Two-axis map
Therapeutic taxonomy
Agents live in therapeutic categories (Axis A); patients present as conditions (Axis B) that route across those categories. A condition is a query, not a bucket.
⚠ Safety cautions — machine-enforced rules
- Contraindication — Cationic peptides can worsen MCAS (MRGPRX2 degranulation) (MCAS)LL-37, VIP/PACAP and full α-MSH degranulate human mast cells via MRGPRX2 — avoid in mast-cell patients. KPV is safe (NF-κB pathway).
- Warning — BPC-157 crash risk in post-viral/ME-CFS (Chronic fatigue / burnout, Long-COVID / post-viral)Post-viral/ME-CFS patients report crashing at standard dose; microdose 10–25%.
- Warning — Thymosin α-1 bidirectional in autoimmune thyroid (Hashimoto's)The only autoimmune-thyroid study showed Tα-1 worsened disease in some hosts — may aggravate. Do not lead with it.
- Warning — Topical peptide/growth-factor serums worsen hirsutism (PMOS)Speed hair growth and cannot distinguish skin from hair — avoid topical peptide serums on the face in PCOS/hirsutism.
Axis A · therapeutic categories
Metabolic & Weight Management
Glycemic control, fat loss, appetite & energy, metabolic & liver dysfunction.
Anchor agents
Routes in from
MASH / NAFLD, Obesity / insulin resistance, PMOS, Perimenopause / menopause · Hashimoto's, Healthspan / longevity (secondary)
Muscle, Performance & Body Composition
GH/IGF axis, myostatin, hypertrophy, recomposition, endurance.
Anchor agents
Routes in from
Athletic performance / endurance · Healthspan / longevity, Low-T / hypogonadism / TRT support, PMOS (secondary)
Tissue Repair & Recovery
Musculoskeletal healing, joint/tendon, wound & gut-lining repair.
Anchor agents
Routes in from
IBD / leaky gut, Osteoarthritis / joint degeneration, Sports injury / post-op · CIRS / mold illness, Endometriosis, Hashimoto's, MCAS (secondary)
Immune & Inflammation Modulation
Immune regulation, autoimmune & chronic inflammation, mast-cell/neuroimmune.
Anchor agents
Routes in from
CIRS / mold illness, Endometriosis, Hashimoto's, Long-COVID / post-viral, MCAS · Chronic fatigue / burnout, IBD / leaky gut, PMOS (secondary)
Cellular Energy, Mito & Longevity
Mitochondrial function, redox, DNA/telomere, healthspan, fatigue.
Anchor agents
Routes in from
Chronic fatigue / burnout, Healthspan / longevity · Long-COVID / post-viral (secondary)
Cognitive, Mood & Neuro
Focus, memory, neuroprotection, anxiety & mood, neurorecovery.
Anchor agents
Routes in from
Anxiety / depression / mood, Cognitive decline / neurodegen / TBI · CIRS / mold illness, Long-COVID / post-viral, Perimenopause / menopause (secondary)
Sexual & Reproductive Health
Libido, arousal, erectile function, reproductive signaling.
Anchor agents
Routes in from
ED / HSDD / low libido · Low-T / hypogonadism / TRT support, Perimenopause / menopause (secondary)
Hormonal Optimization & HPTA Support
TRT adjunct, endogenous testosterone & fertility, HPTA restart, adrenal/HPA.
Anchor agents
Routes in from
Adrenal / cortisol dysregulation, Low-T / hypogonadism / TRT support · Chronic fatigue / burnout (secondary)
Skin, Hair & Aesthetics
Collagen & skin quality, hair, pigmentation, cosmetic wound cosmesis.
Anchor agents
Routes in from
Skin aging / hair loss
Sleep & Circadian
Sleep architecture, circadian & pineal signaling, wake regulation.
Anchor agents
Routes in from
Insomnia / circadian · Perimenopause / menopause (secondary)
Cardiovascular & Vascular
Endothelial function, cardiac resilience, vascular aging.
Anchor agents
Routes in from
Endothelial / cardiovascular
Axis B · condition routing
Autoimmune & chronic complex illness
| Condition | Primary | Secondary | Lead agents | Grade |
|---|---|---|---|---|
| CIRS / mold illness Shoemaker repair-phase; no RCT. Sequence-dependent (after exposure removal + MARCoNS). | Immune & Inflammation Modulation | Tissue Repair & RecoveryCognitive, Mood & Neuro | VIP | Anecdotal |
| Hashimoto's⚠ Zero human RCTs; gut-axis least-speculative; layer on levothyroxine, never replace. | Immune & Inflammation Modulation | Metabolic & Weight ManagementTissue Repair & Recovery | — | None |
| Long-COVID / post-viral⚠ The one rigorously-trialed peptide (aviptadil) failed; prioritize plausibility + safety. | Immune & Inflammation Modulation | Cellular Energy, Mito & LongevityCognitive, Mood & Neuro | Thymosin Alpha-1 | Emerging |
| MCAS⚠ Aberrant mast-cell mediator release; calm immune signaling WITHOUT triggering degranulation. | Immune & Inflammation Modulation | Tissue Repair & Recovery | KPV | Preclinical |
| Chronic fatigue / burnout⚠ Bioenergetic failure with immune & HPA overlap; restore mitochondrial output. | Cellular Energy, Mito & Longevity | Immune & Inflammation ModulationHormonal Optimization & HPTA Support | NAD+ | Preclinical |
Gut & GI
| Condition | Primary | Secondary | Lead agents | Grade |
|---|---|---|---|---|
| IBD / leaky gut Barrier breakdown with mucosal inflammation; rebuild barrier, dampen flare. | Tissue Repair & Recovery | Immune & Inflammation Modulation | Larazotide | Preclinical |
Male & endocrine
| Condition | Primary | Secondary | Lead agents | Grade |
|---|---|---|---|---|
| Adrenal / cortisol dysregulation Dysregulated HPA output; normalize the adrenal axis. | Hormonal Optimization & HPTA Support | Seractide/ACTH (1-39) | None | |
| Low-T / hypogonadism / TRT support Restore/protect the gonadal axis rather than replace downstream hormones. | Hormonal Optimization & HPTA Support | Muscle, Performance & Body CompositionSexual & Reproductive Health | HCG (Human Chorionic Gonadotropin) | Emerging |
Metabolic & hepatic
| Condition | Primary | Secondary | Lead agents | Grade |
|---|---|---|---|---|
| MASH / NAFLD Hepatic fat with inflammatory progression; reduce liver/visceral fat. | Metabolic & Weight Management | Semaglutide | Emerging | |
| Obesity / insulin resistance Incretin & energy-partitioning dysfunction; appetite/glycemic control leads. | Metabolic & Weight Management | Tirzepatide | Strong |
Musculoskeletal
| Condition | Primary | Secondary | Lead agents | Grade |
|---|---|---|---|---|
| Osteoarthritis / joint degeneration Cartilage loss plus low-grade joint inflammation. | Tissue Repair & Recovery | BPC-157 | Preclinical | |
| Sports injury / post-op Localized tissue damage needing angiogenesis, cytoskeletal repair, controlled inflammation. | Tissue Repair & Recovery | BPC-157 | Preclinical |
Neuro, mood & sleep
| Condition | Primary | Secondary | Lead agents | Grade |
|---|---|---|---|---|
| Anxiety / depression / mood Dysregulated GABAergic/monoaminergic tone and stress physiology. | Cognitive, Mood & Neuro | Inositol | Preclinical | |
| Cognitive decline / neurodegen / TBI Neuronal/synaptic loss with strong bioenergetic component. | Cognitive, Mood & Neuro | Exenatide | Preclinical | |
| Insomnia / circadian Disrupted sleep architecture and circadian signaling. | Sleep & Circadian | Estradiol | Preclinical |
Optimization
| Condition | Primary | Secondary | Lead agents | Grade |
|---|---|---|---|---|
| Athletic performance / endurance Work capacity and recovery via AMPK/mito and GH/IGF pathways. | Muscle, Performance & Body Composition | MOTS-c | Preclinical | |
| Healthspan / longevity Targets hallmarks of aging (mito decline, senescence, telomere attrition). | Cellular Energy, Mito & Longevity | Metabolic & Weight ManagementMuscle, Performance & Body Composition | Rapamycin (Sirolimus) | Preclinical |
Sexual, vascular & aesthetic
| Condition | Primary | Secondary | Lead agents | Grade |
|---|---|---|---|---|
| ED / HSDD / low libido Central (melanocortin) and vascular arousal pathways. | Sexual & Reproductive Health | PT-141 (Bremelanotide) | Strong | |
| Skin aging / hair loss Collagen decline and follicular signaling. | Skin, Hair & Aesthetics | GHK-Cu | Preclinical | |
| Endothelial / cardiovascular Endothelial dysfunction and vascular aging. | Cardiovascular & Vascular | Empagliflozin (Jardiance) | Preclinical |
Women's hormonal & reproductive
| Condition | Primary | Secondary | Lead agents | Grade |
|---|---|---|---|---|
| PMOS⚠ Insulin-resistance & hyperandrogenism driven; ovulation is downstream, so metabolic correction leads. | Metabolic & Weight Management | Muscle, Performance & Body CompositionImmune & Inflammation Modulation | Semaglutide | Strong |
| Perimenopause / menopause⚠ Two evidence-backed peptide lanes (metabolic, libido); HRT owns vasomotor/bone/sleep. | Metabolic & Weight Management | Cognitive, Mood & NeuroSexual & Reproductive HealthSleep & Circadian | PT-141 (Bremelanotide), Semaglutide | Strong |
| Endometriosis⚠ No direct peptide trials; GLP-1 emerging, GnRH agonists standard. Repair peptides are extrapolation. | Immune & Inflammation Modulation | Tissue Repair & Recovery | Tirzepatide | Emerging |