Regulation is Public Health - Unregulated Peptides

Perhaps buying unregulated drugs from china off the internet like they are some supplements being sold by influencers isn't a good idea. 

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Transcript

SPEAKER_00 0:05

Welcome back to Everything Is Public Health. I'm MJ. And I'm Cass. When we started this podcast a few years ago.

SPEAKER_01 0:11

So many moons ago. Look how long we've lasted, by the way.

SPEAKER_00 0:14

Yeah, exactly. We said we'll never run out of topics. True. Because public health is such a wide space. That statement has never been more true. There is a public health crisis every other day in 2026, it seems. So we have even more topics to talk about. Topics that we didn't even think were gonna be topics. So much fun. How much do you know about Ozempic, Cass?

SPEAKER_01 0:34

Oh, it's a good question. I know some things, which one might consider a lot of things. I would say very specifically Ozempic. Uh, I'm not 100% sure, but GLP1s as like a broader category. I know things like it can help people lose weight who have otherwise been struggling. I think it originally started for diabetic-specific patients to try to help them manage their weight because of the association with blood sugar and weight and some challenges. I know that we hear on the media all the time about all the really, really good things about GLP ones, but I also know that there are challenges with bone density and demineralization and fracture risks and and other problems. So, and there's like a gajillion different kinds of GLP ones, but there's a lot of attention on all the really good things. Oh, I also know from people who take them that I know that even if you don't like puke your guts up when you take it, you feel super nauseous after you take it, like after you've administered the shot.

SPEAKER_00 1:37

Okay.

SPEAKER_01 1:37

And so a lot of people don't feel super great right after they take it. But I also know people who have lost tons and tons of weight and say it's like the greatest thing that ever happened to them because they really struggled. So we're getting lots of positive stuff, and I don't think that there's been enough attention on the negative stuff. That was probably a longer answer than was required, but there you go.

SPEAKER_00 1:53

Well, it seems like you know a lot about Ozempic, is from what I've seen. You when you said, Oh, I don't know a lot.

SPEAKER_01 1:59

I don't really know how it functions, but I know other stuff.

SPEAKER_00 2:02

You know way more than the average American, which I guess is not surprising. But Ozempic, like you said, is now a viral weight loss drug that was originally meant to be a treatment for type 2 diabetes patients. It's a brand name for the medication, semaglutide, and it's one of several of its class, which are GLP1 agonists. So a little quick rundown on what it is.

SPEAKER_01 2:24

GLP1 agonists mimic GLP1, which is a glucagon-like peptide 1. GLP1 is a hormone naturally secreted by specialized cells in the intestine, typically after a meal. The primary function of GLP1 is promoting insulin secretion, regeneration, and other insulin-related functions. Secondary function is decreasing appetite by inhibiting gastric emptying, acid secretion, and stomach motility. It also has other functions with the brain and neurons that are probably beyond the scope of what we need to talk about today.

SPEAKER_00 2:53

Yeah, and like you said, there's a lot of focus on the weight loss component, but that was not its original intent. And it has other side effects that a lot of people don't talk about. So today's episode is not specifically about Ozempic. This episode is about the class of drug that Ozempic belongs to. Caz, have you heard of peptides?

SPEAKER_01 3:12

Of course I've heard of peptides. I was a biology major. Well they are the building blocks of proteins.

SPEAKER_00 3:16

They're peptides as in the biology 101 peptides, and then there's peptides like with a capital P, I guess, that we're talking about today.

SPEAKER_01 3:23

Yeah, I mean, peptides are generally the building block of protein. And proteins are like amino acids. There's some essential amino acids, there's other like some you get from food, some you get from other things. They're essential parts of human functioning.

SPEAKER_00 3:39

They sure are. Ozempic is a peptide drug, and peptides are making their rounds on the internet, being touted by some as the next frontier of medicine, a miracle drug, the magic bullet. Keep that in mind.

SPEAKER_01 3:52

I just have to say, we've talked about this before. Anytime somebody comes to you and says, I have this one simple thing that you can do to solve your problem, or I know exactly what you need, I'm always, as my 18-year-old say, highly sus.

SPEAKER_00 4:05

Uh-huh.

SPEAKER_01 4:06

As in suspect, folks who don't know what sus means.

SPEAKER_00 4:08

I think people can figure out what that means.

SPEAKER_01 4:10

I'm just, I don't know. I don't want to assume.

SPEAKER_00 4:12

Sure.

SPEAKER_01 4:12

But yeah, it frustrates me that I'm just gonna stop there. It just frustrates me, the whole magic bullet thing.

SPEAKER_00 4:17

Yeah, if you're in the public health space or even like in the academic or medical or biology space, like magic bullet is like a huge red flag every time it comes up. This is what I want to discuss today. The peptide craze. I don't know how plugged in you are to the maha wellness grifter tech bro biohacking space. Uh, that was a lot of adjectives smooshed together. Cast, but peptides are making the rounds.

SPEAKER_01 4:37

I did not know that peptides were making their rounds in the maha wellness grifter tech bro biohacking space. But we did touch on that a tiny bit, or at least sort of adjacent when you were talking about look maxing and like some of the things that folks are doing. So I could totally see those people pulling in to their their piece.

SPEAKER_00 4:56

Yeah. So unfortunately, I have to pollute your mind a little bit more today.

SPEAKER_01 5:01

Okay.

SPEAKER_00 5:01

So sorry. You just came back from traveling and you have to learn about like an absolute cursed thing that's going on on the internet right now. But let's start with peptides. So peptides are not just biology 101 peptides. Let's talk about peptides, the drug class, a little bit.

SPEAKER_01 5:14

So, as I mentioned a little bit earlier, peptides are composed of amino acids, the building blocks of proteins. Essentially, peptides are just short chains of amino acids or really small proteins. Proteins are typically large structures and are complex with branches and different linkages, while peptides are typically short, continuous, unbranched amino acids. There are many different naturally occurring peptides in the body. Almost all of them are some form of hormones. And hormones are really just signaling molecules that have widespread and long-term effects on the body. This is in contrast to a neurotransmitter, which are more for immediate and temporary effects. So examples of peptides in the body, insulin, GLP1, oxytocin, growth hormone, parathyroid hormones, angiotensin, etc., there's a whole bunch of them. The general premise: since our bodies have receptors for these peptides, if we can artificially make these peptides and inject them, there should be a corresponding effect.

SPEAKER_00 6:08

Yeah, you could think of this like when we take, for example, birth control pills, they are just hormone agonists. So it's just another version of it. These things naturally exist in our body. If we can make them artificially, they should also have those similar effects if we inject them into our bodies. Peptides genuinely is an exciting new field of medical research. However, they are not that new. When did you think Ozempic, the most widely known and viral peptide, was approved by the FDA?

SPEAKER_01 6:34

Okay, I recall hearing because we sometimes work closely with physicians, sometimes we hear about things before they sort of hit widespread media.

SPEAKER_00 6:42

Yeah, of course.

SPEAKER_01 6:43

So I have had conversations about these kinds of medications. I don't remember exactly when, but I'm gonna take a guess and say at least 10 years ago.

SPEAKER_00 6:52

Nine years ago. You're almost spot on. 2017. And again, Ozempic is like one type of this class. So there's a lot of other drugs that were approved a little bit prior or a little bit after, but 2017, roughly 10 years ago. And that's when they were approved by the FDA, which means they started testing this thing years prior. The typical drug approval process is a long and complicated series of hurdles. The rules are slightly different between a peptide and a traditional drug, but the general gist is the same. So to illustrate how long that process is, Cass, would you do the honors?

SPEAKER_01 7:22

Absolutely happy to. So new compound is discovered. There is animal testing for toxicity and basic information only, which can take years. And then you submit a formal investigation application to the FDA. You do phase one human trials, which are small and just examining safety, which is about a year. Phase two, human trials, 100 plus people looking at effectiveness and safety, which is one to two years. Phase three, human trials, thousands of people examining the details like different population dosages, drug interactions, and more safety and effectiveness. And this can take one to three years. And then review meeting between the drug maker and the FDA. You submit a formal manufacturing application to the FDA, and then you wait, which can be one to two years. Then there's drug labeling determination, facility inspection, approval, and then phase four, which is monitoring.

SPEAKER_00 8:12

Yeah. So we're looking at easily a decade, at least a decade.

SPEAKER_01 8:17

At least, especially because who knows how long that first sort of animal testing and basic information can take.

SPEAKER_00 8:23

Yeah, so it's not new. It's new-ish in terms of drugs, right? Because of the approval process is so long, but it's not super new. It didn't just come out like two years ago. And that's how it's supposed to work. Obviously, the FDA is far from perfect and it has no shortage of criticisms. There is an argument that this process takes too long, but the general premise of want to be quite sure that a particular drug is safe is valid. Actually, some people say the process is too lax because the FDA mainly assesses safety and not effectiveness.

SPEAKER_01 8:50

So I will have a clarifying point. So people talk a lot about the effectiveness of medication, and I want to differentiate efficacy and effectiveness. Like efficacy is can it work in very specific, very controlled, highly dialed-in situations, like these randomized control trials where you have a particular group of people who often don't have any other kind of comorbidities and you're like really laser focused versus effectiveness, which is like generally a broader does it work out in the real world? So efficacy, can it work? Effectiveness, does it work? So I would argue, no, the FDA isn't really thinking about effectiveness. They're actually thinking about safety and efficacy, not necessarily the effectiveness, which is then the phase four monitoring, which happens once it's already released into the wild.

SPEAKER_00 9:38

Yeah, so FDA, they have a difficult job. No matter what they do, someone's gonna hate them. Now, the reason why I wanted to do this episode is because of a concerning trend that I'm noticing in the general public that peptides are at the center of. We did an episode about the decline of public trust in our public health institution under this administration, and this is a little bit adjacent to that. Typically, drugs need to be approved by the FDA to be sold into states, but what if there's a way to bypass this? What if, say, a company just orders peptides from China and sell them as a wellness thing direct to consumers as a supplier? What do you think is gonna happen?

SPEAKER_01 10:14

Oh, I I've seen this happening already. Not for lack of effort of trying to purge my feed. My Instagram is just full of all of these, like hormone. I'm a woman of a certain age, like I got a lot of hormone advertisements from companies or whatever. And I've started noticing. So GLP wants, you need a subscription.

SPEAKER_00 10:33

It's a medication, yeah.

SPEAKER_01 10:34

It's a medication, you need a subscription.

SPEAKER_00 10:35

Prescription, I think. Did you say subscription?

SPEAKER_01 10:37

Oh, prescription. Okay, guys, I've been gone for six days in Providence doing a lot of work. So anyway, you need a prescription for them. But as you were saying, there are companies that are buying these, mixing and matching these peptides, and then selling them in pill form as a GLP one that is not regulated by the FDA, which is terrifying because you have no idea what you were putting into your body, including protein supplements you might buy that are shipped from China or any number of things. Just in general, not good practice to have non-FDA approved things that are would otherwise be considered medication going into your body.

SPEAKER_00 11:14

Yeah. So, uh, Cass, I actually want you to do this a little exercise, very quick exercise with me. Okay. Um, I want you to go to youtube.com. If you look up peptides on social media or YouTube, you will get a deluge of slop content from wellness and biohacking grifters touting that peptides are literally the miracle drug. Yeah, just search in YouTube peptides.

SPEAKER_01 11:35

You're gonna bastardize my YouTube now.

SPEAKER_00 11:37

Well, go to private browsing if you want, but uh it's too late.

SPEAKER_01 11:40

It's too late.

SPEAKER_00 11:40

Go ahead and take a scroll and tell me the title and the type of uh thumbnail that you see.

SPEAKER_01 11:45

Um, okay, so uh the first thing is Peptide World Congress 2026, a CME accredited event covering peptide therapy. Next, it's the doctor explains the 20 most powerful peptides, and the thumbnail is something about how enough to be dangerous. Check peptide standards before you start peptides. Your doctor answers your biggest questions, doctor explains the science behind the peptide craze. Inside the world of internet peptides, I think my algorithm is not what you would find on your thing.

SPEAKER_00 12:15

This is perfect. Go to incognito mode or private browsing, repeat this exercise with none of your algorithm.

SPEAKER_01 12:20

This is hilarious. I was like, I wonder what is gonna show up, but no, none of the things that I was terrified would ruin my feed.

SPEAKER_00 12:27

Let's try with no algorithm. Do you notice a difference?

SPEAKER_01 12:30

Oh, so the first two are the same. Then learn peptides so fast it's unreal. The FDA just changed everything for peptides, my honest take. The FDA suppressed this for years. Miraculous peptide therapy. Peptides everyone's actually using. Peptide sleep tech and the end of obesity. Oh oh, the shorts are terrifying.

SPEAKER_00 12:53

What's your general gist with these?

SPEAKER_01 12:55

No, I didn't click on them. I just I scrolled down far enough that the shorts came up.

SPEAKER_00 12:59

Oh, I didn't even want you to look at those. I don't want to corrupt you that much.

SPEAKER_01 13:02

This peptide will change your life. When I stopped using copper peptides, this okay, anyway. That was a very different vibe check than what came up on my feet.

SPEAKER_00 13:12

I'm glad we did this exercise. What's your take?

SPEAKER_01 13:15

Okay, first of all, I am very I'm trying to think about how to say this. Okay, people are listening to our podcast because they appreciate what we have to say and they generally think even if we're not necessarily a trusted source of information, we're at least not slop.

SPEAKER_00 13:29

We're not malicious, yeah.

SPEAKER_01 13:30

Right. So please, please, please don't get healthcare advice off of YouTube or Instagram. And if you do, check the sites. There are some very trusted clinicians and physicians on there who will tell you recommendations for what you should do, but they link to the citations that are supporting the things that they're saying. Just like some everyday person who uses Dr. Google should not be the person you're taking medical advice from. So I'm horrified at the things that I was seeing on this YouTube page that people may trust as accurate sources of information.

SPEAKER_00 14:03

Yeah, and I would also, this is a little bit of a tangent, but just because someone has a DR period in front of their name doesn't mean that they are trusted. I would do a little bit of digging. For example, why is a surgeon talking about vaccines? Why is a podiatrist talking about diets, right? Like look into their actual credentials.

SPEAKER_01 14:22

Also, not everybody with a DR in front of their name is a healing doctor. Correct. Like you mentioned podiatrists and surgeons, but there are people like me who have PhDs, but then there are a range of degrees that will give you a DR title that have varying amounts of rigor or content or whatever.

SPEAKER_00 14:41

Yeah, where do they go to school?

SPEAKER_01 14:43

And like I go by doctor, I have a PhD, I'm an academic. No one should trust me for medical advice. That's not the kind of doctor that I am.

SPEAKER_00 14:50

They should trust you for gun violence policies. Just public health advice. Public health advice, but definitely not whether you think this peptide drug is gonna work for you. Yeah, so here are some of the claims that these unapproved direct-to-consumer peptides are claiming muscle growth, focus, sleep. This is wild, tanning your skin, stress, recovery, longevity, libido, energy, just the word energy, nerve repair, immune boost, and hair growth. I don't know. Like the vibe to me, when I first looked up the YouTube, is it gives wellness more than health. You know what I mean? Like it gives wellness industry more than like actual medicine. Here's another exercise that I want to do with you. This is the last one, I promise. There's a video on YouTube published by Stat, the health and medicine magazine slash newsletter publisher, generally trusted, called Inside the World of Internet Peptides. This video popped out on your feed, your nerdy feed. This is just a, in my opinion, a very mild video that just goes over what peptides are, kind of what this episode is doing, and the rise of direct-to-consumer peptides in various forms outside of the FDA regulations. Let me read you some of the comments on this video. Brace yourself. Okay. Quote: No, we now understand that the FDA is there to protect pharma profits and not Americans' health. This is the number two comment. Okay. A peptide recently helped a paralyzed man walk. No citation. Oh, Jesus. The FDA approved oxycotton as non-addictive. I trust Reddit more than I trust the FDA.

SPEAKER_01 16:14

Ooh, yeah. Okay. Not accurate, but okay.

SPEAKER_00 16:18

Yeah, not accurate. I look for the ones the FDA deem unsafe. That's how you know how it works.

SPEAKER_01 16:23

Oh dear God.

SPEAKER_00 16:24

There are worse comments.

SPEAKER_01 16:25

We can stop now.

SPEAKER_00 16:26

So here's what I want to actually discuss. What do you think is the undercurrent of this peptide hype? Like I have my answer, but I want to hear yours.

SPEAKER_01 16:34

Well, this is just the most recent shiny and new snake oil. Correct. I mean, people have been falling prey to quick, easy fix to things for the longest time, whether it was a diet like keto or South Beach or no carbs, you know, whatever it might be, or literal snake oil that people used to peddle that for curing all of your ales, right? Like people are often looking for a quick fix to whatever they see as a problem. And I want to fully acknowledge that for some people, because of genetics or other issues, it is very hard, if not near impossible, for them to lose weight, sort of have a have a healthy weight. And so for some folks, there are strategies that they need to take that might not be for the wider population. So putting that aside, there are people who just want the quickest fix possible because they don't want to put in the work that is required because that takes time and energy. So again, I mentioned I'm a woman of a certain age. My Instagram feed is like constantly about like balancing hormones and perimenopause and all of these kinds of things. And the number of posts I see, advertisements I see saying, Oh, have you been gaining weight because now you're in perimenopause? All you need to do is take our hormones that will cost you $100 a month for a subscription and you'll magically you'll magically lose all of the weight that you've put on. And I was like, no, you won't. Like, you literally won't, because that's not how that works. That was a very long way to say. It's just the flashiest, newest snake oil.

SPEAKER_00 18:09

I share similar sentiments when I first got into this topic and did some research. I've said this already, but it gives wellness industry, it does not give health and medicine.

SPEAKER_01 18:19

Agreed.

SPEAKER_00 18:19

Because medicine is slow. I'm sorry. That's just how science science is slow. Science has a lot of nuance. Science is about building up that evidence base piece by piece. It's not gonna be new and flashy. It's gonna be like, well, here's the academic consensus about this. And this thing is like stage two of the FDA approval process. It's gonna be slow, but this just gives it has a similar vibe to me as AI and crypto and blockchain when it was first out. It's like this will solve all of our problems, which is a very wellness industry coded language.

SPEAKER_01 18:49

Well, and it is, as I mentioned, it is absolutely true that this will solve some problems for some segments of the population. But anytime anybody says, oh, this is the only thing you need, and like this is the magic bullet, like you gotta double check that because it's not passing the sniff test.

SPEAKER_00 19:08

No. What how do you feel about some people, mostly tech bros and like biohacker bros, uh, who claim that this is just them being an early adopter of a new technology and that we should let them embrace this? What do you think?

SPEAKER_01 19:20

Okay, so I have a lot of feels about peptides being called technology, first off.

SPEAKER_00 19:24

Yeah, that's what they say. I'm quoting them. Yeah.

SPEAKER_01 19:26

No, no, no, I hear you on that. But I will also say every day we're getting one step closer to Skynet. Yeah, I just don't understand. 100% like how people don't recognize this. And just because something has potential doesn't mean that that is the end all be all, and and that's where we're going to have this wave of the future. And I find it so interesting that peptides have been latched onto in a way that mRNA vaccines have not.

SPEAKER_00 19:53

Yes.

SPEAKER_01 19:54

Like in the general public.

SPEAKER_00 19:55

MRNA is a groundbreaking technology.

SPEAKER_01 19:58

Yeah, totally, absolutely groundbreaking. You can't do that in your own home, though, right? You can't order mRNA vaccines and do stuff in your own home.

SPEAKER_00 20:05

So I think it's not stable enough. Yeah.

SPEAKER_01 20:07

Even though the technology and the implications for population health and well-being of these mRNA vaccines are so remarkable, yet they were absolutely demonized and attacked during COVID-19. And then on the flip side, like peptides, I mean, okay, like sure there could be some potential, again, some benefits for some populations, but they're becoming sort of the end all be-all. It's a way for people to make money. Like that's really all it is. These peptide bros, it's them trying to set themselves up to rake in as much money as they can until the next snake oil comes along.

SPEAKER_00 20:38

My number one tip for sussing out whether an influencer or like an advice giver on the internet is in your best interest, is you ask the simple question, are they selling something? And if the answer is yes, that should be a huge red flag because what are their motives? Like, why are they promoting this thing that they just happen to be able to sell and make a lot of money off of? And I do think peptides as like a concept is valid and it is a burgeoning field of medical research. Absolutely. Oh, Zempic is approved. It's an actual drug that has been approved and has been shown to work. There are a lot of side effects that people are not talking about, as you mentioned, but it is an approved drug. And I do think there's a lot of potential in this, but that is a massive departure from ordering peptides from China and being sold direct to consumers like a wellness thing. That's just not how medication is supposed to work. Well, now's the time to answer the obligatory question. Uh, why is this public health? We can answer this question on three levels. Go ahead.

SPEAKER_01 21:35

Yeah, so on the first level, safety concerns of untested, unproven substances being sold directly to consumers is a really big concern. Thinking about all of the processes and testing and and regulation, as much as you may have issues with the FDA process, whether it's too fast, too slow, too lax, too strict, whatever it might be, there at least is a process. And so one of the things I Always think about is what do peer European nations do? Because they are like way more stringent than we are in the US. And how are they handling these kinds of things? And if they're not doing it, it's probably not a great idea for us to be doing it. Actually, one of the one of the first papers I wrote in my master's program was just absolutely taking down the concept of direct-to-consumer marketing. Like individual people have not enough information to understand what they should or shouldn't be taking and all the context and things like that. So that's just generally a first-level concern. And this is then going out into the population and doing who knows what to who knows who. On a second level, the erosion of trust in science and instead focusing on these magic bullet miracle drugs is really concerning. I think academia has not done itself a favor with some of the ways we have engaged generally with the public, how, you know, how we talk about our research or how we don't talk about our research, because often people are just publishing and moving on. They're not really doing translation and making sure that people understand what they're doing. So those two things together, right? We're not really seeing high levels of trust in science. And there's always some flashy thing. But when science says, hey, that's not a great idea, nobody trusts that. And instead they're going to go with the snake oil.

SPEAKER_00 23:12

Yeah, absolutely.

SPEAKER_01 23:13

I just want to clarify really quick too. When I said snake oil, I'm not referring to Ozempic, which is an FDA approved. I'm talking about these like mishmashed, homemade, direct-to-consumer peptides. I just, nope, please, pharmaceutical company, don't come after me.

SPEAKER_00 23:26

On a more general level, this hype over these experimental unproven peptides released directly to consumer is distracting from actual peptide research that could have potential to actually change the game. We're putting resources essentially in the wrong direction. It's diluting the actual science behind peptides. Like the mRNA vaccine or mRNA technology, peptides, the fact that we can manufacture them now is actually a massive gain for medicine. But if everyone is associating peptides with like these copper energy shots that you can get from China, like we're not focusing on the right thing, which is the reality that we're living in now, given how how Maha has sort of uh consumed our public health institutions.

SPEAKER_01 24:06

So that started off and then became a rail downer.

SPEAKER_00 24:09

Yeah. We will never run out of topics, especially in 2026. My micro good and also like a PSA is there is a difference between whether something has a flaw and whether something shouldn't exist. So I would say currently the FDA is compromised because the people running the FDA are compromised. Absolutely. That doesn't mean the FDA as a concept is bad, right? There's a big difference between something being compromised, like RFK Jr. is doing in our public health institution, and something that shouldn't exist. Just because the US health system sucks doesn't mean we should turn to the wellness wackos and the solution to our current predicament is fixing the problems in our institutions, in our systems, rather than just say, oh no, no, no, let's go to a tech startup to buy medication from China, which is still wild to me that that is a thing.

SPEAKER_01 24:59

So please believe in science. Um, every example of quote unquote bad science is an example of not science. So if people are doing bad science, then they're really not doing science. They're not following the process, they're not generating replicable data or findings. So trust in science and please don't believe the wack-adoos.

SPEAKER_00 25:21

Yeah. Like every time I see an article about like, oh, this doctor does some unethical things. I'm like, yeah, he's unethical. That was a bad guy. This is nothing to do with the scientific process. Um, don't eject things from places that you don't know. I think it's just a pretty straightforward uh micro good. And of course, vote. Uh by the time this comes out, we will be, I think, mid-summer. So yeah, please go vote up and down the ballot. It does matter. Thank you so much for listening to this episode of Everything is Public Health. New episodes every other week. If you like the show, please tell everyone you know about the show. That helps us immensely. Commenting, subscribing, and leaving us a review also helps us a bunch as well.

SPEAKER_01 25:57

If you have any questions or think we missed an important perspective, you can reach out to us at everything ispublichealth at gmail.com. Follow our website, everything is publichealth.com, for all show updates and bonus material. And remember, everything is public health.

SPEAKER_00 26:10

Everything is public health.