The right question isn't "should I try peptide therapy?" — it's "am I a candidate for peptide therapy?" Those two questions sound similar but lead to very different conversations. The first is about marketing. The second is about clinical evaluation.
This article walks through the evaluation framework we use at Vitality Texas: the symptoms that prompt a peptide-axis consideration, the labs that confirm or rule out candidacy, the contraindications that take peptides off the table entirely, and what the consultation process actually looks like.
Symptoms That Often Prompt a Peptide Conversation
Most patients arriving for a peptide consultation describe a cluster of symptoms rather than a single concern. The most common presentations:
- Persistent fatigue not explained by sleep, thyroid, or testosterone
- Difficulty maintaining lean muscle mass despite consistent training
- Slow recovery from exercise or minor injury
- Poor sleep quality despite adequate sleep duration
- Decline in skin quality, energy, and physical resilience
- Reduced cognitive sharpness or "mental fog" with age
- Slow-healing tendon, ligament, or soft tissue injuries
- Decline in libido, recovery, or sexual function not fully explained by hormones alone
Symptoms alone are not enough to determine candidacy. They define the question. Labs determine the answer.
Labs That Determine Candidacy
Different peptides require different baseline data. The labs Dr. Jaqua typically reviews include:
- IGF-1 (insulin-like growth factor 1). The primary downstream marker of growth hormone activity. Low or low-normal IGF-1 in the right clinical context supports consideration of GH-axis peptides like Sermorelin or — once formal FDA reclassification publishes — CJC-1295 + Ipamorelin.
- Total and free testosterone, SHBG, estradiol. Symptoms patients attribute to "low GH" are frequently driven by low testosterone instead. Hormone panel comes first.
- Comprehensive metabolic panel. Glucose, kidney function, liver function — both for baseline and for monitoring during protocol.
- HbA1c and fasting insulin. Insulin sensitivity matters for GH-axis peptide candidacy and monitoring.
- Thyroid panel. TSH, free T3, free T4. Untreated thyroid disease mimics many of the symptoms patients ascribe to other causes.
- CBC, lipids, and additional testing. Based on history.
For patients considering injectable NAD+, the panel is similar but IGF-1 carries less weight — NAD+ candidacy is built on a metabolic and longevity framework rather than the GH axis.
Who Is Generally a Good Candidate
Across the peptides Vitality currently offers, the typical candidate profile shares a few elements:
- Age 35+. The age-related declines that peptide therapy targets become clinically meaningful in mid-life and beyond.
- Symptom cluster aligned with the proposed therapy. Sermorelin makes sense for sleep, body composition, recovery, and energy concerns. NAD+ makes sense for cellular energy, metabolic health, and longevity-focused protocols.
- Labs that support — or at least don't contradict — candidacy. IGF-1 in the lower portion of the reference range, hormones evaluated, metabolic markers reasonable.
- No active contraindications. No active malignancy, no untreated severe endocrine disease, not pregnant or actively trying to conceive, no medication interactions that preclude the peptide.
- Realistic expectations. Patients who understand that peptide therapy is supportive, not transformative — that outcomes are supported but not guaranteed — tend to do well on protocol.
Contraindications That Take Peptides Off the Table
Some patients are not candidates regardless of how compelling the symptoms are. Common contraindications include:
- Active or recent malignancy. GH-axis peptides should not be used in patients with active cancer or recent unresolved malignancy. The theoretical concern about GH-IGF-1 and tumor growth is taken seriously.
- Pregnancy, lactation, or active conception attempts. Peptide therapy is not appropriate during these periods absent specific physician indication.
- Untreated severe pituitary disease. Patients with documented adult growth hormone deficiency from pituitary disease need replacement therapy under endocrinology care, not an off-label peptide protocol.
- Specific endocrine disorders. Active acromegaly, uncontrolled diabetes, untreated severe thyroid disease — each needs to be addressed first.
- Specific medications. Certain immunosuppressants, chemotherapy regimens, and endocrine medications create interactions that preclude peptide use.
- Athletes subject to WADA testing. Many peptides (TB-500, GH secretagogues) are on the WADA Prohibited List. Tested athletes must disclose their status before any consideration.
What the Consultation Looks Like
Every patient at Vitality starts the same way: a free initial consultation with Dr. Jaqua. The consultation covers:
- A complete review of your symptoms, history, current medications, and goals
- Lab orders if you don't have recent appropriate testing
- A direct conversation about what therapies are appropriate, what evidence supports them, and what limitations the evidence has
- A discussion of cost, monitoring, and what a complete program looks like
- An honest answer if peptide therapy is not the right fit — and referral or alternative recommendation if so
For some patients, the consultation reveals that a different therapy is the better starting point. Many men attribute symptoms to GH decline that are actually driven by low testosterone. Some patients arrive interested in peptides but turn out to benefit more from medical weight loss or a coordinated combination.
Where Regulatory Status Affects Candidacy
As of 2026, candidacy for specific peptides is also affected by their regulatory status. Sermorelin and NAD+ have been continuously available through licensed compounding pharmacies. Other peptides — including CJC-1295, Ipamorelin, and TB-500 — are pending formal FDA reclassification announced in February 2026. Until that formal publication is released, those peptides are not legally compoundable.
For patients whose evaluation suggests these peptides may eventually be appropriate, candidacy is established and the protocol is initiated with currently available alternatives — with the option to expand once formal reclassification publishes. For more on the regulatory landscape, see our 2026 FDA status article.
The Bottom Line
Candidacy for peptide therapy is a defined clinical question, not a marketing decision. The right answer comes from your symptoms, your labs, your history, and your goals — evaluated by a physician who is willing to say "no, this isn't the right fit for you" when that's the honest answer.
If you want that evaluation, the consultation is the starting point. There is no commitment, no obligation, and no charge to find out whether peptide therapy is the right path for you.
Schedule a free peptide therapy consultation at Vitality →
Frequently Asked Questions
What's the minimum age for peptide therapy?
Most peptide protocols at Vitality are appropriate for adults 35 and older — not because younger adults are excluded categorically, but because most of the indications (age-related GH decline, NAD+ decline, recovery support) become clinically relevant in mid-life and beyond. Younger adults presenting with specific lab findings or recovery indications may still be candidates, evaluated on a case-by-case basis.
Do I need labs before starting?
Yes. Every peptide protocol at Vitality starts with labs. For GH-axis peptides (Sermorelin, CJC-1295, Ipamorelin), IGF-1 is the primary baseline marker. Most patients also receive a comprehensive metabolic panel, hormone markers, and any additional testing relevant to their history. Without labs, candidacy cannot be established defensibly.
What disqualifies someone from peptide therapy?
Common contraindications include active malignancy or recent cancer history (particularly for GH-axis peptides), pregnancy or active conception attempts, untreated severe pituitary disease, certain inflammatory conditions, and specific medication interactions. Dr. Jaqua reviews all of these during the candidacy evaluation. Some contraindications are absolute; others require specific timing or coordination with another physician.
Can I do peptide therapy alongside TRT or weight loss medications?
Yes — many patients combine peptide therapy with testosterone replacement therapy (TRT), GLP-1 medical weight loss, or both. Stacking these therapies under a single physician means lab monitoring, dosing decisions, and side effect management are coordinated rather than fragmented across providers. Dr. Jaqua handles the full program.
What if I'm not a candidate?
We tell you. If your history, labs, or current medications make peptide therapy inappropriate, we say so directly and discuss alternatives — which might be a different therapy at Vitality, a referral to endocrinology or another specialist, or no medical intervention at all. The honest conversation about whether something will help is part of the consultation.