MDLinx asked me what happens when do-it-yourself peptide injections land patients in a clinic. I told them what I tell the patient: show me the vial.
“Most patients have never been told that ‘compounded’ and ‘FDA-approved’ are different things, and once they see that the label makes no claim about what is actually inside, the conversation changes.”
What are people injecting?
“The most common peptides I’m seeing patients self-inject are the stacks. The Wolverine stack, the Glow stack, and the KLOW stack.”
“Unfortunately, I am seeing a lot of these come from unlicensed sources. A lot of people are buying these from their trainers, or at the gym. But I think the greatest amount of people are buying them from the internet, from unknown sources. And that is where the real danger lies.”
“I can also say that NAD+ is a very popular self-injected substance, even though it actually is not a peptide.”
What does the label actually say?
“A compounded product from a 503A or 503B pharmacy is made under FDA-regulated conditions, sterility-tested, and labeled with a verified dose and purity. By contrast, any vendor, on the internet or anywhere else, can simply stamp ‘for research purposes only’ on a vial.”
I prescribe compounded medications, through a licensed pharmacy, with a prescription.
What does it look like when it goes wrong?
“Yes, I’ve had a patient, a male in his 30s, who was self-administering the Wolverine stack, which he purchased on the internet. He came in with a red area in the buttock, with fevers and night sweats. When we examined him, he had an area that was boggy. We went ahead and lanced it and removed purulent discharge, and we started packing it for about a week, with antibiotics. The cultures came back as Staph aureus. Luckily, it was not methicillin resistant, which would be MRSA. And the patient recovered and healed well.”
“We did note on that examination that he also had some nodules throughout previous injection sites. This could have been due to the substance not being pure or completely aseptic. The nodules could also be from the injection technique itself, the aseptic technique, or the body’s own response creating fibrosis.”
“I have seen many cases like this, so this is not an isolated case. And the common denominator in all these cases has been that the substances or the peptides have been acquired through unlicensed sources. To avoid this, I recommend obtaining all peptides from a certified pharmacy through your physician.”
When should you stop watching and come in?
“I also tell them what a normal injection site looks like at 24 hours versus what should send them to a physician the same day: expanding redness, warmth, fever, or a nodule that is still growing at day five.”
I have written before about what a peptide is and what monitoring means when it is done properly, and about fillers and neurotoxins bought online, which is a separate mess. The full patient version of this one, with the stack table and the label comparison, is on swplasticsurgery.com.
Bring the vial.
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