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The Science

We don't sell hope.
We prescribe evidence.

Every protocol at AnthologyRX is built on peer-reviewed clinical research, FDA-regulated compounds, and physician oversight. Here's the evidence.

Clinical Evidence

The research behind every protocol.

How GLP-1 Agonists Work

GLP-1 (glucagon-like peptide-1) receptor agonists bind to receptors in the hypothalamus, suppressing appetite signals and modulating the reward pathways associated with food-seeking behavior. Simultaneously, they slow gastric emptying — extending satiety — and enhance glucose-dependent insulin secretion while inhibiting glucagon release. The net result is a significant reduction in caloric intake, improved insulin sensitivity, and favorable metabolic remodeling without the compensatory metabolic slowdown typical of caloric restriction alone.

Tirzepatide (dual GIP/GLP-1 agonism) amplifies these effects by engaging an additional receptor pathway, producing additive reductions in body weight and cardiometabolic risk markers.

Key Trial Data
SURMOUNT-1 — Tirzepatide (2022)
20.9% mean weight reduction over 72 weeks in adults with obesity
Jastreboff et al., NEJM — the largest weight reduction observed in a randomized controlled pharmacotherapy trial at time of publication.
STEP 1 — Semaglutide (2021)
14.9% mean weight reduction over 68 weeks
Wilding et al., NEJM — established semaglutide as the reference benchmark for GLP-1 monotherapy outcomes.
LEADER — Liraglutide Cardiovascular Outcomes (2016)
13% reduction in major adverse cardiovascular events (MACE) in patients with type 2 diabetes (Marso et al., NEJM). Note: LEADER studied liraglutide (a different GLP-1 agent); similar cardiovascular benefit was later demonstrated for semaglutide in SUSTAIN-6. These trials studied branded, FDA-approved formulations. Cardiovascular outcomes data for compounded GLP-1 formulations has not been separately established.
Marso et al., NEJM — established GLP-1 agonism as cardioprotective independent of weight loss magnitude.
Monitoring & Contraindications
  • Absolute contraindication: personal or family history of medullary thyroid carcinoma (MTC) or MEN2 syndrome
  • Pancreatitis history: thorough screening required; not initiated in patients with active or recent episodes
  • Gastroparesis screening: baseline GI function assessed; delayed gastric emptying pre-screened
  • Muscle mass preservation: AnthologyRX protocols incorporate resistance training guidance and protein targets alongside GLP-1 to mitigate lean mass catabolism
  • Common GI side effects (nausea, constipation) managed via dose titration and provider support
Why Our Delivery Model Is Different

AnthologyRX providers prescribe GLP-1 protocols with active monitoring for lean mass preservation — a dimension most telehealth platforms ignore. Dosing is titrated based on individual response, not a one-size schedule. Medications are compounded at licensed 503B facilities, ensuring pharmaceutical-grade purity and consistent formulation. Monthly check-ins allow protocol adjustments based on labs, weight trajectory, and patient-reported outcomes.

Peptide Signaling Pathways

CJC-1295 / Ipamorelin (GHRH agonism): CJC-1295 is a synthetic analogue of growth hormone-releasing hormone (GHRH), extending GH pulse duration. Ipamorelin selectively stimulates pituitary GH release via the ghrelin receptor without significantly elevating cortisol or prolactin. Used in combination, they produce a robust, pulsatile GH release that closely mirrors physiological secretion — amplifying IGF-1 production, promoting lean tissue synthesis, and accelerating recovery from training stress.

BPC-157 (tissue repair signaling): Body Protective Compound-157 is a synthetic pentadecapeptide fragment of a human gastric protein. It upregulates growth hormone receptors at tendon and ligament fibroblasts, promotes angiogenesis at injury sites, and modulates nitric oxide pathways to accelerate musculoskeletal repair.

Research Base
IGF-1 Axis Optimization
GHRH analogue therapy demonstrated significant IGF-1 elevation and improved body composition in GH-deficient adult populations
Ionescu & Frohman, JCEM — foundational evidence for GHRH agonism in adults.
Recovery & Tissue Repair
BPC-157 demonstrated accelerated tendon-to-bone healing and reduced recovery time in multiple animal model studies
Human clinical data for BPC-157 remains limited. AnthologyRX providers disclose research-stage status during intake.
Monitoring & Sourcing
  • Active or prior malignancy: thorough oncology history required before initiating any GH-stimulating peptide
  • 503A / 503B sourcing requirements: all peptides compounded at licensed facilities with appropriate documentation
  • FDA regulatory note: April 2026 FDA Category 2 update reclassified certain peptides — AnthologyRX protocols are continuously reviewed for compliance with current regulatory status
  • IGF-1 baseline labs ordered pre-protocol; monitored at defined intervals
Clinical Framework

Peptide protocols at AnthologyRX are prescribed only by physicians who assess the patient's training load, recovery demands, and baseline labs. Dosing is individualized. Regulatory compliance is non-negotiable — as the landscape evolves post-April 2026 FDA guidance, our clinical team actively reviews and adjusts available protocols to stay within current compounding and prescribing standards.

HPG Axis & Testosterone Physiology

The hypothalamic-pituitary-gonadal (HPG) axis governs testosterone production through a feedback loop: GnRH from the hypothalamus stimulates LH/FSH release from the pituitary, which drives testicular Leydig cell testosterone synthesis. In hypogonadal men, this axis is insufficient — TRT restores circulating testosterone to physiologic range, normalizing SHBG dynamics, muscle protein synthesis, bone mineral density, libido, and cognitive clarity.

Aromatization management (conversion of testosterone to estradiol via aromatase enzymes) is addressed when clinically indicated, as supraphysiologic estradiol can blunt TRT benefits and cause adverse effects. Female testosterone optimization targets HSDD (hypoactive sexual desire disorder) and mood/energy endpoints at micro-dose ranges distinct from male TRT protocols.

Validated Outcomes
ADAM Questionnaire Validation
Androgen Deficiency in Aging Males (ADAM) questionnaire — validated screening tool for symptomatic hypogonadism
Morley et al. — used alongside lab panels for clinical decision-making in AnthologyRX intake.
Clinical Hypogonadism Treatment
TRT demonstrated significant improvements in lean body mass, bone density, sexual function, and mood in hypogonadal men
Testosterone Trials (TTrials) — 7-trial consortium published in NEJM & JAMA 2016.
Female Testosterone — HSDD
Low-dose testosterone demonstrated significant improvement in sexual desire and satisfying sexual events vs. placebo
Davis et al., Lancet — informs the female hormone optimization protocols offered via AnthologyRX.
Monitoring Protocol
  • PSA monitoring: baseline and periodic follow-up for male patients over 40
  • Hematocrit: CBC monitored; TRT can elevate red blood cell mass requiring therapeutic phlebotomy if indicated
  • Sleep apnea screening: TRT may worsen existing OSA; baseline sleep history assessed
  • Fertility routing: patients desiring future fertility are offered enclomiphene-based protocols rather than exogenous TRT to preserve HPG axis function
  • Estradiol monitoring: aromatase inhibitor use only when labs confirm excess conversion; not prophylactic
Individualized, Lab-Driven Protocols

Hormone protocols at AnthologyRX begin with comprehensive baseline labs: total and free testosterone, SHBG, LH, FSH, estradiol, PSA (males), CBC, and metabolic panel. Dosing targets physiologic range — not supraphysiologic — with dose adjustments guided by follow-up labs at defined intervals. Providers are briefed on patient training goals, not just diagnostic criteria.

NAD+ Biology & Cellular Function

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme central to cellular energy metabolism, serving as an electron carrier in the mitochondrial respiratory chain. The NAD+/NADH ratio is a direct indicator of metabolic and redox state. Declining NAD+ levels with age impair sirtuin (SIRT1–7) function — enzymes that regulate DNA repair, gene expression, and mitochondrial biogenesis. Restoring NAD+ levels via precursor supplementation (NMN, NR) or direct IV delivery activates sirtuin pathways and supports PARP-dependent DNA repair mechanisms.

Longevity & Function Research
NMN Precursor — Human Trial
Oral NMN supplementation safely elevated NAD+ levels in skeletal muscle and demonstrated improvements in physical performance metrics in older adults
Yoshino et al., Cell Metabolism 2021 — first human clinical trial demonstrating tissue-level NAD+ restoration.
Sirtuin Activation & Longevity Pathways
Sirtuin activation via NAD+ repletion associated with improved mitochondrial function and reduction in age-associated inflammation markers
Guarente et al. — foundational longevity biology establishing NAD+ as a rate-limiting factor in sirtuin-mediated pathways.
Cognitive Function
NAD+ precursor supplementation associated with preserved cognitive performance and reduced neuroinflammation markers in early trials
Emerging data — AnthologyRX providers contextualize efficacy levels accurately during intake.
Clinical Considerations
  • Cancer history: NAD+ supplementation not initiated without oncology clearance — NAD+ supports cellular replication pathways
  • 503B sourcing requirement: IV NAD+ formulations must originate from licensed 503B compounding facilities with documented endotoxin testing
  • Endotoxin testing: mandatory for all IV-administered compounds; non-negotiable at AnthologyRX
  • Oral vs. IV delivery: provider-determined based on clinical goals; oral precursors (NMN/NR) are lower risk with emerging evidence; IV delivery achieves higher plasma peaks
Longevity as a Clinical Discipline

AnthologyRX approaches NAD+ optimization as a component of a comprehensive longevity protocol — not a standalone IV drip. Providers contextualize the current evidence honestly: strong mechanistic data, growing human clinical literature, and appropriate uncertainty where it exists. All IV formulations are sourced exclusively from 503B facilities with documented batch testing, and cancer history screening is mandatory prior to initiation.

Pharmacy

503B. Not gray market.

01
What 503B means

A 503B outsourcing facility is a compounding pharmacy that operates under direct FDA registration and oversight — subject to Current Good Manufacturing Practice (CGMP) standards, facility inspections, and mandatory adverse event reporting. Unlike traditional 503A pharmacies, 503B facilities produce bulk compounded medications that are tested for potency, sterility, and endotoxin levels before dispensing.

02
How it differs from standard compounding

503A pharmacies compound for individual patients with a specific prescription — valuable for personalized doses, but subject to less stringent oversight. 503B facilities produce larger batches under near-pharmaceutical manufacturing standards. The distinction matters: a 503B-sourced medication is produced in a controlled environment with documented batch release testing. That's what AnthologyRX requires.

03
Why it matters for patient safety

Compounded medications that bypass proper oversight introduce risks: variable potency, contamination, and absent sterility testing. The gray market in performance-adjacent compounds — particularly peptides and GLP-1s — exploits demand without regulatory accountability. AnthologyRX's mandatory 503B sourcing policy is a non-negotiable safety standard, not a marketing claim.

Formulated

Compounded under CGMP standards at a licensed 503B facility

Tested

Batch-tested for potency, sterility, and endotoxin levels before release

Shipped

Dispensed directly to the patient with temperature-controlled logistics

Our Providers

Independent. Board-certified.
Accountable.

Every physician in the AnthologyRX network is independently licensed in their state of practice and board-certified in a relevant specialty — internal medicine, endocrinology, sports medicine, or family medicine with a longevity or performance focus. They are not employees of AnthologyRX. They are independent clinicians who chose to practice through this platform because it gives them the time, tools, and patient context to practice medicine properly.

Prescribing decisions are made by the physician — not by algorithm, not by a customer success team, and not by a protocol template that hasn't been reviewed since it was written. Each patient intake is reviewed individually. Labs inform the prescription. Goals inform the approach.

AnthologyRX providers are required to maintain active licensure, current DEA registration where applicable, and participation in ongoing clinical education for the compounds they prescribe. Providers who prescribe peptides are expected to be current on regulatory developments — including the April 2026 FDA Category 2 reclassification — and to communicate status changes to patients proactively.

Board Certified
Every provider holds active board certification in their specialty
State Licensed
Active licensure verified in every state of practice
503B Pharmacy
Prescriptions fulfilled exclusively through licensed 503B facilities
Monthly Monitoring
Regular check-ins and lab review built into every protocol
Common Questions

The questions smart people ask.

It depends on the compound and its form. Semaglutide and tirzepatide are FDA-approved as branded drugs (Ozempic, Wegovy, Mounjaro, Zepbound). The compounded versions prescribed through AnthologyRX — while using the same active pharmaceutical ingredient class — are not themselves FDA-approved end products. They are compounded by licensed 503B outsourcing facilities under the FDA's compounding framework, which permits such production when specific conditions are met. Testosterone is FDA-approved in multiple forms; compounded versions are legal under prescriber direction. Peptides like CJC-1295/Ipamorelin and BPC-157 exist in a more complex regulatory landscape — their status is subject to ongoing FDA guidance, including the April 2026 Category 2 update. AnthologyRX providers explain the specific regulatory status of each compound during the intake process. We don't obscure nuance.

A 503A pharmacy compounds medications for individual patients — one prescription at a time — and operates under state pharmacy board oversight. Quality standards vary by state and pharmacy. A 503B outsourcing facility is a compounding pharmacy that has registered with the FDA, operates under federal Current Good Manufacturing Practice (CGMP) standards — the same framework applied to pharmaceutical manufacturers — and is subject to FDA inspections and mandatory adverse event reporting. 503B facilities test finished batches for sterility, potency, and endotoxin levels before release. AnthologyRX requires 503B sourcing for all compounded medications. The distinction is not procedural — it's a meaningful difference in quality assurance infrastructure.

Dosing is determined by a licensed physician — not by an algorithm, not by a tiered subscription level, and not by what you requested. After you complete your intake assessment and labs are reviewed, your assigned provider evaluates your clinical picture: current hormone levels, metabolic markers, medical history, medications, and your stated goals. They determine a starting dose based on clinical guidelines and their judgment, with a titration plan built in. Dosing is reassessed at each follow-up based on your labs and response. If a dose needs to be adjusted — up, down, or paused — your provider makes that call. This is physician-led prescribing, not protocol-on-demand.

Every AnthologyRX protocol includes monthly provider check-ins and lab requirements specific to the protocol. GLP-1 protocols include metabolic panels and body composition tracking with lean mass monitoring. Hormone protocols include testosterone (total and free), SHBG, estradiol, PSA for male patients over 40, and CBC. Peptide protocols include IGF-1 baseline and follow-up labs. NAD+ protocols include comprehensive metabolic panel and — for IV delivery — cancer history clearance. Labs are ordered through the platform and reviewed by your provider before and during treatment. If a result falls outside expected range, your provider contacts you directly. Monitoring is not a formality. It's how the protocol is managed.

The regulatory landscape for compounded and performance-adjacent medications moves quickly. The April 2026 FDA Category 2 reclassification of several peptides is a recent example — it changed what can legally be compounded and prescribed in certain states. AnthologyRX maintains an active legal and clinical compliance review process, which means our medical team tracks FDA guidance, compounding framework updates, and state pharmacy board changes on an ongoing basis. When a regulatory change affects an active protocol, affected patients are notified by their provider and offered compliant alternatives where they exist. We do not wait for patients to ask. If a compound we previously offered is reclassified in a way that restricts its use, we stop offering it. Clinical standards and legal compliance are the same thing here — not competing priorities.

For Those Who Never Stop.

For Those Who Never Stop.

You've read the evidence. Now work with a physician who's read it too.