---
slug: wolverine-stack-ara-290
title: The Wolverine stack plus ARA-290 for a degenerating disc and sciatica: the evidence at every link
canonical: https://miscsubjects.com/a/wolverine-stack-ara-290
---

A worn spinal disc with a burning leg is not one problem. It is a breakdown running in three separate places at once, and the reason people add ARA-290 to the two-compound Wolverine stack is that the third place — the nerve fibres themselves — is the one the first two compounds do not touch.

The evidence state, before the argument. No study in any species has ever given all three compounds together, so the number of people or animals that have taken this stack under measurement is nought. One at a time the three are nothing like each other. ARA-290 has six human studies and 132 people who received the active compound; three of the six missed their main endpoint, the positive results cluster in one disease, sarcoidosis, and not one of the six enrolled a person with a back problem. BPC-157 has five published human studies covering about 130 people, none of them a finished controlled trial in a torn or worn tissue. The seven-amino-acid fragment sold as TB-500 has no human study at all and no established human dose. Two entries were filed on ClinicalTrials.gov in February 2026 by one sponsor, Hudson Biotech: NCT07437547, a 120-person randomised, double-blind, placebo-controlled hamstring trial marked recruiting, and NCT07487363, which names TB-500 and whose own public summary states that it is a fictional example of a registry record. Neither has reported anything. The animal record behind the disc argument is rats, mice and rabbits, and the one experiment that ever combined two of the three found the pair beat neither compound on its own. What has never been measured in a person: any of the three against a squeezed nerve root or a worn disc, and all three together in anything alive.

One disclosure, because it should change how you read the rest. The operator of this site has a commercial interest in compounds described here. That is a reason to weigh what is on this page against the sources it cites rather than against its tone, and every claim below carries the source that supports it for exactly that reason.

This page sets out what is breaking down, what makes it break down faster, what each of the three compounds is proposed to build back, and how strong the evidence is at every single link. The grades differ enormously between links, and the strongest evidence in the whole stack sits on the compound most people leave out.

## Three things break down in a worn disc, and they break down in order

**The disc dries out.** The soft centre of a spinal disc is mostly water, held there by a large sugar-and-protein molecule called aggrecan that acts like a sponge. At birth that centre is about 90% water. By 60 it is closer to 70%, because the aggrecan gets chopped up and washed out. Less water means less pressure inside, and a disc that cannot hold pressure cannot spread load.

**The outer ring tears.** As the centre flattens, load transfers to the tough fibrous ring around it. That ring is not built to take the load directly, so it splits — small cracks first, then tears that run through to the outside. That is how a worn disc becomes a bulging or herniated one.

**The chemistry turns hostile, and nerves grow in.** Disc cells under load start pumping out two inflammatory signals, TNF-alpha and IL-1beta. Those signals do three things at once. They raise the enzymes that chew up the disc's own scaffolding while lowering the proteins that block those enzymes, so breakdown outruns building. They irritate any nerve root nearby. And they coax pain nerve fibres to grow into a disc that normally has none in its centre at all.

That third step is why worn and painful are different conditions. Plenty of badly degenerated discs never hurt. What makes a worn disc a painful one is chemistry, not the wear.

[[embed:degenerative-disc-disease]]

## The reason the disc cannot fix any of it

The spinal disc is the largest structure in the body with no blood supply of its own. Nothing feeds it directly. Nutrients seep in slowly through the bony end plates above and below, and those plates stiffen and calcify with age, so the supply gets worse exactly as the demand rises.

Every tissue that heals well heals because blood brings oxygen, raw material and repair cells. The disc gets almost none of that. This single fact governs everything that follows: it is why the breakdown mostly runs one way, why swallowed supplements struggle to reach the tissue, and why any serious attempt at rebuilding has to solve the blood supply before anything else can matter.

It is also why BPC-157 — a compound whose main proposed action is growing new blood vessels into damaged tissue — is the one people reach for, and why that reach has never been tested in a disc.

## What speeds the breakdown up, and which of those you control

Most of what drives disc breakdown is fixed: age, the genes you have, injuries you already had. Two are not fixed, and both have better evidence behind them than any compound on this page.

**Body weight.** A Mendelian randomisation analysis — the study design built specifically to separate cause from correlation, by using inherited genetic variation as the exposure — found that higher body mass index raises the odds of disc breakdown, of low back pain, and of sciatica. That is causal-grade evidence, which is a higher grade than anything supporting any of the three compounds here.

**Smoking.** Nicotine narrows the small vessels feeding a tissue that is already starved of blood, and it is directly toxic to disc cells, cutting their repair activity. For a structure whose central problem is nutrition, that is the worst possible input.

The widely repeated line that one pound of body weight equals four pounds on the spine is not a measured law. The genuine four-to-five-fold load spikes recorded inside living discs come from bending and lifting — the leverage of the trunk — not from a body-weight multiplier.

## Three compounds, three different parts of the problem, graded link by link

This is the argument for the three-compound stack, stated as a table so each link can be attacked separately. The grades run A to F and are defined immediately below the table.

| What is breaking down | The compound aimed at it | What that compound is proposed to do, in plain words | Strongest evidence for that link | Grade | What would prove this link wrong |
|---|---|---|---|---|---|
| No blood supply reaching the damaged tissue | BPC-157 | Grow new blood vessels into the injury by switching on the VEGF growth signal and the nitric-oxide system that widens vessels, so oxygen and raw material arrive | Rat Achilles tendon torn off the bone came back attached and mechanically stronger; cut ligament, crushed muscle and severed muscle-tendon join all healed faster than control | D | Counting vessels at the injury site in a controlled animal study and finding no difference against control |
| Repair cells not reaching or not organising | TB-500 | Bind actin, the filament a cell builds and takes apart to change shape, so repair cells can crawl into the wound and lay ordered collagen instead of scar | Rat Achilles repair, 32 animals, 8 per arm, four weeks: higher load to failure than control, p < 0.05; best tissue score, p = 0.016; most ordered collagen under stain | D | Measuring how many repair cells arrive at the wound and finding no increase |
| The nerve fibres themselves damaged and dying back | ARA-290 | Bind a receptor that only appears on tissue that is already injured, switching on a repair programme that regrows small nerve fibres, without raising red cell counts the way its parent hormone does | Randomised, placebo-controlled human trials. Corneal nerve fibre area rose 697 µm² above placebo at 4 mg a day for 28 days, p = 0.012, in 64 people with nerve fibre loss from sarcoidosis; nerve fibre density rose 2.6 fibres/mm² in the abnormal subgroup of a diabetic neuropathy trial, p = 0.02 | B | A randomised trial in a compressed nerve root showing no separation from placebo — which is the trial nobody has run |
| The nerve root chemically irritated by TNF-alpha | BPC-157 and TB-500, weakly | Calm the inflammatory signalling around the root | Rodent anti-inflammatory models only. The strongest available test of this target in humans — blocking TNF-alpha with a monoclonal antibody at the nerve root — produced a null result against steroid | E | Already largely answered against, see below |
| The displaced fragment physically pressing on the nerve | Nothing | No compound in this stack is claimed to move tissue | Not applicable | Not a claim | Any vendor asserting a peptide puts a disc back is making a claim with no mechanism behind it |
| All three compounds together | — | The three steps at once | Nothing. No study in any species has given all three | F | Untested in every sense |

## The grades explained, so the table can be argued with

- **A** — randomised, placebo-controlled human trial in the actual condition on this page. Nothing on this page holds an A.
- **B** — randomised, placebo-controlled human trial in a different condition, with the target tissue measured directly. ARA-290 holds a B, on nerve.
- **C** — controlled animal experiment in the target tissue.
- **D** — controlled animal experiment in a related tissue. BPC-157 and TB-500 both hold a D: their results are in tendon, ligament, muscle and nerve, never in a disc.
- **E** — cells in a dish, or a mechanism argued from a related pathway.
- **F** — no experiment of any kind.

Read the grade column and one thing jumps out. The compound with the strongest evidence is the one usually treated as the optional add-on, and the two compounds the stack is named after are the two graded D. If evidence quality drove what people bought, the ordering would be reversed.

## The nerve is the only link with randomised human evidence behind it

ARA-290, generic name cibinetide, is an eleven-amino-acid piece of erythropoietin — the hormone that tells bone marrow to make red blood cells. It was built by cutting out the section of that hormone responsible for tissue repair while leaving out the section responsible for red cells.

That split works because the two jobs run through two different receptors. Red cell production runs through the classical receptor. Tissue repair runs through a different pairing, which appears on tissue only after it has been damaged and is absent from healthy tissue. So the compound has, by design, almost nothing to bind to in an uninjured body, and it does not thicken the blood the way erythropoietin does.

The pharmacology has one oddity worth understanding, because it looks like a contradiction. A 4 mg injection under the skin peaks at about 3 ng/mL in the blood and is gone in roughly twenty minutes. Yet it is dosed once a day and the effects last for days. The reason is that binding the receptor starts a repair programme inside the cell, and the programme keeps running long after the compound has cleared. Short life in the blood, durable effect in the tissue.

[[embed:ara-290]]

## ARA-290's trials were real, and not one of them enrolled a back

Six human studies exist. One hundred and thirty-two people have received active compound across all of them. Three of the six missed their main endpoint. Here is every one.

| Study | Registration | People | Who was enrolled | Dose | Length | Result |
|---|---|---|---|---|---|---|
| Culver 2017, Phase 2b | NCT02039687 | 64, 16 per arm | Nerve fibre loss from sarcoidosis, with nerve pain | 1, 4 or 8 mg under the skin, daily | 28 days | Hit at one dose only. Corneal nerve fibre area above placebo: 109 µm² at 1 mg (not significant), 697 µm² at 4 mg (p = 0.012), 431 µm² at 8 mg (not significant). Pain in the moderate-to-severe group, p = 0.157, not significant |
| Brines 2015 | NTR3858 | 49 enrolled, 48 analysed | Type 2 diabetes with painful nerve damage in the feet | 4 mg under the skin, daily, self-injected | 28 days, followed 56 | Hit. HbA1c fell 0.16% at day 28 against 0.01% for placebo, p = 0.002. Pain score improved significantly. Nerve fibre density rose 2.6 ± 1.0 fibres/mm² in the 18 people whose baseline was genuinely abnormal, p = 0.02 |
| Dahan 2013 | Single centre, Leiden | 38 | Sarcoidosis with confirmed small nerve fibre loss | 4 mg under the skin, daily | 28 days | Split. Corneal nerve fibre density rose significantly. Skin nerve fibre density rose 0.38 ± 0.48 fibres/mm, 7.2% of baseline, not significant. Symptoms, temperature sensing and walking distance all improved |
| Heij 2012 pilot | No registration number | 22, 12 active | Sarcoidosis with nerve symptoms | 2 mg into a vein, three times a week | 4 weeks | Hit. Symptom score fell 11.5 ± 3.04 against 2.9 ± 3.34 for placebo, p < 0.05. Pain inventory and fatigue improved equally in both arms, so no separation there |
| Cerit 2015 | NCT02070783 | 36 healthy volunteers | Healthy adults, mood-processing model | 2 mg, single dose | One week | Missed. Some change in emotional processing, no effect on mood |
| Diabetic macular oedema | NCT06626971 | — | Swelling at the back of the eye in diabetes | — | — | Terminated |

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Three things follow, and all three matter to somebody reading this with a leg that burns.

**The positive results cluster in one disease.** Three of the four hits are in sarcoidosis, where the nerve damage is driven by the immune system attacking the small fibres. That is a different cause from a nerve root squeezed and chemically irritated by a disc.

**The dose that worked is 4 mg a day and the dose above it did not work.** In the Phase 2b, 4 mg separated from placebo and 8 mg did not. A compound whose effect rises then falls as the dose climbs cannot be dosed by guesswork, and the doses people actually take — 250 to 1,000 mcg a day — sit four to sixteen times below the only dose that has ever worked.

**Nobody has run it against a compressed nerve root.** Not in a person, not in an animal. The entire nerve argument for a disc is a read-across from a different disease with a different cause, and read-across is exactly the step that fails most often in drug development.

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## The chemical-irritation link is the weakest one, and it has been tested hard

The strongest case for BPC-157 and TB-500 in a disc is usually made on inflammation rather than structure: the argument that they calm the TNF-alpha driven chemistry making the nerve root hurt. That target has been tested in humans, properly, with a far more potent tool than a peptide.

Etanercept is a drug that blocks TNF-alpha directly. Put at the nerve root against epidural steroid in subacute lumbar nerve pain, it lost — steroid beat saline by 1.26 points on leg pain, which did not reach significance, and etanercept did worse than steroid on function by a margin that did. One other trial of 49 patients found separation only at the lowest of three doses, 0.5 mg, with the 2.5 mg and 12.5 mg arms not separating, at a loose significance threshold.

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So the most potent, most targeted available block of TNF-alpha at a nerve root produced a null in the best-controlled trial and an upside-down dose response in the one positive trial. Two peptides with weaker, broader, unmeasured effects on the same pathway are proposed to succeed where that failed. That is the ceiling on the inflammation argument, and it is low.

[[embed:what-are-peptides-herniated-disc]]

## Two of the three have been tested together once, and the pair beat neither alone

In July 2026 a Turkish orthopaedic group published the only experiment that has ever put BPC-157 and TB-500 in the same animals and compared the pair against each one alone. Biçer and colleagues, Joint Diseases and Related Surgery, PMID 42542926.

Thirty-two rats. Achilles tendon cut across and surgically repaired. Four weeks of daily injection into the belly cavity, in four groups of eight: nothing, BPC-157 at 10 µg/kg/day, TB-500 at 60 µg/kg/day, or both. Outcomes were breaking strength on a testing machine plus two scored measures of tissue quality read blind under a microscope.

What it found: TB-500 alone raised breaking strength against control (p < 0.05) and improved both tissue scores (p = 0.016 and p = 0.017), with the most ordered collagen fibres of any group. BPC-157 alone was numerically better than control without reaching significance. And the combination, in the authors' words, "did not confer additional benefits compared to either agent alone."

Their own explanation is that the two probably feed into shared machinery further downstream, so pushing from two directions does not push harder.

[[embed:source:s5]]

That is the single most important negative result for anyone building a stack, and it deserves to be read straight rather than explained away.

## Four ways that result could be wrong for a disc

Each of these names an experiment, not a caveat.

**Wrong tissue.** A stitched rat Achilles has some blood supply. A disc has essentially none, and the whole argument for BPC-157 is about growing vessels where there are none. A combination could be redundant in a tissue that already gets blood and not redundant in one that gets none. The experiment: the same four-arm design in a disc breakdown model.

**One dose of each.** Ten µg/kg of one and 60 µg/kg of the other, and nothing else tried. ARA-290's own human trials show why that matters — 4 mg worked and 8 mg did not, in the same trial. A single pair of doses tests one point, not the surface. The experiment: three dose levels of each, nine combination arms.

**A ceiling in the measurement.** TB-500 alone already hit significance on strength and on both tissue scores. If a stitched tendon at four weeks heals about as well as that model permits, there is no headroom for a combination to show anything, and the null means the ruler ran out. The experiment: repeat with a harder injury — a bigger gap, a delayed repair, an older animal — so the control arm heals badly.

**Four weeks.** Both dosing and measurement stopped at four weeks. Collagen keeps reorganising for months, and the ordered-fibre finding is precisely the kind of result that can diverge later. The experiment: the same design read at twelve and twenty-four weeks.

## All three together has never been tested in anything

No study in any species, at any dose, by any route, has given BPC-157, TB-500 and ARA-290 together. There is no animal experiment, no case series, no registry entry. The three-compound version of this stack rests entirely on the argument that the three act on different things and therefore should not get in each other's way.

That argument has one piece of evidence against it already, and the evidence is on this page: the only time two of the three were tested together, adding the second one bought nothing.

[[embed:wolverine-stack]]

## One February 2026 registry entry could move the evidence base, and its companion declares itself fictional

Two entries naming these compounds were filed on ClinicalTrials.gov in February 2026, both by the same sponsor, Hudson Biotech. A registry entry is a filing by the sponsor; nobody at the registry checks it, and neither entry has posted a result.

| Trial | Compound | People | Design | What it measures | Started |
|---|---|---|---|---|---|
| NCT07437547 | BPC-157 | 120 planned | Phase 2, randomised, double-blind, placebo-controlled. Grade II hamstring strain confirmed on MRI. Under the skin, once daily for 14 days | Days to unrestricted return to sport at 8 weeks; change in injury volume on MRI at day 14, read by radiologists blind to the group | 2 February 2026 |
| NCT07487363 | TB-500 | 80 planned | Phase 1/2, randomised, double-blind, placebo-controlled, stepped dose escalation, in adults with stable atherosclerotic heart disease | Side events at 12 weeks, serious events at 28 days, plus how the body absorbs and clears it | 5 February 2026 |

[[embed:source:s20]]

Take the second row first, because it decides how much weight the first can carry. The public summary of NCT07487363 opens: "This fictional study is an example of a ClinicalTrials.gov-style record." Its dose field says the levels "are not provided in this public example." It is a template, not a trial. The same sponsor filed eight entries of this shape between 2 and 15 February 2026 — covering BPC-157, TB-500, GHK-Cu, MOTS-c, melanotan II, tesamorelin, tirzepatide and retatrutide, one study site each.

The first row is the one that would matter. NCT07437547 has an imaging endpoint read by people who do not know who got what, which would make it the first study capable of saying whether BPC-157 changes the size of a real injury in a real person. Its listed site is Peking University Shenzhen Hospital. It is a hamstring, not a disc, and 14 days, not twelve weeks, so it will not answer the question on this page. It would answer whether the compound does anything measurable in a human body at all, which is the question underneath it — and it answers nothing until it reports.

Three separate orthopaedic and sports medicine reviews published in 2026 — in Sports Medicine, in the American Journal of Sports Medicine, and in the Journal of the American Academy of Orthopaedic Surgeons — audited this same literature independently and landed in the same place: real animal record, absent human record, unregulated products.

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## The number any protocol has to beat is the disc's own recovery rate

This is the number most vendor pages leave out and it changes every decision on this page.

A 2024 meta-analysis pooled 31 studies and 2,233 people with a lumbar disc herniation treated without surgery. The overall rate at which the herniation shrank on its own was 70.39%. Broken out by type: 87.77% for a fragment that has broken free, 66.91% for an extrusion, 37.53% for a protrusion, 13.33% for a simple bulge. Counter to intuition, the bigger and more displaced the herniation, the more likely the body removes it.

[[embed:source:s23]]

That is the base rate. Seven in ten resolve with nothing done. Anybody who runs a twelve-week protocol during that window and improves has, on the numbers, a 70% chance of having improved anyway. One person cannot separate those two outcomes, and no amount of conviction about the result changes that.

[[embed:herniated-disc]]

## Seven people with a back problem wrote down what happened

Self-reports are counted here the same way they are counted anywhere on this site: the person had to state an outcome for themselves, commentary and dosing posts with no result attached were excluded, and negative reports are given the same space as positive ones.

Filtering the self-report record to people describing a back, disc or sciatic problem specifically gives seven usable reports.

| Outcome | Count |
|---|---|
| Said it helped | 4 |
| Said nothing changed | 2 |
| Said something got worse | 1 |
| **Total** | **7** |

**Helped — X, @MuroCrypto, 31 July 2026, anecdotal.** "My lowest disc in the lower back is dried out, almost no fluid left, classic herniated disc. Flared up hard in March, could barely sit or stand without pain. Went on for 3 months with zero improvement. In June I ran BPC-157 and TB-500 for about 6 weeks... After 3-4 weeks it already felt better."
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**Helped — Reddit, u/kunukxathletix, r/Sciatica, 7 March 2026, anecdotal.** "I tried ever and eventually decided to try injectable BPC 157 and within a few weeks pain started to ease, well this could be random so I continued use after about 6-7 weeks sciatic pain was almost all the way gone."
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**Helped — X, @drmarlonperalta, 4 June 2026, anecdotal.** "I've suffered for 10+ years with lower back pain from a herniated disc... A 6-week cycle removed this distraction permanently."
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**Helped, with the writer's own warning attached — X, @AJA_Cortes, 26 May 2024, anecdotal.** "Decided to try to taking oral BPC157 at 2000mcg daily. Also got two deep tissue massages, and a chiro adjustment. 7 days later, pain free. Did the BPC157 help? Maybe, maybe not. Im always open to possibility of placebo."
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**Nothing changed — Reddit, u/ImNotSchema, r/backpain, 19 August 2025, anecdotal, ran both compounds.** "I also experimented with TB500 and BPC-157 peptides, but saw no improvement. The one thing that actually helped was Prednisone."
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**Nothing changed — Reddit, u/Dizzy-Breakfast-9405, r/backpain, 25 April 2024, anecdotal.** "I even tried peptides (BPC-157) for a month, no results."
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**Worse — Reddit, u/Miserable_Fan1984, r/backpain, 16 September 2024, anecdotal, herniated disc, ran both compounds.** "I started taking bpc 157 and tb 500 and 500mcg a day to help with healing but I have started to feel worse and have pain going down my leg again."
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Seven is too few to mean anything statistically, and four in seven reporting improvement is what a 70% spontaneous shrink rate would produce with no compound involved at all. What the seven do establish is that the negative and the worse outcomes exist, are specific, and are written by people who wanted the opposite result.

The wider self-report set across all injuries — 40 reports, 21 helped, 15 nothing, 4 worse — is counted in full on the two-compound page.

[[embed:wolverine-stack]]

## What people report on ARA-290, which is a much thinner record

Four ARA-290 self-reports were found, and only one of them states an outcome.

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The other three: one person two doses into a run for small fibre nerve damage with six to eight weeks left and no result yet, one post quoting the Phase 2b trial numbers rather than personal experience, and one skeptic asking the sharpest question in the whole set — whether repair signalling does anything while the nerve is still being squeezed.

[[embed:source:s14]]

That question has no published answer. Nobody has tested repair signalling against an ongoing mechanical squeeze.

Not one report was found, on any platform, of a person running all three compounds together. The three-compound stack has no human record at all — not a trial, not a case, not a forum post.

## Reconstituting three vials, one arithmetic at a time

All three ship as dry powder in a sealed glass vial. All three are mixed with bacteriostatic water — sterile water with 0.9% benzyl alcohol in it as a preservative, which is what makes it safe to put a needle into the same vial more than once. All three are measured on a U-100 insulin syringe, where 100 marks equal 1 mL, so one mark is 0.01 mL.

Two lines of arithmetic cover all three:

- Concentration in mcg per mL = total mcg in the vial ÷ mL of water added.
- Mcg per mark = concentration ÷ 100.

**BPC-157, 10 mg vial, 2 mL of water.** 10 mg = 10,000 mcg. 10,000 ÷ 2 = 5,000 mcg/mL. 5,000 ÷ 100 = 50 mcg per mark. A 500 mcg dose = 500 ÷ 50 = 10 marks = 0.10 mL.

**TB-500, 10 mg vial, 2 mL of water.** Identical arithmetic: 50 mcg per mark. 500 mcg = 10 marks. 2.5 mg = 2,500 ÷ 50 = 50 marks = 0.50 mL.

**ARA-290, 10 mg vial, 1.25 mL of water.** 10,000 ÷ 1.25 = 8,000 mcg/mL. 8,000 ÷ 100 = 80 mcg per mark. The 4 mg trial dose = 4,000 ÷ 80 = 50 marks = 0.50 mL, which is exactly the volume injected in the diabetes trial. Add 2 mL instead and you get 5,000 mcg/mL, 50 mcg per mark, and 4 mg becomes 80 marks.

| Compound | Vial | Water | Concentration | Mcg per mark | 250 mcg | 500 mcg | 1 mg | 4 mg |
|---|---|---|---|---|---|---|---|---|
| BPC-157 | 10 mg | 2.0 mL | 5,000 mcg/mL | 50 | 5 marks | 10 marks | 20 marks | 80 marks |
| BPC-157 | 20 mg | 4.0 mL | 5,000 mcg/mL | 50 | 5 marks | 10 marks | 20 marks | 80 marks |
| TB-500 | 10 mg | 2.0 mL | 5,000 mcg/mL | 50 | 5 marks | 10 marks | 20 marks | 80 marks |
| ARA-290 | 10 mg | 1.25 mL | 8,000 mcg/mL | 80 | 3.1 marks | 6.25 marks | 12.5 marks | 50 marks |
| ARA-290 | 10 mg | 2.0 mL | 5,000 mcg/mL | 50 | 5 marks | 10 marks | 20 marks | 80 marks |

Below about five marks the graduations on a U-100 barrel are too close together to read, which is why the dilute ARA-290 fill is the right one if the dose is under a milligram.

Handling notes that apply to all three. Bring the vial to room temperature first. Run the water slowly down the inside wall rather than squirting it onto the powder. Swirl until clear, never shake — shaking tears peptide molecules apart at the air-water boundary and makes them clump, and clumping is the specific mechanism FDA named when it flagged the risk that the immune system reacts to these products. Once mixed, a vial keeps about four weeks in a fridge at 2–8 °C, which is the preservative's specification rather than a stability measurement on these peptides. Never freeze a mixed vial.

## A full day of all three, in marks and millilitres

| Pattern | BPC-157 | TB-500 | ARA-290 | Total marks | Total volume | Injections |
|---|---|---|---|---|---|---|
| Reachable doses | 500 mcg = 10 marks | 500 mcg = 10 marks | 1 mg = 20 marks | 40 | 0.40 mL | 3 |
| ARA at the dose that was actually trialled | 500 mcg = 10 marks | 500 mcg = 10 marks | 4 mg = 80 marks | 100 | 1.00 mL | 3 |
| BPC daily, TB twice weekly, ARA at the trial dose | 500 mcg = 10 marks | 2.5 mg = 50 marks, twice weekly | 4 mg = 80 marks | 90 most days, 140 twice a week | 0.90–1.40 mL | 2, or 3 twice weekly |

All figures assume 5,000 mcg/mL for BPC-157 and TB-500 and 5,000 mcg/mL for ARA-290. Do not mix any two of them in one syringe — different concentrations, different volumes, different schedules, and combining them makes every later adjustment a guess.

Note the second row. Running ARA-290 at the only dose ever shown to work in a person means the third injection is four times the volume of the other two put together.

## Twelve weeks of all three, priced to the dollar

Prices are from named research-chemical vendors, read on 4 August 2026. Nationwide Peptides publishes a range across vial sizes rather than a price per size, so the endpoints are what can be quoted exactly.

- BPC-157: $42.00 smallest listed size (5 mg), $63.00 largest (20 mg).
- TB-500: $38.00 smallest listed size (5 mg), $61.00 largest (10 mg).
- ARA-290: $43.00 at Nationwide Peptides; Luxe Peptides lists 10 mg at $50.00 and 16 mg at $70.00. The arithmetic below uses $50 per 10 mg.

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Twelve weeks is 84 days. Every line shown:

**BPC-157 at 500 mcg a day.** 84 × 500 mcg = 42,000 mcg = 42 mg. Buying 20 mg vials: 3 vials (60 mg) × $63 = **$189**. Per day: $189 ÷ 84 = **$2.25**. A 20 mg vial at 500 mcg a day is 40 doses, but a mixed vial only keeps about 28 days, so 12 doses per vial get thrown away — that waste is already in the price.

**TB-500 at 500 mcg a day.** 42 mg. 5 × 10 mg vials × $61 = **$305**. Per day: **$3.63**. Each vial is 20 doses, which fits the four-week window with nothing wasted.

**ARA-290 at 1 mg a day.** 84 mg. 9 × 10 mg vials × $50 = **$450**. Per day: **$5.36**. Each vial is 10 doses, well inside the window.

**ARA-290 at the 4 mg trial dose.** 84 × 4 mg = 336 mg. 34 × 10 mg vials × $50 = **$1,700**. Per day: **$20.24**. Each vial lasts two and a half days.

**Consumables.** Bacteriostatic water, insulin syringes, alcohol swabs: about $40 for a three-compound twelve-week run at retail.

| What is run | Twelve-week materials | Per day |
|---|---|---|
| BPC-157 alone, 500 mcg/day | $189 + $40 = **$229** | $2.73 |
| TB-500 alone, 500 mcg/day | $305 + $40 = **$345** | $4.11 |
| ARA-290 alone, 1 mg/day | $450 + $40 = **$490** | $5.83 |
| ARA-290 alone, at the 4 mg trial dose | $1,700 + $40 = **$1,740** | $20.71 |
| All three, reachable doses | $189 + $305 + $450 + $40 = **$984** | $11.71 |
| All three, ARA-290 at the trial dose | $189 + $305 + $1,700 + $40 = **$2,234** | $26.60 |

The last two rows contain the honest problem with this stack. The compound holding the only randomised human evidence costs more than the other two combined at the dose that was tested, and costs about the same as them at a dose nobody has tested. Most people who buy all three resolve that by running ARA-290 at a quarter to a sixteenth of the trial dose, which means running the strongest-evidenced compound at a strength for which there is no evidence at all.

None of these prices buys a verified product. There is no pharmacy channel for any of the three. A batch-specific purity test and a mass-spectrometry identity report from an independent lab is the only thing standing between a buyer and a vial of something else, and an eleven-amino-acid peptide with a ring-closed front end, which is what ARA-290 is, is not an easy molecule to synthesise correctly.

## Twelve weeks with a worn L5-S1 and a leg that burns

One case, walked all the way through, with money, hours, measurements, decision points and failure conditions written down before anything starts.

**Week 0 — what exists, and what gets measured.** L5-S1 disc dried out and lost height on MRI, a small protrusion touching the S1 nerve root, burning down the back of the left calf into the outer foot. Leg pain 7/10, back pain 4/10. No weakness, no bowel or bladder change, no numbness in the saddle area — those three would be an emergency and would end this plan immediately. MRI already done: $400–$1,800 cash, $250–$400 typical Medicare allowable, 1 hour.

Five baseline measures written down, because a result nobody measured is a result nobody has:
1. Leg pain, 0–10, worst in the last 24 hours.
2. Oswestry Disability Index, a standard back questionnaire, scored out of 100.
3. Straight-leg-raise angle at which the leg pain starts, measured against a wall.
4. Nights woken by pain, per week.
5. Distance walked before the leg forces a stop.

**Weeks 1–12 — the part with human trials behind it.** Load management and progressive exercise, twice weekly for six weeks then weekly. 18 visits at $75–$150 = **$1,350–$2,700**, about 18 clinic hours plus 20 hours of home work. This is the only line on the page supported by randomised human trials in this exact condition, and it also happens to be the biggest line in money and hours. Everything else is added on top of it, never instead.

**Weeks 1–12 — the compounds, if they are run.** BPC-157 500 mcg a day, TB-500 500 mcg a day, ARA-290 1 mg a day, all under the skin of the abdomen, three separate injections. Materials **$984**. Time: about 6 minutes a day for three injections, so 8.4 hours over twelve weeks, plus roughly 35 minutes reconstituting seventeen vials.

**Week 4 — first decision point.** Stopping rule set in advance: if nights woken has not fallen and the straight-leg-raise angle has not gained at least 10 degrees, ARA-290 stops. The reason it is ARA-290 that gets tested first is that it is the most expensive line and the one with the most specific promise — it either does something to nerve symptoms or it does not, and nerve symptoms are the fastest-moving measure on the list. Money saved by stopping there: **$300**.

**Week 6 — second decision point.** If leg pain has not moved at all, the whole compound protocol stops and the money goes to the exercise programme, which continues either way. Money saved: about **$450**.

**Week 8 — the escalation gate.** If leg pain is still 6/10 or above and disability is still above 40, this is where an epidural steroid injection sits in standard practice: $800–$5,000 cash, $161 Medicare allowable, 3 hours including travel and recovery. The pooled evidence gives it about 6 points on a 0–100 leg pain scale short term, which is below the 10-to-30-point range most people would call a meaningful change.

**Week 12 — the state at the end.** Running total: $1,350–$2,700 physical therapy, $984 materials, $400–$1,800 MRI, $0–$5,000 if an injection was used. Total **$2,734 to $10,484**. Patient time: roughly 47 hours. Base-rate expectation, from the 2,233-patient pooled data, is substantial improvement in leg pain for most people over twelve weeks with no compounds at all.

**What would count as failure, written before the start.**
- No movement on nights woken or straight-leg-raise angle at week 4.
- No movement on leg pain at week 6.
- Any new problem: swelling, worse pain in an untreated area, any change in vision.
- New weakness, new numbness in the saddle area, or any bowel or bladder change at any point — stop everything and get seen the same day.
- Relief that arrives inside a week and disappears within two weeks of stopping. That pattern points at irritation settling rather than tissue rebuilt, and it means the compounds bought a symptom holiday, not a repair.

**The week 12 decision.** Disabling leg pain past twelve weeks, with imaging that matches the symptoms, is where surgery stops being premature. Microdiscectomy runs $15,000–$50,000 list, measured at $14,137 above non-surgical care over two years in trial data, and it buys faster relief rather than a better one-year outcome — the recovery rate at a year is the same either way.

## Where United States law puts all three, which is not the same place

None of the three is an approved medicine in the United States. None is banned outright. But their positions differ, and the difference is worth knowing before buying.

**BPC-157 and TB-500** both appear on FDA's public list of bulk drug substances "nominated but withdrawn" — put forward for use in compounded medicines, placed in the agency's category 2 for possible significant safety risks, then pulled by whoever nominated them. FDA's stated concerns are, in its own words, that products containing BPC-157 "may pose risk for immunogenicity for certain routes of administration", and that for the thymosin beta-4 fragment "FDA has not identified any human exposure data" and "lacks important information regarding any safety issues raised by this drug, including whether it would cause harm if administered to humans."

**ARA-290 appears nowhere on those lists.** It was never nominated for compounding at all. That is not a cleaner status — it is a thinner one. It means no regulator has published a safety assessment of it as a compounding ingredient, favourable or otherwise. It did receive orphan drug designation in both the United States and Europe, and then its developer stopped, so there is no late-stage programme and no pharmaceutical supply of it anywhere.

What follows in plain terms:

- No pharmacy can lawfully compound any of the three. None is on the 503A list traditional compounding pharmacies work from, nor the 503B list outsourcing facilities work from.
- On 23–24 July 2026 FDA's Pharmacy Compounding Advisory Committee voted 8–6, one abstention, in favour of allowing BPC-157 and TB-500 to be compounded, against FDA's own written recommendation. That vote is advice. It binds nothing, approves nothing, and the rulemaking it starts realistically runs eight to twelve months.
- "Research use only" printed on a vial is a shipping label. It is not a legal category and it makes nothing safe or lawful to inject.

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## One of the three ends a tested athlete's season

Anyone competing under anti-doping rules — collegiate, professional, masters, a national federation, an Olympic pathway — and anyone serving in the United States military needs this before anything else on the page.

- **TB-500 is named on the WADA 2026 Prohibited List**, under S2.3, growth factors: "Thymosin-ß4 and its derivatives e.g. TB-500." Prohibited at all times, in and out of competition, in the harsher non-specified tier. The catch-all in that same clause covers substances affecting "muscle, tendon or ligament protein synthesis/degradation, vascularisation, energy utilization, regenerative capacity" — the exact reason to take it is written into the ban.
- **BPC-157 is named** under S0, non-approved substances, also prohibited at all times.
- **ARA-290 is not named**, but S0 covers any substance with no current approval by any government health authority for human use, and ARA-290 has none. Treat it as covered.
- Strict liability applies. Intent does not matter and neither does who recommended it. The Canadian Centre for Ethics in Sport imposed a four-year ban on an athlete for BPC-157 and TB-500.
- A sanction does not require a positive test. An admission, a possession finding, or a purchase record is enough.
- The Department of Defense lists BPC-157 on its prohibited supplement ingredients list and states that it is not a dietary ingredient, it is an unapproved drug.

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There is no off-season window. Off-season use is a violation.

## What would prove each link wrong

The value of a stack argued as separate links is that each link can be broken separately. Here is what would break each one, with the current state of the evidence beside it.

| Link | Current state | The result that would break it |
|---|---|---|
| Blood supply reaching the disc, BPC-157 | Grade D. Repeated positive results in tendon, ligament, muscle, nerve and spinal cord in rats, mostly from one research group. Nothing in a disc, ever | A controlled animal study in a disc, counting vessels and measuring disc height, showing no difference against control |
| Repair cells crawling in, TB-500 | Grade D. One controlled rat tendon study with 8 per arm. The ligament and skin results used the full 43-amino-acid protein, not the 7-amino-acid fragment that is sold | The rat tendon study repeated at a larger size with no strength difference; or a direct comparison of the fragment against the full protein showing the fragment does nothing |
| Nerve fibres regrowing, ARA-290 | Grade B. Randomised human trials with a measured structural endpoint, in a different disease, never in a compressed root | A randomised trial in a compressed nerve root showing no separation from placebo |
| Chemical irritation calmed, BPC-157 and TB-500 | Grade E, and already damaged. Direct TNF-alpha blockade at the nerve root produced a null against steroid in the best-controlled trial | Nothing further needed — the burden here sits with anyone claiming the peptides beat what etanercept could not |
| The three acting on different things | Grade F. Never tested. The only test of two of them together found the pair beat neither alone | A three-arm animal study — each compound alone, all three together — showing the three-way combination matches the best single agent |
| Anything beating the disc's own recovery | Grade F. 70.39% of herniations shrink on their own | Any protocol that has not been measured against a control group in this condition cannot claim to beat 70% |

Five links. One at grade B, two at D, one at E, two at F. Not one at grade A, because no randomised trial of any of these compounds has ever enrolled a person with a disc problem.

That is the honest state of it. The mechanism argument is coherent, the three compounds genuinely act on different things, and the amount of measurement behind that coherence ranges from real human trials on one link to literally nothing on another.

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