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Peptide & Therapy Guide

You bring the goals, we'll build the protocol.

Personalized peptide and related therapies, built around your goals and guided by your provider. Explore options for metabolic health, body composition, recovery, performance, and more.

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Your results are educational. Treatment recommendations require a medical evaluation.

1 OF 5

Question 01

What best describes your goals right now?

Choose up to 2.

Therapy details

Know the names. Know the differences.

Entries marked Available through Viva are current offerings when clinically appropriate. Entries marked Educational topic explain what people ask about; they are not a product menu.

Available options

Weight & Metabolic Health

Goals: Appetite control, weight management, metabolic health

The two medications behind Viva’s Metabolic memberships.

  • Available through Viva

    Semaglutide

    GLP-1 receptor agonist

    Semaglutide supports appetite regulation and weight management.

    Available through Metabolic Essential, when clinically appropriate.

    What it is, evidence, and FDA status for Semaglutide

    A long-acting version of GLP-1, a gut hormone that helps you feel full sooner, slows stomach emptying, and helps regulate blood sugar. Many people notice less hunger and food noise.

    Use or research focus
    Chronic weight management and type 2 diabetes.
    Evidence
    In STEP 1 (NEJM 2021), 1,961 adults with obesity or overweight without diabetes took brand semaglutide 2.4 mg weekly with lifestyle support and lost an average of 14.9% of body weight at 68 weeks, compared with 2.4% on placebo.
    Approval status
    FDA-approved as Wegovy for chronic weight management and to lower major cardiovascular risk in adults with heart disease and obesity or overweight, and as Ozempic for type 2 diabetes. Compounded semaglutide is not FDA-approved, and brand trial results do not automatically apply to it.
    STEP 1, NEJM 2021 for Semaglutide
  • Available through Viva

    Tirzepatide

    GIP and GLP-1 receptor agonist

    Tirzepatide acts on GIP and GLP-1 pathways involved in appetite and blood-sugar regulation.

    Available through Metabolic Essential (microdose) and Metabolic Core (standard dosing), when clinically appropriate.

    What it is, evidence, and FDA status for Tirzepatide

    Acts on two gut-hormone pathways, GIP and GLP-1, to reduce appetite and improve how the body handles blood sugar and stored energy.

    Use or research focus
    Chronic weight management, type 2 diabetes, and obstructive sleep apnea with obesity.
    Evidence
    In SURMOUNT-1 (NEJM 2022), 2,539 adults with obesity or overweight without diabetes lost an average of 15.0%, 19.5%, and 20.9% of body weight at 72 weeks on brand tirzepatide 5, 10, and 15 mg, compared with 3.1% on placebo.
    Approval status
    FDA-approved as Zepbound for chronic weight management and obstructive sleep apnea with obesity, and as Mounjaro for type 2 diabetes. Compounded tirzepatide is not FDA-approved, and brand trial results do not automatically apply to it.
    SURMOUNT-1, NEJM 2022 for Tirzepatide

Educational topics

Body Composition & Muscle

Goals: Body composition, strength, lean-mass goals

Growth-hormone-related and body-composition compounds people often ask about.

  • Educational topic

    Sermorelin

    Peptide · growth hormone releasing hormone analog

    Sermorelin stimulates growth-hormone signaling.

    What it is, evidence, and FDA status for Sermorelin

    A short version of the hormone that signals the pituitary gland to release growth hormone.

    Use or research focus
    Historically used to evaluate and treat growth hormone deficiency in children.
    Evidence
    Small studies in older adults have measured changes in growth hormone and IGF-1 levels. An athletic-performance benefit has not been established.
    Approval status
    Geref, the former FDA-approved sermorelin product, was discontinued. That history does not make a compounded preparation FDA-approved.
    Federal Register: Geref discontinuation determination for Sermorelin
  • Educational topic

    CJC-1295

    Peptide · long-acting growth hormone releasing hormone analog

    CJC-1295 is a growth-hormone-releasing hormone analog.

    What it is, evidence, and FDA status for CJC-1295

    A modified version of growth hormone releasing hormone, designed to last longer in the body.

    Use or research focus
    Being studied for raising growth hormone and IGF-1 levels.
    Evidence
    Small studies in healthy adults (JCEM 2006) showed sustained rises in growth hormone and IGF-1. There are no long-term outcome trials for body composition or health.
    Approval status
    Not FDA-approved. Prohibited in sport by the World Anti-Doping Agency.
  • Educational topic

    Ipamorelin

    Peptide · ghrelin receptor agonist (growth hormone secretagogue)

    Ipamorelin stimulates GH release through the ghrelin receptor.

    What it is, evidence, and FDA status for Ipamorelin

    Prompts the pituitary gland to release growth hormone through a different receptor than sermorelin or CJC-1295.

    Use or research focus
    Being studied for growth hormone release; its main human trials were for bowel recovery after surgery.
    Evidence
    Human trials for recovery of bowel function after surgery did not meet their main goal. Evidence for body composition comes mostly from early and animal research.
    Approval status
    Not FDA-approved. Prohibited in sport by the World Anti-Doping Agency.
  • Educational topic

    Tesamorelin

    Peptide · stabilized growth hormone releasing hormone analog

    Tesamorelin is studied for reducing visceral abdominal fat, with established use in HIV-associated lipodystrophy.

    What it is, evidence, and FDA status for Tesamorelin

    A full-length growth hormone releasing hormone with a small change that helps it last longer, raising growth hormone and IGF-1.

    Use or research focus
    Reducing excess abdominal (visceral) fat in adults with HIV-associated lipodystrophy.
    Evidence
    In randomized trials in adults with HIV-associated abdominal fat (NEJM 2007), tesamorelin reduced visceral fat compared with placebo over 26 weeks.
    Approval status
    FDA-approved as Egrifta for excess abdominal fat in adults with HIV-associated lipodystrophy. It is not approved for general weight loss, other uses are off-label, and the approval does not extend to compounded blends.
    FDA label: Egrifta WR for Tesamorelin
  • Educational topic

    AOD-9604

    Peptide · modified fragment of human growth hormone

    AOD-9604 is investigated for fat metabolism.

    What it is, evidence, and FDA status for AOD-9604

    A small piece of the growth hormone molecule that was developed to target fat metabolism.

    Use or research focus
    Studied as a possible obesity treatment.
    Evidence
    Human trials found it well tolerated, but it did not produce meaningful weight loss compared with placebo.
    Approval status
    Not FDA-approved.
  • Educational topic

    IGF-LR3

    Peptide · long-acting IGF-1 analog

    IGF-LR3 is an IGF-1 analog used in growth and muscle-cell-signaling research.

    What it is, evidence, and FDA status for IGF-LR3

    A lab-modified version of insulin-like growth factor 1, a hormone involved in growth and muscle.

    Use or research focus
    Used mainly in laboratory research.
    Evidence
    It has not been tested in clinical trials in people. It is different from mecasermin, the FDA-approved IGF-1 medication for a rare growth disorder in children.
    Approval status
    Not FDA-approved. Prohibited in sport by the World Anti-Doping Agency.

Educational topics

Recovery & Skin

Goals: Recovery concerns and skin health

Peptides being studied for tissue repair, inflammation, and skin.

  • Educational topic

    BPC-157

    Peptide · derived from a protein in stomach juice

    BPC-157 research focuses on tissue repair and GI health.

    Educational information only. Viva does not currently offer this.

    What it is, evidence, and FDA status for BPC-157

    A 15-amino-acid peptide researchers are studying for tissue repair and blood flow to healing tissue.

    Use or research focus
    Being studied for tendon, ligament, muscle, and gut healing.
    Evidence
    Most research is in animals. A small 2021 retrospective report followed 16 people who received knee injections and reported pain relief, without a control group.
    Approval status
    Not FDA-approved. FDA removed it from its list of compounding substances with significant safety risks in April 2026, and an FDA advisory committee voted in July 2026 to recommend it for the compounding list, against FDA staff advice. FDA has not made a final decision.
    FDA: July 2026 compounding advisory committee for BPC-157
  • Educational topic

    TB-500

    Peptide · fragment of thymosin beta-4

    TB-500 research focuses on cellular processes in tissue repair.

    Educational information only. Viva does not currently offer this.

    What it is, evidence, and FDA status for TB-500

    A synthetic piece of thymosin beta-4, a protein that helps repair cells move into damaged tissue.

    Use or research focus
    Being studied for soft-tissue and wound healing.
    Evidence
    Full-length thymosin beta-4 has been tested in small human trials for wound and eye healing. The TB-500 fragment itself has been studied mostly in the lab.
    Approval status
    Not FDA-approved. FDA removed it from its list of compounding substances with significant safety risks in April 2026, and an FDA advisory committee voted in July 2026 to recommend it for the compounding list, against FDA staff advice. FDA has not made a final decision.
    FDA: July 2026 compounding advisory committee for TB-500
  • Educational topic

    GHK-Cu

    Peptide · copper peptide

    GHK-Cu is explored for skin appearance, collagen-related processes, and tissue repair.

    Educational information only. Viva does not currently offer this.

    What it is, evidence, and FDA status for GHK-Cu

    A naturally occurring copper-binding peptide that signals skin cells to build collagen.

    Use or research focus
    Skin firmness, fine lines, and wound healing.
    Evidence
    Topical GHK-Cu has been used in skin care for years, with small human studies on skin appearance. Evidence for injected GHK-Cu is mostly preclinical.
    Approval status
    Not FDA-approved as a drug. FDA plans to bring injectable GHK-Cu to its compounding advisory committee before the end of February 2027.
  • Educational topic

    KPV

    Peptide · fragment of alpha-MSH

    KPV research focuses on inflammatory signaling in the gut and skin.

    Educational information only. Viva does not currently offer this.

    What it is, evidence, and FDA status for KPV

    A three-amino-acid peptide researchers are studying for calming inflammation.

    Use or research focus
    Being studied for gut and skin inflammation and wound healing.
    Evidence
    Studied mainly in animal models of colitis and skin inflammation. Human trials are lacking.
    Approval status
    Not FDA-approved. FDA removed it from its list of compounding substances with significant safety risks in April 2026, and an FDA advisory committee voted in July 2026 to recommend it for the compounding list, against FDA staff advice. FDA has not made a final decision.
    FDA: July 2026 compounding advisory committee for KPV

Educational topics

Performance & Longevity

Goals: Physical capacity, energy metabolism, healthy aging

Compounds being studied for cellular energy, immune function, and healthy aging.

  • Educational topic

    MOTS-c

    Peptide · mitochondrial-derived

    MOTS-c research focuses on metabolic signaling and exercise-related processes.

    What it is, evidence, and FDA status for MOTS-c

    A small peptide made by mitochondria, the energy centers of cells, that rises with exercise.

    Use or research focus
    Being studied for insulin sensitivity, metabolism, and exercise capacity.
    Evidence
    Mouse studies suggest effects on metabolism and insulin resistance. Human research so far mostly measures natural MOTS-c levels; it has not tested MOTS-c as a treatment.
    Approval status
    Not FDA-approved. FDA removed it from its list of compounding substances with significant safety risks in April 2026, and an FDA advisory committee voted in July 2026 to recommend it for the compounding list, against FDA staff advice. FDA has not made a final decision.
    FDA: July 2026 compounding advisory committee for MOTS-c
  • Educational topic

    SS-31 (elamipretide)

    Peptide · mitochondria-targeted

    SS-31/elamipretide targets mitochondrial function, and its established clinical use is condition-specific.

    What it is, evidence, and FDA status for SS-31 (elamipretide)

    Binds cardiolipin, a fat in the inner mitochondrial membrane, to help mitochondria produce energy.

    Use or research focus
    Barth syndrome, a rare inherited mitochondrial disease.
    Evidence
    Approved based on improved knee-extensor muscle strength in a 12-patient Barth syndrome trial. Trials in more common conditions, including primary mitochondrial myopathy, did not meet their main goals.
    Approval status
    FDA granted accelerated approval in September 2025 as Forzinity to improve muscle strength in people with Barth syndrome weighing at least 30 kg; a confirmatory trial is underway. Use for energy or healthy aging is off-label and not established.
    FDA: Forzinity accelerated approval for SS-31 (elamipretide)
  • Educational topic

    Epithalon (Epitalon)

    Peptide · synthetic tetrapeptide

    Epithalon research focuses on circadian rhythms and cellular-aging processes.

    What it is, evidence, and FDA status for Epithalon (Epitalon)

    A four-amino-acid peptide studied for sleep rhythms and cellular aging.

    Use or research focus
    Being studied for sleep and circadian rhythm; FDA’s advisory committee reviewed it for insomnia.
    Evidence
    In cell studies it activated telomerase. Human studies are small, mostly from Russian laboratories, and not widely replicated.
    Approval status
    Not FDA-approved. FDA removed it from its list of compounding substances with significant safety risks in April 2026, and an FDA advisory committee voted in July 2026 to recommend it for the compounding list, against FDA staff advice. FDA has not made a final decision.
    FDA: July 2026 compounding advisory committee for Epithalon (Epitalon)
  • Educational topic

    Thymosin Alpha-1

    Peptide · thymic

    Thymosin alpha-1 is studied for immune signaling.

    What it is, evidence, and FDA status for Thymosin Alpha-1

    A 28-amino-acid peptide from the thymus that supports immune cell maturation and signaling.

    Use or research focus
    Immune support; approved outside the US for hepatitis B and as an immune adjunct.
    Evidence
    Studied in human trials for hepatitis B and C and as an immune adjunct in other countries, where it is sold as Zadaxin.
    Approval status
    Not FDA-approved in the US.
  • Educational topic

    NAD+

    Coenzyme (not a peptide)

    NAD+ is a coenzyme in cellular energy metabolism.

    What it is, evidence, and FDA status for NAD+

    A coenzyme found in every cell that helps turn food into energy and supports DNA-repair enzymes. Levels fall with age in research studies.

    Use or research focus
    Being studied for energy metabolism and healthy aging.
    Evidence
    Human studies of NAD+ precursors show they can raise NAD+ levels, with mixed results for health outcomes. Evidence for injected NAD+ is limited.
    Approval status
    FDA has reported adverse events associated with injectable NAD+ and has cautioned compounders about ingredient quality.
    FDA: ingredients for sterile compounding for NAD+
  • Educational topic

    SLU-PP-332

    Experimental small molecule (not a peptide)

    SLU-PP-332 is an experimental small molecule investigated for exercise-related metabolic pathways.

    What it is, evidence, and FDA status for SLU-PP-332

    A lab-made compound that activates estrogen-related receptors involved in exercise-related genes.

    Use or research focus
    Being studied as a possible exercise mimetic.
    Evidence
    Studied only in cells and animals. It has not been tested in people.
    Approval status
    Not FDA-approved.

Educational topics

Cognitive & Focus

Goals: Attention, clarity, stress-related concerns

Two nasal peptides developed in Russia.

  • Educational topic

    Semax

    Peptide · ACTH(4-7) analog, nasal

    Semax research focuses on neurological signaling and brain function.

    What it is, evidence, and FDA status for Semax

    A synthetic peptide that raises BDNF, a growth factor involved in learning, memory, and brain-cell health.

    Use or research focus
    Used clinically in Russia; FDA’s advisory committee reviewed it for stroke-related brain injury, migraine, and facial nerve pain.
    Evidence
    Supporting studies are mostly small and from Russia.
    Approval status
    Not FDA-approved. FDA removed it from its list of compounding substances with significant safety risks in April 2026, and an FDA advisory committee voted in July 2026 to recommend it for the compounding list, against FDA staff advice. FDA has not made a final decision.
    FDA: July 2026 compounding advisory committee for Semax
  • Educational topic

    Selank

    Peptide · tuftsin analog, nasal

    Selank research focuses on anxiety-related and stress-response pathways.

    What it is, evidence, and FDA status for Selank

    A synthetic peptide studied for its calming effects on stress and anxiety.

    Use or research focus
    Approved in Russia for anxiety.
    Evidence
    Evidence outside Russia is limited.
    Approval status
    Not FDA-approved.

Educational topics

Sexual Health

Goals: Desire, arousal, intimacy

A desire-focused medication that works in the brain rather than on blood flow.

  • Educational topic

    PT-141 (bremelanotide)

    Peptide · melanocortin receptor agonist

    PT-141/bremelanotide acts on pathways involved in sexual desire, with an established indication for certain premenopausal women with distressing low desire.

    What it is, evidence, and FDA status for PT-141 (bremelanotide)

    Activates melanocortin receptors in the brain involved in sexual desire and arousal.

    Use or research focus
    Acquired, generalized low sexual desire (hypoactive sexual desire disorder) in premenopausal women.
    Evidence
    Approved based on the RECONNECT trials in premenopausal women with HSDD, which showed modest improvements in desire and related distress. Nausea, flushing, and headache are common, and blood pressure rises briefly after a dose.
    Approval status
    FDA-approved in 2019 as Vyleesi for premenopausal women with acquired, generalized HSDD. Use in men or after menopause is off-label.
    FDA label: Vyleesi (bremelanotide) for PT-141 (bremelanotide)

How care works

Your goals first, then the right tools.

  1. Your goals and history

    Lili reviews what you want to improve, what you have tried, your health history, and your current medications and care.

  2. The specific product

    If a therapy is discussed, you will know the exact product, its intended use, its approval status, and why it may fit your plan.

  3. Evidence and alternatives

    You talk through what the research does and does not show, the known risks, and other options, including ones that do not involve a peptide.

  4. Follow-up and adjustments

    If you start a therapy, follow-ups and direct messaging help you and Lili decide whether it is helping and what to adjust.

Safety

Why safety matters.

Your protocol starts with a medical evaluation, not just a vial. We review your health history, medications, goals, and appropriate labs, then provide ongoing guidance and monitoring. When compounded medication is prescribed, Viva uses licensed 503A compounding pharmacies for patient-specific prescriptions. We do not recommend research-use-only or gray-market substances.

About this guide

This page includes available treatment options and educational research topics. Availability and suitability vary by the specific product, formulation, and intended use. Some therapies are FDA-approved for particular conditions; other uses are off-label, and compounded preparations are not FDA-approved. FDA does not review compounded medications for safety, effectiveness, or quality before dispensing. Evidence varies, and research findings do not guarantee clinical benefits. Use of a 503A pharmacy does not establish approval or permit every compound. All prescriptions require individualized evaluation, and results vary.

Many peptides are prohibited in competitive sport. Athletes should check with their governing body.

Sources and further reading

Included with every membership

Concierge care at your fingertips.

Your membership includes ongoing provider support, direct messaging with prompt responses, and one complimentary acute/sick visit per month for an appropriate minor illness, because life happens between follow-ups.

Medication or testing prescribed during that visit may cost extra. Not for emergencies.

See membership benefits

Membership value and costs

Peptide management is included.

Peptide management is included with all active Viva memberships. When prescribed, compounded peptide medications are dispensed by licensed 503A compounding pharmacies. Peptide therapies typically cost an additional $199 to $349 per month, depending on dose, pharmacy, and whether the formulation contains a single compound or a combination. Therapy costs are separate from membership.

  • Viva Concierge Access

    $99per month

    Ongoing provider access, including peptide management. Peptide therapy, medication, and lab costs are separate.

  • TRT All-Inclusive

    $199per month

    Testosterone care with peptide management included. Peptide therapy costs are separate.

  • Metabolic Essential or Core

    $249+per month

    Metabolic care with peptide management included. Peptide therapy costs are separate.

Compare all memberships and terms

Peptide questions

What patients ask before booking.

What does “peptide therapy” mean?

Peptides are short chains of amino acids that act as signals in the body; insulin and GLP-1 are examples. “Peptide therapy” is a broad phrase that covers many different products, each with its own evidence, approval status, and risks. That is why Lili looks at the specific product and your goals rather than the category name.

Are compounded peptides FDA-approved?

No. Compounded drugs are not FDA-approved, and FDA does not review their safety, effectiveness, or quality before they are dispensed. A compounded preparation and an FDA-approved drug are not interchangeable.

Can I receive peptide therapy through telehealth?

A telehealth visit can be used to review your history, goals, available evidence, and whether Viva is an appropriate setting for the question. A prescription is never automatic. Labs, an in-person examination, another clinician, or a different treatment may be the appropriate next step.

Which therapies are covered in this guide?

Semaglutide and tirzepatide; sermorelin, CJC-1295, ipamorelin, tesamorelin, AOD-9604, and IGF-LR3; BPC-157, TB-500, GHK-Cu, and KPV; MOTS-c, SS-31 (elamipretide), Epithalon, Thymosin Alpha-1, NAD+, and SLU-PP-332; Semax and Selank; and PT-141 (bremelanotide). NAD+ is a coenzyme and SLU-PP-332 is an experimental small molecule, not peptides. Each entry says whether it is available through Viva or an educational topic. BPC-157, TB-500, GHK-Cu, and KPV are educational information. They are not services Viva currently offers.

How much do peptide therapies cost?

Peptide management is included with all active Viva memberships. When prescribed, compounded peptide medications are dispensed by licensed 503A compounding pharmacies. Peptide therapies typically cost an additional $199 to $349 per month, depending on dose, pharmacy, and whether the formulation contains a single compound or a combination. Therapy costs are separate from membership.

Can I combine metabolic, hormone, and peptide care?

Yes. Hormone management requires an additional membership if you're enrolled in a metabolic program. Peptide management is included with all active memberships, with peptide therapy costs separate.

Where is Viva peptide care available?

Viva is an Austin-based telehealth practice serving adults who are physically located in Texas, Colorado, Florida, or Iowa at the time of the visit. Viva does not provide walk-in or in-person clinic visits.

Ready to talk about your goals?

Your first visit is with Lili, to review your history and goals and decide together what belongs in your plan.

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