Illegal peptides are still being openly sold and promoted to Australians across dozens of websites despite a crackdown by the regulator.

Earlier this year, the Therapeutic Goods Administration (TGA) issued a warning about the dangers of importing, supplying, compounding, or advertising peptides that it has not evaluated for safety, quality, or effectiveness.

Since then, the TGA has targeted the suppliers of illicit peptides, but the online marketplace is thriving — and more Australians are landing in the hospital with serious side effects after using black-market peptides.

In May, the TGA seized almost a million units of illicit pharmaceuticals, including hundreds of peptide vials, as part of a global police operation that saw 5700 online sellers shut down.

The TGA also issued 27 infringement notices and a fine of more than $100,000 to a person living in New South Wales (NSW) who had supplied the unapproved peptide melanotan II to Australian consumers.

The TGA issued a warning in June about the serious adverse effects associated with using unapproved peptides, which include liver damage, severe allergic reactions requiring hospitalization, and inflammation.

Peptides are naturally occurring short chains of amino acids that perform functions inside the human body, including acting as hormones, stimulating growth, repairing tissue, and modulating metabolism.

Some peptides are approved for use in people, such as insulin and GLP-1 receptor agonists. Others have not been studied in humans but have long been popular among bodybuilders and influencers.

Online vendors often claim that unapproved peptides have a range of health benefits, such as weight loss, muscle growth, skin improvement, and antiaging effects, but the evidence is absent.

Peptide Craze Online 

The internet is flooded with illicit peptides. Medscape News Australia counted 30 online vendors marketing unapproved peptides to Australians, including melanotan II, BPC-157, GHK-Cu, CJC-1295, TB-500, and retatrutide.

“This is the beginning of the boom, not the peak,” Casey Jones, the director of Medical Marketing Group, told Medscape News Australia. 

Jones recently surveyed 50 Australian peptide vendors and clinics as part of an internal review for his marketing agency. Of these vendors, 36 had websites that were “clearly noncompliant” with TGA regulations, he said. These websites named prescription-only drugs and claimed that unapproved products had health benefits.

Many websites included disclaimers saying, “This product is for research purposes only,” a tendency that has “drifted over from the US market,” said Jones. “Consumer-focused claims, lifestyle imagery, a checkout page, and then a small line somewhere saying, ‘Research only.’ It’s like putting a sign on a door that says, ‘This is not a door,’” he said.

“You cannot advertise prescription-only medicines to the Australian public,” said Jones. “It’s not a gray area, and a disclaimer doesn’t fix it. We stopped [our survey] at 50 [vendors] but could have kept going,” he said.

Busy Helpline 

A Queensland-based helpline called Steroid QNECT now receives more than 10 calls/wk about peptides from people needing support. This number is a “noticeable increase,” compared with 6 months ago, Timothy Piatkowski, PhD, a public health researcher at the University of Queensland in Brisbane, who helps run the service, told Medscape News Australia.

The helpline pursues harm reduction. “People are already doing these things, so we are there to support safer use,” said Piatkowski, who used peptides as part of his strength training regimen as a teenager.

Some callers to the helpline are using peptides for cosmetic reasons, while others are after performance enhancement or want to address a chronic health issue, he said. The side effects that they report include injection-site reactions, gastrointestinal symptoms, fatigue, headaches, and unexpected effects.

Some peptides are bought at compounding pharmacies with a prescription, but most tend to be purchased online via illicit markets that evade regulatory oversight, quality assurance, and sterility requirements, said Piatkowski. “ Consumers generally have no reliable way of verifying what is in the vial,” he said.

An investigation by the Australian Broadcasting Corporation found that a vial of injectable retatrutide had nearly double the labeled concentration of the active ingredient, thus dramatically increasing the risk for an overdose.

A study published in 2018 reported that 10 illicit peptides on the Belgian market contained arsenic and lead, both of which are highly toxic to humans.

It’s not uncommon for people to use two to six peptides at once, a practice known as stacking, which makes it much harder to pinpoint the cause of side effects and identify drug interactions, said Piatkowski.

Rise of the Peptide Clinics 

Some Australian healthcare providers are pivoting to peptides as a business strategy, describing their facilities as peptide clinics or explicitly promoting peptides as a treatment option online.

Medscape News Australia counted 13 Australian peptide clinics, including Pepticlinic, Vitahealth Clinic, thevitadrip, cosmedix, Hydralyfe, ivplusdrips, Bio Regeneration Clinic, and Human Performance Health Clinic.

The following four peptide clinics named prescription-only, unapproved peptides on their websites: Folium Dispensary and Wellness Centre, GL Vitality Drips, Rumen, and BioV8.

Peptide clinics usually offer a consultation with a healthcare professional who prescribes peptides that can be accessed through a compounding pharmacy.

One Australian clinic called Bobbi was reported to be prescribing the unapproved peptide CJC-1295 via 15-minute GP telehealth consults before it went offline in May.

There is a legal pathway for prescribing, importing, compounding, or selling unapproved peptides in Australia, but “the legislation is complex and layered,” criminal lawyer Zoe Whetham told The Law Society of NSW. Practitioners violating regulations leave themselves “at risk of significant penalties, including imprisonment,” she said.

Doctors should not be prescribing peptides that have not been tested in humans or approved by the TGA, Caroline Johnson, PhD, a general practitioner, researcher, and associate professor of general practice and primary care at the University of Melbourne, told Medscape News Australia.

Patients should also be wary of clinics that heavily promote one treatment, such as peptides, because these businesses “ may not have that capacity to look at you as a whole person” and might not communicate their findings to general practitioners, she said.

People should not assume that topical agents are safer than injectables, said Johnson. “It doesn’t matter how you take them, the risk is still real,” she said.

Johnson reported having no relevant financial relationships. 

Piatkowski reported receiving funding from the National Health and Medical Research Council, Queensland Mental Health Commission, Queensland Injectors Health Network, and Hyphen Health. He reported being affiliated with the Queensland Injectors Voice for Advocacy and Action, the Loop Australia, and the Enhanced Games. 

Jones reported being director of Medical Marketing Group, a healthcare-only marketing agency whose clients included clinics run by Australian Health Practitioner Regulation Agency-registered practitioners that prescribe peptides. Neither Jones nor the agency reported holding any financial interest in, or receiving payment from, any peptide manufacturer, supplier, or pharmacy. None of the 50 websites in our review are current or former clients of Medical Marketing Group. Jones reported receiving no payment in connection with this article. 

Felicity Nelson is a freelance journalist based in Sydney, Australia.