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cjbgkagh 15 hours ago

Peptides are a revolution and you don't need to know how they work to know that they work (for various people for various conditions). There is a tension between empiricism and fundamentalism with much of medical science focusing on fundamentalism. Now with the ability to collect and search large amounts of empirical data and communicate it peer-to-peer people are picking up on a lot of things that work without knowing why they work. I think people are just going to circumvent the fundamentalist and chase after whatever works.

I owe my health to early adoption of experimental peptides, I have life long ME/CFS and there is no known treatment for this nor is there any on the horizon. At least they finally have a diagnostic test and know it's not psychosomatic but I could have told them that from day 1. Most doctors are not researchers and have little understanding on statistics instead preferring to rely on discrete classifications and simple decision tress. As someone with hEDS from TNXB I am a walking bag of symptoms and yet not a single doctor could figure it out. I had to research it myself which involved post-doc level textbooks and research journals. I came across the work done by Prof. Khavinson (USSR) and it did appear to me that peptides were incredibly under-explored. Given the poor quality of life with ME/CFS I was willing to take serious risks so previous trials were helpful to give an idea on dosing and lethality, I went through most of the research peptides one by one. I actually waited on semaglutide a bit because I suspected there was a small minority who would have hyper sensitivity and I both expected that to appear in the data, which it did, and I expected to have hypersensitivity, which I did. Others who were less careful ended up with pretty bad gastroenteritis. Semaglutide has been the most effective and with it and a few others I am largely able to lead a normal life. I was getting gray market from the US but now I get it direct from China.

deng 4 hours ago | parent | next [-]

> There is a tension between empiricism and fundamentalism with much of medical science focusing on fundamentalism.

This is a deeply unfair statement, and also a false dichotomy. Medical science is of course empiric. What you call "fundamentalism" is that compounds need to undergo a rigorous regiment of empiric testing before they are given to potentially millions of people. And no, it's not just because of Thalidomide. Many, many compounds fail clinical trials because of severe side effects, like liver toxicity, severe immune reactions or heart problems. Then there's of course increased risk of cancer, which can take many years to manifest itself empirically. You argue that you prefer living with these uncertainties rather than ME/CFS, and that's of course entirely understandable, but disparaging the field of medical science as focused on "fundamentalism" because we do not give large patient cohorts untested compounds is polemic. I understand where you are coming from, and I'm sorry that you suffer from this terrible condition, but likewise, you should try to understand the other side.

ndr 2 hours ago | parent [-]

I think the grandparent meant "fundamentalism" as "mechanistic", and lots of things we can know (as you say using the scientific method) to be useful long before we have a good mechanistic explanation of how they work.

Some examples: aspirin (willow bark used for thousands of years, drug synthesized in 1897 and mechanism explained almost 100y later), or general anesthesia used again since mid 1800s and the mechanism is quite still debated.

This is not to downplay all the long term, or developmental, risks that using something novel can result in. But we can empirically know something about the effects without having good mechanistic models.

deng 2 hours ago | parent [-]

But it is usually not necessary for approval of a compound to be able to describe how it works on a molecular or cellular level. What you need to show are three things: efficacy, safety and quality, so basically: the compound has the intended clinical benefit, has an acceptable safety profile and can be produced with a consistent manufacturing quality. Most compounds fail because of lack of efficacy (roughly half), and roughly a third because of lack of acceptable safety.

stalfie 6 hours ago | parent | prev | next [-]

Non blinded self experimentation is not a useful branch of empiricism.

I had an ME/CFS patient that had tried 100s of things and documented the effects thoroughly. She had a quite impressive list. Roughly 30% had had an effect to begin with, but the trend she observed was that it lasted for around a month at most. Placebo was her overall conclusion, but she occasionally got relief anyways so we both agreed that there was no harm in continuing. I'm sure several "peptides" is on her list by now.

There is nothing new under the sun, and fad cures for diffuse conditions have come and gone many times before. This is especially the case for conditions involving pain or tiredness, which are extremely sensitive to both placebo and nocebo.

What would be revolutionary would be 2-3 double blinded RCTs showing a lasting effect. Which would be great if someone did! But you have to actually bother to do it. And personally I would put money on the outcome being "no effect".

bertylicious 8 hours ago | parent | prev | next [-]

I'm pretty sure there is no diagnostic test for ME/CFS. What are you referring to?

Also I don't understand how semaglutide did help you while you're at the same time part of a minority risk group with a hypersensitivity to it. Isn't that a contradiction?

deng 6 hours ago | parent [-]

https://link.springer.com/article/10.1186/s12967-025-07203-w

pablobaz 5 hours ago | parent | next [-]

I think I would need to see testing on a control group of housebound patients with other conditions to believe this. It's easy for ME testing to pick up markers for being housebound and limited exercise for an extended period of time.

empiricus 5 hours ago | parent | prev [-]

looks interesting, but has the classic "40 patients".

throwaway2037 an hour ago | parent [-]

What would be enough? 400 patients, 4000, 40k, 400k, 4M?

dotancohen 6 hours ago | parent | prev | next [-]

  > Peptides are a revolution and you don't need to know how they work to know that they work
Perhaps. But knowing the mechanism of how they work sure seems fundamental to ensuring that they are safe to use.
Amezarak 3 hours ago | parent [-]

I agree with this, but we don't have a good understanding of the mechanisms of how most drugs work, and what else they do. That's why, generally speaking, we require actual observational safety data, and not just a thorough description of the mechanism(s) of a drug. And sometimes we find out years or even decades later we were badly wrong. "Safe" is a very qualified term when it comes to drugs. What actually distinguishes $randompeptide from $approveddrug is the safety data - there are papers all about the proposed mechanisms for most of them.

ramraj07 6 hours ago | parent | prev | next [-]

Im sorry for your quality of life problems but calling doctors bad at statistics and then giving anecdotal evidence as proof has to start ringing some logical bells right? You dont even have to take our word. Use an LLM as judge. Paste your comment into chatgpt and see what it says.

aeonik 3 hours ago | parent | next [-]

I didn't read their whole comment, but I worked in the Internal Research department of a medical school. I did their statistical studies and built software for analysis pipelines.

Doctors, at least 15 years ago, were definitely bad at statistics.

They were not required to take a statistics course at all. Most programs would require Algebra and Calculus as part of their science reqs.

Some would maybe take one basic research course, and they would then become obsessed with p values of 0.05.

They did not have a basic understanding of how to interpret research unless they were an auto didactic and went out of their way to improve. It's something my director (a doctor and software engineer), and the Dean complained about relentlessly.

ben_w 5 hours ago | parent | prev | next [-]

> Paste your comment into chatgpt and see what it says.

Isn't one of the bigger problems with ChatGPT that it's much too supportive of whatever the human is talking about?

alex_duf 5 hours ago | parent | next [-]

I guess it depends on how you frame it. "I've just posted this comment, what do you think" vs "Someone online has just posted this comment, what do you think".

But it does require to know the bias that LLMs have ahead of testing this.

ramraj07 3 hours ago | parent | prev [-]

Thats the point. If even such a sycophantic ai disagrees with your points you have a problem

5o1ecist 5 hours ago | parent | prev [-]

[dead]

blitzar 6 hours ago | parent | prev | next [-]

> chase after whatever works

Crack is really moreish.

4 hours ago | parent | prev | next [-]
[deleted]
beowulfey 6 hours ago | parent | prev | next [-]

Clinical trials are not looking for fundamental mechanisms, they are there to ensure an effect is strong enough to say a product should be sold for that purpose. Otherwise you end up with snake oil salesmen. Because how can you be sure you are even injecting the thing the sellers claim it is?

I would encourage everyone interested in peptides to read about the state of medical science before the establishment of the Pure Food and Drug Act of 1906.

5o1ecist 5 hours ago | parent [-]

[dead]

dev_l1x_be 6 hours ago | parent | prev | next [-]

Have you tried omega3? There were some improvements I was reading about.

deinonychus 8 hours ago | parent | prev | next [-]

can you talk about how semaglutide improves ME?

Angostura 6 hours ago | parent | prev [-]

> you don't need to know how they work to know that they work

Welcome to the powerful world of the placebo