It would seem I found an antibiotic that disagrees with me. As the tail end of my soft tissue recovery from my abscess surgery and deep tissue infection appears in sight I had a setback with an additional antibiotic.
Cephalexin was one of the top choices on the pathology report from the hospital and recommended as a first line treatment by the surgeon, several artificial intelligence differential diagnostic secondary checks and my primary care doctor.
They did not prescribe it first and I found out why yesterday when I felt as if I’d hurt a shoulder ligament doing, of all things, tai chi. I was despondent over it (ironically another side effect). The gut-brain axis gets weird when you kill off bad microflora.
So yeah not the antibiotic for me. As it turns out we recently learned it’s associated with tendon rupture. Not quite as bad as the other more infamous Cipro. Which ironically I was on with no issues. But Cephalexin has got some risks to tendons and ligaments too.
Being on an immune suppressant (an IL-17 called Bimzelx) for ankylosing spondylitis and psoriatic arthritis has improved a number of biomarkers but also made me susceptible to skin infections. Like the kind that require slicing. Not fun.
Now in the wake of the deep tissue infection, we had a systemic MSSA problem. It was entirely rational to nuke that thing from orbit. Any resurgence needs maximum force to prevent chances for regrowth. You simply have to to be very watchful for side effects in all things now.
I feel like I’m in some awful healthcare version of pimp my ride. Pimp my diagnosis?
“So I heard you had side effects so I gave you a side effect for that side effect.“
And so I’ve been sent down the peptide rabbit hole to see if that might help with tissue healing. My shoulder is probably fine as I stopped quite quickly but a reminder that I need to be watchful of what I’m taking and experiment carefully.
Naturally I’m already considering my risk profile carefully but as it’s peptide season in Silicon Valley (who isn’t on at least a micro dose of a next generation GLP-1 agonist or some new fangled GIP.
Why not add some more to the mix? Strong tissues and lean mass being protective against many a problem. Behold a little Grok breakdown of what I was recommended.
GHK-Cu (Copper Peptide)
GHK-Cu is a naturally occurring tripeptide (glycyl-L-histidyl-L-lysine) that binds to copper ions, forming a complex that plays a role in tissue repair and regeneration. Its mechanism in tendon healing involves several key processes:
- Collagen and Extracellular Matrix Synthesis: GHK-Cu directly acts on fibroblasts (cells responsible for producing connective tissue) by increasing the production of mRNA and proteins for collagen (types I and III), elastin, proteoglycans, glycosaminoglycans, and decorin. This enhances the structural integrity of tendons during repair. Sources Sources
- Angiogenesis and Nerve Outgrowth: It stimulates the growth of blood vessels (angiogenesis) and nerves, improving nutrient delivery and innervation to the healing site, which accelerates wound contraction and tissue remodeling. Sources
- Anti-Inflammatory and Antioxidant Effects: GHK-Cu blocks the release of tissue-damaging free iron from ferritin channels, reducing oxidative stress and lipid peroxidation after injury. It also modulates inflammation to create a favorable environment for healing. Sources Sources
- Systemic Effects: When administered, it can enhance healing systemically, even if injected away from the injury site, by regulating copper-dependent enzymes involved in cell growth and repair.
Research, primarily from animal models and in vitro studies, suggests these actions lead to faster tendon recovery, but human clinical trials are limited, and it’s not FDA-approved for therapeutic use.
TB-500 (Thymosin Beta-4 Fragment)
TB-500 is a synthetic peptide derived from thymosin beta-4, a protein involved in actin regulation. It primarily aids tendon healing by promoting cellular mobility and regeneration:
- Actin Upregulation and Cell Migration: TB-500 binds to actin, a key protein in cell structure, enhancing cell migration (chemotaxis) and proliferation. This allows fibroblasts and other repair cells to quickly move to the injury site, accelerating tissue repair. Sources
- Angiogenesis: It stimulates the formation of new blood vessels, improving blood flow and oxygen delivery to damaged tendons, which supports faster healing.
- Anti-Inflammatory and Antifibrotic Properties: TB-500 modulates inflammation by reducing pro-inflammatory cytokines and preventing excessive fibrosis (scar tissue formation), creating a balanced healing environment.
- Tissue Regeneration: In animal studies, it promotes overall wound healing and tissue regeneration, though evidence for tendon-specific effects in humans is anecdotal and lacks robust clinical data.
TB-500’s effects are mostly observed in preclinical research, with potential for muscle, tendon, and ligament repair, but it’s not approved for human use and carries risks.
BPC-157 (Body Protective Compound-157)
BPC-157 is a synthetic pentadecapeptide derived from a gastric protein, known for its protective and regenerative effects on various tissues, including tendons:
- Fibroblast Activation and Migration: It promotes the outgrowth, survival, and migration of tendon fibroblasts under stress, enhancing cell proliferation and tendon explant growth in vitro.
- Growth Hormone Receptor Upregulation: BPC-157 dose-dependently increases the expression of growth hormone receptors in tendon fibroblasts at both mRNA and protein levels, facilitating anabolic processes for tissue repair. 19 14
- Angiogenesis via VEGFR2 Pathway: It activates vascular endothelial growth factor receptor 2 (VEGFR2), leading to the VEGFR2-Akt-eNOS signaling pathway, which promotes new blood vessel formation and improves nutrient supply to healing tendons. 22
- FAK-Paxillin Pathway and Anti-Inflammatory Effects: BPC-157 activates focal adhesion kinase (FAK) and paxillin, proteins that regulate cell adhesion and motility, while also exerting protective effects against inflammation and organ damage. 24 25 20
- Overall Tissue Protection: It accelerates post-injury healing in muscles, tendons, and ligaments, restoring function similar to uninjured tissue in animal models. 27 26
Extensive animal studies support BPC-157’s role in tendon and ligament recovery, but human evidence is limited to anecdotal reports, and it’s not FDA-approved, with potential unknown side effects.