Two people nearly died, and several more sought treatment, after receiving peptide injections at the last RAADfest in Las Vegas. We might not know what happened until the ongoing investigations are concluded, but we asked several experts to share their thoughts on the broader context of unproven “rejuvenation therapies.”
The nightmare scenario
Admittedly, progress in the longevity field has been rather slow. A quarter of a century after the field rose to prominence, no approved, dedicated anti-aging therapies exist; a handful of promising treatments are working their way through the notoriously convoluted, slow, and expensive approval system. This frustrates many people, prompting them to try options that may not have been thoroughly tested for safety and efficacy.
Such treatments might include everything from dietary supplements to stem cells, off-label drugs, and gene therapies, and the market is growing fast. Longevity clinics are a new fad, as is longevity-oriented medical tourism. People want to live longer, healthier lives and are willing to shell out money and take certain risks to fulfill their dream. There’s nothing inherently bad about this, of course. However, it is important that the risks and benefits are faithfully communicated to them.
The mainstream media leans towards sensationalism and alarmism when it comes to people self-medicating or receiving treatments outside of the healthcare system’s rigid framework. Longevity enthusiasts, however, are aware that there is substantial evidence – even if mostly preclinical – supporting at least some experimental treatments. Many people also believe that people should have more leeway in choosing their own healthcare.
Yet, the risks from unproven therapies, unscrupulous providers, and even honest mistakes are also high. A nightmare scenario, often discussed on conference sidelines and in online debates, is that someone will eventually end up dead after receiving a “rejuvenation therapy,” which would draw scrutiny and suspicion from both regulatory bodies and the public and end up hamstringing the nascent longevity field.
The RAADfest debacle
This is what almost happened several weeks ago at the Revolution Against Aging and Death Festival, commonly known as RAADfest, one of the world’s largest, most colorful, and longest-running longevity conferences. Organized by the Coalition for Radical Life Extension, it featured solid scientific programming, as well as, for the first time, the “RAADclinic”, a hall where several providers offered longevity diagnostics and therapies. According to the coalition’s spokesperson, RAADfest hosted the event, but the therapies in question were provided independently. These ranged from benign ultrasound-based bone density scans to peptide injections administered directly at the booth.
On the last day of the conference, two women, 38 and 51 years old, were admitted to a Las Vegas hospital in critical condition after receiving peptide shots at the booth overseen by Kent Holtorf, MD, founder of the Holtorf Medical Group. Holtorf is licensed in California, but not in Nevada, although he said that, for the conference, he hired a practitioner who is.
According to ProPublica, which broke the story, “The two women who were taken by ambulance to the hospital reported feeling as if their tongues were swelling and had trouble breathing and increased heart rates. By the time they reached the hospital, one was already intubated, and the other had lost muscle control in her neck and couldn’t open her eyes or communicate with doctors.”
The Las Vegas police department originally reported that up to seven people sought treatment after receiving peptide injections at Holtorf’s booth. However, according to the Coalition for Radical Life Extension, the Southern Nevada Health District concluded its review on July 22, 2025, confirming only the two severe cases. Both patients have recovered since then.
Full of potential – and risks
Peptides are short chains of amino acids (40 residues or fewer in the US regulation), while proteins usually contain hundreds. Like proteins, peptides interact with other biomolecules: proteins, DNA, and RNA. This can be used for therapeutic effect or to shuttle various molecular cargoes. Peptides are generally more stable, less immunogenic, and more easily administrable than complete proteins. The small size also helps with the regulatory process.
The biggest peptide success story is of the GLP-1 receptor agonists, such as Ozempic. There is a handful of other approved peptide-based therapies, and many more are under development and review. Being enzyme-sensitive, peptides are typically administered by injection, but oral routes are becoming increasingly feasible. For instance, orally administered collagen peptides have gained popularity in the longevity community.
However promising, peptides carry risks, including immunogenicity and off-target binding. Their regulation in the US is, actually, too lax, according to Dr. Matt Kaeberlein, a prominent geroscientist who often decries overregulation by the FDA. Kaeberlein recorded a podcast episode about the incident at RAADfest, in which he criticizes Holtorf’s handling of the situation. Kaeberlein himself gave a talk at the conference and witnessed “therapeutic exosomes for longevity” being administered intravenously in a hotel room (exosomes are vesicles secreted by cells; there are currently no approved exosome-based treatments). Recently, Kaeberlein has been speaking out about the dangers of such unapproved therapies.
The regulatory no-man’s-land
While we are not in a position to estimate compliance, some important corners might have been cut here. Holtorf refused to clarify to ProPublica which peptides were administered at the conference. However, only three are listed on the IV price list on his clinic’s website: BPC-157, tymosine beta 4 (TB-4), and tymosine alpha 1 (Tα1).
None of these is an approved drug in the US. The FDA places them on its public risk list for compounded products and instructs pharmacies not to manufacture them from raw ingredients for routine care, for reasons that include limited human evidence, products that are difficult to characterize and maintain purity, and a higher risk of adverse reactions. Basically, outside a properly run clinical trial, these peptides sit in a regulatory no-man’s-land: they are neither lawful supplements nor standard prescriptions.
Another problem is the way these therapies are marketed to the public. As with many such clinics, the IV menu on Holtorf’s clinic’s website lists several sweeping claims about the therapies it offers. For example, BPC-157, according to the document, “has displayed the unique ability to have significant rejuvenating properties throughout the gastrointestinal tract and proven to be an effective treatment for a variety of gastrointestinal conditions.” This goes well beyond the scarce human data that we have, and most available work isn’t for IV use.
“The statements do seem overstated,” says Kaeberlein, “though that’s not unusual in this space. Many physicians offering these kinds of services tend to make similar exaggerated claims.”
For him, however, this is the least of the problems: “While I’m not a supporter of that type of advertising or medical care, I’d put what happened in Vegas in a completely different category. Handing out prescription medications in a hotel setting – without, I assume, obtaining full medical histories or current health information – takes things to an entirely new level.”
Holtorf’s clinic did not respond to a list of questions we sent. To ProPublica, Holtorf said that “in 30 years of providing such treatments, he’s never seen such a reaction,” and that, having consulted an AI, he was now convinced that the problem was not with the peptides. While it is entirely possible that the problem was with how the drugs were compounded and administered, this in itself does not invalidate many of the concerns.
Where do we go from here?
What happened at RAADfest highlighted some well-known problems and contradictions in the longevity field. On the one hand, there is a sense of urgency that pushes some people to offer and others to try therapies that have not been rigorously tested for safety and/or efficacy. Many rightfully lament the increasingly lengthy and expensive regulatory process, which is not properly suited for rejuvenating therapies. There is a growing push to extend the “right to try” to all patients and all reasonably safe therapies, and to accelerate clinical trials by relaxing certain regulations and transitioning towards cost-effective methods, such as human organoids and in silico models.
On the other hand, a legitimate concern exists that the longevity movement might be overshadowed, compromised, and ultimately impeded by the murky wave of overblown claims, unfounded promises, unproven therapies, and flat-out “snake oil” cures. To make some sense of all this in the context of the RAADfest incident, we have turned to several prominent figures in the field with a series of questions.
Therapies that haven’t been properly tested for safety and/or efficacy – how bad are they for the overall standing of the longevity field?
Matt Kaeberlein, founder of Optispan:
This is a complex question, and even the premise – what it means for a therapy to be “properly tested” for safety or efficacy – can be debated. Informed people can disagree on how much evidence is “enough,” and the level of proof needed for efficacy depends partly on how confident we are in its safety. That said, I tend to think about these therapies in three broad categories:
FDA-approved drugs or procedures used off-label include rapamycin, SGLT2 inhibitors, metformin, therapeutic plasma exchange, and other interventions already approved for other indications. When prescribed by ethical, competent clinicians, these pose minimal reputational risk to the longevity field and may have substantial upside if shown to benefit healthspan or lifespan. Criticisms of responsible off-label prescribing often miss the mark; the real concern is unprofessional practice, not the concept of off-label use itself.
With supplements, the damage to the field’s credibility is significant – not because supplements can’t work, but because we have very few with solid human efficacy data. The industry is rife with deceptive marketing and weak oversight, creating strong incentives for companies to mislead and outright lie to consumers. Until the regulatory and economic incentives change, this sector will remain problematic and will continue to harm the public’s perception of longevity science.
Unapproved or illegal interventions, often delivered offshore, include many stem cell treatments, gene therapies, exosomes, and so on. Here, the risks are high both for patients and for the field’s reputation. Adverse outcomes are often unreported, but when they become public (e.g., the RAADFest incident), the media coverage is damaging and plays into a narrative that the longevity space is unsafe and exploitative.
The lack of quality control in many offshore clinics means patients are relying entirely on the trustworthiness of providers – and, frankly, many in this space are not trustworthy. I understand the motivation to explore promising therapies more quickly, especially given regulatory hurdles, but operating outside legal and ethical frameworks is not the right path forward for the field.
Reason, CEO of Repair Biotechnologies:
What does “properly tested” mean? It is hard to have a conversation around the challenges in medical development without having a defensible position on that term. The regulatory community, by which I mean some assembly of FDA staff, consultants in the quality industry, and established drug developers big enough to have a say in shaping standards, presently demands more than twice the cost and effort leading up to approval than was the case twenty years ago. Do we believe that 20 years past, drug development was radically unsafe?
Equally, Australia allows drugs to be introduced into human patients for the first time without full Good Manufacturing Process, without a central regulator, at the discretion of institutional review boards and clinical trial sites. It costs about half of what an equivalent effort would require in North America. 10% of all Phase 1 clinical trials take place in Australia. Do we believe that this lower degree of safety assurance is radically unsafe?
Various groups, from media to Big Pharma to government outlets, vigorously attack those who do not conform to the present high standards. It isn’t because these high standards are necessary: for many types of manufacturing and therapy, they are overkill many times over in terms of cost and requirements. We know this because safe drugs of this type were produced in past decades, with a much lesser degree of regulatory oversight and cost.
Zero risk is impossible, yet it is the goal. Medicine always has risk, patients must always assess those risks in full knowledge, and yet every layer of the system tries to remove that task from the patient, even to the point of making it impossible for the patient to find out details, costs, and more until after the fact.
Within the context of this environment, there will always be bad actors. There are bad actors out there throughout the system, inside it, and outside it, in all branches of medicine. Some of them get a pass because they play ball and deliver marginally effective drugs with meaningful side effects and sell out before the consequences arrive. Others are sued, go out of business, are shut down by regulators, or are otherwise punished at some point. None of this has halted medicine more generally, and none of this will halt the longevity field.
Oliver Medvedik, Chief Science Officer, Lifespan Research Institute:
I think this is a broader question that can be directed to any and all therapies that purport to have efficacy without adequate data suggesting this to be the case. At one extreme, we can see items for sale online and in chain pharmacies, such as “magnetic healing bracelets,” which have no data that they work, yet continue to be sold. At the other end of the spectrum, we have certain accepted surgical procedures in medicine, such as certain arthroscopic knee surgeries that are known to be no better than placebo sham surgeries.
Therefore, such untested “therapies” within the field of geroscience fall within this spectrum. They certainly make it more difficult for potential patients to navigate what is demonstrably proven to be effective, which in the field of geroscience, is precious little outside of proper exercise, diet, reducing stress, living within a supportive community, etc.
Andrew Steele, longevity advocate, author of “Ageless”:
I think it’s hard to generalize when there’s such a diversity of levels of evidence for different therapies – a longevity scientist self-experimenting with rapamycin is very different from a non-expert seeking out stem cells from an unlicensed practitioner. But I think overall we should be very cautious if we want longevity medicine to be perceived as a legitimate medical specialty. If people start to think that ‘longevity’ is unproven supplements or peptides, it’s just another communications challenge for a field that’s already facing numerous ethical questions, such as whether treatments will only be accessible to billionaires.
Ivan Morgunov, CEO of Unlimited Bio, a company offering gene therapies that passed Phase 1 safety trials at overseas locations:
Aging-related diseases kill around 120 people every minute (or 62 million a year). That’s thousands of times more than any realistic risk from experimental approaches. The real problem isn’t that some people try untested therapies, it’s that billions have no access to trying anything at all.
We must distinguish between two cases: when developers make exaggerated, unverified promises (which is indeed harmful), and when patients are honestly informed about the risks and status of a therapy (which is part of progress).
Just as spreading misinformation by some people doesn’t mean we should abolish free speech, if someone misleads people about treatments, that’s not a reason to ban all new approaches. Instead of blanket bans, we need transparency, informed consent, and accountability.
What is your opinion on medical tourism in the longevity context?
Kaeberlein:
I don’t think the core issue with medical tourism is that people are seeking it out. In fact, I’m fairly libertarian in my views on health care: I believe individuals who are truly informed about both the risks and potential benefits should have the right to pursue therapies, interventions, or diagnostics they believe are in their best interest. People should have agency over their own health, and the government should not unnecessarily stand in the way.
The real challenge is what it means to be “appropriately informed.” Too often, people engaging in medical tourism are not fully aware of the risks or of the lack of safeguards in place. Compounding this, many of the providers and product manufacturers (stem cells, exosomes, gene therapies, etc.) operating in this space are not the most professional, ethical, or trustworthy. Quality control is often minimal to nonexistent, and when something goes wrong, patients have little to no legal recourse.
Another major problem with medical tourism is that it rarely produces quality data on safety or efficacy. Even when patients do experience benefits, those outcomes are anecdotal and uncontrolled, making it impossible to distinguish between placebo effects and real biological impact. Adverse outcomes are often underreported or hidden – anyone in the space is aware of numerous reports of serious adverse outcomes that never come to light. So, the field as a whole learns very little. This lack of reliable data slows progress for everyone – patients, clinicians, and scientists alike – because we can’t confidently build on what works or avoid what doesn’t.
Reason:
Growth and maturity in the medical tourism industry is the best path towards bringing beneficial change to the development and provision of medicine in heavily regulated jurisdictions. Regulators do not respond to advocacy or attempts to bring change from within. The past few decades have amply demonstrated that.
Consider all the intense lobbying and patient advocacy that have taken place over a period in which the costs of regulatory compliance have more than doubled, and the number of new drug approvals has decreased. The only thing that will tame the regulators is for effective therapies to be widely available in other countries, a short plane flight away.
Currently, medical tourism suffers from being scattered, disorganized, hard to penetrate, to perform discovery, to determine quality. If that industry grows tenfold in size in the transition from therapies for very sick people, a small fraction of the population, to enhancement therapies that can be applied to nearly everyone, many of these challenges will likely be addressed, and in this growth lie the seeds of real change to the medical regulatory environment in the US and Europe.
Medvedik:
I think the context matters here. Will medical tourism be coupled with the patients being enrolled in a clinical trial where this data can be shared? Or will this be for an intervention that is being sold as a proven remedy, with no data being recorded or shared? If it’s the former, then I believe it can be a great way to move the field forward. If the latter, then buyers beware.
Steele:
Medical tourism exists on a sliding scale of risk, from travelling to save money on dental work to going somewhere with less stringent regulation to receive a treatment that isn’t approved at home. I think the issue for longevity medicine isn’t so much regulatory as that we don’t have any aging interventions that we know work! Personally, I only want to take longevity therapies that have been through rigorous testing and undergo rigorous quality control to make sure they contain what they say they do – meaning, broadly speaking, that they’d need the kinds of evidence that the FDA or the EU’s EMA would need to see to approve any experimental therapy.
Morgunov:
Medical tourism in the longevity field is an indictment of national healthcare systems. When people have to fly thousands of miles to get a treatment that could extend their life, it means something is deeply broken at home.
I’m doing this first and foremost for myself — to undergo a combination of gene therapies that, under classical regulations, I would never be allowed to have in my lifetime. Why should I need permission to save my own life?
What is your reaction to the particular incident at RAADFest?
Kaeberlein:
First, peptides as a class are often misunderstood. Some are FDA-approved and well-characterized, but many others have little to no human safety or efficacy data. They are bioactive molecules, no different from other classes of pharmaceutical drugs, and should be evaluated case by case based on available evidence, not treated as inherently “safe” or “natural.” Unfortunately, the space is filled with misinformation and hype.
That’s why I found it so concerning that a medical provider was administering peptide injections in the vendor hall at a major conference. We would never accept a physician handing out unapproved pharmaceutical drugs in that setting, and it should not happen with peptides either. I don’t know the exact details, whether this was within or outside conference guidelines, but regardless, it highlights a serious problem: peptides are being handed out far too casually, sometimes by licensed professionals, sometimes by people with no medical credentials at all.
This raises real questions about liability, patient safety, and the broader reputation of the longevity space. Unfortunately, when incidents like the one at RAADFest make headlines, the entire emerging field of “longevity medicine” takes a reputational hit. Some physicians in this area are outstanding, but many are not. And when questionable practices dominate the public narrative, the space begins to look unprofessional, unsafe, and even exploitative.
Reason:
Unfortunate, not surprising. At some point, there will be errors, there will be bad actors, and there will be people who don’t appreciate the level of risk they undertake in a particular circumstance. It is, of course, entirely unclear what exactly happened, the degree to which everyone involved was informed, and the beliefs they held about risk and safety; we may never know.
Consider that exactly this class of event occurs in hospitals throughout the country on a daily basis. It occurs quietly when physicians prescribe drugs off-label, and the normal human variability leads to an adverse reaction. It occurs when self-experimenters are incautious.
Zero risk in medicine is an illusion. An environment in which patients can trust without verifying is an illusion. It cannot exist. Some people believe it can or have had a run of good luck and misjudge their situation. Then there is cognitive dissonance when the dice turn up snake eyes.
Steele:
It’s tragic, and I hope that the two people affected are fully recovered or will soon be.
Morgunov:
Any severe health incident is serious and should be investigated. But let’s be honest: on that same day, more than 100,000 people worldwide died from aging-related diseases. Why is no one talking about that?
Think of self-driving cars: one crash doesn’t mean they should be banned, when hundreds die every day in accidents caused by human error, something that autonomous vehicles promise to avoid.
The same goes for anti-aging therapies: a single incident involving what is possibly an allergic reaction and emergency resuscitation shouldn’t outweigh millions of deaths every year. The solution isn’t to ban the technology, it’s to make it as safe and as accessible as possible.
(Medvedik chose not to comment on this particular episode)
Name one or more instances where regulation should be added and where it should be relaxed.
Kaeberlein:
In my view, the most obvious area where regulation should be strengthened is around supplements and other unapproved interventions that the FDA currently considers “generally recognized as safe.” I don’t think new rules are necessarily needed around demonstrating efficacy, but I do believe there should be clear, enforceable standards for honesty. Right now, many supplement companies in the longevity space make deceptive or outright false claims about their products. This kind of marketing not only misleads the public but also erodes trust in the entire field. Ensuring truthful communication would be a straightforward way to address this problem.
Another area where regulation doesn’t need to be expanded so much as enforced is with licensed medical professionals who knowingly operate outside the law or ethical standards of their profession. These laws exist, but enforcement is inconsistent at best.
That said, there are cases where the regulations themselves may need to evolve. Stem cells are a good example. I wouldn’t argue that regulation should simply be “relaxed,” but rather updated so that medical providers can responsibly deliver these therapies using products manufactured under strict quality standards, while also generating real-world data on safety and efficacy. Right now, the system gives us the worst of both worlds: little oversight of product quality and very limited collection of data that could actually tell us whether these treatments are safe or effective.
Reason:
The world would be a better place in the absence of most medical regulations. It is a cost that outweighs the benefits. The risk is still there, just now hidden, while patients are told to just trust rather than evaluate.
Medvedik:
Speaking from a US-centric view, I think the FDA should be much more proactive in testing our foods and supplements and regulating certain OTC medications that pose a high risk of lethality.
As for medical interventions, I do believe that regulations should be much more relaxed when it comes to adults who have terminal or painful illnesses to agree to being participants in clinical trials that the FDA presently deems to be too “high risk.”
Steele:
I think the issue of regulation in longevity science is important, but it can be a bit of a distraction – the most important thing we need is more funding for the field so we can do the kinds of large-scale trials that tell us whether treatments for aging work. Once this happens, I think we can have a more serious debate around regulation based on the known costs and benefits of tested therapies.
Morgunov:
Access to therapies with full and honest disclosure of the risks is a fundamental human right. The state shouldn’t stand between an informed adult and their decision to try to save their own life. Fifty years ago, maybe I could have accepted the current FDA rules. But today, we live in a unique moment where a technological leap — achieving longevity escape velocity — is theoretically possible. The millions of lives we could save outweigh the risks. We don’t need more brakes; we need accelerators.
Should people in the field get together and develop guidelines that would balance the need to accelerate progress with safety and PR concerns?
Kaeberlein:
Yes, I do think there’s real value in developing guidelines that balance accelerating progress with safety and public trust. The challenge, of course, is getting the right people in the room and ensuring the effort has a genuine impact. Too often, initiatives like this are launched with good intentions but struggle to move the needle in practice.
One of the difficulties today is that honesty and credibility don’t seem to carry the weight they once did. Dishonesty in the space has become increasingly normalized, which makes it harder for people with high ethical standards to feel motivated to invest their time in shaping guidelines. That said, I believe it’s exactly because of this environment that we do need a credible, science-driven framework for longevity medicine.
Such a framework should bring together experts in the biology of aging and geroscience, along with clinicians experienced in healthspan optimization and voices from regulatory and public policy. The goal would be to produce a kind of playbook for how to practice responsibly at the highest standards, rooted in evidence and integrity. Even if the immediate impact is uncertain, it could serve as an anchor point for the field and a benchmark for best practices.
Reason:
No. Everyone who can should focus on the only thing that makes a difference, which is building new medical technologies. There is a whole world full of people happy to fight over what to do with those technologies, what to say about those technologies, and who should have access to those technologies. Let them. They are irrelevant in the long term. Do we know or even care what regulators were doing in 1910? Of course not. But what was important were the new technologies developed in that year. So too, for every year. Without the technologies, there is no possibility of progress in our health.
Medvedik:
I think the ethical guidelines that can be worked on within this field (geroscience) should be applicable to all or most other medical interventions. I do not presently believe that the issues in clinical trials and therapeutics this field faces are qualitatively different from those of most other medical interventions. That said, I do believe that the development of useful and medically accepted cellular biomarkers of aging will be critical towards moving this field forward into clinical applications and accelerating the development of scientifically validated interventions that target the key drivers of the aging process.
Steele:
I think the guidelines should be pretty simple: anything that doesn’t have substantial human safety data shouldn’t be used outside of a trial setting. Untested therapies branded ‘longevity’ don’t advance the field – they pose a risk to its future progress.
The place I think it would be useful to develop guidelines is on how to aggregate data from therapies with solid safety data that are being taken off-label. The problem at the moment is that people taking drugs or other interventions in this way can’t accelerate progress because protocols and doses aren’t standardized, and data aren’t being collected centrally. If we can solve that problem, then it would be the time to debate which treatments would balance safety and accelerating the field.
Morgunov:
Yes – but they shouldn’t create regulatory monopolies like the FDA. We need a system of “quality stamps” from different independent regulators, ranging from the most stringent to the more flexible.
If you want only ultra-vetted products, choose the FDA stamp. If you’re willing to take more risk for a breakthrough, consider a different standard. Ideally, these regulators would also act as insurers, covering liability so patients are protected if something goes wrong. This would give people a real choice: maximum caution or a chance to give it a try today.
Editor’s note (Sept. 3, 2025): This story was updated to reflect additional information from RAADfest organizers and the Southern Nevada Health District.
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