What to Expect During Your First Peptide Therapy Session in Ann Arbor

What Are Therapeutic Peptides?

Peptides are short chains of amino acids - the same building blocks that make up proteins in your body. Unlike pharmaceutical drugs that often override biological pathways, therapeutic peptides work by signaling your body's own repair, regeneration, and regulatory mechanisms. Think of them as targeted molecular messengers.

According to a 2026 comprehensive review in Frontiers in Aging, nine therapeutic peptides spanning diverse aging interventions including metabolic restoration, tissue repair (BPC-157), neuroprotection, growth hormone modulation, and sexual function were identified. The authors noted that "therapeutic peptides offer mechanistically diverse approaches to multiple aging hallmarks" (Mavrych et al., 2026).

At Arbour Longevity, we offer a comprehensive peptide menu including BPC-157, Thymosin Alpha-1, NAD+, and MOTS-c - each selected for specific clinical applications in longevity, recovery, immune support, and metabolic health.

Before Your First Visit: Preparation

Your peptide therapy journey actually begins before you walk through the door. Here's how to prepare:

• Complete your intake forms: You'll receive a comprehensive health questionnaire covering your medical history, current medications, supplements, allergies, and health goals. Be thorough - this information directly shapes your peptide protocol.
• Get baseline labs (if not already done): Depending on your goals, we may order bloodwork including a complete metabolic panel, hormone levels, inflammatory markers, and other relevant biomarkers. If you've had recent lab work, bring those results.
• Write down your goals: Whether it's faster recovery from workouts, better sleep, gut healing, immune support, or improved energy and cognitive function, knowing your priorities helps your provider design the right protocol.
• Eat normally: Unless instructed otherwise for specific lab work, eat and hydrate as you normally would before your appointment.

Step 1: The Consultation (30–45 minutes)

Your first visit begins with a one-on-one consultation with Gandhi Bhattarai, FNP-BC, PMHNP-BC. This is not a quick in-and-out appointment - it's a thorough clinical evaluation that typically covers:

• Health history review: Your provider will review your intake forms, discuss your medical history, and identify any contraindications or interactions with current medications.
• Goal assessment: What are you hoping to achieve? Tissue repair? Immune support? Anti-aging? Metabolic optimization? Different peptides target different pathways, so your goals determine your protocol.
• Lab review: If baseline labs have been completed, your provider will walk through the results, explaining what each marker means and how it informs your treatment plan.
• Treatment plan presentation: Based on your goals, health status, and lab results, your provider will recommend specific peptides, dosing schedules, and administration methods.

What makes Arbour's approach unique is Gandhi Bhattarai's combination of board certifications across family practice, psychiatric mental health, and anti-aging and functional medicine. As both a Family Nurse Practitioner (FNP-BC) and Psychiatric-Mental Health Nurse Practitioner (PMHNP-BC), she evaluates both the physical and mental health dimensions of your concerns - fatigue, brain fog, mood changes, and sleep disruption are not just "stress." They often have measurable biological drivers that peptide therapy can address.

Step 2: Peptide Selection - Matching Peptides to Your Goals

Here's an overview of the key peptides available at Arbour Longevity and what each targets:

• BPC-157 (Body Protection Compound): Supports gut healing, tendon and ligament repair, and reduces inflammation. Ideal for patients with gut issues, joint pain, or recovering from injury.
• Thymosin Alpha-1: An immune-modulating peptide approved in 35+ countries. Supports immune system regulation and may benefit patients with chronic infections, autoimmune conditions, or those seeking enhanced immune resilience.
• NAD+ (Nicotinamide Adenine Dinucleotide): A coenzyme critical for cellular energy production, DNA repair, and mitochondrial function. Declines significantly with age. Delivered via IV infusion or subcutaneous injection.
• MOTS-c (Mitochondrial Open Reading Frame of the Twelve S rRNA): A mitochondria-derived peptide with exercise-mimetic effects. Supports metabolic flexibility, insulin sensitivity, and fat metabolism.

A 2026 review in Integrative Medicine examined peptide therapies including Thymosin Alpha-1 and BPC-157, noting their effects on immune signaling, inflammatory regulation, tissue repair, and cellular stress responses. The authors emphasized that "substantial evidence gaps persist, and well-designed clinical trials are needed to clarify safety, efficacy, and appropriate clinical roles" (Mazza, 2026).

Your provider will be transparent about the evidence level for each peptide - some have robust clinical data, while others are supported primarily by preclinical research and emerging clinical reports. Informed consent and realistic expectation-setting are non-negotiable at Arbour Longevity.

Step 3: Administration - What the Treatment Actually Feels Like

Subcutaneous Injection (Most Common)

Most peptides (BPC-157, Thymosin Alpha-1, MOTS-c) are administered via small subcutaneous injections - typically in the abdominal area or thigh. If this sounds intimidating, here's the reality: the needles are tiny (insulin-gauge, 30–31G), and most patients describe the sensation as a brief pinch lasting one to two seconds. During your first visit, your provider will:

• Demonstrate the proper injection technique
• Supervise your first self-injection (if prescribing at-home protocols)
• Provide written instructions and video resources for at-home use

IV Infusion (NAD+)

NAD+ is typically delivered via IV drip, which takes approximately 60–120 minutes depending on dose. During the infusion, you can read, work on your phone, or simply rest. Some patients experience mild flushing, chest tightness, or nausea during the infusion - these sensations are temporary and managed by adjusting the drip rate. Many patients report feeling increased mental clarity and energy within hours of their first NAD+ infusion.

Step 4: After Your First Session

Here's what to expect in the days and weeks following your first treatment:

• Days 1–3: You may notice subtle changes in energy, sleep quality, or mood. Injection sites may show minor redness or bruising that resolves quickly.
• Weeks 1–2: Patients on BPC-157 for gut or joint issues often report early improvements. NAD+ patients frequently notice enhanced mental clarity and reduced fatigue.
• Weeks 4–8: This is when the more substantial benefits typically emerge - improved recovery, better sleep architecture, enhanced immune function, and measurable changes in relevant biomarkers.
• Ongoing: Peptide therapy is not typically a one-time treatment. Most protocols involve cycles (e.g., 4–12 weeks on, followed by an assessment period) with adjustments based on your response and follow-up lab work.

What Peptide Therapy Costs at Arbour Longevity

Peptide therapy pricing depends on the specific peptides prescribed, dosing, and treatment duration. At Arbour Longevity, your initial consultation covers the full clinical evaluation and treatment plan design. Peptide medication costs are transparent and discussed upfront before any treatment begins. We believe patients deserve to know exactly what they're investing in.

Frequently Asked Questions

Are peptides FDA-approved?

Some peptides (like bremelanotide/PT-141) are FDA-approved for specific indications. Others (BPC-157, Thymosin Alpha-1) are used clinically under a provider's medical judgment and are obtained from regulated compounding pharmacies. Your provider will explain the regulatory status of each peptide in your protocol.

Can I do peptide therapy alongside other treatments?

Yes. Peptide therapy integrates well with hormone replacement therapy, medical weight loss, and aesthetic treatments. In fact, combining modalities is a cornerstone of the longevity medicine approach.

How long do I need to continue peptide therapy?

It depends on your goals. Some patients use peptides in targeted cycles for specific concerns (e.g., 8–12 weeks of BPC-157 for gut healing), while others incorporate peptides like NAD+ into an ongoing longevity protocol. Your provider will design a timeline that matches your objectives.

Is peptide therapy covered by insurance?

Peptide therapy is generally not covered by health insurance. However, the investment is often comparable to or less than many common monthly wellness expenses, and the clinical benefits for the right patient can be substantial.

Who is NOT a good candidate for peptide therapy?

Peptide therapy may not be appropriate for pregnant or breastfeeding women, patients with active cancer, or those with certain autoimmune conditions (depending on the specific peptide). A thorough health history review during your consultation will identify any contraindications.

Start your peptide therapy journey. Book a consultation at Arbour Longevity in Ann Arbor to explore which peptides are right for your health goals. Gandhi Bhattarai, FNP-BC, PMHNP-BC will design a personalized, evidence-informed protocol tailored to your unique biology.