The clients who walk through the door of Gameday Men’s Health in Alamo Ranch often have much in common with the clinic’s owner, Vern Lieb, a 45-year-old military veteran, fitness junkie and self-described longevity geek who’s skeptical of the U.S. healthcare system.
Lieb tracks and optimizes all of his personal health metrics: body fat down to the decimal, heart rate variability, time spent in deep sleep each night.
“Recovery, nutrition, biohacking devices — like the WHOOP that I’m wearing right here,” he says, slapping the health tracker on his wrist. “That’s my jam.”
His clinic feels more like a man cave than a medical office. The red and black walls are covered in military and sports iconography. Patients wait for their appointments in leather chairs in front of a wide-screen TV playing NBA games.
The concierge clinic is one of several hundred operating under the Gameday Men’s Health franchise in the U.S. Historically, the franchise has focused on testosterone replacement, erectile dysfunction, weight management, and other men’s health services.
Lieb, however, expects that peptides — a growing, loosely regulated trend in wellness, fitness and longevity — will soon become the core of his business.
Peptides have become increasingly common offerings at wellness clinics, med spas and membership-based clinics in San Antonio and across the U.S. The trend is partly fueled by a growing skepticism toward the American healthcare system, pushing some people in search of results they feel traditional medicine can’t deliver.
Many of the peptides offered at these clinics are not approved by the U.S. Food and Drug Administration, and the data on their safety and effectiveness is limited, raising red flags among some doctors about their use and the marketing around them.
That hasn’t stopped many from seeking them for a range of purported benefits, which have been amplified by social media wellness and fitness influencers: deeper sleep, more muscle growth, faster wound healing, increased sex drive, and much more.
What are peptides?
Peptides are short chains of amino acids, the same organic compounds that link together in chains to form proteins.
You can picture amino acids as Lego blocks that vary in size and shape, connecting to form more complex structures, explained Aaryn Mustoe, a behavioral endocrinologist at Texas Biomedical Research Institute.
“Some of these amino acids our bodies can make naturally, while many amino acids we can only get from our diet, and we call these ‘essential amino acids,’” Mustoe said.
Proteins and peptides play a vital role in just about every bodily function that keeps us alive, including metabolism, muscle growth and the immune system, among many others.
Peptides have since become an important part of modern medicine, with a number of FDA-approved peptide drugs helping treat a range of diseases today.
Among the most well-known are GLP-1 receptor agonists like semaglutide — sold under brand names like Ozempic and Wegovy — which have surged in popularity for their effects on blood sugar and weight loss. These medications are backed by extensive peer-reviewed research on their safety and efficacy.
But for most of the peptides now gaining popularity in the wellness space, the scientific evidence is far more limited.
‘Aging is optional’
Joshua Holden, a 45-year-old U.S. Army veteran and medical device sales director who lives in New Braunfels, started taking peptides last year. He started with sermorelin, a peptide previously approved by the FDA to treat growth hormone deficiency in children.
Although it was discontinued for commercial reasons in 2008, the drug has found new life in the longevity and sports performance world for purported muscle mass, wound healing and anti-aging effects.
More recently, Holden started what’s called the “wolverine stack,” a combination of TB-500 and BPC-157 aimed at accelerating muscle healing, reducing inflammation and quicker injury recovery.
After consulting with a nurse practitioner at Gameday Men’s Health, a cooler containing small vials of peptides, a syringe and instructions on injection arrives at Holden’s home.
Holden said he had been interested in peptides for years, watching them grow in popularity before he felt it made sense for his own health, his main objective being strength and anti-aging benefits.
“There’s a lot of information out there,” he said. “It’s kind of hard to sort through what’s right, what’s wrong, what’s just fluff.”
Over the last several years, peptides have moved out of niche “biohacking” communities into more mainstream wellness communities with the help of fitness and health influencers on social media.
In San Antonio, dozens of med spas and concierge medical clinics now offer peptides, with claims of benefits ranging from muscle growth and weight loss to improved sleep and mental health.
According to a review of wellness and concierge clinic websites in the San Antonio area, at least 27 clinics advertise non-FDA approved peptide therapies, often alongside other wellness-centered services like IV drip therapy and vitamin injections, testosterone replacement for men, saunas and red light therapy, as well as skin and beauty services often geared toward women.
One local clinic website positions peptides as a natural, safe option with fewer side effects compared to other drugs. Another opens its longevity medicine section with a bold claim: “Aging is optional.”
Some clinics are more reserved and careful with how they advertise peptides. Others lean into natural health, anti-aging and messaging that mirrors broader skepticism toward conventional medicine.
“Ideally, the people who are supposed to have some degree of authority over those clinics should keep an eye on those things,” said Paulo Carvalho, a pharmacy professor at the University of the Incarnate Word’s Feik School of Pharmacy. “But there are so many things they are saying that, for practical purposes, until somebody is hurt, nothing happens.”
A common argument from proponents of peptides is that they’re safer than traditional drugs because many are designed to signal naturally occurring processes in the body. But that distinction doesn’t eliminate risk, experts pointed out, and the compounds are still manufactured synthetically, despite the marketing.
“Even though insulin is a natural and life-saving hormone, and perfectly safe at a correct dose, it can be deadly if taken in excess or in combination with other peptides,” Mustoe said. “The reason most [peptides] require medical prescriptions and are FDA regulated is to ensure proper dosing and purity.”
Peptides known as TB-500 and CJC-1295, for example — often used by people looking to recover quickly from exercise and weight training — are banned by the World Anti-Doping Agency in competitive sports.
But the range of peptides being marketed goes well beyond physical performance. Clinics also advertise compounds such as dihexa and cerebrolysin as cognitive enhancers or neuroprotective agents; semax and selank for anxiety; and others for skin health, libido, sleep and general anti-aging or anti-inflammatory effects.
These compounds, many of which are sourced from compounding pharmacies and administered via injection, are not cheap. At the Alamo Ranch clinic, peptide injections generally fall somewhere between $300 to $550 per month, depending on the peptide and dose, Lieb said.
The enthusiasm for these compounds has been amplified by online fitness and wellness influencers. The trend has also drawn concern from doctors and researchers who say there isn’t enough evidence on the safety and efficacy of most of the peptide drugs being touted.
“Do [peptides] have potential? Yes,” Carvalho said. “But they are not researched well enough. We don’t know enough, that’s the real problem.”
U.S. Health Secretary Robert F. Kennedy, who said he’s a big fan of peptides and has used them himself, is pushing the U.S. Food and Drug Administration to make changes to their regulations to make it easier for compounding pharmacies to produce the drugs.
The peptide debate
UT Health San Antonio endocrinologist Dr. Maria Escobar-Vasco has had a growing number of patients tell her about their peptide use over the last several years.
Oftentimes, she said, her patients have not been aware of the lack of data behind the compounds they’re taking.
“These are things that really don’t have much science behind them,” Escobar-Vasco said. “And when I go and I try to look for any data regarding what they do or the side effects, there’s very sparse data out there. We don’t even know if these compounds are safe or not.”
A handful of her patients also disclosed that they were getting the injections not at wellness clinics under the supervision of a medical practitioner, but from online retailers selling the drugs at much lower prices.
By labeling the products as “research-grade” or “not for human consumption,” online retailers are able to source the drugs from overseas pharmacies and sell them online with little oversight.
“God knows what’s in there,” Carvalho said. “When it comes to contaminants … they do not really screen for those things. They just come with purity enough that you can do your research.”
The evidence behind peptide therapies varies depending on the compound.
There’s FDA-approved peptide drugs like GLP-1 agonists with increasingly large volumes of research behind their safety and efficacy, as well as a handful of FDA-approved peptide drugs being prescribed off-label for supposed anti-aging and muscle mass benefits.
Others have been studied in early human trials, but most of them are limited to animal research, extrapolation and anecdotes. Few of them, Dr. Escobar-Vasco points out, have robust long-term human data, including guidance on proper dosing, duration and potential adverse effects.
A 2026 narrative review published in the Journal of Sports Medicine concluded that while some peptides have “significant therapeutic and regenerative potential,” there’s simply too many unanswered questions clouding their use in clinical settings.
“Information regarding the indications, dosing, frequency, and duration of treatment remains unknown,” the authors wrote. “Despite the popularity of these peptides … significant research regarding the safety and efficacy of these therapeutic methods is required before definitive recommendations can be made to patients.”
Some experts also worry that some of the growth hormone peptides pose a theoretical risk of accelerating tumor growth, though evidence remains limited.
According to Dr. Haleem Mohammed, better known as “Dr. Hal,” a board-certified internal medicine doctor based in Miami and the chief medical officer for the Gameday Men’s Health franchise, there’s a responsible middle-ground argument for peptides.
“I push back against this blanket dismissal of, ‘peptides are experimental,’” he said. “Medicine evolves. And a lot of the therapies that we consider standard now started with small data sets [and] mechanistic plausibility. If you are able to find that middle ground where it’s not just hype, but you’re not completely dismissing it — you’re not saying it’s a longevity miracle, or snake oil — you’re humble about what it can actually do.”
Longevity rebrand
To Lieb, the sluggish research and regulatory process simply hasn’t caught up to the benefits of peptides. And he’s content with not waiting on such stamps of approval for what he says is already doing wonders for him and his clients.
“The vast majority of our patients come in here with a beef toward insurance,“ Lieb said. “They are individuals that are very spun up on holistic care. They are individuals that want to go to cash pay businesses that address their health the way they want to address it.”
Although the bulk of Lieb’s business has historically come from testosterone replacement therapy, he expects that the peptide craze will only accelerate from this point forward.
“I think we’re going to get rebranded to be longevity optimization experts, once we transition more to peptides and over testosterone,” he said. “I’m already gearing my team up for that.”
To Escobar-Vasco, the larger issue underneath the peptide debate is the general mistrust and dissatisfaction with mainstream medicine. Part of that is because of how little time most doctors are able to spend educating their patients, she said.
“When you go to [a wellness clinic] and spend an hour with the doctor giving you information, valid or not, they’re giving you time and information,” she said. “That’s one of the big reasons why they’re diverting toward that. If we were doing a better job of educating our patients, maybe we wouldn’t be having so much mistrust in the system.”
