How the peptide craze is turning deadly - ABC News & Headlines – Australian Broadcasting Corporation
They promise everything from anti-ageing to weight loss, or even a glowing tan.
But for a growing number of people, injectable peptides are delivering severe illnesses instead. Hospital presentations linked to their use are surging.
Today, Dr Norman Swan, co-host of Radio National's The Health Report, on the death of Australian actor Richard Norton, who had reportedly been taking unapproved peptides, and the concerning trends emerging around their use.
Sam Hawley: They promise anything from anti-ageing to weight loss and even a glowing tan. But peptides can and increasingly are delivering severe illness. Hospital presentations linked to their use have been surging. Today, Dr Norman Swan, co-host of Radio National's The Health Report, on the death of Australian actor Richard Norton, had been taking peptides and the concerning trends now clearly emerging. I'm Sam Hawley on Gadigal Land in Sydney. This is ABC News Daily. Norman, I think we should start our conversation around the spike in peptide use with Richard Norton's story. Now, he's an Australian-born actor who starred in some pretty big films like Mad Max, Fury Road. He died in March last year and that made headlines around the world. But initially, the cause of death wasn't revealed, was it?
Norman Swan: No, and the reporting was that he died at home, which in fact wasn't true. He died at the Alfred Hospital in Melbourne. It's a terrible story. I mean, he's aged 75. He, you know, obviously very fit, but he did have problems. He'd had two shoulder reconstructions. He had pain in his shoulders. He was obviously trying to keep himself fit. He had an enlarged heart. Now, when you're very fit, you can have an enlarged heart or you can have an enlarged heart because there's abnormalities in the muscle. And he also had asthma. And he consulted a doctor seeking peptides. The doctor did blood tests. He also checked his heart for calcium in the arteries of the heart. So the doctor did quite a few investigations. This is where a doctor known to prescribe peptides and made Richard Norton sign an informed consent, saying this was an experimental off-label treatment. He was wanting treatment for fatigue. He felt he was losing muscle, which is what you do when you get older, physical recovery from training and help with his shoulder pain. So he was given two peptides, one called CJC1295 and another one called Ipamorelin. Anyway, these peptides have not been approved for any use worldwide. They've not been tested for safety worldwide, but they do have an effect on the body. They probably induce the release of growth hormone from the brain. He was certainly involved with that. Not fully understood. And this story, this terrible story, unfurled over a period of nine days. So on the 19th of March last year, he was given the prescription for these two drugs. On the 25th of March, he told the doctor he was feeling pretty good. On the 28th of March, he consulted a nurse at the doctor's clinic and said he'd broken one of the vials and could he have a repeat prescription. The doctor authorised release of more of the peptides, but Norton had disclosed to the nurse that he was using double the dose of the peptides. And the nurse advised him not to do that. The doctor added two more peptides to his prescription, one called BPC157, which is given in the gym industry for recovery and another called TB500. At 9pm on the 28th of March, same day, after injecting the 1295 and the Ipamorelin, he developed a headache. He was hot and flushed and then he became unresponsive. His wife rang the general practitioner who called 000 at 10 past nine. At 20 past nine, paramedics arrived, diagnosed cardiac arrest. They got his circulation going over the next 20 or 30 minutes and transported him intubated to the Alfred Hospital. Very sadly, his bowel had necrosed, he had died during this long period of lack of oxygen and he then died on the 30th of March at the Alfred Hospital. So an appalling story.
Sam Hawley: It is, and we know all of this detail, Norman, because the Victorian coroner did investigate his death, of course.
Norman Swan: That's right, and I should have said that right at the beginning. That's where I'm taking these details from, the coroner's report. We should just say what a peptide is. A peptide is a short chain of amino acids. So in other words, amino acids are the building blocks of proteins and a peptide is not long enough and complicated enough to be called a protein and it's a short chain. GLP-1s are peptides, insulin's are peptide.
Sam Hawley: So Richard Norton, he died last year. The coroner released its findings last week.
News report: A Victorian coroner has reported what's believed to be the first known death in Australia linked to the use of unapproved peptides.
Sam Hawley: So what else did we glean from that report?
Norman Swan: So the coroner's findings were that he died of anaphylaxis, which is an overwhelming allergic reaction, and secondary to that anaphylaxis, he had a cardiac arrest, but essentially they blamed the peptides for it. They also investigated the doctor. The doctor was found to have, with the informed consent and so on, to have fulfilled what would be expected of a doctor in the circumstances, but was found not to have met standard of care with the issuing of the second prescription and also his note-taking. And the doctor was told to go and get further education and I think the doctor has undertaken not to prescribe more peptides.
Sam Hawley: Okay, well Norman, let's now consider the spike in use of peptides in Australia. More and more people, we know this now, are using them, right?
Norman Swan: So yeah, you can look at a social influencer. We did a Four Corners on the longevity industry, which I think it went to air the 20th of July, which people can go back to and have a look at, where we got a prescription very easily for peptides from a telehealth clinic in Queensland. So it's relatively easy to get these peptides from either doctors, but you can also import them. People will sell you these peptides or supposedly sell you these peptides. And when they arrive, you actually are not sure what's in them. There's one peptide which is copper-containing and the actual pure version of this substance is white, but when it arrives, it's blue. And that's because they put metallic copper, which is highly toxic, into it to give it a marketing fizz that it's a blue substance. You don't know what the dose is. You don't know what the contaminants might be in these peptides. There are compounding pharmacists who will make up peptides. And one of the most popular ones, so New South Wales Health reported an increase from in over a year, five people presenting to emergency departments with peptide-related problems to over 200. And the commonest one was Retatrutide, which is a new GLP-1 that's stronger than the Mounjaro and the Ozempics. It's not yet approved for use. It is potent, but people are getting this online. It was a very high percentage of the cases are presenting to ED in New South Wales were Retatrutide, or what people thought were Retatrutide, and then there were the other peptides as well. So increasing problems with anaphylaxis, abdominal pain, headaches, increasing sugar levels, presenting to our largest states' emergency departments. And it's quite likely it's happening elsewhere as well.
Sam Hawley: Wow. And just to make it clear, people inject these peptides.
Norman Swan: Yes, when you swallow them, the stomach acid and the enzymes in your gut break them down. So you've actually got to inject them so that they bypass the gastrointestinal system. So the other measure of the increasing use is the sale of clean syringes and needles from pharmacies. There was some evidence that, for example, on the Gold Coast, pharmacies were finding it difficult to keep up with demand for needles and syringes to inject these. And these are needles and syringes that are supposed to be for people with diabetes injecting insulin.
Sam Hawley: Okay, and who is using them then? Is it younger people, older people, a mix?
Norman Swan: Well, we don't have much evidence on that, apart from these valuable data from New South Wales Health, as reflected by the people who turn up in ED. Okay, so just to provide. So it looks like it's pretty equal between men and women, but it's younger. It's the younger age group. Just to say it again, these are substances which actually have real effects on the body. There's one called melanotan, which people take for tanning. And it does work, it tans your skin, but it also can turn moles into malignant moles. And it affects a chemical messenger, a hormone in the body, which has about 12 different versions in the body affecting different organ systems, not just tanning. So it can affect the brain as well. And people are injecting this stuff with no idea, A, what's in the vial, and even if it is what's in the vial, the effects on the body, because these are real things. This is not like homeopathy where there's nothing in the bottle. This is real stuff.
Sam Hawley: Alright, well, Norman, let's have a look at what the regulator is doing about this then. The coroner, in Richard Norton's case, it did recommend the TGA make some significant changes.
Norman Swan: Yes, the other thing that the coroner advised was that these peptides move off what's called schedule four, which are unapproved drugs, where the TGA, the therapeutic medicine physician, has not approved these drugs, but gives the freedom to doctors under certain circumstances, pretty narrow circumstances, they can prescribe those drugs if they feel there's no alternative and other options have been tried. And in some ways, it was introduced to allow cancer specialists to prescribe drugs that are, say, in the United States market, but not yet here and not yet approved by the TGA. The coroner has said that consideration should be given to moving these peptides off schedule four to schedule 10, and schedule 10 is where they're basically prohibited. So much as a doctor would like to prescribe them, they won't be able to. Then there's APRA, there's this regulatory gap between the TGA and APRA. So the TGA's role, amongst many, is to ensure the safety of regulated substances. APRA, on the other hand, regulates the behaviour of doctors, pharmacists, and other health professionals in order to protect the public's safety. And APRA has expressed concern about these peptides. They've warned doctors about this, as has the TGA, but there's this regulatory gap in the middle where these telehealth companies are handing out GLP-1s to young people with anorexia nervosa. And they're not doing a proper assessment and they're not doing a video, necessarily, a video consultation, sort of a phone. And some evidence that the doctors are following a script rather than just getting into treating the person. The peptide story is only part of a bigger story of the quality of care that you get on telehealth. Now, if it's your own GP, and it's a follow-up appointment, repeat script with your regular GP, then telehealth is fine. But when you're going for a specific telehealth appointment with a doctor you don't know and a company you don't know, just thinking that it's going to be safer, it's not necessarily going to be safer.
Sam Hawley: Well, in the meantime then, Norman, as the regulators try to catch up, what would be your simple message to people who presumably will continue to buy these peptides and use them?
Norman Swan: Well, my advice is don't. What else can I say? If I thought there was any evidence on any of them, I would say so, but there isn't. There just isn't. If you're not feeling well, if you're feeling that you're under the weather and you've got odd symptoms, I mean, for example, there's a growing number, and you and I have spoken about this before, of younger people in their 30s and 40s developing cancer, 10 different tumours in Australia going up in incidence. I'm not saying these peptides are causing that, but you could have peculiar symptoms to which you go to a telehealth clinic to get peptides because that's what you've seen from social influencers or that's what you've heard at the gym. And those symptoms could be the signs of cancer, which are missed. So I'm not saying the peptides are going to cause cancer, but you're missing symptoms. You need to get properly assessed when you've got symptoms that you can't explain.
Sam Hawley: Dr Norman Swan is co-host of Radio National's The Health Report and What's That Rash? This episode was produced by Ilaria Brophy. Audio production by Anna John. Our supervising producer is Sydney Pead. I'm Sam Hawley. Thanks for listening.
