I’m a Longevity Doctor. Here’s Why I’m Fighting for Safe Access to Peptides.

Mike is in his 70s, but you’d never know it watching him ride over three mountain passes in Colorado’s Triple Bypass race or ski downhill like an Olympian. A lawyer by profession, he spent decades building a life that revolved around the mountains — until two health conditions threatened to take it all away.

Mike developed ankylosing spondylitis, a severe form of spinal arthritis, along with ulcerative colitis. The two conditions often occur together. They left him in debilitating pain even after a hip replacement. His doctors told him: This is your life now. Learn to live with it.

I didn’t accept that. I treated him with the injectable peptides BPC-157, which is great for soft tissue healing and easing joint pain, and Thymosin Beta-4, an anti-inflammatory that helps with tissue repair. He eventually stopped needing his other medications and went back to skiing black diamond trails and climbing mountain cliffs.

Mike will tell you that a simple molecule he couldn’t access until he walked into my clinic gave him back everything he thought he’d lost.

I have a thousand stories like Mike’s. That’s why I went to Washington, D.C., in July and testified before an FDA advisory committee in support of legal, physician-supervised access to peptides.

About the Expert

Elizabeth Yurth, M.D., is the Chief Medical Officer of the Boulder Longevity Institute and a Hone-affiliated physician.

What Even Are Peptides?

Peptides are short chains of amino acids, the building blocks of proteins. Some are already widely used as medicines. Insulin is a peptide. So are GLP-1s like semaglutide (Ozempic) and tirzepatide (Zepbound).

What makes peptides powerful is their precision. Each one can lock onto a specific receptor on a cell and deliver a signal — to repair tissue, reduce inflammation, release growth hormone, or regulate metabolism.

By contrast, many traditional drugs affect several parts of a biological system at once — I call it “carpet-bombing” the whole system. I have seen the more targeted action of peptides reduce unwanted side effects.

What 10 Years of Using Peptides Has Taught Me

I’ve been the Chief Medical Officer of the Boulder Longevity Institute for 20 years; it’s one of the longest-running longevity clinics in the world.

I came to this field from orthopedics. Again and again, I saw patients who still had pain after steroid injections, joint replacements, and other conventional treatments. That frustration drove me to retrain in longevity and healthspan medicine.

For nearly 10 years, I’ve prescribed peptides made by licensed compounding pharmacies, with dosing tailored to each patient. I’ve watched peptides change lives when conventional treatments couldn’t. I’ve also watched access to peptides become increasingly restricted.

Why I Stepped Into Policy

As a physician, I used to think advocacy wasn’t my lane. For 30 years, I stayed in the exam room, seeing one patient at a time and trying to work within a system I often disagreed with.

What changed my mind was simple: If physicians who understand these compounds don’t speak up, patients could lose access to treatments that have spared them serious pain and suffering.

Medicine can be slow to change. It’s hard to unlearn decades of training, and new approaches can challenge established standards of care. That resistance won’t disappear on its own.

What the FDA Is Considering

On July 23 and 24, the FDA’s Pharmacy Compounding Advisory Committee, or PCAC, met to consider whether licensed pharmacies should be allowed to compound seven peptides for individual patients.¹

To permit that, the FDA would need to add the peptides to what’s known as the Section 503A Bulk Drug Substances List, or 503A Bulks List. If a substance is on the list, doctors can prescribe it and licensed pharmacies can prepare it.

If a peptide isn’t on this list, patients may turn to unregulated online sellers, often without medical supervision or reliable quality controls.

Before the hearing, FDA scientists recommended rejecting all seven peptides, saying there wasn’t enough evidence that the compounds were safe and effective.²

The committee voted the other way on six of them.³

BPC-157, KPV, TB-500, and MOTS-c passed on day one. Semax and Epitalon passed on day two. The only rejection was emildeltide, also known as DSIP, or Deep Sleep Inducing Peptide, which failed 6-7.

The votes are ultimately just recommendations. The FDA must still complete a formal rulemaking process before licensed pharmacies can compound any of the six peptides under 503A. That typically takes more than a year.

Why the System Creates a Catch-22

The FDA says peptides need more research, but it demands data that its own rules make nearly impossible to collect.

Large, double-blind, placebo-controlled trials can take years and cost millions of dollars. Because many of these molecules can’t be patented, pharmaceutical companies have little reason to fund those trials. The system then points to the lack of data as a reason to deny access. It’s a catch-22.

What we do have is something arguably more meaningful: years of real-world evidence from thousands of physicians using these compounds under careful clinical supervision, with thousands of patients, over a decade or more. That evidence isn’t as rigorous as a controlled trial, but it shouldn’t be dismissed.

Montana’s recently passed “Right to Try” law offers one potential model for studying experimental compounds legally in monitored patients. Unlike Colorado’s version, which applies only to people with terminal illnesses, Montana’s law gives more doctors and patients a legal framework for trying certain compounds and tracking what happens.

I also believe the FDA gives too little weight to research conducted outside the United States. Semax, for example, has been used clinically in Russia for more than 20 years and has been studied in Russian-language research. Thymosin Alpha-1 is approved in other countries for certain cancers and immune-related conditions.

Research conducted in another country may not answer every question about how a peptide should be used here. But it should still be part of the scientific conversation.

What’s more, in my experience, the peptides I prescribe have caused fewer serious complications than some FDA-approved treatments. For example, I’ve seen gastrointestinal bleeding from widely approved anti-inflammatory drugs, but I’ve never seen it from the peptides BPC-157 or TB-500. 

What Happens If the FDA Doesn’t Support Safer Access

Patients who have experienced results like Mike’s aren’t going to stop looking for these compounds. If doctors can’t prescribe them, many patients go online.

They buy research-grade vials from overseas sellers with no medical oversight and no guarantee that the product is sterile, accurately dosed, or even correctly labeled.

When we’ve tested peptides bought through the gray market, we’ve found more than inaccurate labels. Nearly all the samples contained significant contaminants, including heavy metals, even when the amount of peptide matched what was listed on the label.

We’ve seen this pattern before. During Prohibition, cutting off the legal alcohol supply didn’t eliminate demand. People made or bought unsafe alcohol, sometimes with devastating consequences.

Restricting safe access doesn’t stop use. It just removes the safeguards around it.

What’s Next for Peptides

The PCAC committee recommended adding six of the seven peptides to the 503A Bulks List: BPC-157, KPV, TB-500, MOTS-c, Semax, and Epitalon.

That’s a significant step, but it doesn’t change any policies yet. The FDA must publish a proposed rule, accept public comments, and issue a final rule before licensed pharmacies can compound the six peptides under 503A. That process could push pharmacy access into 2027.

In the meantime, physicians need to keep collecting data in a rational, consistent way. We need knowledgeable doctors tracking patient outcomes, side effects, dosing, and other meaningful measures. Better evidence will help us separate real benefits from noise.

For Mike, and for thousands of patients like him, the committee’s vote is a step in the right direction. But until the FDA finalizes its decision and physicians can prescribe these peptides through legitimate pharmacies, the fight isn’t finished.

About the author

Elizabeth Yurth, M.D., is the Co-Founder and Chief Medical Officer of Boulder Longevity Institute, where she has been providing Tomorrow’s Medicine Today to her clients since 2006. Along with her 25-plus years as a practicing orthopedist specializing in sports, spine, and regenerative medicine, Yurth is double-Board Certified in Physical Medicine & Rehabilitation and Anti-Aging/Regenerative Medicine.