|Dr. Neil Paulvin, DO
Functional Medicine Doctor
Peptide Therapy Expert
With a growing body of evidence, peptide therapy is an exciting emerging approach to health that may offer impressive promising applications many patients and clinicians consider. But, is it safe? What are the side effects of using peptides? Do we know enough to start enjoying some of the reported benefits or should we wait until more data is available on the long-term effects?
In this interview, we spoke with Dr. Neil Paulvin, a functional medicine doctor who specializes in peptide therapy. As an osteopath and member of the American Academy of Anti-Aging Medicine, Dr. Paulvin has successfully combined peptide therapy with functional medicine and other healing modalities to help his patients with their health concerns and goals.
In this overview, Dr. Paulvin discusses some of the top peptide therapy questions – what are peptides, how do they work, safe uses and benefits, and what to expect during treatment. We’ll also look into some of the potential side effects of peptides and common mistakes to avoid.
Disclaimer: This interview is for general information only to help educate you about peptide therapy, and not a medical advice. Share this information with a qualified health practitioner who can further assist you with any health conditions or concerns you may have. So, together, decide if peptide therapy may be a good fit for you. For those of you who still consider the DIY peptide therapy option, as Dr. Paulvin highlights in the interview, peptide therapy is not a one size fits all treatment. The type of peptides and protocols can be very specific and must be evaluated on an individual basis.
Q&A with Dr. Neil Paulvin
How did you first become interested in peptide therapy?
As an osteopath & functional medicine practitioner, I work with many patients who deal with pain, sports injuries and chronic conditions such as fibromyalgia. As I was researching new solutions to help my patients, I came across a naturally occurring peptide called BPC-157 (Body Protective Compound). The data around this peptide was very promising. BPC-157 showed an impressive ability to accelerate the healing of ligaments, bones, and tendons, effectively reduce inflammation, help with gut issues, even improve brain health among other benefits.
When I saw how much just one peptide could do, I was drawn into learning more about the world of peptide therapy.
What is peptide therapy? How does it work?
Peptides are a small group of amino acids organized in a specific sequence, linked together to form a protein. Peptides are found naturally in our bodies and have crucial roles in human physiology. This includes hormones, neurotransmitters, enzymes and important growth factors.
An example of a well-known peptide is growth hormone, which consists of 191 amino acids. The peptides used in peptide therapy however, are 50 amino acids or smaller.
Simply put, peptides send messages to our bodies with instructions that can turn on or off the functions of certain genes or cells. The body recognizes these signals and produces a reaction(s) which can have positive therapeutic outcomes.
Think of it this way; our body is extremely intelligent and knows to heal and maintain health. With peptide therapy, we’re tapping into this incredible natural wisdom that gives our body an ability to repair itself and sustain good health.
Peptide therapy uses peptides that may be identical to the ones naturally found in the body or contain a smaller part of them. Some peptides work in a very specific way. Others can affect multiple pathways in the body. Depending on the peptide, we may know the exact mechanism of how it influences a specific pathway, or only know the end result. So, while we still have a lot to learn on the exact way some peptides work, we may still know enough on their effectiveness and safety and can benefit from including them as a part of many health protocols.
Did you know? Peptide therapy is not that new.
- Peptide therapy has been a treatment option for decades outside the US.
- More than 7,000 naturally occurring peptides have been identified. Over 60 peptides have been approved by the FDA to be used as medications, and there’s more to come: 140 peptides are being evaluated in clinical trials, and 500 are in pre-clinical development.
- The most common way to use peptides is subcutaneous injections (similar to insulin injections). With that said, some peptides can also be administered orally, transdermal (creams, patches) or by using a nasal spray.
- Peptide therapy can augment other healing modalities. For this reason, it is often combined with other health and wellness protocols.
What are the Benefits of Peptide Therapy*?
Some of the more common uses of peptide therapy include:
- Improving gut issues. Peptides therapy may include peptides such as BPC-157, KPV (Lysine-Proline-Valine), LL-37, Thymosin Beta-4 (Tb4), Thymosin Alpha-1 (TA1)
Learn more: the surprising connection between gut health & overall health.
- Reducing inflammation. BPC-157, KPV (Lysine-Proline-Valine), TB-500, Thymosin Beta-4 (Tb4), GHK-Cu, Growth hormone releasing peptides such as CJC 1295 and AOD 9604
- Reversing erectile dysfunction (ED). PT-141
- Anti-aging & longevity. Thymosin Alpha-1, MOTS-c, 5-Amino-1MQ, humanin, SS-31, CJC 1295, Epithalon, Thymulin.
Learn more: the 5 pillars of functional medicine for longevity and healthy aging.
Peptides may also be used to boost exercise performance, support fat loss and muscle growth, improve cognitive function, modulate the immune system, and more.
As you can see, there are many applications to peptide therapy, with several options of peptides to choose from. Do you need all of them? Of course not! Keep in mind, in many of these areas, the research is still in progress and more studies are needed to learn about the ideal dosage, protocol, length of use, combination of peptides, etc. So, it is imperative to work with a physician who can help determine the best options for you, and tailor the peptide therapy to your needs.
*As a reminder, the names of the peptides here are given as examples, not as a recommendation!
What are the side effects or risks of using peptides?
The potential side effects of peptide therapy depend on both the peptides, the dosage, duration, and the patient’s health:
Safety of peptides therapy
Some peptides are much safer than others. Among the safest peptides are BPC-157, PT-141 and MOTS-c. Other peptides may cause some side effects or undesired effects in the body. These can greatly vary from one peptide to another. To mitigate some of these risks, there may be a need to monitor things more closely. For example, the popular peptide Thymosin Beta-4 commonly used for tissue repair, can also affect growth hormone levels or influence other growth factors. So, you may want to monitor these if you are using this peptide.
The bottom line here, is that until more research is done, we don’t always know the exact effects every peptide has for each patient. Not to mention, the combination of multiple peptides. It is therefore important to understand the specifics and run the necessary tests when needed.
The potential side effects and risks of peptide therapy depend not only on the peptide, but also on the patient. For example, a young healthy individual who seeks to use peptide therapy for anti-aging purpose or to repair a small injury may quickly benefit from peptide therapy with no side effects. Whereas someone with an autoimmune disease, Lyme disease or other lifelong health issues, may be much more sensitive and susceptible to undesired reactions and adverse effects. In fact, he or she may require a gentle, slow moving protocol that is carefully monitored. So, an individual’s state of health and needs are always important factors that must be considered. We often say that in functional medicine we don’t treat the disease; we treat the patient. This is a great example.
Generally speaking, other side effects may be caused by a reaction to the injection and not the peptide.
What are some of the common mistakes you see with peptide therapy?
- Starting with too many peptides all together. Instead, start slow and see how you feel.
- Unrealistic expectations. Peptides are not magic potions. Before you start your therapy, understand the potential benefits and risks. Know the reasons you want to take them for, how long you may need to continue, and what happens after you stop.
- Neglecting other important lifestyle choices. Proper nutrition, sleep, and stress management for example, can play a key role in many conditions and should be considered. In fact, a healthy lifestyle may also improve the effectiveness of peptide therapy.
- Not addressing the root cause. Peptides are not cure all wonders. Work with your doctor to make sure you identify and treat the root cause of your health concerns.
- Where to buy peptides? Many peptides are injected and go directly into your bloodstream. For this reason, you want to make sure what you’re putting into your bloodstream is as pure as possible and isn’t contaminated. It is very important to get peptides from a compounding pharmacy with a doctor who knows how to properly regulate and stack the peptide. Be safe! Save yourself a lot of trouble and do not waste your money on peptides from untrusted sources.
Do I have to use injections as a part of my peptide therapy?
Some good news for those of you who are nervous about injections. You may still be able to enjoy the benefits of peptide therapy, as there are some needle-free options. But are they as effective as injections?
While we used to assume that injectable peptide therapy was the best way to go, we now know it’s not always the case. Depending on the peptide and your specific health condition, there may be other options. For example:
- KPV and some growth hormone releasing peptides are commonly used orally.
- For local pain, creams or skin patches with peptides may help.
On the other hand, someone with a leaky gut or gut inflammation, may not be able to absorb the peptides orally, so at least initially, injections or IV infusions may be required.
The bottom line: many peptides still require subcutaneous injections, but there may be other ways that can be effective for you as well. Save yourself the guesswork and consult with a qualified health practitioner who can tailor the best plan for you.
What should I expect? How long do peptides take to work? How much does peptide therapy cost?
- Peptide therapy’s duration varies. If you are looking to use peptide therapy to cure an acute problem like an elbow or a knee injury, then it may be a one-shot deal. You may be done after a few weeks. Other uses that may involve a lifelong issue such as chronic inflammation or autoimmune disease are likely to require longer protocols. Then, there are peptide therapies that require ongoing use. For example, a typical anti-aging peptide therapy protocol may include 2-3 “cycles” a year.
- The cost of peptide therapy runs the gamut. It depends on what you are taking the peptides for. For example, a full-blown anti-aging regimen that’s include peptide therapy along other things like NAD or rapamycin could run well over $1000 twice a year. Just so you know, a typical cost of one bottle of a single peptide from a compounding pharmacy can range from $100-$500. So, if you start with single peptide therapy, the average cost may be $600-$700 a month.
- Frequency of injections. On average, most peptides require a subcutaneous injection once or twice a day. Some peptides may require less. It all depends on the type of peptides and your objectives. Keep in mind, 95% of injectable peptides are injected subcutaneously, which means that you use a very thin and small needle to inject the peptide into the fat layer under the skin. This is the same way people with diabetes inject insulin. It is much less scary or painful than you may think.
I believe peptide therapy will be an important component of the future of medicine, especially because of the very specific way it acts and the minimal side effects. While more research is needed to fully understand the exact way some peptides work including potential combination of peptides, etc., we still have enough data for a safe and effective peptide therapy right now. Especially regarding gut issues, joint problems and inflammation.
If you consider peptide therapy, I highly recommend that you work with a qualified health provider. Peptides types, doses and programs are not a one size fits all treatment. Work with a professional who understands their complexity and can help you experiment, heal and optimize safely.
- Peptide therapeutics: current status and future directions
- Human Growth Hormone, PubMed search
- Peptide based therapeutics and their use for the treatment of neurodegenerative and other diseases
- Future directions for peptide therapeutics development
- Brain-gut Axis and Pentadecapeptide BPC 157: Theoretical and Practical Implications
- Antiinflammatory effect of BPC 157 on experimental periodontitis in rats
- PT-141: a melanocortin agonist for the treatment of sexual dysfunction
- The Mitochondrial-derived peptide MOTS-c promotes metabolic homeostasis and reduces obesity and insulin resistance
- Peptide Therapy: Tapping into the Body’s Natural Healing Intelligence - December 9, 2020