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Peptide Therapy: What Patients Should Know
Fishtown Medicine•3 min read
4.96 (124)

Peptide Therapy: What Patients Should Know

Ashvin Vijayakumar MD

Medically Reviewed

Ashvin Vijayakumar MD•Updated May 22, 2026
On This Page
  • What Peptides Are
  • Why the Regulatory Posture Matters
  • What Fishtown Medicine Does Offer
  • Why We Don't Prescribe Research-Grade Peptides
  • If You Are Already Using a Research-Grade Peptide
  • Common Questions
  • Is Fishtown Medicine a "peptide clinic"?
  • Why has the regulatory environment changed?
  • Are GLP-1 medications considered peptides?
  • Why do other clinics still advertise BPC-157 or similar?
  • Can I get any peptide prescribed if I want to pay cash?
  • What if a peptide is sold legally as a "supplement"?
  • Does this restriction apply to FDA-approved peptides too?

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TL;DR30-second take

Peptides are short chains of amino acids that act as signaling molecules in the body. A small number of peptide medications are FDA-approved and can be prescribed by physicians; the vast majority of peptides discussed in wellness media are not. State medical boards have clarified that physicians cannot prescribe, recommend, administer, or supply research-grade or non-FDA-approved peptides. Fishtown Medicine prescribes only FDA-approved peptide medications sourced through licensed US pharmacies.

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:

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  • 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

3 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.


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.

Frequently Asked Questions

Common Questions

No. Fishtown Medicine is a Direct Primary Care practice. We prescribe FDA-approved medications, including a small number of FDA-approved peptide medications when clinically indicated, but we do not market or operate as a peptide clinic and we do not prescribe research-grade peptides.
State medical boards and the FDA have been increasingly explicit about the prescribing standards that apply to peptides. The FDA's 503A and 503B compounding categories have been clarified, and several peptides that were previously available through compounding pharmacies are no longer compoundable. State boards have followed with guidance that prohibits physician involvement with non-FDA-approved peptides.
Yes. Semaglutide, tirzepatide, and liraglutide are peptide medications. They are FDA-approved, manufactured by pharmaceutical companies under FDA oversight, and dispensed through licensed pharmacies. They are what most patients are actually asking about when they ask "do you prescribe peptides for weight."
We cannot speak to other clinics' practices or the legal exposure they may be taking on. State medical boards have been clear that the prohibition applies regardless of how a clinic frames the offering, what consent forms a patient signs, or which staff member writes the prescription.
No. The regulatory standard does not bend based on payment method. A physician's prescribing authority is defined by the FDA and state licensure, not by whether the patient pays through insurance or cash.
A small number of peptides are sold over the counter as dietary supplements. These sit outside the prescription system entirely. We do not endorse, evaluate, or take clinical responsibility for over-the-counter peptide supplements. If you are using one, that is a decision you have made independently.
No. FDA-approved peptide medications (GLP-1s, Sermorelin, Tesamorelin, insulin, and others) are prescription medications and are prescribed through the normal process when clinically indicated. The prohibition applies specifically to research-grade and non-FDA-approved peptides.

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