Best Peptides for Autoimmune and Thyroid in 2026
This page reports what published trials measured when a peptide was given to people who already had a named autoimmune diagnosis. Each entry gives one study: who was enrolled, the endpoint, and the number. Every figure was read from that study's PubMed record on 9 August 2026.
12
Enrolled in the ATX-GD-59 phase 1 (PMID 31194638)
179
Randomised in the Nexvax2 phase 2 (PMID 36898393)
342
Randomised in the larazotide trial (PMID 25683116)
Read this before the rest of the page.
Hashimoto thyroiditis, Graves' disease, coeliac disease and lupus are diagnosed, treated and monitored by a doctor, and treatment decisions belong in that consultation only. The 2014 American Thyroid Association task force on thyroid hormone replacement, a United States professional-society document, concluded that levothyroxine should remain the standard of care for hypothyroidism (PMID 25266247), and the 2016 ATA guideline sets out radioactive iodine, antithyroid drugs and surgery for Graves' hyperthyroidism (PMID 27521067). Nothing here is a protocol or a treatment plan, and a result recorded in one disease population is a result in that population only.
Study Table
One row per study. Where a cell carries a dose figure, its attributed block sits below.
| Compound | Population (n) | What was measured | Result | Design | PMID |
|---|---|---|---|---|---|
| Copolymer 1 (glatiramer acetate) | 251 patients with relapsing-remitting multiple sclerosis (125 drug, 126 placebo) | Two-year relapse rate | 1.19 against 1.68 on placebo, a 29 percent reduction, p = 0.007. More treated patients improved by one EDSS step or more, p = 0.037 | Randomised, double-blind, placebo-controlled phase III | 7617181 |
| ATX-GD-59 (two thyrotropin receptor peptides) | 12 participants, 11 female, with previously untreated mild to moderate Graves' hyperthyroidism | Free thyroid hormones and thyrotropin receptor autoantibodies | Of the 10 who received all 10 doses, five reached free triiodothyronine within the reference interval by week 18 and two more improved; three showed worsening thyrotoxicosis. Autoantibody change tracked free triiodothyronine change, r = 0.85, p = 0.002. No comparison arm | Phase 1, open label, no control group, 10 intradermal doses over 18 weeks | 31194638 |
| Nexvax2 (gluten peptides) | 179 adults with coeliac disease randomised, HLA-DQ2.5 positive, gluten excluded for at least a year. The primary endpoint was analysed in the non-homozygous group, 76 on drug and 78 on placebo | Change in total gastrointestinal symptom score to a masked 10 g gluten challenge | Unmasked post-hoc analysis combining data from 67 patients: mean change 2.86 (SD 2.28) against 2.63 (SD 2.07) on placebo, p = 0.43. Discontinued after a planned interim analysis of 66 non-homozygous patients | Randomised, double-blind, placebo-controlled phase 2, 41 sites | 36898393 |
| Lupuzor / P140 (rigerimod) | 149 intention-to-treat patients with systemic lupus erythematosus, added to standard of care | SLE Responder Index response at week 12 | 53.1 percent every 4 weeks (p = 0.048) and 45.1 percent every 2 weeks (p = 0.18) against 36.2 percent on placebo | Randomised, double-blind, placebo-controlled phase IIb | 23172751 |
| Larazotide acetate (AT-1001) | 342 adults with coeliac disease still symptomatic after a year or more gluten-free | Average on-treatment Celiac Disease GI Symptom Rating Scale score | Primary endpoint met at 0.5 mg (P = 0.022). The 1 mg and 2 mg arms did not differ from placebo on any endpoint. Doses in the block below | Randomised, double-blind, placebo-controlled, 12 weeks | 25683116 |
| Larazotide acetate (AT-1001), pooled | 626 patients with coeliac disease across four randomised trials (465 drug, 161 placebo) | Change in lactulose-to-mannitol ratio; symptom rating scales | The permeability endpoint did not differ significantly from placebo, irrespective of gluten status. Symptom scores favoured the drug in the gluten-challenge subgroup | Systematic review and meta-analysis of four randomised trials | 34339872 |
| Cibinetide (ARA 290) | 64 subjects with sarcoidosis-associated small nerve fibre loss and neuropathic pain | Change in corneal nerve fibre area at day 28 | Placebo-corrected 109 (95 percent CI -429 to 647) at 1 mg, 697 (159 to 1236, P = 0.012) at 4 mg, 431 (-130 to 992) at 8 mg. Doses in the block below | Randomised phase 2b, 28 days, four arms | 28475703 |
| KPV (alpha-MSH 11-13) | Mice: dextran sodium sulfate colitis and CD45RB-high transfer colitis | Body weight, colonic histology, myeloperoxidase activity | Earlier recovery and significantly stronger weight regain; inflammatory infiltrates and colonic myeloperoxidase significantly reduced | Animal study, two murine models | 18092346 |
| Thymosin alpha 1 | Mice, B10.Br (sensitive) and B10.D2 (resistant) strains with experimental autoimmune thyroiditis | Thyroid lymphoid infiltration, anti-thyroglobulin antibody titre, splenic T-cell subsets | Treatment in the first 2 weeks suppressed thyroiditis in the sensitive strain and increased it in the resistant strain. Effects were dose dependent | Animal study, two congenic strains | 3873993 |
What the Immunotherapy Trials Did
A design idea runs through the immunotherapy trials: deliver a controlled dose of an antigen tied to the reaction, in a form meant to switch that response off. ATX-GD-59 combined two thyrotropin receptor peptides and was given intradermally to participants with Graves' hyperthyroidism (PMID 31194638). A 2025 review of targeted immunotherapies in Graves' disease discusses it among early-phase work (PMID 40145088).
Nexvax2 applied the idea to coeliac disease, using immunodominant gluten peptides recognised by gluten-specific CD4+ T cells, given subcutaneously against a saline placebo (PMID 36898393). Rigerimod reached a positive phase IIb in lupus (PMID 23172751); a 2023 review examines it alongside epratuzumab, baricitinib and ustekinumab when asking why lupus phase III results have diverged from phase II (PMID 36202589). Copolymer 1, sold as Copaxone, completed its phase III in relapsing-remitting multiple sclerosis, a demyelinating disease of the central nervous system (PMID 7617181).
Doses Reported in These Trials
Reported in the phase III Copolymer 1 trial (Johnson et al., Neurology 1995, PMID 7617181):
20 mg by daily subcutaneous injection for 2 years.
Disclaimer: a study fact describing what a supervised multiple sclerosis trial administered. Not a recommendation for any reader.
Reported in the Lupuzor phase IIb lupus trial (Zimmer et al., Ann Rheum Dis 2013, PMID 23172751):
200 micrograms subcutaneously, one group every 4 weeks and one every 2 weeks, added to standard of care.
Disclaimer: a study fact describing what a supervised lupus trial administered alongside existing care. Not a recommendation.
Reported in the larazotide acetate trial (Leffler et al., Gastroenterology 2015, PMID 25683116):
0.5 mg, 1 mg or 2 mg three times daily for 12 weeks. The primary endpoint was met at 0.5 mg only.
Disclaimer: these figures are printed because the trial met its primary endpoint at 0.5 mg only, which is the finding. A study fact, not a recommendation.
Reported in the phase 2b cibinetide sarcoidosis trial (Culver et al., Invest Ophthalmol Vis Sci 2017, PMID 28475703):
1 mg, 4 mg or 8 mg per day for 28 days, each compared against placebo. Only the 4 mg arm reached P = 0.012 on the corneal endpoint.
Disclaimer: a study fact describing the arms a supervised sarcoidosis trial compared. Not a recommendation.
Compounds Sold as Research Peptides
BPC-157. A 2026 review in Pharmaceutics, searching PubMed, Embase and the Cochrane Library to April 2026 plus patent and regulator databases, reports that the available clinical data derive from fewer than 30 subjects across three uncontrolled pilot studies, none using standardised pharmaceutical preparations (PMID 42198317). Background sits on our BPC-157 page.
Thymosin alpha-1. A 1985 study of experimental autoimmune thyroiditis ran in two congenic mouse strains, so its result is an animal result and its direction depended on which strain was treated (PMID 3873993). More on the thymosin alpha-1 page.
KPV. KPV is the tripeptide tail of alpha-melanocyte-stimulating hormone, and its colitis result was recorded in two murine models, not in patients (PMID 18092346). Human gut research sits in our gut health guide and leaky gut guide.
LL-37. LL-37 was measured as an autoantigen, not administered as a treatment, in a 2014 Nature Communications study. That study reported that two-thirds of patients with moderate to severe plaque psoriasis harbour CD4+ and/or CD8+ T cells specific for LL37, and that circulating LL37-specific T cells correlate significantly with disease activity, characterising LL37 as a T-cell autoantigen in psoriasis (PMID 25470744).
The Thyroid-Specific Literature
Teprotumumab is a monoclonal antibody directed at the insulin-like growth factor I receptor; it produced an 83 percent proptosis response at week 24 against 10 percent on placebo in 41 versus 42 patients with active thyroid eye disease, P below 0.001 (PMID 31971679). Selenium is a mineral: a 2023 overview of six systematic reviews covering 75 randomised trials in autoimmune thyroiditis reported thyroid peroxidase antibody reductions at 3 and 6 months in both the levothyroxine-treated and the untreated groups, with no reduction at 12 months in the untreated group, on low to very low certainty evidence (PMID 37513612).
Clinicians monitor thyroid peroxidase antibodies, thyrotropin receptor antibodies, TSH and free hormone levels. Local panels are covered in our blood testing guide, and the wider endocrine picture sits in the hormones guide.
Direction of Effect: What One Meta-Analysis Measured
A meta-analysis of 38 randomised trials covering 7,551 patients with advanced solid tumours measured endocrine adverse events across immune checkpoint inhibitor regimens. Compared with ipilimumab, patients on combination PD-1 plus CTLA-4 therapy had higher odds of hypothyroidism (odds ratio 3.81, 95 percent CI 2.10 to 6.91, P below 0.001) and of hyperthyroidism (odds ratio 4.27, 95 percent CI 2.05 to 8.90, P = 0.001); patients on PD-1 inhibitors had higher odds of hypothyroidism (odds ratio 1.89, 95 percent CI 1.17 to 3.05, P = 0.03) (PMID 28973656).
What that measured, and what it did not. Those are cancer drugs given to cancer patients, and the analysis measured endocrine adverse events on checkpoint inhibitor regimens in advanced solid tumours. It documents that when immune activation is increased deliberately in humans, thyroid dysfunction shows up in the results. Anyone with a thyroid antibody result weighing an immune-active compound has a question for their doctor.
How the Sources Were Searched
Searches ran through the NCBI E-utilities interface. Each line records the query as submitted, the index, the date and the count. A count is a fact about a search, and a compound can be indexed under a synonym or MeSH entry term a name-only query misses.
- peptide immunotherapy AND (Hashimoto OR "thyroiditis, autoimmune"[mh]) in PubMed on 9 August 2026 returned 307 records.
- "Hashimoto Disease"[mh] AND peptides[mh] AND randomized controlled trial[pt] in PubMed on 9 August 2026 returned 14 records. Interventions in that set included vitamin D, selenium, myo-inositol, Nigella sativa, levothyroxine, a reducing diet, acupoint application and moxibustion.
- "thymosin alpha-1"[tiab] AND (Hashimoto[tiab] OR "autoimmune thyroiditis"[tiab]) in PubMed on 9 August 2026 returned 2 records: PMID 42222211 and PMID 3873993.
- BPC-157 AND randomized controlled trial[pt] AND humans[mh] in PubMed on 9 August 2026 returned 0 records, while BPC-157[tiab] AND humans[mh] returned 47 the same day, so the count comes from the publication-type filter rather than the search term.
- thymosin beta-4 AND autoimmune AND randomized controlled trial[pt] in PubMed on 9 August 2026 returned 0 records.
- KPV[tiab] AND (colitis OR "inflammatory bowel") AND humans[mh] in PubMed on 9 August 2026 returned 8 records.
Frequently Asked Questions
Why does an autoimmune diagnosis change how a peptide sold for immune support is read?+
Because the rationale published for those compounds describes immune stimulation. A 2016 review of thymosin alpha 1 by two authors at SciClone Pharmaceuticals states that, due to its immune stimulating effects, it would be expected to show utility for treatment of immune suppression, whether related to aging or to diseases such as infection or cancer (PMID 27450734). An autoimmune diagnosis describes a response already aimed at the body: at thyroid peroxidase in Hashimoto thyroiditis, at the thyrotropin receptor in Graves disease. Whether a compound suits that setting is a question for the treating clinician alone.
What does an open-label trial with no control group change about a result?+
It removes the comparison that makes a percentage interpretable. The ATX-GD-59 study was phase 1 and open label: participants knew what they were receiving and there was no placebo arm, so its responder figure cannot be separated from the natural course of untreated mild to moderate hyperthyroidism. Its conflict-of-interest statement lists authors serving as officers, directors, employees or shareholders of Apitope, the company developing it (PMID 31194638).
What did a 2026 review of peptides in thyroid health conclude about the evidence base?+
A 2026 review in Integrative Medicine (Encinitas) summarised the evidence for thymosin alpha-1, thymosin beta-4, BPC-157 and growth hormone secretagogues in thyroid biology. Its stated position is that available data consist primarily of preclinical investigations, mechanistic studies and early exploratory clinical reports rather than large randomised trials focused on thyroid-specific outcomes, that safety profiles vary across peptide classes, and that clinical use remains largely investigational in the context of thyroid disease (PMID 42222211).
Is material sold as a research peptide the same as trial material?+
That is a separate question from efficacy, and it is answered per lot. Trial material is manufactured to a pharmaceutical specification, released against that specification, and documented before a dose is given. Outside a trial, identity and purity rest on a certificate of analysis tied to the lot number printed on the vial, read against a reference standard and dated. Our guide on verifying a certificate of analysis sets out what those documents show.
What is worth asking the doctor managing a thyroid antibody result?+
These questions keep the conversation on evidence. Which published trial is this suggestion based on, and was that trial run in my disease or a different one? Was it randomised and placebo-controlled, or open label with no comparison group? Does this compound stimulate or suppress the immune response, and which direction does my condition involve? Could it interfere with my medication, or with the thyroid peroxidase antibodies, thyrotropin receptor antibodies, TSH and free hormone levels used to monitor me?
Sources
- Johnson KP et al. Neurology. 1995;45(7):1268-1276. PMID 7617181
- Pearce SHS et al. Thyroid. 2019;29(7):1003-1011. PMID 31194638
- Tye-Din JA et al. Lancet Gastroenterol Hepatol. 2023;8(5):446-457. PMID 36898393
- Zimmer R et al. Ann Rheum Dis. 2013;72(11):1830-1835. PMID 23172751
- Lorenzo-Vizcaya A, Isenberg DA. Ann Rheum Dis. 2023;82(2):169-174. PMID 36202589
- Leffler DA et al. Gastroenterology. 2015;148(7):1311-1319.e6. PMID 25683116
- Hoilat GJ et al. Clin Res Hepatol Gastroenterol. 2022;46(1):101782. PMID 34339872
- Culver DA et al. Invest Ophthalmol Vis Sci. 2017;58(6):BIO52-BIO60. PMID 28475703
- Douglas RS et al. N Engl J Med. 2020;382(4):341-352. PMID 31971679
- Jonklaas J et al. Thyroid. 2014;24(12):1670-1751. PMID 25266247
- Ross DS et al. Thyroid. 2016;26(10):1343-1421. PMID 27521067
- Wang YS et al. Nutrients. 2023;15(14):3194. PMID 37513612
- Barroso-Sousa R et al. JAMA Oncol. 2018;4(2):173-182. PMID 28973656
- King R, Tuthill C. Vitam Horm. 2016;102:151-178. PMID 27450734
- Tomazic VJ et al. Cell Immunol. 1985;93(2):340-349. PMID 3873993
- Lande R et al. Nat Commun. 2014;5:5621. PMID 25470744
- Kannengiesser K et al. Inflamm Bowel Dis. 2008;14(3):324-331. PMID 18092346
- Mateescu DM et al. Pharmaceutics. 2026;18(5):625. PMID 42198317
- Mazza AD. Integr Med (Encinitas). 2026;25(2):29-37. PMID 42222211
- Lee ACH, Kahaly GJ. Front Immunol. 2025;16:1571427. PMID 40145088
Related Reading
This guide is educational and is not medical advice. Autoimmune and thyroid conditions are diagnosed, treated and monitored by a doctor. If you have a diagnosis or take medication, speak to the clinician managing your care before changing anything.