BIG Peptide News (Must-Listen!): What Really Happened In Washington, D.C., & A 7-Peptide Breakdown, With Dr. Matt Cook.

Ben Greenfield

My name is Ben Greenfield, and on this episode of the Boundless Life podcast, the complication

Dr. Matt Cook

rate from peptides is

Ben Greenfield

no doctor has ever really figured out, in terms of the whole picture. These

Dr. Matt Cook

peptides are the way that our body communicates with itself. It has an effect kind of like what would happen if a cell was exercising.

Ben Greenfield

So none of us need to exercise anymore. The

Dr. Matt Cook

more that you exercise, the better.

Ben Greenfield

Welcome to the Boundless Life with me, your host Ben Greenfield. I'm a personal trainer, exercise physiologist, and nutritionist, and I'm passionate about helping you discover unparalleled levels of health, fitness, longevity, and beyond.

Hey, what's up? Quick intro to this podcast. An intro before the intro, actually. A few numbers were thrown around in this pretty important and pretty fascinating peptides podcast with Dr. Matt Cook. We sat down, and he just started dropping knowledge bombs right and left. I did get my hands on some actual data, and he wanted to make sure I got the actual numbers out to you for the number of units administered of each of these different peptides, along with a shockingly low number of adverse events. So, during these PCAC hearings back in Washington, D.C. (and we'll get into what that means, alphabet soup and all, during the podcast today), about 16 million BPC-157 doses were taken into consideration, about two and a half million TB-500 doses, about 680,000 MOTS-c doses, about 3.6 million KPV doses, roughly 100,000 delta sleep inducing peptide doses, about 210,000 Epitalon doses, and about 350,000 Semax doses. So when we're talking about all of the studies, or the administrations, or the doses that were given, those were the actual numbers that were being investigated. So hopefully that helps. And I just wanted to, for you real nerds out there, for everybody who's putting your propeller hats on and wanting to take the deep dive, there you go.

All right, show notes are at BenGreenfieldLife.com/peptides2026. Let's go talk with my buddy Matt Cook.

Welcome to the show. I am out of my normal element because I traveled to a studio far away from home for this show, because there has been a lot going on from a legislative standpoint in the whole world of peptides. Now, my guest today has been deeply involved in that scene, and you may be familiar with him. He doesn't need much of an introduction. Dr. Matt Cook, I think this might be like your eighth time on the show. You've made it around quite a few times, and there's been a lot going on in D.C. the past few days. Matt just got back from D.C., and he's going to share that with us and share what is happening right now in the peptide industry and what you can expect. All the show notes for today are going to be at BenGreenfieldLife.com/peptides2026. That's BenGreenfieldLife.com/peptides2026. I will also have some juicy links there, including one to a special cheat sheet in case you can't remember everything that every peptide does that Matt's going to be spitting out today.

So, Matt, welcome back to the show for the umpteenth time.

Dr. Matt Cook

Thank you so much. Great to be here.

Ben Greenfield

So, D.C., you flew there. You just got back like two or three days ago?

Dr. Matt Cook

Yeah.

Ben Greenfield

So why'd you go?

Dr. Matt Cook

Well, so the FDA has a committee called the Pharmacy Compounding Advisory Committee, PCAC. Their job is to review basically the data and the literature and make a decision about which drugs can be compounded. And if those drugs can be compounded, they're put on a bulk list. And if they're put on that bulk list, then pharmacies can compound those for patients.

Ben Greenfield

And when you say, I'm going to interrupt you a lot, by the way, when you say compounding, are you referring to those being available for just the big pharmaceutical companies that we hear about, like GSK or Eli Lilly, or are we talking about these smaller compounding pharmacists that a lot of people might be familiar with?

Dr. Matt Cook

Yeah, so then that would be called a 503A compounding pharmacy, or a 503B. So then what they can do is, once a compounding pharmacy can compound it, that means there's a specific prescription for a specific patient, and that compounding pharmacy can make that drug or that peptide and then distribute it to that individual patient.

Ben Greenfield

So this meeting was meant to determine which peptides can be compounded.

Dr. Matt Cook

If any. Now, there's some peptides that are already compoundable. There's a host of peptides that are already compoundable for one reason or another. But six of the seven of the most popular peptides that were taken away from compounding two years ago by the Biden administration, they brought those back to evaluate the data to make a decision about whether we can start compounding with those again. So these were things that we had two years ago and then went away, and now the vote was about whether the FDA will put them back on the compounding list, so patients can start using them again.

Ben Greenfield

So you said that there were some that weren't even taken off the list in the first place. I was kind of sort of not really even joking. I said insulin, because a lot of people don't realize that's a peptide people have been injecting for a long time successfully. GLP-1s, I know, are another one that I believe are allowed to be compounded. Are there others that weren't taken off that list that people might be familiar with?

Dr. Matt Cook

So what I'm going to do is read you what those are.

Ben Greenfield

Okay.

Dr. Matt Cook

So, Sermorelin, Gonadorelin, and Thymosin Alpha-1 are all currently in category-one compliant programs today.

Ben Greenfield

Okay. So when these peptides disappeared two years ago, the ones you just got back from the meeting on, in that time span, if somebody was going to use something like Sermorelin, which is one that even the bodybuilding industry and health and fitness industry (people who want to increase growth hormone during sleep, or enhance sleep) turn to, you could at any point in the past few years go to a doctor and get that from a compounding pharmacist?

Dr. Matt Cook

100 percent.

Ben Greenfield

Okay, so the ones they had the meeting about, is there a reason you think it was those specific seven that they were talking about?

Dr. Matt Cook

So these are probably seven of the most popular peptides, and seven of the ones that have some of the best data. These were popular in the early moment of peptides. All of these were very, very popular, and I think what happened is the FDA a couple of years ago said, "We're going to take all of these away, because if they became too popular it would have been hard to take them away." So they took them away, but they're somewhat backed by popular demand, because during the hearings, somebody said, "Why are you even bringing these back?" They were having the committee meeting, and we were listening, and they said, "Well, there's so much popular demand." They did a whole bunch of polling in anticipation of the hearings, and 70 to 75 percent of people across both Republican and Democratic political spectrums want the ability for compounding pharmacies to be able to give people peptides.

Ben Greenfield

And when you say across Republican and Democrat, were these politicians they polled, or just regular people?

Dr. Matt Cook

This was just regular polling, just political polling.

Ben Greenfield

Interesting. So how does that work when you're in D.C.? I actually know a lot of people who were over there in our industry, doctors and clinic owners and pharmacy owners. Are you guys just watching this discussion take place in a big room somewhere?

Dr. Matt Cook

So what happened is it's a big room, about 150 times as big as this room, and there's about 14 to 16 members, depending on the peptide, who were voting and reviewing it. And then the public could come and make comments. So I spoke on five peptides and went through the science and the data and how they work and why people were using them and why people were disappointed when they were taken away. We had pharmacists who talked about the science and the pH and the biology and how they work. And then the FDA took basically all of those comments, everything that had been submitted, and voted on whether they would add them to this bulk list to bring them back.

Ben Greenfield

Interesting. So it's like representatives from the FDA that you and all these other people trying to be a voice of reason for peptides are attempting to convince that they should be legal for compounding.

Dr. Matt Cook

100 percent.

Ben Greenfield

So does the FDA do its own research? Did they come in with their own studies and science that they'd looked into and compare it against what you guys said? Because I'm assuming the people in that room were somewhat vetted, like you're a licensed physician, but it seems like somebody could just stand up in front of a microphone and start talking and saying things that the FDA would then need to look into and see if it's actually backed up by research.

Dr. Matt Cook

So on the committee there were people with a diversity of opinions, so it probably seemed like there were some people who were pro-peptide and maybe some not so much. Each peptide had an indication that the FDA was taking into consideration when reviewing it, but people also spoke about the diversity of different reasons that people use those peptides. So all of that was taken into account. For each one, the public made our speeches, and then at the FDA level they analyzed articles and all of that. Then basically there was a vote. We did one peptide, had a vote, did the next one, had a vote, and over two days we covered all seven peptides.

Ben Greenfield

And so, I think a lot of people are already aware that different peptides can do a lot of different things. And there's this term in medicine, off-label usage, where there are certain things a doctor is legally allowed to prescribe for a specific reason, but they're not allowed to make a recommendation to use that off-label. So when these peptides are being presented to the FDA, and the FDA is making that decision, are they making the decision about the ability to use this peptide for anything at all, or do they literally need to say, "You're allowed to use this peptide, but only for reasons A, B, and C"?

Dr. Matt Cook

What happens is they're voting on this, and I'm not a lawyer, so I don't play one on TV, but my understanding is that they're voting on whether it can be placed on the bulk list for an indication. But once it gets on the bulk list, a physician can use it for an off-label purpose. So by putting it on the bulk list, it basically approves it for everything.

Ben Greenfield

Okay, and if something is put on the bulk list, could a pharmaceutical company go in and make a drug based on that compound being on the bulk list, or do they need to own rights to that peptide to be able to do something like that? Do you know?

Dr. Matt Cook

A pharma strategy is a drug strategy, so the drug strategy typically goes through what's called an Investigational New Drug application, the IND. That's a fairly expensive, multi-million-dollar process, and if you go through it, a pharma company could take that drug to market after going through that process.

Ben Greenfield

Okay. So even from a semantics perspective, let's say (and we'll talk about which peptides actually made it onto this bulk list), even if they're on the bulk list, we still don't call them drugs?

Dr. Matt Cook

No, we would call them drugs, because anything that a compounding pharmacy makes, for the most part, they sometimes make vitamins (sometimes they compound NAD, which is a compounded vitamin, a derivative of vitamin B3), but most of the things a compounding pharmacy compounds are drugs. So all of the peptides are technically considered drugs. They're protein-based drugs, just like a GLP, like tirzepatide, is a protein-based drug.

Ben Greenfield

Okay, got it. Now, I remember when RFK was on Joe Rogan's podcast, he threw around a number, like they were reviewing something close to 14 or 16. We're talking about, I think, seven that were considered in this last round in Washington, D.C. Does that mean there's going to be another round just like this for the other ones on that list, closer to that number? Do you know? Is it like 14, 16?

Dr. Matt Cook

So my understanding is that there's going to be another meeting in February that I'm going to go to. Hypothetically, I heard the number five when I was there, which would take us to 13, but it could be that number gets expanded by then.

Ben Greenfield

Well, no, there were seven at the last meeting, right? Seven.

Dr. Matt Cook

At this one. And I heard five at the next.

Ben Greenfield

So five would bring it to 12, right? Yeah, 12. Okay. What I heard, and again, I am literally sitting down and talking with you about this because I want to know, and I've barely seen or watched anything since those meetings, so I'm going in a little blind here. But from what I understand, six of the seven made it onto the bulk list.

Dr. Matt Cook

Six of the seven were recommended to be approved for the bulk list, but the FDA still has to actually go in and finalize that.

Ben Greenfield

How long does that take?

Dr. Matt Cook

Could take two weeks, could take a month, could take longer. But it's a major step, because if the PCAC committee approves it, that's a very positive sign that Secretary Kennedy will most likely be able to enact that.

Ben Greenfield

Right, and if they didn't, then a lot of people would basically be in the position they've been in for the past couple of years, which is going to the gray market, getting things sold for "human research only,"

Dr. Matt Cook

That's exactly it.

Ben Greenfield

Nudge, nudge, wink, wink type of peptides that aren't allowed to come with prescribed advice or instructions, but that people are kind of Mickey-Mousing around with, anyway.

Dr. Matt Cook

100 percent. And when something's coming through a compounding pharmacy, the company that makes it has a lot number, they've got batches, they know the sterility. There's all kinds of details, so that if a problem ever happens, if I sent you something and a problem happens, we look at the vial, we look at what it says, and we find out what happened. Now, if you're in the gray market, they're not saying where they got it from. It could be a good product, but they can't say that, because they can't. So it really is going to improve quality and safety and access to have a physician guide people through that process.

Ben Greenfield

Yeah, that makes sense, because even in the gray market, there are a lot of websites that, for example, publish what is supposedly third-party lab testing on these research-based peptides, or claim they're made in a CGMP (Current Good Manufacturing Practices) facility, which is at least one sign they might be doing something right. Some of them come with a laboratory certificate of analysis, which, from what I understand, can in some cases even be fraudulent. It's not a given that any peptide sold for "research only" is going to be bad for you, but if you were getting something from a compounding pharmacist, you'd have a much higher likelihood that what you're getting is safe.

Dr. Matt Cook

100 percent.

Ben Greenfield

Yeah. Okay.

Dr. Matt Cook

100 percent.

Ben Greenfield

Well, let's go into the fun stuff. I want to know, now that we're past all the legal mumbo jumbo, what the peptides are that made the bulk list, and the one that didn't make the bulk list. I don't know if there's a rank order of importance you want to share, or if you just want to start with any of them.

Dr. Matt Cook

So then what I'm going to do is give you a high-level view of how peptides differ from other pharma drugs, because this is an interesting one. As we go through, we're going to talk a little bit about the mechanism of each of these and how they work. Traditional drugs that you've ever heard of all typically do one thing, and they do that one thing to have one effect. So we know a drug is a thing that has an effect. A lot of antidepressants act as serotonin reuptake inhibitors. There's a whole group of blood pressure medicines that block an enzyme called the ACE enzyme, so they're ACE inhibitors, and they lower your blood pressure. And if you took Zyrtec, or one of the histamine drugs, they block the histamine receptor. So most of the famous drugs that we grew up thinking about and living with, and even taking, all act on one receptor and do one thing, so it's fairly easy for us to think about them and understand them.

Ben Greenfield

And by the way, I think I see where you're going with this, because melanotan is a peptide, and it can darken your hair, darken your skin, give you a four-to-six-hour erection, increase blood flow. It does a whole bunch of stuff. That's different from what a drug would do.

Dr. Matt Cook

Yeah, they called that the Barbie doll peptide, because it makes you look like a Barbie doll. Yeah, exactly.

Ben Greenfield

That's my secret.

Dr. Matt Cook

And so that's something working across multiple different organ systems, having diverse effects. A lot of the time, these peptides are the way our body communicates with itself, because in the last podcast I said, "What does DNA code for?" and you said, "Proteins and peptides." Our genes are basically encoding for proteins if they're big, or peptides if they're small, and that's how our body talks to itself. A lot of times it'll make a peptide, and that peptide may have an influence on cells that do something, and it may also influence organ systems, and it may also influence receptors, and it may also influence which genes we express. They can actually go in and influence genes, so what happens is they tend to have a very high diversity of different effects. People are talking about this when they say pleiotropy, is that what that means?

Ben Greenfield

Pleiotropic would mean a diversity, I would say a diversity of effects.

Dr. Matt Cook

Okay.

Ben Greenfield

So that's the difference between a peptide and a drug. But drugs do have side effects.

Dr. Matt Cook

Drugs generally, if you block a receptor, the body kind of tries to find a way around that, so it may downregulate that receptor, it may upregulate that receptor, but often the body finds a way around a foreign thing that's blocking something in the body. Whereas most of the peptides we're going to talk about today either work the way the body actually works (these are either identical or close to a peptide in our body, and they influence our body the same way our body is always being influenced), and as a result we find that the complication rate from peptides is probably not just an order of magnitude less, but orders of magnitude less, compared to traditional drugs.

Ben Greenfield

And some people would push back on that and say, "Well, if it's working on all these different areas, like the melanotan example you gave, wouldn't it be riskier?" Because if you were taking something for a specific reason, like getting a tan, and it gives you priapism, an erection that won't go away, wouldn't that be considered an undesirable side effect because of its pleiotropy?

Dr. Matt Cook

The complication rates are so low. The American Academy of Peptide Medicine, which I'm working super closely with, and which we were there advocating together with, did a review across poison control centers, compounding pharmacies, and clinicians. We reviewed 16 million cases of BPC, 2.5 million doses of TB-500, 350,000 doses of Semax, and 3.6 million doses of KPV, and in that review they didn't see any drug complications from that entire prior review.

Ben Greenfield

You mean a drug complication being a deleterious reaction?

Dr. Matt Cook

Yeah.

Ben Greenfield

Oh, wow.

Dr. Matt Cook

There's an extreme level of safety, which was part of what brought us to the idea of bringing these back, because they're so safe. People are having such little complications from them, and there are actually truly interesting biological mechanisms for each one.

Ben Greenfield

I mean, that's probably also the reason they've achieved such widespread popularity, even in the gray market. People like them because they're actually working. So when it comes to this list, you mentioned BPC, KPV, TB, and one other just now. Those were on that list of seven, right?

Dr. Matt Cook

That's right.

Ben Greenfield

Okay, so people are probably curious, because it sounds like it could be pretty promising that the FDA is going to put these on the bulk list. What are the reasons people would use each of these different peptides, generally?

Dr. Matt Cook

So that's kind of a

Ben Greenfield

Loaded question.

Dr. Matt Cook

So we'll just start at the top and run the table. Let's start with BPC. BPC-157 is probably one of the most famous peptides, and one of the most popular that people have been using for a long time. We'll talk about how it works, but it seems to have an effect on the gastrointestinal system, and it's also really helpful for wound healing and musculoskeletal benefits. It turns out this was isolated as the active end of a protein found in digestive juices. Imagine there's a big protein that has an active segment, and the active segment is like a hand, and that hand is the end thing that does a handshake. BPC is the terminal end of this digestive protein that's secreted into the stomach and has an anti-inflammatory effect inside the stomach. A lot of people take this as an oral pill, and it goes in, and that active fragment has an anti-inflammatory effect on the inside of the intestine wall. The other thing is that people will take that peptide fragment and inject it subcutaneously, and when they inject it subcutaneously, it gets absorbed into the systemic circulation, and some of that circulation is going to go to the intestine, so you could have an effect on the intestine. It was reviewed for ulcerative colitis, which is an inflammatory autoimmune condition of the intestines. It may be that you can affect it by taking it as a pill for a gastrointestinal cause, and it may be that you could also take it subcutaneously, or even through a patch, and that's going to get systemically absorbed and go to the stomach. But then you can also inject it subcutaneously near a tendon, or in a muscle tear, for a musculoskeletal purpose, and have that effect as well.

Ben Greenfield

Yeah, and that's where the straw man argument comes in, where people will say, "Well, you'll find it in gastric juices, so maybe it's natural and safe in the gut, but if you don't find it naturally in the body being produced in, say, a tendon, is it safe to actually put it somewhere you wouldn't naturally find it in the body?"

Dr. Matt Cook

Which then takes me back to 16 million doses.

Ben Greenfield

Yeah, good point.

Dr. Matt Cook

Now, to me, putting this on the bulk list is a bridge to really doing a lot of clinical trials. Once this happens, people can do a clinical trial here in North America and choose a problem, whether that's a tendon problem or a gut problem. You could inject it or take it as an oral pill, and now we can start to get data on that. It's going to be only through the next three or four years of gathering a whole bunch of data that we're really going to bring the mechanisms, how these things work, and their effectiveness into clearer focus.

Ben Greenfield

Okay, so the way I understand that is a doctor could have, let's say, 500 patients, and maybe they want to look at, let's throw something out there, lateral epicondylitis, tennis elbow. And they want to take all of the patients they have who've had tennis elbow issues and put them on BPC-157. They can do that as part of a research study, and then somehow collect that data and make it publicly available, or available to the FDA. Is that how that works?

Dr. Matt Cook

How that would work, let's say you're looking at lateral epicondylitis, tennis elbow. What happens is you need to say, "I'm going to do a trial on tennis elbow." So you say, "This is the criteria to diagnose that they have tennis elbow, and this is who we're going to include in this trial and who we're going to exclude." Let's say we decide we're going to prospectively treat 20 patients. What you'd do is gather data on how you diagnose it and what the severity is. Typically what we'd do is an ultrasound on each one, and then we'd look at that and diagnose it. Then the trial would say, "We're going to give this dose, this is how we're going to give it, this is where we're going to give it, and this is how we're going to follow up to determine effectiveness." One way you could do that is you could just pinch a little subcutaneous skin and do a subcutaneous injection superficial to the elbow. BPC seems to be able to improve collagen production and help lay down collagen, so a subcutaneous injection there is very safe to do, and it may have a local effect by injecting it in that area. Idea two is you could use an ultrasound and stick a needle into the tendon,

Ben Greenfield

using the ultrasound to guide it.

Dr. Matt Cook

Right, using the ultrasound to guide how you do that. Now the issue is, if you inject too much fluid into a tendon, that can tear the tendon, and tendons are very sensitive, so you have to be very meticulous in how you inject into it. When I inject into a tennis elbow tendon, I typically will only inject 0.2, maybe 0.3 cc's. That's out of a one cc syringe, so it's a tiny amount, the equivalent of maybe five drops. A super small amount. So we could do an ultrasound-guided injection, we could do a subcutaneous injection, or you could even do a trial where you did a subcutaneous injection in the hip, and some of that peptide would get absorbed systemically and could reach the tendon that way too. That would be an example of how you'd think about putting together a trial to gather data on that.

Ben Greenfield

That sounds like a complex process for a doctor to be able to do and keep track of all that data. Are they using software, or some kind of method in the clinic to actually track all of that?

Dr. Matt Cook

So this has been kind of my biggest frustration: how do you help doctors who are busy in the clinic gather data? Then you ask, what data are you going to get? And this leads into another topic, but I'll touch on it. Right now the problem is all the data is siloed everywhere. So, like, you're my patient, but you've got a whole bunch of wearables, and I don't get access to any of that. You've got lab data across all the different doctors you see, but they're not necessarily sharing it. So your lab data is siloed, your wearable data is siloed, your genetic data (you have about six gigabytes of genetic data) I also don't have access to. So we created LifeOS, which is a digital AI platform, and what we're doing is tracking lab, genetic, wearable, and other questionnaire data that you enter, and all of that is flowing into what's called an IRB-approved database. Our database is a tool we can use to track data, so I can onboard you, and now I can prospectively watch how those labs and wearable data are changing in response to the different treatments we do, and that at least gets us IRB-ready, publishable data. Now, if we want to get really granular and think about how BPC works, we can do a trial on top of that, specifically looking at BPC and using the LifeOS database to track that data.

Ben Greenfield

But you're just one clinic running LifeOS in your clinic, or is this something other doctors use? LifeOS,

Dr. Matt Cook

this is a B2B solution. This is a solution for all doctors.

Ben Greenfield

Okay, so this isn't, I don't know how many patients you see, probably hundreds, but not the hundreds of thousands or millions that would be necessary to actually get big data on these peptides, for example. So what you're saying is a whole bunch of clinics at a time could use a platform like that, all feeding into one source?

Dr. Matt Cook

Right. Just with the clinics we've signed up so far, it looks like those clinics represent about 30,000 patients right now, but we're signing up a whole bunch more. LifeOS is something we're going to deploy in gyms and also for corporate health. Our goal is that within a couple of years we've got millions of patient lives tracking data prospectively, and we're tracking what treatments they do, whether that's stem cells, or an ACE inhibitor for blood pressure, or a statin for cholesterol, or something else, whether they're taking BPC. We're tracking all of the modalities they use and getting that data. That's a long-term data set we're tracking for lots of people, and then we'll use that tool to do more granular studies, where we might compare PRP to BPC for tennis elbow.

Ben Greenfield

All right, so that's basically like me and a lot of my friends taking all of our lab data from the past five, ten, or fifteen years and uploading it to Claude or GPT, and having it spit out a bunch of recommendations for us, but then combining that with the ability to also pull in wearable data, workouts, what I'm eating, etc.

Dr. Matt Cook

100 percent, and what would be gigantically interesting is, it used to take us 10 hours to sit down and pull all of that data together and come up with a plan for a new patient, and now what used to take 10 hours we've got down to about two hours. Now imagine all of that data is living inside a HIPAA-compliant vehicle, so all of that data can now be searched by Claude or GPT, and now you're tracking all of your data for the rest of your life, and that data is going to compound. Like, one thing we've talked about is your gut health. I said, "How's that going?" And you said, "What did you tell me?"

Ben Greenfield

Well, at breakfast this morning, while we were eating the beautiful blueberry smoothies I made, I was like, "Well, I actually figured out quite a bit, because I finally buckled down and took 15 years of gut test lab data." I wasn't able to pull in wearables and stuff like that, but at least all of my labs fed into it, and it identified, I mean, I just let it go to work, and it identified within about 40 minutes three specific things that have been going on in my gut for years that, no offense to the medical community, no doctor has ever really figured out, in terms of the whole picture. And I had it all in front of me, with actionable information about what to do with that.

Dr. Matt Cook

And so imagine, but you didn't even have all of the data. Now imagine all of the data, and everything you do, is in one location.

Ben Greenfield

Yeah.

Dr. Matt Cook

And now you can interrogate that, and continually interrogate that, and interrogate your genetics, and compare that. But remember, it's

Ben Greenfield

legal, it's secure. You said HIPAA-compliant. That means this isn't just floating around on the internet, because I couldn't even legally, from what I understand, print all that stuff off of Claude and just email it to you at your clinic, could I?

Dr. Matt Cook

You could, but then what happens is there are rules for HIPAA compliance, so if you just throw that data into Claude, and Claude has your data, whereas if you put this into LifeOS, now it's in a HIPAA-compliant place, and there's nowhere it's going to go out that has the names of the bacteria in your gut alongside your name.

Ben Greenfield

My doctor has it. If they're running LifeOS in their clinic, my doctor, your doctor, has all of that. Okay, cool. We rabbit-holed.

Dr. Matt Cook

Speaking of that, remember you told me you did the Novel Biome fecal microbiota transplant capsules? How did that go? Did that help the gut?

Ben Greenfield

It helped. It stabilized my tolerance to eating a wide variety of foods. What it didn't seem to do, and this is basically one of the major things those 15 years of lab data found, is that I produce massive amounts of hydrogen sulfide, which even SIBO tests hadn't really detected. So anything sulfur-based, like eggs, poultry, broccoli, etc., was causing a pretty significant amount of gut disruption for

Dr. Matt Cook

me. My experience with that has been that it's super helpful to recolonize and create that diversity, but if there's a structural issue going on, a lot of times you have to go back to the drawing board on lifestyle, and go back to managing that system. But I've seen quite a few people who had positive results from that. Now you begin to realize we're influencing a system, and a lot of times if I influence the gastrointestinal system, that's going to have side effects that help other systems too. Taking a probiotic, or even a fecal transplant, is one way to affect the gastrointestinal system. Another way to affect the gastrointestinal system would be to take BPC.

Ben Greenfield

Okay, I want to dig into some of these other peptides, not quite a lightning round, but I definitely want to have time to touch on each one. So let's dig into these other six. What else do we have?

Dr. Matt Cook

Let me just run you through BPC before we close out that one. There's no single confirmed receptor. One thing it'll do, and the top two peptides are probably BPC and Thymosin Beta-4, TB-500, so now they do some similar things. It'll be interesting to compare them and how they work together. What happens is these have effects both inside and outside of cells. On the inside of a cell there's an internal structure, kind of like a scaffolding, and one of the proteins in that internal structure is called actin. It appears BPC can go all the way inside a cell and act on that, and when it acts on that, it gets that cell to mobilize. I think of this almost like, have you ever seen one of those balls you can get into and roll around? We should find a video of that. BPC can do that, so it seems to influence the ability of cells to migrate through tissues and through scars. Probably the most impactful thing, one of the things I do, is hydrodissection, where I stick a needle into a fascial plane, and if that needle happens to have BPC-157 in it, that would influence the ability of the cells it's talking to in that area to migrate through. A lot of people have seen a big improvement in patients who had scars, and scars often lead to nerve entrapment and nerve pain, and often in scars there's not good collagen. BPC helps with collagen, it helps with cell migration, it seems to affect nitric oxide, which has to do with vasodilation of blood vessels, and it seems to be able to balance that whether it's up or down. As a result, all of those things can affect wound healing, and it can also help grow new blood vessels, and all of those effects at the musculoskeletal level lead to improved healing. Some people experience that by injecting it right where they need it, some inject it subcutaneously right over an area, and some will experience it by just taking it in the hip. All of those mechanisms are live for a tendon problem, but they're also probably having an effect systemically in the gut, so a lot of people who take BPC, whether systemically or as a pill, will notice an improvement in gut symptoms. So when we're thinking about a systems approach to optimizing someone, maybe we give them a probiotic to work on their gut, but maybe we'd add BPC-157 to that. In the same way, when you think about a problem like inflammatory bowel disease, like ulcerative colitis, that's a crazy autoimmune condition, and if that doesn't go well, the Western medicine approach is to cut out the colon and do an ostomy, where they basically give you a bag to poop into. That's a crazy condition, and it's definitely hard to treat. How we treat that is we give something that suppresses the immune system, and that's why you hear about people who are immunosuppressed, taking medications to suppress their immune system. But sometimes people are on maximal immune suppression and still have symptoms, and sometimes they can't get up to a high enough dose. Both of those are candidates where they could take BPC-157 in addition to their immunosuppressive medication. So you begin to see that BPC has broad regulatory benefits, can work across multiple systems, and is a helpful adjunctive drug that can help a diversity of people.

Ben Greenfield

I've heard that KPV is also one that people use a lot for leaky gut or gut inflammation. Do you put that in the same category, or stack it with BPC-157? And that's on the list too, right?

Dr. Matt Cook

That's on the list, so we'll go there next. So KPV, there's a bigger protein called Alpha-MSH, and Alpha-MSH is one of the most anti-inflammatory proteins in the body. Remember, I said sometimes you have a protein with a little terminal end that does something, the handshake that does something. KPV is a three amino acid terminal end of MSH. Right now I could shake your hand, but there's 180 pounds of Matt attached to one active right hand that can shake a hand. KPV is basically just the hand, kind of like Lurch, that can shake your hand and have the effect.

Ben Greenfield

Yeah.

Dr. Matt Cook

Or maybe it's just the hand. Did you see "Wednesday"?

Ben Greenfield

No.

Dr. Matt Cook

Oh, it's from the Addams Family. There was a hand that could do stuff.

Ben Greenfield

Okay.

Dr. Matt Cook

So KPV is just that terminal end, and what happens is it gets absorbed into cells and regulates how a cell leads to inflammation. When a cell is in a state of stress, it can make inflammatory cytokines and anti-inflammatory cytokines, and KPV suppresses the inflammatory cytokines, having an anti-inflammatory effect.

Ben Greenfield

Right, and would that be oral or injectable?

Dr. Matt Cook

KPV is a two-for-one peptide, because you can take it injectable and it will have a systemic effect. We've seen many patients over the years take KPV as an injection, but also many people take it as a pill, and sometimes as a pill with more than one ingredient.

Ben Greenfield

Okay, and one other question about KPV. If it's anti-inflammatory like that, could you theoretically use it on wounds or tissue injuries?

Dr. Matt Cook

So often what happens is, if there's a wound, a wound has inflammation. That inflammation is a signal for something to come in, turn that inflammation off, and basically say, the coast is clear, we can move in and fix this area. KPV was actually, in our hands and our experience, mostly used for gastrointestinal purposes. However, the FDA looked at it for wound healing and approved it based on that. So KPV can have an anti-inflammatory effect, and by turning the inflammation off, switch the body into healing mode for wound healing. But it can also work on the gut, managing inflammation, and it seems to also help with barrier function, so it may help those cells be tighter and work together in that way. So this is a very wide diversity of ways it can help people.

Ben Greenfield

Was TB-500 on the list? Because that fits into the category of another one that a lot of athletes look at for tissue injuries.

Dr. Matt Cook

Right, and this is the perfect sequence, we didn't plan this, but it's kind of perfect to talk about this next, because TB-500 was also assessed for wound healing. TB-500 works for wound healing, and KPV works for wound healing too, primarily by an anti-inflammatory mechanism. TB-500 is kind of almost like a brand name. Somebody said to me at the meeting that TB-500 is a nickname, and there's a bigger, 54 amino acid peptide called Thymosin Beta-4. Thymosin Beta-4 is actually a protein, a peptide that's inside of cells, and it has several active fragments, kind of like a right hand and a left hand, and they do different things.

Ben Greenfield

Okay.

Dr. Matt Cook

And remember I said that idea of a ball you could crawl into and roll around?

Ben Greenfield

Yeah.

Dr. Matt Cook

TB-500 is really very active at activating that actin cytoskeleton and influencing the ability of cells to migrate around.

Ben Greenfield

Okay, so we've got kind of three different mechanisms of action. So theoretically, if you had an injury, when you say "wound," by the way, does that include injuries in the medical sense, or is a wound just like whatever, the cat clawed my arm?

Dr. Matt Cook

So there'd be a variety of different types of wounds, from a surgical wound to a non-healing wound. There's a diversity of different types. I don't know what happened, but it was kind of stressful in COVID, and we suddenly went to never going out to dinner and cooking all the time, and in the first six months of COVID, Barb burned her forearm probably six times. Barb, the CEO of BioReset Medical, and my wife,

Ben Greenfield

Okay, yeah, and my wife. Congratulations, by the way.

Dr. Matt Cook

Yeah, thank you so much, that's amazing. We had a Willie Nelson song play at our ceremony by going to a Willie Nelson concert, but it still worked. Somebody told me, "Oh, Barb got a horrible burn on her arm from hitting a hot oven," and then what we would do is inject BPC and TB-500 around that, and Barb doesn't have a single scar from any of those injuries. That was this aha moment when we realized, oh, these work on wounds, they work on the gut, they influence healing, they have this diversity of different ways they work. KPV, BPC, and TB-500 work synergistically, so a lot of people like to put those together, and when you put those together with GHK-Cu, they call it GLOW.

Ben Greenfield

Oh yeah, I've heard that. Okay, cool, the GLOW stack. Interesting.

Dr. Matt Cook

BPC and TB-500 put together, they call that Wolverine.

Ben Greenfield

The Wolverine stack.

Dr. Matt Cook

And even John Francois, our buddy, when I first met him years and years ago, he said, all he knew, and this is from a decade of bodybuilding people, is that what happens is you take BPC and TB-500 and put them together.

Ben Greenfield

Yeah.

Dr. Matt Cook

And sure enough, now there are millions and millions of people using these combinations.

Ben Greenfield

Yeah. By the way, for those of you who really want to keep track of mechanisms of action, I'll give you a URL at the end where you can go get the cheat sheet for all of these different peptides, if you just want to see what they do, how to get them, etc.

Dr. Matt Cook

Now, can I dive in just a tiny bit more on TB-500?

Ben Greenfield

Yeah.

Dr. Matt Cook

So TB-500 comes from this big protein, Thymosin Beta-4, which is 54 amino acids, but it's got an active fragment, and the most active and most important fragment is the 17-to-23 amino acid fragment. So TB-500 is just a fragment of this bigger peptide, and that fragment has an effect intracellularly to get those cells to migrate, but it's also having effects extracellularly to help with collagen, so it's having a diversity of different effects, and it's probably having some immune-regulatory effects as well. But we talked about KPV being three amino acids. Three amino acids is really small, like an individual amino acid supplement you'd walk into the clinic with. KPV is three of them, TB-500 is seven. When you have three to seven amino acids, that's such a small amount that it's smaller than the size at which either our T cells, which are one side of our immune defense, or our B cells, which are another side, can react against. That's why, across millions and millions of doses, we're not seeing any immunogenicity, which is a big topic the FDA was concerned about, because these are too small for people to really have any immune reactions to.

Ben Greenfield

Like redness, swelling, inflammation, stuff like that?

Dr. Matt Cook

Yeah. Now, I have seen a few more immune reactions with BPC, but that's 15 amino acids, so it's a little bit bigger. The smaller peptides are really, really safe in terms of not causing any type of reaction in general.

Ben Greenfield

Yeah, okay. Matt, I've got you for about 15 minutes or so, and I want to do the other four peptides. Can you give me a glimpse into the most important aspects of these other four? Although I think there's one that didn't make the list.

Dr. Matt Cook

Yeah, there's one that didn't make the list.

Ben Greenfield

Okay, so the three that did, and the one that didn't.

Dr. Matt Cook

The three that did. So the next one is MOTS-c.

Ben Greenfield

Okay.

Dr. Matt Cook

And MOTS-c is a mitochondrial peptide, so all of these are kind of interesting. In a setting of stress, remember, the mitochondria make the energy in the cell,

Ben Greenfield

right.

Dr. Matt Cook

And if you could help the mitochondria, I call that the rising tide that lifts all boats, because if I help the mitochondria in my brain, I can think better. If I help the mitochondria in my liver, I can detox better, because the liver does a lot of stuff, makes stuff, does all kinds of things. What happened is, there's a gene called a mitochondrial gene, because we have genes in our mitochondria, and other genes that are in the cell itself.

Ben Greenfield

Okay.

Dr. Matt Cook

And what happens is, a peptide that's coded for in the mitochondria, in a setting of stress, the mitochondria transcribes that, turns it into a peptide, and that peptide goes into the nucleus of the cell and activates AMPK. It basically has an effect kind of like what would happen if a cell was exercising.

Ben Greenfield

Oh, so this is like when people say something is an exercise mimetic, it mimics the effects of exercise. MOTS-c does that.

Dr. Matt Cook

Yeah.

Ben Greenfield

Interesting. Fasting does that too. Does it mimic, I mean, anything that increases AMPK would cause a similar effect?

Dr. Matt Cook

Exactly.

Ben Greenfield

So none of us need to exercise anymore.

Dr. Matt Cook

Probably not. There's no surrogate for exercise, and the more you exercise, the better. We just need to program ourselves.

Ben Greenfield

And you can also kind of throw bone density, skeletal muscle mass, and all that out the window, but you at least get the AMPK.

Dr. Matt Cook

But interestingly, there's a theory that if you could improve mitochondrial function, and that could get a cell working better, and that cell happened to be a bone cell, then, and that was one of the things it was evaluated for, osteoporosis. The other thing it was evaluated for was obesity, because the idea is, if you could get those cells to act more like exercising cells and be healthy, maybe you could burn energy better, so it would have an effect on obesity or osteoporosis.

Ben Greenfield

Interesting.

Dr. Matt Cook

But we also think people tend to have a bit more energy, and that makes sense with a mitochondrial peptide, and it also makes sense from an efficiency perspective of how these cells work.

Ben Greenfield

Right, and for people who already exercise, it could still help them in terms of producing additional AMPK.

Dr. Matt Cook

Exactly, and that's kind of the sweet spot. So what you're doing with these peptides is influencing a system,

Ben Greenfield

yeah,

Dr. Matt Cook

and the way these cells are working,

Ben Greenfield

right,

Dr. Matt Cook

and then stacking that with exercise,

Ben Greenfield

yeah,

Dr. Matt Cook

or better sleep,

Ben Greenfield

okay,

Dr. Matt Cook

or supplements that are working on that same system.

Ben Greenfield

Okay, so we've got BPC, KPV, TB-500, MOTS-c. What's the fifth?

Dr. Matt Cook

Semax is another peptide that's a brain-based peptide. There's a hormone called ACTH, and Semax is a fragment of that. Remember, a lot of these are fragments. KPV is a fragment of Alpha-MSH, BPC is a fragment of a stomach protein, and Semax is a fragment of ACTH. It has an effect on the central nervous system, and it has an effect on the hypothalamus. But unlike ACTH, which stimulates cortisol, Semax doesn't stimulate cortisol, but it has an effect of regulating different nuclei in the central nervous system, and what it does is increase one of the most interesting molecules, brain-derived neurotrophic factor, BDNF.

Ben Greenfield

Yeah, it's like miracle grow for the brain, right?

Dr. Matt Cook

Exactly. Brain-derived neurotrophic factor binds onto something called TrkB, a tyrosine kinase. Semax may increase both of those, or it may just increase the sensitivity of the tyrosine kinase. When it binds onto that, it activates it, and that leads to improved ability for learning. Everybody thinks the elephant is the smartest animal, but maybe it's the hippo, and that's just a little mnemonic I use, because the area of the brain related to memory is called the hippocampus.

Ben Greenfield

The hippopotamus.

Dr. Matt Cook

The hippopotamus. What was that song, the hip hip hip hop hippopotamus? Anyway, so Semax is active in the hippocampus to increase BDNF and activate this tyrosine kinase, and that turns on learning, and

Ben Greenfield

it's not like a central nervous system stimulant, certainly not like caffeine, or paraxanthine, or any of these other things people use as energy compounds. It's more something that just increases the ability to learn, or I guess synaptic plasticity, is that the type of thing?

Dr. Matt Cook

It's thought to do that. And it has anti-inflammatory effects in the central nervous system, so it was assessed for trigeminal neuralgia, and it was assessed for migraine headaches, which it has some effect on, but less so. We've really seen improvements with cognitive function. I have a practitioner I was talking to who said that basically they have a genetic condition where everybody in their family gets Alzheimer's in their 50s, and they were struggling with memory. They take this every day, and they're back to functioning totally fine. And this is a cognitive enhancer that also has anti-inflammatory effects, because remember we're thinking about migraine headaches, but this was developed by Dr. Khavinson in Russia, who's the godfather of all peptides, and they actually studied giving it to patients who'd had a stroke, and it improved benefits after a stroke. And so this is going to be something where, up until now, you had doctors in clinics doing this. What we need to do is first be able to track data on this, but then these things need to be available in hospitals where people can use them.

Ben Greenfield

BPC, KPV, TB-500, MOTS-c, Semax. What's number six?

Dr. Matt Cook

Epitalon. Epitalon was also developed by Dr. Khavinson, synergistically, and I actually got a chance to go study with him.

Ben Greenfield

Oh, wow! And he's dead though, now, isn't he?

Dr. Matt Cook

He died. Yeah, and that was a tragedy. He basically found out that all of these different organs had what are called bio-regulator peptides, which had regulating effects on those organs. What he and his team found is they synthesized them, and initially what they did was make oral preparations of these bio-regulator peptides, which were all two or three amino acids. One of the areas they were really interested in was the pineal gland, because the pineal gland makes melatonin and controls our sleep-wake cycle and our circadian rhythms, and they thought, if we could regulate that pineal gland, wouldn't that be interesting? It turns out they found a variety of different sequences of bio-regulators within the pineal gland, and they called it Epithalamin. Then they chose the sequence they felt was the most active, and that's a synthetic peptide called Epitalon, a four amino acid peptide, which we'd consider to be a bio-regulator peptide. It was evaluated for insomnia, the idea being that if it can regulate the pineal gland, it may influence it to secrete more melatonin, which tends to decline just like all of our other hormones as we age. So they studied it for that indication. The other thing Epitalon seems to do is turn on an enzyme called telomerase. All of our chromosomes have a little cap at the end, and that cap tends to be long when we're young and gets smaller and smaller as we age, and there's a theory that Epitalon seems to catalyze or turn that on, which could be useful from a longevity perspective. So one thing it's doing is regulating our central nervous system in a sleep-wake cycle, another is maybe lengthening telomeres, which could have an effect, and it also seems to have anti-inflammatory effects. A lot of people will use it from a stress perspective. Dr. Khavinson actually found that it reduced all-cause mortality, and that's what led it to become a very popular peptide early on from a longevity perspective, also based largely on a very robust base of Russian research.

Ben Greenfield

Yeah, the decreased mortality is something I first learned about with Epitalon, and then I found out about the telomerase activity, and then recently, I can't believe I didn't realize its effects on sleep and indications for insomnia. But it is super fascinating that it could both help you live longer and sleep better, potentially.

Dr. Matt Cook

Yeah, and if you could sleep better, that might help you live longer too. But then, compared to other sleep aids, other sleep things put you to sleep, but in putting you to sleep there's often a hangover effect, and there's also a risk with anything that puts you to sleep, since those tend to be sedating. Morphine could put you to sleep, but it could put you all the way to sleep. But both Epitalon and DSIP, which stands for delta sleep-inducing peptide, seem to have an ability to regulate sleep architecture, influencing the central nervous system broadly in terms of how it's sleeping, rather than just putting you to sleep.

Ben Greenfield

Let's finish with that one, DSIP. That's the one that didn't make it, right? Why?

Dr. Matt Cook

What happened is, they took rabbits, this is back in the 70s, and the rabbits were asleep, and they were able to take a sample of venous blood from the rabbit and found this peptide, DSIP. They thought maybe it's something in the central nervous system, since they were only finding it when the rabbits were asleep. So maybe it's something that regulates the central nervous system during sleep, and that's how they came up with the name delta sleep-inducing peptide. Some of us aren't so confident that's the primary thing it does. It seems to more broadly regulate the central nervous system's response to stress at a variety of levels, and it also seems to have an effect on sleep architecture, but it's not necessarily putting people to sleep in the way it might have been marketed. The problem with this one is that the initial trials involved IV dosing of it, and, well, a friend of mine said he might have said no to that one too, from a data perspective, if he hadn't been using it for a long, long time already.

Dr. Matt Cook

And that was that. Shout out to Dr. Jim LaValle, who's just one of the godfathers. I love

Ben Greenfield

you, former podcast guest, Matt. Your encyclopedic knowledge of peptides blows me away. I know you created a super handy cheat sheet, I'm going to reach for my phone because I have the magical URL written down. Repeat that. So the show notes, by the way, are at BenGreenfieldLife.com/peptides2026, but there's also a cheat sheet at ShopLifeMarket.com/cheatsheet. ShopLifeMarket.com/cheatsheet. I'll also put that in the show notes. Because the regulatory landscape is so rapidly evolving, as is peptide access, where to get them, how to vet them, etc., I'll put as much information on that website as I can to help all of you out. But now you know what happened in Washington, D.C. I would love to hear your comments, your questions, your feedback over at BenGreenfieldLife.com/peptides2026. I know we flew through this and fed you through the fire hose, but I promise Matt will be back sometime in the near future to dive into the next meeting that happens. So, Matt, thanks for doing this, man.

Dr. Matt Cook

Thank you. The best.

Ben Greenfield

To discover even more tips, tricks, hacks, and content to become the most complete, boundless version of you, visit BenGreenfieldLife.com.

In compliance with FTC guidelines, please assume the following about links and posts on this site. Most of the links going to products are often affiliate links, of which I receive a small commission from sales of certain items, but the price is the same for you, and sometimes I even get to share a unique and somewhat significant discount with you. In some cases, I might also be an investor in a company I mention. I'm the founder, for example, of Kion LLC, the makers of Kion-branded supplements and products, which I talk about quite a bit. Regardless of the relationship, if I post or talk about an affiliate link to a product, it is indeed something I personally use, support, and, with full authenticity and transparency, recommend in good conscience. I personally vet each and every product I talk about. My first priority is providing valuable information and resources to you that help you positively optimize your mind, body, and spirit, and I will only ever link to products or resources, affiliate or otherwise, that fit within this purpose. So there's your fancy legal disclaimer.