Peptides, honestly.

First, the part I need you to know

I do not prescribe peptides. I am a registered nurse and an injector. Peptides are prescription medications, and at Manor they are prescribed by a nurse practitioner after a consultation that looks at your health history, your bloodwork where it is needed, and what you are actually trying to change. Prescribed only when it is clinically appropriate, which is a sentence I like, because it means the answer is sometimes no.

What I do is have the first conversation, which is usually the part people have been missing, and make the introduction when it makes sense to. Where I describe what people notice on this page, I am describing what people tell me and what I have felt, and I will say so each time.

Not everyone is trying to lose weight

The GLP-1 medications took all the attention, and they earned it. But when I run through what people actually ask me about, weight is maybe a third of it. The rest is sleep that does not restore, energy that falls off a cliff at two in the afternoon, a knee that never came all the way back, a midsection that changed shape while the scale stayed put, skin that did not follow the weight down, and a couple of things people have never had a comfortable place to ask about.

So this page is organized the way those conversations happen: by what you are feeling, not by molecule.

“I sleep. I just don’t wake up rested.”

Where the conversation goes: sermorelin, or CJC-1295 with ipamorelin.

These are growth hormone releasing peptides. They do not replace growth hormone; they signal your own pituitary to produce it on its own nightly schedule, which is why they are taken at bedtime.

How they are helping people. Sleep is the first thing anyone mentions, usually inside the first two weeks: deeper, and dreams they remember. Recovery from workouts and changes in body composition are the slower conversation, at two to three months. The people who ask for these are often the ones who train consistently and feel softer and slower to recover than they did five years ago. Baseline bloodwork comes first, and a history of cancer is a conversation with your oncologist before it is a conversation with anyone here.

“I’m tired, and nobody can find anything wrong.”

Where the conversation goes: NAD+.

NAD+ is a coenzyme found in every cell, central to how the body turns nutrients into energy, and levels fall with age. It is given as an IV infusion or as a small injection under the skin.

How it is helping people. The infusion itself is the story everyone tells: a pressure in the chest and some flushing if it runs fast, which is why I run it slowly. Afterward people describe a clearer, steadier energy for anywhere from a few days to a couple of weeks, which is why it tends to become a monthly rhythm rather than a one-time thing. The under-the-skin version is gentler and slower. If you are already coming in for an infusion, this is a natural thing to ask about, and it is one I use myself.

“Food noise runs my whole day.”

Where the conversation goes: tirzepatide or semaglutide.

These are the GLP-1 medications, and tirzepatide acts on two metabolic pathways rather than one. Taken as a weekly injection, they work with the body’s own appetite signals to quiet the noise that some people have been fighting with willpower for decades. Food noise is the phrase patients use, and it is exactly right.

How they are helping people. The quiet arrives in the first week or two. Clothes fit differently by six to eight weeks. Nausea early on is common and usually settles. And somewhere around month four to six I hear the sentence that brings people to my chair: “I lost the weight, but my face lost it first.” The screening for these is specific, which is why the health history comes before anything else, and the nurse practitioner oversees the whole course rather than handing you a pen and a wave.

This is also where my own work starts. Rapid weight loss compresses twenty years of facial change into months, because nobody gets to choose where the weight comes off. I have written about why that happens, and about how Sculptra and facial balancing put the support back. If you are on one of these medications and starting to see it, come and talk to me before you decide it is just what you look like now.

“I’m not heavy. My middle is.”

Where the conversation goes: tesamorelin.

Tesamorelin is a growth hormone releasing hormone analog that specifically reduces visceral fat, the fat packed around your organs rather than the fat you can pinch. It is the reason a midsection can feel hard and changed while the scale has barely moved.

How it is helping people. The waist measurement moves before the weight does, typically over eight to twelve weeks, which is a strange and satisfying thing to watch if you have been staring at a scale. There is real trial data behind it. Blood sugar is watched while you are on it, which is one of the reasons the bloodwork is not optional.

“My knee never came all the way back.”

Where the conversation goes: BPC-157, sometimes with TB-500.

BPC-157 is a short peptide sequence derived from a protein found in the stomach, studied for tissue repair. TB-500 is a fragment of a naturally occurring protein, thymosin beta-4. Together they are what the internet calls the healing stack.

How they are helping people. This category has the most enthusiastic word of mouth of anything on the page: old tendon injuries easing, joints loosening, gut symptoms quieting, usually described over two to four weeks. The research behind it is still early and mostly not in humans, and I say that plainly to everyone who asks, because enthusiasm and evidence are different things. Whether it is an option for you, and right for you, is the nurse practitioner’s call after the consultation.

“I lost the weight and my skin didn’t come with me.”

Where the conversation goes: copper peptides on the skin, and then the work I actually do.

GHK-Cu is a copper-binding peptide that occurs naturally in the body and declines with age. Used topically, it has been studied for its role in skin and hair, and it is a serum I am happy to talk about. The injectable version being sold on social media is a different product, and not one I use.

How it is helping people. Firmer, smoother skin over eight to twelve weeks of daily use. Not dramatic. Consistent. The honest answer for skin that did not follow the weight down is usually not a peptide at all: it is putting structure back with a biostimulator, rebuilding collagen with microneedling or laser, and medical-grade skincare underneath all of it. That is a plan, and it is one I can build with you.

“I love my husband, and I feel nothing.”

Where the conversation goes: PT-141, also called bremelanotide.

Most of what is marketed for intimacy works on blood flow. This works on desire, in the brain, which surprises people. It is taken as a small injection before intimacy rather than every day, and it is meant for premenopausal women whose desire was there once and faded.

How it is helping people. That the wanting comes back, which they did not expect from a medication. Nausea is the common trade, and it is off the table for anyone with uncontrolled high blood pressure or heart disease, which is another reason the health history comes first. Nobody brings this up at a Botox appointment, which is exactly why I put it on this page. If it is relevant to you, the nurse practitioner is the right person to ask, and you do not have to explain yourself to me to get there.

“I catch everything,” and “I’m foggy by two o’clock.”

Where the conversation goes: thymosin alpha-1 for the first; semax and selank for the second.

Thymosin alpha-1 is an immune-modulating peptide, used for years outside the United States and asked about most in the months when everyone in the house is sick. Semax and selank are nootropic peptides taken as a nasal spray, with devoted users who describe sharper focus and a quieter kind of calm. Both are newer to this country and the evidence is thinner than for the rest of this page, so they sit on the education side of my list rather than the recommendation side. If fatigue and fog are your actual complaint, the more useful first conversation is usually sleep, thyroid and hormones, and that is a conversation Manor’s wellness team has every day.

How Manor decides who is a fit

The same way it decides anything: with a nurse practitioner guiding every step, and prescribed only when clinically appropriate.

1. You tell us what you are feeling. In the chair with me, or through Manor’s online intake. No pressure either way.
2. The nurse practitioner reviews your health history. Some peptides are ruled out by specific conditions, and this is where that gets caught.
3. A consultation, and bloodwork where it is needed. In person here in Fort Worth, or through Manor’s virtual consultation, available as I write this to people in Texas, Arizona and Utah. Labs give you a baseline, which is the only way to know later whether anything actually moved.
4. A plan, then ninety days. Most peptides are dispensed in roughly three-month supplies, and ninety days is about how long it takes to know. So at ninety days we talk properly, not a check-in: what changed in your words, what did not, your labs against your baseline, and whether to continue, pause or stop. And the thing that is bothering you now, because that is usually where the next useful conversation starts.

Which of these is right for you, and whether it is an option at all, is the nurse practitioner’s call, and Manor takes care of everything from there. I would rather you get those answers from them than from a website.

What I have used myself

Several, under a provider, with bloodwork, and I will tell you which ones and what I noticed if you ask me in the chair, because that is a conversation with context. I am not going to write it here as a list. A list of what one nurse liked becomes a recommendation the moment it is on a website, and it should not be one. What I will say in print is that my experience is one person’s, and that nothing about it replaced sleep, sunscreen or the boring fundamentals.