Honest look at peptides | Drinkable Skincare | Non-Hormonal Remedies | Recipe

If you spend even five minutes in the wellness corners of the internet right now, you could be forgiven for thinking IV peptides are the next great shortcut to healing, fat loss, muscle gain, recovery, anti-aging, or some glamorous combination of all five. The marketing is slick, and the promises are broad. The science, at least for the peptide cocktails being pushed to healthy people in med spas and online clinics, is not there yet.

To be clear, this is not because peptides are biologically meaningless. Contrarily, peptides can be extremely powerful. For example, insulin is a peptide, and GLP-1 medications are peptide-based drugs. And precisely because they act on real physiology, they can also cause real side effects, from hypoglycemia with insulin to pancreatitis, gallbladder disease, and serious hypersensitivity reactions with semaglutide. When something is biologically active, it deserves evidence, not enthusiasm. So when I see casual, unsupervised enthusiasm around IV or injectable peptides being sold to otherwise healthy people, my concern is not that they do nothing. My concern is that they actually DO work, and we may not fully understand the downside. 

In medicine, that standard is simple: first, do no harm. Before I recommend that a healthy person put a biologically active compound into their bloodstream, I want evidence from well-designed human trials showing what it does, what it does not do, what the side effects are, how it should be dosed, who should not get it, and what happens over time. The most reputable published peer-reviewed data on peptide use at this time come from the fields of orthopedic surgery and clinical nutrition, and those studies are limited to very specific patient populations and focus on specific peptides. 

For many of the peptides now being marketed for recovery, metabolism, inflammation, “cellular repair,” or body composition, that level of evidence in healthy humans is thin to nonexistent. A recent review in the orthopedic literature noted that BPC-157, one of the best-known peptides in this space, has potential based largely on preclinical data, but remains largely unvalidated in human trials. Part of the way in which this  peptide works is by stimulating new blood vessels to grow. (One of the unknowns/concerns is whether or not these new blood vessels can help feed or stimulate tumor growth at the same time as stimulating repair.) 

This does not mean the future is empty here; it means it’s still being written. Some peptides may eventually prove useful in tightly defined medical settings; that is how medicine works. We identify a target, test it carefully, characterize benefits and risks, and then decide whether it belongs in practice. There are even early signals with certain peptide-related agents in very controlled research settings, which is exactly where they belong for now. But “promising” is not the same as “ready,” and “mechanistically interesting” is definitely not the same as ‘safe to drip into healthy people on a Tuesday afternoon between Pilates and a blowout.’ 

Then there is the scam factor, and yes, I am using that word deliberately. Many of these products live in the gray zone of compounding, concierge wellness, and direct-to-consumer marketing. The FDA states plainly that compounded drugs are not FDA-approved, meaning the agency does not verify their safety, effectiveness, or quality before marketing. The FDA has also flagged multiple peptide substances used in compounding (including CJC-1295, ipamorelin, MOTS-c, AOD-9604, and thymosin alpha-1) for concerns such as immunogenicity, peptide-related impurities, limited human safety data, and, in some cases, serious adverse events. Also, let’s remember that many ‘medi-spas’ are administering these peptides in settings that make it impossible for the user/patient to know where the substance is coming from, how it’s been stored, what is actually in it, how it is being injected (often by non-medical personnel), etc., etc., etc. 

So where do I land? Curious, but unconvinced. Interested, but not recommending it at this time. This is not a moral objection to peptides. It is a medical one. When evidence in healthy humans is limited, quality control is uncertain, and marketing gets ahead of the data, that is a bad combination. Anecdotes that people “feel amazing” are not enough to outweigh that, especially when we know the placebo effect alone can drive meaningful perceived benefit 30% of the time.

My thumbs-down, for now, is not because these compounds cannot work. It is because biologically active things do work, and that is exactly why they require rigor, respect, and restraint. Until that standard is met, IV peptides are not ready for primetime, certainly not in the wellness or spa setting.

The idea of ‘skincare you can drink’ is showing up everywhere right now. Marketed as a simple, inside-out approach to skin health in drinkable powder form. The idea is to support skin from within using antioxidants and compounds that may influence hydration, elasticity, and inflammation.

At the core of these formulations are polyphenols, particularly those derived from tea, which have been studied for their antioxidant properties and their potential role in reducing oxidative stress, one of the key contributors to skin aging, including collagen breakdown, pigmentation changes, and loss of elasticity. There is some evidence suggesting that tea-derived compounds, such as catechins, may offer photoprotective benefits and help mitigate UV-induced damage at a cellular level, although this does not replace the need for sunscreen or other protective measures.

In addition to polyphenols, ingestible skincare products often include ingredients like ceramides, hyaluronic acid precursors, and other bioactive compounds that have been explored in small clinical studies, with some data indicating modest improvements in skin hydration, barrier function, and overall appearance when taken consistently over time. However, it is important to note that much of this research is limited in scale, varies in quality, and is not always conducted on the exact formulations being marketed, which makes broad claims difficult to fully substantiate.

What makes this category interesting is that it aligns with a growing body of research in dermatology and nutrition that recognizes the skin as an organ influenced by systemic factors, including diet, inflammation, and metabolic health, but translating that concept into a single product or even a “duo” that delivers visible, reliable results across a broad population is still a bit of a leap beyond the current evidence.

The ingredients in Pique’s Skincare Duo* are not random. The formulas center on polyphenols, including compounds found in tea and botanicals, which have been studied for their potential to reduce oxidative stress, a primary driver of skin aging.

There is some interesting science here. Early research on tea polyphenols suggests they may help protect against UV-related skin damage and support collagen pathways. Other ingredients often included in similar blends, like ceramides or hyaluronic acid precursors, have data demonstrating improvements in skin hydration when taken orally.

Pique’s B·T Fountain (found in the Duo) is a daily hydration reset. This refreshing beauty electrolyte is powered by clinically studied ceramides to support the skin barrier and hydrate at a cellular level.

Together, these formulas help restore balance, support hydration, and nourish the body from within, creating a strong foundation for spring, without sugar, fillers, or artificial flavors.

This duo is not a miracle, with most of the evidence is small-scale or indirect. You are not going to replace sunscreen, retinoids, or a solid skincare routine with a drink. Think of this as an add-on, not a swap. If you are already investing in your skin, this could be a reasonable layer. If you are looking for a shortcut, this is not it. 

Like many things, consistency matters. If there is a benefit, it is likely subtle and cumulative, meaning weeks, not days.

I have generally replaced my morning coffee on most days with Matcha Green Tea, and I add BT Fountain in my water bottle. And yes, it may be a placebo, but I really do notice a ‘glow’ in my skin. Of course, it may be due to the consistent use of my favorite topical products, in a synergistic manner, but I do like the fact that my morning matcha not only tastes good but DOES good for my body/skin too. 

You can save up to 20% off Pique’s Skincare Duo using the button below. 

Let me start with something I say regularly: the goal for menopause management isn’t all about taking hormones or not taking hormones; the goal is to make an informed decision. And for the millions of women who can't use hormone therapy, or who choose not to, there's a growing, and genuinely promising, non-hormonal toolkit worth understanding clearly.

SSRIs and SNRIs (paroxetine, venlafaxine, escitalopram) have the most published evidence behind them, after fezolinetant, the new kid on the block for non-hormonal treatment. Low-dose paroxetine salt (Brisdelle) is actually FDA-approved specifically for hot flashes. In clinical trials, these drugs reduced hot flash frequency by roughly 25-60%, which is less than HRT, but clinically meaningful for many women. The trade-offs include potential sexual side effects, nausea, and, critically, drug interactions. Paroxetine, for example, inhibits tamoxifen metabolism, so that combination is off the table for women on tamoxifen.

Gabapentin has modest evidence, mostly from smaller trials, showing reductions in hot flash frequency and improved sleep. It's sedating, which is either a side effect or a feature depending on the patient. The data is less robust than SSRIs and more variable across studies.

Clonidine, an older blood pressure drug, has weak and inconsistent evidence for hot flashes. I have never prescribed this in my career, and don’t know any Gyns who have either. It has significant risks, especially when discontinuing it, and has largely fallen by the wayside in the ‘menopause museum’ of modern-day usage.

In 2023, the FDA approved Fezolinetant (Veozah), the first non-hormonal drug specifically designed for menopausal hot flashes. It works by blocking neurokinin B receptors in the brain, targeting the thermoregulatory pathway that goes haywire during perimenopause. This is not a repurposed antidepressant. It's a mechanism-specific treatment, and that matters.

Clinical trial data showed statistically significant reductions in the frequency and severity of moderate-to-severe vasomotor symptoms compared with placebo, with effects observed as early as week one. The side effect profile is generally mild, with headache and insomnia being the most commonly reported.

The one flag worth knowing: there's a liver enzyme monitoring requirement for women with pre-existing liver conditions, and it's contraindicated with certain CYP1A2 inhibitor medications. It is necessary to check liver function with blood tests before and during treatment. It's not the right fit for everyone, including women with kidney or liver disease, but for appropriately selected patients, it's a meaningful option.

Cognitive behavioral therapy (CBT) has stronger evidence than most people realize. Multiple randomized trials, including the MENOS studies out of the UK, showed CBT significantly reduced the problem rating of hot flashes, meaning the degree to which they interfered with daily life,  even when it didn't always reduce the raw frequency. This is important because how we experience a symptom is as clinically relevant as the symptom itself. CBT isn't "just therapy" here; it's a validated intervention.

Clinical hypnosis has a smaller but real evidence base, with one well-designed randomized controlled trial showing a significant reduction in hot flash scores. I find this underused.

Mind-body approaches such as yoga, mindfulness, and paced breathing show benefits in some studies, but the quality of evidence is inconsistent. They're low-risk, potentially helpful for sleep and anxiety, and worth recommending alongside other strategies. I put them in the ‘use WITH’ category, rather than the ‘use on their own category.’

We need longer-term data on fezolinetant so that we can look at the incidence of other medical endpoints, such as cardiovascular disease, various cancers, and quality of life issues. We need head-to-head trials comparing non-hormonal options to each other, not just to a placebo. We have almost no data on many of the supplements and botanical options women are already using, such as black cohosh, phytoestrogens, and magnesium, with studies that are largely underpowered, short-duration, and often industry-funded. The absence of evidence isn't evidence of absence, but it does mean I can't confidently tell you they work.

Non-hormonal treatment for menopause symptoms has moved well beyond "just deal with it”. Fezolinetant is a genuine clinical advance. SSRIs and SNRIs have real data behind them. CBT is underutilized and undervalued. None of these are perfect substitutes for hormone therapy in all patients, but for many women, they're effective, appropriate, and sometimes exactly right.

The conversation isn't (as many influencers suggest) hormones versus nothing. It's about understanding the full menu — and making a decision that fits your history, your risk profile, and your life.

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In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” Dr. Jennifer Ashton—”Dr. Jen”—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time. And she has gone through menopause…

^{This material is provided solely for informational purposes and is not providing or undertaking to provide any medical, nutritional, behavioral or other advice or recommendation in or by virtue of this material.  This newsletter is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter or materials linked from this newsletter is at the user’s own risk. The content of this newsletter is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions.}

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