Rising Documented Use of Unapproved BPC-157 and Associated Patient-Reported Outcomes Curated from Clinical Notes

Abstract

Body Protection Compound-157 (BPC-157) is an unapproved synthetic peptide marketed directly to consumers without adequate human evidence of efficacy or safety. Using large-language-model (LLM) curation of de-identified clinical notes from a U.S. federated health-system network, with unblinded physician validation, we characterized documented BPC-157 use and reported outcomes (2020–2026). Of 1,536 patients with a note mentioning BPC-157, 1,039 (67.6%) had confirmed documented use; newly documented users rose 22-fold, from 23 in 2020 to 508 in 2025 (18-fold per capita). Co-use of other agents (e.g., testosterone, non-steroidal anti-inflammatory drugs [NSAIDs], TB-500, corticosteroids) was documented for 588 (56.6%) patients. When documented, BPC-157 was most often obtained from compounding pharmacies or gray-market vendors. Among 354 users with an ascertainable response direction (unavailable for 685 of 1,039, 65.9%), improvement was documented in 79%, predominantly patient-reported (263/279) rather than independently verified (LLM accuracy for response direction, 88.2%). Propensity-matched comparisons with corticosteroid, platelet-rich plasma or non-aspirin NSAID initiators found no significant difference in documented improvement but cannot estimate effectiveness: BPC-157 was indexed at first documentation, not initiation, and concurrent treatments were not excluded. Placebo or contextual effects, spontaneous recovery, ordinary healing over time, regression to the mean, concurrent interventions and selective reporting could account for these reports in part or entirely, so the study can neither attribute improvement to BPC-157 nor exclude an entirely non-BPC-157 explanation. Adverse events were infrequently documented, likely under-reported signals of unknown incidence. This study describes documented use and reported outcomes; it establishes neither efficacy nor safety and motivates rigorous prospective evaluation.