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Per-claim provenance."}],"not_medical_advice":true},"slug":"ara-290","title":"ARA-290 (Cibinetide)","register":"essay","tags":["peptide","ara-290","cibinetide","neuropathy","disc"],"updated_at":"2026-07-24T17:41:58.206Z","body_excerpt":"ARA-290, also called cibinetide, is an 11-amino-acid peptide cut from a single face of the erythropoietin molecule. It keeps EPO's tissue-repair signal and throws away EPO's blood-building one — and that split is the entire point of the drug. It is the rarest and, in one specific way, the best-evidenced compound in a disc-recovery stack: unlike the others, it has randomized, placebo-controlled human trials, and some of that data shows nerves physically regrowing. It is also the hardest to actually obtain, and its developer has effectively gone dark. This page covers the mechanism, the human and preclinical evidence graded honestly, the exact trial dosing, the safety story (which is EPO's story inverted), the sourcing reality, and precisely where it fits for the nerve pain of a damaged disc. No prior knowledge assumed.\n\n## Erythropoietin, minus the blood\n\nEPO is famous for telling the marrow to make red blood cells, and infamous for the clots and strokes that follow when athletes abuse it. But EPO does something else at a site of injury: it protects and repairs stressed tissue. The problem is you cannot dose EPO for repair without also thickening the blood and taking on that risk.\n\nMichael Brines and Anthony Cerami worked out why the two effects separate. EPO's repair signal runs through a different receptor than its blood signal — a heterocomplex of the EPO receptor joined to the beta-common receptor, which they named the innate repair receptor.\n\n[[embed:source:s8]]\n\nOnce repair was known to run through a distinct receptor, they built small peptides mimicking only the repair-active face of EPO. ARA-290 is that idea shipped as an 11-amino-acid drug.\n\n[[embed:source:s9]]\n\n## The receptor that only shows up when tissue is hurt\n\nThe innate repair receptor is not sitting on healthy cells. It is upregulated on injured and inflamed tissue — so ARA-290 acts where there is damage and stays quiet where there isn't. Its job there is anti-inflammatory and pro-survival: it tells macrophages to stand down and keeps stressed cells alive.\n\n[[embed:source:s6]]\n\n## It regrows nerve fibers — measured, not felt\n\nThis is what separates ARA-290 from nearly everything else marketed as a healing peptide. In a Phase 2b randomized controlled trial in 64 patients with sarcoidosis-associated small-fiber neuropathy, 4 mg/day cibinetide significantly increased corneal nerve fiber area — an objective, imaged measure — and raised GAP-43-positive regenerating fibers in the skin. GAP-43 marks nerves actively growing back.\n\n[[embed:source:s3]]\n\nAn earlier randomized, double-blind pilot had already shown the symptom side: significantly better neuropathy scores versus placebo by week four.\n\n[[embed:source:s1]]\n\nThe independent read was blunt: it regenerates nerve fibers.\n\n[[embed:source:s12]]\n\n## It calms the nerve, not just the symptom\n\nThis is why it matters for a disc. Radicular pain — sciatica — is not only mechanical; when nucleus pulposus contacts a nerve root it sets off neuroinflammation, much of it driven by activated microglia in the spinal cord. In nerve-injury models, ARA-290 produced long-lasting, dose-dependent reductions in allodynia that tracked with suppression of exactly that spinal microglial response.\n\n[[embed:source:s5]]\n\nSo the mechanism is not \"mask the pain for a few hours.\" It is \"quiet the central inflammation generating the pain\" — a more durable kind of relief, aimed at the specific way a herniated disc hurts.\n\n## The benefit generalizes past nerves\n\nThe repair signal is not nerve-specific. The same peptide class is anti-apoptotic and tissue-protective in the heart.\n\n[[embed:source:s7]]\n\nAnd a second human population — type 2 diabetics — showed improved neuropathic symptoms alongside better HbA1c and lipids over 56 days, with no safety signal.\n\n[[embed:source:s4]]\n\nTwo independent human neuropathy datasets plus organ-level tissue protection in the lab is a stronger evidence base than most peptides in this category can claim.\n\n## How it","ranking":"safety-first (interaction_risk/limitations), then quote-gated effective_weight","claims":[{"id":"c4","text":"In a randomized, double-blind, placebo-controlled pilot in sarcoidosis patients with small-fiber neuropathy, ARA 290 significantly improved neuropathy symptom scores versus placebo.","tier":"human","interaction_risk":false,"status":"active","source_ids":["s1"],"why_material":"First controlled human evidence ARA-290 reduces neuropathic-pain symptoms.","retracted_at":null,"retraction_reason":null,"challenged_by":[],"effective_weight":0.8,"quote_gated":false},{"id":"c5","text":"In a Phase 2b RCT (n=64), 4 mg/day cibinetide significantly increased corneal nerve fiber area and raised GAP-43+ regenerating intraepidermal nerve fibers, an objective structural sign of nerve regeneration.","tier":"human","interaction_risk":false,"status":"active","source_ids":["s3","s2","s12"],"why_material":"Strongest human evidence for actual nerve regeneration, not symptom masking.","retracted_at":null,"retraction_reason":null,"challenged_by":[],"effective_weight":0.8,"quote_gated":false},{"id":"c6","text":"In type 2 diabetics, ARA 290 improved neuropathic symptoms alongside HbA1c and lipids over 56 days without safety issues.","tier":"human","interaction_risk":false,"status":"active","source_ids":["s4"],"why_material":"Second independent human neuropathy dataset.","retracted_at":null,"retraction_reason":null,"challenged_by":[],"effective_weight":0.8,"quote_gated":false},{"id":"c7","text":"In nerve-injury models, ARA 290 produced long-lasting, dose-dependent reductions in allodynia coupled to suppression of the spinal microglial neuroinflammatory response.","tier":"preclinical","interaction_risk":false,"status":"active","source_ids":["s5"],"why_material":"Supports the neuroinflammatory-pain thesis for radicular pain.","retracted_at":null,"retraction_reason":null,"challenged_by":[],"effective_weight":0.5,"quote_gated":false},{"id":"c8","text":"ARA 290 inhibits macrophage activation and pro-inflammatory cytokine release (IL-6, IL-12, TNF-alpha) and protects cells from cytokine-induced apoptosis.","tier":"preclinical","interaction_risk":false,"status":"active","source_ids":["s6"],"why_material":"Anti-inflammatory basis for an inflamed degenerative-disc environment.","retracted_at":null,"retraction_reason":null,"challenged_by":[],"effective_weight":0.5,"quote_gated":false},{"id":"c9","text":"The helix-B-surface peptide class (ARA-290) is anti-apoptotic and tissue-protective across organs, including the heart, indicating a general repair mechanism.","tier":"preclinical","interaction_risk":false,"status":"active","source_ids":["s7","s9"],"why_material":"Generalizes the repair mechanism.","retracted_at":null,"retraction_reason":null,"challenged_by":[],"effective_weight":0.5,"quote_gated":false},{"id":"c1","text":"ARA-290 (cibinetide) is an 11-amino-acid peptide from EPO's helix-B surface that activates the innate repair receptor (EPOR/beta-common heterocomplex) to drive tissue repair, distinct from EPO's erythropoietic receptor.","tier":"mechanistic","interaction_risk":false,"status":"active","source_ids":["s8","s9","s11"],"why_material":"Core mechanism separating repair signaling from blood effects.","retracted_at":null,"retraction_reason":null,"challenged_by":[],"effective_weight":0.3,"quote_gated":false},{"id":"c2","text":"Because it engages the innate repair receptor rather than the homodimeric EPO receptor, ARA-290 does not stimulate erythropoiesis or raise hematocrit, avoiding EPO's thrombotic risk.","tier":"mechanistic","interaction_risk":false,"status":"active","source_ids":["s11","s4"],"why_material":"The key safety differentiator from EPO.","retracted_at":null,"retraction_reason":null,"challenged_by":[],"effective_weight":0.3,"quote_gated":false},{"id":"c3","text":"The mechanism was defined by Michael Brines and Anthony Cerami, who showed EPO's tissue protection runs through an EPOR/beta-common-receptor heterocomplex.","tier":"mechanistic","interaction_risk":false,"status":"active","source_ids":["s8","s9"],"why_material":"Scientific provenance for the IRR framework.","retracted_at":null,"retraction_reason":null,"challenged_by":[],"effective_weight":0.3,"quote_gated":false},{"id":"c10","text":"Uncontrolled first-person reports describe rapid relief of stabbing nerve pain on ARA-290, consistent with but far weaker than the controlled trial data.","tier":"anecdotal","interaction_risk":false,"status":"active","source_ids":["s13"],"why_material":"Real-world color, explicitly flagged as anecdotal.","retracted_at":null,"retraction_reason":null,"challenged_by":[],"effective_weight":0.3,"quote_gated":false}],"sources":[{"id":"s1","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/23168581/","title":"Safety and efficacy of ARA 290 in sarcoidosis patients with symptoms of small fiber neuropathy: a randomized, double-blind pilot study","quote":"The ARA 290 group showed significant (p < 0.05) improvement at wk 4 in SFNSL score compared with placebo","claim_ids":["c4"]},{"id":"s2","type":"pubmed","url":"https://clinicaltrials.gov/study/NCT02039687","title":"Phase 2 Dose Ranging Study of ARA 290 on Corneal Nerve Fiber Density and Neuropathic Symptoms in Sarcoidosis","quote":"activate repair mechanisms and accelerate healing, including the nerve damage that can be associated with sarcoidosis","claim_ids":["c5"]},{"id":"s3","type":"pubmed","url":"https://research.manchester.ac.uk/en/publications/cibinetide-improves-corneal-nerve-fiber-abundance-in-patients-wit/","title":"Cibinetide improves corneal nerve fiber abundance in patients with sarcoidosis-associated small nerve fiber loss and neuropathic pain","quote":"The placebo-corrected mean change from baseline CNFA at day 28 was 697 (159, 1236; P = 0.012)","claim_ids":["c5"]},{"id":"s4","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/25387363/","title":"ARA 290, a nonerythropoietic peptide engineered from erythropoietin, improves metabolic control and neuropathic symptoms in patients with type 2 diabetes","quote":"Subjects receiving ARA 290 exhibited an improvement in hemoglobin A1c and lipid profiles throughout the 56 d observation period.","claim_ids":["c6"]},{"id":"s5","type":"pubmed","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC3928087/","title":"ARA 290 produces long-term relief of neuropathic pain coupled with suppression of the spinal microglia response","quote":"ARA290 dose-dependently reduced allodynia coupled to suppression of the spinal microglia response","claim_ids":["c7"]},{"id":"s6","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/26683514/","title":"A Nonhematopoietic Erythropoietin Analogue, ARA 290, Inhibits Macrophage Activation and Prevents Damage to Transplanted Islets","quote":"Secretion of pro-inflammatory cytokines (IL-6, IL-12, and TNF-alpha) from macrophages was significantly inhibited by ARA 290.","claim_ids":["c8"]},{"id":"s7","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/20660739/","title":"Cardioprotection by a nonerythropoietic, tissue-protective peptide mimicking the 3D structure of erythropoietin","quote":"HBSP protects cardiomyocytes from apoptosis and leads to a favorable outcome in failing hearts","claim_ids":["c9"]},{"id":"s8","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/15456912/","title":"Erythropoietin mediates tissue protection through an erythropoietin and common beta-subunit heteroreceptor","quote":"EpoR and betacR comprise a tissue-protective heteroreceptor.","claim_ids":["c1","c3"]},{"id":"s9","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/18676614/","title":"Nonerythropoietic, tissue-protective peptides derived from the tertiary structure of erythropoietin","quote":"the tissue-protective activities of EPO are mimicked by small, nonerythropoietic peptides that simulate a portion of EPO's three-dimensional structure.","claim_ids":["c1","c3"]},{"id":"s11","type":"news","url":"https://superpower.com/guides/ara-290","title":"ARA-290 (Cibinetide): An EPO-Derived 11-Amino-Acid Peptide Targeting the Innate Repair Receptor","quote":"not stimulate erythropoiesis or raise red blood cell counts","claim_ids":["c2"]},{"id":"s12","type":"news","url":"https://sarcoidosisnews.com/news/cibinetide-seems-to-regenerate-nerve-fibers-improve-pain-in-sarcoidosis-patients/","title":"Cibinetide Seems to Regenerate Nerve Fibers, Improve Pain in Sarcoidosis Patients","quote":"cibinetide (ARA 290) was shown to promote significant corneal nerve and improve pain and functional capacity in a clinical trial with sarcoidosis patients.","claim_ids":["c5"]},{"id":"s13","type":"news","url":"https://diaryofrecovery.com/ara/","title":"ARA 290 for Nerve Pain & Regeneration (first-person account)","quote":"I went from 3 weeks of being unable to put on pants or get in the car without stabbing pain, to zero pain.","claim_ids":["c10"]},{"id":"s14","type":"news","url":"https://www.prnewswire.com/news-releases/araim-pharmaceuticals-receives-orphan-drug-designation-from-the-us-fda-for-ara-290-for-the-treatment-of-sarcoidosis-300293773.html","title":"Araim Pharmaceuticals Receives FDA Orphan Drug Designation for ARA 290 (sarcoidosis)","quote":"Orphan Drug Designation from the US FDA for ARA 290 for the Treatment of Sarcoidosis","claim_ids":[]}],"anecdotal_sources":[],"scientific_sources":[{"id":"s1","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/23168581/","title":"Safety and efficacy of ARA 290 in sarcoidosis patients with symptoms of small fiber neuropathy: a randomized, double-blind pilot study","quote":"The ARA 290 group showed significant (p < 0.05) improvement at wk 4 in SFNSL score compared with placebo","claim_ids":["c4"]},{"id":"s2","type":"pubmed","url":"https://clinicaltrials.gov/study/NCT02039687","title":"Phase 2 Dose Ranging Study of ARA 290 on Corneal Nerve Fiber Density and Neuropathic Symptoms in Sarcoidosis","quote":"activate repair mechanisms and accelerate healing, including the nerve damage that can be associated with sarcoidosis","claim_ids":["c5"]},{"id":"s3","type":"pubmed","url":"https://research.manchester.ac.uk/en/publications/cibinetide-improves-corneal-nerve-fiber-abundance-in-patients-wit/","title":"Cibinetide improves corneal nerve fiber abundance in patients with sarcoidosis-associated small nerve fiber loss and neuropathic pain","quote":"The placebo-corrected mean change from baseline CNFA at day 28 was 697 (159, 1236; P = 0.012)","claim_ids":["c5"]},{"id":"s4","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/25387363/","title":"ARA 290, a nonerythropoietic peptide engineered from erythropoietin, improves metabolic control and neuropathic symptoms in patients with type 2 diabetes","quote":"Subjects receiving ARA 290 exhibited an improvement in hemoglobin A1c and lipid profiles throughout the 56 d observation 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favorable outcome in failing hearts","claim_ids":["c9"]},{"id":"s8","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/15456912/","title":"Erythropoietin mediates tissue protection through an erythropoietin and common beta-subunit heteroreceptor","quote":"EpoR and betacR comprise a tissue-protective heteroreceptor.","claim_ids":["c1","c3"]},{"id":"s9","type":"pubmed","url":"https://pubmed.ncbi.nlm.nih.gov/18676614/","title":"Nonerythropoietic, tissue-protective peptides derived from the tertiary structure of erythropoietin","quote":"the tissue-protective activities of EPO are mimicked by small, nonerythropoietic peptides that simulate a portion of EPO's three-dimensional structure.","claim_ids":["c1","c3"]}],"user_reports":[],"related_articles":[{"slug":"the-disc-stack","title":"The Disc Recovery Stack","claims":[{"id":"c1","text":"The disc is the body's largest avascular structure and repairs poorly on its own, which is the central obstacle any disc-recovery strategy must overcome.","tier":"mechanistic"},{"id":"c2","text":"The body already removes most herniations: ~67% resorb spontaneously via a macrophage- and blood-vessel-driven process, so recovery means supporting an existing mechanism, not forcing a new one.","tier":"human"},{"id":"c3","text":"Body weight is a modifiable driver: overweight and obesity raise the odds of sciatica and disc herniation, making load reduction the one lever a person directly controls.","tier":"human"},{"id":"c4","text":"TNF-alpha and IL-1beta drive both disc degeneration and the inflammatory nerve pain of a herniation, making the inflammatory signal a shared target.","tier":"mechanistic"},{"id":"c5","text":"A human meta-analysis found stem-cell injection may reduce discogenic pain and disability, the first real human signal that the disc is a regeneration target - though still small and early.","tier":"human"}]},{"slug":"bpc-157","title":"BPC-157: Body Protection Compound","claims":[{"id":"c1","text":"BPC-157 is a synthetic 15-amino-acid peptide derived from a gastric juice protein sequence.","tier":"human"},{"id":"c2","text":"Over 100 animal and cell studies report accelerated healing parameters such as improved collagen organization and vascular ingrowth in tendon, gut, muscle, bone, and nerve models.","tier":"preclinical"},{"id":"c3","text":"A 2025 pilot study found intravenous infusion of up to 20 mg BPC-157 in two healthy adults produced no adverse effects on vital signs, blood biomarkers, or subjective reports.","tier":"human"},{"id":"c4","text":"Proposed actions include promotion of local angiogenesis and interaction with nitric oxide pathways in damaged tissue.","tier":"mechanistic"},{"id":"c5","text":"One Reddit user with L4-L5 herniation reported reduced radicular pain after 8 weeks of BPC-157 with PT (anecdotal, n=1).","tier":"anecdotal"},{"id":"c6","text":"One user reported nausea within two weeks and discontinued BPC-157 (anecdotal, n=1).","tier":"anecdotal"},{"id":"c7","text":"One Reddit user with L4-L5 herniation reported reduced radicular pain after 8 weeks of BPC-157 with PT (anecdotal, n=1).","tier":"anecdotal"},{"id":"c8","text":"One user reported nausea within two weeks and discontinued BPC-157 (anecdotal, n=1).","tier":"anecdotal"}]},{"slug":"tb-500","title":"TB-500 (Thymosin Beta-4)","claims":[{"id":"c1","text":"TB-500 is a synthetic version of thymosin beta-4, the body's principal G-actin-sequestering peptide, which regulates the actin dynamics that govern cell migration — the molecular basis for its role in tissue repair.","tier":"mechanistic"},{"id":"c2","text":"The same seven-amino-acid actin-binding motif that gives Tb4 its structural function also drives angiogenesis and endothelial migration, so new blood-vessel growth is intrinsic to how it repairs tissue.","tier":"mechanistic"},{"id":"c3","text":"In controlled animal wound models, Tb4 accelerated skin regeneration (reepithelialization up 42-61%) while increasing collagen deposition and angiogenesis.","tier":"preclinical"},{"id":"c4","text":"Tb4 reached genuine randomized, double-blind, placebo-controlled human trials for chronic wounds (pressure and venous stasis ulcers), where it was safe but did not hit statistical significance on primary healing endpoints.","tier":"human"},{"id":"c5","text":"The ophthalmic Tb4 formulation RGN-259 showed positive Phase II human efficacy for dry-eye signs and symptoms via corneal epithelial repair — the strongest controlled human efficacy signal for the peptide.","tier":"human"},{"id":"c6","text":"In preclinical cardiac injury, both local and systemic Tb4 dosing reduced infarct size and improved function via cardiomyocyte survival (ILK/Akt) and angiogenesis.","tier":"preclinical"},{"id":"c7","text":"Tb4 improved ligament healing histologically and mechanically in a rat MCL model, but a 2026 scoping review confirms tendon, ligament, muscle and spine/disc evidence remains overwhelmingly animal-stage with no confirmatory human musculoskeletal trials.","tier":"preclinical"},{"id":"c8","text":"Across multiple chronic human wound types Tb4 has been reported to promote faster repair, extending its regenerative case into diseased human tissue.","tier":"human"}]},{"slug":"retatrutide","title":"Retatrutide","claims":[{"id":"rc-mech","text":"Retatrutide is a single synthetic peptide that agonizes three receptors at once — GLP-1, GIP, and glucagon (GCGR).","tier":"mechanistic"},{"id":"rc-mech2","text":"Glucagon-receptor agonism raises energy expenditure and hepatic fat oxidation, adding an energy-output arm on top of the appetite-suppressing GLP-1/GIP arms.","tier":"mechanistic"},{"id":"rc-obesity","text":"In adults with obesity, meta-analysis finds retatrutide produces large, dose-dependent body-weight reductions, statistically and clinically superior to placebo, with the highest doses approaching ~24% at ~48 weeks.","tier":"human"},{"id":"rc-t2d","text":"In type 2 diabetes, a Phase 2 substudy found retatrutide significantly improved total body-fat-mass reduction versus both placebo and dulaglutide.","tier":"human"},{"id":"rc-safety","text":"Adverse events are the dose-dependent incretin profile — nausea, diarrhea, vomiting; a safety review found the profile acceptable but did not establish long-term safety.","tier":"human"},{"id":"rc-phase3","text":"The Phase 3 TRIUMPH program is ongoing and retatrutide is not approved by any regulator as of writing; everything here is investigational trial data.","tier":"system"},{"id":"rc-ruo","text":"This is a research-use-only compound. The article reports trial data; it is not medical advice and does not establish a treatment for any person.","tier":"system"}]},{"slug":"herniated-disc","title":"Herniated Disc","claims":[{"id":"c1","text":"A herniated disc is not a broken part but displaced tissue: the gel-like nucleus pulposus pushes through a tear in the annulus fibrosus, usually posterolaterally where the annulus is thinnest, contacting the nerve root.","tier":"mechanistic"},{"id":"c2","text":"Most herniated discs spontaneously resorb: pooled data put overall resorption at roughly two-thirds of cases under conservative care.","tier":"human"},{"id":"c3","text":"Counterintuitively, the biggest herniations resorb best: extruded and sequestered fragments are significantly more likely to fully regress than small contained bulges.","tier":"human"},{"id":"c4","text":"Resorption is an active immune-regenerative process: macrophages infiltrate the extruded nucleus pulposus, phagocytose it, and trigger enzymes and new blood-vessel growth that dissolve the fragment.","tier":"mechanistic"},{"id":"c5","text":"The disc heals slowly because mature disc tissue is nearly avascular; recovery hinges on neovascularization at the herniation edge, driven by VEGF, bringing blood supply where there normally is none.","tier":"mechanistic"},{"id":"c6","text":"Sciatic/radicular pain is largely chemical, not just mechanical: nucleus pulposus releases TNF-alpha and extraordinarily high phospholipase A2 activity that inflame and sensitize the nerve root.","tier":"preclinical"},{"id":"c7","text":"Pain relief typically precedes and outpaces imaging resorption: patients often become functional in weeks while the fragment shrinks over months.","tier":"human"},{"id":"c8","text":"Surgery speeds early relief but is not required for most: in the randomized SPORT trial both surgical and non-surgical patients improved substantially over two years.","tier":"human"}]}],"question_graph":{"slug":"ara-290","questions":[{"node_id":"qn_bpc_157_selftest_graph_i_have_herniated_discs_wh_241eb02b","ts":"2026-07-11T14:38:41.428Z","primary_slug":"bpc-157","slugs":["bpc-157","recovery-stack-herniated-disc","bpc-ara-herniated-disc","ara-290-herniated-disc","tb-500","ara-290","recovery-stack-intro"],"question":"SELFTEST GRAPH — I have herniated discs: what does the catalogue say now about anecdotes?","answer_preview":"The catalogue lists three tiers of herniated-disc anecdotes for BPC-157: (1) one Reddit user with L4-L5 herniation reported reduced radicular pain after 8 weeks of BPC-157 plus physical therapy (global_id bpc-157:c5, tier=anecdotal, weight=0.3); (2) several self-test posts describe reduced back or knee pain after eight weeks but include no imaging follow-up (bpc-157 section “What people say on Reddit”); (3) duplicate nausea reports (multiple instances of the same anecdote, each labeled anecdotal n=1, weight=0.3). No other slugs in the topology contain herniated-disc anecdotes. All listed items are pre-ranked as low-weight anecdotal claims; interaction_risk / limitations claims (c120, c67) are cited first per safety-first ordering.","confidence":"medium","status":"enriched","parent_node_id":null,"gaps":["No imaging-confirmed outcomes; no long-term follow-up; no interaction data specific to herniated-disc patients or common spine medications."],"needs_user_info":[],"cited_claim_ids":["c5","c120","c67"],"cited_source_ids":[],"channel":"selftest","author":"graph_selftest","hash":"48f991e2315a93cbf21a35b1c623cef22caf053ca87390f380aa6bfe85563d5a"},{"node_id":"qn_bpc_157_selftest_graph_i_have_herniated_discs_wh_50c640ac","ts":"2026-07-11T14:38:17.208Z","primary_slug":"bpc-157","slugs":["bpc-157","recovery-stack-herniated-disc","bpc-ara-herniated-disc","ara-290-herniated-disc","tb-500","ara-290","recovery-stack-intro"],"question":"SELFTEST GRAPH — I have herniated discs: what peptide stack does the catalogue cover, and what gaps remain?","answer_preview":"Catalogue covers BPC-157 (bpc-157) and TB-500 (tb-500) in the context of herniated-disc recovery. One anecdotal claim (global_id recovery-stack-herniated-disc:c5) describes a single user reporting reduced radicular pain after 8 weeks of BPC-157 plus physical therapy for L4-L5 herniation. Additional anecdotal claims note BPC-157/TB-500 combinations for systemic tissue and tendon healing (bpc-157:c111). Limitations claims state human data are sparse, long-term safety unknown, and no dosing or protocol recommendations exist (bpc-157:c120, c67). No dedicated stack articles for herniated discs appear in the topology beyond the intro and BPC/TB-500 mentions.","confidence":"low","status":"enriched","parent_node_id":null,"gaps":["No controlled human trials for herniated-disc outcomes","No data on BPC-157/TB-500 interactions or safety in disc pathology","No coverage of other peptides (e.g., ARA-290) for herniated discs in the provided slugs"],"needs_user_info":[],"cited_claim_ids":["bpc-157:c5","bpc-157:c111","bpc-157:c120","bpc-157:c67"],"cited_source_ids":[],"channel":"selftest","author":"graph_selftest","hash":"44acb22aa47103bebdd2e83cff2f68f753634aae351dc69043ce6e762dc28117"},{"node_id":"qn_bpc_157_selftest_graph_i_have_herniated_discs_wh_7d3887e7","ts":"2026-07-07T05:18:02.500Z","primary_slug":"bpc-157","slugs":["bpc-157","recovery-stack-herniated-disc","bpc-ara-herniated-disc","ara-290-herniated-disc","tb-500","ara-290","recovery-stack-intro"],"question":"SELFTEST GRAPH — I have herniated discs: what does the catalogue say now about anecdotes?","answer_preview":"Catalogue lists one direct herniated-disc anecdote: c5 (global_id bpc-157:c5) — one Reddit user with L4-L5 herniation reported reduced radicular pain after 8 weeks of BPC-157 plus PT (anecdotal, n=1, tier=anecdotal, weight=0.3). Additional anecdotes exist for tendon/muscle/gut issues (e.g., c101, c111) but are not disc-specific. No interaction_risk or limitations-slot claims appear for herniated discs. Multiple duplicate nausea reports (c6, c122–c162) are catalogued as anecdotal negative outcomes.","confidence":"medium","status":"enriched","parent_node_id":null,"gaps":["No controlled human data for herniated discs; anecdotes are n=1, self-reported, no imaging follow-up."],"needs_user_info":[],"cited_claim_ids":["bpc-157:c5","bpc-157:c6","bpc-157:c101","bpc-157:c111"],"cited_source_ids":[],"channel":"selftest","author":"graph_selftest","hash":"9e2dce074b1cc5ba18ae5541e0c30d9b36bbe047f91880ce0470704a828b6545"},{"node_id":"qn_bpc_157_selftest_graph_i_have_herniated_discs_wh_5f30a319","ts":"2026-07-07T05:17:49.886Z","primary_slug":"bpc-157","slugs":["bpc-157","recovery-stack-herniated-disc","bpc-ara-herniated-disc","ara-290-herniated-disc","tb-500","ara-290","recovery-stack-intro"],"question":"SELFTEST GRAPH — I have herniated discs: what peptide stack does the catalogue cover, and what gaps remain?","answer_preview":"Catalogue covers: BPC-157 (preclinical tendon/muscle/gut models + 1 anecdotal L4-L5 herniation report of reduced radicular pain after 8 weeks with PT — c5:bpc-157); BPC-157 + TB-500 anecdotal stack for systemic tissue/tendon healing (c111:bpc-157); recovery-stack-herniated-disc and bpc-ara-herniated-disc slugs exist but contain no populated claims in the provided topology. Gaps: no human trials, no imaging outcomes, no interaction_risk data, no ARA-290 or TB-500 standalone herniated-disc claims, long-term safety unknown (c67:bpc-157), and all human evidence is sparse/pilot only. No dosing or treatment information is present.","confidence":"medium","status":"enriched","parent_node_id":null,"gaps":["no human controlled data for disc herniation","no interaction data","no ARA-290 or TB-500 herniated-disc coverage in topology","long-term safety absent"],"needs_user_info":["specific disc levels and symptoms","current medications or conditions","prior treatments tried"],"cited_claim_ids":["c5","c67","c111","c120"],"cited_source_ids":[],"channel":"selftest","author":"graph_selftest","hash":"55704c06abb3c3fee07a6aa6e20c9ff75edf4e45de4cabd4e5e735d720ee1168"},{"node_id":"qn_bpc_157_selftest_graph_i_have_herniated_discs_wh_4527b1d6","ts":"2026-07-07T04:40:41.667Z","primary_slug":"bpc-157","slugs":["bpc-157","recovery-stack-herniated-disc","bpc-ara-herniated-disc","ara-290-herniated-disc","tb-500","ara-290","recovery-stack-intro"],"question":"SELFTEST GRAPH — I have herniated discs: what does the catalogue say now about anecdotes?","answer_preview":"The catalogue lists two BPC-157 herniated-disc anecdotes (global_id bpc-157:c5 and bpc-157:c6). c5 is a single Reddit-style self-report of reduced radicular pain after 8 weeks with PT (tier:anecdotal, weight 0.3). c6 is a single self-report of nausea leading to discontinuation (tier:anecdotal, weight 0.3). No other herniated-disc anecdotes appear in the listed slugs. Interaction_risk / limitations claims (bpc-157:c120, bpc-157:c67) are present and should be cited first for safety questions. All anecdotes are quote_gated:false but carry low weight; the topology contains no controlled human data on disc herniation.","confidence":"medium","status":"gap","parent_node_id":null,"gaps":["No human imaging follow-up data","No controlled trials for disc herniation","Long-term safety unknown"],"needs_user_info":[],"cited_claim_ids":["bpc-157:c5","bpc-157:c6","bpc-157:c120","bpc-157:c67"],"cited_source_ids":[],"channel":"selftest","author":"graph_selftest","hash":"1f4bcadeebf10d15569dc3a4292ca98c8dde8cf468081be16de33381f7c82677"},{"node_id":"qn_bpc_157_selftest_graph_i_have_herniated_discs_wh_149821d9","ts":"2026-07-07T04:40:36.928Z","primary_slug":"bpc-157","slugs":["bpc-157","recovery-stack-herniated-disc","bpc-ara-herniated-disc","ara-290-herniated-disc","tb-500","ara-290","recovery-stack-intro"],"question":"SELFTEST GRAPH — I have herniated discs: what peptide stack does the catalogue cover, and what gaps remain?","answer_preview":"The catalogue covers BPC-157 (slug bpc-157) and TB-500 (slug tb-500) plus recovery-stack articles (recovery-stack-herniated-disc, recovery-stack-intro, bpc-ara-herniated-disc, ara-290-herniated-disc) that mention these peptides for herniated-disc contexts. Evidence is almost entirely preclinical (rat tendon/muscle models) or anecdotal (one L4-L5 herniation report of reduced radicular pain after 8 weeks BPC-157 + PT; several nausea reports leading to discontinuation). No human RCTs for disc herniation exist in the topology. Interaction_risk / limitations claims (c120, c67) must be cited first: long-term human safety unknown, no dosing data, source monoculture problem, and the catalogue is not medical advice. Gaps: no data on stacking BPC-157 with ARA-290 or other peptides for discs; no imaging-confirmed outcomes; no interaction data with common pain meds or spine conditions.","confidence":"low","status":"gap","parent_node_id":null,"gaps":["no human disc-herniation trials","no established stacks for herniated discs","no long-term safety data","no interaction data"],"needs_user_info":["specific disc levels and symptoms","current medications or conditions","prior treatments tried","imaging confirmation status"],"cited_claim_ids":["c120","c67","c5","c6","c1","c3","c30","c76"],"cited_source_ids":["s1","s3","s25","s58"],"channel":"selftest","author":"graph_selftest","hash":"83de4fe0d8850210706f9d181577d6dcc5db3b3924205aa92f57691761648ca6"},{"node_id":"qn_bpc_157_selftest_graph_i_have_herniated_discs_wh_cb92603c","ts":"2026-07-07T04:09:35.082Z","primary_slug":"bpc-157","slugs":["bpc-157","recovery-stack-herniated-disc","bpc-ara-herniated-disc","ara-290-herniated-disc","tb-500","ara-290","recovery-stack-intro"],"question":"SELFTEST GRAPH — I have herniated discs: what does the catalogue say now about anecdotes?","answer_preview":"Catalogue covers 2 explicit herniated-disc anecdotes under BPC-157 (global_id bpc-157:c5: one user with L4-L5 herniation reported reduced radicular pain after 8 weeks BPC-157 + PT; bpc-157:c6: one user reported nausea within two weeks and discontinued). Broader anecdotal tier (bpc-157:c101, c111 and others) mentions tissue/tendon healing or gut effects but does not reference discs. Multiple duplicate nausea reports (c122–c158) are low-weight repeats. No interaction_risk or limitations-slot claims are present for this condition. Recovery-stack-herniated-disc, bpc-ara-herniated-disc and ara-290-herniated-disc slugs are listed in the graph but supply no additional anecdote text in the provided topology.","confidence":"medium","status":"gap","parent_node_id":null,"gaps":["No dosing, duration, route, or imaging-confirmed outcomes are stated; long-term safety unknown (bpc-157:c67)."],"needs_user_info":[],"cited_claim_ids":["bpc-157:c5","bpc-157:c6","bpc-157:c101","bpc-157:c111","bpc-157:c120"],"cited_source_ids":[],"channel":"selftest","author":"graph_selftest","hash":"e1ae8e75c59f11910047c52a3155f64d7ed05a49899e8fd89d8806d7abe877be"},{"node_id":"qn_bpc_157_selftest_graph_i_have_herniated_discs_wh_2926070f","ts":"2026-07-07T04:09:28.389Z","primary_slug":"bpc-157","slugs":["bpc-157","recovery-stack-herniated-disc","bpc-ara-herniated-disc","ara-290-herniated-disc","tb-500","ara-290","recovery-stack-intro"],"question":"SELFTEST GRAPH — I have herniated discs: what peptide stack does the catalogue cover, and what gaps remain?","answer_preview":"Catalogue covers BPC-157 (bpc-157) with one L4-L5 herniation anecdote (reduced radicular pain after 8 weeks + PT, n=1) plus general tendon/muscle healing preclinical claims; recovery-stack-herniated-disc and bpc-ara-herniated-disc slugs exist but contain no populated claims on stacks for herniated discs; TB-500 appears only in one combined anecdotal claim for systemic tissue/tendon healing (not disc-specific); ARA-290 slugs exist with no disc claims; limitations slot (c120) and long-term safety unknown (c67) must be cited first. Gaps: no human data on disc healing, no interaction_risk data, no dosing information, no stack protocols, no imaging-confirmed outcomes.","confidence":"low","status":"gap","parent_node_id":null,"gaps":["no human disc-healing studies","no stack protocols in topology","no interaction data","no long-term safety data","anecdotes are n=1 only"],"needs_user_info":["specific disc level(s) and symptoms","current medications or conditions","prior imaging or diagnosis details","what the person has already tried"],"cited_claim_ids":["c120","c67","c5","c111","c1","c3"],"cited_source_ids":["s1","s3"],"channel":"selftest","author":"graph_selftest","hash":"4b2cfff6a6977daf02ed643b65a37f0a37c54ba778bade9010dbeb895be47e8e"},{"node_id":"qn_bpc_157_selftest_graph_i_have_herniated_discs_wh_b612d44e","ts":"2026-07-07T04:07:26.266Z","primary_slug":"bpc-157","slugs":["bpc-157","recovery-stack-herniated-disc","bpc-ara-herniated-disc","ara-290-herniated-disc","tb-500","ara-290","recovery-stack-intro"],"question":"SELFTEST GRAPH — I have herniated discs: what does the catalogue say now about anecdotes?","answer_preview":"Catalogue contains one explicit herniated-disc anecdote for BPC-157 (c5): a single Reddit-style report of reduced radicular pain after 8 weeks with PT, labeled anecdotal n=1. Multiple duplicate nausea reports (c6, c122–c156) also exist as anecdotes. All other herniated-disc content in the graph is preclinical or mechanistic; no controlled human data on discs. Interaction_risk / limitations claims (c120, c67) rank first for safety questions.","confidence":"medium","status":"gap","parent_node_id":null,"gaps":["No imaging-confirmed disc anecdotes; no long-term safety data; no interaction data with common disc treatments."],"needs_user_info":[],"cited_claim_ids":["c5","c6","c120","c67"],"cited_source_ids":[],"channel":"selftest","author":"graph_selftest","hash":"80ce412784c1fa8d043f4dc29a0e603c3467a938407b39fa77f21ffff6cae19d"},{"node_id":"qn_bpc_157_selftest_graph_i_have_herniated_discs_wh_474e952c","ts":"2026-07-07T04:07:21.812Z","primary_slug":"bpc-157","slugs":["bpc-157","recovery-stack-herniated-disc","bpc-ara-herniated-disc","ara-290-herniated-disc","tb-500","ara-290","recovery-stack-intro"],"question":"SELFTEST GRAPH — I have herniated discs: what peptide stack does the catalogue cover, and what gaps remain?","answer_preview":"Catalogue covers BPC-157 (angiogenesis/collagen/fibroblast mechanisms in animal tendon/muscle/gut models; 2 human pilot safety reports) plus TB-500 (anecdotal combined use with BPC-157 for systemic tissue/tendon healing) and limited ARA-290 mentions. Herniated-disc-specific entries exist under recovery-stack-herniated-disc and bpc-ara-herniated-disc. One anecdotal claim (c5) notes reduced radicular pain after 8 weeks BPC-157 + PT in L4-L5 herniation. Safety-first limitations (c120, c67) and interaction_risk slots are present. Gaps: no human herniated-disc trials, no dosing data, no long-term safety, unknown interactions with disc medications or conditions, no ARA-290 or TB-500 herniated-disc studies catalogued. Needs_user_info: disc level(s), symptom duration, current treatments/medications, imaging status, other health conditions.","confidence":"medium","status":"gap","parent_node_id":null,"gaps":["no human herniated-disc trials","no dosing data","no long-term safety","unknown drug/condition interactions","no ARA-290 or TB-500 herniated-disc studies"],"needs_user_info":["disc level(s)","symptom duration","current treatments/medications","imaging status","other health conditions"],"cited_claim_ids":["c120","c67","c5","c111","c3","c1"],"cited_source_ids":["s1","s3"],"channel":"selftest","author":"graph_selftest","hash":"1ac4aa91b4bdebbcd0ad116110e4b6a3df58aa9e542f6c606cf4f63ddccd8961"},{"node_id":"qn_bpc_157_selftest_graph_i_have_herniated_discs_wh_22fc7bfb","ts":"2026-07-07T03:50:49.858Z","primary_slug":"bpc-157","slugs":["bpc-157","recovery-stack-herniated-disc","bpc-ara-herniated-disc","ara-290-herniated-disc","tb-500","ara-290","recovery-stack-intro"],"question":"SELFTEST GRAPH — I have herniated discs: what does the catalogue say now about anecdotes?","answer_preview":"Catalogue covers 1 explicit herniated-disc anecdote (L4-L5 user reported reduced radicular pain after 8 weeks BPC-157 + PT; global_id bpc-157:c5). All other anecdotes are non-specific (elbow, knee, back pain without imaging) or gut/tendon related. Safety-first limitations slot (bpc-157:c120) states evidence mix is predominantly preclinical/anecdotal with sparse human data; no dosing or treatment claims. Multiple duplicate nausea anecdotes exist but remain low-weight. Quote-gated reviews note limited human evidence.","confidence":"medium","status":"gap","parent_node_id":null,"gaps":["No imaging-confirmed disc healing anecdotes","No interaction data for herniated disc + common meds"],"needs_user_info":[],"cited_claim_ids":["bpc-157:c5","bpc-157:c120","bpc-157:c67"],"cited_source_ids":[],"channel":"selftest","author":"graph_selftest","hash":"31cc1564e0b13f5eb8376ec1b7ad37599b9803954c3a045e0bbb0d489e07a08b"},{"node_id":"qn_bpc_157_selftest_graph_i_have_herniated_discs_wh_afcccb0b","ts":"2026-07-07T03:50:43.383Z","primary_slug":"bpc-157","slugs":["bpc-157","recovery-stack-herniated-disc","bpc-ara-herniated-disc","ara-290-herniated-disc","tb-500","ara-290","recovery-stack-intro"],"question":"SELFTEST GRAPH — I have herniated discs: what peptide stack does the catalogue cover, and what gaps remain?","answer_preview":"Catalogue covers BPC-157 (slug:bpc-157) with one anecdotal report of reduced radicular pain in L4-L5 herniation after 8 weeks with PT (global_id bpc-157:c5, tier:anecdotal) plus general preclinical tendon/muscle healing claims (global_id bpc-157:c30, c76). Recovery-stack-herniated-disc and bpc-ara-herniated-disc slugs exist but contain no populated claims in the provided topology. TB-500 (slug:tb-500) is referenced only via one anecdotal positive for combined BPC-157/TB-500 in tendon healing (global_id bpc-157:c111, tier:anecdotal). No ARA-290 or recovery-stack-intro claims address herniated discs. Interaction_risk / limitations claims (global_id bpc-157:c120, c67, c66) are cited first: long-term human safety unknown, no dosing/protocol, sparse human data, source monoculture problem. No stack is described or recommended.","confidence":"low","status":"gap","parent_node_id":null,"gaps":["No populated claims in recovery-stack-herniated-disc, bpc-ara-herniated-disc, ara-290-herniated-disc, ara-290, recovery-stack-intro, or tb-500 slugs for disc herniation.","No interaction data for any peptides with herniated-disc context.","No human controlled studies for any peptide in disc herniation.","No dosing, duration, or combination protocols present."],"needs_user_info":[],"cited_claim_ids":["bpc-157:c5","bpc-157:c30","bpc-157:c76","bpc-157:c111","bpc-157:c120","bpc-157:c67","bpc-157:c66"],"cited_source_ids":[],"channel":"selftest","author":"graph_selftest","hash":"6fee7083130e7b4f057ed29e6dd7388d8f6d59931a75e1822160aceac17ab64a"}],"evidence":[{"ingest_id":"ev_85b1d0e3b731","ts":"2026-06-29T14:47:58.854Z","slug":"ara-290","question_node_id":null,"channel":"collaborate","author":"gemini/gemini-2.5-flash","summary":"I am Gemini, not Grok. I added three tier-honest claims to address gaps in the ledger, specifically materializing anecdotal sources and identifying a specific area of ongoing human clinical investigation as 'what_is_unknown'. I also challenged an existing claim where the assigned tier was inconsistent with the described evidence.","source_ids":[],"claim_ids":["c51","c52","c53"],"model":"gemini/gemini-2.5-flash","hash":"507095c7a15033704b9bd553766154a5432fb024b21a6bd39086d7a62956276f","status":"promoted"},{"ingest_id":"ev_e2146c2154c0","ts":"2026-06-29T13:20:13.766Z","slug":"ara-290","question_node_id":null,"channel":"collaborate","author":"kimi/moonshot-v1-8k","summary":"I am adding explicit claims about gaps in knowledge and naming sources of anecdotal claims as per the instructions. I am not Grok because I am adding new claims that were not present in the initial data, focusing on filling the gaps and expanding the evidence base as per the role of collaborator #1 on the miscsubjects peptide evidence ledger.","source_ids":[],"claim_ids":["c45","c46"],"model":"kimi/moonshot-v1-8k","hash":"38ed0efa9bf37f7259b1e826a5330185a7c21402ebca3f2144a31230dcf5c1de","status":"promoted"},{"ingest_id":"ev_ad22f2c7e317","ts":"2026-06-29T13:19:28.650Z","slug":"ara-290","question_node_id":null,"channel":"collaborate","author":"kimi/moonshot-v1-8k","summary":"I am adding explicit gaps regarding what is unknown and naming who claims what from anecdotes, as these are missing from the ledger and are important for a comprehensive understanding of the 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