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Athletes · TUEs

Therapeutic use exemptions: when a prohibited peptide can be allowed

Some prohibited peptides are real medicines: the GnRH drugs, hCG, tesamorelin. An athlete who needs one for a diagnosed condition can apply for a therapeutic use exemption. This page sets out the rules in WADA's 2027 standard, and why a research peptide bought online is a different matter.

Last updated November 3, 2026 · Reviewed by Grey Peptides Editorial Board · ✓ Every claim sourced · No products sold, no seller named

📋 Key takeaways

Four conditions, all required: a diagnosed condition, an indicated treatment with no reasonable permitted alternative, no enhancement beyond a return to normal health, and a need not caused by earlier prohibited use.1

Apply first. The standard requires a TUE before using or possessing the substance, unless one of the retroactive exceptions applies.1

Research peptides rarely qualify. USADA has said a TUE for BPC-157 is unlikely because permitted alternatives exist.2

On this page

  1. The four conditions
  2. When to apply: in advance, or afterwards
  3. Which peptides could qualify
  4. In practice
  5. Frequently asked questions
  6. Related on Grey Peptides
  7. Sources

The four conditions

Under Article 4.2 of the 2027 standard, an athlete may be granted a TUE only if they show, on the balance of probabilities, that each of these is met:1

  1. The athlete has a diagnosed medical condition supported by relevant clinical evidence.
  2. The prohibited substance is an indicated treatment for that condition, and there is no reasonable permitted therapeutic alternative. The standard's commentary says it may not always be necessary to try and fail the alternatives first.
  3. The therapeutic use will not produce any additional enhancement of performance beyond what might be expected from a return to the athlete's normal state of health.
  4. The need for the substance is not a consequence, wholly or in part, of earlier use of a prohibited substance without a TUE.

The commentary adds that granting a TUE rests solely on these conditions: it does not consider whether the substance is the most clinically appropriate or safe, or whether its use is legal in all jurisdictions.1

When to apply: in advance, or afterwards

An athlete who needs a prohibited substance for therapeutic reasons must apply for and obtain a TUE before using or possessing it, unless entitled to apply retroactively.1 The 2027 standard allows a retroactive application, still judged against the four conditions, if, for example, emergency or urgent treatment was needed; there was not enough time or opportunity to apply before the sample; the athlete's national anti-doping organisation did not require an advance application for their level; or the athlete was tested without being an international- or national-level athlete.1 Meeting an exception only allows the application to be considered; it does not mean the TUE will be granted.1

The 2027 Prohibited List itself refers athletes to the TUE route for prohibited substances that are medically needed.3

Which peptides could qualify

The peptides most likely to meet condition 2 are approved medicines with a recognised indication: for example the GnRH drugs such as leuprolide, hCG in fertility treatment, or tesamorelin for its labelled use (our reasoning: an approved indication is the clearest evidence of an "indicated treatment"). Their List status is on the WADA status page. Approved GLP-1 drugs such as semaglutide do not need a TUE if, as that page shows from our records, the List does not prohibit them.

Research peptides are the hard case. BPC-157 has no approved indication anywhere, and the US Anti-Doping Agency has said a TUE for it is unlikely because there are permitted alternatives, while noting that applications are considered case by case.2 The same reasoning applies to other unapproved peptides (our reasoning, from condition 2).

In practice

  • Ask your anti-doping organisation where and how to apply before you start a prohibited treatment, since the standard expects the TUE first.1
  • Keep the medical file. The standard's commentary advises athletes who may need a retroactive TUE to have their medical file ready to show the four conditions are met.1
  • A prescription is not a TUE. A doctor's prescription shows a treatment was prescribed; only a TUE granted under the standard permits a prohibited substance in sport (our reading of Article 4.1).

Frequently asked questions

Can I get a TUE for BPC-157?

The US Anti-Doping Agency has said it is unlikely, because permitted alternatives exist, though each application is considered case by case.

Does a TUE cover a substance that is illegal in my country?

The standard's commentary says granting a TUE does not consider whether the substance's use is legal in all jurisdictions. A TUE is an anti-doping decision, not a legal permission.

Athletes, peptides and testing hub WADA status by compound The 2027 Prohibited List How testing finds peptides Contaminated supplements and products WADA Prohibited List hub Do peptides show up on drug tests? Our report on the 2027 List TB-500 is not thymosin beta-4 The grey market

Sources

WADA documents are cited with the date we read them; USADA's page with its modification date.

  1. World Anti-Doping Agency. International Standard for Therapeutic Use Exemptions (ISTUE) 2027, approved by the WADA Executive Committee on December 5, 2025, effective January 1, 2027, Articles 4.1 to 4.3 and commentary; read November 3, 2026 in the 2023-to-2027 comparison published by the Japan Anti-Doping Agency. Source
  2. US Anti-Doping Agency. BPC-157: what athletes should know about the prohibited experimental peptide (page modified August 10, 2026): a TUE is 'unlikely ... because there are permitted alternatives available', considered case by case; read October 27, 2026. Source
  3. World Anti-Doping Agency. Prohibited List 2027, in force January 1, 2027; read September 27, 2026. Each compound's status is our record of that List, kept in the dataset. WADA · Dataset

This section reports the WADA Prohibited List, the anti-doping standards and published research, and our reading of them. It is not legal advice or an anti-doping ruling: an athlete's own anti-doping organisation gives the answer that counts. Grey Peptides sells nothing, links to no seller and rates none.