People using increasingly popular “wellness” peptide products have no reliable way to know whether the substances are safe or effective, according to a new white paper from two patient safety groups.

The Institute for Safe Medication Practices (ISMP) and ECRI say the commercial market for compounded peptides has outpaced the scientific evidence for their safety and effectiveness. Various types are marketed for muscle building, injury recovery, and immune support. 

Many of the products, including BPC-157, TB-500, and epitalon, are not approved for human use and have not undergone adequate clinical testing. 

The warning comes amid a recent move by the Trump administration to remove the substances from a list barring them from being compounded because of safety risks. The FDA in April 2026 set meetings with an advisory committee to discuss allowing the peptides to be compounded. 

US Department of Health and Human Services Secretary Robert F. Kennedy, Jr, has said he previously used peptides to heal injuries. 

“This action begins to restore regulated access and will immediately begin shifting demand away from the black market,” Kennedy wrote about the decision on X.

Critics, however, say the policy change was not accompanied by new clinical evidence demonstrating the peptides are safe or effective.

“Patients are injecting substances that have never been adequately tested in humans, based on marketing claims the available evidence simply does not support,” said Rita Jew, PharmD, president of ISMP. 

Despite the risks, patients can easily obtain peptide products online, often labeled “for research use only.” Many are sold without prescriptions, pharmacist oversight, or standardized quality testing, according to the report. 

Clinicians who work in obesity and nutrition medicine say the growing interest has become increasingly common in patient conversations. 

“The success of GLP-1 medications has put the word ‘peptide’ into everyday vocabulary, and I think many patients may not understand the difference between something that went through rigorous FDA trials and something sold online with no regulatory oversight,” said Abeer Bader, RD, lead clinical nutrition specialist at the Weight Center, Mass General Hospital in Boston, who was not involved in the white paper. 

Contamination and Safety Risks

Patients are increasingly hearing about products such as BPC-157 for recovery and growth hormone secretagogues for antiaging from social media and wellness influencers, Bader said. 

“The broader peptide conversation is everywhere now,” she said.

But the report highlights major gaps in human research. For one widely marketed peptide, BPC-157, published studies were mostly conducted in animals, with no phase 1 safety trials or controlled studies demonstrating effectiveness in people.

Previous testing of products sold through unregulated channels — known as “gray market” peptides — found purity levels ranging from 5% to 75%, according to the groups. Some samples also contained arsenic and lead at levels exceeding established safety limits for injectable drugs.

Jew said, the current market raises concerns similar to those exposed during the 2012 outbreak of fungal meningitis linked to compounded steroids, which killed dozens of people nationwide due to contamination.

“Wellness companies offering peptides fall into regulatory loopholes in a similar way to how compounding pharmacies did back in 2012,” she said. “These companies are not currently regulated by any existing regulatory agencies.”

The white paper also cites reports of serious adverse events associated with some peptides, including cardiac events, kidney dysfunction, melanoma, and infections.

“For me, this is really a safety conversation more than anything else,” Bader said. “I understand why people are drawn to these products — they want to feel better, recover faster, age well. Those are legitimate goals. The issue is that for most wellness peptides, we simply don’t have the human clinical trial data to know whether they work or what the risks are.”

Evidence-based approaches to metabolic health are overshadowed by the promise of quick results, she said.

“The fundamentals we know are effective — nutrition, adequate protein, physical activity, sleep, and stress management — these often get overlooked,” Bader said.

Jew said, clinicians should specifically ask patients where they are obtaining peptides and monitor for signs of infection, immunologic reactions, and other unusual symptoms.

Clinicians may also need to begin routinely screening patients about peptide use in the same way they ask about supplements, Bader said.

“If clinicians aren’t asking, patients aren’t telling and that means people could be self-injecting products with unknown contents alongside prescribed medications, with no one on their care team aware of it,” she said.

Jew and Bader reported having no relevant conflicts of interest.

Lara Salahi is a health reporter based in Boston.