Influencers Are Peddling Peptides, but Is Tanmaxxing Worth the Risk?

View the full episode transcript.

Seems like everywhere you turn these days, influencers are gushing about their peptide use and how it’s done wonders for their appearance and health. One of the more popular ones, Melanotan II, also known as the “Barbie” peptide, is said to give you a tan without the harmful effects of sun exposure. But many of these substances aren’t approved by the FDA and are often sold through unregulated gray market sources. So, how safe is any of this stuff? And what does the peptide boom tell us about the risks people will take in the name of “looksmaxxing?” Morgan talks to skin cancer surgeon Dr. Sungat Grewal and board certified dermatologist Dr. Caren Campbell about the risks of taking peptides. Then Morgan and STAT News reporter Sarah Todd break down how American medical libertarianism and the MAHA movement led us to this very point in time. 

• Dr. Sungat Grewal, double board-certified dermatologist and Mohs surgeon
• Dr. Caren Campbell, board-certified dermatologist
• Sarah Todd, reporter for STAT News

• What the peptide craze reveals about Americans’ relationship with risk — Sarah Todd, STAT News
• FDA advisory panel narrowly rejects compounding of one peptide, backs two others  — Lizzy Lawrence and Sarah Todd, STAT News
• FDA panel backs compounded BPC-157, KPV peptides in win for RFK Jr. — Sarah Todd and Lizzy Lawrence, STAT News
• What the peptide craze reveals about Americans’ relationship with risk — Sarah Todd, STAT News
• Is Tanmaxxing an Addiction? A Dermatologist and Psychologist Explains — Katie Berohn, ELLE
• Inside the Weird New World of Peptide Tanning — Savannah Sobrevilla, GQ 
• Melanotan: The “Barbie drug” tanning peptide, explained — Carly Mallenbaum, Axios
• Inside the Viral Tanning Peptide That Accidentally Created Vyleesi’s FDA-Approved Low Sex Drive Drug — Sara Kitnick, LA Times
• The FDA May Reverse a Ban on 14 Injectable Peptides—What That Means For the Beauty Industry — Kara Nesvig, Allure
• The Skin Cancer Foundation Issues Warning Regarding Melanotan II —  Deborah S. Sarnoff, MD, Skin Cancer Foundation

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Host, Morgan Sung:  Hello! Do you like these deep dives? Do you want more? Then please rate and review Close All Tabs on Spotify, Apple Podcasts, or wherever you listen to the show! And tell your friends! Post about it! On Instagram, Bluesky, X, Discord, Reddit, the comments of whatever random recipe blog you start arguments in. Basically, it would be a huge help to get the word out. Ok, let’s get to the show.

Morgan Sung: Can I be honest? I am pretty vain.

I take my skincare routine very seriously: Prescription-strength azelaic acid in the morning, and prescription-strength tretinoin at night. Lots of sunscreen and moisturizer and barrier creams in between, and every other night, I skip the tretinoin and spend three minutes under a red light mask. If I’m feeling indulgent, I’ll throw in a Korean gel mask and a jade roller. Do those do anything? I honestly can’t tell. But it feels nice! 

I wouldn’t call myself a looksmaxxer, but I do spend a good amount of time on these beautification rituals. And as a woman who exists on the internet, I feel like my For You Page is constantly lobbing beauty trends at me, and like I’m always trying to avoid getting sucked into yet another fad. I have tried so many serums and face masks and supplements before finally settling into what I consider to be a pretty pared down beauty regiment. But the one thing I haven’t tried yet is a peptide. 

It seems like everyone is on them. 

[Clips of influencers raving about peptides]
Speaker 1: This is, in my opinion, the most slept-on peptide on the market today. There’s two main benefits that have been life-changing for me . 

Speaker 2: You’re telling me there’s a botox alternative that’s easier on your wallet? Whoa! Let’s talk about Snap-8, the peptide that targets wrinkles without the needles. 

Morgan Sung: Peptides are chemical signals that your body naturally makes to regulate all kinds of bodily functions, like digestion and recovery. 

Guest, Dr. Sungat Grewal: So peptides are like text messages. 

Morgan Sung:  Dr. Sungat Grewal is a double board certified dermatologist and skin cancer surgeon. She’s the co-director of Laser Surgery and Cosmetic Dermatology at UCSF. And she’s been keeping an eye on the synthetic peptides people are taking to boost their bodies’ natural processes. 

Dr. Sungat Grewal: They’re not necessarily good or bad inherently, but it depends on who’s sending the message, what the message is, and who receives it. 

Morgan Sung: And I’m not just talking about GLP-1s. Peptide stacking is really in right now. Retatrutide and Tesamorelin for weight loss, Ipamorelin for muscle growth, the “Wolverine Stack” of BPC-157 and TB-500 to boost healing after a gym sesh. If you throw in the copper peptide GHK-Cu, you’ve got a “Glow Stack,” the hot girl combo optimized for anti-aging collagen production. It’s a lot, right? 

Some of these compounds are not cleared by the FDA, so the way people get a hold of them is a legal hit or miss. But peptides remain incredibly popular despite the gray market. And there’s one that’s really blown up this summer: Melanotan II. 

[Clip from Youtube User @SpaandTell]
Kylie says hi Kim your tan looks great. Thank you! I’ve been using the melanotan II peptide over the last month, and I’ve been going outside, and it’s been working like a charm, so excited. 

Morgan Sung: MT-2 for short — also known as “The Barbie peptide” or “the vacation drug.” It makes you tan, skinny, and horny (it’s a libido booster) — with no harmful UV exposure required. But Dr. Grewal says it also comes with legitimately concerning risks. 

Dr. Sungat Grewal: It’s pretty scary and it’s very sad, you know, when, um, people are chasing aesthetic goals and are being misdirected and exposing themselves to unknown risks or known risks, not only in the moment, but for future and forever forward, right? Some of these impacts have long-lasting effects.

Morgan Sung: Today, we’re diving into the world of peptides: the dangers of tanmaxxing despite the influencer promotion, and RFK Jr’s crusade to reverse the peptide bans in the U.S. What does the peptide craze say about Americans’ relationship with health and risk? Let’s jump in. 

This is Close All Tabs. I’m Morgan Sung, tech journalist and your chronically online friend, here to open as many browser tabs as it takes to help you understand how the digital world affects our real lives. Let’s get into it.

We’re starting with a new tab. What is melanotan?

I’m part of a few weddings this year, and I wanted to look a little more sunkissed. But I’m inside like, all the time, and I have no interest in tanning beds because I don’t want to wrinkle. Again, vain! Sorry! So I started looking into self tanners. I looked up a few beauty influencers who reviewed tanning lotions … and that’s when my feed was inundated with people recommending this miracle drug: MT-2.

[Clip from Instagram user @toxdaddy]

Oh man, I’m super excited. I just got Melanotan 2 this morning and I’m really excited to try it.

[Clip from TikTok user @carlysnaxwell]

I started taking MT2. I’m tan. I haven’t gone bed tanning in a while… 

[Clip from TikTok user @itsdevync]
I’m now at two months of taking it. I’m obsessed. My tan is only getting better …  

[Clip from Youtube user@SpaandTell]
I am crazy impressed by this – by this, I mean, the Melanotan 2 peptide.

Morgan Sung:  And it’s not just the tan that makes it so appealing. Dr. Grewal says Melanotan II also has some specific side effects…

Dr. Sungat Grewal:  It’s marketed as the Barbie peptide because tanning might be the effect that you’re shopping for, but it’s not the only effect and some of them can translate into, um, increased libido or decreased appetite.

Morgan Sung:  How does it do all that? Well, let’s talk about how peptides work.  

Again, peptides are the chemical signals for your body to perform certain functions. Your body has tons of receptors, and peptides can target specific ones, almost like sending a text to a specific phone number. 

Dr. Sungat Grewal: You can think about two kinds, like natural versus synthetic. So our body makes peptides naturally. Some common examples would be like insulin or GLP-1. And synthetically, you know, we can create, uh, synthetic peptides to mimic those that are made naturally in the body to get a specific effect

Morgan Sung: Melanotan I and Melanotan II are synthetic peptides that…

Dr. Sungat Grewal: …mimic a naturally occurring peptide in the body called alpha-MSH or melanocyte-stimulating hormone. And so there are receptors that are in numerous places in the body called melanocortin receptors that can respond to this signal or chain of events.

Morgan Sung: There are five types of melanocortin receptors in the body. The first regulates hair and skin pigmentation, and it’s what triggers tans. And it’s also really important to understand what getting tan really means for your body. 

Guest, Dr. Caren Campbell: It’s literally your nucleus and your cell saying, “Oh my God, save my DNA.” 

Morgan Sung : This is Dr. Caren Campbell, a board certified dermatologist who practices medical, surgical, and cosmetic dermatology in San Francisco.  

Dr. Caren Campbell: You know, it’s putting an umbrella over it. Your cell is saying, like, “Help me. Protect my DNA so I don’t mutate and cause cancer.”

Morgan Sung: That little umbrella is called eumelanin, and it produces brown and black pigments in the body. It’s what causes darker colors in skin, eyes, and hair. 

So Melanotan I sends a text to that first melanocortin receptor, which tells your cells to pop their little umbrellas up to protect their DNA … which is what triggers a tan, without actual UV exposure.  

Melanotan I is actually FDA-approved for a very, very specific, very rare skin condition that causes extreme sensitivity to light.

Dr. Sungat Grewal: Erythropoietic protoporphyria

Morgan Sung: Or EPP for short. It’s actually so rare that Dr. Grewal has never seen the condition in her medical career. 

Dr. Sungat Grewal: Its incidence has been estimated at two to five cases per million people. You would know if you had this because you have symptoms when you’re a young child. Children have very severe, painful, uh, photosensitivity after exposure to sunlight or even visible light, which can come from even indoor lights, laptop screens.

Morgan Sung: EPP causes extreme swelling, burning, and pain when exposed to certain light. So the FDA approved a prescription implant of Melanotan I for people with EPP, which stimulates their bodies to produce eumelanin. These little cell umbrellas absorb that light before it can damage their skin. 

Now, Melanotan II, which is the hot one right now, sends a group text to that first receptor. But remember, there are 5 melanocortin receptors in the body. So it’s also sending that text to receptors three, four, and five as well. And these aren’t just in the skin. They’re all over the body, including in the central nervous system, which is why MT-2 can cause appetite suppression and boost libido. And because these receptors are all over the body, MT-2 can also cause unpredictable systemic changes … with unpleasant and even dangerous symptoms. Here’s Dr. Campbell again. 

Dr. Caren Campbell: In men, that can lead to potentially what’s called priapism, which is where you have an erection that, you know, doesn’t go away, and there was a, a case report of someone needing to have that surgically drained in the emergency room.

Um, it, it also can cause nausea and vomiting. It’s also stimulates our sympathetic nervous system, which you can think about that like your fight or flight. So anything you needed to, like, run away from a predator, it does. So it dilates your pupils so you can see better.

It causes, you know, increased heart rate so you can get running. It causes hypertension ’cause it constricts your blood vessels. Um, so that fight or flight response can be elevated and you can get what’s called rhabdomyolysis, which is where you get muscle breakdown, and it can be very dangerous, um, life-threatening.

Morgan Sung: So those side effects are pretty rough. But Dr. Grewal says there’s also this main one … 

Dr. Sungat Grewal: We have seen reports of patients like breaking out in moles, for example, and breaking out in atypical or what we call funky looking moles, right?

[Clip from TikTok user @cablequeencourt]
Let’s count how many moles we have on our face since taking MT2. So this one’s new. This is new …Yeah, um, and that’s not including what’s going on on my body….

Morgan Sung: Moles are clusters of melanocytes, the skin cells that make pigment. Most are totally benign. But like Dr. Grewal said, Melanotan moles are … funky.

Dr. Sungat Grewal: Because it’s stimulating the same pathway that can eventually lead to melanoma. And again, we don’t have causation yet, but we do not have long-term data. And so why would you subject yourself to that risk when you can use other methods to tan the skin safely without breaking out in moles? And the moles are not just darker, the moles, like, look concerning. They, they often have atypical features.

Morgan Sung: Those little cell umbrellas can only protect so much. And if you’re exposing them to harmful UV rays over and over again, they can mutate and become cancerous. One of the ways dermatologists evaluate moles for cancer is by checking if they’ve evolved — if they’re getting bigger, darker, and wonkier. This isn’t as much of a concern for patients who are prescribed MT-1 for EPP, since they’re generally not engaging in risky behavior that causes additional UV damage — like intentionally tanning. 

But when it comes to the tanmaxxers … 

[Clip from Instagram user @sooshbrah]
This is 2021, 2022, I was doing 500 micrograms of Melanotan and I was jumping in the tanning bed for 15 minutes. I literally changed race in like three sessions. 

Dr. Caren Campbell: I can’t say for certain that, you know, melanotan causes melanoma. But we do know based on what are, again, called case [00:23:00] reports, where we don’t have large numbers, but we have good evidence of people who’ve started melanotan and then as soon as two weeks noticed almost immediate darkening and irregularity of their moles.

Morgan Sung: Dr. Campbell said that in this case report, one of the patients had used tanning beds and melanotan at the same time, and had five new moles biopsied. All five were cancerous. And there aren’t many clinical studies on the effects of long-term melanotan use, in a broad population of users who don’t have EPP. 

Melanotan II was actually developed in the late 80s to early 90s, and in the early 2000s, researchers began testing it to treat sexual dysfunction. But Dr. Grewal says there’s a reason it never made it to market. 

Dr. Sungat Grewal: Usually when a peptide or any product is on its way to becoming a drug, it goes through rigorous testing, and pharmaceuticals would love to sell it because they’re gonna profit immensely. So usually when it drops off the track, it’s because either it’s not providing the results that they’re hoping for or the safety is not promising

Morgan Sung: Despite that, both MT-1 and MT-2 are still wildly popular on the gray market, as both a nasal spray and an injectable. 

Dr. Sungat Grewal: Unfortunately I am not surprised because, you know, the story of wanting tanner skin is a story we’ve heard before. 

Um, you know, first it was tanning beds, now we know how dangerous those are in terms of increasing melanoma risk even with one use, you know, before the age of 30. 

Morgan Sung: And as is the case with many unregulated, technically illegal peptides, vendors can sell them around the US thanks to a handy loophole: the “Research Use Only” pathway. Essentially saying, this product legally isn’t for human consumption, with no quality guarantee or regulatory oversight. But there’s really nothing that can stop buyers from using it on themselves. 

Dr. Sungat Grewal: You have to remember that when it’s not FDA regulated, you really have no idea what’s in the bottle. What you’re getting in your bottle is like a crapshoot. So, you know, and historically we’ve seen issues with, um, sterility of products, contamination with unregulated products, and the concentration and the purity is also unknown.

So that alone is like a huge reason why I would never advise anyone to take a non FDA-approved medication, whether or not it’s a peptide, you know?

Morgan Sung: So knowing all of these risks, both healthwise and lookswise, why are people bent on taking Melanotan? And this is just one of many unregulated, very popular peptides! What’s driving the peptide boom in spite of medical experts’ warnings?

That is a whole new tab… for after this quick break. 

But first, we wanted to remind you that Close All Tabs depends on listeners like you! To become a member and support the show, go to donate dot kqed dot org slash podcasts. Ok, after the break: we’re diving into medical libertarianism. Stick around.

Morgan Sung: Welcome back! Time to open a new tab. Peptides and medical libertarianism. 

RFK Jr, the vaccine denier and guy in charge of our entire country’s health department, is also a pep pusher. 

[RFK Jr. speaking on the Joe Rogan Podcast]
Yeah I mean I’m a big fan of peptides. I’ve used them myself. 

Morgan Sung: That was RFK Jr on Joe Rogan’s podcast earlier this year, where he spoke about the proliferation of unregulated peptides. 

[RFK Jr. speaking on the Joe Rogan Podcast]
A black market came out and the black market is run by companies that say they’re making the peptides for animal use or research purposes. 

Sarah Todd: So basically when you buy peptides online you don’t have any guarantees about the safety and the quality of what you’re buying. 

Morgan Sung: That’s Sarah Todd, a reporter at STAT News. She covers the business of health, which means she’s also been following the gray market peptide industry. 

Sarah Todd: New York Magazine had a bunch of peptides tested and found that about a third of them were mislabeled or under or overdosed or contaminated by bacteria. So those are all some of the potential health risks that you run into when you’re getting them off the gray and black market.

Morgan Sung: But that hasn’t diminished people’s appetite for peptides. Sarah says this all falls in line with a concept called “medical libertarianism” — the idea that we should be allowed to do whatever we want with our bodies regardless of what the government or medical establishment says.

Sarah Todd: And that extends to taking drugs like peptides that don’t have a lot of data behind them when it comes to their impacts on humans, either their benefits or their potential risks. But the idea with medical libertarianism is, like, that’s my choice, and if I’m willing to put my body on the line for the hopeful benefits that I can get, then I should be able to do so.

Morgan Sung: It’s a very American mindset. 

Sarah Todd: It really goes along with this sort of all-American idea that we can control our own destinies and make our own choices, right? And a sort of suspicion about the government’s role in overseeing people’s lives, a desire to, you know, ward off the idea of the nanny state and the idea that people should be able to chase their own pursuit of happiness and the American dream.

And if that includes self-optimizing your body and your health, then that’s something that people should be allowed to do, would be the argument that these people are making.

Morgan Sung: Americans have always had this attitude about health. In the 1970s, there was a huge backlash from the public when the government tried to regulate vitamin and supplement industries…

Sarah Todd: People wrote in and said, “Don’t take my vitamins away, “ and we wound up with the situation that we have today, where they’re still many people would argue, uh, largely unregulated or very under-regulated. I think that people really wanted to hold on to these kinds of products. 

Morgan Sung: There have been ebbs and flows to medical libertarianism throughout modern American history. And then the COVID 19 pandemic hit.

Sarah Todd: People started self-experimenting with all kinds of things, like everything from ivermectin, which you m- may remember, to some sort of herbal medicines.

Sarah Todd: On one hand, you had a lot of interest in sort of like experimentation with drugs to see what you could do to improve your own health, protect yourself potentially from COVID in various ways. We also saw a big boom in the rise of social media health influencers, health and wellness influencers during this time as well, and I think that has played a huge role.

Many of the sort of man-fluencers like Joe Rogan and, and Gary Brecka and Andrew Huberman were already popular pre-pandemic, but sort of like became even more so, gained huge followings during, and I think that that’s had a lot to do with the sort of rising awareness of peptides and interest in trying them.

Morgan Sung: People started taking this “folk pharmacology” approach to medicine. 

Sarah Todd: So that term folk pharmacology was mentioned by a researcher I spoke with for a story.

His name is Luke Turnock, and he talked about how first it sort of started, uh, with peptides in the gym, with bodybuilders and powerlifters sort of sharing, like, “Oh, this, this drug is really helping me recover from this industry. This drug is making me stronger.” But he applies that to the way that people talk about peptides in online spaces and forums as well, where people are generally a lot more likely to believe somebody else on a Reddit forum than they might be to listen to a researcher who’s telling them there’s not enough data to support taking these drugs.

I think it, it has to do with some of the decline of trust in science, and then it also has to do with the sort of, like, just stock that we put in recommendations from other people who we perceive as regular people, whether that’s, like, you know, somebody telling us, like, “Oh, I love this vacuum,” or in this case, “I love my Wolverine stack,” you know?

Morgan Sung: The Make American Healthy Again movement is also pretty staunchly anti-vaccine. 

Sarah Todd: When I first started thinking about this, I was like, “This seems like a huge contradiction.” I didn’t understand why the MAHA movement would be so skeptical toward vaccines and yet really welcoming toward peptides. But I think it comes back to what we were talking about with medical libertarianism.

A lot of the MAHA people don’t necessarily want nobody to get vaccines. They say they are more wary of certain vaccine mandates. So there the idea again is like, “Don’t tell me what to do with my own body. It should be my choice whether or not I take it.” Peptides, again, they’re saying they don’t want everybody to have to take peptides.

They just wanna be able to take peptides if they want to. So that’s where it all sort of begins to make sense in an overall worldview.

Morgan Sung: And this brand of medical libertarianism is applied pretty inconsistently. RFK Jr’s MAHA agenda is actively restricting access to trans healthcare, birth control, and abortion — issues that revolve around bodily autonomy. But when it comes to peptides? They believe the government should be hands-off. 

It goes back to a Biden-era decision.

Sarah Todd: So back in 2023, the Biden administration moved a bunch of peptides into a different category. That meant that compounding pharmacies could no longer produce them, and their reasons were basically, you know, what we’ve been talking about the typical warnings that we get from the medical community, that these drugs haven’t been studied enough to be able to say definitively that they are either going to do what they promise they’ll do or that they won’t cause some other big problem like cancer as well.

So that was the reason for moving over the classification. Now what Robert F. Kennedy Jr. is looking to do is to reclassify some of those peptides so the compounding pharmacies can indeed begin producing them again.

Morgan Sung: Which means that they can be legally produced in the US, under some regulatory oversight — unlike the facilities that are producing gray market peptides now. Compounding pharmacies at least have to be licensed and routinely inspected through state pharmacy boards. 

RFK JR. has been on this crusade to get the FDA to lift this Biden-era peptide ban — which he talked about on that same Joe Rogan podcast episode.

Sarah Todd: He basically said that he is a fan of peptides. He wants to make them more accessible via compounding pharmacies. Uh, but the reason he says is not necessarily he understands that not all the science and data is out there on peptides yet, but he says that it’s gonna be safer for people to get them from compounding pharmacies than to get them off the gray and black market, and that’s sort of his logic for, for why it would make sense to, to reclassify them.

Morgan Sung: And that is a new tab. Are peptides legal now? 

It’s complicated. We’re gonna start by explaining different kinds of pharmacies. 

So, typical pharmacies make and dispense FDA-approved drugs. There are the retail pharmacies that sell over-the-counter allergy meds or fill your prescriptions for blood pressure pills. There are specialty pharmacies that manage medications for very rare, highly complex health conditions, which might require stricter protocols for handling, storing, and administering meds. Both of these types of pharmacies mainly deal with medications that have already been manufactured. The pharmacy makes sure they’re giving patients the right dosage and right amount of pre-made meds. 

Now, compounding pharmacies mix the medications themselves. There are lots of reasons why people use them: maybe the commercial version of the drug includes ingredients they’re allergic to, or maybe they need a cream, not a gel. Maybe the only way to get the right dosage is by getting a custom mix. 

Sarah Todd: Sometimes there are drug shortages, and compounding pharmacies can be an alternative as well then because they can custom make a particular drug that maybe, uh, isn’t available at the moment. It might also be, as was the case with GLP-1 weight loss drugs, uh, compounding pharmacies were making a lot of, uh, GLP-1 drugs that were alternatives to the more expensive ones, like Ozempic and Wegovy, and the idea h- here was, like, you sacrifice the sort of name brand, uh, aspect, but then you, you could get the, the drugs that would have, hopefully, the same effects for cheaper.

So that’s another reason why people might turn to compounding pharmacies as well.

Morgan Sung: In recent years, compounding pharmacies have become wildly lucrative, thanks to the rise of for-profit telehealth. A lot of telehealth companies have in-house compounding pharmacies, and they sell all kinds of prescription meds: personalized topical creams with Tretinoin and Niacinamide for acne, chewable tablets of Finasteride and Minoxidil for hair loss, low-dose Vardenafil for erectile dysfunction, custom-mixed hormone replacement suppositories for menopause, and now, compounded GLP-1s for weight loss. 

Compounding pharmacies can legally make anything … as long the ingredients they’re working are good with the FDA. The final product doesn’t have to be FDA-approved.

Sarah Todd: The drugs that a compounding pharmacy makes do not necessarily have to have been authorized by the FDA. Um, as long as, you know, they have a prescription for that drug from a healthcare provider, they will, will produce the drugs. And then there’s certain, uh, substances that they’re not allowed to make, such as the peptides that are currently on the 503B substances list. 

Morgan Sung: There are 19 peptides on that 503B substances list, including Melanotan II. Earlier this year, the FDA announced that they were going to consider reclassifying some of those banned peptides. This is not the same as FDA approval. They haven’t gone through clinical trials that guarantee safety or efficacy, and the FDA doesn’t verify the quality before they hit the market. But if they are reclassified, that means that compounding pharmacies are allowed to make and distribute medications that contain them. 

Sarah Todd: The argument that was probably most common from the people on the side of making peptides more accessible via compounding pharmacies was that it’s true that we don’t have all the data yet, and we do need more of it. However, we really don’t want people getting these drugs off the gray and black market because of the other health risks, you know, the risks of contamination, the risk of mislabeled drugs where you think that you’re getting one thing, you’re actually getting something else. And they basically said patients are demanding these drugs and we should make sure that if they’re going to take them, they’re taking it the safest way they can.

Morgan Sung: In other words, it’s better to have Americans sourcing their peptides from regulated facilities, rather than overseas labs that may not be held to the same standards of sterility and quality.

In July, an FDA advisory panel met to discuss whether or not to recommend reclassification for seven peptides.

Sarah Todd: The advisory panel itself was really controversial. So this is a group of people who aren’t members of the FDA themselves, and the FDA doesn’t have to follow their recommendations, but typically, their recommendations carry a lot of weight, and typically, an advisory panel is made up of doctors, researchers, other experts in their field.

In this case the people who were appointed to the panel, a lot of them were people who had some sort of potential conflict of interest or stake in the outcome of the decision on peptides, people who are prescribing peptides themselves, people who are you know, affiliated with compounding pharmacies in some way.

So that immediately raised a lot of red flags for critics who said, “How can we trust the advice of an advisory panel if it’s people who would potentially stand to profit from what the outcome is?”

Morgan Sung: The pro-peptide crowd on the panel pointed out that patients are demanding these drugs, and that some regulatory oversight is better than continuing to allow Americans to get their peptides from sketchy overseas labs. 

Sarah Todd: Then the counterargument from the medical experts is basically  that there, again, simply isn’t enough human data on these drugs. There’s a lot of concern about what it would mean to make it easier for people to take these drugs that are indeed in high demand but that we simply don’t know what kinds of short or long-term health effects they might have.

And there have been cases of people reporting getting sick, having injuries from peptide doses. So, you know there are real concerns about what should be done in order to monitor peptides better and make sure that they’re safe. And you could hear a lot of frustration from the medical experts who were on the advisory panel as each vote on each separate drug went down.

They vote on each drug individually, so as they started seeing what was going to happen of those seven drugs, six got recommended to be reclassified so that compounding pharmacies could make them. So a lot of frustration from the medical experts saying like,’Once again, we don’t know enough about how these drugs will impact people. We’re really worried that this is gonna be dangerous and put people’s health and potentially even their lives at risk.’ And then they were outnumbered on the panel by the, the people who were affiliated with the peptide industry or prescription in some way.

Morgan Sung: And this is where it gets really dicey. Before the advisory panel met, the FDA itself came out and said, hey, we say no to allowing compounding pharmacies to make any of these peptides. This was a decision made by multiple FDA staff scientists. 

Sarah Todd: And that was directly in conflict with the outcome of the meeting, which said six out of these seven peptides, they do recommend changing classifications.

Morgan Sung: Advisory panels rarely go against the FDA staff recommendation. According to reports of that meeting, after the votes were tallied and the recommendation was announced, an audible gasp rippled through the room. 

Sarah Todd: So with that, it’s gonna be really interesting to see now what happens. The ultimate decision is up to the FDA. So normally, it would be even if the advisory panel had recommended against, if FDA staffers felt really strongly, they could do whatever they felt was right but Robert F. Kennedy Jr., of course, is the head of the health department. He has a lot of power and influence, and I think a lot of outside observers are betting that even if FDA staff don’t think that this change should be made, that Kennedy may push it through which would obviously be quite bad for FDA morale as well.

Morgan Sung: Who will benefit from this decision? Well, like we talked about earlier, the telehealth industry and their in-house compounding pharmacies make a TON of money. And now they stand to make even more. 

Sarah Todd: When you have people on the panel who it’s clear to see how they’re seeing a lot of patient demand. If they’re able to provide more prescriptions to patients for peptides, that is good for their business.

For the compounding pharmacies, it’s certainly huge for their bottom line. Hims and Hers announced that they’re looking to start offering peptides this year. Noom has also moved to start offering peptides. They purchased a compounding pharmacy business. So there are a lot of companies that certainly see an upside to giving into demand.

But as one of the people who I spoke with pointed out, simply because people want drugs isn’t a good reason to authorize them, and simply because we don’t want them to get it off the gray market. If that were the case, then we would legalize heroin, which indeed actually some libertarians think we should, but which the majority of people think that there are good reasons to not do such a thing.

Morgan Sung:  so given the FDA’s, uh, I guess, like despite their tensions, um, what does the future of peptide stacking look like now?

Sarah Todd: For people who are enthusiastic about peptides, I think the future is bright in the sense of them being able to access them. I think it looks like more and more likely that there’s going to be a lot of regulatory interest under Kennedy as long as he’s in power in making these products more accessible.

I think that in terms of what the future looks like from a health perspective, the reality is that we simply don’t know, and that’s kind of scary. We don’t know what kind of effects these are going to have, and we don’t really right now have a robust way of monitoring or surveying for those effects either.

So what you would really wanna see are clinical trials that are studying people who are taking peptides and researching those outcomes, and that is one thing that we don’t currently have right now. 

Morgan Sung: But again, a recommendation isn’t the same as FDA approval. 

Sarah Todd: Just because this, uh, the panel has said this, that doesn’t mean that compounding pharmacies now have the go-ahead to start producing them. The final decision is up to the FDA and the FDA rulemaking. I believe that outside experts think that process could take up to a year, so it’s not something that we would expect to see immediately happening.

That doesn’t mean it’s hard to get a hold of now, though. When I searched “Melanotan II near me,” I found dozens of medical spas across LA that advertise it as part of their “peptide therapy.” For $95, I could drive over to Beverly Hills and pick up a 5 mL vial at a clinic, or $150, I could get it delivered! Mobile IV clinics also offer it as an add-on to their on-demand IV services, so I could get my tan on, get a whole GLOW stack injected, and get a hangover cure administered at the same time, in my own living room! It’s like doordash for peptides! 

Though, Dr. Grewal does not find that as amusing as I do. 

Dr. Sungat Grewal: My gut reaction is honestly mortified, terrified, but also not surprised. And again, it just really brings me back to the point of, you know, the body is really complicated and medicine is complicated.I think the most important thing is that you research the person that is endorsing a specific product or, um, or approach, right? So, like, I love that people research, but I would really encourage, and I’m an advocate of spending the most time researching your source, who you’re going to assign as being credible

Morgan Sung: As much as I love my skincare routine and gratuitous pursuit of beauty, I personally will be staying clear of the Barbie peptide. A little gradual tanning lotion and my trusty tanning mitt has never done me wrong. Plus, I don’t have to worry about breaking out into funky looking moles! 

Ok, let’s close all these tabs. 

Close All Tabs is a production of KQED Studios, and is reported and hosted by me, Morgan Sung. 

This episode was produced by Cayla Mihalovich and Maya Cueva. It was edited by Chris Hambrick. 

The Close All Tabs team also includes senior editor Chris Egusa, who also composed our theme song and credits music, and audio engineer Brendan Willard. Our intern is Lauren Yoon. Additional music by APM.

Audience engagement support from Maha Sanad. Jen Chien is Executive Director of Podcasts, and Ethan Toven-Lindsey is our Editor in Chief.

Some members of the KQED podcast team are represented by The Screen Actors Guild, American Federation of Television and Radio Artists. San Francisco Northern California Local.

This episode’s keyboard sounds were submitted by Alex Tran, and recorded on his white Epomaker Hi75 keyboard with Fogruaden red samurai keycaps and gateron milky yellow pro v2 switches. Thanks for listening. 

This episode includes clips from TikTok creators carlysnaxwell, itsdevnyc, and cablequeencourt, clips from the Instagram accounts ToxDaddy and sooshbrah, and YouTube clips from SpaAndTell and Joe Rogan Experience.

Thanks for listening! 

Morgan Sung: I mean, my ‘foryou’ page every day it’s like, “Who’s on Glow? Who’s on the Glow stack or the Barbie stack?” Like you can’t escape it.

Sarah Todd: Yeah, all over.