When did peptides, the body’s building blocks, move out of the lab and into the retail landscape? As the cachet of social media wellness influencers has grown, so has patients’ interest in using unregulated, injectable peptides to clear skin, build muscle, fight aging, and “maximize” their physical appearance. The trend has become so pervasive that Health Canada issued a public advisory in early April warning consumers of the dangers and illegality of purchasing peptides online. A year earlier, the Canada Border Services Agency also seized more than 40 unauthorized injectable formulations from a wellness center in Calgary.

Peptides have been studied for therapeutic purposes for roughly a century and are readily available for research purposes from various companies and Canadian compounding facilities. But the products that are tempting consumers are not the same approved peptide products that have met Health Canada safety standards (eg, insulin or GLP-1s such as Ozempic).

There is a big difference between research-grade peptides and peptides for human use, said Carlie Charron, PhD, assistant professor of chemistry at Dalhousie University in Halifax, whose research involves the application of peptides to cancer detection.

“What I use in my program are building blocks to make peptides for research use, meaning that their purity is lower,” Charron told Medscape News Canada. “For all the things that I am doing, like working with cells or smaller animal models, I don’t have to worry about reaching the high purity bar set by Health Canada. The difference is that what I make in my lab is not suitable for human use because I don’t go through all the regulatory standards and approval.”

The risks arise when stringent standards are bypassed, Charron added.

Riding the GLP-1 Wave

Much of the current hype around peptides started to gain speed while demand for GLP-1s was rising. Though US wellness influencers hold sway around the world, many Canadian influencers are also making unproven health claims or providing sourcing information on social media platforms such as TikTok.

“Social media has pushed peptides into the mainstream, online sellers have made them easier to get, and the success of drugs like the GLP-1s created a kind of halo effect and normalized the idea that it’s okay to inject yourself with something for health as opposed to it being a high-risk behavior,” Stuart Phillips, PhD, Canada Research Chair in Skeletal Muscle Health in Aging at McMaster University in Hamilton, Ontario, told Medscape News Canada.

“People hear the word ‘peptide’ and think, ‘Oh, this sounds modern and medical, so it must be legit.’ That’s a bad leap,” said Phillips. “‘Peptide’ is a chemistry term, not a proof-of-efficacy term.”

“I call it ‘scienceploitation,’” said Timothy Caulfield, health misinformation expert, professor of law and public health, and research director of the Health Law Institute at the University of Alberta in Edmonton. “It’s when you take a real and genuinely exciting area of science and exploit it to build a brand or sell products. It’s a very common strategy in the wellness space,” he said.

Influencers often rely on a small amount of data from things such as animal studies to support an immediate clinical application, Caulfield explained. The challenge is that it’s rare for an animal study to translate into useful clinical applications. However, because legitimate and effective drugs such as Ozempic are available, it can be difficult to counter the misinformation.

Unregulated and Risky

One of the largest challenges associated with unregulated peptides is the ease with which companies have been able to acquire these short chains of amino acids from authorized and unauthorized commercial labs and program instruments to create various formulations overnight.

“The formulation is very important. It’s confirmed by Health Canada to be a specific recipe for what goes into the final drug product,” said Charron. “The peptides are only a small portion of what’s in the vial and aren’t immediately a drug. We need to add things to it that are important as well. So the identity of each of these components on top of peptides needs to be verified.”

Because unregulated peptides for research use do not undergo testing and approval, quality is often an issue, as are the risks for exposure to harmful contaminants, the dosage, and safety and efficacy.

“To me, the biggest danger is not just that it might not work, it’s that people often have no real idea of what’s in the vial, if the dose is accurate, whether the product is sterile, if there are contaminants, or even if the label is correct,” said Phillips. “Once you inject something, you’ve bypassed some of the body’s usual barriers — such as the digestive system, kidneys, and liver, which filter out toxins,” he said.

Countering Peptide Fever

The list of risks associated with the use of unregulated, injectable peptides is long. It includes hormonal imbalances, blood sugar imbalances, mood swings, liver or kidney damage, blood clots, cancerous tumors, infections, and allergic reactions.

In Canada, physicians remain the most trusted sources for health advice, trumping even the most influential influencer. Caulfield emphasized the need for greater awareness among clinicians of health trends such as peptides.

“It’s becoming increasingly important for physicians, especially primary care physicians, to have an awareness of the bunk that is emerging online” and to be made aware of the lack of evidence supporting the claims, said Caulfield. “There’s a real potential for harm; it’s biologically active.”

The attention being paid to peptides provides an opportunity for clinicians to explain to patients that testimonials from wellness influencers do not equate to good evidence, Caulfield suggested.

Similarly, the existence of legitimate peptide-based drugs that are useful in medicine does not validate the world of gray market peptides, said Phillips.

“There’s a problem of false attribution,” he said. “People might take two or three things at once, or an injury might improve as time passes, and the peptide gets the credit. That’s one reason that anecdotes are so powerful and misleading,” he explained.

Thus far, Health Canada has not made a direct causal link between reports of adverse effects and the products being taken, but it is taking the reports seriously. For doctors, clear communication with patients about which peptides have a solid, evidence-based, medical purpose and have been cleared for use is imperative.

Charron, Phillips, and Caulfield reported having no relevant financial relationships.

Liz Scherer is an independent health and medical journalist. She frequently reports on Canadian and European health news.