introduction
The use of BPC-157, also known as body protective compound-157, has grown over the past few years. Many may run across online advertisements and podcasts discussing this compound for anti-inflammatory or wound healing properties. Sports medicine and orthopedic providers should be up to date on products like this. We covered the basis of peptides in a prior post (click).
Body protective compound-157 (BPC-157) is a naturally occurring peptide in gastric juices that endogenously functions to promote gastric mucosal integrity and homeostasis [1]. Increasingly, BPC-157 is being studied in a variety of disease states due to its proposed angiogenic, anti-inflammatory, and wound healing properties. In preclinical (animal or in vitro) models, BPC-157 demonstrates significant cytoprotective effects in a range of organs and tissues, including the alimentary canal, liver, pancreas, heart, and nerves [2]. The compound also shows promise in rapid healing of muscles, bones, and joints, which highlights its potential application in orthopedic sports medicine [2-3]. There seem to be little to no adverse effects reported in the preclinical literature [2,4].
BPC-157 accelerates tendon and ligament repair through enhanced fibroblast proliferation and collagen synthesis, primarily via focal adhesion kinase (FAK)-paxillin signaling pathways. It also increases growth hormone receptor (GHR) expression in fibroblasts, augmenting the anabolic healing response, thus improving tendon structure and biomechanical function, even in conditions impaired by corticosteroids or limited vascular supply [9-10].
In rodent models, BPC-157 significantly enhances myogenesis, muscle fiber regeneration, and functional recovery post-injury in skeletal muscle [9]. By facilitating rapid re-establishment of myotendinous junctions and reducing fibrosis at injury sites, BPC-157 improves overall muscular integrity and contractile function, crucial for recovery from severe muscular trauma or degenerative muscular conditions [9-10].
In regards to bone healing, BPC-157 promotes osteogenesis and accelerates bone healing, particularly under compromised conditions such as delayed union, avascular osteonecrosis, or impaired fracture healing. By stimulating angiogenesis within bone tissue and enhancing osteoblast activity via VEGFR2-NO signaling, BPC-157 markedly improves bone matrix deposition and fracture consolidation, highlighting its clinical promise for orthopedic conditions [9-10].
Figure 1. Pathway of BPC-157. Adopted from [9].
There are some studies looking directly at musculoskeletal injuries in rat and mice models [9]. Injury healing typically progresses through three phases: the inflammatory phase (days 1–5), the repair/proliferative phase (days 5–14), and the remodeling phase (days 14–90+) [11]. During the inflammatory phase, inflammatory cells infiltrate the injury site, followed by fibroblast proliferation and the synthesis of collagen fibers in the repair phase. The remodeling phase sees the maturation and alignment of these fibers to restore tissue integrity. BPC-157 has shown potential in accelerating the healing process by targeting these key stages, particularly in tissues with limited blood supply (i.e. tendons and ligaments) [9].
Cerovecki et al. demonstrated healing of the medial collateral ligament in rats after surgical transection [12]. Perovic et al. suggested this peptide has the ability to impact healing of spinal cord injury by targeting all stages of the secondary injury phase [13]. Through its angiogenic properties, BPC-157 promotes the growth of new blood vessels, significantly enhancing the healing of the myotendinous junction, which is typically a weak spot due to its poor vascularization [10]. In rats with hind limb ischemia, BPC-157 both increased the vessel density and accelerated blood flow recovery [14].
Studies have demonstrated that BPC-157 not only improves tendon healing but also enhances tendon-to-bone integration, even in the presence of corticosteroids, which is notable due to steroids usual effect impairing recovery [15-16]. This effect extends to muscle injuries, where BPC-157 has shown to restore muscle function and integrity, even after traumatic injuries or corticosteroid application [17]. The majority of musculoskeletal animal studies dose BPC-157 once daily, with regimens ranging from a single dose to daily administration for 7, 14, 28, or up to 90 days, depending on the injury model and outcome measures [9].
However, while animal studies have shown promising results, it is important to recognize that there is still a lack of extensive human studies to fully assess the impact of BPC-157 on musculoskeletal injuries in humans.
Although there is little clinical evidence, select cash practices offer BPC-157 intraarticular injections and oral formulations for knee pain and arthritis [5]. This was a retrospective study with sixteen patients with 12 receiving BPC-157 and 4 receiving BPC-157 and TB4 (thymosin beta 4). Overall, 14 of 16 patients (87.5%) had relief of their knee pain when BPC 157 or a combination of BPC 157 and TB4 was used.
Although for other indications, two other studies exist studying the effects of BPC-157. In another pilot study of 12 individuals, conducted by Lee et al. (2024), intravesicular (bladder) injections of BPC-157 were reported to result in 80–100% resolution of moderate to severe interstitial cystitis at 6 weeks post- treatment [18]. Notably, all patients had previously been treated with pentosan polysulfate, which is currently the only FDA approved treatment for interstitial cystitis, and had not responded.
Most recently, Lee and Burgess conducted a pilot study to test for side effects. This involved two healthy adults who received intravenous BPC-157 infusions up to 20 mg. The treatment was well tolerated, with no adverse events or clinically meaningful changes observed in vital signs, electrocardiograms, or laboratory biomarkers assessing cardiac, hepatic, renal, thyroid, or metabolic function. Pharmacokinetic analysis showed that plasma BPC-157 concentrations returned to baseline within 24 h, consistent with its known rapid clearance and short half-life
Athletes are increasingly using BPC-157 for general musculoskeletal recovery and injury, including muscular strains and tendon injuries [6-7]. Recently, many leading regulatory agencies and professional and collegiate sports leagues in the United States have banned its use either by name or by association as a peptide hormone (Figure 2).
WADA banned BPC-157 in 2022 under the S0 Unapproved Substances category, prohibiting its use in both competition and training due to its lack of human clinical approval. In 2023, the FDA named BPC-157 a Category 2 bulk drug substance, meaning it cannot be compounded by commercial pharmaceutical companies and that there is insufficient evidence on whether it would cause harm to humans [7]. Nonetheless, many BPC-157 products are legally sold as “dietary supplements” or “research chemicals,” classifications that are not subject to FDA regulations.
In addition, because BPC-157, along with many peptide hormones, are not Drug Enforcement Agency (DEA) scheduled substances, possession is not illegal (unlike substances such as anabolic steroids). Thus, any products marketed as BPC-157 are unregulated for quality and safety [8]. In the wake of this gray-area legal status, numerous medical clinics with licensed physicians across the United States offer treatment with this peptide, and it remains readily accessible for purchase online, with interest on the rise.
Summary
In conclusion, early preclinical evidence suggests that BPC-157 promotes structural, biomechanical, and functional recovery in tendon rupture, ligament tear, muscle tear, and fracture models. Like other peptide hormones, BPC-157 modulates cell growth, proliferation, survival, anti-inflammatory, and angiogenesis pathways. While no acute adverse events were reported in preclinical animal models, clinical safety in humans remains unknown. Due to limited high-quality clinical evidence, clinicians and athletes should exercise caution when considering the use of BPC-157. To promote outcome reporting and athlete safety, we recommend that during history-taking, clinicians specifically inquire about dietary or sports supplements and provide counsel about the risks associated with unregulated manufacturing, contamination, and poor clinical safety data. Clinicians should urge athletes to understand their organizations’ rules and be cautious of the medication or supplements they take to remain compliant with safety and testing standards. Further basic science and clinical studies are needed to validate these preliminary findings pertaining to BPC-157.
References
Brcic L, Brcic I, Staresinic M, Novinscak T, Sikiric P, Seiwerth S. Modulatory effect of gastric pentadecapeptide BPC 157 on angiogenesis in muscle and tendon healing. J Physiol Pharmacol Off J Pol Physiol Soc. 2009;60(Suppl 7):191–196. Vasireddi, Nikhil, et al. “Emerging Use of BPC-157 in Orthopaedic Sports Medicine: A Systematic Review.” HSS Journal® (2025): 15563316251355551. Chang C-H, Tsai W-C, Lin M-S, Hsu Y-H, Pang J-HS. The promoting effect of pentadecapeptide BPC 157 on tendon healing involves tendon outgrowth, cell survival, and cell migration. J Appl Physiol. 2011;110:774–780. Gwyer D, Wragg NM, Wilson SL. Gastric pentadecapeptide body protection compound BPC 157 and its role in accelerating musculoskeletal soft tissue healing. Cell Tissue Res. 2019;377:153–159 Lee E, Padgett B. Intra-Articular Injection of BPC 157 for Multiple Types of Knee Pain. Altern Ther Health Med. 2021;27:8–13 WADA’s 2022 Prohibited List Now in Force. World Anti-Doping Agency; 2022. Available at: https://www.wada-ama.org/en/ news/wadas-2022-prohibited-list-now-force#:~:text=For%20the%20first%20time%2C%20a,re%2Devaluation%20of%20 its%20status. Accessed June 5, 2024. Ultimate Fighting Championship. Anti-Doping Statement on Courtney Casey. Ultimate Fighting Championship; 2023. Available at: https://www.ufc.com/news/statement-cortneycasey?language_content_entity=en Cox HD, Miller GD, Eichner D. Detection and in vitro metabolism of the confiscated peptides BPC 157 and MGF R23H. Drug Test Anal. 2017;9:1490–1498. McGuire, Flynn P., et al. “Regeneration or Risk? A Narrative Review of BPC-157 for Musculoskeletal Healing.” Current Reviews in Musculoskeletal Medicine (2025): 1-9. Seiwerth S, Rucman R, Turkovic B, Sever M, Klicek R, Radic B, et al. BPC 157 and standard angiogenic growth factors. Gastrointestinal tract healing, lessons from tendon, ligament, muscle and bone healing. Curr Pharm Des. 2018;24:1972–89. Hope M, Saxby TS. Tendon healing. Foot Ankle Clin. 2007;12:553–67 Cerovecki T, Bojanic I, Brcic L, Radic B, Vukoja I, Seiwerth S, et al. Pentadecapeptide BPC 157 (PL 14736) improves ligament healing in the rat. J Orthop Res. 2010;28:1155–61 Perovic D, Kolenc D, Bilic V, Somun N, Drmic D, Elabjer E, et al. Stable gastric pentadecapeptide BPC 157 can improve the healing course of spinal cord injury and lead to functional recovery in rats. J Orthop Surg. 2019;14:199. Hsieh M-J, Liu H-T, Wang C-N, Huang H-Y, Lin Y, Ko Y-S, et al. Therapeutic potential of pro-angiogenic BPC157 is associated with VEGFR2 activation and up-regulation. J Mol Med Berl Ger. 2017;95:323–33. Krivic A, Anic T, Seiwerth S, Huljev D, Sikiric P. Achilles detachment in rat and stable gastric pentadecapeptide BPC 157: promoted tendon-to‐bone healing and opposed corticosteroid aggravation. J Orthop Res. 2006;24:982–9 Pevec D, Novinščak T, Brčić L, Šipoš K, Jukić I, Starešinić M, et al. Impact of pentadecapeptide BPC 157 on muscle healing impaired by systemic corticosteroid application. Med Sci Monit. 2010;16:81–8. Staresinic M, Petrovic I, Novinscak T, Jukic I, Pevec D, Suknaic S, et al. Effective therapy of transected quadriceps muscle in rat: gastric pentadecapeptide BPC 157. J Orthop Res. 2006;24:1109–17. Lee E, Walker C, Ayadi B. Effect of BPC-157 on symptoms in patients with interstitial cystitis: A pilot study. Altern Ther Health Med. 2024;30:12–7. Lee E, Burgess K. Safety of Intravenous Infusion of BPC157 in Humans: A Pilot Study. Altern Ther Health Med [Internet]. 2025;