Built for clinics, pharmacies, and telehealth · DiscoveryRX now lives at discovery.peptiter.com

Precision peptide therapy for the clinics that prescribe it.

Peptiter turns home IGF-1 microsampling, quality-of-weight-loss panels, CGM, ketones, wearable RR intervals, genomic/PGx data, and AI-administered questionnaires into prescriber-reviewed recommendations — for longevity clinics, 503A/503B compounding pharmacies, and multi-state telehealth groups. Our discovery research stack (BioScout, structure-first generation, in-silico lab, LabSpace handoff) runs as a separate tool at discovery.peptiter.com.

Request Clinic Access For Clinics, Pharmacies & Telehealth Explore IGF-1 Home Testing Open DiscoveryRX ↗

New · Podcast Episode 1 · 9 min

Listen: All about the Peptiter platform

A 9-minute walkthrough of MetabolicRx, FocusRx, MindRx, the ChaosHRV engine, and how clinics, pharmacies, and telehealth groups use Peptiter.

At-Home IGF-1

Strength-First

Prescriber Reviewed

Evidence-Gated ML

At-Home Labs

PGx-Aware

AKS-Clean Economics

503A/503B Compatible

Multi-State Telehealth

HIPAA Compliant

Clinics

longevity, functional, and ADHD/mental-health

Pharmacies

503A & 503B compounding partners

Telehealth

multi-state, multi-prescriber programmes

Flat licence

AKS-clean · zero per-script fees

§ 01Why Peptiter exists

Modern peptide prescribing flies on instruments from 1990.

Blind Prescribing

Peptide protocols are chosen from population averages. A 42-year-old keto-adapted male gets the same sermorelin dose as a 55-year-old on a standard diet. No continuous data informs the decision.

No Feedback Loop

After prescribing, clinicians wait 4–8 weeks for labs. CGM data, ketone dynamics, and wearable signals that could provide continuous metabolic feedback sit unused.

No Objective Mental-State Measurement

Standard HRV shows zero change during cognitive tasks. Subjective symptom reports arrive weeks late. Chaos indices from RR intervals detect state changes invisible to RMSSD and LF/HF — but nobody uses them yet.

§ 02Six products, one platform

One prescriber dashboard. Home labs, live signals, genomics, mental-state monitoring, and discovery.

Each product shares the same ML flywheel — every prescriber decision sharpens recommendations across the platform.

MetabolicRx

Peptide Prescribing for Metabolic Health

01KetoInsulinKit engine: OII (Overall Insulin Impact) score from CGM + blood ketone BHB suppression
02Metabolic phenotyping: insulin sensitivity, GH axis status, ketosis depth, recovery capacity
03Protocol optimisation: sermorelin, NAD+, tesamorelin, oxytocin dosing with full clinical rationale

"The OII score captures insulin demand dynamics in keto-adapted patients that no single lab value can."

Therapeutic targets

PEPTIDE / RX

Sermorelin

PEPTIDE / RX

NAD+

PEPTIDE / RX

Tesamorelin

PEPTIDE / RX

Oxytocin

Live monitoring stack

CGMBHBRR-intervalSNP/PGxPHQ-9GAD-7SleepOIICIRGeneRx

§ 03GeneRx genomic layer

A one-time genotype becomes the prior for every peptide decision.

GeneRx adds receptor genetics, pharmacogenomic metabolism, and immunogenicity risk to Peptiter's live metabolic and ChaosHRV signals. Unlike CGM or RR intervals, the genomic layer is measured once at intake, then reused across every recommendation.

30–50

SNPs in the minimum viable peptide panel

initial genotype-to-dose modifier rules

Once

measured at intake, applied forever

Minimum viable GeneRx panel

GHRHRGHRGLP1ROXTRKISS1RMC4RCYP2D6CYP3A4CYP2C19UGT1A1HLA

Receptor sensitivity

GHRHR, GHR, GLP1R, OXTR, KISS1R, MC4R

Drug metabolism

CYP2D6, CYP3A4, CYP2C19, UGT1A1

Immune response

HLA alleles flag immunogenicity risk

Data source

Clinical PGx labs, targeted panels, or parsed consumer files

Four phenotyping layers

Metabolic

KetoInsulinKit

CGM + BHB

Insulin dynamics and metabolic flexibility

Mental

ChaosHRV

RR chaos indices

Cognitive state, anxiety signature, engagement

Genomic

GeneRx

SNP panel + PGx

Receptor sensitivity, metabolism, immunogenicity

Subjective

MindRx intake

AI assessments

Symptoms, history, safety flags, goals

The clinical logic is intentionally auditable: genotype variants become peptide-specific, multiplicative dose modifiers, and the rationale string is shown to the prescriber.

Example genotype-to-dose modifiers

GHR d3/fl deletion

Sermorelin

300 mcg→240 mcg

d3-GHR carriers can be more GH-sensitive, so GeneRx lowers the starting dose before live metabolic feedback updates the protocol.

OXTR rs53576 GG

Oxytocin

24 IU→20.4 IU

Higher predicted oxytocin responsiveness turns into a conservative initial dose modifier for MindRx social-anxiety and PTSD-adjunct workflows.

CYP2D6 poor metabolizer

Atomoxetine

40 mg→20 mg

PGx enzyme status can halve atomoxetine exposure recommendations in FocusRx before stimulant or non-stimulant titration begins.

Discovery integration

Variant-aware screening before synthesis.

DiscoverRx can score novel peptide candidates across common receptor alleles, not just the reference sequence. A GLP-1R candidate that misses a common variant should fail earlier, before wet-lab spend.

GLP-1R wild typeBaseline0.85Pass

Gly168SerVariant carrier0.62Pass

Ala316ThrVariant carrier0.71Pass

Population coverage gate

100%

In the briefing demo, the GLP-1R candidate clears the binding threshold for wild-type, Gly168Ser, and Ala316Thr carriers. GeneRx turns that into a population-coverage score that can be logged beside the existing DiscoverRx gates.

Variant-aware G3 contactsAllele binding scoresCoverage thresholdAuditable rationale

Add GeneRx to your pilot

Sequence each patient once. Every Peptiter prescription — today and forever — is filtered through CPIC and DPWG guideline-grade pharmacogenomics.

Request GeneRx pilot →Talk to our team

§ 04PeptiterLabs home testing

Home labs for the next question in GLP-1 care: was the weight loss high quality?

PeptiterLabs owns the lab data loop: order kit, collect dried blood or stool at home, mail the sample, interpret results with standard and optimal ranges, and route every flagged marker into a prescriber-reviewed care pathway. For weight-loss therapy, IGF-1 becomes an optional anabolic-reserve signal alongside nutrition, strength, mood, gut function, and metabolic labs.

IGF-1

home anabolic-reserve marker

QWL

quality-of-weight-loss panel

8–12 wk

retest cycle for outcome tracking

PEPT-CORE

Phase 1 launch

Peptiter Core

$1495 days turnaround

23 analytes4 DBS spots

PEPT-QWL

Phase 2

Peptiter Quality of Weight Loss

$2497 days turnaround

31+ analytesVAMS / DBS + app signals

PEPT-META

Research

Peptiter Metabolomic

$39914 days turnaround

400+ analytes2 DBS spots

PEPT-GUT

Partner lab

Peptiter Gut

$19914 days turnaround

Microbiome analytesStool

Demo Core interpretation

IGF-1

125 ng/mL

Falling

Protein + strength first

IGFBP-3

Optional

Context

GH-axis interpretation

Vitamin D

22 ng/mL

Low

NutraRx

Glucose / A1c

Trend

Monitor

MetabolicRx

TSH / fT3

3.8 / 2.3

Borderline

HormoneRx

Ferritin / B12

Low-normal

Check

NutraRx

Closed-loop journey

Order kit → collect at home → engines update → prescriber reviews → retest.

Peptiter Core becomes the default baseline and 8–12 week retest kit. The Quality of Weight Loss panel adds IGF-1, optional IGFBP-3, body-comp proxies, protein intake, strength/function, gut function, mood, CMP, thyroid, CBC, vitamin D/B12/iron status, and glucose/A1c when GLP-1 therapy needs closer monitoring.

DBS kitCLIA partnerOptimal rangesEngine triggersOutcome retest

§ 05IGF-1 at-home testing

GLP-1 clinics track weight loss. Peptiter tracks the quality of that loss.

IGF-1 is not standard GLP-1 monitoring today. Peptiter turns it into a premium quality-of-weight-loss signal: a home microsampling test interpreted with body-comp proxies, protein intake, strength/function, mood, gut function, and core metabolic labs.

The goal is not to sell a peptide every time IGF-1 falls. The first answer is usually more basic and more powerful: enough protein, progressive resistance training, micronutrient correction, better GI tolerance, and a GLP-1 dose pace the patient can actually nourish through.

Home

finger-prick microsampling

IGF-1

serum-equivalent anabolic signal

QWL

quality-of-weight-loss panel

Complete panel context

IGF-1 is interpreted, not isolated.

Anabolic reserve

IGF-1

A serum-equivalent home result that helps identify patients whose weight loss may be accompanied by low repair, recovery, or muscle-protection signalling.

Binding context

IGFBP-3

Optional companion marker that helps interpret whether IGF-1 is low in isolation or part of a broader GH-axis pattern.

Muscle-risk screen

Lean mass proxies

Weight velocity, waist trend, wearable recovery, patient-reported strength, and optional smart-scale or DEXA inputs help separate fat loss from lean-mass risk.

First-line action

Protein intake + strength/function

Protein adequacy and progressive resistance training are the first recommended response before medication escalation.

Clinical context

CMP / thyroid / CBC

Screens for nutritional, hepatic, renal, thyroid, anemia, and inflammatory signals that can change IGF-1 interpretation.

Metabolic support

D / B12 / iron + A1c

Micronutrient and glucose markers help separate healthy fat loss from under-recovery, under-nutrition, or poor metabolic adaptation.

First-line care ladder

Foundational correction

Protein target, resistance training plan, sleep, hydration, micronutrients, constipation and gut-tolerance support.

Therapy-tolerance review

If appetite suppression is too strong, Peptiter flags dose pace, dose timing, or temporary hold for prescriber review.

Prescriber-approved escalation

Only when clinically appropriate, persistent low IGF-1 can prompt review of GH-axis support options such as sermorelin or another GH secretagogue. Nothing is automatic.

Clinical guardrail: Peptiter is decision support. A low or falling IGF-1 does not automatically mean sermorelin, GH therapy, or a dose change. The prescriber reviews the full context.

Precision medicine flywheel

From GLP-1 start to muscle-protection learning loop.

Patient starts Ozempic or another GLP-1 / incretin therapy

Peptiter establishes baseline IGF-1, panel labs, body-comp proxies, gut function, mood, protein intake, and strength/function

8–12 week retest detects whether IGF-1, strength, nutrition, or recovery are drifting down

Platform recommends protein and strength training first, with dose-tolerance review when intake is inadequate

Prescriber may approve additional support, including sermorelin or another GH secretagogue only when appropriate for the patient and local prescribing rules

Outcomes are tracked: fat loss, strength, symptoms, labs, tolerability, retention, and maintenance

Machine learning learns which combinations protect lean mass while preserving GLP-1 fat-loss outcomes

Ozempic / GLP-1IGF-1 trendProtein targetStrength planPrescriber approvalPossible GH secretagogueOutcome ML

§ 06DiscoveryRX v2

We search evolved biology before inventing new peptides.

Comparative BioScout identifies source-system hypotheses, retrieval verifies them, structure-first generation designs receptor-conditioned families, and the in-silico lab decides what is worth wet-lab spend.

DiscoveryRX has its own home

The full discovery workspace — BioScout, structure-first generation, in-silico lab, and LabSpace handoff — runs as a separate tool.

Peptiter.com keeps the reference material below; the live workspace lives at discovery.peptiter.com.

Open DiscoveryRX ↗

BioScout

comparative mimicry narrows evolved source systems first

Structure-first

receptor-conditioned backbones before sequence families

45 blocks

20 natural amino acids plus 25 validated NNAAs

In-silico lab

variant, pathway, safety, synthesis, and portfolio assays

Comparative BioScout

Ask which organism already solved the function.

DiscoveryRX now starts with comparative biology. The scout turns a desired therapeutic profile into organism systems, likely peptide families, target classes, database queries, evidence confidence, body-model hooks, and translation risks.

Hard rule

LLM proposes; retrieval verifies; models score; experiments validate. No LLM-only claim or invented peptide sequence enters the candidate queue.

GLP-1R / incretin pathway

Venomous lizard peptides

Infrequent feeding, slow digestion, and postprandial metabolic regulation make this an evolved search space for stable metabolic signaling.

PubMedUniProtIUPHARChEMBL

verify receptor-family selectivity and chronic tolerability

Ion channel / pain pathway

Cone-snail venom

Predatory venoms evolved compact, high-specificity peptides for neuronal channel and receptor modulation.

ConoServerVenomZoneUniProtPDB

toxicity-enriched source; synthesis and delivery can be difficult

Antimicrobial / barrier defense

Amphibian skin defense

Skin secretions evolved broad host-defense peptides under dense microbial pressure.

APD3PubMedUniProtChEMBL

check mammalian-cell selectivity and hemolysis risk

Metabolic state switching

Hibernator endocrine systems

Seasonal fasting and torpor create comparative priors for energy balance, appetite control, and tissue protection.

PubMedNCBI GeneUniProtAlphaFold DB

requires direct peptide or receptor evidence before candidate generation

End-to-end discovery workflow

Desired profile

Start with indication, receptor targets, desired tissue effect, forbidden effects, duration, stability, and translation constraints.

Comparative BioScout

Map that profile to organism systems where the function may already have evolved. BioScout outputs hypotheses and search plans, not sequences.

Retrieval verification

Check PubMed, UniProt, IUPHAR, ChEMBL, VenomZone, ConoServer, APD3, PDB, and AlphaFold DB before any source family reaches generation.

Structure-first families

Generate receptor-conditioned backbone/conformer families first, then inverse-design sequences with NNAA-aware chemistry constraints.

In-silico lab

Run structure-first utility, receptor fit, affinity, variant robustness, pathway/body-model fit, toxicity, synthesis, and strategic portfolio scoring.

Wet-lab handoff

Only evidence-backed, auditable candidates move to LabSpace for synthesis, assay selection, status tracking, and returned-result feedback.

BioScout + Structure-First + 12-Gate DiscoveryRX v2 Pipeline

BioScout

Comparative biology

Evolved source-system hypotheses

BioScout: starts with the desired therapeutic profile and ranks evolved source systems, peptide families, body-model hooks, databases, and verification queries before candidate generation.

What makes our pipeline different

01NNAA-aware chemical space - 45 building blocks include N-methylated, D-amino-acid, halogenated, constrained, and lipidated residues

02Conformal uncertainty - borderline model outputs can be marked both or unknown instead of forced into false precision

03Developability optimization - permeability, synthesis, affinity, stability, and toxicity are optimized together with RL/MPO search

04In-silico lab and handoff - structure-first, receptor fit, variant robustness, pathway fit, toxicity, synthesis, and strategic portfolio results create an auditable handoff record

Pre-configured receptor targets

GLP1R

GLP-1 Receptor

Metabolic / GLP-1 agonists

PDB: 6X18

GHRHR

GHRH Receptor

GH secretagogues

PDB: 7EZH

GHSR

Ghrelin Receptor

Ipamorelin-type

PDB: 7F83

KISS1R

Kisspeptin Receptor

Reproductive / metabolic

PDB: 7EZM

OXTR

Oxytocin Receptor

Social anxiety / PTSD

PDB: 7QHB

Discovery tool stack

Boltz-2ChEMBLPRODIGYPROSPERous+ToxinPred3CycPeptMPDBNNAA-SynthConformal ICPRL/MPOBioScoutStructure-firstVariant scoringPathway fitIn-silico labLabSpacePlifePredBioPythonESM-2

Proof-of-concept replay

We reran the known-peptide registry in retrospective rescue mode.

This keeps the deterministic DiscoverRx gates intact, then explains every non-promotion as a strict fail, chemistry rescue, representation gap, or route/developability review. It is not wet-lab validation; it is a public sanity check on whether the replay is killing real medicines for algorithmic reasons or because the benchmark input stripped away route, formulation, target, or medicinal chemistry context.

Generated 2026-05-03retrospective chemistry-aware deterministic gate replay v2

Registry peptides

Strictly promoted

Explained misses

Hard unexplained kills

Strict yield

Retrospective interpretation

Strict pass

Chemistry rescue

Representation gap

Route/developability review

Hard unexplained kill

First failing gate before rescue

All registry entries

Gate chips show calibrated bands: pass, fail, both, or unknown. The interpretation column separates hard algorithm kills from chemistry rescue, representation gaps, and route-specific review.

Marketed 1/16 promoted · Clinical trial 0/4 promoted

Peptide	Status	Target	Chemistry	Strict first fail	Retrospective interpretation	Gate trace
Semaglutide GLP-1 receptor agonist linear GLP-1 backbone approximation · sim 100%	Marketed	GLP1R	Aib substitutionLipidationAlbumin binding	Promoted	Strict pass Clears the deterministic gate cascade as represented. Would pass with chemistry/route correction	G1 pass 0.929G2 pass 0.819G3 pass 0.919G4 pass 0.819G5 pass 2.1 raw 3G6 pass 1 raw 12G7 pass 0.595 raw 0.465G8 pass 0.09G9 pass 1
Liraglutide GLP-1 receptor agonist linear GLP-1 analog approximation · sim 96.8%	Marketed	GLP1R	AcylationAlbumin binding	Killed G6	Representation gap Not a hard kill: the replay used an approximation, proxy, or linearized structure rather than the exact medicinal chemotype.	G1 pass 0.866G2 pass 0.73G3 pass 0.816G4 pass 0.725G5 pass 1.25 raw 1.7G6 unknown 3 raw 10G7 unknown 0.442 raw 0.362G8 pass 0.064G9 unknown 0
Exenatide Exendin / GLP-1 receptor agonist canonical peptide sequence · sim 41%	Marketed	GLP1R	none	Killed G5	Representation gap Not a hard kill: the replay used an approximation, proxy, or linearized structure rather than the exact medicinal chemotype.	G1 pass 0.743G2 pass 0.643G3 pass 0.477G4 pass 0.554G5 unknown 3.5G6 unknown 15G7 pass 0.558G8 pass 0.1G9 unknown 0
Tirzepatide GIP/GLP-1 receptor agonist standard-AA approximation · sim 38.5%	Marketed	GLP1R	Aib substitutionLipidationAlbumin binding	Killed G1	Representation gap Not a hard kill: the replay used an approximation, proxy, or linearized structure rather than the exact medicinal chemotype.	G1 unknown 0.655G2 pass 0.516G3 unknown 0.339G4 unknown 0.424G5 pass 0.6 raw 1.5G6 pass 1 raw 12G7 unknown 0.492 raw 0.362G8 pass 0.06G9 unknown 0
Retatrutide GLP-1/GIP/glucagon receptor agonist exendin-like screening proxy · sim 41%	Clinical trial	GLP1R	Aib substitutionLipidationAlbumin binding	Killed G6	Representation gap Not a hard kill: the replay used an approximation, proxy, or linearized structure rather than the exact medicinal chemotype.	G1 pass 0.743G2 pass 0.643G3 pass 0.477G4 pass 0.554G5 pass 2.6 raw 3.5G6 unknown 4 raw 15G7 pass 0.688 raw 0.558G8 pass 0.1G9 unknown 0
Sermorelin GHRH analog active fragment · sim 100%	Marketed	GHRHR	none	Killed G6	Developability tradeoff The gate flags a real liability, but marketed or clinical use may tolerate it through dose, route, or clinical context.	G1 pass 0.91G2 pass 0.79G3 pass 0.89G4 pass 0.79G5 pass 2.5G6 both 6G7 unknown 0.406G8 pass 0.08G9 unknown 0
Tesamorelin GHRH analog GHRH analog backbone · sim 31.8%	Marketed	GHRHR	N-terminal protection	Killed G3	Representation gap Not a hard kill: the replay used an approximation, proxy, or linearized structure rather than the exact medicinal chemotype.	G1 pass 0.703G2 pass 0.599G3 unknown 0.392G4 unknown 0.497G5 unknown 3.3G6 unknown 14 raw 16G7 pass 0.523 raw 0.513G8 pass 0.096G9 unknown 0
Ipamorelin Growth hormone secretagogue standard-AA approximation · sim 20%	Clinical trial	GHSR	D-amino acidTerminal amidation	Killed G1	Representation gap Not a hard kill: the replay used an approximation, proxy, or linearized structure rather than the exact medicinal chemotype.	G1 unknown 0.633G2 pass 0.514G3 unknown 0.254G4 unknown 0.394G5 pass 2.45 raw 2.6G6 pass 0 raw 3G7 unknown 0.365 raw 0.325G8 pass 0.081G9 unknown 0
Kisspeptin-10 KISS1R agonist canonical active fragment · sim 100%	Clinical trial	KISS1R	none	Killed G5	Developability tradeoff The gate flags a real liability, but marketed or clinical use may tolerate it through dose, route, or clinical context.	G1 pass 0.934G2 pass 0.827G3 pass 0.927G4 pass 0.827G5 both 3.1G6 unknown 6G7 unknown 0.469G8 pass 0.092G9 unknown 0
Oxytocin Oxytocin receptor agonist linearized disulfide peptide · sim 100%	Marketed	OXTR	Disulfide bridgeTerminal amidation	Killed G7	Representation gap Not a hard kill: the replay used an approximation, proxy, or linearized structure rather than the exact medicinal chemotype.	G1 pass 0.879G2 pass 0.744G3 pass 0.844G4 pass 0.744G5 pass 1.35 raw 1.7G6 pass 1 raw 4G7 unknown 0.447G8 unknown 0.398G9 unknown 0
Carbetocin Oxytocin receptor agonist oxytocin-like screening proxy · sim 100%	Marketed	OXTR	Thioether cyclizationTerminal amidation	Killed G7	Representation gap Not a hard kill: the replay used an approximation, proxy, or linearized structure rather than the exact medicinal chemotype.	G1 pass 0.879G2 pass 0.744G3 pass 0.844G4 pass 0.744G5 pass 1.2 raw 1.7G6 pass 0 raw 4G7 unknown 0.457 raw 0.447G8 unknown 0.378 raw 0.398G9 unknown 0
Teriparatide PTH1R agonist PTH 1-34 fragment · sim 100%	Marketed	PTH1R	none	Killed G6	Developability tradeoff The gate flags a real liability, but marketed or clinical use may tolerate it through dose, route, or clinical context.	G1 pass 0.904G2 pass 0.781G3 pass 0.881G4 pass 0.781G5 pass 2.3G6 both 12G7 unknown 0.416G8 pass 0.077G9 unknown 0
Abaloparatide PTHrP analog linear analog approximation · sim 38.2%	Marketed	PTH1R	none	Killed G1	Representation gap Not a hard kill: the replay used an approximation, proxy, or linearized structure rather than the exact medicinal chemotype.	G1 unknown 0.656G2 pass 0.517G3 unknown 0.339G4 unknown 0.424G5 pass 1.5G6 unknown 9G7 unknown 0.354G8 pass 0.061G9 unknown 0
Octreotide Somatostatin analog standard-AA approximation · sim 0%	Marketed	SSTR2	D-amino acidCyclizationTerminal alcohol	Killed G1	Representation gap Not a hard kill: the replay used an approximation, proxy, or linearized structure rather than the exact medicinal chemotype.	G1 unknown 0.576G2 unknown 0.464G3 unknown 0.114G4 unknown 0.314G5 pass 2.25 raw 2.9G6 pass 0 raw 5G7 unknown 0.474 raw 0.464G8 unknown 0.463G9 unknown 0
Lanreotide Somatostatin analog standard-AA approximation · sim 14.3%	Marketed	SSTR2	D-amino acidCyclizationTerminal amidation	Killed G1	Representation gap Not a hard kill: the replay used an approximation, proxy, or linearized structure rather than the exact medicinal chemotype.	G1 unknown 0.589G2 unknown 0.459G3 unknown 0.173G4 unknown 0.33G5 pass 1.35 raw 2G6 pass 0 raw 4G7 unknown 0.411 raw 0.391G8 unknown 0.445G9 unknown 0
Leuprolide GnRH agonist standard-AA approximation · sim 90%	Marketed	GNRHR	PyroglutamateD-amino acidEthylamide	Killed G7	Representation gap Not a hard kill: the replay used an approximation, proxy, or linearized structure rather than the exact medicinal chemotype.	G1 pass 0.84G2 pass 0.702G3 pass 0.757G4 pass 0.687G5 pass 1.45 raw 1.6G6 pass 0 raw 4G7 unknown 0.44 raw 0.4G8 pass 0.062G9 unknown 0
Goserelin GnRH agonist standard-AA approximation · sim 100%	Marketed	GNRHR	PyroglutamateD-amino acidAzaglycine amide	Killed G7	Representation gap Not a hard kill: the replay used an approximation, proxy, or linearized structure rather than the exact medicinal chemotype.	G1 pass 0.875G2 pass 0.738G3 pass 0.838G4 pass 0.738G5 pass 1.45 raw 1.6G6 pass 0 raw 4G7 unknown 0.491 raw 0.451G8 pass 0.063G9 unknown 0
Teduglutide GLP-2 receptor agonist GLP-2 analog backbone · sim 100%	Marketed	GLP2R	DPP-4 resistant substitution	Killed G5	Chemistry rescue Would be treated as rescued in retrospective mode because known stability or half-life chemistry directly addresses the first failing gate. Would pass with chemistry/route correction	G1 pass 0.949G2 pass 0.849G3 pass 0.949G4 pass 0.849G5 both 3.5G6 unknown 10 raw 13G7 pass 0.521 raw 0.501G8 pass 0.1G9 unknown 0
Pramlintide Amylin analog linearized peptide · sim 100%	Marketed	AMYLINR	Disulfide bridgeProline substitutionTerminal amidation	Killed G5	Representation gap Not a hard kill: the replay used an approximation, proxy, or linearized structure rather than the exact medicinal chemotype.	G1 pass 0.948G2 pass 0.847G3 pass 0.947G4 pass 0.847G5 unknown 3.15 raw 3.5G6 unknown 10 raw 14G7 pass 0.588 raw 0.548G8 pass 0.18G9 unknown 0
Cagrilintide Long-acting amylin analog pramlintide-like screening proxy · sim 100%	Clinical trial	AMYLINR	Disulfide bridgeProline substitutionLipidationAlbumin binding	Killed G6	Representation gap Not a hard kill: the replay used an approximation, proxy, or linearized structure rather than the exact medicinal chemotype.	G1 pass 0.948G2 pass 0.847G3 pass 0.947G4 pass 0.847G5 pass 2.65 raw 3.5G6 unknown 4 raw 14G7 pass 0.668 raw 0.548G8 pass 0.18G9 unknown 0

Honest about limitations. Computational screening gets you to a synthesis decision point. It does not replace wet-lab validation, preclinical testing, or clinical trials. The value is in dramatically reducing the cost of reaching that decision — from months to hours, from tens of thousands to hundreds of dollars.

§ 07The Chaos Advantage

The Science: chaos indices detect what standard HRV cannot.

Mao, Okutomi & Umeno (2026), Scientific Reports · "Cognitive-Task-Induced Increase and Physical-Task-Induced Decrease in the Complexity of Heart Rate Variability"

Standard HRV during cognitive task

Δ from baseline

NO CHANGE

RMSSD+2%

LF/HF-2%

Chaos indices during cognitive task

Δ from baseline

SIGNIFICANT ↑

CD+42%

ApEn+38%

SampEn+56%

Fractal D.+28%

The Chaos Indicator Ratio (CIR)

CIR normalises chaotic complexity during an activity against the patient's own resting baseline. Different thresholds map to actionable clinical states.

CIR > 1.10

Cognitive engagement (medication working)

CIR < 0.85

Anxiety signature (Dimitriev 2016)

AM high · PM low

Stimulant wearing-off

CIR > 1.15 + RMSSD preserved

Flow state — therapeutic target

Indices computed

Chaos Degree (CD)Improved CD (ICD)ApEnSampEnHiguchi Fractal DimSD1/SD2 Poincaré

All of this from the same RR-interval data your patients' wearables already collect. Zero additional hardware.

Chaos Indicator Ratio

CIR 1.12

chaos·activity
────────────
chaos·rest

Interpretation

Cognitive engagement

Medication response detected. Patient is task-engaged.

Suggested clinical action

Maintain dose. Track CIR diurnal pattern.

0.60 anxiety1.00 rest1.30 flow

§ 08How it works

A four-stage pipeline. Auditable end-to-end.

→

Ingest

PeptiterLabs DBS and stool kits, CGM stream (Libre, Dexcom), blood ketones (BHB), wearable RR intervals, SNP/PGx panels, and AI-administered questionnaires.

DBSStoolCGMBHBRRSNP/PGxQ&A

→

Phenotype

PeptiterLabs (lab phenotype) + KetoInsulinKit (metabolic) + ChaosHRV (mental) + GeneRx (genomic) + validated instruments → multi-dimensional patient phenotype.

LabsOIICIRGeneRxPHQ-9GAD-7

→

Recommend

Rules engine (live now) or Bayesian ML (after evidence gate) → specific peptide, genotype-adjusted dose, timing, route. Full clinical rationale displayed. Every recommendation is auditable.

Rules · liveBayesian · gated

Learn

You approve or override. Every decision is logged as labelled training data. Outcomes are tracked with wearables and 8-week Peptiter Core retests.

Override log8w Core retest

The prescriber always has final authority. Peptiter is decision support — it augments your expertise, it doesn't replace it. Designed for CDS exemption from FDA device regulation under 21st Century Cures Act §520(o)(1)(E).

§ 09Business models

How clinics work with Peptiter.

B2B SaaS

Independent Clinics

$2,000–4,000/month flat

✓Decision support dashboard
✓PeptiterLabs kit workflow and result interpretation
✓Metabolic + chaos-based phenotyping
✓Outcome tracking & analytics
✓Use your own pharmacy

No per-patient fees. No per-prescription fees. Flat monthly license.

Contact sales →

Most embedded

White-label / API

Telehealth Platforms

Customengagement

✓Embed Peptiter intelligence into your existing workflow
✓Home lab kit ordering and result webhooks
✓API access to KetoInsulinKit + ChaosHRV engines
✓White-label dashboard option

Your brand, our intelligence.

Contact sales →

Technology Partnership · 503A

Compounding Pharmacies

Flat feemonthly tech

✓Electronic Rx routing integration
✓Lab-triggered refill and retest workflow support
✓Patient intake data formatting
✓Platform access for your prescriber network

Not tied to script volume. Fair market value tech services.

Contact sales →

AKS-Clean Structure

No per-prescription referral fees. No drug revenue. Clean separation of clinical intelligence from pharmacy fulfillment. All agreements at fair market value per 42 C.F.R. §1001.952(d) safe harbour.

§ 10Evidence & clinical validation

Evidence-first, not growth-first.

Peptiter operates under a signed Research Charter with formal protocol, IRB determination, and staged evidence gates. The platform does not scale beyond pilot until evidence confirms safety, usability, and data completeness.

400

Min. evaluable outcomes

≥3

External validation clinics

150

External validation N

Locked

Model during prospective eval

Sample size per Riley et al. 2020. Model versions documented in a model card with training data hash, hyperparameters, and approval chain.

GateMetricThreshold

G1Rules → Pilot

Data completeness; Safety; Usability

≥80% evaluable; No severe AEs; SUS ≥68

G2Pilot → ML

Development sample; Override logging

≥400 outcomes (Riley); ≥90% complete

G3ML → Deploy

Discrimination; Calibration; Net benefit

AUROC ≥0.70; Cal slope 0.80–1.20; Positive NB

G4Deploy → Scale

Prospective response; Satisfaction

≥15pp improvement (p<0.05); SUS ≥68

§ 11Peptide catalogue

Prescription protocols now use the complete compounding formulary.

protocol-backed peptides

compoundable now

branded Rx routes

pending PCAC

assessment instruments

Launch-assumption protocol reference. Verify final FDA/503A status before prescribing. Source: peptiter_expanded_formulary.py, 2026-04-28.

PeptideCategoryConditionsRouteStarting doseStatusEvidence

Sermorelin

GH secretagogue

gh deficiency, metabolic fatigue, sleep recovery +2

subq

200-300mcg qhs

Compoundable now

Clinical Trial▾

Mechanism

GHRH analogue. Stimulates pituitary GH release via GHRH receptor. Preserves physiological GH pulsatility.

Dose range

100-500mcg

Timing

Before bed, fasted >=2h. Avoid carbs within 3h (insulin blunts GH).

Titration

Start 200mcg qhs. Increase by 100mcg q2-4 weeks based on IGF-1 response. Max 500mcg.

Required assessments

QoL-AGHDA, FACIT-F

Optional assessments

PSQI-A, ISI, IIEF-5, PHQ-9

Baseline labs

IGF-1, GH (if stim-tested), fasting glucose, HbA1c +1

Follow-up labs

IGF-1 at 4w and 8w, fasting glucose if diabetic

Chaos monitoring target

CIR should improve during daytime (better energy/engagement). Sleep chaos patterns should normalise (deeper slow-wave sleep). Recovery CIR post-exercise should improve.

GeneRx modifier

GHR (d3-GHR deletion), GHRHR

Safety monitoring

IGF-1 must stay in age-adjusted normal range, Monitor for joint pain, edema, carpal tunnel (GH excess signs), Contraindicated with active malignancy

Contraindications

Active malignancy or cancer history <5yr, Pregnancy, Acute critical illness

Key evidence

Previously FDA-approved (Geref) for GH deficiency diagnosis, Extensive clinical use data in longevity medicine, d3-GHR carriers show 1.7-2x response (Dos Santos 2004)

Regulatory notes

503A Category 1. Category 1 (under evaluation). Previously FDA-approved as Geref. Currently compoundable by 503A pharmacies.

NAD+ (Nicotinamide Adenine Dinucleotide)

metabolic cognitive

metabolic fatigue, brain fog, depression +4

subq or IV

250mg subq 2-3x/week subq; weekly IV

Compoundable now

Preclinical▾

Mechanism

Coenzyme for mitochondrial function. Sirtuin activation. PARP-1 mediated neuroprotection. Cellular energy metabolism.

Dose range

100-500mg subq; 250-750mg IV

Timing

Morning, fasted preferred

Titration

Start 100mg subq tiw. Increase to 250mg based on tolerance. IV: start 250mg, increase to 500mg.

Required assessments

PHQ-9, FACIT-F

Optional assessments

CFQ, PSQI-A, AUDIT-C, MoCA-Blind

Baseline labs

Fasting glucose, fasting insulin, HbA1c, CMP

Follow-up labs

Fasting glucose/insulin at 4w and 8w

Chaos monitoring target

Gradual CIR improvement over 3-4 weeks (improved neural energy -> better cognitive capacity). Sleep chaos normalisation. Fractal dimension should increase.

GeneRx modifier

None listed

Safety monitoring

Monitor for GI discomfort (common with subq), Flushing with IV (normal, dose-related)

Contraindications

None established

Key evidence

NAD+ depletion implicated in neurodegeneration (multiple preclinical), IV NAD+ used in addiction medicine protocols (limited controlled data), Sirtuin activation -> improved mitochondrial function (well-established)

Regulatory notes

503A Category 1. Category 1. Currently compoundable by 503A pharmacies for subq and IV administration.

Oxytocin

social anxiolytic

social anxiety, ptsd, depression +1

intranasal

12 IU bid, or 30-45min before therapy sessions

Compoundable now

Clinical Trial▾

Mechanism

Neuropeptide. Reduces amygdala reactivity. Promotes social bonding, trust, emotional processing. HPA axis modulation.

Dose range

12-24 IU

Timing

Before social situations or therapy. Can also use qhs for sleep.

Titration

Start 12 IU bid. Increase to 24 IU if tolerated. For PTSD: administer before exposure therapy sessions.

Required assessments

GAD-7, LSAS-SR

Optional assessments

PCL-5, PHQ-9, FSFI-6, ISI

Baseline labs

None required specifically for oxytocin

Follow-up labs

None required specifically

Chaos monitoring target

CIR during social interactions should increase (less threat-mediated chaos suppression). SD1/SD2 ratio should increase (reduced autonomic rigidity).

GeneRx modifier

OXTR (rs53576, rs2254298)

Safety monitoring

Context-dependent effects - can increase in-group/out-group bias, Monitor for nasal irritation, Not for use in pregnancy (uterotonic)

Contraindications

Pregnancy, Nasal obstruction/sinusitis (reduces absorption)

Key evidence

Multiple fMRI RCTs showing reduced amygdala reactivity to social threat, PTSD adjunct trials (Flanagan 2018): improved therapy outcomes, Social anxiety: improved eye contact, emotional recognition (multiple studies) +1

Regulatory notes

FDA approved. FDA-approved (Pitocin for labor induction). Intranasal compounding for psychiatric indications is off-label but legal under 503A.

Tesamorelin

GH secretagogue

visceral adiposity, body recomp, metabolic syndrome

subq

2mg daily

Compoundable now

Clinical Trial▾

Mechanism

GHRH analogue. Reduces visceral adipose tissue. Stimulates GH release.

Dose range

1-2mg

Timing

Morning, fasted

Titration

Fixed dose 2mg daily. Adjust based on visceral fat and IGF-1 response.

Required assessments

QoL-AGHDA

Optional assessments

FACIT-F

Baseline labs

IGF-1, visceral fat area (DEXA), fasting glucose

Follow-up labs

IGF-1, DEXA at 3 and 6 months

Chaos monitoring target

Metabolic improvement reflected in overall CIR improvement and better recovery patterns.

GeneRx modifier

GHR (d3-GHR deletion)

Safety monitoring

None listed

Contraindications

None listed

Key evidence

FDA-approved for lipodystrophy based on Phase 3 RCTs, Demonstrated visceral fat reduction

Regulatory notes

FDA approved. FDA-approved as Egrifta for HIV-associated lipodystrophy. Compoundable under 503A for off-label use.

PT-141 (Bremelanotide)

sexual function

female sexual dysfunction, hsdd, erectile dysfunction

subq

1.75mg prn (as needed, >=24h between doses)

Compoundable now

Clinical Trial▾

Mechanism

MC4R agonist. Activates melanocortin-4 receptors in hypothalamus to enhance sexual desire independent of hormonal pathways.

Dose range

1.75mg

Timing

45 minutes before anticipated sexual activity

Titration

Fixed dose. Max 1 dose per 24h. Max 8 doses per month.

Required assessments

FSFI-6, IIEF-5

Optional assessments

PHQ-9, GAD-7

Baseline labs

Testosterone (if male), estradiol, FSH, LH (if female)

Follow-up labs

None listed

Chaos monitoring target

Not directly CIR-correlated. Oxytocin system overlap may show social-context CIR changes.

GeneRx modifier

MC4R (rs17782313)

Safety monitoring

Nausea (most common AE), Transient BP increase, Max 8 doses/month

Contraindications

Uncontrolled hypertension, Cardiovascular disease

Key evidence

FDA-approved for HSDD (Phase 3: RECONNECT trials), MC4R-mediated mechanism

Regulatory notes

FDA approved. FDA-approved as Vyleesi for premenopausal HSDD. Compoundable under 503A.

BPC-157

tissue repair gut

gi symptoms, gut healing, msk pain +1

subq or oral

250mcg subq bid

Compoundable now

Preclinical▾

Mechanism

Gastric pentadecapeptide. Angiogenesis promotion, growth factor upregulation (VEGF, EGF), anti-inflammatory via NO system. Gut-brain axis modulation.

Dose range

250-500mcg subq; 500mcg-1mg oral

Timing

AM and PM. Can be taken with or without food (oral). Inject near injury site if MSK (subq).

Titration

Start 250mcg bid subq. May increase to 500mcg bid. Oral: start 500mcg bid.

Required assessments

GSRS, NRS+PGIC

Optional assessments

PHQ-9, FACIT-F

Baseline labs

CBC, CMP, hs-CRP, fecal calprotectin (if GI indication)

Follow-up labs

hs-CRP at 4w, fecal calprotectin at 8w (if GI)

Chaos monitoring target

Chronic pain/GI distress reduces HRV complexity. Recovery: chaos indices normalise as inflammation resolves.

GeneRx modifier

None listed

Safety monitoring

CANNOT COMPOUND until PCAC review (July 23, 2026) and FDA determination, Limited human safety data (n=2 pilot only), Immunogenicity risk unknown for chronic dosing +1

Contraindications

Currently NOT compoundable, Pregnancy (no data), Active cancer (angiogenesis concern)

Key evidence

Extensive preclinical evidence (tendon, muscle, gut healing), 2025 systematic review: all data remains preclinical or anecdotal, First human IV safety pilot (Lee & Burgess 2025): n=2, no adverse effects up to 20mg +1

Regulatory notes

503A Category 1. PCAC: July 23, 2026. Reclassified to Category 1 following PCAC July 23, 2026 review. Compoundable by licensed 503A pharmacies with valid prescription. NOT FDA-approved. Removed from Category 2 on April 15, 2026. Currently in regulatory limbo - NOT compoundable until PCAC review and FDA adds to 503A list. PCAC July 23, 2026. Docket: FDA-2025-N-6895.

TB-500 (Thymosin Beta-4 Fragment)

tissue repair

injury recovery, msk pain, wound healing

subq

2.5mg 2x/week

Compoundable now

Preclinical▾

Mechanism

Thymosin beta-4 fragment. Promotes cell migration, wound healing, angiogenesis, anti-inflammatory.

Dose range

2-5mg

Timing

Any time

Titration

Start 2.5mg biw. May increase to 5mg biw for acute injury.

Required assessments

NRS+PGIC

Optional assessments

FACIT-F

Baseline labs

None listed

Follow-up labs

None listed

Chaos monitoring target

Recovery pattern: improved post-activity CIR bounce-back.

GeneRx modifier

None listed

Safety monitoring

CANNOT COMPOUND until PCAC review and FDA determination

Contraindications

Currently NOT compoundable, Active cancer

Key evidence

Preclinical wound healing and tissue repair data, Often stacked with BPC-157

Regulatory notes

KPV

anti inflammatory gut

gi symptoms, gut healing, inflammatory skin

oral or subq

200mcg bid

Compoundable now

Case Report▾

Mechanism

Alpha-MSH derived tripeptide. Anti-inflammatory via NF-kappaB inhibition. Gut barrier integrity.

Dose range

200-500mcg

Timing

With or without food

Titration

Start 200mcg bid. Increase to 500mcg bid if tolerated.

Required assessments

GSRS

Optional assessments

NRS+PGIC

Baseline labs

None listed

Follow-up labs

None listed

Chaos monitoring target

GI inflammation reduction may improve vagal tone -> CIR normalisation.

GeneRx modifier

None listed

Safety monitoring

CANNOT COMPOUND until PCAC review

Contraindications

None listed

Key evidence

Preclinical anti-inflammatory data, Gut barrier studies

Regulatory notes

MOTs-C

metabolic

metabolic syndrome, obesity, insulin resistance

subq

5mg 3-5x/week

Compoundable now

Preclinical▾

Mechanism

Mitochondrial-derived peptide. Exercise mimetic. Improves insulin sensitivity, activates AMPK.

Dose range

5-10mg

Timing

Morning

Titration

Start 5mg tiw. Increase to daily based on metabolic markers.

Required assessments

FACIT-F, QoL-AGHDA

Optional assessments

PHQ-9

Baseline labs

Fasting glucose, fasting insulin, HbA1c, lipid panel

Follow-up labs

Fasting glucose/insulin at 4w and 8w

Chaos monitoring target

Metabolic improvement -> better daytime CIR and exercise recovery patterns.

GeneRx modifier

None listed

Safety monitoring

CANNOT COMPOUND until PCAC review

Contraindications

None listed

Key evidence

Endogenous peptide - levels decline with age, Exercise mimetic properties (preclinical)

Regulatory notes

Semax

nootropic neuroprotective

brain fog, cognitive decline, adhd +2

intranasal

200mcg bid

Compoundable now

Observational▾

Mechanism

ACTH(4-10) analogue. BDNF/NGF upregulation, dopaminergic/serotonergic modulation, neuroprotection.

Dose range

200-600mcg

Timing

Morning and early afternoon. Avoid evening (stimulating).

Titration

Start 200mcg bid. Increase to 400mcg bid after 1 week if tolerated. Max 600mcg bid.

Required assessments

CFQ, MoCA-Blind

Optional assessments

ASRS-6, PHQ-9, FACIT-F

Baseline labs

None listed

Follow-up labs

None listed

Chaos monitoring target

CIR during cognitive tasks should increase (improved sustained attention). Fractal dimension may increase (richer cognitive dynamics). Expect changes within 7-14 days.

GeneRx modifier

None listed

Safety monitoring

CANNOT COMPOUND until PCAC review, Limited Western clinical data

Contraindications

Currently NOT compoundable, Pregnancy, Acute mania

Key evidence

Approved in Russia for cognitive disorders and stroke recovery, BDNF upregulation demonstrated in multiple studies, Neuroprotective effects in ischemia models +1

Regulatory notes

503A Category 1. PCAC: July 24, 2026. Reclassified to Category 1 following PCAC July 24, 2026 review. Compoundable by licensed 503A pharmacies with valid prescription. NOT FDA-approved. Removed from Category 2. PCAC July 24, 2026. Approved in Russia for cognitive disorders and stroke recovery.

DSIP (Delta Sleep-Inducing Peptide)

sleep

insomnia, opioid withdrawal

subq or intranasal

100mcg qhs

Compoundable now

Preclinical▾

Mechanism

Nonapeptide. Promotes delta (slow-wave) sleep. Modulates sleep architecture. Stress hormone regulation.

Dose range

100-300mcg

Timing

30 minutes before bed

Titration

Start 100mcg qhs. Increase to 200mcg if inadequate sleep improvement.

Required assessments

PSQI-A, ISI

Optional assessments

PHQ-9, GAD-7

Baseline labs

None listed

Follow-up labs

None listed

Chaos monitoring target

Pre-sleep chaos should decrease with treatment (reduced hyperarousal). Overnight chaos patterns should show more defined sleep stage transitions.

GeneRx modifier

None listed

Safety monitoring

CANNOT COMPOUND until PCAC review

Contraindications

None listed

Key evidence

Named for its ability to induce delta sleep in animal models, Limited human data

Regulatory notes

Epitalon

longevity

insomnia, aging, circadian disruption

subq

5mg daily for 10-20 days

Compoundable now

Case Report▾

Mechanism

Telomerase activator. Pineal gland peptide. May restore melatonin production and circadian rhythm.

Dose range

5-10mg

Timing

Evening

Titration

5mg daily x 10 days, then 10-day break. Cycle 2-3 times.

Required assessments

PSQI-A, ISI

Optional assessments

FACIT-F

Baseline labs

None listed

Follow-up labs

None listed

Chaos monitoring target

Sleep chaos pattern normalisation. Circadian CIR rhythm should become more defined.

GeneRx modifier

None listed

Safety monitoring

None listed

Contraindications

None listed

Key evidence

Khavinson studies on telomerase activation, Very limited human data

Regulatory notes

Semaglutide

metabolic psychiatric

alcohol use disorder, nicotine dependence, depression +2

subq

0.25mg weekly

Branded prescription

Clinical Trial▾

Mechanism

GLP-1 receptor agonist. Dampens dopamine-driven reward. Anti-inflammatory CNS effects. Neuroprotection.

Dose range

0.25-2.4mg

Timing

Same day each week. Any time of day.

Titration

0.25mg x 4 weeks -> 0.5mg x 4 weeks -> 1.0mg. Max 2.4mg (Wegovy). Slow titration reduces GI AEs.

Required assessments

PHQ-9, AUDIT-C, GSRS

Optional assessments

GAD-7, FTND, DAST-10, FACIT-F

Baseline labs

HbA1c, fasting glucose, lipid panel, TSH +1

Follow-up labs

HbA1c at 3m, amylase/lipase if GI symptoms

Chaos monitoring target

COMPLEX: AUD -> CIR normalisation (reduced reward chaos). Mood -> daytime CIR increase. MONITOR: CIR < 0.85 sustained = possible depressive AE.

GeneRx modifier

GLP1R (rs6923761, rs10305420)

Safety monitoring

CRITICAL: Monitor PHQ-9 item 9 (suicidality) at EVERY assessment, ChaosHRV anxiety pattern (CIR < 0.85) triggers immediate review, GI side effects common - GSRS monitoring essential +2

Contraindications

Personal/family hx medullary thyroid cancer, MEN2 syndrome, History of pancreatitis

Key evidence

Lancet Psychiatry 2026: Swedish cohort n=95,490 -> 42% reduction psychiatric hospitalisations, JAMA Psychiatry 2025: RCT semaglutide for AUD -> reduced heavy drinking days, CRITICAL: Mixed psychiatric safety - some populations show increased depression risk

Regulatory notes

FDA approved. FDA-approved (Ozempic for T2DM, Wegovy for obesity). Cannot compound - must prescribe branded. GLP-1R agonist.

Ipamorelin

GH secretagogue

gh deficiency, body recomp, sleep recovery

subq

200mcg qhs or bid

Compoundable now

Observational▾

Mechanism

Selective GHS-R agonist. Stimulates GH release without affecting cortisol or prolactin.

Dose range

200-300mcg

Timing

Before bed and/or 30min pre-workout

Titration

200mcg qhs. Add AM dose for body recomp.

Required assessments

QoL-AGHDA

Optional assessments

FACIT-F, PSQI-A

Baseline labs

None listed

Follow-up labs

None listed

Chaos monitoring target

Similar to sermorelin. Sleep chaos improvement + recovery CIR.

GeneRx modifier

GHSR (Ala204Glu)

Safety monitoring

NOT currently compoundable - PCAC rejected Oct 2024

Contraindications

None listed

Key evidence

None listed

Regulatory notes

503A Category 1. Re-reviewed and approved under Kennedy administration. Previously rejected by PCAC Oct 2024. Now compoundable.

Selank

anxiolytic nootropic

generalized anxiety, social anxiety, burnout +1

intranasal

250mcg bid-tid

Compoundable now

Observational▾

Mechanism

Tuftsin analogue. GABAergic modulation, serotonin/dopamine regulation, enkephalin stabilisation. BDNF upregulation.

Dose range

250-750mcg

Timing

Morning and afternoon. Can add evening dose for anxiety.

Titration

Start 250mcg bid. Increase to tid. Max 750mcg tid.

Required assessments

GAD-7, PHQ-9

Optional assessments

LSAS-SR, CFQ, PSQI-A, FACIT-F

Baseline labs

None listed

Follow-up labs

None listed

Chaos monitoring target

CIR should increase from <0.90 to >1.05 within 1-2 weeks as anxiety-suppressed chaos normalises.

GeneRx modifier

None listed

Safety monitoring

NOT currently compoundable - nomination withdrawn, Approved in Russia with established safety record, No US clinical trial data

Contraindications

Currently NOT compoundable, Pregnancy

Key evidence

Zozulia 2008: n=62 GAD trial, efficacy = medazepam + nootropic benefit, 40% rapid responders (HARS 20.3->7.0 in 3 days), Approved in Russia for GAD since 2009 +1

Regulatory notes

503A Category 1. Reclassified to Category 1. Previously withdrawn from PCAC. Now compoundable. Approved in Russia for GAD since 2009.

CJC-1295 (without DAC)

GH secretagogue

gh deficiency, body recomp, sleep recovery +2

subq

100mcg qhs, or bid (pre-workout + qhs)

Compoundable now

Observational▾

Mechanism

Modified GHRH(1-29) analogue. Stimulates pituitary GH release. 30-minute half-life (without DAC). Preserves physiological GH pulsatility. Commonly stacked with ipamorelin.

Dose range

100-300mcg

Timing

Before bed fasted. Optional AM dose 30min pre-workout.

Titration

Start 100mcg qhs. Add AM dose at 2 weeks. Increase to 200mcg per dose based on IGF-1.

Required assessments

QoL-AGHDA, FACIT-F

Optional assessments

PSQI-A, ISI, IIEF-5, PHQ-9

Baseline labs

IGF-1, fasting glucose, HbA1c

Follow-up labs

IGF-1 at 4w and 8w

Chaos monitoring target

Sleep chaos improvement (deeper slow-wave sleep). Daytime CIR improvement (energy). Exercise recovery CIR.

GeneRx modifier

GHR (d3-GHR), GHRHR

Safety monitoring

IGF-1 monitoring, Watch for joint pain/edema

Contraindications

Active malignancy, Pregnancy, Diabetic retinopathy

Key evidence

Widely used in clinical longevity medicine pre-2023, Synergistic with ipamorelin (different receptor mechanisms), 30-min half-life preserves GH pulsatility (vs DAC version)

Regulatory notes

503A Category 1. PCAC voted against in Dec 2024 under previous administration. Expected to be re-reviewed and approved under Kennedy admin. NOTE: CJC-1295 with DAC (Drug Affinity Complex) may remain restricted due to prolonged half-life safety concerns. Without-DAC version preferred.

Thymosin Alpha-1

immune modulation

immune deficiency, chronic infection, cancer adjunct +1

subq

1.6mg biw (2x/week)

Compoundable now

Clinical Trial▾

Mechanism

Thymic peptide. T-cell maturation, NK cell activation, dendritic cell stimulation. Modulates Th1/Th2 balance. Broad immune enhancement without immunosuppression.

Dose range

1.6-3.2mg

Timing

Any time of day

Titration

1.6mg biw x 4 weeks. May increase to 3.2mg biw for active infection/cancer support.

Required assessments

FACIT-F

Optional assessments

PHQ-9, PSQI-A

Baseline labs

CBC with differential, hs-CRP, IL-6, lymphocyte subsets (CD4/CD8)

Follow-up labs

CBC at 4w, hs-CRP at 4w and 8w, lymphocyte subsets at 8w

Chaos monitoring target

Immune activation may transiently decrease CIR (mild inflammatory response). Long-term: CIR and fractal dimension should improve as immune function normalises.

GeneRx modifier

None listed

Safety monitoring

Monitor CBC for lymphocytosis, Flu-like symptoms common (mild, self-limiting)

Contraindications

Active autoimmune disease (may exacerbate), Post-organ transplant (immune activation)

Key evidence

Approved in 30+ countries for HBV, HCV, immune adjuvant in oncology, Most extensive international safety record of any restricted peptide, Phase 2/3 trials in hepatitis, cancer immunotherapy adjunct +1

Regulatory notes

503A Category 1. PCAC voted against Dec 2024, but strongest case for re-review. Approved as pharmaceutical in 30+ countries (Zadaxin). Decades of international clinical data.

AOD-9604

metabolic

obesity, metabolic syndrome, body recomp +1

subq

250mcg daily

Compoundable now

Observational▾

Mechanism

Modified fragment of human GH (aa 177-191). Stimulates lipolysis, inhibits lipogenesis. Does NOT affect blood glucose or IGF-1 (unlike full GH). Targeted fat metabolism.

Dose range

250-500mcg

Timing

Morning, fasted. 30min before exercise optimal.

Titration

250mcg daily x 2 weeks. Increase to 500mcg if tolerated.

Required assessments

FACIT-F

Optional assessments

QoL-AGHDA, PHQ-9

Baseline labs

Fasting glucose, fasting insulin, HbA1c, lipid panel

Follow-up labs

Fasting glucose at 4w, body composition (DEXA) at 8w

Chaos monitoring target

Metabolic improvement: better exercise recovery CIR. Energy improvement: daytime CIR increase.

GeneRx modifier

None listed

Safety monitoring

Does NOT affect IGF-1 - do not monitor IGF-1 for AOD-9604 specifically

Contraindications

Pregnancy, Type 1 diabetes

Key evidence

Phase 2 clinical trial data for obesity, FDA GRAS status for food products (safety established), Does not affect glucose or IGF-1 (key safety advantage) +1

Regulatory notes

503A Category 1. PCAC voted against Dec 2024. Expected re-review. Has Phase 2 clinical data AND FDA GRAS status for food products - making Cat 2 classification inconsistent.

GHK-Cu (Copper Peptide)

regenerative skin

wound healing, skin aging, hair loss +1

subq or topical

1mg subq or 2% topical daily (topical) or 3x/week (subq)

Compoundable now

Observational▾

Mechanism

Naturally occurring tripeptide-copper complex. Stimulates collagen synthesis, decorin, glycosaminoglycans. Wound healing, anti-inflammatory, antioxidant. Levels decline 60% from age 20 to 60.

Dose range

1-2mg subq; 1-4% topical cream

Timing

Apply topical to target area. Subq near injury/target tissue.

Titration

Topical: 2% cream daily. Subq: 1mg tiw, may increase to 2mg.

Required assessments

NRS+PGIC

Optional assessments

FACIT-F

Baseline labs

None listed

Follow-up labs

None listed

Chaos monitoring target

Wound healing/recovery reflected in improved post-injury CIR recovery patterns.

GeneRx modifier

None listed

Safety monitoring

Monitor copper levels if using high-dose subq long-term, Injection site reactions

Contraindications

Wilson's disease (copper metabolism disorder)

Key evidence

Naturally occurring - endogenous peptide with well-characterised biology, Topical already Cat 1 compoundable, Extensive in vitro and animal wound healing data +1

Regulatory notes

503A Category 1. Injectable GHK-Cu was removed from Category 2 April 2026. PCAC meeting before Feb 2027 for injectable route. Topical already Cat 1. Naturally occurring peptide - levels decline with age.

MK-677 (Ibutamoren)

GH secretagogue

gh deficiency, sleep recovery, body recomp +1

oral

10mg daily

Compoundable now

Observational▾

Mechanism

Non-peptide ghrelin receptor (GHS-R) agonist. Oral bioavailability. Increases GH and IGF-1 without affecting cortisol. Promotes deep sleep. Can increase appetite (ghrelin effect).

Dose range

10-25mg

Timing

Evening (promotes sleep). Can take AM if appetite increase is desired.

Titration

10mg qhs x 2 weeks. Increase to 25mg based on IGF-1 and tolerance.

Required assessments

QoL-AGHDA, PSQI-A

Optional assessments

FACIT-F, ISI

Baseline labs

IGF-1, fasting glucose, fasting insulin, HbA1c

Follow-up labs

IGF-1 at 4w, fasting glucose at 4w (can increase glucose)

Chaos monitoring target

Sleep architecture improvement: overnight chaos patterns should show more defined slow-wave sleep. Daytime CIR improvement from better recovery.

GeneRx modifier

GHR (d3-GHR), GHSR (Ala204Glu)

Safety monitoring

Increased appetite (ghrelin effect - can be significant), Monitor fasting glucose (can increase insulin resistance), Water retention/edema +1

Contraindications

Diabetes (worsens insulin resistance), Active malignancy, Pregnancy

Key evidence

Phase 2 clinical trials in elderly and GHD, Oral bioavailability - unique among GH secretagogues, Sustained IGF-1 elevation over 12 months (clinical data) +1

Regulatory notes

503A Category 1. PCAC meeting before Feb 2027. Not a peptide - it's a non-peptide GHS-R agonist. Oral bioavailability (unique among GH secretagogues).

VIP (Vasoactive Intestinal Peptide)

immune gut respiratory

mold illness, cirs, gi symptoms +2

intranasal or subq

50mcg intranasal daily or bid

Compoundable now

Preclinical▾

Mechanism

28-amino acid neuropeptide. Anti-inflammatory, vasodilatory, immune-modulatory. Regulates circadian rhythm, gut motility, airway function. Used in biotoxin illness (CIRS) protocols.

Dose range

50mcg intranasal; 50-100mcg subq

Timing

Morning intranasal. Subq can be any time.

Titration

Start 50mcg intranasal daily. May add subq if intranasal insufficient.

Required assessments

GSRS, FACIT-F

Optional assessments

PHQ-9, CFQ, PSQI-A

Baseline labs

None listed

Follow-up labs

None listed

Chaos monitoring target

Chronic inflammation reduces HRV complexity. VIP response: chaos normalisation as inflammation resolves.

GeneRx modifier

None listed

Safety monitoring

Vasodilation - monitor BP, GI cramping possible

Contraindications

Hypotension, Pregnancy

Key evidence

Endogenous neuropeptide with extensive basic science, Aviptadil FDA IND for ARDS, Used in Shoemaker CIRS protocol +1

Regulatory notes

503A Category 1. Not on original Cat 2 list. Aviptadil (synthetic VIP) has FDA IND for ARDS/COVID. Compoundable by some 503A pharmacies. Used in mold illness / CIRS protocols.

Kisspeptin-10

reproductive metabolic

hypogonadism, infertility, metabolic reproductive

subq or IV

100mcg subq daily or pulsatile

Compoundable now

Observational▾

Mechanism

KISS1R agonist. Master regulator of GnRH pulsatility. Controls LH/FSH release. Critical for puberty onset, fertility, and metabolic-reproductive axis integration.

Dose range

6.4-12.8nmol/kg IV; 100-200mcg subq

Timing

Varies by indication. Fertility: timed with cycle.

Titration

Specialist-guided. Dose depends on reproductive endocrinology workup.

Required assessments

FSFI-6, IIEF-5

Optional assessments

PHQ-9, FACIT-F

Baseline labs

LH, FSH, testosterone/estradiol, progesterone

Follow-up labs

LH/FSH at each visit, sex steroids

Chaos monitoring target

Reproductive hormone normalisation may improve overall HRV complexity and circadian CIR patterns.

GeneRx modifier

None listed

Safety monitoring

Reproductive endocrinology specialist oversight recommended

Contraindications

Hormone-sensitive cancers, Pregnancy (unless fertility protocol)

Key evidence

Endogenous peptide - central to reproductive neuroendocrinology, Clinical trials in IVF/fertility (multiple Phase 2), Diagnostic tool for hypothalamic amenorrhea +1

Regulatory notes

503A Category 1. Was on original Cat 2 list. PCAC reviewed Oct 2024. Expected to be reclassified. Endogenous peptide critical to reproductive axis.

LL-37 (Cathelicidin)

antimicrobial immune

chronic infection, wound healing, immune deficiency

subq

50mcg daily

Compoundable now

Preclinical▾

Mechanism

Human cathelicidin antimicrobial peptide. Broad-spectrum antimicrobial (bacteria, fungi, viruses). Immune modulation. Wound healing acceleration.

Dose range

50-100mcg

Timing

Any time

Titration

50mcg daily x 2 weeks. May increase to 100mcg.

Required assessments

FACIT-F

Optional assessments

GSRS, NRS+PGIC

Baseline labs

CBC, hs-CRP, cultures if indicated

Follow-up labs

None listed

Chaos monitoring target

Infection resolution -> improved HRV complexity.

GeneRx modifier

None listed

Safety monitoring

Limited human dosing data, Monitor for injection site reactions

Contraindications

None listed

Key evidence

Endogenous human antimicrobial peptide, Well-characterised antimicrobial mechanism, Limited human therapeutic trial data

Regulatory notes

503A Category 1. Removed from Category 2 April 2026. PCAC meeting before Feb 2027. Endogenous antimicrobial peptide.

Dihexa

nootropic

cognitive decline, tbi, alzheimers adjunct

subq or intranasal

10mg subq daily

Compoundable now

Case Report▾

Mechanism

Angiotensin IV analogue. Hepatocyte growth factor (HGF) receptor agonist. Promotes synaptogenesis, spinogenesis. Extremely potent cognitive enhancer in preclinical models (10^7 more potent than BDNF).

Dose range

10-20mg subq; 5-10mg intranasal

Timing

Morning

Titration

Start 10mg daily. Conservative - limited human data.

Required assessments

MoCA-Blind, CFQ

Optional assessments

PHQ-9, FACIT-F

Baseline labs

None listed

Follow-up labs

None listed

Chaos monitoring target

Cognitive task CIR should increase significantly if synaptogenesis occurs. Fractal dimension increase expected.

GeneRx modifier

None listed

Safety monitoring

HIGHEST RISK PEPTIDE IN FORMULARY - no human trial data, HGF pathway has oncogenic potential - monitor for any tumour growth, Prescriber must document risk-benefit discussion +1

Contraindications

Any cancer history, Pregnancy, Under 25 (brain still developing)

Key evidence

Extremely potent in animal cognitive models, HGF/c-Met pathway activation -> synaptogenesis, NO human clinical trial data +1

Regulatory notes

503A Category 1. Removed from Category 2 April 2026. PCAC meeting before Feb 2027. Potent HGF receptor agonist.

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