What to know about peptide therapy - Yahoo

Dr. Jesse Mills regularly sees men who want to improve something about their body.

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Mills, the director of the Men’s Clinic at UCLA Health, usually offers advice like diet, exercise — maybe physical therapy to help recover from an injury.

In recent months, however, some patients have come to him with a solution already in mind: peptide therapy.

“Week by week more people are asking about peptides,” Mills said.

Peptide therapy has become a mainstay online and in fitness communities. Popular figures including Andrew Huberman and Joe Rogan have discussed them on podcasts. On Reddit, one group focused on peptides has 100,000 subscribers, where users are flocking to them looking to tone their physique, recover faster from injuries, sleep better and even improve skin tone. In February, the telehealth giant Hims & Hers announced it had acquired a peptide facility in California to help “deliver personalized medications.”

“Everybody’s looking for that edge and everybody’s looking to build the perfect Hollywood body,” Mills said. “I think the thought is that they look at it [peptide therapy] as a more natural way of doing either growth hormone replacement or testosterone replacement.”

However, while there are some small studies suggesting certain peptides may have benefits, there’s no strong evidence that peptide therapy provides any meaningful difference in performance and recovery, experts said.

“You have to do your research to know what actually has undergone human trials and what has undergone podcast trials,” Mills said.

What are peptides?

Peptides are short chains of amino acids, the building blocks of proteins. Long peptide chains will fold onto themselves and link with other peptide chains, forming proteins.

A huge range of molecules found in the body are peptides, including insulin, oxytocin and endorphins. Many other synthetic peptides — made in a lab — are approved as drugs, including semaglutide (the active ingredient in Ozempic) and linaclotide (the active ingredient in Linzess, a drug for irritable bowel syndrome).

But a number of peptides — not approved by the Food and Drug Administration and entirely unregulated — have grown in popularity, pitched as solutions to shorten recovery time from injuries, enhance athletic performance and improve libido.

“The ones that are getting attention in the gym are what we call ‘secretagogues,’” Mills said, which are popular because of the belief they can aid in muscle growth and repair.

This includes a synthetic peptide called sermorelin. Sermorelin is meant to act on the pituitary gland in the brain, telling it to release human growth hormone, which, in turn, leads to higher levels of insulin-like growth factor-1, a molecule that’s believed to help stimulate muscle growth and repair.

Dr. Larry Lipshultz, chief of the division of male reproductive medicine and surgery at the Baylor College of Medicine in Houston, said that his patients who take sermorelin primarily take it because they want to lose body fat and have a more defined physique.

“People who take it claim they feel better, they sleep better, they wake up more refreshed,” Lipshultz said. “But a lot of the problem with your peptides is there’s very little scientific evaluation of what they do and of their side effects.”

Another peptide popular in the fitness community is body protection compound-157, or BPC-157, Mills said. In lab studies, it’s been shown to promote wound and tissue healing, leading some to call it the “wolverine peptide.”

It’s thought to work by promoting activity of fibroblasts, said Dr. Travis Dekker, an orthopedic surgeon at the United States Air Force Academy in Monument, Colorado. These are cells that can help to restore connective tissue such as tendons and ligaments after an injury. It’s also believed to help with synthesizing proteins, which could help with recovery, he said.

He added that BPC-157 is the peptide he gets the most questions about from patients.

“Athletes ask me, ‘Hey, I injured my rotator cuff. Can I get this online and then therapeutically injected into my rotator cuff?’” Dekker said.

The demand — and lack of strong evidence supporting the peptide’s use — led him to write a letter to the editor in the Journal of Arthroscopic and Related Surgery calling for more research into these compounds.

BPC-157 and sermorelin are both banned by the World Anti-Doping Agency, and, as of , BPC-157 was listed as a prohibited substance by the NCAA.

Do they work and are they safe?

“If you have a drug that is manufactured by a big-brand pharmaceutical company, they won’t even bring it to the public until the due diligence is done with efficacy and side effects,” Lipschultz said. Peptides, he added, “just come out from these peptide laboratories with little or no studies.”

Most of the studies on popular peptides have largely been conducted in animals and there isn’t much data in humans.

However, a handful of human studies suggest that some peptides might be worth exploring further in larger, more rigorous studies.

A small study of 16 patients found that an injection of BPC-157 directly into the knee may help alleviate knee pain. Another small study, with just 12 participants, found that the compound helped reduce symptoms in women with interstitial cystitis, a painful bladder condition, after traditional treatment stopped working. No adverse events were reported in either study, but the small number of participants makes it difficult to draw broader conclusions.

Another peptide, kisspeptin, has shown promise in improving libido in both men and women in two small randomized trials in the United Kingdom. The peptide is naturally occurring in the body, but synthetic versions also exist.

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Lipschultz said that if he has patients who are trying to lose weight or having trouble sleeping, he will sometimes prescribe peptides through a compounding pharmacy, but only in addition to regular FDA-approved treatments.

“I don’t treat people just with peptides,” he said.

The lack of rigorous human studies also means that data about side effects is missing as well as proper dosing regimens, Dekker said.

“We don’t know the duration or concentration of the drug that needs to be delivered,” he said. “We don’t know the timing during the day or the timing of when it is administered in the setting of an injury.”

As a result, patients often try a variety of doses at various intervals with unclear benefits.

“I think that there’s still a lot more to be learned when it comes to these peptides and figuring out exactly what they’re doing,” Dekker said.

Peptides have emerged as versatile and powerful tools in the development of modern therapeutics, with a variety of unique advantages that result from their high levels of specificity and their ability to mimic complex biological processes. Because of peptides’ utility in treating cancer, bacterial and viral infections, metabolic disorders, and more Full Reference:Rossino, G; Marchese, E; Galli, G; Verde, F; Finizio, M; Serra, M; Linciano, P; Collina, SPeptides as Therapeutic Agents: Challenges and Opportunities in the Green Transition EraOctober https://pmc.ncbi.nlm.nih.gov/articles/PMC/Date Accessed: 20/02/25DOI: 10./molecules , peptide chemistry has become an important area of innovation in the pharmaceutical industry.

In this FAQ, we’ll answer commonly asked questions about peptide synthesis, including the advantages of synthetic methods, compliance standards, and the importance of a specialised partner, whether you’re navigating early-stage peptide research or pursuing commercial-scale peptide manufacturing.

Peptide production has grown significantly in the pharmaceutical industry, with more than 200 peptide therapeutics in clinical development and 600 in the preclinical stage today Full Reference:Rossino, G; Marchese, E; Galli, G; Verde, F; Finizio, M; Serra, M; Linciano, P; Collina, SPeptides as Therapeutic Agents: Challenges and Opportunities in the Green Transition EraOctober https://pmc.ncbi.nlm.nih.gov/articles/PMC/Date Accessed: 20/03/25DOI: 10./molecules . A variety of factors have contributed to this growth.

One significant reason for peptides’ growth is their ability to target specific receptors in order to increase therapeutic efficacy while mitigating side effects. For this reason, peptides play an important role in personalised medicine, which has an anticipated CAGR of 11.2% by Full Reference:Bora, DPersonalized Medicine Market SizeJanuary https://straitsresearch.com/report/personalized-medicine-market#:~:text=The%20global%20personalized%20medicine%20market,the%20forecast%20period%%E2%80%.Date Accessed: 20/03/25 . The ability to vary chain lengths and sequences also makes it possible to harness peptides for a wide variety of targets. Because of their versatility, peptides can be utilised in the treatment of cancer, viral infections, and other challenging and highly nuanced indications.

Another benefit of peptides is their predictability. Because peptides are naturally occurring and essential in a variety of natural biological processes, they generally have more predictable behaviour compared to small molecules. Full Reference:Rossino, G; Marchese, E; Galli, G; Verde, F; Finizio, M; Serra, M; Linciano, P; Collina, SPeptides as Therapeutic Agents: Challenges and Opportunities in the Green Transition EraOctober https://pmc.ncbi.nlm.nih.gov/articles/PMC/Date Accessed: 20/03/25DOI: 10./molecules

Proteins and peptides are both made up of amino acids and follow the same basic structure. However, peptide chains are composed of fewer amino acids than proteins, which leads to differences in synthetic routes.

Peptides, which consist of between two and 50 amino acids, are often developed using solid-phase peptide synthesis (SPPS), where amino acids are added to a peptide chain that is bonded to a solid resin. This can be carried out in a lab setting to produce custom peptides. At Sterling, we offer capabilities to support peptide chain lengths up to 40 amino acids.

Because of their size and complexity, protein synthesis is far more complex, as proteins involve 50+ amino acids. Biologically, proteins are synthesised in living cells, involving the transcription of DNA into mRNA. In a lab setting, this generally occurs via cell-free protein synthesis (CFPS) or in vivo synthesis with recombinant DNA technology, but smaller protein chains can also be synthesised using SPPS.

In solid-phase peptide synthesis, peptides are assembled stepwise by building an amino acid sequence on a solid support. This technique was invented by Bruce Merrifield Full Reference:Kent, S. Bruce MerrifieldBruce Merrifield (–)https://www.nature.com/articles/a#citeasDate Accessed: 20/03/25DOI: 10./a , who was awarded the Nobel Prize in Chemistry for his discovery.

Today, solid-phase is the gold-standard method for peptide synthesis for several reasons, including:

• Efficiency: Adding amino acids sequentially simplifies and streamlines the process.
• Precision: The approach used in SPPS ensures that peptide sequences are highly accurate.
• Scalability: SPPS is applicable to small-scale research and larger-scale manufacturing.

Liquid-phase peptide synthesis is an alternative approach where a peptide chain is built in a liquid solution. While this approach can help to minimise the use of excess materials Full Reference:Sharma, A; Kumar, A; G. de la Torre, B; Albericio, FLiquid-Phase Peptide Synthesis (LPPS): A Third Wave for the Preparation of PeptidesJuly https://pubs.acs.org/doi/10./acs.chemrev.2cDate Accessed: 20/03/25 , it is generally better suited to shorter peptide chains. As a result, it is important to choose a synthetic method based on the length of a peptide chain, intended target, and other key factors.

Custom peptide synthesis allows for the creation of precise amino acid sequences to target specific biological pathways. Peptides can be manufactured to mimic or block natural biological processes in order to produce a desired therapeutic effect, such as inhibiting tumour growth or regulating metabolic deficiencies.

Furthermore, while naturally occurring peptides may quickly degrade in the body, custom synthesis enables scientists to improve stability and bioavailability. Synthesised peptides can also be leveraged to identify new targets and screen therapeutic candidates.

Purification is essential in peptide synthesis to remove unwanted byproducts or unreacted reagents. High-performance liquid chromatography (HPLC) is among the most commonly used methods because of its precision, widespread applicability, and effectiveness.

Sterling’s North Carolina, US facility offers standard HPLC equipment to evaluate conditions for peptide purification, while our Cork, Ireland facility houses one of the largest HPLC columns in the world, with a 1.6m diameter, to purify peptides on a large scale.

In addition to HPLC, ion-exchange chromatography, size-exclusion chromatography, and solid-phase extraction may also be used in peptide purification.

At Sterling, we have more than 25 years of expertise in peptide synthesis, manufacturing, and purification. Our Cork, Ireland and North Carolina, US facilities can support peptide projects from the preclinical stage through to commercial-scale manufacturing.

The North Carolina facility supports peptide development with comprehensive analytical services including product characterisation, stability and impurity studies, and more.

The range of specialised peptide equipment at our Cork facility includes two peptide synthesisers up to 170L capacity, a variety of agitated filter dryers, three ion exchange columns, eight lyophilisers up to L capacity, and more, enabling us to support a range of peptide manufacturing project requirements.

In addition, our Cork facility offers a low bioburden manufacturing environment, comprehensive solvent recovery capabilities, and support for cold chain transport.

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