Peptides have been a hot topic in the health world for several years, and right now they are at the center of an FDA approval debate. The FDA scientific staff didn’t recommend approval due to lack of human efficacy evidence and understanding of long-term safety.

But an FDA advisory committee narrowly voted to recommend placing six peptides on the 503A Bulks List. That means peptides haven’t been approved - yet.

It’s still far from a final ruling by the FDA, but the recommendation has had an impact on how people view peptides and their safety. Since it will be some time before peptides are legally available, there’s good reason to believe more people could start purchasing peptides on the grey market.

Regardless of whether peptides come from a pharmacy or the grey market, anyone who is taking them should be monitoring their kidney and liver health. Here’s why.

What Are Peptides?

A peptide is sort of like a messenger. They are chains of amino acids that send signals to organs and cells to perform a function. The most well-known peptide right now is GLP-1 that are known to help regulate insulin and blood sugar levels.

Peptides are made naturally in the body, but they can also be made in a lab. There are thousands of peptides that serve a wide variety of purposes. Today they are being used to treat obesity, type 2 diabetes, for skincare, anti-aging and to aid in muscle recovery.

Which Peptides Gained a Recommendation

Before delving into the potential kidney and liver effects, take a look at which peptides were and weren’t recommended for FDA approval:

• BPC-157 - ulcerative colitis - recommended
• KPV - reviewed for wound healing and inflammatory conditions - recommended
• TB-500 - reviewed for wound healing - recommended
• MOTS-c - reviewed for obesity and osteoporosis - recommended
• Epitalon - reviewed for insomnia - recommended
• Semax - reviewed for cerebral ischemia, migraine and trigeminal neuralgia - recommended
• Emideltide / DSIP - reviewed for opioid withdrawal, chronic insomnia and narcolepsy - not recommended

The FDA advisory committee recommended the peptides in part because people are already using them. The argument is that it’s better to have them regulated and compounded in a pharmacy. It also doesn’t hurt that the peptide industry’s worth is projected to be almost $564 billion by 2035 with a compound annual growth rate (CAGR) of 7% to 11%.

And these peptides will likely be marketed for a lot more than what the committee voted on. They are already hyped up as being a solution for longevity, anti-aging and cognitive optimization, even though there’s little research to back up these claims.

Regardless of why people are interested in taking peptides, they still won’t be legalized and available for at least another 8-12 months.

What Peptide Bloodwork Protocols Reveal

We’re still learning about peptides, and the manufacturers know more than just about everyone else. Right now, it’s best to follow their recommendations on what to do before and during the use of peptides. The monitoring protocols are primarily focused on kidney and liver health along with blood pressure, lipids, metabolism and inflammation. Below are protocols from two manufacturers for monitoring kidney and liver function.

MediVera bloodwork protocols for kidney and liver function include:

• AST
• ALT
• Creatinine
• BUN
• Fasting Glucose

Sermorelin bloodwork protocols for liver function include:

• AST
• ALT

Based on these two manufacturers, there is a need to monitor how well the body’s clearance system is working.

Peptides Impact on Liver Function: Good or Bad?

FDA scientists brought up a number of points about peptides. Clearance through the body was one of them.

The liver is the body’s filter. It gets rid of all the toxins, which is a pretty tough job. Some peptides help the liver recover, reduce inflammation and protect cells from damage, but the toxicity of others could be potentially harmful. And because some peptides help with lipid regulation there’s potential that they could help with fatty liver conditions.

Because you could see improvements or liver function decline while taking peptides, regular monitoring is highly beneficial.

How Peptides Affect Kidneys

Like the liver, the kidneys can be protected and improved by peptides or suffer damage. It largely depends on the peptide that’s taken.

Toxicity and filtration stress are the biggest concerns with the kidneys. The kidneys are what filters peptides out of the body. The process can lead to organ strain in some cases.

Then there are peptides like GLP-1 that reduce blood sugar, blood pressure and inflammation for a protective benefit.

There is also evidence that peptides could be protective and reduce cell death when there’s acute kidney injury.

The Real Concern With Unregulated Peptides

Currently, many peptides that are being taken are completely unregulated. Even if they are coming from a reputable source, the peptides are being used off-label and are for research purposes only.

Taking medications that aren’t FDA-approved and aren’t regulated is very risky, especially if they are coming from an unknown source. It definitely increases the need for monitoring because there’s no guarantee that the ingredients are pure or will perform as expected.

Who Should Be Particularly Careful While Using Peptides

Anyone who is taking peptides should monitor key biomarkers at regular intervals, but some people need to pay particularly close attention.

• Pre-existing kidney disease
• People with cancer or that are in remission
• Unmonitored or high-dose bodybuilding
• Taking regenerative peptides that can cause build up in kidneys

Each type of peptide affects people differently, so who is at higher risk for complications will vary.

How to Monitor Liver and Kidney Function While Taking Peptides

If you’re going to track your liver and kidney function there’s a few ways of doing it to make sure you get the most benefit out of it.

Baseline Measurements

Before taking peptides it’s ideal to get baseline measurements so that you know how biomarkers move.

Kidney and Liver Testing Every 6 Months

Kidney and liver health can change within months due to medications, lifestyle changes and nutrition.

Comprehensive Metabolic Panel

This is an ideal option because comprehensive metabolic tests like the one offered by Choose Health allows you to test biomarkers for kidney and liver function. Our panel also includes hsCRP, which another recommended market to check.

Monitor Liver and Kidney Function With an At-Home Blood Test

Choose Health has a number of at-home blood tests that can help you monitor all of the biomarkers that are recommended when taking peptides.

One and Done Tests

Two Liver Function Tests

Kidney Function Test