Who Should (and Shouldn't) Use Peptides: A Functional Medicine Doctor's Clinical Framework

Welcome back once again. Here we're going to finish up our session on peptides, talking about how I actually use peptides currently in my clinical practice. I want to start there. If you're watching this, most people are watching this currently or listening to us currently actually don't subscribe or follow. So if you could do that below, subscribing or follow, that'd be super helpful. Just helps us know that what we're doing is getting out there and also helps us with getting good information out there. So if you do that below, I'd be really, really appreciative. So let's talk about how peptides are used in my clinical practice. You know, I went back, I've talked before, I've been using, you know, you know, I started my primary practice, medical school back in 1996 to 2000. This is just to put things in perspective. From 2000, 2003, my residency program, and then in the military from 2003 to 2007. And 2006 was when I started using the first, you know, GLP-1, quote unquote, in the kingdom market. But the idea with that was we were taking a peptide and using it supra-physiologically, right? When you use the GLP-1s the way they're dosed right now, sometimes they're 30 to 40 times your body's physiologic dosing, which is one of the reasons why microdosing actually still helps because it's still a super physiologic dose. It's just not, you know, 40 times higher, it might be 4 times higher. Peptides are meant to be used as an adjunct to be a gentle nudge to your body system. As you get older, you tend to make less of them. So, in the functional medicine approach, we tend to use them in conjunction with our standard stuff. It's— the philosophy is you're going to work with your body's biology, not against it. And peptides are perfect in this situation. There are some that you can push that can act like hormones. But in general, peptides are working with your body, not against it. They're working through natural processes. And many of the peptides look very, very the same to what your body makes, if not the same, like almost like bioidentical hormones. The chemistry is not foreign. We're not forcing your body to do something it's not meant to do. But you want to do this on top of the foundations. You know, what's your diet look like? Are you eating real food? Am I getting adequate sleep? What's your body look like stress-wise? How stressed are you? Do you have nutrient deficiencies? You know, vitamin D deficiency, amino acid deficiencies. You know, if you're not consuming enough protein, good point here. If you're not consuming enough protein and you were taking these peptide things to make your body heal itself, it won't do quite as well if you don't have the adequate nutritional reserves to do that. So peptides are nice once you've done all the foundational stuff, adding them in. You know, one of the philosophies I have is, you know, I come alongside— your body was made to heal and self-repair. So, in part, what we do is find out where your body's not doing that, where it's stuck, removing the sticking blocks, giving your body what it's lacking, and your body will do what it's made to do. And in that idea, this is where peptides fit in perfectly. So the question becomes, you know, who, who do I think about when I see people? Who do I think about, you know, using peptides with? Anybody with a gut issue, whether it's IBS, IBD, inflammatory bowel disease, you know, particularly some inflammatory bowel diseases, certain peptides like BPC and TB4 can be super helpful not just to calm the inflammation down, but also to help heal the gut and prevent scarring. You know, I have a lot of patients with food allergies, sensitivities, Hashimoto's, anybody with an autoimmune issue. By definition has leaky gut. And some people actually will get leaky brain. This is where certain peptides like BPC can be super helpful. If someone has a chronic infection, whether that's a viral, bacterial, you know, infected root canal, dysbiosis in the gut, certain peptides can come alongside and help their immune system kind of clamp this down, sequester it away, or remove it. And again, if you have an autoimmune disease, you have to have 4 things. And one of those is leaky gut. And the other one is a chronic infection. So all of a sudden now, you know, peptides are sounding helpful in some people after the Foundation. A lot of individuals, when we get over 40, our growth hormone goes down. I'm 53. My body is starting to look a little different. I'm starting to get a little fat around the mid-range. I don't heal quite as well as I used to heal. And that's a sign of growth hormone deficiency. Where it gets tricky though, is in literature we know that people with lower— if you live to be 100, you tend to have lower growth hormones than people who get cancer in their 70s, right? So there's an age at which you want to be careful with these, but in the 40s to 50s, mid-50s, using them to help with healing repair still can be really, really beneficial. And then metabolic issues, weight loss, insulin resistance, chronic inflammation, even some of my mast cell patients, peptides can be helpful with a whole host of these kinds of conditions. So those are the people I tend to think about peptides after the foundational things. The next thing is who's not a candidate. And this is probably the most important point, I think, to talk about here is who should you not do peptides with. Because in our current system, it's like peptides for everybody, you know, and there's no— who's saying be careful? And the answer is nobody's saying be careful. No one's saying take it easy. Everybody's like just throwing it at the wall. The first thing is anybody with an active cancer, you 100% should avoid certain peptides, especially the growth hormone stimulating peptides. Those can actually feed the cancer. If you, if you actively have cancer, you should not consider peptides unless you're working with someone who actually is certified. Whether through it's the SEEDS Institute or through A4M. Those are the two most recognized organizations. I've done training through both of them and certified through both of them. Because you don't know the nuances of some of these things. If you have active cancer, you could actually make yourself worse. The second thing is someone who has a history of cancer. Okay, fair enough. So you had cancer 4 or 5 years ago. When is it safe to look— consider certain peptides? Typically, it's after 10 years of resolution of your cancer. Certain ones like prostate cancer that are less that are, I want to say, milder. You can consider earlier, but again, you have to make sure you're working with your practitioner. You know, one of the things I do is integrative oncology support. I'm not an integrative oncologist, but I've actually done certification through A4M with this. And what I will do is I'll do markers looking for, if someone's had cancer, do you still have an elevated LDH? Is your— do you still have insulin resistance? You know, do you still have markers for inflammation in your body? Is your D-dimer still up? Up. You know, I look for these things. They're metabolic markers of your body's increased risk for cancer. If they're up, I would try to get them down first before jumping to peptides. Because if you've had cancer and those are up, you're still at increased risk. If you haven't had cancer, if they're up, then you should get them down. Then family history. You have a family history of certain cancers, particularly epithelial cell cancers, prostate, ovarian, colon, and lung. You need to be careful with some of the metabolic-related peptides like your growth hormone ones because— or the ones related with insulin resistance because those pathways can actually increase your risk for those cancers, which just happen to be the most common cancers we're dealing with. And I mean, and couple things I think go without saying, don't take them if you're pregnant or trying to get pregnant or could become pregnant. You make sure that you don't expose a developing baby to these peptides because they can change physiology. So when do I use peptides personally? What's my clinical framework? The idea is what's my primary goal? What's my primary target? You know, is it your immune system? Is it leaky gut? Is it inflammation? Is it healing? Is it fighting a viral infection? Is it a traumatic brain injury you had 3 years, 5 years ago? And then how I quantify that, because I start using a peptide, I want to be able to quantify what I'm doing, you know, in my COVID patients, usually it's patients' clinical responses. During acute COVID, it was their inflammatory markers. MRI, traumatic brain injury patients, it's usually MRI findings, neurocognitive findings, and then clinical response. You need to have some kind of endpoint you're tracking to know if they're helping or not. The next, you know, what kind of evidence am I using behind peptides? All the ones I've mentioned so far have great evidence. There are some newer ones coming out that don't have as much evidence that are more speculation. There's so much stuff out there. I just stick with the stuff that's been tried and true and been around for a long time. And the reality is a lot of those things people haven't even heard of yet. So why jump to the fancy new thing that's been out for a year when literally the good old-fashioned BPC, TB4, thiaminylphorone, like these, you know, tried, true, around, and super helpful. KPV is another great one. And some of those are actually available as a supplement form, which I talked about in a previous episode. And how am I going to monitor it? Why am I doing it? How am I going to monitor? Which we've discussed before. And then the regulatory environment's interesting because right now it's changing like every couple of months, right? It's been really tricky since end of last year, which is end of 2025. I feel like every couple of months I'm having to resource things. One of the places I was getting stuff from stopped shipping to Virginia. They started shipping to Virginia again, then they stopped. A couple of other places I switched to Virginia where I live, they're beginning to get a little more strict with stuff. Clamp down on certain ones being shipped to the state. So the regulatory environment is in rapid flux. So the biggest difficulty I have right now is just knowing what the newest rule regulation is and then figuring out how to work around it to keep on taking care of my patients. But first and foremost, do no harm. You want to make sure that what you're doing is best for the patient. You know, my tried and true, you know, a couple basic protocols I use a fair amount. You know, someone's got chronic gut issues with inflammation, BPC-157, thymosin beta-4, thymosin alpha-1, or TB-500 instead of TB-4. These you can actually get fairly easy, not super difficult to get, whether by mouth or by, yes, or other means. Just make sure you order the practitioner knows how to use them and get clean products. If you're getting older, over 40, you tend to have lower growth hormone levels. That's where using some kind of growth hormone adjunct support can be super helpful. And don't forget, with growth hormone, the biggest ways you increase growth hormone is physical activity, lifting heavy weights, adequate sleep. So, if you're not physically active, lifting heavy weights, and getting adequate sleep, like, why jump to a peptide, right? So, those are my basic thoughts. You know, 19 years I've learned, 19, 20 years I've learned a lot about peptides. There's been access issues since 2023. And there's lots of opportunities in the future. Super excited about potentially for some things I've been hearing from the RFK taking back some of the restrictions on peptides. Whether you like the current administration or not, there are some things like the food pyramid, like removing the black box warning from hormone replacement therapy, like hopefully reducing limitation to peptide access. There are some things that actually are beneficial that I think we should focus on the good, not the bad. At least that's what I'm trying to do. And I'm just really hopeful that as we learn more about this, as more people demand this kind of stuff, that that, and we vote with our dollars as well as our ballot box stuff, we can actually get more access to these things that are super helpful that are used in other countries around the world that have been around for decades. And really, if used the right way, they can, you know, they stick to the mantra, do no harm. They can, you can strict that mantra. So hopefully this information was helpful. This is like the last one of our peptide series. Again, if you're, if you, this information is helpful, odds are you're not following. So please follow, subscribe below. It'll help us a lot with what we're doing. Take care and we'll talk to you soon.