peptide certification through the SSRP [Seeds Scientific Research and Performance Institute], among others,” Dr. Kuo says. “They tell you that someone pursued formal training rather than assembling a practice from forums and conference hallways.”
Before you even take a dose, Dr. Glatter says to make sure you get a read on all these things:
Insulin levels
Certain peptides affect your insulin levels, so get your fasting glucose and your A1C level checked. It’s especially important to get tested before you begin, in the first six to eight weeks, then every six to eight months. “Insulin resistance is the most reproducible adverse effect,” Dr. Glatter says.
Examples of peptides that can affect insulin levels are CJC-1295, ipamorelin, and GHRP-2. Growth hormone peptides are used for muscle development and faster recovery.
Cortisol levels
The peptides GHRP-2/6 and MK-677, which people take to try to increase muscle mass, can increase your cortisol levels. There’s no hard-and-fast rule about how often to check cortisol levels, but your doctor should definitely check your early morning cortisol at baseline and periodically. Cortisol tests are especially important if you experience symptoms related to adrenal insufficiency.
Complete blood count (CBC) with differential
This is an organ-health baseline. It also allows your doctor to screen for infection, anemia, or a hematologic abnormality that could be worsened by peptides.
Comprehensive metabolic panel (CMP)
This is the single most important panel you should get, Dr. Glatter says. It gives your doctor information about your liver enzymes, renal function, and glucose, among other important data. For example, people taking BPC-157 and TB-500 should regularly get a metabolic panel along with checking for kidney and liver function.
Lipid panel
Some peptides could contribute to plaque buildup in your arteries; a lipid panel tells your doctor what your baseline lipid profile is so they can monitor you for worrisome changes.
hs-CRP
This is a marker of systemic inflammation and cardiovascular risk, and it’s good to monitor this.
TSH + free T4
This blood test tells your doctor how well your thyroid works. This is especially important with growth hormone peptides, which can lower free T4 (a thyroid hormone) and unmask central hypothyroidism.
Total/free testosterone, estradiol, prolactin
Some peptides stimulate the release of a hormone called prolactin, so it’s important to have a baseline so your doctor can watch for elevations. Testosterone can fall due to certain peptides, and estradiol can increase when T changes, so get both of those levels monitored.
IGF-1
IGF-1 is a hormone that manages the effects of growth hormone. Those include regulating cell growth and tissue repair. Dr. Glatter notes that IGF-1 concentrations can change dramatically as you get older, so a single value is virtually meaningless unless you have references of how it’s changed over time. Make sure the results are reported with an age- and sex-specific Z score, meaning they’re compared to other people like you. Don’t just settle for IGF-1 scores that are reported to be “within range.”
Blood pressure
Some peptides cause fluid retention and metabolic changes. By having a baseline blood pressure reading, a doctor can better detect pre-existing hypertension and any drug-induced rises. People taking peptides for sunless tanning should prioritize blood pressure screenings since melanocortin agonists can induce systemic effects.
Weight and body composition
If you’re taking peptides in an effort to help lose weight or lower your BMI, you’ll want a baseline. Your doctor may also use this time to ask you questions on joint pain, a side effect of several peptides, including ones affecting growth hormones. Your doctor should be checking for symptoms of joint pain, edema, and carpal tunnel at each visit. If muscle pain develops, your doctor may also order a blood test to measure creatine phosphokinase.
Up-to-date cancer screenings
Certain peptides, such as BPC-157, promote cell growth, which has led some experts to voice concerns about a potential increased risk for cancer.
Dr. Glatter says you should have up-to-date, age- and risk-appropriate screenings for colorectal cancer, prostate cancer, skin cancer, and lung cancer before starting peptides.
One of the biggest controversies in using the peptide melanotan is that it may raise the risk of skin cancer. Full-skin exams and baseline mole mapping are essential while taking this peptide. This should be done at baseline and every year while taking these peptides.
Ultimately, it is important to have an honest conversation with your doctor about peptides, especially if you’re getting it from not-so-legal channels. The more information they have, the more you can work together to keep track of your health and look out for severe side effects. If the goal of taking these is for you to be healthier than you were before, take the time to make sure that’s what’s really happening.
Maggie is a freelance writer and editor based in New York who covers health and wellness. Her work has appeared in Everyday Health, Outside, Well+Good, BBC, Verywell Health, SELF, Health, Vice, CNN, Observer, and elsewhere. She was a fellow of the Association of Health Care Journalists’ 2020 class on Women’s Health Journalism and 2021 class on Cancer Reporting.
Marty Munson, currently the health director of Men’s Health, has been a health editor at properties including Marie Claire, Prevention, Shape and RealAge. She’s also certified as a swim and triathlon coach.
Jocelyn Solis-Moreira, MS is the associate health & fitness for Men’s Health and has previously written for CNN, Scientific American, Popular Science, and National Geographic before joining the brand. When she’s not working, she’s doing circus arts or working towards the perfect pull-up.
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