A University of Missouri physician is warning about the potential dangers of injecting unregulated peptides that federal safety and health regulators have not approved. The concern, as she frames it, is less about the molecules than about who is selling them.

Peptides are amino acids that regulate body functions. The body makes its own, including insulin and oxytocin, and drug companies and retailers also make injectable and oral versions, which is the category now being advertised on social media, cable television and podcasts for everything from pale skin to muscle soreness.

The seller is the warning sign

Dr. Regina DePietro, a community and family medicine physician at MU Health Care, put the test in commercial terms rather than pharmacological ones. "I think any time you're getting something from someone who financially benefits from your purchase in medicine, you should be concerned about your purchase and look into it really thoroughly," she said.

That is a sharper framing than the usual safety boilerplate, and it points at the part of this market that actually distinguishes it: online retailers and compounding pharmacies pushing products labeled "for research purposes." DePietro said those labels are frequently attached to unregulated peptides.

What approval actually buys

GLP-1 medications sold under brand names including Ozempic are among the best known peptide-based drugs, and DePietro drew the line there. Ozempic went through the Food and Drug Administration's screening process, which runs from animal studies to small patient studies, clinical trials, larger trials and post-market surveillance. Products such as BPC-157 have not.

The last step is the one she emphasized. "When you have unregulated medication, we don't have that post-market surveillance making sure that our medications are safe and are actually what they say they are," she said.

Not a verdict on the compounds

Notably, she did not write the category off. "Does that mean that these will never be safe and studied? No. These might become medications that are approved eventually. I just think we don't have the research yet."

Health experts have raised concerns that peptides lacking FDA approval could cause immune issues, be contaminated or cause unintended side effects, and that some products may be ineffective or fraudulent.

Bottom line

DePietro credits Ozempic's popularity with introducing peptides to the masses and making people less squeamish about injecting themselves. She said anyone curious about a peptide should ask a doctor about it first.