Next, Koniver led me to the clinic’s I.V.-infusion room, where he offered me a poke bowl for lunch. Concoctions were scrawled on a dry-erase board like specials in a diner; one was described as “Dr. Koniver’s blend” of vitamins, minerals, and amino acids. He asked me if I’d like a complimentary drip of methylene blue, a chemical dye that is increasingly marketed for improving longevity and memory. I knew it as a last-resort blood-pressure drug that, at high doses, constricts blood vessels so much that it can cause gangrene. I accepted the poke but declined the drip.
After lunch, a new patient, a handsome middle-aged man I’ll call Toby, eased into a recliner topped with a fluffy pillow. A nurse inserted an I.V. into one arm; Koniver shook his other hand, saying, “Welcome aboard!” Toby and his family had recently been in a car accident, but he’d lost trust in most doctors, he said, after they became “obsessed” with viruses and vaccinations during the pandemic. He was glad that Robert F. Kennedy, Jr., the Secretary of Health and Human Services, was getting the country “on the right track.”
“I’m not a big vaccine guy,” Koniver replied. “A lot of them don’t have the data.”
Toby wasn’t here for a peptide injection, but Koniver advised him to try one on a future visit. “I’ve seen tremendous results,” he said. He also said that one of his I.V. drips, which includes methylene blue, makes his patients “feel like they’ve been plugged into an electrical socket.”
“Love that!” Toby responded.
I was puzzled, perhaps naïvely, that little-studied peptide shots had earned Koniver’s trust, while meticulously studied COVID-19 vaccinations had not. “Anecdotal data means a lot to me,” he said. “Two days after a vaccine, someone has a stroke. Two days later, they’re dead. . . . You see enough of that, it makes an impression.”
In recent years, federal efforts to control peptides have placed Koniver at odds with public-health agencies. In 2023, during Biden’s Presidency, the Food and Drug Administration placed nineteen peptides, including BPC-157, on a “do not compound” list, citing “potential significant safety risks” that included immune reactions, pancreatitis, and accelerated growth of cancerous cells. In response, Koniver began offering a peptide that differed by a single amino acid. “So far, we’re getting very similar results,” he told me.
In 2024, Koniver was sanctioned by South Carolina public-health officials who found, among other things, that he’d failed to maintain his registration with the Drug Enforcement Administration while prescribing controlled substances, and that he’d neglected to check patient vital signs before administering ketamine. Koniver attributed these lapses to charting issues and said that no patients were harmed. “There was never a clinical complaint,” he added. He paid a ten-thousand-dollar fine and agreed not to administer ketamine or testosterone for a year. The state of New York, where he was also allowed to practice, ordered him to surrender his medical license there.
As far as peptides go, Koniver seemed to support America’s public-health agencies coming under new management. “Some of my patients are very high up in the government,” he said. “They’re extremely concerned about what the F.D.A. is doing to peptides.” In the era of Make America Healthy Again, the popularity of peptides has risen. Many compounding pharmacies are experiencing soaring demand; the Times reported that U.S. imports of gray-market peptides and hormones from China roughly doubled last year. The podcaster Joe Rogan has credited BPC-157 with healing a case of elbow tendonitis in two weeks. Beauty influencers who want deeper tans and enhanced libidos are taking Melanotan II, also known as the “Barbie peptide.” Even New York magazine recently published a freelance writer’s account of self-injecting peptides, titled “Life on Peptides Feels Amazing,” which failed to cite any peer-reviewed research or academic scientists. In February, R.F.K., Jr., said, on Rogan’s podcast, that he had taken peptides himself and that, under his leadership, the F.D.A. would stop restricting many of them. Kennedy, who has railed against the agency’s “aggressive suppression” of unproven treatments, has vowed to “end the war.”
The human body produces thousands of peptides. Many are portions of proteins which send messages or regulate systems in the body, often in ways that scientists don’t fully understand. Researchers have known about some peptides for decades, and dozens have been turned into safe and effective drugs. The hormone insulin is a peptide that moves sugar from the bloodstream into cells; GLP-1, or glucagon-like peptide-1, spurs the pancreas to release insulin and slows the passage of food through the gut. (Peptides are usually defined as having about fifty amino acids or fewer; more than that and they’re proteins.) But the science underpinning the current peptide craze dates to the turn of the century, when Pinchas Cohen, a respected pediatric endocrinologist at the University of California, Los Angeles, started to focus on age-related diseases. For one project, Cohen tried to disrupt a protein associated with insulin resistance and diabetes. By injecting human DNA into yeast cells, he was able to produce several chains of amino acids that clung to his target. Cohen told me that the first two chains were known proteins, but the third was “this ridiculous little thing” made up of only twenty-four amino acids. Strangely, he couldn’t figure out where it had come from. According to the conventional wisdom of the day, the DNA he’d injected shouldn’t have coded for it.
“Ever since you gave up abducting humans, you seem happier.”
Cartoon by P. C. Vey
The peptide, humanin, was ultimately traced to a tiny snippet of mitochondrial DNA—part of the ninety-eight per cent of the human genome that had long been dismissed as “junk DNA.” Cohen’s work helped reveal that, in the three-billion-letter book that is our genome, even obscure one-liners can be an important part of the story. Junk DNA, it turned out, wasn’t junk: it contains instructions for numerous peptides and proteins that had never been studied. “The public conception of peptides doesn’t grasp what’s going on from a scientific perspective,” Cohen told me. “This is not a dozen or so things you can buy at the gym. This is a revolution in science. It’s going to start a new era of drug discovery.”
