There are very few compounds that can make a functional medicine doctor sound like a bouncer, but BPC-157 manages it. “It’s become a bit like the Wild West,” says Dr Neil Paulvin, a Manhattan-based physician who specialises in functional and regenerative medicine. He’s talking about peptides, and specifically the one that’s gone from underground bodybuilding circles to mainstream TikTok recovery trend, all without regulators, clinicians or customs officers quite knowing what to do about it.
BPC-157 – short for Body Protective Compound – is derived from the stomach lining and has been touted as everything from a miracle anti-inflammatory to a joint-regenerating cure-all. That reputation makes it a go-to peptide for curious patients and online cowboys alike. But Paulvin’s take is more cautious. Yes, it reduces inflammation. Yes, it’s promising for gut healing. Yes, it may boost nitric oxide and improve recovery. But no, you shouldn’t be injecting it into your elbow just because a Reddit post told you to.
In fact, the conversation around BPC-157 often says more about the current state of health optimisation than it does about the peptide itself: fast-moving, fragmented and fuelled by a mix of hope, hustle and half-truths. Regulation varies wildly between countries. Clinical data is patchy. And yet physicians like Paulvin keep seeing results. Sometimes subtle, sometimes dramatic and often in patients who’ve exhausted conventional treatments.
So how should you actually think about BPC-157? What can it really do and what’s still speculative? In this exclusive interview, Paulvin strips it back: what it is, what it helps and why a little knowledge is still a dangerous thing.
How would you describe BPC-157 and does it work?
It’s derived from something called “body protective compound”, which is found in the gut. More specifically, in the stomach. It helps to decrease inflammation and lowers inflammatory chemicals in the body. It helps build muscle and heal the gut lining. That’s where it first got noticed.
It may boost nitric oxide, which can help with energy. It can also help with lifting. It may even help with mood. It’s now been used in skin creams too, because it reduces inflammation. So it’s very user-friendly and does a lot of things that most people want. It’s kind of the “entry” peptide.
Are all forms of BPC-157 equally effective? If someone has a joint issue for example, do they need to inject it directly into the joint?
That’s still debated. In general, if it’s a stomach complaint, we use self-injection but that can just be done in the belly. There’s no strong data showing that if you have a shoulder issue, injecting it directly into the shoulder works better. Same with the knee. We don’t typically do that unless it’s a specific situation.
These days, for gut issues, we’ve largely moved to using pills, unless there are systemic issues that might justify injections. The one time I do inject directly into joints is when someone has, say, knee arthritis – then we’ll do a high dose into the knee. If someone has shoulder pain, we may inject into the shoulder. In those cases, I might add BPC with Thymosin Beta-4 or other compounds to target the issue more directly.
We’re assuming these are all legally prescribed by someone like you and it wouldn’t be smart for someone to try injecting their own elbow or something like that?
No — it’s definitely not smart. But it happens all the time. It’s become a bit like the Wild West – especially now, because they’re harder to get. It’s a strange situation. In the U.S., you can still get them somewhat easily, though it’s getting harder. In some countries in Europe, you can’t get them at all or they’re strictly regulated. I know of countries where, if you try to bring them in, customs will confiscate them and that’s it. It’s just a weird regulatory situation right now. I don’t know if or when it’ll ever be standardised globally.
Do you think, with GLPs and so on, more people travelling with these will push some kind of shift?
They do travel with them, and so far it hasn’t been horrible. Most of my patients haven’t had any issues. But there are definitely countries – I don’t want to name names because I’m not positive – where it’s really tough. I know Australia is strict on injectable peptides. The UK has started to have issues too, especially with the injectable forms. In many places, they’ll say the pills are fine, but they don’t want injectables available at all.
So we’ll see. It’s always evolving. I think something will hopefully make it easier, but we’ll see what happens.
What are the benefits of BPC-157 and how do you know if it is working?
It depends on what you’re using it for. In a lot of cases, it’s still not perfect. To do a perfect study – where you know someone’s gut healed and you can prove it with lab work or a colonoscopy – but to say it was definitely all the BPC’s benefit, that’s hard to do. That said, we can get a decent idea with lab work.
If it’s a joint issue, that’s sometimes the easiest. I’ve had patients who’ve had x-rays or MRIs, and then six or eight weeks later, their orthopaedic doctor says, “Oh my God, this is healed or healing really well.” And they’re like, “I don’t know what you’re doing, but keep doing it.”
I’ve had patients with colonoscopies for gut conditions — whether it’s irritable bowel or, more commonly, Crohn’s or ulcerative colitis, which are often autoimmune-related. They’ll have ulcers or inflammation. And then three to six months later, they go back in and the gastroenterologist says, “Your gut is healing really well — I’ve never seen this before.” So it can be a clear A-to-B case. Other times, you’re guesstimating a bit. But usually, we have a decent idea of what’s working and what’s not.
What are the downsides of using BPC-157?
I mean, beyond the obvious ones common to all peptides – yes, you can get an infection, you might get flushing or soreness – the main thing is with people who are histamine-sensitive or have mast cell issues. They can sometimes get an exacerbation. I very rarely see it, and that’s usually only at higher doses. But that’s the main thing we might see. And of course, the other major issue is quality – making sure you’re dealing with a pure, pharmaceutical-grade peptide.
Are there particular peptides that you often combine with BPC-157?
The most common one people might’ve heard of is called the Wolverine Stack. For the Marvel fans. Some people don’t know what that is anymore, which occasionally makes me feel old! But yeah – it’s a combination of BPC, Thymosin Beta-4 (TB-500), and CJC-1295. We usually use it in high-intensity situations – two to three months for extreme recovery. Think high-end athletes or someone who flipped over on a snowmobile. Things like that. Or, where I am, a lot of MMA or even CrossFit – and that stuff is abusive to the body continuously. So we’ll throw them on something like that.
How long does it usually take to see results? And is there anything people should be aware of alongside it?
It depends. I tell people that in a vacuum, it’s four to six weeks. But I’ve had patients who start it and two days later email me saying, “Hey, this is already feeling so much better.”
With any of these things, and I know it sounds cheesy after 20 years, it really depends how empty your gas tank is. If you’re very inflamed – say a 9 out of 10 pain – then you’re going to notice improvement quickly. If you’re just looking to “top things off” and make marginal gains, then it might take four to six – or even up to eight – weeks to really notice a change.
Is there anything else people should be aware of with BPC-157?
The only thing I’d add is that when using it for gut health – which is where it really got its start – we now often combine it with other compounds. For example, something called Larazotide, which helps to heal the gut lining, or Pentosan, which is really helpful in repopulating the microbiome. So there are other add-ons for gut protocols – not necessarily the cool-sounding ones, but still really effective.
For more on Dr Pauvlin, visit doctorpaulvin.com. Photography Ian Talmacs
