What Bloodwork Should I Get Before Peptide Therapy?

GLP-1 receptor agonist therapy requires hemoglobin A1c, eGFR for kidney function, lipase for pancreatic baseline, and lipid panel. Anabolic osteoporosis peptide therapy requires calcium, 25-hydroxy vitamin D, parathyroid hormone, and creatinine for kidney function. The framework also requires bone turnover markers per AACE/ACE 2020 and Endocrine Society 2019 CPGs. Growth hormone secretagogue therapy requires IGF-1, fasting glucose, hemoglobin A1c, and lipid panel per AACE 2019 GHD CPG. Compounded tissue repair, sexual health, and immune peptide therapy requires baseline comprehensive metabolic panel and complete blood count. The framework also requires AMA Code of Medical Ethics 1.1.5 documentation. Discuss specific panels with your physician.

Six Things You Need to Know About Bloodwork Before Peptide Therapy

This page covers baseline bloodwork before peptide therapy across six compound classes. The framework spans six sections. Section one covers GLP-1 receptor agonist baseline. Section two covers anabolic osteoporosis peptide baseline. Section three addresses growth hormone secretagogue baseline. Section four covers compounded tissue repair peptide baseline. Section five addresses sexual health peptide baseline. Section six covers immune peptide baseline plus the universal four-stage monitoring schedule.

Research Suggests

How to Approach Your Decision

• For GLP-1 receptor agonist therapy baseline, expect hemoglobin A1c, eGFR via creatinine, lipase, and lipid panel per FDA labels.
• For osteoporosis peptide therapy baseline, expect calcium, vitamin D, PTH, creatinine, and bone turnover markers per AACE/ACE 2020 CPG.
• For growth hormone secretagogue baseline, expect IGF-1, fasting glucose, A1c, lipid panel, plus ITT or glucagon stim for GHD diagnosis.
• For compounded peptide therapy baseline, expect CMP and CBC plus indication-specific markers under AMA Code 1.1.5 framework.
• For Evenity baseline, expect cardiovascular risk stratification per the FDA cardiovascular boxed warning.
• Bring prior bloodwork from past twelve months to reduce redundant baseline testing where panels overlap.
• Expect four-stage monitoring cadence: baseline week 0, early follow-up week 4-8, stabilization month 3, maintenance month 6 then annual.
• For telehealth bloodwork, expect orders through external laboratory networks like Quest Diagnostics or LabCorp.

Limitations and Caveats

• Baseline panels differ by compound class. The required tests follow FDA prescribing information for the specific peptide and indication. There is no generic baseline panel applicable across all peptide therapy.
• GLP-1 receptor agonist baseline focuses on A1c, kidney, pancreatic, and lipid markers per FDA labels and ADA 2024 Standards of Care framework.
• Anabolic osteoporosis peptide baseline focuses on mineral metabolism and bone turnover markers per AACE/ACE 2020 and Endocrine Society 2019 CPGs.
• Growth hormone secretagogue baseline requires dynamic testing for adult-onset GHD diagnosis plus IGF-1 and glucose metabolism markers per AACE 2019 GHD CPG.
• Compounded peptide therapy operates under AMA Code 1.1.5 framework requiring documented risk-benefit assessment, alternatives considered, and patient understanding.
• Self-ordered direct-to-consumer bloodwork is not a substitute for physician-ordered baseline with documented clinical interpretation under AMA Code 1.1.5 informed consent for off-label or compounded prescribing.
• Monitoring follows a four-stage cadence with class-specific markers at baseline, early follow-up, stabilization, and maintenance stages.
• Telehealth bloodwork orders go through external laboratory networks with results delivered to the prescribing physician for clinical interpretation.

What's Marketed vs What's Studied

7 common claims, corrected.

Common Questions

Evidence Ranking

1. Rank 1

   GLP-1 Receptor Agonist Baseline

   Strongest evidence anchoring: FDA approvals for Wegovy, Ozempic, Zepbound, Mounjaro plus ADA 2024 Standards of Care plus SELECT 2023 cardiovascular outcomes plus SUSTAIN-6 plus SURMOUNT-1.

2. Rank 2

   Anabolic Osteoporosis Peptide Baseline

   Strong evidence anchoring: FDA approvals for Forteo, Tymlos, Evenity plus AACE/ACE 2020 plus Endocrine Society 2019 CPG. Validated bone turnover marker biomarkers.

3. Rank 3

   Growth Hormone Secretagogue Baseline

   Strong evidence anchoring: FDA approval for Tesamorelin (HIV-associated lipodystrophy) plus somatropin (GHD) plus AACE 2019 Adult GHD CPG. Off-label Sermorelin under AMA Code 1.1.5.

4. Rank 4

   Compounded Tissue Repair Peptide Baseline

   Limited evidence anchoring: AMA Code 1.1.5 framework only. Compounded BPC-157 and TB-500 evidence base primarily preclinical with limited human trial data.

5. Rank 5

   Compounded Sexual Health Peptide Baseline

   Moderate evidence anchoring: bremelanotide FDA-approved as Vyleesi for HSDD in premenopausal women provides some anchoring. Compounded use outside Vyleesi operates under AMA Code 1.1.5.

6. Rank 6

   Compounded Immune Peptide Baseline

   Limited evidence anchoring: AMA Code 1.1.5 framework only. Compounded thymosin alpha-1 and variants evidence base primarily preclinical for most indications.

Sourcing Checklist

• Order baseline bloodwork through prescribing physician with documented clinical interpretation.

  Self-ordered direct-to-consumer bloodwork is not a substitute for physician-ordered baseline. AMA Code 1.1.5 informed consent for off-label or compounded prescribing requires physician clinical interpretation of the panel.

• Match the baseline panel to the specific peptide and indication per FDA prescribing information.

  GLP-1 RA panel includes A1c, eGFR, lipase, lipid. Osteoporosis peptide panel includes calcium, vitamin D, PTH, creatinine, bone turnover markers. GH secretagogue panel includes IGF-1, glucose, A1c, lipid plus dynamic testing.

• For compounded peptide therapy, expect AMA Code 1.1.5 informed consent documentation.

  The documentation includes risk-benefit assessment, alternatives considered (including FDA-approved options), monitoring requirements, and patient understanding. Patients can request copies.

• Verify physician-pharmacy verification for compounded peptide pathways.

  Verification includes 503A state pharmacy board license or 503B FDA registration, PCAB accreditation, USP Chapter 797 and 800 compliance, and third-party testing practices.

• Bring prior bloodwork from past twelve months to reduce redundant baseline testing.

  Prior panels covering required markers may reduce repeat ordering depending on FDA prescribing information for the specific peptide and time elapsed since prior testing.

• Expect four-stage monitoring cadence across the therapy course.

  Baseline week 0, early follow-up week 4 to 8, stabilization month 3, maintenance month 6 with annual continuation. Class-specific markers apply at each stage per FDA prescribing information.

• For Evenity specifically, expect cardiovascular risk stratification at baseline.

  Evenity carries an FDA cardiovascular boxed warning issued April 2019. Contraindicated in patients with myocardial infarction or stroke in the prior twelve months.

• For Tesamorelin specifically, expect IGF-1 plus glucose metabolism markers at baseline.

  Tesamorelin can worsen insulin resistance. FDA label specifies glucose monitoring. For HIV-associated lipodystrophy indication, baseline HIV viral load with CD4 count is required.

• For telehealth peptide consultation, expect bloodwork orders through external laboratory networks.

  Quest Diagnostics, LabCorp, and local laboratory networks support telehealth bloodwork ordering with electronic results delivery to the prescribing physician.

Regulatory Context

The regulatory framework governing baseline bloodwork before peptide therapy evolves continuously. FDA prescribing information for each FDA-approved peptide updates with each labeling cycle including new indications, contraindications, monitoring specifications, and adverse event profile updates. ADA Standards of Care updates annually for type 2 diabetes peptide therapy. AACE/ACE and Endocrine Society guidelines for osteoporosis update periodically. AACE GHD CPG updates periodically. The FDA Compounding Quality Act enforcement landscape evolves with state pharmacy board oversight cycles and 503B outsourcing facility inspection cadences. AMA Code of Medical Ethics 1.1.5 and 2.1.1 frameworks remain foundational with periodic refinements. PSI tracks regulatory changes and updates this page per the Editorial Standards review cadence. Discuss with primary care or specialty practice for current baseline panel specifications applicable to your specific clinical context.

Who This Applies To

• · Adult preparing for first GLP-1 receptor agonist therapy and reviewing baseline panel requirements.
• · Adult preparing for bone-forming peptide therapy and reviewing mineral metabolism plus bone turnover markers.
• · Adult preparing for growth hormone secretagogue therapy and reviewing IGF-1 plus dynamic testing framework.
• · Adult preparing for compounded peptide therapy and reviewing AMA Code 1.1.5 informed consent framework.
• · Adult comparing FDA-approved versus compounded peptide pathways for indication-specific decisions.
• · Adult preparing for Evenity therapy and reviewing cardiovascular boxed warning risk stratification.
• · Adult preparing for Tesamorelin therapy and reviewing IGF-1 plus glucose monitoring framework.
• · Adult planning four-stage monitoring cadence across peptide therapy course.
• · Adult considering telehealth peptide consultation with external laboratory network bloodwork ordering.
• · Patient seeking documentation copies including baseline panel orders and informed consent.

Verdict

Baseline bloodwork before peptide therapy follows FDA prescribing information for each specific peptide. The required panels differ by compound class. The PSI framework covers six compound classes through six baseline panels. For GLP-1 receptor agonist therapy, baseline includes A1c, eGFR, lipase, and lipid panel per FDA labels and ADA 2024 Standards of Care. For anabolic osteoporosis peptide therapy, baseline includes calcium, vitamin D, PTH, creatinine, and bone turnover markers per AACE/ACE 2020 and Endocrine Society 2019 CPGs. For growth hormone secretagogue therapy, baseline includes IGF-1, glucose, A1c, lipid panel, and dynamic testing per AACE 2019 GHD CPG. For compounded peptide therapy, baseline includes CMP and CBC plus indication-specific markers under AMA Code 1.1.5 framework. Monitoring follows a four-stage cadence across the therapy course. Patients should consult primary care or specialty practice for individualized clinical context.

In Plain Terms

Bloodwork before peptide therapy is not one-size-fits-all. The required tests depend on which peptide you are taking. For weight loss drugs like Wegovy or Ozempic, expect A1c, kidney function, lipase, and lipid panel. For osteoporosis drugs like Forteo or Evenity, expect calcium, vitamin D, PTH, kidney function, and bone turnover markers. For Evenity, also expect cardiovascular workup. For growth hormone drugs, expect IGF-1, glucose, A1c, lipid panel, plus a special diagnostic test. For compounded peptides, expect basic safety labs (CMP and CBC) plus specific markers for what you are treating. Bloodwork is repeated at baseline, week 4-8, month 3, and month 6 then yearly.

Different peptides need different blood tests. The doctor orders specific tests based on what peptide you are taking and why. Some tests are for safety (kidney, liver, blood count). Some tests track if the peptide is working (A1c for weight or diabetes drugs, bone markers for osteoporosis drugs, IGF-1 for growth hormone drugs). Tests are done before starting, then again at week 4 to 8, month 3, month 6, and yearly. Bring any prior bloodwork to your appointment. For telehealth visits, you go to a lab like Quest or LabCorp for the blood draw.

For any peptide therapy decision, physician selection through state medical board license verification, ABMS board certification, peptide experience verification, and AMA Code 1.1.5 framework adherence is the legal and clinical gate. PSI maintains a vetted directory of practitioners ordering comprehensive baseline bloodwork per FDA prescribing information across primary care, endocrinology, rheumatology, weight medicine, and other relevant specialties.

Related Conditions

• → Peptides for Weight Loss
• → Peptides for Type 2 Diabetes
• → Peptides for Bone Health and Osteoporosis
• → Peptides for Growth Hormone Deficiency
• → Peptides for Sexual Health
• → Peptides for Immune Function

Related Education

• → Bloodwork for GLP-1 Therapy
• → Bloodwork for Osteoporosis Peptide Therapy
• → Bloodwork for Growth Hormone Therapy
• → Bloodwork for Tissue Repair Peptides
• → Bloodwork for Sexual Health Peptides
• → Bloodwork for Immune Peptides
• → Peptide Consultation: What to Expect

Featured Compounds

• → Semaglutide (Wegovy / Ozempic / Rybelsus)
• → Tirzepatide (Zepbound / Mounjaro)
• → Teriparatide (Forteo)
• → Romosozumab (Evenity)
• → Sermorelin
• → Tesamorelin (Egrifta)
• → BPC-157
• → Thymosin Alpha-1

Common Contexts

• · Adult preparing for FDA-approved GLP-1 receptor agonist therapy with insurance prior authorization
• · Adult preparing for FDA-approved anabolic osteoporosis peptide therapy under specialty coordination
• · Adult preparing for FDA-approved Tesamorelin therapy for HIV-associated lipodystrophy indication
• · Adult preparing for diagnosed adult-onset growth hormone deficiency replacement therapy with somatropin
• · Adult preparing for off-label or compounded peptide therapy under AMA Code 1.1.5 framework
• · Adult comparing FDA-approved versus compounded peptide pathways for indication-specific decisions
• · Adult evaluating monitoring requirements for chronic peptide therapy continuation across the course
• · Adult preparing for telehealth peptide consultation with external laboratory network bloodwork
• · Adult bringing prior bloodwork to consultation to reduce redundant baseline testing
• · Adult requesting documentation copies including baseline orders and AMA Code 1.1.5 consent

Sources and Citations

1. [1] FDA Prescribing Information: Wegovy (semaglutide) injection 2.4 mg · 2024 · FDA NDA 215256 · Source
2. [2] FDA Prescribing Information: Ozempic (semaglutide) injection · 2024 · FDA NDA 209637 · Source
3. [3] FDA Prescribing Information: Zepbound (tirzepatide) injection · 2024 · FDA NDA 217806 · Source
4. [4] FDA Prescribing Information: Mounjaro (tirzepatide) injection · 2024 · FDA NDA 215866 · Source
5. [5] FDA Prescribing Information: Forteo (teriparatide) injection · 2020 · FDA NDA 021318 · Source
6. [6] FDA Prescribing Information: Evenity (romosozumab-aqqg) injection with cardiovascular boxed warning · 2019 · FDA NDA 761062 · Source
7. [7] FDA Prescribing Information: Egrifta (tesamorelin) for HIV-associated lipodystrophy · 2023 · FDA NDA 022505 · Source
8. [8] FDA Prescribing Information: Vyleesi (bremelanotide) injection for HSDD in premenopausal women · 2023 · FDA NDA 210557 · Source
9. [9] Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (SELECT trial) · New England Journal of Medicine · 2023 · DOI
10. [10] Jastreboff AM, Aronne LJ, Ahmad NN, et al. Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1) · New England Journal of Medicine · 2022 · DOI
11. [11] Marso SP, Bain SC, Consoli A, et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes (SUSTAIN-6) · New England Journal of Medicine · 2016 · DOI
12. [12] American Diabetes Association. Standards of Care in Diabetes 2024 · Diabetes Care · 2024 · DOI
13. [13] Camacho PM, Petak SM, Binkley N, et al. AACE/ACE Clinical Practice Guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis - 2020 Update · Endocrine Practice · 2020 · DOI
14. [14] Eastell R, Rosen CJ, Black DM, et al. Pharmacological Management of Osteoporosis in Postmenopausal Women: An Endocrine Society Clinical Practice Guideline · Journal of Clinical Endocrinology and Metabolism · 2019 · DOI
15. [15] AACE Adult Growth Hormone Deficiency Clinical Practice Guidelines for Diagnosis and Treatment · Endocrine Practice · 2019
16. [16] AMA Code of Medical Ethics Opinion 1.1.5: Off-label and Investigational Use of Pharmaceuticals · American Medical Association · 2024 · Source
17. [17] AMA Code of Medical Ethics Opinion 2.1.1: Informed Consent · American Medical Association · 2024 · Source
18. [18] FDA Compounding Quality Act of 2013: 503A pharmacy and 503B outsourcing facility framework · US Food and Drug Administration · 2013 · Source
19. [19] FDA MedWatch: The FDA Safety Information and Adverse Event Reporting Program · US Food and Drug Administration · 2024 · Source