Nevada regulators have fined three people who played a role in offering peptide injections last year at a Las Vegas anti-aging conference where two women became critically ill following treatment.

Last month, the Nevada Pharmacy Board levied $10,000 fines against a doctor and a pharmacist who are licensed in California but who don’t have permission to practice in Nevada. It imposed a $5,000 fine against a third man who describes himself as an “integrative health coach” but who doesn’t appear to be a licensed health care practitioner.

The pharmacy board also imposed a $10,000 fine against a Texas-based private membership association, which authorities accused of mailing the peptides to Nevada. The group, Forgotten Formula, claims a constitutional right to conduct private transactions with its members and contends those transactions occur “outside the scope” of state commercial regulations.

The citations stem from an incident in July at the Revolution Against Aging and Death Festival, which is put on by an Arizona-based organization that promises pathways to an “unlimited lifespan.” Dr. Kent Holtorf, whose anti-aging medical practice is based in El Segundo, California, operated a booth at the festival offering alternative health therapies, including peptide injections. Peptides are short amino acid chains that have exploded in popularity thanks to claims they can fight aging and chronic disease. 

The board alleged that Forgotten Formula mailed the peptides to the casino resort hosting RAADFest, marking the package “to the attention of Dr. Kent Holtorf.” That shipment constituted “unlicensed wholesaling of drugs,” according to the board’s citation.

A trustee of Forgotten Formula told ProPublica his association was not present at the festival and did not provide peptides to be offered for public use.

After being injected with peptides at Holtorf’s booth, two women left the conference in ambulances, so ill they had to be intubated to assist them in breathing. They have since recovered. 

The pharmacy board was unable to determine why the women became ill — including whether the injections were contaminated or the women reacted to the peptides themselves. Investigators were unable to test the serums.

“We were not able to obtain the product, although attempts were made,” said David Wuest, the board’s executive secretary.

Although the Food and Drug Administration has approved many peptide-based medications to treat serious diseases such as diabetes and cancer, peptide therapies used for anti-aging and regenerative health are largely unregulated. (Health and Human Services Secretary Robert F. Kennedy Jr. has been a strong proponent of peptides.) The FDA allows compounding pharmacies to dispense some peptides, but has listed 19 of some of the most popular peptides as posing “significant safety risks.” Compounding pharmacies are prohibited from dispensing those on the list. As a result, many unsafe peptides are sold on a booming gray market, including directly to consumers by entities in the U.S. and abroad that are skirting FDA rules.

The injections administered to both women at the Las Vegas convention included at least one peptide that the FDA warns poses a safety risk, according to the pharmacy board’s citations. Kennedy said recently that the FDA plans to reclassify 14 of the peptides currently listed as unsafe, which could allow compounding pharmacies to begin dispensing them. 

Holtorf, who did not respond to repeated attempts to contact him, was fined for practicing in Nevada without a state license. Han Bao Nguyen, the pharmacist accused of mixing the peptides for both women and administering the serums to one of them, also was cited for the same violation. Nguyen works at Holtorf’s practice, according to its website. He did not respond to requests for comment.

Michael McNeal, the “integrative health coach” and director of education at Integrative Peptides, a company founded by Holtorf, was accused of prescribing or recommending a peptide cocktail to one of the women. Wuest said McNeal does not appear to hold any health care licenses. McNeal did not respond to requests for comment.

In July, Holtorf told ProPublica he didn’t believe the peptides caused the women’s illnesses, saying he’d asked an artificial intelligence app to analyze the incident. He wouldn’t share what the app had concluded was the cause. He also apologized for the situation and said he was “reassessing everything we are doing” to keep patients safe.

Wuest said the board notified the California boards that license Holtorf and Nguyen of the fines so they may consider additional discipline. The FDA also has been notified, he said.

Michael Blake Fiveash is co-founder and first trustee of Forgotten Formula, which the board accused of unlicensed wholesaling of pharmaceuticals. He said pharmacy board regulations, while necessary for regulating public commerce, don’t apply to his association because it offers services only to members who have signed a contract. He said such member-to-member activity is protected by the First and 14th amendments. In a letter to ProPublica, he said Holtorf, whose peptide company is listed as a partner on Forgotten Formula’s website, was operating at RAADFest under his public medical practice, not as an association member. Nor were the women who became ill members of the association, Fiveash said.

“Dr. Holtorf’s booth at RAADFest was a public commercial activity,” Fiveash said in a letter. The Forgotten Formula Private Member Association “did not supply materials for public commercial use or public distribution. If Dr. Holtorf utilized any materials in his public professional practice, that would represent his individual choice to apply private member resources to his separate public professional activities, which is beyond FFPMA’s control or responsibility.”

Fiveash did not directly answer questions about whether the association mailed the peptides to Holtorf. He also shared a video of testimonials from Forgotten Formula members, including children and adults, suffering serious illnesses such as cancer, Lyme disease, diabetes and cirrhosis who said they were helped by the association’s products. 

He challenged the premise that the women became ill from the peptides. “Without comprehensive toxicology, full medical histories, and analysis of all substances and treatments administered that day, attributing causation to peptides is speculation masquerading as reporting,” he said. “Any adverse event is concerning, and we hope both patients have fully recovered.”

Laura Tucker, the pharmacy board’s lawyer, said this is the board’s first encounter with a private membership association making such legal claims, but emphasized that mailing drugs to the state without a Nevada license is against state law. She added that any of the parties can appeal their citations to the board.

“Of course anyone is free to make any sort of legal argument they would like to try to make in front of the board,” she said.