The Peptide Gamble
Why GLP-1s, BPC-157, and SS-31 are everywhere despite of minimal human data - and how to think about your personal risk tolerance
One thing is clear: peptides are not going away.
I get the question constantly now.
“Do you have a peptide person in [insert city name]?”
Having one has become a status symbol, like knowing a guy who knows a guy.
I used to think Hims & Hers prescribing GLP-1s with essentially zero oversight was reckless. I still do. But now everyone’s entering the game - Superpower at least asks for your bloodwork first. Small victories.
Somewhere in the Polish mountains, I realized I needed to figure out my own peptide risk tolerance.
Here’s what most people miss about peptides: they’re not new.
GLP-1 agonists hit the market for diabetes in 2005. That’s nearly two decades of longitudinal data on side effects, safety profiles, real-world use. This matters. It also places GLP-1s in one of longevity’s most promising categories: existing drugs repurposed for life extension. Smart money is betting here - James Peyer PhD, founder of Cambrian Bio and advisor to my company, is one of them.
Then you have BPC-157 for injury recovery, inflammation and gut. SS-31 (elamipretide) for mitochondrial function - a key aging pathway. Thymosin Alpha-1 for immune support. TB-500 for tissue repair. CJC-1295 and ipamorelin for growth hormone optimization, and so on. The landscape is sprawling.
But not all peptides are created equal. Most have only been proven in mice. And as any scientist will tell you: mice rarely translate to humans.
Yet we have something that’s hard to ignore: massive-scale anecdotal evidence.
People report feeling better - for sleep, recovery, gut health, metabolism. The data is self-reported, yes, but it’s happening at volume. We’ll likely never see clinical longitudinal studies on every peptide. They take too long, cost too much. Even when we do have studies, we can get it wrong - see hormone replacement therapy for (menopausal) women, which we completely botched for decades until recently.
What we do have is a growing mountain of anecdotes that carry weight. Take GLP-1s and fertility. Technically, GLP-1s shouldn’t impact fertility. Yet now we’re casually discussing “Ozempic babies.” Reality doesn’t wait for peer review.
Risk #1: Quality control is a nightmare. Jordan Shlain MD once third-party tested a peptide vial from one of his patients. Sure enough, it contained the compound labeled on the bottle, alongside traces of MDMA and weed killer . With regulation lagging, you’re playing Russian roulette with what enters your body.
Risk #2: We lack long-term efficacy data at scale. We’re flying blind on what happens after years of use.
As Anant Vinjamoori, MD put it when we discussed this: the question isn’t “are peptides good or bad?” It’s “what’s your personal risk tolerance?”
Are you comfortable injecting something without knowing its long-term impact? Some people raise cancer concerns, a valid conversation I’ve explored with Anant here.
Others, like me, wonder: if it wasn’t made by nature, can we really expect a free lunch long-term?
And practically speaking: are you okay stabbing yourself with a syringe? That friction might disappear soon - GLP-1 pills are scheduled for 2026, and BPC-157 already exists in oral form. The experience becomes no different than swallowing a supplement.
Here’s my personal (non-medical) risk framework:
The body is capable, but sometimes needs a boost. When it does, I’m open to trying low doses for a maximum three-month window. The logic: if there are unintended consequences, a low dose and short duration means the body can likely recover. Benefits hopefully outweigh harm.
My actual experience? I tried peptides when conventional medicine failed my gut. Two months of high-dose BPC-157 (oral + injections) plus low-dose SS-31. It helped marginally but didn’t fix me - another reminder that without finding root cause, these interventions are Band-Aids.
From a psychological standpoint, GLP-1s fascinate me. They’re clearly rewiring how we think and operate. At some point I’ll experience it myself for 2-3 months. Otherwise, how can I possibly understand the major consumer shift we’re witnessing? The emerging science is compelling for longevity and I’ve seen first hand many doctors and scientists who argued against them, now micro-dosing them themselves.
For actual medical perspective, here’s my interview with Anant Vinjamoori, MD.
APPENDIX: Key Scientific References
Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med. 2023;389(24):2221-2232. [SELECT trial showing 20% reduction in major adverse cardiovascular events in 17,604 adults]
Guo H, Yang J, Huang J, et al. Comparative efficacy and safety of GLP-1 receptor agonists for weight reduction: A model-based meta-analysis of placebo-controlled trials. Obes Pillars. 2025;13:100162. [Comprehensive meta-analysis comparing efficacy and safety across GLP-1 agonists]
Pharmacovigilance analysis of neurological adverse events associated with GLP-1 receptor agonists based on the FDA Adverse Event Reporting System. Scientific Reports. 2025. [Analysis of 28,953 neurological adverse events from 2005-2024]
Emerging Use of BPC-157 in Orthopaedic Sports Medicine: A Systematic Review. PMC. 2024. [Review of 36 studies from 1993-2024; only one small human study with 12 patients showing pain relief]
Multifunctionality and Possible Medical Application of the BPC 157 Peptide—Literature and Patent Review. Pharmaceuticals. 2025;18(2):185. [Comprehensive review noting lack of FDA approval and cancelled Phase I trial results in 2016]
Campbell MD, Duan J, Samuelson AT, et al. Improving mitochondrial function with SS-31 reverses age-related redox stress and improves exercise tolerance in aged mice. Free Radic Biol Med. 2019;134:268-281. [8-week treatment in aged mice showing improved ATP production and exercise tolerance]
Birk AV, Liu S, Soong Y, et al. The mitochondrial-targeted compound SS-31 re-energizes ischemic mitochondria by interacting with cardiolipin. J Am Soc Nephrol. 2013;24(8):1250-1261. [Mechanistic study demonstrating SS-31’s cardiolipin binding and mitochondrial protection]
Colalto C. Aspects of complexity in quality and safety assessment of peptide therapeutics and peptide-related impurities. A regulatory perspective. Regul Toxicol Pharmacol. 2024;153:105699. [Italian Medicine Agency analysis of quality control challenges and impurity assessment in peptide therapeutics]
FDA Guidance for Industry: ANDAs for Certain Highly Purified Synthetic Peptide Drug Products That Refer to Listed Drugs of rDNA Origin. U.S. Food and Drug Administration, 2017. [Regulatory framework for peptide impurity thresholds and quality standards]
Agree on the risk tolerance. I have a pull to try GLP-1s but I’m still too worried about the lack of data and potential long-term consequences. Especially with the muscle loss.
Separately, our pediatric neurologist has the same stance on trying things for a short term to see if it works (as long as there isn’t too much risk). And if it doesn’t make a difference or causes adverse reactions, then stop.