Victorians are landing in emergency departments after suffering severe side effects linked to illegal peptides, including vomiting, abdominal cramping, and chest pains that mirror heart attacks.
Doctors also warn that contaminated peptides are fuelling a surge of serious skin infections which have required skin grafts and even amputations.
Royal Melbourne Hospital’s director of emergency medicine, Dr Mark Putland, said doctors initially suspected some patients were suffering heart attacks, only to discover after extensive tests and monitoring that the true culprit was a complication or overdose from black-market peptides.
“They’re very distressing symptoms,” the emergency physician said. “We’re talking about really severe vomiting and chest pain. This can go on and on for days.”
As social media influencers fuel a surge in injectable peptides – being spruiked for everything from weight loss and body building to skin improvements – it can also be revealed that a Victorian has died after using the substances.
The Coroner’s Court confirmed it was investigating a death related to the use of growth-stimulating peptides (CJC 1295 and ipamorelin) prescribed by a medical practitioner.
Putland said the hospital had treated some patients who had consumed 10 times the recommended dose of peptides.
“They have obtained something that’s meant to be taken once a week, but they’re taking it every day because they thought it would work better,” he said.
“There’s no quality control. My fear is as this market grows we will see more extreme things happen.”
The Royal Australian College of General Practitioners’ Dr Tim Jones, who chairs the specific interests child and young person’s health network, said peptides were causing severe and unpredictable complications.
“The most common issue we’re seeing at the coalface is serious contamination from these backyard products,” he said. “We’ve heard of young people even needing amputations or skin grafting as a result of this.”
Jones said some people were developing severe infections at the injection site, which he said was caused by bacterial contamination of the peptides during the manufacturing process.
This has led to cases of compartment syndrome, a dangerous condition where pressure builds up within an enclosed muscle, restricting blood flow, and causing a limb-threatening emergency.
In some rare cases, this has resulted in fingers, toes or arms, needing to be amputated, he said.
Jones, based in Tasmania, also recently treated an 18-year-old man who had a heart attack after consuming experimental peptides.
“They were using a product that they felt to be safe,” he said. “We still don’t know what the specific ingredient was that triggered it, we just know that it can’t have been what that young person thought they were taking.”
Jones said body issues among young men were at “astronomical levels”, making them particularly vulnerable to social media influencers peddling the peptide craze.
“They are saying things like they don’t look strong enough, they look chubby, they’re concerned they’re not attractive, and they want to fix it,” he said.
Dr Beng Eu, a general practitioner and co-director of Prahran Market Clinic, said there had been a sharp increase in patients using experimental peptides for muscle building, skin care or biohacking. These products can be swallowed, injected or rubbed into the skin.
The doctor, who has been studying the rise of peptide use and is pushing for tighter regulations, said many of the substances had not even been tested on humans.
“It’s quite dodgy because they’re relying on studies which have been undertaken on rats,” he said. “There is no real safety data.”
In one recent case, he treated a 14-year-old boy, brought into the clinic by his worried mother after taking steroids and peptides he purchased illegally online to try to increase muscle growth.
The teenager’s use of the substances affected his testosterone levels and suppressed the onset of puberty.
“He’s got significant issues now that we will have to try and resolve,” he said. “It’s a bad situation when someone that age can access these sorts of substances so easily.”
At the Royal Melbourne Hospital, Putland said most of those presenting with peptide complications were aged in their 20s or 50s. Some were reluctant to tell doctors they had used peptides due to embarrassment, which delayed diagnosis.
The vast majority were using peptides for weight loss, with products promising to offer the same effects as well-known drugs like Ozempic. Others were consuming the substances for anti-ageing or muscle building.
“They’re often sold as part of a suite of anti-ageing or weight-loss therapies and treatments, some of which are reasonably sketchy,” Putland said.
He said the spike in patients arriving in hospital had occurred suddenly.
“Recently, it’s become routine,” he said. “We really think this is just the tip of the iceberg.”
Treatment often involves managing the unpleasant side effects and discontinuing use of the substance.
Peptides are short strings of amino acids that occur naturally in the body to manage everything from inflammation to blood sugar levels. Many have been synthesised in labs to create approved therapeutic goods like insulin and the weight-loss drug Ozempic.
A boom online has seen unregulated lab-made peptides being touted as a cure-all or quick fix. The most popular substances include BPC-157 for muscle growth and recovery, GHK-CU for skin rejuvenation, and Melanotan-II, the “Barbie peptide” popular for tanning.
Often, they are bought illegally online or directly from Chinese manufacturers.
Dr Timothy Piatkowski and his colleagues at Queensland Injectors Voice for Advocacy and Action run the national hotline Steroid QNECT, which provides free and confidential safety advice to steroid and peptide users.
There has been an explosion of inquiries from people using peptides over the past year, with about 30 calls received every week, said the senior research fellow at the University of Queensland.
Earlier this week, a 16-year-old phoned the hotline to seek advice on how to safely start peptides.
Many callers seek help for side effects, such as severe gastrointestinal upsets linked to the peptide retatrutide and potential damage to their kidneys. They also seek guidance on how to reconstitute peptide powder and safely inject.
Some callers report using five times the dosage administered in clinical trials.
“When people purchase unregulated injectable peptides, they don’t really get any wrap-around care or education,” Piatkowski said. “They’ve got no idea in terms of dosing. They’ve got no idea about potential effects.”
He warned that without clinical oversight, growth-promoting peptides could accelerate malignant growths in people who are unaware they have cancer.
Piatkowski said Australian regulators had been slow to respond to the surge in illegal peptide use and called on them to restrict online access to the medicines.
“You’ve got a whole new cohort of people injecting drugs,” he said. “They aren’t exposed to our blood-borne virus prevention and injection-related bacterial infection prevention information.”
The Victorian Poisons Centre, which is run out of the Austin Hospital, has also seen an increase in calls relating to peptides in recent years.
But a spokesman for the service said this included both prescribed medicines and unregulated peptides, as well as cases where people have been confused about dosing.
The Therapeutic Goods Administration said it was actively monitoring and taking action against the global rise of unapproved, unevaluated peptide products driven by social media and online clinics.
A spokesman said while it handles illegal advertising and supply, the responsibility for regulating the doctors prescribing these peptides and the pharmacists compounding falls under Australian Health Practitioner Regulation Agency.
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