If you’re the kind of person who reads about peptides, you’ve probably heard of TB-500. You may even have a vague idea that it helps with recovery or muscle repair. What you may not know is just how widely it’s used or how flexible it is.

“TB-500 maybe gets a little less attention than BPC-157,” says Dr. Neil Paulvin, a Manhattan-based physician known for combining functional medicine with leading-edge optimisation tools. “But it’s really great for muscle-building and recovery.” He also uses it for lung inflammation, brain health and even hair.

The delivery is calm and methodical, but Paulvin’s underlying message is clear: this stuff can work, if you know what you’re doing. That’s a theme he returns to repeatedly throughout our conversation. There’s no single ‘peptide protocol’ because there’s no single type of patient. Some are recovering from injury. Others are pushing through chronic training fatigue. Many just want something in their locker when wear and tear flares up.

Cost matters. So does needle tolerance. So does willingness to stack, cycle or stagger different compounds. Paulvin describes TB-500 as a sort of shapeshifter; effective on its own, or as part of an all-out ‘Wolverine Stack’ with BPC-157 and CJC-1295. “It just depends on your goals and your situation.”

That phrase – clinical in tone, but radical in implication, is at the heart of Paulvin’s practice. He’s not there to prescribe a single magic bullet. He’s there to craft a bespoke protocol with the right ratio of ambition and realism.

Could you give a quick overview of what TB-500 is?

Sure. TB-500 maybe gets a little less attention than BPC-157, but it’s really great for muscle-building and recovery. It’s also helpful for lung inflammation – we use it for that – and sometimes even for brain inflammation, though “brain inflammation” might not be the best phrasing. We also occasionally use it for hair health. 

So it does have a broad range of effects. But its main uses are anti-inflammatory and muscle-building. It shares a lot of the same applications as BPC-157. There’s a decent amount of overlap in how we use the two. 

Is there anything in particular people should be aware of when using TB-500? 

It’s pretty clean. If someone has a reaction, it’s typically the usual stuff – mild and transient. We don’t really have a category of patients that we specifically try to avoid using it with. 

Could TB-500 be taken on its own, or is it always better stacked with BPC-157? 

It can go either way. There are two concepts people need to know: cycling and stacking. 

Cycling refers to how long you’re taking a peptide in a given period – usually two to four months per cycle. Stacking refers to the optimal combinations – as in, which peptides work best together. 

What I tend to do, and this comes from experience, is first find out from the patient… Okay, is your goal really short-term? Like, “I just want to recover from this shoulder injury and be done in three months”? If so, then we’ll go with a really heavy stack. We have other patients who say, “Look, I’m a long-distance runner,” or “I train really hard,” and they want to use peptides pretty much in perpetuity. 

What we tend to do then is say: “You’ll use BPC and maybe CJC or something else for these three months, and then we’ll add in TB-500 for the next three months,” and kind of mix and match depending on what works best for them. You always want to have something in your back pocket for the patient. 

So it really varies. If it’s an acute injury, we’ll throw the kitchen sink at them with a big stack. But if they’re in more of a maintenance phase, and some people just like having one peptide in their pocket – we’ll go back and forth. It just depends on their goals and their situation. 

And honestly, in the U.S., peptides are not the most inexpensive thing. So that’s always a factor too. 

Let’s say I’m 35, very active, and I injure my shoulder. What would you suggest? 

I mean, it would depend. It’s case by case. If it’s a very localised injury, we’d probably consider a targeted injection into the shoulder and then use technologies like red light, hyperbaric oxygen, shockwave therapy, and so on, while keeping other options in our back pocket. 

If it’s a more global issue – like the whole arm or upper back – then we’d throw the kitchen sink at it from the start. For shoulders and knees, I tend to prefer putting the medication directly into the joint rather than having it diffuse through the body. But if it’s a back injury or a hamstring issue, then we’re more likely to go with something like the Wolverine Stack. 

But again, everyone gets a slightly different protocol. Also, it’s very patient-centric. Some patients are afraid of needles. If I say, “You’ll need two or three injections a day,” some look at me like I have five heads and say, “No way.” Others say, “That’s nothing, no problem.” 

So a lot of it is about bobbing and weaving with the patient, then taking what I know and crafting the right recipe. It’s a bit of a dance. 

Is there any major downside to TB-500? 

Not really, no. Of the peptides we’re talking about, the ones with more potential downside are the growth hormone-related peptides like CJC. That’s where the major concerns are. 

For more on Dr Paulvin, visit doctorpaulvin.com.