In late July, an advisory panel at the U.S. Food and Drug Administration (FDA) recommended loosening restrictions on access to four prescriptions for peptides. This recommendation came after a rapid increase in demand for peptides, which have been touted by online influencers and people in the health and wellness industry. Health experts, including some at the FDA, caution against this recommendation, because these products have not been studied for human use and there’s no known safe formulation. So what are peptides, what do they do, and why are they all the rage?
What are peptides?
Peptides are short strings of amino acids. Our bodies naturally create some peptides, which are used to create proteins, which are then used by the body to generate or regulate hormones, grow or repair tissue, reduce inflammation, digest food, or boost our immune systems. Peptides can also be created synthetically in laboratories or in compounding pharmacies, and more than 80 peptides have been approved by the FDA. Some peptides you may have heard of include insulin, endorphins, collagen, or ghrelin.
Types of peptides available to consumers
Peptides can be sold in skincare products, food supplements, or injectable devices.
Peptides in skincare products
Two specific proteins—which are made in part by peptides—that often come up in discussions around skin care are elastin and collagen. Our bodies naturally produce both of these proteins, but the idea is that adding them to products designed for our skin can help boost our natural peptide production and reduce the appearance of wrinkles and fine lines, discoloration, or dryness.
"I think of peptides as messengers,” says Dr. Tiffany Libby, MD, MPH, of Brown Health Medical Group Dermatology. “Certain peptides can signal skin cells to support processes involved in collagen production, repair and maintaining the skin barrier. There is promising evidence that some well-formulated topical peptides may modestly improve fine lines, texture and hydration over time, but ‘peptide’ is a broad category and not every peptide-containing product has the same evidence behind it. They’re best thought of as a supportive skincare ingredient rather than a replacement for proven interventions like daily sunscreen or retinoids.”
Dr. Libby continues. “One misconception is that applying collagen or peptides to the skin simply replaces the collagen we lose with age but it doesn’t work quite that way. Collagen is a large protein that does not readily penetrate the dermis; instead, certain smaller peptides may function as biological signals that encourage skin cells to support collagen production and repair pathways. There is promising data for select topical peptides, but consumers should be cautious of broad ‘collagen-boosting’ claims because the evidence is very specific to the peptide and formulation studied."
Peptides in consumable powders, pills or shakes
You may have come across powders, supplements or shakes in the health aisles of large retail stores that contain different types of peptides, such as collagen or creatine. These formulations may provide a boost to the peptides that our bodies naturally create, or they may be broken down and not do anything at all, as most break down into amino acids in the stomach and intestines. Peptide supplements, as with many supplements in health aisles, are not regulated by the FDA, so there’s limited data on the safety, dosage, and concentration of the supplements.
Peptides in injectable devices
Decades of research have shown that certain peptides in injectable formulations are safe and effective for treating certain conditions. Injections allow the medication to be placed in the body to increase their effectiveness—for example, injecting a GLP-1 into fatty tissue in the abdomen, thigh, or upper arm helps the hormones break down more consistently and provide reliable results, while also making it easy for someone to inject themselves.
Peptides and your health
The reality is that peptides may or may not truly be beneficial for your health. There are many factors, including dosage, potential side effects, and other ingredients, that determine whether any medication can be helpful, harmful, or just a waste of money. We know that there are many ways in which peptide medications can improve a person’s health. In medically administered formulations, peptide therapies have been studied and approved for use to treat diabetes, irritable bowel syndrome, prostate cancer, multiple myeloma, osteoporosis, heart failure, sepsis, HIV, and many, many more conditions.
Some early research has also been done on using peptides to help treat triple negative breast cancer. Other research has indicated that some peptides can lower blood pressure and improve gut health.
The problem with many of the newer peptide formulations, including those recently recommended by the FDA advisory panel, is that they have not undergone clinical trials or human-use studies, so there’s no telling what potential side effects may occur with these newer medications.
Are peptides safe?
Many peptides are very safe, having been studied in clinical trials for many, many years. However, some of the newer peptides that have gained popularity on the internet in the last few years have not yet undergone rigorous trials to determine their safety and effectiveness for humans.
One of the reasons the FDA advisory panel voted to recommend certain peptides for looser restrictions is that people were already buying these peptides online from sites that might not be selling safe formulations—there could be harmful ingredients mixed in with the formulations, or they may not actually contain the ingredients that were marketed. An argument was made that by allowing compounding pharmacies to create these peptide products, there would be more oversight to make sure they were safe and effective for their approved and prescribed use.
A counter argument points out that, given the lack of research into these formulations, there’s no way to know what a safe or effective dose is, what the side effects may be, or that they can even do what people are claiming they do. A specific example is the discussion around a peptide known as BPC-157. The FDA is evaluating its use for ulcerative colitis. If the FDA follows the advisory panel’s recommendations and allows for BPC-157 to be used by compounding pharmacies, the medication should only be used with a prescription for treating ulcerative colitis. But BPC-157 is being marketed online for other uses, including general gut health, tissue repair, and treatment for inflammation. Could it treat all of those things and ulcerative colitis? Possibly. But there have been very limited studies showing that it treats any of those conditions.
Talk to your healthcare provider about taking peptides or supplements
Before taking any supplements, including peptides, talk with your healthcare provider about your specific concerns and reasons for wanting to take a new supplement, especially if you are pregnant or have pre-existing medical conditions. Certain supplements have known interactions with other medications and could cause severe health complications if taken together. Your healthcare provider can work with you to find solutions or refer you to a specialist for your health concerns.
Additionally, as more research is done on peptides, there may be opportunities to participate in clinical trials to help test their effectiveness. Your healthcare provider or specialist can determine if you qualify for a trial and help you enroll if you choose.
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