The pitch is hard to argue with: scan the whole body, no radiation involved, allow us to find anything hiding. It’s the evidence underneath that gets complicated.

What the scan is good at

MRI is excellent at showing soft tissue in detail. If you have a symptom, a targeted MRI can often be the appropriate test. However whole-body screening in people with no symptoms is a different question, and it hasn’t been shown to help healthy people live longer.

The problem is what else it finds

Scan enough of a healthy body and you’ll find something, but more often than not it isn’t clinically meaningful. Studies of whole-body screening MRI report incidental findings in plenty of healthy people, such as a cyst on a kidney, or a small nodule on a lung. These tend to be harmless, but once these findings are discovered they can’t be ignored or forgotten. It leads to another scan, sometimes a biopsy, a referral, and always an additional worry on the patient.

What that costs you

Follow-up tests carry their own risks and their own costs, and they are often not covered. A biopsy is a procedure with real complications. For the small number of people where a scan finds something important early, it can be significant. But for most people, the finding was never going to cause harm.

Where professional bodies land

No major guideline recommends whole-body MRI screening for people without symptoms or specific risk factors. It isn’t due to the cost, or that the technology is poor, but rather that screening a healthy population hasn’t been shown to do more good than harm.

If you still want one

Trean does not arrange whole-body MRI screening, and we do not refer for it. That is a considered position rather than a gap in what we offer, and it follows from everything above.

If you decide to go ahead somewhere else, we would still rather you went in with your eyes open. Understand what an incidental finding is before the scan rather than after it, and make sure whoever arranges it has a plan for following up anything they find. A scan with no one attached to the result is the version that causes harm.

We customize your blood panel to test what is important to you as an individual. It is not a standard blood panel for everyone. This is a shared decision between you and your clinician to identify what you want to find out, and what result would actually change. From there, we order what is appropriate.

What a reference range really means

When a lab flags a result as outside the reference range, most people read that as a finding. What is important to know is that reference ranges are statistical, not biological. They are built so that about 95 per cent of healthy people fall inside them. That means roughly one healthy person in twenty falls outside the range on any given test, while being perfectly well.

Reference ranges do not account for activity levels and training load, and how the values may differ significantly in active individuals. The range describes how a population varies, rather than a line between health and illness.

Why more tests isn’t better

If one test in twenty comes back flagged in a well person, the arithmetic adds up fast.

What has good evidence for a healthy person

The list is short: lipids, blood sugar in the right age and risk groups, iron studies where there’s a reason to look, and a liver fibrosis score for people with specific risk factors.

Almost everything else, including vitamin D, B12, thyroid and hormones, is a test for someone with symptoms or a specific risk, but not a routine test for a healthy person.

Most people aren’t symptom-free

If you’re exhausted despite sleeping, your recovery has fallen off a cliff, your periods have stopped, or you’re taking something you bought online, you aren’t being screened any more. You have a reason for a test, and the test follows the reason. Our intensive intake helps us recognize what tests may be truly valuable.

One question almost nobody asks

When did you last train hard? This changes how several tests should be read. For example, ferritin rises after exercise, so a normal result the day after training doesn’t rule out iron deficiency. Inflammation markers also go up after a hard session, and creatine kinase, which reflects muscle breakdown, can stay elevated for a week. Hemoglobin can look low in endurance athletes simply because blood volume expands with training.

We ask this question on training before you go for your bloodwork, and the answer goes on your requisition. This way we can interpret the lab work based on training load to get a better understanding of what is actually happening.

What happens to your results

Every result is interpreted, not just flagged. A clinician reads it in the context of everything you’ve told us.

If something falls outside what we look after, we refer you on. We write to the specialist, copy your family doctor if you want, and follow up to confirm it was received.

If something is mildly out of range and needs nothing, we address it and tell you what could change that. Sometimes the answer may be to repeat bloodwork in three months, and that is a decision rather than an omission.

What is it?

Without preparation or warm up, you squeeze a handheld gauge as hard as you can. This test is incredibly simple but one of the strongest markers in adult health.

What the evidence shows

The largest study is PURE, published in The Lancet in 2015. Each 5 kg drop in grip strength was linked to roughly 16% higher all-cause mortality and about 17% higher cardiovascular mortality. Later reviews have found similar associations.

What that doesn’t mean

These are associations, not causes. A weak grip doesn’t cause early death, but may be a call out to something broader like muscle mass, nerve function, and accumulated health.

So training your grip in isolation misses the point. Squeezing a hand gripper will improve your score without changing what the score stood for.

It is also worth knowing that where studies measure both grip strength and cardiorespiratory fitness (CRF), CRF shows a stronger link to mortality than grip does.

Why we measure it

It tracks change in you. The same measurement over months, against your own baseline, is useful in understanding changes in you. The scale can only tell us so much, but if we see grip also declining, we need to adjust our plan.

It costs almost nothing. A minute, no preparation, no recovery cost.

Getting a number that means something

It is integral to follow appropriate protocol. Position, elbow angle, which hand and how many attempts all change the result, so comparisons only work when the method is the same each time. Hand injuries, arthritis and recent heavy training all affect it, and must be captured and recorded by whoever is testing you.

There are far more private health services in Canada than there were three years ago, and from the outside they all look the same. Comprehensive testing. Personalised insights. A dashboard.

Underneath they differ in ways that only matter once something is actually found. Here are the questions we would ask. Ask them of us too — our answers are at the end.

1. Can anyone here actually prescribe?

People skip this one. Several services test thoroughly, interpret carefully, then stop, because they are not a medical practice. What you get is a report and a suggestion to see your family doctor.

That is a legitimate service. Just be clear what you are buying. If a test finds something treatable, a service that cannot prescribe hands the problem back to you.

2. Who checks the prescription?

A prescription checked only by the person who wrote it has one set of eyes on it. Pharmacist review is standard in hospitals for good reason: it catches interactions, dosing problems and contraindications.

Ask whether it happens at all.

3. Was the panel designed, or assembled?

Bigger panels are easier to sell. A hundred and fifty markers sounds more thorough than thirty-six.

The arithmetic is not on their side. Reference ranges are built so that about 95% of healthy people fall inside them — which means roughly one healthy person in twenty falls outside on any given test. Run a hundred tests on a well person and you should expect about five flags from normal variation alone. None of them mean anything, and every one needs explaining, chasing or repeating.

Ask what each test would actually change.

4. What do the words actually mean?

Some terms sound clinical without being defined anywhere.

“Optimal.” Calling a result suboptimal implies there is an established better value and evidence that moving toward it helps. For a few markers that is true. For many now sold in large panels it is not. An optimal range is usually narrower than the lab range, rarely published, and conveniently places more people outside it.

“Imbalance.” Not a diagnosis. No test, no threshold, no agreed definition. It can mean whatever the person selling the correction needs it to mean.

“Root cause.” Appealing, because everyone wants the real reason rather than a patch. But most chronic conditions have no single root cause — there is genetics, behaviour, environment and luck.

“Biological age.” A number saying you are tracking younger or older than your years is a risk estimate presented as a fact. Different methods give different answers on the same person, the same sample can give different answers at different labs, and no regulator has cleared any of them.

None of this is a scandal. It is worth recognising each for what it is.

5. Do you sell what you recommend?

We would treat this as a bright line.

When the person telling you what you need is also the person selling it, the advice is no longer clean — and the effect on their judgement is usually invisible even to them. It does not require anyone to be dishonest. The incentive simply points the wrong way.

Ask it directly: do you sell what you recommend, and do you earn anything if I buy it?

6. Is it approved for what you are offering it for?

Some of what gets sold in this space has not been approved for anything, and the clearest example is regenerative medicine.

In Canada, cell therapies count as drugs. Not procedures, not something a clinic can simply decide to offer. Which means they have to be approved before anyone can sell them to you.

Using your own cells changes nothing. The usual argument is that cells taken from your own body must be safe, so the rules should not apply. Health Canada has answered that directly: your own cells are covered too.

Almost nothing has been approved. The few cell therapies Health Canada has authorised are for serious illness — certain cancers, and a complication of bone marrow transplant. None has been approved for skin, hair, or ageing. Health Canada has warned the public that unapproved cell treatments have not been shown to be safe or to work, and can cause serious infections, and it has ordered clinics to stop offering them.

The same question applies elsewhere. Intravenous vitamins are real medicine in someone who is genuinely deficient and cannot absorb nutrients by mouth; in a healthy person with a normal diet the evidence is very thin. Peptides sold for recovery or fat loss are mostly not approved for those uses in Canada.

So: is this approved by Health Canada for what you are offering it to me for? If the answer is anything other than a straight yes, you are paying for something that has not been through the process.

7. Does anyone understand how you train?

If you train seriously it changes how your results should be read. Creatine kinase is high after heavy lifting and means little on its own. A medication decision in a heavy block is different from the same one in a rest week.

A generalist service is not wrong. It is just not built for that.

8. Where does your data live?

Ask who holds it, whether it sits under provincial health privacy law, and where it is processed. Ask what happens if you cancel.

Ask whether a coach can see any of it, what exactly, and whether that is something you switch on rather than something that happens by default.

9. What do you say when the answer is no?

This is the one that tells you most. A service that has never turned anyone away is either extraordinarily lucky or is not really assessing anyone.

Ask what proportion of people they decline, and what happens to those people. And be wary of testimonials as an answer — you are hearing from the people who were happy, not from everyone who tried it. Ontario physicians are not permitted to use patient testimonials in advertising, which is worth knowing when you see them.

Our answers

Yes, we can prescribe. Care is delivered by physicians registered with the College of Physicians and Surgeons of Ontario. Every prescription is reviewed by a Sports Pharmacist before it is dispensed.

Our panels are chosen with you, test by test, against what a result would change. We do not sell supplements, and we take no commission on medication or laboratory testing.

We do not offer stem cell or regenerative treatments, IV vitamin therapy, or biological age testing, and we do not prescribe or supply peptides. We do not use testimonials.

Your record is held by Trean Clinical Services under Ontario health privacy law. Nothing reaches a trainer unless you expressly consent, and you can withdraw that at any time.

Where we do test, we have tried to be honest about the limits. Our VO2 equipment measures oxygen only, so it cannot tell you anything about fuel use. Body composition figures are estimates, and the trend matters more than the number. Wearable data carries its source and its reliability alongside it.

And we say no. If a programme is not appropriate for you, or you would be better served by your family doctor or a specialist, your clinician will tell you. We would rather lose a sale than prescribe something that is not right.

The scale tells you something moved. It has no idea what. Drop twelve pounds, four of them muscle, and it will happily call that a win.

So measuring body composition is worth doing. The question is really how much to trust the number you get back.

There’s no perfect method outside a lab

Every method available to you is an estimate. They differ in how good the estimate is, and in what assumptions they make when they can’t measure something directly.

The reference standard in research is a four-compartment model, which combines several measurements to separate fat, water, protein and mineral. It’s slow, expensive and not something a gym or clinic offers. It exists to judge everything else against.

Everything you can actually book is measured against that.

DEXA

A DEXA scan passes two low-dose X-ray energies through you and separates tissue into fat, lean soft tissue and bone. It takes about ten minutes and you lie still.

It’s the most useful thing most people can access. It gives regional detail, so you can see where fat and lean mass sit, and repeated on the same machine it tracks change well.

What it isn’t is a gold standard. DEXA is a three-compartment method and it makes its own assumptions, particularly about the water content of lean tissue. It’s a very good practical reference, not truth.

Two limits matter in practice. Machines aren’t interchangeable. Different manufacturers, and even different software versions, produce different numbers on the same person. A DEXA from one clinic can’t be compared to a DEXA from another. And hydration and recent food shift the result, which is why the scan conditions matter as much as the scan.

Bioimpedance

Bioimpedance passes a small current through you and measures resistance. Fat and lean tissue conduct differently, so resistance carries information about body composition.

But resistance isn’t body fat. To get from one to the other the device applies a prediction equation, and that equation rests on an assumption: that lean tissue is a fixed proportion of water, conventionally about 73%.

That assumption is where the error comes from. Hydration status, a recent meal, a hard training session, alcohol, where you’re in your menstrual cycle, even skin temperature all move the number without anything about your body actually changing.

What the evidence shows

A 2026 systematic review in the Journal of Functional Morphology and Kinesiology compared bioimpedance devices against the four-compartment model across twelve studies in healthy adults.

The average error looked small: mean bias for body fat percentage ranged from about −3.5% to +4.4%. But the spread around that average was the finding. Limits of agreement typically spanned 15 to 20 percentage points.

In plain terms: across a group the errors cancel out and the average looks fine. For one person, on one day, the number can be a long way off.

Not all devices are equal. Eight-electrode machines, the kind you stand on while holding handles, agree with DEXA better than four-electrode ones, and both agree better than a bathroom scale that only contacts your feet. In one comparison of consumer and clinical devices, agreement with DEXA ranged from unacceptable for a consumer scale to moderate for clinical-grade units.

The distinction that actually matters

Here’s the bit almost nobody explains, and it clears up most of the confusion.

Precision and accuracy are different things. Precision is whether you get the same answer twice. Accuracy is whether the answer is right.

Bioimpedance devices are precise. Measured twice in a session they typically agree within 2%. That’s genuinely good. But precise isn’t accurate, and the same review that found excellent repeatability found poor agreement with the reference method.

A device can be reliably wrong. If it reads three points high on you, it will keep reading three points high — which is useless for knowing your actual body fat, and extremely useful for tracking whether it’s moving.

So how should you use it?

Treat the absolute number with suspicion. If a scan says 22% and you expected 18%, the honest answer is that either figure could be closer to the truth.

Treat the trend as the real measurement. Same device, same machine, same conditions, repeated over months. That’s where the information is.

Standardise the conditions or you’re measuring noise. Same time of day, similar hydration, no training in the hours before, no large meal beforehand, and for women, ideally the same point in the cycle. A scan that ignores these isn’t comparable to the one before it.

Never compare across devices. A DEXA against a gym bioimpedance reading, or one clinic’s machine against another’s, isn’t a comparison. It’s two different estimates with different assumptions.

What we do

We use body composition the way the evidence supports: as a repeated measure on one device, read alongside everything else, rather than as a number that stands on its own.

It matters most during weight loss, where the question isn’t how much weight came off but what kind. Scale weight falling while lean mass holds is a good outcome. Scale weight falling while lean mass falls with it’s a signal to change something — protein, training, the pace of loss, sometimes the treatment.

That’s also why grip strength sits alongside it. Two imperfect measures pointing the same way is more convincing than either alone.

And your record marks where each figure came from, so a gym bioimpedance reading and a DEXA are never averaged together or treated as the same kind of evidence.

If you wear a ring or a watch, you’re already collecting more data about yourself than most clinics will ever ask you for. So what’s it actually worth, and what should a clinician do with it?

Here’s our honest answer.

They aren’t medical devices

Consumer wearables are consumer electronics. Health Canada hasn’t licensed them as medical devices, and the manufacturers are careful to say so in their own terms.

That’s not a scandal. It reflects a real difference: a medical device has to prove it measures what it claims to measure, to a standard, before it can be sold for that purpose. A consumer wearable does not.

So nothing your ring or watch reports is a diagnosis, and no number from you should be treated as a clinical result. Where a figure matters clinically, it needs measuring properly.

Some of it’s good. Some of it’s not.

The quality varies enormously depending on what’s being measured, and lumping it all together as "wearable data" hides that.

Heart rate at rest is generally reliable. Optical sensors do this well when you’re still, and resting heart rate tracked over weeks is genuinely useful.

Heart rate variability is measured reasonably well but interpreted badly. The number moves with sleep, alcohol, illness, stress and measurement position. A single reading tells you very little. A trend over weeks tells you something.

Steps and workout duration are fine. They are counting, not inferring.

Sleep duration is reasonable. Sleep staging is not. Deciding whether you were in deep or REM sleep from wrist movement and pulse is an inference, and it agrees poorly with the laboratory method that actually measures it.

Blood oxygen from a wrist or finger sensor isn’t comparable to a medical pulse oximeter, and consumer devices aren’t validated for the clinical uses people assume.

The scores are the weakest part

Most devices wrap all of this into a single daily score: readiness, recovery, body battery, whatever the brand calls it.

Those scores are proprietary. The formula isn’t published, it changes between software versions, and it can’t be reconstructed or checked by anyone outside the company. Two devices on the same person on the same morning will disagree.

They can be useful to you personally, as a rough prompt to back off or push on. They aren’t something a clinician can reason from, because nobody outside the manufacturer knows what went into them.

What we take, and what we leave

With your consent, you share a small, specific set of measures into your clinical record: resting heart rate, heart-rate variability, sleep duration, steps and workout summaries.

We deliberately don’t take sleep staging, blood oxygen, or the proprietary readiness and recovery scores. Not because they are uninteresting, but because they are either not accurate enough to act on or not open enough to check. That exclusion is built into the system rather than left to judgement.

We also don’t take a VO2 max estimate from a watch. That number is a prediction from your heart rate response, not a measurement of the oxygen you used. If it matters, we measure it properly.

Every number carries its own label

This is the part that makes the rest work. In your record, every value carries two things alongside it: where it came from, and how well that instrument measures that quantity.

A sleep duration from a ring is genuinely measured, and simultaneously a limited estimate. Both facts travel with the number. So a clinician looking at your record can see at a glance which figures are solid and which are indicative, and is never invited to over-trust a consumer device.

A laboratory result and a wrist reading don’t sit in the same field, aren’t averaged together, and aren’t treated as interchangeable.

What it actually changes

Wearable data rarely decides anything on its own. What it does is give context that would otherwise be missing.

A resting heart rate that has been climbing for three weeks is worth knowing before a consultation. Sleep that collapsed when a dose changed is worth knowing. Training load that tripled the month before a blood test explains results that would otherwise look alarming.

None of that’s a diagnosis. All of it makes the conversation better than one built on what you can remember.

What it won’t do

Nothing is automated. No score triggers a message, no threshold sends you a recommendation, and no algorithm decides anything about your care. A clinician reads it, in context, and makes the call.

Your trainer doesn’t get it by default. Sharing with a coach happens only if you consent, covers only what helps them adapt your training, and can be withdrawn.

We don’t use it to market to you. Data you share for care is used for care.

And sharing anything is optional. No part of your care depends on it, and plenty of our patients share nothing at all.

Everyone asks the same two things: what should I expect, and how long will it take. The honest answer is that trials tell you what happened, on average, to people in a study. They can’t tell you what will happen to you.

Here’s what the published trials actually report, and what they do not.

What these trials studied

Two classes of medication have been tested at scale for weight management. One acts on a single hormone pathway (GLP-1). The other acts on two (GLP-1 and GIP). Both are given as weekly injections alongside diet and activity changes, and both are approved in Canada for chronic weight management.

All the figures below come from randomised controlled trials run by the manufacturers. They aren’t our results, not a promise, and not a prediction about you.

Why twelve weeks is early

Most trials run for 68 to 72 weeks. Twelve weeks sits inside the dose build-up phase for these medications, so it’s early to judge anything.

A post-hoc analysis of the SURMOUNT-1 trial of the dual GLP-1/GIP medication looked at where people were at twelve weeks. About 82% had lost at least 5% of their body weight by then. About 18% had not.

That second group matters. Of the people who had lost less than 5% at twelve weeks, 70% had reached at least 5% by week 24, and 90% had reached it by week 72.

What twenty-four weeks looks like

By around twenty-four weeks the dose build-up is generally complete, so the picture is clearer.

In a head-to-head trial comparing the two classes, 44% of people on the dual GLP-1/GIP medication had lost at least 15% of their body weight by week 24, against 21% on the GLP-1 medication.

A separate analysis found the point at which weight loss levels off tends to fall between about 24 and 36 weeks, later for people starting at a higher body weight.

Where the trials end up

For context, at 72 weeks in the largest trials the dual GLP-1/GIP medication produced average weight reductions of about 16% to 22.5% depending on dose, and the GLP-1 medication produced about 15% at 68 weeks. Placebo groups lost roughly 2 to 3%.

A head-to-head trial at 72 weeks found about 20% with the dual medication.

What these numbers don’t tell you

These are averages, and the spread is wide. Some people in these trials lost far more than the average. Some lost very little. An average isn’t a forecast for an individual.

Trial conditions aren’t real life. Participants were screened, supported closely, seen regularly and given structured diet and activity input alongside the medication. That support is part of the result.

These trials studied specific populations. Most enrolled adults with obesity, or overweight with a weight-related condition, and excluded people with diabetes. If you don’t resemble the people studied, the numbers apply less well.

Weight came back when treatment stopped. In an extension of one trial, participants regained about two thirds of the weight they had lost within a year of stopping, and the improvements in other markers drifted back toward where they started.

And not everyone tolerates these medications. Gastrointestinal side effects were common, and some people stopped because of them.

Why we offer twelve and twenty-four weeks

The twelve-week course is a reasonable starting point, and enough to see whether you tolerate treatment and whether the wider plan is working.

The twenty-four week course exists because the trials suggest twelve weeks is often too early to judge, and because a slow start doesn’t appear to predict a poor finish.

Neither length is a course of medication. They’re courses of care: assessment, monitoring, bloodwork, body composition and adjustment. Whether medication is part of that’s a clinical decision made with you, and for some people the answer is no.

Almost every number reported as a VO2 max isn’t one. That sounds like nitpicking, but it leads to the useful part.

The two terms, plainly

VO2 max is the highest rate at which your body can take in and use oxygen. You know you’ve reached it because the oxygen you use stops climbing even as the work keeps getting harder. The graph flattens. That flattening is called a plateau, and it is the proof.

VO2 peak is the highest value recorded during a test where that flattening never happened. It’s the most you managed on the day, not a demonstrated ceiling.

It is the same test either way, and the same effort from you. The only thing that separates the two words is whether the plateau appeared.

Why most people get a peak

Reaching a true max means pushing until oxygen delivery is the thing that stops you. Usually something else stops you first: your legs give out, your breathing feels unbearable, or you’ve simply had enough.

That has nothing to do with how hard you tried. It simply means the limit you ran into wasn’t the one the test was looking for.

So unless someone tells you a plateau was reached, the honest word for your number is peak.

None of this makes the number less useful. The big studies linking fitness to living longer were run on exactly this kind of test, so what they really measured was peak. Calling it by the right name costs you nothing.

The number everyone talks about matters least

Your peak barely moves. A good deal of it you inherited, shifting it takes months, and knowing the number tells you nothing about what to do on Tuesday.

The part of the test that does tell you what to do is everything else it measures.

Where your easy pace really sits

As the work gets harder, your breathing changes twice. The first change marks roughly where easy stops being easy. The second sits near the point where things fall apart.

Those two points are where your training zones actually are, measured on you rather than guessed from a formula.

The usual alternative is subtracting your age from 220. That’s an average, and plenty of people sit twenty beats either side of it. Get it wrong and you can spend months on easy days that aren’t easy, wondering why you’re tired and not improving.

Why two people with the same number can be very different

Put two people on the same machine at the same pace and one of them will be using less oxygen than the other. That is efficiency, and it decides whether an effort feels steady or feels like a fight.

It improves faster than your peak does. If your peak has sat still for six months and you’re still getting quicker, this is usually why.

About zone 2

The part that holds up is straightforward: most of the gain comes from doing plenty of easy work you can recover from, and going easier lets you do more of it.

The part that gets overstated is the claim that this one intensity does something for your mitochondria that harder training cannot. Harder training does it too. Easy work just happens to be easier to repeat week after week.

The practical problem is that most people have no idea where their zone 2 actually sits. If the number came from a formula, there is a good chance you are training above it, and that is the usual reason easy days quietly stop being easy.

One thing we can’t tell you

You’ll read that this kind of test shows whether you’re burning fat or carbs. That’s real, and it’s useful, and our equipment can’t do it.

Working that out means measuring the carbon dioxide you breathe out, not just the oxygen you take in. Our analyser measures oxygen only. Without the carbon dioxide reading there is no way to work out the ratio, so there is no answer to give you.

It also means the resting metabolic rate we give you assumes a fuel mix rather than measuring one. Fine for watching your own trend, but worth knowing.

If fuel use is what you’re after, you need a machine with a CO2 sensor. We’d rather say so than sell you a test that can’t answer your question.

What you get

You get your peak, described as a peak rather than dressed up as a max. You get the two points where your breathing changes, so your training zones come from your own physiology instead of a formula. You get your oxygen cost at a given pace, so efficiency can be tracked over time. And you get the same test on the same machine each visit, which is what turns a set of numbers into a trend.

Your clinician reads it next to your bloodwork and your training. With your consent, the parts your coach needs go to your coach.

What it’s like

A mask over your face, work that gets harder until you stop. Hard near the end, and about ten to fifteen minutes of real effort.

Because it’s maximal, we screen you first. Chest symptoms and uncontrolled blood pressure need looking at before you go anywhere near it.

Peptides are confusing, and a lot of that is because one word is being asked to cover two completely different things.

Two things, one word

A peptide is just a short chain of amino acids. That’s chemistry, not a category of treatment. Plenty of ordinary medicines are peptides.

Approved peptide medicines have been through the full process. Trials were run, data was submitted, Health Canada authorised them for a specific use. They have known doses, known side effects, and a manufacturer who is accountable.

Unapproved peptides are what people usually mean in a gym. Compounds sold for recovery, growth or longevity. None is authorised by Health Canada for human use. Most have never completed a review at all.

What compounding is, and is not

Compounding is a normal part of pharmacy. A pharmacist prepares a medicine for one patient for a real reason: a child who needs a liquid, someone allergic to a dye, a strength nobody makes.

It isn’t a way around approval. Preparing something doesn’t create the evidence approval would’ve required. When a clinic calls an unapproved substance "compounded", that word is doing a lot of reassuring it hasn’t earned.

The FDA decision, and what it means here

You may have read that the FDA banned peptides. Not quite.

In late 2023 the American regulator moved nineteen peptides into a category meaning they couldn’t be compounded, citing immune reactions, impurities and thin safety data. In April 2026 twelve came back out, largely because the nominations behind the review were withdrawn.

Removal isn’t approval. It returned them to a queue. And this is a United States process with no legal effect in Canada.

The safety questions were never answered. They were set aside.

What the evidence looks like

For most of these compounds: promising idea, animal data, very little in humans.

Studies tend to be in rodents at doses that don’t translate, or small trials without control groups, measured over weeks. Long-term safety data is largely absent. That matters most for compounds acting on growth and repair, because those are the same pathways involved in things you don’t want growing.

This isn’t the same as saying they do nothing. It’s saying nobody currently knows.

The grey market

Because they are unapproved, these compounds reach people through sellers operating outside the medicines system, often labelled "for research use only". That phrase exists to shift legal responsibility, not to describe the buyer.

Certificates of analysis are often not what they appear to be. They may be produced by the seller, relate to a different batch, be copied from another product, or simply be invented.

When you buy from this market you don’t know what’s in the vial, how much, what else came with it, or how it was stored. However professional the packaging looks.

Why we don’t prescribe them

Trean doesn’t prescribe or supply peptides. Not as a programme, not on request.

Our rules require that anything we recommend can be traced to evidence supporting it. For these compounds that evidence doesn’t exist yet.

What we’ll do is monitor. A lot of people are using these already, sourced privately, with no bloodwork and no oversight. Refusing to engage doesn’t make that safer. It just makes it invisible.

So a clinician can agree which tests matter, track them on a schedule, read them alongside your training, and say plainly when something looks unsafe or looks like it’s doing nothing. The decision stays yours. It’s just made with information.

This position isn’t permanent

If good human evidence emerges for a specific compound in a specific use, our position on it should change, and it will. What won’t change is the standard: evidence in people showing a benefit worth the risk.