If you’re considering taking injectable peptides with mysterious names because an influencer or friend raves about them, Novant Health family physician Dr. Vaishnavi Gadicharla would like a word.

What to know right off the bat:

• Peptides are already in your body naturally.
• Scientists can make them in labs, too: Some peptide-based drugs have been extensively researched and are approved by the Food and Drug Administration (FDA).
• But not all peptide drugs are safe: You’re taking some serious risks when you try unregulated peptide drugs.

We’ll talk health in a minute — but first, a bit of science.

What’s a peptide?

On a chemical level, your body is made of water, fats, minerals, biomolecules and proteins. Your body is constantly making new proteins by combining molecules called “amino acids” into long, complex chains.

Peptides are shorter, simpler chains of amino acids that still play an important role.

Some peptides act as messengers, telling your cells what to do: Release that hormone. Grow. Peptides can also control appetite, digestion, or mood, support your immune system, and help build skin, muscles, and bones.

Your body contains thousands of “endogenous” peptides, made by your body.

What’s a synthetic peptide?

Scientists can also make synthetic peptides in a laboratory.

Some drugs are made with synthetic peptides, including insulin, certain hormone-based drugs, and GLP-1 drugs like Ozempic and Wegovy (the “P” in “GLP-1” stands for “peptide”).

You can also find synthetic peptides in skincare products and supplements like capsules, gummies and powders. More recently, you can find peptides in injectable medication, which is what the rest of this article will focus on.

Why are peptides trending?

Since GLP-1 drugs have been so effective, there’s excitement about what else peptides can do.

The FDA has approved more than 100 peptide drugs to treat specific medical conditions. And they’ve announced plans to review the restrictions on seven additional peptides that aren’t currently approved.

But some people are intrigued enough to take peptides off-label, while others are turning to entirely unapproved compounds. The term “off-label” refers to the legal use of a medication to treat conditions beyond its FDA-approved use.

Aesthetic and wellness clinics are marketing personalized peptide injections known as “peptide therapy.” Social media influencers rave about peptide “stacks” — combining injectable peptides in hopes of achieving certain results.

And some are buying injectable peptides through the “gray market”: online retailers who sell peptides imported from other countries, while stating that they’re not for human consumption.

Do peptides work?

There’s evidence that the FDA-approved peptide drugs are safe and effective — for the specific medical condition each was tested on.

“There are years of multifaceted preclinical and clinical trials that go into how the FDA regulates and approves a medication for it to be on market,” Gadicharla said.

A drug must go through extensive testing on people before the FDA approves it. Researchers have to demonstrate:

• Safety: The drug causes more benefits than harm.
• Effectiveness: The drug produces the desired result in patients with a specific medical condition, in clinical trials and in real-world conditions.
• Dosing: The optimal dose of the drug, where patients get the benefits with minimal side effects.

In contrast, manufacturers of unapproved peptide products don’t have to demonstrate any of that — meaning, “we have no idea about its safety, its effectiveness or efficacy or its dosing,” Gadicharla said.

“There’s no oversight or regulation as to what you’re actually getting — so you may be getting a dose that’s not efficacious, that isn’t safe, or you may not even be getting that particular medication at all.”

Because unapproved peptides haven’t been extensively studied in clinical trials, there can be unexpected side effects or interactions with other medications you take. These same risks apply if you take FDA-approved peptides “off label” without a doctor’s supervision.

Independently tested, injectable gray-market peptides have been found to contain contaminants, heavy metals like lead and arsenic, and different doses than advertised. To be clear: You’re rolling the dice with your health when you inject these products, Gadicharla said.

And though injections offered in a “wellness clinic” may seem safer, they still haven’t gone through the same rigorous safety and quality testing requirements as FDA-approved medications.

Do peptides have potential?

They’re quite promising, Gadicharla said.

Most drugs on the market are small-molecule drugs, which are straightforward and cheap to make, usually as pills or liquids. Small-molecule drugs easily move through your body and into your cells, but they’re less targeted, which can lead to unwanted side effects (like when your medicine for a sore back also increases your risk of GI bleeding).

There are also large-molecule drugs (biologics), which are more difficult and expensive to make. These are specifically targeted to enter the right cell, often achieving significant results for people with cancer and autoimmune diseases. But they can also trigger unwanted immune reactions and require careful storage and administration, usually by injection or infusion.

Peptide drugs may offer a middle ground: Peptides fit precisely into your body’s cells, so they can target a specific cell without side effects for other parts of your body. And peptide drugs are simpler, cheaper and easier to produce in a laboratory than large-molecule drugs (though they’re less stable than small-molecule drugs, which is why they’re often offered in injected format).

So, peptide drugs have potential, Gadicharla said, adding that she’s personally watching to see if future peptide drugs can help middle-aged and older women gain muscle.

But she won’t be injecting a Wolverine stack — a trendy combo of two peptides — anytime soon: “I practice evidence-based medicine — recommendations based on rigorous scientific evidence,” Gadicharla said. “I would advise my patients, family members and myself to be cautious about medications they take and to make sure there is scientific basis behind it.”

She strongly recommends that patients stick to FDA-approved medications, which have a track record of safety and effectiveness.

But she recognizes your right to make your own healthcare decisions — so if you choose to experiment anyway, Gadicharla said, “Please let your doctor know if you’re having symptoms.”

How can I gain muscle, lose weight and look younger?

Most of us have a few concerns about aging, our bodies or our health — but there are alternatives to injecting yourself with unregulated peptides.

Here’s what Gadicharla recommends:

• For anti-aging: Drink plenty of water, moisturize, use sunscreen every day even if you’re indoors, and wear physical protection like long-sleeved shirts, sunglasses and wide-brimmed hats to minimize your sun exposure outdoors. If you’re worried about fine lines, wrinkles or skin texture, talk to a dermatologist about whether retinoids may be right for you.
• For weight loss: For lasting weight loss, you need a comprehensive plan targeting your nutrition, exercise, stress management and sleep, Gadicharla said, adding, “Your doctor can help you build a plan that fits your life.” Your doctor can also explore whether medication — like a peptide-based GLP-1 drug — is right for your situation.
• For building strength: Consistency is very important. Most health organizations recommend exercising hard enough so that you’d struggle to hold a conversation for at least 150 minutes weekly. Twice a week, perform resistance training targeting every major muscle group.
• For fatigue: Your doctor can order blood tests to make sure you don’t have a thyroid problem or an underlying deficiency like vitamin D or iron deficiency anemia that’s causing your fatigue. After that, focus on getting quality sleep, practicing good sleep hygiene and eating regular balanced meals that contain protein, fat and carbohydrates. Make sure you’re addressing your mental health, too, Gadicharla said, as untreated depression or anxiety can be draining.

And if you have a particular concern, turn to your doctor — not TikTok.

“My job as a family care physician is to help you achieve the best health you can within your financial and time constraints,” Gadicharla said. “We’re there to help you figure out what your particular goals are, and to make sure you have the knowledge, screenings, and tools you need to live the healthiest life possible.”