Six of the eight members appointed to an FDA advisory panel to evaluate peptide safety run clinics that already sell peptides. On Thursday, those same members voted to loosen restrictions on the peptides they sell. If you're looking for a cleaner definition of a conflict of interest, you are going to be looking for a while.
What Actually Happened at This Meeting
The FDA's Pharmacy Compounding Advisory Committee voted Thursday to recommend loosening restrictions on four peptides: BPC-157, KPV, TB-500 and MOTS-c. A vote in favor doesn't make these compounds FDA-approved drugs. What it does is recommend adding them to a list that allows compounding pharmacies, which are specialized facilities that mix medications not available from standard drugmakers, to produce and sell them via prescription. The FDA isn't required to follow the panel's recommendation, but it usually does.
According to NBC News, all eight of the members newly appointed under Health Secretary Robert F. Kennedy Jr. voted yes on BPC-157, KPV and TB-500. Six members voted no. One abstained. For MOTS-c, the vote was slightly tighter: seven of the new appointees voted yes, five voted no and two abstained. The deciding votes, in other words, were entirely the people Kennedy put on the panel. The people Kennedy put on the panel are, overwhelmingly, people who profit from selling these drugs.
The Scientists in the Room Were Not Happy
Throughout the daylong meeting, FDA career scientists raised objections that went beyond the usual regulatory caution. This wasn't just 'we need more data.' It was something more fundamental and more alarming.
NBC News reports that the FDA scientists kept returning to the same sticking point: nobody can agree on what these peptides chemically are. There is no universally accepted chemical formula for each compound, which makes safety evaluation essentially impossible. Russell Wesdyk, an FDA official, told the panel bluntly: 'We've never faced a problem of, what is it?' Think about that for a second. The question being asked at a federal drug safety hearing was not 'is it safe?' It was 'what even is this thing?'
For specific peptides, the FDA scientists said there was simply no data to assess at all. During discussion of KPV, Josh Mailman, a panel member and president of the Neuroendocrine Tumor Research Foundation board, put it plainly to NBC News: 'I'm voting on something here, but I don't know what that something is. It's kind of like a black box to me.' He voted no. His candor is appreciated and apparently rare.
The Yes Votes Were Doing Their Best Kennedy Impression
The reasoning offered by panel members who voted yes reads like a greatest hits compilation of Kennedy-era health rhetoric. Dr. Haleem Mohammed, the chief medical officer at Gameday Men's Health, a Florida clinic that offers peptides, told NBC News he voted yes for BPC-157 citing 'patient safety, you know, the greater good and medical freedom.' Medical freedom. There it is.
Dr. Gabriel Alizaidy, a clinical researcher at Maximus, an online clinic that also offers peptides, said he voted in favor of BPC-157 because he was 'frankly disappointed at how incomplete the data was.' Read that again. He was disappointed at how incomplete the data was, and his solution to that disappointment was to vote yes on loosening restrictions. David Pope, chief pharmacy officer at Xifin Pharmacy Solutions, said his yes vote was about putting the decision 'back into the hands of the patient, the physician and the pharmacist.' Beautiful. Classic. Completely untethered from the concept of evidence-based medicine.
Kennedy has been cheerleading this outcome for months. The BBC reports he has described himself as a 'big fan' of peptides and vowed to ease restrictions that the Biden administration had put in place after FDA officials found the drugs did not meet safety requirements. This panel vote is Kennedy's vow coming true, courtesy of a committee he stocked himself.
What These Drugs Actually Are and Why People Are Taking Them
Peptides are short chains of amino acids, small proteins that the body naturally produces. They act as chemical messengers, telling cells what to do, and play roles in skin health, immune function and hormone regulation. Some peptides have legitimate medical uses. Insulin is technically a peptide. GLP-1 drugs like Ozempic are peptide-based. Nobody is arguing the entire category is junk.
The specific peptides under review are a different matter. BPC-157, one of the most popular, is derived from stomach protein and marketed online for gut health, tissue repair and inflammation, according to the BBC. It has been studied in animals for muscle healing. The US Anti-Doping Agency says that because it hasn't been extensively studied in humans, 'no-one knows if there is a safe dose, or if there is any way to use this compound safely to treat specific medical conditions.' It is also banned by the World Anti-Doping Agency. The BBC reports that these compounds have exploded in popularity in online wellness communities, particularly on TikTok among teenage boys under buzzwords like 'biohacking' and 'looksmaxxing,' where influencers stack them for unproven benefits like muscle gain and faster aging. They are currently legal to buy and own but not approved for human use, meaning they are not subject to pharmaceutical manufacturing quality controls.
The People Voting No Were Not Subtle About Why
Dr. Elizabeth Rebello, an anesthesiologist at MD Anderson Cancer Center and one of the panel's no votes, did not mince words at any point during the day. On KPV, she told NBC News she was 'concerned that we're responding to a market-induced demand rather than a decision based on solid science.' On TB-500, she went further: 'I'm also concerned with the argument that patients are getting it anyway. That actually goes against the Hippocratic oath, which is do no harm, and if we don't know if we're causing harm, that's an issue.'
The BBC notes that Rebello also voted no on BPC-157 because of 'the lack of efficacy data' and safety concerns. She is, by all available evidence, a person trying to do her job. Dr. Brian Lee, an associate professor at USC's Keck School of Medicine, voted no and warned the rest of the panel that an FDA sign-off could lead the public to treat a regulatory green light as proof these drugs work, when some may be no better than placebos. He told NBC News that roughly 30 percent of patients on placebo will report a real improvement anyway. Nobody in the yes column appeared to engage with any of this.
One More Thing Worth Knowing About This Panel
NBC News reports that one of the eight Kennedy-appointed panel members is Tennessee state Sen. Bobby Harshbarger, whose mother, Rep. Diana Harshbarger, wrote to Kennedy last year asking that compounding pharmacies be allowed to make certain peptides. That is a detail that lands differently the longer you sit with it.
The committee will continue Friday to evaluate three more peptides: emideltide, epitalon and semax. Given the vote breakdown Thursday, you can probably sketch out how Friday is going to go.
The Dingo Take
Here is the architecture of what just happened. Kennedy stocked a federal advisory panel with people who run clinics selling the exact products the panel was asked to evaluate. Those people voted to loosen the restrictions on those products. The FDA scientists who actually reviewed the compounds said they couldn't even establish a basic chemical identity for some of them, let alone confirm a safe dose. And the yes votes cited 'medical freedom' and 'the greater good.' The FDA does not have to follow the panel's recommendation. But Kennedy runs the agency now, and he told everyone what outcome he wanted before the meeting even started.
The gray market argument being floated by yes voters, that loosening restrictions is actually safer because it moves people away from unregulated online vendors, is not entirely stupid as a policy argument. But it assumes the compounds being compounded will somehow be safer or more standardized than the ones already circulating, which is a hard case to make when the FDA scientists spent all day explaining they can't even nail down what these things chemically are. You cannot regulate your way to quality control on a substance nobody can fully define yet.
Teenage boys are injecting this stuff because Joe Rogan and a parade of TikTok influencers told them it would make them look better and heal faster. The US Anti-Doping Agency says nobody knows if there is a safe dose. And the people the federal government just asked to weigh in on all of this are, substantially, the people making money off the trend. Somewhere, a career FDA scientist is staring at the ceiling tonight asking themselves what exactly they are doing with their life. The answer, unfortunately, is watching.
