What we don't currently prescribe — and what we use instead

A “full peptide menu” is a phrase used by enough telehealth clinics that it deserves a clarification: nobody actually carries everything. Catalogs are determined by pharmacy capability, regulatory posture, and clinical judgment — and the honest answer for most thoughtful practices is that the catalog is wide but not unlimited. This page is the small list of compounds patients ask about that Vektor does not currently prescribe, why, and what we do offer that addresses the same therapeutic goal.

The list is short, and it is not closed. Pharmacy partners publish new formulations, FDA posture on individual peptides shifts, and our internal review of efficacy and quality control evolves. When something on this page moves into our active menu, we update the post — and the treatments catalog and pricing page.

Thymosin Alpha-1

Thymosin Alpha-1 is an immune-modulating peptide with a long clinical history outside the United States — it's approved for hepatitis B treatment in roughly thirty countries, and used off-label by U.S. clinicians for immune resilience in patients dealing with chronic stress, frequent illness, or post-viral recovery (long COVID, post-EBV fatigue). The mechanism is interesting: it appears to recalibrate the T-cell response rather than crank it up, which is what dysregulated immune systems actually benefit from.

Why we don't currently carry it: Thymosin Alpha-1 isn't on our current 503A pharmacy partner's compounding catalog, and its FDA category status in the U.S. remains unsettled. We're unwilling to route patients to compounding sources we haven't directly verified for an unsettled compound.

What we offer instead: For immune resilience and post-viral recovery, we lean on the fundamentals first — sleep architecture, cortisol regulation via hormone optimization, and metabolic health. On the peptide side we carry NAD+ (mitochondrial energy and DNA repair, central to immune cell function) and glutathione (the body's master antioxidant, supports Phase II detoxification). Both address upstream drivers of immune dysregulation rather than only the symptom.

Gonadorelin

Gonadorelin is a synthetic GnRH analog. Exogenous testosterone suppresses the body's LH and FSH signaling, which suppresses testicular function and fertility. Gonadorelin replaces the missing GnRH pulse at the hypothalamic level, restoring the downstream signal so the testes keep working through a TRT protocol. It's a relatively new addition to the fertility-on-TRT toolkit.

Why we don't currently carry it: Our pharmacy partner does not list compounded gonadorelin. The therapeutic need is real, but the substitute we do carry covers the same clinical territory with longer history and more consistent supply.

What we offer instead: HCG (human chorionic gonadotropin) — the classic fertility-preservation adjunct on TRT. HCG mimics LH signaling directly at the testes rather than the hypothalamus, with decades of clinical use behind it. Most patients dose it two to three times weekly alongside their primary protocol, slightly less frequent than gonadorelin's daily-or-EOD cadence. Clinical outcomes for fertility preservation are comparable. HCG is on our menu — see the men's hormone optimization page.

Methylene blue

Methylene blue is one of the oldest synthetic pharmaceuticals still in use — it has FDA indications for methemoglobinemia (an emergency-medicine context) and is being studied at lower doses for cognitive enhancement and mitochondrial support. The mechanism of interest is its role as an electron carrier in the mitochondrial respiratory chain, with secondary effects on monoamine oxidase activity. The longevity and biohacker communities have driven significant demand for it as a daily cognitive supplement.

Why we don't currently carry it: Two reasons. First, our compounding pharmacy partner doesn't carry it in the formulations patients ask for. Second, methylene blue quality control is more variable than most patients realize — pharmaceutical grade and industrial grade look identical to the eye, and we don't want to be in the position of routing patients to sources we haven't directly verified for a compound where contamination has real downside.

What we offer instead: For cognitive support and mitochondrial energy we have NAD+ (injectable and nasal) — central to cellular energy production and DNA repair, with a larger evidence base for sustained cognitive support than methylene blue. Paired with sleep optimization and hormone work (low testosterone or low thyroid are both surprisingly common drivers of “brain fog”), most patients see the subjective improvement they came in looking for.

Vardenafil

Vardenafil is the third PDE5 inhibitor in the sildenafil (Viagra) and tadalafil (Cialis) family. Faster onset than sildenafil, higher receptor selectivity for PDE5, shorter duration than tadalafil. For a subset of patients — particularly those who can't tolerate tadalafil's off-target effects but want a faster onset than sildenafil delivers — it's genuinely useful.

Why we don't currently carry it: Our compounding pharmacy partner doesn't supply vardenafil. Industry-wide, vardenafil is the least-prescribed of the three — the volume gap with sildenafil and tadalafil is large enough that most compounding pharmacies don't carry it.

What we offer instead: Sildenafil (compounded and commercial; fast onset, four-to-six hour duration — the workhorse) and tadalafil (compounded and commercial; longer duration, often dosed daily rather than on-demand). For patients who've plateaued on either monotherapy, we have compounded combination protocols that pair PDE5 inhibitors with other on-demand agents.

Oral minoxidil

Minoxidil started life as an oral antihypertensive. At low doses (1.25–5 mg daily) it's been repurposed for androgenic alopecia with strong evidence — particularly for patients whose topical minoxidil response has plateaued. The systemic exposure is the trade-off: oral minoxidil can drive ankle edema, transient tachycardia, and unwanted body hair growth in some patients.

Why we don't currently carry it: Our pharmacy partner doesn't supply standalone oral minoxidil. The hair-restoration menu they do supply leans into combinations.

What we offer instead: The standard-of-care first-line option is finasteride (DHT-blocking, strongest evidence base for male androgenic alopecia), and our pharmacy partner supplies compounded finasteride/minoxidil topical formulations (combines both classic agents with reduced systemic exposure vs. oral minoxidil). For most patients the topical combination delivers most of what oral minoxidil offers without the cardiovascular signal. The combo is on our menu under hair restoration.

How this list changes

This is a living catalog. The decisions above reflect our 503A pharmacy partner's current compounding capability and our own clinical-quality bar. When either changes — and both do — we update the catalog and this article. A few specific paths to watch:

• Pharmacy network expansion. We're actively reviewing additional pharmacy partners with wider niche-peptide capabilities. If clinical-quality vetting clears, items from this list may move into active menu.
• FDA posture changes. Several compounds above are under FDA category review. Movement in either direction (clearer pathway, or restriction) shifts our internal call.
• Patient-driven demand signals. When founding members ask for something consistently and the underlying evidence is solid, we re-evaluate.

A practice that says it carries everything is either lying or hasn't looked carefully at its supply chain. We'd rather publish a short list of what we don't prescribe and explain why than catch a patient with a prescription we can't fulfill or a compound we don't actually trust the source of.