Peptide Therapy: What Patients Should Know

Important: Fishtown Medicine does not prescribe, recommend, administer, or supply research-grade or non-FDA-approved peptides. This page is provided for general educational purposes only and is not medical advice or an offer of treatment. We prescribe only FDA-approved peptide medications obtained through licensed US pharmacies. State medical boards across the country have clarified that any recommendation, prescription, or administration of non-FDA-approved peptides by a medical professional constitutes the unauthorized practice of medicine.

What Peptides Are

Peptides are short chains of amino acids - the same building blocks proteins are made from. In the body, peptides act as signaling molecules: instructions that tell cells when to repair tissue, release a hormone, or modulate inflammation. Insulin is a peptide. Many of the hormones your body produces every day are peptides. A subset of peptide medications are FDA-approved and sit firmly inside the prescription landscape. These are manufactured under FDA oversight, tested for safety and efficacy, and dispensed through licensed pharmacies. They are what physicians can legally prescribe. A much larger group of compounds marketed online as "peptides" are not FDA-approved. They are sold as research chemicals or compounded products outside of FDA oversight. The compounds in this category - frequently discussed in podcasts and longevity-adjacent forums - have not been tested or approved for human use by the FDA, and their manufacturing standards, purity, and dosing accuracy cannot be verified.

Why the Regulatory Posture Matters

State medical boards have grown increasingly explicit on this point. The boards have stated that:

• Physicians may only purchase prescription products from entities permitted by the relevant State Board of Pharmacy.
• All drugs administered or dispensed to a patient must be prescription-quality.
• Compounding, administering, or dispensing a non-FDA-approved or research-grade peptide is prohibited.
• This prohibition includes advising, recommending, supplying, prescribing, or administering.
• Patient consent forms purporting to identify a product as "research-grade" are ineffective and do not eliminate professional or legal liability.
• A medical professional cannot delegate this work to a nurse practitioner or physician assistant.

The boards are clear: any involvement by a medical professional in recommending, supplying, prescribing, or administering non-FDA-approved peptides constitutes the practice of medicine and is prohibited. When a patient independently acquires and self-administers such substances, the associated risk rests solely with the patient. Fishtown Medicine takes no part in that decision and provides no clinical guidance on those substances.

What Fishtown Medicine Does Offer

For patients interested in peptide-based therapies, the FDA-approved landscape is real and useful. The medications below are prescribed where clinically indicated, sourced through licensed pharmacies, and integrated into a broader care plan rather than offered in isolation:

• GLP-1 receptor agonists (semaglutide, tirzepatide, liraglutide) for metabolic disease, type 2 diabetes, and obesity treatment.
• Sermorelin for adult growth hormone deficiency in appropriately diagnosed patients.
• Tesamorelin for FDA-labeled indications including HIV-associated lipodystrophy.

These are the peptide medications inside the regulatory perimeter. They have human safety data, manufacturing oversight, and a clear prescribing framework. We use them when the clinical picture warrants and the data supports them.

Why We Don't Prescribe Research-Grade Peptides

Three reasons, in order of importance:

1. Patient safety. When manufacturing oversight does not exist, neither the physician nor the patient can verify the contents of a vial, the purity of the compound, or the consistency of the dose. The "peptide" sold online may not contain what the label claims.
2. Legal and licensing exposure. State medical boards have made the rule explicit. A physician who recommends, prescribes, or administers a non-FDA-approved peptide is practicing outside the scope authorized by their license.
3. Long-term evidence. Even the most-studied research-grade peptides have limited long-term human safety data. The evidence base does not support the confidence that wellness marketing implies.

If You Are Already Using a Research-Grade Peptide

We do not provide clinical advice on substances we cannot legally prescribe. If you have independently obtained and are using a research-grade peptide, that decision and the associated risk are yours. We can:

• Discuss the broader clinical picture you are trying to address.
• Order labs that may be relevant to your overall health, independent of any peptide.
• Help you weigh FDA-approved alternatives that may serve the same goal.
• Coordinate care with your other physicians.

We will not interpret, optimize, or troubleshoot a research-grade peptide protocol, and we will not write prescriptions for compounds outside the FDA-approved formulary.

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This article is educational and does not constitute medical advice. Fishtown Medicine prescribes only FDA-approved medications sourced through licensed US pharmacies. If you are considering peptide therapy, talk to a licensed physician about FDA-approved options that may apply to your situation.