A reporter from Peptides Business Wire asked me earlier this month what long-term peptide care actually looks like in practice. My answer became the line the article was built around.
“We put them on a protocol. They visit monthly, get bloodwork done every 3 to 6 months and we titrate their medication as we go, over a period of years. As the patient stabilizes on his therapy, our relationship continues long term.”
That is the part that gets lost when someone orders a vial from a website. The vial is the easy piece. Everything around it is the treatment. Below are the questions patients ask most about how we run peptide therapy at Southwest Plastic Surgery, answered as I gave them.
There are dozens of peptides now. How do you decide which one a patient gets?
Dr. Agullo: “With the growing number of peptides now available, each peptide may target specific cellular pathways and mechanisms that can help optimize the body’s natural response related to restoration, recovery, performance, and prevention. Peptide therapy should be individualized based on each patient’s specific needs, goals, and clinical presentation.
“Protocols are developed according to the desired therapeutic outcome and may involve a single peptide or a combination of peptides. Each peptide protocol should be tailored to the individual, and patients may respond differently to the same peptide.
“Ongoing monitoring, assessment, and re-evaluation are essential throughout treatment to evaluate response, adjust the protocol when appropriate, and ensure patient safety. Many peptides also require careful timing and duration.”
What happens at the first visit?
Dr. Agullo: “At Southwest Plastic Surgery, the first visit for peptide therapy consists of establishing the patient’s indication and treatment goals, obtaining a comprehensive medical and medication history, and screening for medication allergies and potential contraindications.
“Patients are referred for comprehensive baseline laboratory testing prior to initiating therapy. Baseline laboratory evaluations include assessment of liver and kidney function through a CMP. Additional testing, including a hormonal panel, may be obtained when clinically indicated based on the patient’s medical history, treatment goals, and the specific peptide therapy being considered.
“Establishing these baseline values allows the provider to appropriately evaluate the patient’s overall health, identify potential concerns before treatment, and provide a reference point for ongoing monitoring throughout peptide therapy.”
Once someone starts, how often do you actually see them?
Dr. Agullo: “At Southwest Plastic Surgery, we communicate to patients the importance of ongoing follow-up and monitoring once they begin peptide therapy. Regular follow-up appointments allow us to reassess for adverse reactions, determine whether the patient is tolerating the treatment appropriately, and make any necessary adjustments based on the patient’s response, clinical status, and individual treatment goals.”
People are buying peptides online. What is the actual risk?
Dr. Agullo: “We strongly discourage patients from purchasing or ordering peptide products online from sources that are not properly regulated or dispensed through a reputable licensed pharmacy. Our primary concern is patient safety and ensuring that the product being administered meets appropriate standards for quality, purity, strength, and consistency.
“There are several potential risks associated with obtaining peptide products from unverified online sources. Products may be counterfeit, contaminated, improperly stored, or contain an inaccurate concentration or dose. These issues can result in inadequate treatment or potentially serious complications.
“For injectable products, contamination or poor sterile conditions can lead to injection site reactions and serious infections.
“Another concern is inaccurate dosing. If the concentration listed on a product is incorrect, or the patient is unfamiliar with proper dosing and administration, there is an increased risk of receiving too much or too little medication. This is one reason we emphasize provider oversight, appropriate patient education, and continued monitoring throughout peptide therapy.”
How long does a course last? Is this forever?
Dr. Agullo: “At Southwest Plastic Surgery, we offer different peptide therapy protocols based on the patient’s individual treatment goals and clinical needs. Some therapies, such as NAD+ and weight loss therapies, including the GLP-1 medications, may be used as a longer-term protocol with ongoing monitoring and follow-up appointments.
“In comparison, our shorter recovery-focused protocols, such as KLOW and GLOW, are typically structured as four- to eight-week treatment courses. These protocols are followed by an appropriate break and may be cycled on and off every two to four months, depending on the patient’s response, treatment goals, and clinical evaluation.
“Once a patient has achieved their desired treatment goal, the provider evaluates whether therapy should be discontinued or whether the patient may benefit from continued treatment at a lower maintenance dose. Any continuation or cycling of therapy should be individualized and performed under appropriate medical supervision, with ongoing assessment of the patient’s response, tolerance, and overall safety.”
The Short Version
Goals and history first. Then a CMP, and a hormone panel when it is indicated. Nothing is prescribed before those results come back. Monthly visits after that, labs every three to six months.
A website can sell you the vial. That is all it can do.
Dr. Agullo is certified by the American Board of Plastic Surgery and the American Board of Surgery, completed his plastic surgery fellowship at the Mayo Clinic, and serves as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. He has been a Castle Connolly Top Doctor for thirteen consecutive years.
Talk to Us About Peptide Therapy
Curious whether a peptide protocol fits your goals, or already running something you ordered online and unsure what is in the bottle? Bring it to your consultation. You will get a straight evaluation, and if peptides are not the right answer for your situation, you will hear that too.
Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com. #StayBeautiful
@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
