#387 - AMA #83: Peptides—evaluating the science, safety, and hype in a rapidly growing field

**Peter Attia** (0:10)
Hey, everyone, welcome to a sneak peek, Ask Me Anything, or AMA episode of the Drive podcast. I'm your host, Peter Attia. At the end of this short episode, I'll explain how you can access the AMA episodes in full, along with a ton of other membership benefits we've created. Or you can learn more now by going to peterattiamd.com/subscribe. So without further delay, here's today's sneak peek of the Ask Me Anything episode.
Welcome to Ask Me Anything. In today's AMA, we take on one of the most requested and most confusing topics we've ever covered, peptides. Peptides sit at the intersection of biological plausibility, clinical promise and rampant commercialization. They're often marketed as cutting edge regenerative therapies for everything from muscle repair and longevity to cosmetic enhancements. But the reality is that the peptide ecosystem is sprawling, poorly regulated and filled with claims that range from legitimate to completely ungrounded. So the goal of this episode is not to promote peptides or dismiss them as a category, but to give you a framework for evaluating them. Because as you know, we love us some frameworks over here. We walk through what peptides are, what questions you should ask before putting any peptide or any drug into your body, and how to think about the strength of evidence, the safety profile, and the difference between science and marketing hype. So specifically, we're going to discuss why peptides have become such a dominant topic in the wellness and longevity culture, the differences between FDA-approved peptide therapeutics, and quote unquote peptides, which are what most people refer to with quotes in the biohacking world, a framework for evaluating any peptide, mechanism, intended effects, safety, dosing, and alternatives. And then we're going to run our framework through a handful of examples in detail. SS31, talk about the background, the biology, and the types of conditions it has been studied for. Melanotin-2, receptor activity, common claims, related FDA-approved compounds in the same pathway. CJC1295, and talk about growth hormone signaling, why it has been studied in humans, what it's been studied for, and how dosing is typically approached. Of course, BPC157, no discussion on the topic would be complete without that. The origin story, the proposed mechanisms, and the nature of the animal and human evidence that's often cited. We're going to talk about the role of patents and the incentives in drug development, and why some compounds do or don't advance through formal clinical pipelines. We're going to compare peptide evidence standards to other widely discussed interventions that fall into high interest in complete data categories. We're going to talk about how peptides are manufactured and sold in the gray market, and what the research use only designation actually means, what third party testing can evaluate, and what it doesn't capture. We'll talk about oral peptides, digestive breakdown, absorptive challenges, and what we know from pharmaceutical examples. Talk about what needs to happen for peptides to become more broadly usable therapies, and where peptide therapeutics may expand in the future, and what areas of medicine might be most actively and positively benefitted right now.

**SPEAKER_1** (3:31)
Peter, welcome to another AMA. How are you doing?

**Peter Attia** (3:34)
I'm doing great, man. How are you?

**SPEAKER_1** (3:36)
I'm doing good. For today's AMA, we are going to be talking about peptides. So peptides are a topic that we get asked about an insane amount. You see so much content on there. Even today, going through our e-mail inbox, we had two e-mails asking us to talk about peptides. So it's a topic we see over and over. And our goal with this episode is not to promote, dismiss peptides overall, but just to give people a framework and how to think about them, which is what are peptides, where is the science solid, weak or non-existent, and how to evaluate the claims that people make. With this, we'll walk through a core set of questions that apply to any peptide, and we'll apply it to a variety of peptides to kind of walk through some of the most popular ones, which is whether we know there's a mechanism of action. What do we know about safety and dosing? Is there any evidence that it can be helpful in humans? How do someone compare the risks and the potential benefits? And are there any other legitimate approved solutions that are available? And then at the end, we'll also zoom out and talk about the gray market space for peptides, including how people should think about purity, sourcing, etc. And then we will truly end on the potential future of peptides and what we would need to know, what new information would have to come out to really understand where these could be promising. A lot to cover, a lot of different things we said. Anything you want people to know before we get rolling?