As a side note more dangerous than any drug is stopping a prescription drug cold turkey. Watch what happens when global trade to/from China and India are cut off for a year. Attitudes will change.
This is briefly addressed in the article, but basically it's one thing to eat a peptide and quite another thing to inject it. Your digestive system is extremely adroit at taking peptides and proteins and breaking them down into individual amino acids, which are then absorbed via "transporters" in the gut. (e.g. SLC6A14 for glutamate and cysteine.)
If you eat insulin, absolutely nothing will happen. If you inject just a little bit too much, you're dead.
So, generally: Ingested proteins/peptides aren't drug-like, whereas they can be extremely potent drugs if administered via injection.
Granted, there are exceptions. If you accidentally get a drop of botox into your mouth, you'll be okay, but if you drink a vial, you'll be poisoned. And people have been trying to make orally-active peptides and proteins for decades, with some noteworthy successes, however few and far between in the general case.
GLP's are all the rage these days. Doctors seem to be giving GLP peptides out like candy and those are injected. People are looking like zombies. That said if doctors are going to be so liberal with them I should be able to buy it in the grocery store and slap it down on the conveyor belt. Again I can buy things far more dangerous than any prescription drug. There are very dangerous supplements, some that are shilled heavily on youtube. For example, Glycine (for me specifically used without a specific process) is more dangerous than heroine and the vast majority of doctors would have no idea what I am talking about.
Can you point to the clinical trials that demonstrate this?
> Doctors seem to be giving GLP peptides out like candy and those are injected.
There have been several _thousand_ clinical trials that have shown GLP-1s to be safe and effective.
Pretty much all venoms are mixes of short (10-15 base) peptide chains.
It's the naturalistic fallacy in an utterly perverse form ( and also goes to show why a regulatory system is good: the average person has no idea that they're dealing with or even common sense about it).
It’s also just a silly rhetorical technique. The ability to construct a grammatical sentence of that form does not constitute a valid argument.
“Restricting nuclear material is silly given that nearly all the stuff I interact with every day contains atomic nuclei.”
The reason we don't need tight regulations on bleach is because we don't have a societal issue causing people to drink it and hurt themselves... at least, not anymore: most of the locking lids on household cleaning chemicals are there by law.
This is a deeply weird take. You think anyone ought to be able to buy, for instance, warfarin and freely take it without a doctor’s involvement? We should let parents self-diagnose diabetes and administer insulin without a prescription or discussion? We should just hope that patients heard their doctor say hydralazine and not hydroxyzine?
> As a side note more dangerous than any drug is stopping a prescription drug cold turkey.
Abject nonsense. It was very easy to stop my prescribed amoxicillin. It’s clear you don’t have any actual idea what “prescription drugs” are, in aggregate, and that should maybe inform your decision to have Big Opinions about them.
Yes.
Weird examples. You can buy insulin without a prescription today in the USA.
In much of the world -- including almost all of Asia, Africa, and much of Eastern Europe -- you can buy almost any drug without a prescription. The only exceptions are potent CNS stimulants or narcotics, and in some rare cases antibiotics.
This is legitimately a better system. Takes out the middleman.
In the US you can get any drug if you pay $120 and recite the magic words to a telemedicine "doctor."
Doctors in the US get a nice $200 to $500 per doctors visit, required to extend the prescription drug. I only notice because I pay cash. This is why they will argue against anything I am saying until they are code-blue in the face. I will leave them with my code brown.
In the US you can get any drug if you pay $120 and recite the magic words to a telemedicine "doctor."
That's how a number of us in a particular circle stock up on anti-biotics. That said anti-biotics are a last resort for me whereas I find doctors are quick to prescribe them.
That’s exactly what some biological drugs are too - peptides!
And peptides are just short chains of amino acids. Almost all the other biological drugs are just longer chains of amino acids - antibodies, enzymes, antigens, some hormones, and others.
Derek is right that the safety risks are exponentially higher when you inject peptides - you basically skip a bunch of protective mechanisms like enzymes that quickly break them down if taken orally or routes.
As a former R&D scientist there is no way I’d inject any peptide that hasn’t at least gone through a phase 1 safety study in humans. Otherwise you have no idea what it could be doing to your body.
A good example was a drug that was quickly pulled from market for causing fatal anaphylactic reactions. It wasn’t even caught in the clinical trials!
At the same time, I think people have the right to take whatever substance they want. But I worry a lot of people aren’t aware of the risks.
A lot of people do not understand the trial system or the value of Phase 0/1 tests when it comes to the substances that they put into their body. And thanks to the influencer/grifter/biohacker ecosystem that exists, more people would put their trust in accidental evidence, from people who's incentive it is to make money off of them, while complaining about the pharmaceutical industry operates off of a profit motive.
That's like saying that since neither one nor zero requires regulation, neither does software. Maybe software does or doesn't, but in either case its best based on the nature of the aggregate, not the nature of its components.
I mean, why regulate anything? Everything is just different arrangements of hydrogen and time. It's so weird that certain arrangements of hydrogen and time try to claim to have things like "morals", and try to force other arrangements of hydrogen and time to not do arbitrary contrived concepts like "murder".
All is one. Just hydrogen and time. Therefore everything should be legal.
Ok, and? At worst you waste a couple hundred dollars and deem the alternative therapy not worth it and go back to your doctor but I know dozens of people at my gym that used BPC 157 and TB 500 that fixed their chronic tendon/joint issues within weeks of starting the therapy that physios couldn't fix for years.
I am a super introvert and know at least half a dozen folks with such issues, more if you include my close friend group.
Any place that has a lot of physically active people stressing their limits a bit is going to have a lot of injured folks over a decent period of time. And of course it gets talked about quite a lot, since it limits performance and ability.
My trainer knows I have a chronic shoulder issue, and an adductor issue at the moment I'm working through that we need to avoid stressing too much. The few other folks who tend to work out around my schedule know of this, and I know of theirs.
Not very uncommon really.
I'm very on the fence over BPC-157/TB500, I really want to see some actual clinical trials ran on it. I have a feeling the effects are overstated, but I also have had a number of "insider" conversations where I know these and other compounds are very much being utilized in pro athlete injury recovery programs. Those athletes certainly are getting state of the art medical care via traditional sources, plus elite level physio therapy - so it's hard to say if the illicit injury recovery drugs are doing much or not.
I don't think I even know dozens of people, full stop, let alone well enough to talk to them about their peptide use.
According to our new AI overlords, a short synopsis of potential risks of BPC 157 based on mechanistic and animal work to date (don't know human risks because there haven't been sufficient clinical studies):
* Possible pathologic angiogenesis (abnormal blood‑vessel growth), which theoretically could support tumor growth or inflammatory and autoimmune processes. * Modulation of nitric‑oxide pathways that, at high levels, might contribute to anemia, altered drug metabolism (CYP enzyme activity), and possibly neurodegenerative processes in theory. * Concerns that its pro‑healing, pro‑growth signalling (e.g., FAK–paxillin) could encourage cancer spread if malignant cells are already present; this remains theoretical, with no proof in humans. * Possible liver and kidney toxicity suggested in some commentary and extrapolated from preclinical work, but not well characterized in people. * Immune reactions or allergic responses, including fevers, rash, hives, muscle aches, or systemic inflammatory responses
These do not appear to be results that would appear overnight. It would be "nice" if the folks injecting random shit into their bodies also disclaimed any subsequent medical intervention as a result of said shit, but that I suspect that's unlikely.
People for so upset that GLP-1 has no long term side effects.
There's still the crowd completely sure everyone will get HyperCancer in 10 years or something (they won't).
1: https://www.reddit.com/r/endocrinology/comments/1jb2cce/grow...
Bench 1rm: 315
Squat: 5x10 225
Deadlift: 5x5 315
After: same height lol, 154lb
Bench 1rm: 285
Squat: 5x10 205
Deadlift: 5x5 275
Suffered some anhedonia towards the end but that went away ~1wk after stopping. Overall pretty good, not any side effects. Definitely fixed my food craving problem. I didn't have a high intake of protein during the 10 weeks, so I suspect thats why I lost muscle mass :/
Also, if you plan to be on it a good long time, you can buy a bunch of kits yourself (a kit is 10 vials), run a bunch of tests, and then just have a nice stockpile that will last you years. The testing will likely cost as much or more than the product itself, but given how inexpensive the product is, you still come out way ahead financially.
It is illegal, but it doesn't stop people from doing it. In fact, if you don't have any sort of test results for your peptides people will absolutely avoid buying your wares until you have them. Purity and mg/ml are the 2 basic test results that any shop worth their stuff will have.
After nearly getting hosed in a group buy (I did get refunded, but that is far from a guarantee) because of a product mismatch, I decided to just pay for nexaph. Love him or hate him, his popularity relies on his reputation and he has been more careful than most suppliers to cultivate it with more extensive testing and quality control.
<Insert that "one of us, one of us..." GIF here>
I know a bunch of people with multi-year stockpiles. I've got ~5 years of reta and ~6 years of tirz. This is too much, of course, but I determined a while back that under no circumstances do I ever intend to find myself unable to source it. My life is immeasurably better after losing 110 pounds.
There's this company that offers free testing: https://finnrick.com/
Another popular testing company is https://janoshik.com
Some other useful resources: https://graymarket.substack.com/ and https://glp1forum.com/
There are a few subreddits as well.
FWIW, I never ended up buying any myself.
Where do you think Hims, Ro, Brello, or the rest get the APIs they sell to their customers? They get them from grey market suppliers in China. They don't go to Ely Lilly or NovoNordisk and say, "politely sir, may I skirt around your IP and sell your drugs for 10x what they cost instead of 10,000x what they cost?" Hopefully, they test them and filter them and use sterile/pharma processes for what they sell to their customers. Well, except for the Medspas, those are just wild west snake oil farms.
Today ... who knows? It might just be the same gray market stuff us plebes can get.
My gf is in medicine so she had a friend test it through their work.
There must be an irony that it was Trumps crackdown on peptides, I presume to prop up his prescription company, that forced me to switch to Chinese supply. By doing it all at once it created a critical mass for that market.
I owe my health to early adoption of experimental peptides, I have life long ME/CFS and there is no known treatment for this nor is there any on the horizon. At least they finally have a diagnostic test and know it's not psychosomatic but I could have told them that from day 1. Most doctors are not researchers and have little understanding on statistics instead preferring to rely on discrete classifications and simple decision tress. As someone with hEDS from TNXB I am a walking bag of symptoms and yet not a single doctor could figure it out. I had to research it myself which involved post-doc level textbooks and research journals. I came across the work done by Prof. Khavinson (USSR) and it did appear to me that peptides were incredibly under-explored. Given the poor quality of life with ME/CFS I was willing to take serious risks so previous trials were helpful to give an idea on dosing and lethality, I went through most of the research peptides one by one. I actually waited on semaglutide a bit because I suspected there was a small minority who would have hyper sensitivity and I both expected that to appear in the data, which it did, and I expected to have hypersensitivity, which I did. Others who were less careful ended up with pretty bad gastroenteritis. Semaglutide has been the most effective and with it and a few others I am largely able to lead a normal life. I was getting gray market from the US but now I get it direct from China.
A_D_E_P_T•2h ago
At this point, broscience is considered no less valid than actual clinical trials, and the FDA should blame itself for this. Not "human nature being what it is in this fallen world" in a sort of general or abstract sense.
Another point I could raise is that telemedicine has turned the entire prescription system into nothing more than a parasitic middleman/gatekeeper.
FDA reform is very badly necessary. That ought to come before harsher enforcement, and I think that much of the populace already intuitively understands this.
jmye•1h ago
I’m curious what you mean by this. I’m not sure what you mean by “prescription system” specifically.
tastyfreeze•1h ago
If you can call up a teledoc and they give you a prescription based on your description why could you not just go buy the meds yourself without a prescription. You have essentially diagnosed yourself and just asked the doctor for permission to buy the drug you want.
A_D_E_P_T•1h ago
> https://www.nytimes.com/2026/04/02/technology/ai-billion-dol...
People want GLP-1 drugs. They can't get them without a prescription. They pay $$$ to a "telemedicine" "doctor", recite a list of well-known symptoms, and buy the prescription.
The system is that you can't buy these drugs without the piece of paper, and the piece of paper is basically something that anybody can buy regardless of whether or not they actually need the drug. Wanting it is usually enough.
hombre_fatal•1h ago
Also, most doctor's visits aren't any different from getting it if you want it except it's gated on the mood/attitude of the doctor, maybe your ability to sell some sob story. And then you book a different doctor until you get it. Telemedicine just makes the process easier an arbitrary system.
kube-system•1h ago
The prescription hurdle is absolutely necessary -- these are not drugs that anyone can safely take without guidance. It's the price that needs to be fixed.
hombre_fatal•1h ago
You take a dose every two weeks. And if you accidentally double dose because you misread 1U to mean 1 dose, it just gives you some nausea.
Are we going to pretend it's hard to take this drug now too? Or that the doctor has some magical insight into your getting-on? Remember to eat. That's it. I guess a few people might need the doctor to go "you're eating, right?" but I don't believe in infantilizing everyone over that.
kube-system•1h ago
Additionally, getting the correct dose is not straightforward for a layperson as it is for other OTC drugs with standard doses.
tptacek•1h ago
kube-system•1h ago
I do think GLP-1s are just about right. It is appropriate to take them under personalized professional guidance.
tptacek•54m ago
Certainly you can abuse a GLP1 and get yourself very sick, or not abuse it and still end up with pancreatitis. But smoking and alcohol presumably cause way more cases of pancreatitis, and you don't need a script for a handle of Popov.
kube-system•48m ago
rootusrootus•39m ago
Indeed. In fact, I think just recently there were updated studies for at least one of the popular GLP1s that disclaimed entirely a link to pancreatitis.
bsder•1h ago
Apparently we have forgotten people who died from eating disorders (previously called anorexia nervosa)?
There is a VAST difference between someone who weighs 300lbs asking for GLP-1 to combat morbidity and someone who is barely 100lbs asking for a GLP-1 to take off weight for bikini season. That's what needing to ask a doctor for a prescription is for.
rootusrootus•1h ago
Weekly, if you are following guidelines correctly. The half-life of most GLP1 peptides is 5-6 days.
I otherwise agree with your point entirely. Though anecdotally, I may have given my brother-in-law a single small vial of tirzepatide at his request so that he could experience it, and the results were ... not good. Turns out he's an idiot, thought that 'more is better', 'drinking enough water is for weenies', and 'I am not an alcoholic even though I get plowed most evenings.' All against my very specific advice on how to give it a try. Whoops.
My fault, yes, I should have realized he was too stupid to do it without adult supervision. He made himself so sick he almost went to the ER. Nothing really dangerous, of course, tirzepatide is pretty safe stuff, but overdosing on it can make you feel very shitty for a few days until the blood concentration drops.
phil21•1h ago
You're totally missing the point thought. The prescription hurdle effectively does not exist. It's just a paywall.
You pay your $100, get a 3 minute call with a NP/PA/whomever, and basically the robot writes you a prescription for whatever you want. The point is you pay and you get the prescription. Patient safety has nothing to do with anything.
kube-system•1h ago
The advantage to a telehealth is not getting the prescription written -- it's that they'll fill it for cheap through a tiny compounding pharmacy that is making it, technically illegally, but are small enough to be off the FDAs enforcement radar for the moment.
phil21•40m ago
It's slightly cheaper for me to use telehealth vs. billing through my insurance. The downside is it doesn't go towards my deductible of course.
The stuff you are describing are entire supply chains of a sort where you want a GLP-1 or perhaps a few other things like TRT. Those you are signing up for the drug itself, which happens to include the prescription part with it.
Telehealth can be used for any old medication you want. It removes the permission slip part of the process and replaces it with a payment gateway. If you have $75-150 you can just click some buttons and have a prescription for nearly anything you want at most a day later. This includes antibiotics, ADHD meds (getting harder on these), certain benzos, etc.
HIMS/HERS/etc. and their smaller ilk are super popular, but they are the tip of the iceberg.
Telehealth providers can certainly work with compounding pharmacies but not necessarily. If you are looking to get a prescription for Diazapam you are going to be getting that sent to your local Walgreens or whatnot.
ai_critic•1h ago
In Mexico, for meds like mine, you can just buy them at the pharmacy. There's no reason for all this nonsense.
(Edit: same PCP refused to prescribe GLP-1s early, without any scientific or medical reason not to. Delayed my weightloss by months until I found a place that would.)
pedalpete•1h ago
Due to drug advertising rules, the prescription system has been turned on its head, and the patient now goes to their doctor asking for a specific prescription.
Telemedicine took advantage of this and has effectively removed the middleman (the doctor) in many cases and you just sign-up look at a person on a camera, and get your drugs sent to you.
phil21•1h ago
They basically operate as a "pay for a prescription" service.
Figure out what drug you want, google the drug name and telehealth. You will be marketed in a wink wink sort of manner over how easy it is to get them, just hours away! Then if you are not a total idiot, you answer certain questions in the right manner on the intake form, the doctor (usually NP/PA or similar for most things) will quickly run through that and expect you to answer correctly - perhaps guide you a bit if you don't.
5 minutes later you have a prescription in the web portal and it's sent to your pharmacy of choice.
It really shows how the whole "permission slip" program is BS. I've used these services a couple times vs. my normal doctor just to save time and expense of an office visit. If I can click some buttons, have a call 30 minutes later, and be on my way to the pharmacy for $50 it's sometimes the path I take now vs. traditional route.
Someone used to the traditional doctor/patient relationship thing and prescriptions being "holy" would be shocked at how easy and gamed it all is.
cwmoore•1h ago
Simulacra•1h ago
secabeen•1h ago
rootusrootus•50m ago
tzs•49m ago
And doctors are not dietitians.
Doctors in the US receive an average of under 20 hours of training in nutrition over four years of medical school. What little they do receive is often focused on nutrient deficiencies rather than on meal planning for health and chronic disease prevention. Less than 15% of residency programs include anything on nutrition.
To become a registered dietician requires at least a Master's degree in dietetics or nutrition or a related field, and at least 1000 hours of supervised internships.
PS: before any Europeans hold this up as an example of the poor US health care system, doctors in Europe average 24 hours of nutrition training.
hammock•1h ago
In the drug division specifically, the number is about 75%.
XorNot•1h ago
And it shows on the research: e.g. does creatine help muscle building? No.[1] But cue some anecdote from someone where they also changed a dozen other things at the same time but are sure it was that.
[1] https://www.unsw.edu.au/newsroom/news/2025/03/sports-supplem...
GenerWork•1h ago
As for broscience, moving into peptides was a logical next step after exhausting anabolic steroid "research". In fact, I'd say that biohackers are actually behind the bros when it comes to trying various peptides out and documenting experiences.