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Category: Health Systems

  • We Built a System to Keep You Alive. We Forgot to Keep You Well.

    Healthspan • Prevention • Food • Medicine • Incentives

    We Built a System to Keep You Alive. We Forgot to Keep You Well.

    Living longer is an incredible achievement. But adding years to life is not the same thing as adding life to those years.

    Modern medicine has become remarkably good at rescuing us from disease. Modern food production has become remarkably good at giving us inexpensive, convenient, shelf-stable calories.

    The problem is that neither accomplishment automatically creates healthspan.

    Drew Kirkley, MSN, APRN, AGNP-C KirkleyCare Personalized Wellness

    There is a difference between being alive and being well.

    That distinction sounds obvious until you look at the way we measure success in health care.

    Did the patient survive?

    Did we prevent the heart attack?

    Did the medication lower the number?

    Did we get another five years?

    Those are important questions.

    But I think we need another one:

    What condition are you going to be in during those extra years?

    Can you walk?

    Can you travel?

    Can you think clearly?

    Can you get off the floor?

    Can you play with your grandchildren?

    Are you strong enough to tolerate an illness?

    Are you living independently?

    That is the conversation about healthspan.

    Lifespan Is Not Healthspan

    The real goal is to delay functional decline and compress the years spent sick, weak, or dependent
    Three Different Ways to Think About Aging
    Conceptual illustration of functional health across the lifespan
    Healthspan versus lifespan conceptual diagram Conceptual graph comparing reactive care, disease-focused management, and healthspan-first care across the lifespan. Reactive trajectory Disease management Healthspan-first Function • Capacity • Health Lifespan HIGH 50% LOW Compress low-function years
    Reactive
    Disease Management
    Healthspan-First
    Conceptual illustration only. Curves do not represent literal population data or predicted individual lifespan.

    Reactive Care

    Wait until something breaks, hurts, becomes abnormal, or produces a diagnosis—then intervene.

    Disease Management

    Diagnose earlier and manage disease effectively, potentially extending life—but often after significant functional decline has already occurred.

    Healthspan-First

    Build physical, metabolic, cognitive, and physiological reserve before disease or disability forces the issue.

    The goal isn’t simply to move death farther to the right. It’s to move decline farther to the right.

    Fallacy #1: If You Aren’t Sick, You Must Be Healthy

    Disease is often a late point on a much longer biological timeline

    Health care needs thresholds.

    We need criteria for diabetes. Hypertension. Osteoporosis. Heart failure. Kidney disease.

    Those definitions help us diagnose and treat disease.

    But biology does not suddenly flip from healthy to diseased the day someone crosses a diagnostic threshold.

    Function can change gradually.

    Muscle can disappear gradually.

    Insulin sensitivity can worsen gradually.

    Blood pressure can trend upward.

    Sleep can deteriorate.

    Physical capacity can decline.

    Body composition can shift.

    There Is a Large Space Between “No Diagnosed Disease” and “Optimal Health”

    That space is where healthspan lives.

    Modern Medicine Is Incredible at Rescue

    This is not an argument against conventional medicine

    If I am having a heart attack, I do not want a wellness coach.

    I want a cardiac catheterization lab.

    If I have bacterial sepsis, I want antibiotics.

    If I rupture my appendix, I want a surgeon.

    If I have cancer, I want people who understand oncology.

    Emergency Medicine Stabilize immediately
    Surgery Repair structural problems
    Diagnostics Identify disease
    Pharmacology Modify risk and disease

    But Rescue Medicine and Healthspan Medicine Are Different Jobs

    Saving someone from a heart attack is not the same thing as spending twenty years building the metabolic, cardiovascular, muscular, and behavioral reserve that lowers the chance of ever needing that rescue.

    The Health Care System Has an Incentive Problem

    You don’t need a conspiracy when incentives can explain the behavior

    Historically, much of American health care has operated through fee-for-service.

    The basic structure is simple: provide a service and receive payment for the service.

    Patient Has Problem
    →
    Visit / Test / Procedure
    →
    Service Delivered
    →
    Payment

    Medicare’s own advisory commission has acknowledged that traditional fee-for-service payment historically rewarded the volume of services provided rather than the quality of those services.

    That is precisely why CMS and other payers have spent years trying to shift toward value-based care, where quality and outcomes matter more.

    Prevention Does Exist

    Screening, vaccination, preventive visits, counseling, and value-based payment programs are real parts of modern medicine.

    The criticism is not that prevention is absent. It is that our system has historically been much better structured to pay for measurable medical services than for decades of health that never become a billable disease.

    Screening for Disease Is Not the Same as Building Health

    Both matter—but they are not interchangeable

    Disease Prevention & Detection

    Check blood pressure.

    Screen for cancer.

    Measure cholesterol.

    Monitor glucose.

    Vaccinate.

    Identify disease earlier.

    Building Healthspan

    Build muscle.

    Improve cardiovascular fitness.

    Protect sleep.

    Improve metabolic health.

    Eat nutrient-dense food.

    Maintain mobility and physical reserve.

    Finding disease earlier is valuable. Building a body that resists disease is a different strategy.

    Then There Is the Food System

    Food has become easier to obtain than ever. That doesn’t mean our food environment is optimized for healthspan.

    For most of human history, obtaining calories was difficult.

    Today, many of us face the opposite problem.

    Calories are everywhere.

    They are inexpensive.

    Convenient.

    Portable.

    Shelf-stable.

    Engineered to taste good.

    55% of calories consumed by Americans age 1+ came from ultra-processed foods in 2021–2023
    61.9% of calories consumed by U.S. youth came from ultra-processed foods
    53% of calories consumed by U.S. adults came from ultra-processed foods

    That Is Not a Willpower Statistic

    When more than half of the calories consumed by an entire population come from a category of food, it is difficult to explain the problem solely as millions of individual failures of discipline.

    Environment matters.

    The Food Industry Has Different Goals Than Your Mitochondria

    A commercially successful food product and a healthspan-promoting food are not always the same thing

    A food manufacturer has to make something people will buy.

    That means commercial products often compete on things like:

    Taste

    People have to enjoy it enough to purchase it again.

    Convenience

    It needs to fit a fast, portable, low-preparation lifestyle.

    Shelf Life

    Longer storage reduces waste and makes distribution easier.

    Price

    Products must compete for consumer attention and household budgets.

    None of those goals is inherently evil.

    But notice what is missing.

    Nobody at the checkout counter gets paid because that food helped preserve your muscle, insulin sensitivity, or cardiovascular function 25 years later.

    Healthspan is valuable to you.

    It is not automatically priced into the transaction.

    The NIH Put Ultra-Processed Food to the Test

    One of the most interesting nutrition experiments was remarkably simple

    Researchers admitted 20 healthy adults to an NIH metabolic unit.

    Each participant spent two weeks eating an ultra-processed diet and two weeks eating an unprocessed diet in random order.

    The offered diets were designed to be matched for calories and major nutrients including sugar, fat, carbohydrates, fiber, and sodium.

    Participants were allowed to eat as much or as little as they wanted.

    What Happened?

    ~500 more calories eaten per day on the ultra-processed diet
    +0.9 kg average weight change during two weeks of ultra-processed eating
    −0.9 kg average weight change during two weeks of unprocessed eating

    The researchers did not conclude that every processed ingredient is toxic.

    They demonstrated something more practical:

    Food Structure Can Change Eating Behavior

    People spontaneously consumed substantially more energy when eating the ultra-processed diet.

    That means the health conversation cannot be reduced to “just have more self-control.”

    “Just Eat Better” Isn’t a Complete Strategy Either

    Healthy behavior has to exist in the real world

    Whole food takes planning.

    Often preparation.

    Sometimes more money.

    It may spoil more quickly.

    People work long hours.

    They have kids.

    They travel.

    They live in different communities with different resources.

    Even the NIH investigators who performed the ultra-processed-food experiment pointed out that simply telling people to eat better may be inadequate when access, time, and cost are working against them.

    Personal Responsibility Still Matters

    But personal responsibility and environmental influence can both be true at the same time.

    Understanding the environment makes it easier to build a strategy that actually works inside it.

    Look at the Result

    We have extraordinary medical technology—and extraordinary chronic disease burden

    Chronic diseases are now the leading causes of illness, disability, and death in the United States.

    According to the CDC, three in four American adults have at least one chronic health condition, and more than half have two or more.

    That is not evidence that modern medicine has failed.

    People survive illnesses today that would have killed previous generations.

    But it should make us ask whether survival alone is a sufficient measure of success.

    A longer life filled with a longer period of preventable disability is only a partial victory.

    Healthspan Is About Capacity

    How much reserve do you have before life starts taking withdrawals?

    I think one of the better ways to understand healthspan is through the idea of physiological reserve.

    How much capacity does your body have above the minimum required to function?

    Muscle & Strength

    How much strength can you lose during illness or aging before everyday tasks become difficult?

    Cardiovascular Fitness

    How much aerobic capacity do you have beyond what is required to simply walk through your day?

    Metabolic Health

    How effectively can your body handle glucose, fat, energy intake, and changes in demand?

    Bone & Mobility

    Can your skeleton tolerate falls, loading, movement, and the physical demands of aging?

    Brain & Cognition

    Can you continue learning, making decisions, interacting, and independently managing your life?

    Recovery

    How well can you tolerate illness, surgery, stress, injury, sleep disruption, or temporary inactivity?

    We Know Movement Works. Most People Still Don’t Do Enough.

    Knowing what improves health and creating a system that makes it happen are different challenges

    Physical activity is not an experimental longevity therapy.

    Its benefits are well established.

    Yet in 2024, only about 26% of American adults met both the aerobic and muscle-strengthening components of the federal physical activity guidelines.

    Among adults 65 and older, the percentage was even lower.

    This Is the Healthspan Paradox

    We are willing to spend enormous amounts of money treating the consequences of physical decline while struggling to build environments, habits, and incentives that help people preserve physical capacity in the first place.

    What Would a Healthspan-First Strategy Look Like?

    Start decades before the crisis
    1

    Build Muscle

    Preserve strength, metabolism, mobility, and functional reserve.

    2

    Build Aerobic Capacity

    Maintain cardiovascular fitness and the ability to tolerate physical demand.

    3

    Eat Real Food

    Make nutrient-dense, minimally processed food the foundation rather than the exception.

    4

    Protect Sleep

    Treat sleep as a major component of metabolic, neurologic, and physical recovery.

    5

    Know Your Risk

    Use appropriate screening, labs, family history, and medical evaluation to identify problems early.

    6

    Protect Metabolism

    Pay attention to body composition, glucose regulation, blood pressure, lipids, and activity.

    7

    Maintain Mobility

    Strength, balance, coordination, and movement preserve independence.

    8

    Use Medicine Wisely

    Use medications and other therapies when the expected benefit justifies them—without expecting them to replace the foundation.

    This Is Not “Lifestyle Instead of Medicine”

    That is another false choice

    Sometimes the right lever is exercise.

    Sometimes it is better nutrition.

    Sometimes it is treating sleep apnea.

    Sometimes it is lowering blood pressure.

    Sometimes it is a statin.

    Sometimes it is a GLP-1-based medication.

    Sometimes it is surgery.

    Sometimes it is physical therapy.

    Sometimes emerging therapies may eventually provide additional options.

    Personalized Wellness Means Choosing the Right Lever

    The mistake is believing one lever can replace the entire system.

    I Am Not Interested in Being Anti-Medicine

    I am interested in using medicine earlier, smarter, and inside a bigger strategy

    Modern medicine has saved an extraordinary number of lives.

    I work in medicine.

    I teach medicine.

    I prescribe medications.

    I believe deeply in evidence-based care.

    But believing in medicine does not require pretending that our current system perfectly incentivizes long-term health.

    In fact, acknowledging its blind spots is how we improve it.

    I don’t want less medicine. I want less disease that requires rescue medicine.

    The Same Is True of Food

    The goal is not purity. The goal is a better default.

    I am not interested in convincing people that every packaged food is poison.

    It isn’t.

    Processing can improve safety, convenience, affordability, transportation, and access.

    The problem is when highly processed food becomes the foundation of the diet rather than a convenience within it.

    A healthy food environment does not require perfection.

    It requires making the healthier decision easier to make more often.

    Better Defaults Beat Perfect Discipline

    Build your environment so protein, produce, minimally processed foods, water, movement, sleep, and recovery are easier—not decisions that require heroic willpower every single day.

    The Goal Is to Change the Shape of the Curve

    Keep capacity high. Push decline later. Compress disability.

    Nobody gets to remain 30 years old forever.

    Aging happens.

    Disease cannot always be prevented.

    Genetics matter.

    Luck matters.

    Social circumstances matter.

    Medicine cannot guarantee a perfect ending.

    But there is an enormous difference between accepting mortality and accepting decades of preventable decline.

    Don’t Just Add Years to the End

    Build enough muscle, metabolic reserve, cardiovascular fitness, nutritional resilience, cognitive health, mobility, and recovery capacity that you can remain functional for as much of your life as possible.

    The goal is not simply a longer lifespan. The goal is a longer healthspan.

    Maybe We Have Been Asking the Wrong Question

    “How long can we keep someone alive?” is not enough

    A better question might be:

    How long can we keep someone strong, capable, independent, metabolically healthy, cognitively engaged, and able to do the things that make their life worth extending?

    That changes the conversation.

    It changes when we intervene.

    It changes what we measure.

    It changes how we think about food.

    It changes how we think about exercise.

    It changes how we think about medications.

    And most importantly, it gives the patient something much more meaningful to work toward than simply avoiding death.

    Build Health Before You Need Health Care

    Use modern medicine when you need it. Use screening to identify risk. Use medications when they make sense. But spend the years before disease building a body with enough reserve to resist decline for as long as possible.

    Stay strong longer. Stay capable longer. Stay you longer.

    What Does Your Healthspan Strategy Look Like?

    A personalized wellness consultation starts with your goals and looks at the systems that influence them—including metabolic health, muscle, sleep, nutrition, cardiovascular risk, recovery, medications, and other available levers.

    Book a Wellness Consultation

    About the Author

    Better health happens when the whole system works together

    Drew Kirkley, MSN, APRN, AGNP-C

    Adult-Gerontology Nurse Practitioner • University Nursing Professor • Founder of KirkleyCare

    Drew Kirkley’s approach to personalized wellness focuses on helping people understand how the body’s systems interact, identify what may be limiting their health or performance, and evaluate practical, evidence-informed levers that may help them achieve their individual goals.

    Selected Sources

    Public-health data and research supporting the concepts discussed in this article
    Centers for Disease Control and Prevention. 2026.
    Chronic diseases in the United States, including their prevalence, contribution to disability and mortality, and associated health care costs.
    View CDC Data →
    National Center for Health Statistics. 2025.
    Ultra-processed food consumption among U.S. youth and adults, based on NHANES August 2021–August 2023.
    View NCHS Report →
    Hall KD, et al. Cell Metabolism. 2019.
    Randomized inpatient trial comparing ad-libitum ultra-processed and unprocessed diets.
    View on PubMed →
    NIH Clinical Center.
    Summary of the controlled ultra-processed-food trial, including observed calorie intake and body-weight changes.
    View NIH Summary →
    Medicare Payment Advisory Commission.
    Discussion of historical fee-for-service payment incentives and Medicare delivery-system reform.
    View MedPAC →
    Centers for Medicare & Medicaid Services.
    CMS value-based programs designed to shift payment emphasis from quantity of care toward quality and outcomes.
    View CMS →
    Healthy People 2030 / U.S. Department of Health and Human Services.
    National data on the proportion of U.S. adults meeting both aerobic and muscle-strengthening physical activity guidelines.
    View Healthy People 2030 →
    Educational Disclaimer: This article is intended for general education and commentary and does not replace individualized medical evaluation or treatment. The healthspan diagram is a conceptual teaching model and is not intended to predict individual lifespan, disability, disease onset, or response to treatment. Genetics, environment, socioeconomic factors, medical conditions, injuries, access to care, lifestyle, and other variables all influence lifespan and healthspan. References to health care or food-system incentives describe broad structural considerations and should not be interpreted as implying that individual clinicians, organizations, food manufacturers, or other professionals share identical motives or practices.

  • When “No Human Trials” Really Means “No One Paid for Them”

    Evidence • Research • Peptides • The Economics of Medicine

    When “No Human Trials” Really Means “No One Paid for Them”

    Peer-reviewed research, anecdotal evidence, animal studies—and the uncomfortable economics behind what gets studied.
    Drew Kirkley, MSN, APRN, AGNP-C KirkleyCare Wellness & Peptide Education

    One of the most overused phrases in health care is: “There’s no evidence.”

    Sometimes that is true.

    But sometimes what people really mean is: “There isn’t a large randomized human trial.”

    Those are not the same thing.

    A therapy can have a plausible mechanism, years of laboratory research, peer-reviewed animal studies, and substantial anecdotal experience—and still have very little high-quality human research.

    That should make us cautious. It should not automatically make us dismissive.

    The more interesting question isn’t always, “Why isn’t there evidence?” Sometimes the better question is, “Why was the human research never funded?”

    Peer Reviewed Does Not Mean “Proven”

    Peer review describes publication—not the strength of the evidence

    First, we need to get our terminology straight.

    Peer reviewed describes how research was evaluated before publication. It does not automatically tell you how strong the evidence is.

    A laboratory experiment can be peer reviewed. A mouse study can be peer reviewed. A case report can be peer reviewed. A randomized controlled trial can be peer reviewed.

    Those studies do not carry the same evidentiary weight.

    Anecdotal Evidence

    Real-world observations that can identify signals and generate questions—but cannot establish cause and effect.

    Laboratory Research

    Helps identify mechanisms and biological plausibility under controlled experimental conditions.

    Animal Research

    Allows researchers to study whole-body biological effects before moving into human trials.

    Human Clinical Trials

    Needed to determine whether a therapy is actually safe and effective in people.

    Evidence Exists on a Spectrum

    If researchers give a peptide to injured rats and the animals recover faster, that is evidence. It is simply not the same level of evidence as a controlled human trial.

    Anecdotes Aren’t Proof. They Aren’t Worthless Either.

    Observation has always been one of the starting points of science

    Anecdotal experience has obvious limitations.

    People know what they took. Expectations affect perception. Symptoms fluctuate. Injuries naturally heal. People often change several variables at once. Positive experiences are also more likely to be repeated than neutral ones.

    That is exactly why controlled trials exist.

    But if hundreds or thousands of people consistently report the same observation, I don’t think the scientifically appropriate response is:

    Wrong Extreme #1

    “People say it works, therefore it is proven.”

    Wrong Extreme #2

    “There isn’t a Phase 3 trial, therefore the observation means nothing.”

    Interesting observations should create questions. Good science should then attempt to answer them.

    Somebody Has to Pay for the Trial

    Scientific curiosity alone does not fund pharmaceutical development

    Large human clinical trials are extraordinarily expensive.

    Drug development may involve laboratory research, manufacturing, toxicology, pharmacokinetics, regulatory filings, Phase 1 testing, Phase 2 trials, Phase 3 trials, monitoring, data analysis, and ultimately regulatory review.

    Somebody has to pay for all of that.

    Interesting Molecule
    →
    Preclinical Research
    →
    Funding
    →
    Human Trials
    →
    Regulatory Approval

    And Funding Usually Requires an Economic Reason

    Pharmaceutical research and development is strongly influenced by expected revenue, development cost, probability of success, market size, patent protection, and regulatory exclusivity.

    What Happens When the Molecule Is Harder to Own?

    The patent story is more complicated than “peptides can’t be patented”

    You will sometimes hear people say: “Peptides can’t be patented.”

    That statement is too broad.

    Novel peptide analogues, new formulations, delivery systems, manufacturing methods, and new therapeutic applications may potentially receive intellectual-property protection.

    But naturally occurring molecules, older compounds, and molecules already described in the scientific literature may have a weaker intellectual-property position than a completely novel pharmaceutical compound.

    And weaker exclusivity can mean weaker financial incentive to spend enormous amounts of money proving that molecule works.

    The research pipeline has an economic filter.

    Promising biology does not automatically become a billion-dollar clinical program.

    That Doesn’t Prove a Conspiracy

    It demonstrates something far more ordinary: companies generally invest where they believe there is a reasonable opportunity for return on investment.

    And Yet Some of the Animal Research Is Hard to Ignore

    Promising does not mean proven—but it still deserves scientific attention
    Tissue Repair Research

    BPC-157

    Experimental tendon research has reported effects involving fibroblast migration, cellular survival, and tissue-repair signaling.

    Rat tendon studies provide legitimate biological reasons for continued investigation.

    They do not prove that injectable BPC-157 heals human orthopedic injuries.

    Metabolic Research

    MOTS-c

    A 2015 study reported that MOTS-c administration in mice protected against age-dependent and high-fat-diet-induced insulin resistance.

    Researchers also observed effects involving metabolism and diet-induced obesity.

    Again—interesting animal biology, not proof of equivalent human outcomes.

    Mitochondrial Research

    SS-31

    Researchers treated old mice with SS-31 for eight weeks and reported improvements in age-related cardiac dysfunction, exercise capacity, mitochondrial proton leak, and oxidative stress.

    That is compelling preclinical research.

    The words “in old mice” still matter.

    Sometimes the Animal Research Eventually Becomes Medicine

    SS-31 offers an interesting example

    SS-31 did not remain an interesting mitochondrial peptide confined to laboratory research.

    It was developed clinically as elamipretide.

    In September 2025, the FDA granted accelerated approval to Forzinity™ for a specific indication in patients with Barth syndrome.

    That does not validate every proposed wellness or longevity use of SS-31.

    But it illustrates an important point:

    Preclinical Research Can Matter

    Sometimes fascinating animal or laboratory findings eventually move through years of development and become legitimate human medicine.

    So Does Positive Animal Research Mean We Should Use Something?

    No—and this is where both sides can get themselves into trouble

    Mice are not small humans.

    Doses do not always translate cleanly. Pharmacokinetics differ. Disease models are imperfect. Manufacturing quality matters. Long-term human safety may be completely unknown.

    An impressive effect in a laboratory can disappear when tested in a diverse human population.

    Promising is not proven. But promising is not meaningless either.

    What About “Peptides vs. Drugs”?

    Another area where oversimplification creates confusion

    Peptides are sometimes discussed as though they are fundamentally different from drugs.

    Pharmacologically, that isn’t accurate.

    A peptide can absolutely be a drug.

    Insulin is peptide-based. GLP-1 receptor agonists are peptide therapeutics. Bremelanotide is a peptide drug. Elamipretide is now an FDA-approved peptide drug.

    What is interesting is that some experimental peptide approaches are discussed as short courses, cycles, recovery tools, or as-needed interventions rather than medications intended to be taken indefinitely.

    But That Does Not Apply to Every Peptide

    Some peptide medications are used chronically. Some conventional medications are used temporarily. The molecule and clinical problem determine the treatment strategy—not whether something carries the label “peptide.”

    Does Conventional Medicine Depend on Keeping People on Drugs?

    This criticism deserves more precision than it usually gets

    Chronic therapy is obviously an attractive business model.

    A medication taken every day for years creates recurring revenue. Add patent protection and regulatory exclusivity, and the economics become even more attractive.

    But it would be inaccurate to say that conventional drugs are universally designed to lose effectiveness so patients continually need larger doses.

    Tolerance does occur with certain drugs and certain biological pathways. It does not happen with every medication.

    And many people remain on medication because the underlying disease is chronic—not because the medicine intentionally created dependence.

    The More Defensible Criticism Is Also the More Interesting One

    Our pharmaceutical-development system naturally directs capital toward therapies that can generate enough revenue to justify the cost and risk of development.

    That means the compounds receiving the largest clinical trials are not necessarily the only biologically interesting compounds.

    Follow the Evidence—But Also Follow the Incentives

    Science and economics exist in the same world

    I don’t want to live at either extreme.

    I don’t believe:

    “It’s peer reviewed, therefore it must be true.”

    I don’t believe:

    “People online say it works, therefore it must work.”

    And I don’t believe:

    “There isn’t an FDA-approved indication, therefore there is no interesting science here.”

    I want better questions.

    What was actually studied?
    Cells, animals, or humans?
    Was the study controlled?
    How large was the effect?
    Has it been replicated?
    What do we know about safety?
    What don’t we know?
    Who funded the research?
    Who benefits financially from the result?

    The Uncomfortable Middle Ground

    This is where the most interesting conversations in modern wellness are happening

    Sometimes the difference between “promising experimental therapy” and “evidence-based medicine” is not that one molecule has fascinating biology and the other doesn’t.

    Sometimes one of them had someone willing to spend the money required to prove it.

    That doesn’t mean we lower our scientific standards.

    It means we understand how the scientific system actually works.

    Anecdotes Create Questions
    Animal Research Creates Hypotheses
    Human Trials Test Them
    Funding Determines Which Get Tested

    Scientific Skepticism Should Work in Both Directions

    We should be skeptical when someone claims an experimental therapy is proven because it worked in mice.

    We should also be skeptical when someone claims there is “no evidence” simply because nobody has spent the money required to run a large human trial.

    Ask what we know. Ask what we don’t know. Then ask who had an incentive to find out.

    About the Author

    Health education should make complicated science easier to understand

    Drew Kirkley, MSN, APRN, AGNP-C

    Adult-Gerontology Nurse Practitioner • University Nursing Professor • Founder of KirkleyCare

    Drew Kirkley’s approach to wellness focuses on helping people understand how the body’s systems work together, evaluate the evidence behind available options, and identify practical levers that may help them reach their individual health goals.

    Selected Sources

    Research and policy sources related to the topics discussed
    Congressional Budget Office.
    Research and Development in the Pharmaceutical Industry — discussion of expected revenue, development cost, market exclusivity, and pharmaceutical R&D incentives.
    View CBO Report →
    U.S. Patent and Trademark Office.
    Patent subject-matter eligibility guidance, including naturally occurring products and patentable inventions.
    View USPTO Information →
    BPC-157 Tissue-Repair Research.
    Experimental research examining BPC-157 and tendon fibroblast migration, survival, and repair-related biology.
    View on PubMed →
    Lee C, et al. Cell Metabolism. 2015.
    MOTS-c research involving metabolic homeostasis, insulin resistance, and diet-induced obesity in mice.
    View on PubMed →
    Chiao YA, et al. eLife. 2020.
    Eight-week SS-31 research examining age-related cardiac dysfunction, mitochondrial proton leak, oxidative stress, and exercise performance in old mice.
    View Study →
    U.S. Food & Drug Administration. 2025.
    FDA accelerated approval of Forzinity™ (elamipretide) for a specific indication in Barth syndrome.
    View FDA Approval →
    Educational Disclaimer: This article is intended for general education and commentary and should not be interpreted as medical advice or as a recommendation to use any experimental compound. Discussion of laboratory research, animal studies, mechanistic evidence, or anecdotal experience does not establish that a substance is safe or effective in humans. Decisions regarding medications, experimental therapies, or other health interventions should be based on individual medical history, available evidence, potential benefits, potential risks, product quality, and appropriate clinical evaluation.