Peptides are short chains of amino acids that act as signals in the body. Many of the hormones you already know, including insulin, are peptides. Therapeutic peptides are versions of those signals, prescribed to nudge a specific process: prompting the pituitary to release more growth hormone, accelerating tissue repair, or reducing visceral fat. They are given by small subcutaneous injection, usually self-administered at home.
At NYMD Center peptide therapy is part of our longevity medicine program, and it works the way the rest of that program works. There is an evaluation, there are labs, and there is a defined goal before anything is prescribed. Dr. David Shusterman, who wrote the book Peptides Unlocked, leads it. We are not a menu, and we are frank that the evidence behind different peptides varies widely and that the regulatory status of compounded peptides has changed more than once in recent years.
Who it affects and the symptoms that bring people in
Three kinds of patients come to us about peptides. The first is an adult in his or her forties or beyond who has noticed that body composition is drifting, with more fat around the middle and less muscle despite the same effort, and whose sleep has become lighter and less restorative. Growth hormone output falls steadily with age, and these are the changes that follow.
The second is someone recovering from a tendon, ligament or muscle injury that is healing slowly, often an athlete or a patient after surgery, who has read about peptides that support tissue repair.
The third has already been offered peptides, often bundled with testosterone by a clinic that did not run labs or explain what either one does, and wants a physician's opinion before continuing. That is a good instinct, and we are glad to give it.
How we evaluate it at NYMD Center
The evaluation is a full visit, not a questionnaire. We take a history that covers your goals, training, sleep, prior hormone use, and family and personal history of cancer, because growth hormone pathways are not something to stimulate in someone with an active or recent malignancy. The exam includes weight, waist and blood pressure.
Labs through our on-site lab include a metabolic panel, fasting glucose and A1c, lipids including ApoB, IGF-1 as a measure of growth hormone activity, thyroid function, and a hormone panel including testosterone and, for women, estradiol and FSH. For body composition goals we obtain a baseline DEXA scan so that changes in visceral fat and lean mass can be measured rather than guessed at. If the history suggests sleep apnea, we evaluate that first, because no peptide fixes it.
Then we set a goal in writing: a change in a measurement, a symptom, or a recovery milestone, and a date to check it.
Treatment options
Lifestyle, sleep and resistance training
We say this first because it is true: strength training, protein intake and sleep do more for body composition and growth hormone release than any peptide, and a peptide layered on top of none of them does little. Every plan starts here and continues here.
Growth hormone secretagogues (ipamorelin, CJC-1295)
These peptides prompt the pituitary to release its own growth hormone in pulses, rather than supplying the hormone from outside. Ipamorelin is selective and has less effect on cortisol and appetite than older agents; CJC-1295 extends the signal. Used together at bedtime they are prescribed for body composition and for deeper sleep. The benefits accrue over months. The trade-offs are nightly injections, water retention or tingling early on, a need to monitor glucose and IGF-1, and a cost that insurance does not cover. Our earlier post on the benefits of ipamorelin goes further.
BPC-157
A peptide derived from a protein in gastric juice, prescribed for tendon, ligament, muscle and gut recovery. The laboratory and animal evidence for faster tissue healing is consistent; human trial data is limited. We prescribe it for a defined injury over a defined period, with a physical exam or imaging to confirm the injury and to judge the result. Its compounding status has changed and may change again, and we will tell you where it stands.
Tesamorelin
A growth-hormone-releasing hormone analog with the strongest clinical evidence of the group, approved for reducing visceral abdominal fat in a specific population and prescribed off label for the same purpose in others. It is the peptide we consider when DEXA shows visceral fat as the problem. Daily injection, monitoring of glucose and IGF-1, and cost are the considerations.
What we do not do
We do not prescribe peptides without labs, without a goal, or as an automatic add-on to testosterone. We do not source from unlicensed suppliers, and we do not prescribe peptides that cannot currently be legally compounded. If your goal is better served by treating low testosterone, sleep apnea or diet, we will say so.
What to expect at your visit
The first visit, at the Manhattan office or by telehealth with labs drawn in the office, runs about forty-five minutes and covers the history, exam and the conversation about goals and evidence. Labs are drawn the same day and DEXA is scheduled if body composition is the target. A follow-up within two weeks reviews results and, if a peptide is appropriate, you receive the prescription through a licensed compounding pharmacy, injection teaching, and written instructions.
Follow-up visits, usually at six to eight weeks and then every few months, repeat the relevant labs and the DEXA where it applies, and compare the result against the goal. Courses run in cycles and end with a reassessment rather than an automatic refill. You can reach the team between visits through the patient portal with questions about injections or side effects.
Questions patients ask
Are peptides the same as steroids or growth hormone?
No. Anabolic steroids are synthetic testosterone derivatives. Growth hormone is the hormone itself, given by injection. The peptides we use most, ipamorelin, CJC-1295 and tesamorelin, work upstream by prompting your pituitary to release its own growth hormone in a more natural pulse. That is a meaningfully different mechanism with a different safety profile, though it still needs monitoring, particularly of glucose and IGF-1.
Are peptides legal and FDA approved?
It varies by peptide, and it changes. Tesamorelin is FDA approved for a specific indication. Most others are prepared by compounding pharmacies under a physician's prescription, and the FDA has restricted which peptides pharmacies may compound, with the list revised over time. We prescribe only through licensed pharmacies, only peptides that can currently be compounded, and we tell you when the regulatory picture changes. Peptides bought online without a prescription are outside all of that.
How strong is the evidence?
Uneven, and we say so. Tesamorelin has well-designed clinical trials behind it. Growth hormone secretagogues have solid data on hormone release and reasonable data on body composition and sleep. BPC-157 has encouraging laboratory and animal work but limited human trials. We prescribe where the mechanism is clear and the expected benefit is worth the cost, and we stop when the marker we agreed to track does not move.
Do I have to be on testosterone to use peptides?
No, and we are wary of the reverse assumption. Some clinics add peptides automatically to every testosterone prescription. We evaluate each separately. Many patients use a peptide alone; some use both when labs and goals support both. Testosterone therapy has consequences of its own, including suppression of natural production, that need their own conversation before anything is added on top.
How long does a course last?
Most courses run in cycles of several weeks to a few months, followed by a reassessment. We set a goal at the start, such as a change in visceral fat on DEXA, in sleep, or in recovery from a specific injury, and check it against labs and your own report. If the goal is met or clearly not going to be, we stop. Indefinite use without a reason is not something we support.
Make an appointment
Manhattan (212) 991-9991 · Forest Hills (718) 360-9550 · same-week visits, most major insurance accepted.