By Ashkan Alkhamisi, MD, HonorHealth Orthopedics

When discussing peptide use with patients, the goal is to create a productive, evidence-based and non-confrontational conversation. My advice for physicians and APPs includes the following strategies:

Focus on the evidence, not the social media influencer

Rather than saying, “That person isn’t a real doctor,” consider responding with, “Let’s look at the actual evidence from clinical studies.”

This approach demonstrates respect for the patient’s questions while keeping the conversation grounded in science. Patients are often more receptive when they feel heard rather than dismissed, which helps reduce friction and strengthens the therapeutic relationship.

Explore the patient’s goals and understand why they are interested in peptides

Many patients seeking peptides are simply looking for faster recovery from an injury, or ways to improve their overall health and performance. It is important to validate those goals.

For example, you might say:

“Your desire for a faster recovery makes sense. Let’s review the evidence-based treatment options that currently exist and discuss whether you have already tried them.”

This approach acknowledges the patient’s concerns while opening the door to discussing established treatments that may have stronger supporting evidence. Patients are often unaware of other available options and may benefit from learning about therapies with more robust clinical data.

Explain the hierarchy of medical evidence

If patients ask what type of evidence is needed to support a treatment recommendation, it can be helpful to explain the evidence ladder that physicians use in clinical decision-making:

Anecdotes → Case reports → Small clinical studies → Randomized controlled trials (RCTs)

Patients should understand that many peptide claims are based primarily on animal studies, laboratory data, case reports or anecdotal experiences. Human clinical evidence remains limited for many peptides being promoted online.

Explaining this framework helps patients understand why physicians may be cautious, even when a treatment appears biologically promising.

You might say:

“One of my concerns is that we do not have enough high-quality human data to determine the most appropriate dosing, duration of treatment and long-term safety profile for many peptides. That uncertainty makes it difficult for physicians to confidently recommend them.”

This emphasizes that your concern is centered on patient safety rather than skepticism alone. Explaining that while small case reports and observational studies exist for some peptides, these studies are generally uncontrolled and may come from clinics or organizations with a financial interest in the product.

Help patients understand that not all peptides are the same

Patients may ask, “Aren’t GLP-1 medications peptides too?” or “Insulin is a peptide, so why are doctors okay with that?” These are reasonable questions and provide an opportunity to explain how physicians evaluate treatments.

You might say:

“You’re absolutely correct that medications like insulin and GLP-1 receptor agonists are peptides. The difference is not that they’re peptides, but the amount and quality of evidence supporting their use. Insulin and GLP-1 medications underwent years of laboratory research, human clinical trials, safety testing, dose-finding studies and large randomized controlled trials before receiving FDA approval. We know the appropriate dosing, expected benefits, common side effects and potential long-term risks because they’ve been studied extensively in thousands of patients.”

Then contrast that with many currently marketed peptides:

“For many of the peptides being promoted online for injury recovery, performance enhancement or anti-aging purposes, we don’t yet have that same level of human evidence. The concern isn’t that they’re peptides, but that we don’t yet know enough about their effectiveness, optimal dosing, long-term safety or which patients may benefit most from them.”

A helpful analogy is:

“Saying all peptides are the same would be like saying all antibiotics are the same because they’re antibiotics. Physicians don’t judge a treatment by its category alone. We judge it by the quality of evidence supporting that specific treatment for a specific condition.”

Acknowledge that early interest doesn’t necessarily mean a treatment is ineffective

Influencers are not always wrong, and it’s important to say this too. Some therapies that eventually became widely accepted generated significant online interest before more extensive clinical evidence emerged. The key issue is not who is promoting a treatment, but rather the quality of evidence supporting it.

A balanced message for patients is:

“The proposed benefits of these peptides may be biologically plausible, but many remain clinically unproven. At this time, the available evidence is not strong enough for me to routinely recommend their use. However, if future high-quality human clinical trials demonstrate safety and effectiveness, I’d be happy to revisit this conversation.”

This approach communicates open-mindedness and a commitment to keeping up with emerging evidence. Most importantly, it reassures patients that the discussion is ongoing and that your recommendations will continue to evolve as better clinical data become available.

Bottom line

When discussing peptides with patients, lead with curiosity, empathy and evidence. Validate the patient’s goals, acknowledge the excitement surrounding emerging therapies, explain the current limitations of the data and emphasize that treatment recommendations should be guided by well-conducted human clinical research.

This approach helps preserve trust while ensuring patient care remains grounded in evidence-based medicine.