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WADA Prohibition The World Anti-Doping Agency classifies both peptides as prohibited substances for competitive athletes: Section S2 classification Peptide Hormones, Growth Factors, and Related Substances Prohibited at all times (both in-competition and out-of-competition) No Therapeutic Use Exemptions available not recognized as legitimate medical treatments Performance-enhancing potential acknowledged due to growth hormone secretagogue effects Detection methods under development for anti-doping testing programs WADAs position reflects that these peptides possess clear performance-enhancing properties and lack approved therapeutic applications that would justify medical use exemptions

Spine 40, 18161823

Statements Author contributions SB: Conducted literature review and prepared the manuscript

However, the placebo group experienced a 9.6% reduction in PP and a 6.6% reduction in RPP compared to the intervention group participants