Thread by @anthonystaj

🧵a few months ago i started looking at bpc-157. my research showed me that while there is very little clinical evidence to show it works, there's even less to show it's safe. there are zero long term studies on BPC-157 use. the FAERS database is underutilized since most people who take it don't see a doctor and don't report adverse events.

so i asked: can we mine existing online communities for people discussing this peptide and its adverse events?

the answer is yes, and i am sharing my results here today with the goal of improving informed consent to users of this peptide. to be clear i don't care if people take it, but I think if you want to take it you should know what might happen to your body before you do.

in order to do this work I mined mostly Reddit. I downloaded every single comment I could find in most of the popular peptide sub-reddits, but this analysis focused on the r/bpc_157 subreddit

i processed about 37k comments with claude 4.6 according to a pharmacovigilance adjudication rubric. it would categorize comments into AE buckets, pull the full quote, infer severity, report on concomitant medications if mentioned and try to determine re/de challenge data which is critical to determining causality with these agents (and more)

you can find the full paper on my substack, or see the results for yourself on the website

bpc157ae.xyz

some highlights: i found over 2400 AE reports with 3000 AE category mentions from 1370 unique users over 4+yrs

by far the biggest category was neuropsych, with anhedonia dominating the reported AEs, and anxiety close behind. of note as we head into the PCAC meeting this week, there was a substantial GI tox signal including one person with detailed account (including hospitalization and clinician attribution to the peptide) resulting in colitis. this is the same indication the adcom will vote to approve the use of the peptide for *treatment*

there was also a high level of severity associated with these results. it's tough to say what this means to a population since people who go online to report an event are probably more severe by nature, but nonetheless some of the most severe cases were alarming

some may ask: yes but how is this causal data

and to that i have a few replies. 1. there was a wealth of re/de challenge data and i have documented it for every indication. in the case of GI specifically, we have 7 cases of positive rechallenge which means that a user reported an AE, stopped taking bpc157, then took it again after some time and the AE manifested again. this is gold standard pharmacovigilance data. complementarily, we have 74 cases of dechallenge which is when a uses discontinues the peptide and sees symptom improvement.

i also ran a number of cross-cutting analyses across the whole dataset including dosing which was very interesting as it showed that dosing is generally up in the public reports. that could be real users taking more subtstance over time, that could be positive bias in the dataset since heavy users report AEs more often, or something else. but in general i would say this is worrying because it's not like there's an official dose with clinical data supporting it. people are just taking what they think works and underwriting the risk of AEs

i also found routes of admin interesting, as it seems that people are injecting the substance more over time. it seems that people are more willing to take a syringe today than several years ago

a ton of users reporting AEs appear to be "stacking", in particular the "wolverine" stack with TB500

these were interesting but the single most interesting finding i pulled was the comparison to pharmacy sourced materials against the broader data set which showed that the AEs were basically the same.

This also corroborates previously published reports suggesting that the vials are mostly pure material! so the AEs are likely not the result of impurities, but actual drug substance related adverse events

one spot I noticed a significant uptick in AEs was the ocular toxicity cohort which more than doubled with pharmacy sourced product

the most troubling signal i found though was the cancer risk signal. I've been pretty vocal about this already so i won't rehash that part. but I found about 20 cases where people report cancer like AEs from taking bpc157.

remember the MoA here is VEGF agonism, and we have about 15 approved cancer drugs which act in the exact opposite manner. so it makes sense that this could actually accelerate cancer formation in people. there was also an case report of an individual who (very, very sadly) gave bpc157 to her dog only to watch its masses grow and arthritis get worse.
x.com/anthonystaj/st…

now for some caveats/ limitations. I have no idea what total number of people used bpc157 for us to get these numbers. it could be 10 000, it could be 100 000. that's not the point. the point is to identify potential adverse events and let users make informed choices. this is an internet based retrospective analysis. I think you face more bias in promoting this product (since people have financial gain) than you would from people reporting AEs online in forums but it is a source of bias nonetheless. I speak a lot more about this in the substack writeup

on informed consent:

if you're a 20yo healthy male and have very very little to gain from taking this peptide, maybe don't until we know more about it. if you're a 56yo former construction worker who's got two busted shoulders and you've tried rehab for 5yrs to no avail, maybe you proceed with caution knowing that you could get some bad AEs.

i am a big believer in bodily autonomy. imo people should be allowed to smoke even if i think it's super bad for them. people can play football and get a concussion. people can join the military and get killed at war.

that's all fine with me. but in all those cases, people know what they're getting themselves into. with bpc157 this has not been the case and this is my attempt to fix it

going a bit further, if you're a clinician and you give a script for this and people get hurt/ die from it, it's on YOU. that liability is on the prescribing physician. you ought to be extremely mindful of that risk if you are writing that script. I've seen some truly weird "docs" online say "you need to get insurance that covers this" if you're going to prescribe these peptides.

super weird take! nothing wrong with waiting for clinical data to tell us how safe or not these peptides are

all in all, you can see the full write up/ paper on my substack, and the interactive data results on the website.

I am interested in sharing the raw data with academics and governmental agencies