Gut Healing

This protocol is for ADJUNCTIVE gut-healing work alongside diet and clinical care. It is NOT first-line. If you have overt rectal bleeding, melena (black tarry stools), persistent severe abdominal pain, unexplained weight loss, fever, iron-deficiency anemia, or a family history of colorectal cancer, the answer is a gastroenterologist and a workup — not peptides. Peptides should never be used to mask symptoms that warranted a scope.

The protocol assumes you have already had appropriate workup for any alarm features, are managing diet (eliminating personal triggers — gluten, FODMAPs, alcohol, NSAIDs — to the extent applicable), and want to layer mucosal-repair and anti-inflammatory peptide support on top of that foundation. It is intended for adults with IBD-adjacent inflammatory presentations, post-antibiotic dysbiosis, NSAID-related GI inflammation, or chronic non-specific "irritable bowel" patterns that have already had the workup.

It is NOT for active GI bleeding, active oncology, pregnancy, breastfeeding, or any user under 18.

Phases

1. Phase 1 — Mucosal-repair foundation (BPC-157)

   weeks 1-8

   BPC-157 250mcg SubQ once daily — the most-cited peptide for GI mucosal healing in the community, anchored on consistent rodent colitis models and one small uncontrolled human case series reporting symptom improvements at ~2 weeks. Continue alongside diet work and any prescribed GI medication; this is layered support, not a replacement. Phase 1 alone for the first 4-8 weeks before deciding whether to escalate.

   • BPC-157250 mcg · once daily · morning

     250mcg SubQ once daily. Middle of the community-experience dose range (250-500mcg). The SubQ route is what the rodent colitis evidence used; oral BPC has bioavailability questions for systemic effect (the oral pathway may still help locally for upper-GI presentations, but SubQ is the better-supported route).

   What “working” looks like

   Reduced bloating, reduced post-prandial discomfort, improved stool consistency over 3-6 weeks. Most users notice changes by week 3-4; some take the full 8 weeks. The signal is gradual symptom reduction layered with diet work — if you change diet AND start BPC simultaneously, you won't know which is doing the work. The cleaner read is to stabilize diet for 2-4 weeks first, then add BPC.

   Decision criteria

   After 8 weeks of Phase 1: if you have meaningful symptom improvement, hold or step down (BPC long-term continuous use beyond ~30 days has no human safety data — community practice is to cycle 4-8 weeks on, 4-8 weeks off). If only partial improvement and your presentation is IBD-adjacent or inflammatory-skin-comorbid, consider Phase 2. If no improvement: discontinue and revisit the workup — this protocol isn't the right tool for your presentation.

   Labs to pull

   • CBC + ferritin (baseline — anemia from chronic GI inflammation is common)
   • hs-CRP (systemic inflammation baseline)
   • Fecal calprotectin (gold standard for differentiating IBD from IBS; do this BEFORE the protocol so you have a baseline)

2. Phase 2 — Anti-inflammatory layer (+KPV)

   weeks 4-12

   OPTIONAL. Add KPV 500mcg SubQ daily for users with IBD-adjacent inflammation, inflammatory-skin comorbidity (eczema, rosacea presenting alongside gut issues), or persistent mucosal-inflammatory signals at the end of Phase 1. Continue BPC-157 Phase 1 dose throughout. KPV is the C-terminal tripeptide of α-MSH; the mechanism is real (anti-inflammatory at NF-κB and elsewhere), the human-outcome evidence is thin (small UC case series, dermatologic anecdote).

   • BPC-157250 mcg · once daily · morning

     Continue Phase 1 dose throughout Phase 2.

   • KPV500 mcg · once daily · evening

     500mcg SubQ daily. Anti-inflammatory tripeptide with mucosal + dermatologic signal in small clinical reports. Co-administer with BPC (different injection sites is fine; same site is fine).

   What “working” looks like

   Reduced calprotectin on follow-up testing if you had a baseline elevation. Reduced inflammatory-skin comorbidity (eczema flares, rosacea) running alongside the gut work. Less urgency / less symptom unpredictability during the day. Phase 2 effects often take an additional 4-6 weeks beyond Phase 1.

   Decision criteria

   After 8-12 weeks of Phase 1+2 combined: if calprotectin trends down and symptoms improved, this is your working dose — taper to a cycling pattern (4-8 weeks on, 4-8 weeks off). If symptoms improved but calprotectin didn't move, the improvement might be diet-related; consider stopping the peptides for 4 weeks to see what holds. If neither symptoms nor calprotectin improved across the full Phase 1+2 cycle: discontinue and revisit specialist care.

   Labs to pull

   • Fecal calprotectin at week 12 (trend matters more than single values)
   • hs-CRP at week 12 (if Phase 1 baseline was elevated)

3. Phase 3 — Tight-junction layer (+Larazotide, optional)

   weeks 8+, layered on Phase 1 or Phase 1+2

   OPTIONAL AND TIER-DOWNGRADED. Larazotide 500mcg orally three times daily before meals. The strongest evidence for this peptide is residual symptoms in celiac patients on a strict gluten-free diet — that is the indication the Phase 2b trial (n=342) supported and the Phase 3 (CeDLara) failed to confirm in 2022. Use outside that diagnosed-celiac context is off-label with weak evidence. Functional-medicine "leaky gut" framing extends far past what the trial program supported. Phase 3 is for users whose Phase 1+2 plateau hasn't fully resolved symptoms AND who have a specific reason to target tight-junction permeability (diagnosed celiac with residual symptoms; non-celiac gluten sensitivity with confirmed dietary triggers).

   • BPC-157250 mcg · once daily · morning

     Continue Phase 1 dose.

   • KPV500 mcg · once daily · evening

     Continue Phase 2 dose (if you escalated to Phase 2).

   • Larazotide500 mcg · three times daily · 15 minutes before meals (oral)

     500mcg oral capsule 15 minutes before each main meal — the Phase 2b dosing pattern. Higher doses (1mg, 2mg) in Phase 2b performed WORSE than 0.5mg, suggesting an inverted U dose-response; do not assume more is better.

   What “working” looks like

   If you have diagnosed celiac with residual symptoms despite a strict gluten-free diet, this is the indication the trials targeted — Phase 2b reported improved symptom scores. If you do not have a celiac diagnosis, the honest answer is the trials did not support the use case you're applying it to, and any improvement could be the BPC + KPV + diet stack doing the work.

   Decision criteria

   Phase 3 is a 6-8 week trial. If you have celiac and symptoms improve, this is your indication. If you do not have celiac and ran Phase 3 anyway, discontinue after 8 weeks regardless of outcome — the evidence base for continued use is too thin, and the cost (oral capsules taken 3x daily before meals) is not justified by the trial data outside the celiac indication.

Often combined with

• Recovery from Injury

  BPC-157 is in both protocols. If running both, do NOT double-dose — pick the higher dose (Recovery uses 500mcg twice daily for active injury; Gut Healing uses 250mcg once daily) and treat that as primary. Most users running both have active injury + GI inflammation simultaneously; the Recovery dosing is sufficient for both indications.

• Immune Resilience

  KPV is in both protocols (Immune Phase 2 + Gut Healing Phase 2). If running both, do NOT double-dose — single 500mcg/day dose covers both surfaces. The immune-resilience + gut-healing co-presentation is common; user often has chronic inflammatory load with both gut + systemic signals.