Repair and pain
Does it reduce pain?
Pain anywhere other than a joint, which has its own entry. Measured on a scale a person filled in, which is the only way pain gets measured.
5,470
people in trials
14
human studies
1
compounds, animal or cell only
4
trials found nothing
Measured in people
Ranked by how many people, which is a fact about the evidence and not a judgement about the compound. The one at the top is the most studied, which is not the same as the best. Counts are never added across compounds, because the same person can appear in more than one trial.
- 1,384 people1 human study
The therapeutic evidence that is usually left out of cosmetic coverage. Two multicentre phase 3 trials pooled, 1384 adults randomised 1 to 1 to onabotulinumtoxinA 155 to 195 units or placebo every 12 weeks. Mean change in headache days at week 24 was minus 8.4 versus minus 6.6 in favour of the toxin, P below 0.001, with significant differences at all other timepoints. Note that placebo also produced a large decrease, so the between-group difference is under two headache days per month.
Headache, 2010 · 1,384 people
- 1,267 people1 human study
1,267 premenopausal women across two identical 24-week trials: bremelanotide 1.75 mg as needed significantly increased FSFI desire scores (+0.35 integrated) and reduced desire-related distress versus placebo; nausea, flushing and headache in 10% or more.
Obstetrics & Gynecology, 2019 · 1,267 people
What people using it report
- Flushing and headache come up regularly alongside nausea, and the overall picture people describe is a compound that works but is difficult to tolerate at conventional doses.
- 1,161 people1 human study1 found nothing
found nothing1,161 patients hospitalised with acute heart failure randomised 1:1 to a 48 hour infusion of serelaxin at 30 micrograms per kilogram per day or placebo within 16 hours of presentation. Serelaxin improved the visual analogue scale dyspnoea endpoint by 448 mm times hours (95 percent CI 120 to 775, p = 0.007) but had no effect on the co-primary Likert endpoint (27 percent against 26 percent, p = 0.70). There was no effect on cardiovascular death or readmission at 60 days (hazard ratio 1.02, 0.74 to 1.41) or on days alive out of hospital. Among prespecified additional endpoints, 42 deaths occurred by day 180 on serelaxin against 65 on placebo, hazard ratio 0.63 (0.42 to 0.93, p = 0.019). Funded by Corthera, a Novartis affiliate company. Registered as NCT00520806.
The Lancet, 2013 · 1,161 people
- 968 people2 human studies
The scale of evidence behind blocking this peptide, not administering it. 955 patients randomised to subcutaneous erenumab 70 mg (n=317), 140 mg (n=319) or placebo (n=319) monthly for six months. From a baseline of 8.3 monthly migraine days, days fell by 3.2 and 3.7 respectively against 1.8 on placebo (P<0.001 for each dose). A 50% or greater reduction was reached by 43.3% and 50.0% against 26.6% on placebo. Adverse event rates were similar to placebo. Several authors are Amgen employees.
The New England Journal of Medicine, 2017 · 955 people
What happens when you give CGRP to a human. Thirteen migraine patients previously enrolled in erenumab trials received CGRP in a double-blind, placebo-controlled, randomised crossover design. CGRP induced migraine-like attacks in 10 of 13 patients (77%) compared with none after placebo, P = 0.002. Area under the curve for headache intensity was greater after CGRP at 0 to 90 minutes (P = 0.009) and 2 to 12 hours (P = 0.014), and median peak headache intensity was 5 against 2 on placebo (P = 0.004). Registered NCT03481400. The senior author discloses consultancy or advisory relationships with Allergan, Amgen, Alder, Eli Lilly, Novartis and Teva.
The Journal of Headache and Pain, 2018 · 13 people
- 258 people2 human studies1 found nothing
found nothing258 patients after bunionectomy randomised to a single oral dose of cebranopadol 200, 400 or 600 mcg, morphine controlled release 60 mg, or placebo. On the primary endpoint (summed pain intensity 2 to 10 hours), 400 and 600 mcg beat placebo and beat morphine, whose effect emerged later; 200 mcg did not differ from placebo. Adverse events rose with dose and were highest on morphine. Developer funded.
Pain Physician, 2018 · 258 people
Planned for 524, enrolled 126 because of low accrual; up to 7 weeks of cebranopadol (200 to 1,000 mcg) versus prolonged release morphine. On the primary endpoint, daily rescue morphine use, cebranopadol was non-inferior and superior (difference -7.48 mg, 95% CI -12.05 to -2.92). Non-inferiority on pain reduction itself was not shown. Adverse events in 83 versus 82 percent. Developer funded; corresponds to the terminated CORAL trial NCT01964378.
European Journal of Pain, 2019 · no headcount in the line
- 175 people1 human study
The decisive trial. 175 participants randomised 1:1 to carbetocin 3.2 mg three times daily (n=85) or placebo (n=90) over 12 weeks. Least squares mean change from baseline at week 12 on HQ-CT was -4.8 (SE 0.8) on carbetocin and -5.1 (SE 0.8) on placebo; treatment difference 0.3, 95% CI -1.8 to 2.4, P = 0.79. The authors state there was no separation between carbetocin and placebo for any secondary or exploratory endpoint. Most frequent treatment-emergent events on carbetocin were headache (6 participants, 7.2%) and pyrexia (5, 6.0%). The authors' own conclusion is that carbetocin nasal spray did not demonstrate efficacy compared with placebo. Four of the ten authors are employees and stakeholders of ACADIA Pharmaceuticals, the sponsor.
Clinical Therapeutics, 2026 · 175 people
- 111 people2 human studies
Double-blind, placebo-controlled, 32 centres in the United States, Australia and the Netherlands, 111 patients aged 24 to 85 randomised 2 to 1. Mean percentage improvement in the visual analogue scale of pain intensity was 53.1 percent (95 percent CI 44.0 to 62.2) with ziconotide versus 18.1 percent (95 percent CI 4.8 to 31.4) with placebo, P below 0.001. Moderate to complete pain relief in 52.9 percent versus 17.5 percent. Primary endpoint met.
JAMA, 2004 · 111 people
255 inpatients, 169 on ziconotide and 86 on placebo, treated over six days. Mean percent reduction in the visual analogue scale of pain intensity was 31.2 percent versus 6.0 percent. The protocol was amended during the trial, cutting the starting dose from 0.4 to 0.1 micrograms per hour and the maximum from 7.0 to 2.4 micrograms per hour, because of adverse events. The primary endpoint was met but at the original dosing the tolerability was not acceptable.
Neuromodulation, 2006 · no headcount in the line
- 75 people1 human study1 found nothing
found nothingDouble-blinded randomised controlled trial at a single centre, enrolling June 2018 to May 2019. 75 people with symptomatic Kellgren-Lawrence grade 2 or 3 knee osteoarthritis randomised to intra-articular A2M-rich concentrate, conventional platelet-rich plasma, or methylprednisolone, followed 12 weeks; 68 (90.7 percent) completed, 73 percent female, mean age 59. At 12 weeks the A2M group improved significantly on visual analogue scale, WOMAC, KOOS and Tegner; the platelet-rich plasma group improved on nothing; the steroid group improved on Lysholm only. Between-group changes did not differ significantly. The authors concluded A2M is not superior and, given higher preparation cost, may not be justifiable for routine treatment.
Bulletin of the Hospital for Joint Diseases, 2024 · 75 people
- 54 people1 human study
54 patients with non-specific chronic low back pain, six sessions of real or sham bee venom acupuncture over 3 weeks on top of loxoprofen. Bothersomeness, pain intensity and function improved more in the venom group at 3 weeks; minimal adverse events in both groups. Korean academic funding.
Toxins, 2017 · 54 people
What people using it report
- Bee venom therapy, using live stings or injected venom, has a long lay tradition for arthritis, multiple sclerosis and chronic pain; the 2005 MS trial was run because patients were already doing it, and the Parkinson trial used a standard allergy desensitisation dosing scheme for the same reason.
- 17 people1 human study
Retrospective chart review of 17 patients given 2 to 4 mg intra-articularly at one Florida clinic; of the 16 reached by phone months later, 11 of 12 who received BPC-157 alone reported meaningful pain relief. No control group, no validated outcome measure, no imaging.
Alternative Therapies in Health and Medicine, 2021 · 17 people
- no headcount stated1 human study1 found nothing
found nothingIndependent, academic, and null. Both arms improved by roughly 1.6 to 1.9 points on the pain scale, which is larger than the between-group differences industry-funded trials attribute to collagen.
Applied Physiology, Nutrition, and Metabolism, 2020 · no headcount in the line
Measured in animals or cells, not yet in people
These are separated from the trials above rather than ranked against them, because they answer a different question. A result in a rat is a real result and a reason somebody ran the study; it is not a measurement of what happens in you. Where the human work is missing, the reason is usually money rather than failure, and that is set out at the bottom of this page.
- 1 preclinical study
Measured in animals or cells
Mice given weekly oxaliplatin developed neuropathic pain and lost intraepidermal nerve fibres in the hind paw. Continuous SS-20 prevented the pain and returned nerve fibre density to normal levels. The authors note that SS-31 was the inventor's compound and declare that competing interest. Mice, prevention rather than treatment, and no human follow-up has been located.
ACS Chemical Neuroscience, 2018 · animal
What people using these actually report
Uncontrolled self-reports, gathered from clinic write-ups, regulatory complaint records and public forums, and reproduced here as written. They are the best guide on this page to what people actually do, what they expect, and what goes wrong, and they cannot show that anything works, because nobody was measured against a placebo and the people who saw no effect mostly stopped posting. Both halves of that are true at once. The negative reports are kept in for the same reason.
- Flushing and headache come up regularly alongside nausea, and the overall picture people describe is a compound that works but is difficult to tolerate at conventional doses.
Sources: Threads on ExcelMale, Bluelight and LongeCity, found by site-restricted search and read directly, September 2026. Nothing above is attributed to any specific post and no post is reproduced.
- Bee venom therapy, using live stings or injected venom, has a long lay tradition for arthritis, multiple sclerosis and chronic pain; the 2005 MS trial was run because patients were already doing it, and the Parkinson trial used a standard allergy desensitisation dosing scheme for the same reason.
Sources: The published apitherapy and bee venom acupuncture literature, including the Toxicon 2018 review, the Korean safety trial of filtered versus unfiltered venom, the recruitment rationale stated in the MS and Parkinson trials, and the registered Apitox trials. No forum or social media content was retrieved for this entry and nothing here is attributed to a specific post.
- Negatives reported include injection site redness, warmth or itching in the first 15 to 45 minutes after dosing, occasional nausea or headache, and a 2020 forum warning describing a hypoglycemia-like reaction after a dose, though this was a single unverified report and not something seen in the published human literature. Sourcing and purity concerns come up in the same threads that carry claims of purity certificates of unknown provenance.
Sources: FDA's July 2026 evaluation of MOTS-c-related bulk drug substances, which found no FAERS adverse event reports and no published clinical studies of any kind; a forum thread on iSARMS Forums (retrieved directly) describing dosing and stacking; a 2020 warning thread on eroids.com referenced in search results but not independently retrievable for this entry; and commercial peptide-dosing and side-effect guide sites (Path to Peptides, PerfectB, FormBlends, PeptidesExplorer, Rite Aid, gethealthspan.com), which are vendor- or affiliate-adjacent and are cited here only for the dosing conventions and side-effect categories they describe, not as evidence of anything. Reddit's r/Peptides could not be retrieved for this entry, so nothing above is attributed to any specific post, and no quotation is reproduced from any of these sources.
- Vendor and dosing-guide sites describe humanin as generally well tolerated relative to hormone-modulating peptides, since it is a naturally occurring signal rather than a hormone analogue, with injection site irritation, headache, mild digestive upset and light-headedness in fasted users named as the most commonly described issues. None of these reports come from a clinical study.
Sources: A blog self-experiment attributed to 'KenkoHacks', accessible only through its citation on secondary peptide-vendor sites (Jay Campbell, Swolverine, PeptidesExplorer); those same vendor and dosing-guide sites for the general side-effect categories described above. Reddit and the peptide and bodybuilding forums checked for the MOTS-c entry in this dataset (iSARMS, eroids) returned no substantive humanin-specific threads at the time of this review, so this section is deliberately thin rather than padded with unrelated material.
- Combining nattokinase with serrapeptase or lumbrokinase is common, and framed online as boosting fibrinolytic effect. Lumbrokinase is generally described as more potent than nattokinase and correspondingly more likely to cause an intense initial reaction; serrapeptase is more often associated with reports of nausea and headache and, per the same survey, less consistent perceived benefit than nattokinase itself.
Sources: A published pharmacist-run survey of the Long COVID and ME/CFS supplement-using community (Martha Eckey, PharmD, writing on Substack), which is the only named, citable source for dosing and outcome patterns used here; the Health Canada licensed natural health product label and the Canadian NHPID ingredient entry, which supply the specific warfarin and bleeding-disorder caution language quoted in the legal status section; Memorial Sloan Kettering's integrative medicine monograph on nattokinase, which was used to cross-check the case reports and mechanism claims against a clinical secondary source; and the case-report and clinical literature cited directly elsewhere on this page. Reddit's r/Supplements and r/Biohackers, and any other Reddit community, could not be retrieved for this entry.
- Generally described as easy to tolerate, which is consistent with the clinical record, with headache, nausea and fatigue the most common early complaints.
Sources: Longevity forums and clinic write-ups. Uncontrolled self-report, useful for what to watch for, not evidence of effect.
- Headache and lightheadedness.
Sources: The infusion reactions and the price complaints come from IV clinic write-ups and user forums and are not trial data. The B6 neuropathy signal comes from published case reports and from the cell work cited on this page. The fatigue improvement in genuine deficiency comes from clinical literature. The Myers cocktail trial is the only controlled comparison here, and it is the reason to treat the post-drip lift as unproven rather than as a finding.
- Headache and nasal irritation, stinging or a runny nose, which users attribute to the volume and the preservative rather than to the peptides.
Sources: None of this is from a trial. There are no exit interviews for the combination because there is no trial of the combination. These reports come from nootropic and peptide user forums including r/Nootropics and r/Peptides, and from vendor and clinic write-ups. The Russian studies cited on this page did not collect side effect data in a form comparable to a Western adverse event table.
- Headache and, at higher amounts, a raised blood pressure reading.
Sources: The nausea, yawning and stretching appear in the melanotan II controlled trial. The pigment changes and the rest come from forums including r/peptides and from the dermatological review of unregulated alpha-MSH analogue use.
- Headache.
Sources: The nausea and flushing appear in the melanocortin controlled trials. The rest comes from forums including r/peptides and clinic write-ups, uncontrolled, in an area where the placebo arm of a randomised trial improved as much as the drug arm.
- Headache.
Sources: Nootropic forums including r/nootropics and r/peptides, and vendor pages. Uncontrolled self-reports in a domain where expectation effects on subjective cognition are large and where nobody is measuring anything.
Why the trial record looks like this
A missing trial is usually a missing sponsor. Nobody runs a nine-figure programme on a molecule they cannot own, so the compounds with the thinnest human records are often the oldest and most freely available ones rather than the weakest. Taking SS-20 as the example, because it states the problem most clearly:
The useful comparison is with what happened to its sibling. SS-31, elamipretide, went all the way through clinical development and received accelerated approval in the United States in 2025 for Barth syndrome, on an open-label uncontrolled extension, after randomised placebo-controlled trials in other mitochondrial conditions missed their primary endpoints. That is the ceiling this chemistry has demonstrated in humans so far: an approval in an ultra-rare disease on uncontrolled evidence, alongside negative randomised results in more common conditions.
SS-20 did not go down that road at all. Read against its sibling's record, the absence of SS-20 trials is not a gap waiting to be filled with good news. A developer holding both peptides chose one, took it through randomised trials that largely failed, and left the other in animals.
One structural note about this literature: the SS peptides are licensed to a commercial developer and the senior author, coauthors and Cornell hold financial interests, disclosed in the papers themselves. That does not invalidate the findings. It does mean essentially all of the SS-20 literature comes from one laboratory and its collaborators.
A compound appears here only when a citation on its own page states this outcome and reports a result for it; naming it is not enough. Human, animal and cell work are counted separately and never merged. Participant counts are read from the study lines and deliberately undercount. Nothing here is advice, and nothing here is a recommendation to take or to avoid anything.