Peptide use ‘emerging faster than we’re tracking it’

‘We don’t really know what people are actually using’.
 
So says RACGP Specific Interests Child and Young Person’s Health Chair Dr Tim Jones about the tsunami of unregulated peptide products being peddled online.
 
While there is yet no research to offer a clear picture of just how many young Australians are seeking enhancements ranging from deeper tans, bigger muscles, better focus, and everlasting youth through the illegal online peptide products, anecdotal evidence is stacking up, Dr Jones told newsGP.
 
‘There’s been at least one young person I know of, aged 18, who’s had a heart attack as a result of using a product bought online,’ he said.
 
‘And there’s been quite a few hormonal side effects too; people reporting a change in body hair, change in sexual function, change in libido, just as a result of mucking around with these things.
 
‘But this is a space that’s emerging faster than we’re tracking it.’
 
In response to this rapidly emerging trend, the ABC is now seeking input from GPs for a survey on injectable peptide use in the community. No identifiable information will be shared or published without permission.
 
After being quoted in a recent ABC story about peptides, Dr Jones was contacted by someone alarmed by what they had read.
 
‘I got a text from a 17-year-old I know quite well, I didn’t know that he was involved in this scene, and he just sent me a text message, saying “I had no idea things were potentially this worrisome. I’ve been looking at them online”.’
 
Dr Jones began asking young patients whether they use peptides about six months ago, after reading a report from a Griffith University trial that said children as young as 14 had sought information on steroid testing.
 
‘They’ve been ordering products online and using them, but now they’re having second thoughts and were really worried, or they were getting some unanticipated side effects, because the vast majority of illegal social media messaging on these products is that they’re completely safe,’ he said.
 
‘But these products are being made in backyard laboratories, marketed through little Tik Toks, and people are just getting a link to say, “text this number on WhatsApp, and we’ll send it to you if you pay us”.
 
‘There’s absolutely no oversight of what you’re actually getting. It’s just being promoted that this is a safe, tested product, when in fact it may be nothing of the sort.’
 
An added complexity is that GPs have no guidelines to manage patients’ use of drugs that potentially are not what they claim to be, says Dr Jones.
 
‘We don’t really know what people are actually using,’ he said.
 
‘You know what they think they’re getting, but because these are unregistered products they might be entirely different.
 
‘So, if people have come in declaring that they’re using these products, we actually don’t have any guidelines to support what we should do.’
 
At present the media is awash with stories of the new peptides trend, supercharged by celebrity proponents ranging from Hollywood star Gwyneth Paltrow to US Health Secretary Robert F Kennedy.
 
A recent Guardian story references a 21-year-old influencer promoting retatrutide, a peptide still in clinical trials and not approved by any regulator. His post even includes information on a ‘reputable source’ for the drug.
 
RACGP NSW&ACT Deputy Chair Dr James Kelly said retatrutide is a ‘useful example’ of a drug ‘already circulating through online sellers, social media and gym networks’ despite still undergoing trials’.
 
‘People may genuinely believe they’re accessing a next-generation medicine when in reality they may be injecting a black-market product with no reliable quality control whatsoever,’ he said.
 
Dr Jones is particularly concerned by the increasing popularity of the synthetic peptide melanotan, which boosts melanin production for quick tanning.
 
The Therapeutic Goods Administration issued a warning about melanotan more than a year ago, listing a menu of potential ‘serious side health problems’ ranging from headache and nausea to serious skin cancer and swelling of the brain.
 
Despite the grave warning – and a reminder that supply of it without a prescription is illegal – melanotan continues to be ‘heavily hyped’ says Dr Jones.
 
‘Anyone who’s got a melanoma and doesn’t know about it, that product is going to send it into overdrive and cause that melanoma to spread rapidly,’ he said.
 
‘We have to be really proactive to find out what people are using and why, because there may be young people who we wouldn’t normally be doing skin checks on, where we have to be increasingly aware of what could be a risk.’
 
Dr Jones says regulation of social media marketing is urgently needed to prevent the exploitation of young people, given the increase in both accessibility and false advertising.
 
‘It’s not that people haven’t been able to buy products online that are purported to enhance whatever they’re trying to enhance, but the difference is now about how readily accessible that information is and how much false advertising is just there in someone’s palm whenever they open an app,’ he said.
 
‘This is illegal marketing of illegal products to vulnerable young people, and we have to hold the social media companies to account for permitting this on their platforms.’
 
He said GPs need to go ‘back to basics’ when discussing potential peptide use with young patients and use the opportunity to provide evidence-based information.
 
‘If people have come in declaring that they’re using these products, we actually don’t have any guidelines to support what we should do,’ he said.
 
‘They’re just so vulnerable to the marketing because of adolescent insecurity; if something’s there going, “you know, we can fix this. Send us 50 bucks, you’ll feel fine, you’ll be more muscular or more tanned”, I think as GPs we’ve got to be really out there, saying “that’s not true”.’
 
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