I'm not big on the non-GLP peptides anyway, most of which I have been too lazy to try yet. Tirz or reta could be the best peptides for carpal tunnel, even without obesity.
Though you have already seen a PT, I would see a hand surgeon for a definitive diagnosis, such as to rule out tendonitis:
Gemini said:
When the surgeon asks about your symptoms, be sure to mention:
"The pinky is/is not involved." (Crucial for ruling out the Ulnar nerve).
"The numbness does/does not wake me up at night." (Crucial for CTS vs Tendonitis).
"The palm is/is not numb." (Crucial for ruling out Pronator Syndrome).
Condition Primary Symptoms Key Distinguisher Why it’s NOT Carpal Tunnel Carpal Tunnel (CTS) Numbness/tingling in thumb, index, and middle fingers. Worse at night. Positive Tinel’s sign (tapping the wrist causes "zingers"). The "standard" diagnosis. Pinky finger is never involved. Wrist Tendonitis Dull ache, localized swelling, pain with specific movements. Pain is triggered by stretching the tendon , not by nerve pressure. No numbness or tingling. Pain is usually on the top or side of the wrist. Pronator Syndrome Pain in the forearm; numbness in the same fingers as CTS. Numbness in the palm. (The palm branch splits off before the tunnel). Compression is at the elbow/forearm . Wrist surgery won't help. Cervical Radiculopathy Numbness that may involve the whole hand or arm. Pain/tingling changes when you move your neck or look up. Source is a pinched nerve in the neck (C6/C7). Usually includes neck stiffness. Cubital Tunnel Numbness and tingling in the pinky and ring finger . Symptoms triggered by bending the elbow for long periods. Affects the Ulnar nerve , which does not pass through the carpal tunnel. De Quervain’s Sharp pain at the base of the thumb when gripping/fisting. Positive Finkelstein’s test (thumb-in-fist ulnar deviation). Strictly an inflammatory tendon issue ; no neurological "zinging." Metabolic Neuropathy Symmetrical numbness ("stocking-glove" pattern) in hands/feet. Symptoms are constant and usually present in both hands and feet. Systemic nerve health issue (linked to A1c ), not mechanical pressure.
Or your PCP can order a nerve conduction study to get the ball rolling.
At some point, if you ask, a hand surgeon may agree to a cortisone injection for some relief and to confirm the diagnosis, but then surgery can't be done for three months. The cortisone injection only works temporarily. Wore off completely within a few months and my numbness only got worse later since I refused to use the uncomfortable night wrist splits unless the numbness was bothersome enough. Hand therapists offer customized splints, but I never saw a hand therapist.
Lots of people take anti-inflammatories to buy time with carpal tunnel, so it makes sense the first suggestion was KPV. BPC and everything else in KLOW could help with the compression aspect, with the KPV giving relatively immediate relief. ARA-290 is also anti-inflammatory enough that it helped with A1c levels to some degree, in a small phase-2 study (more robust than any study with KPV, BPC-157, TB-500, or GHK-Cu).
If you have more money than I do or better luck with insurance, the endoscopic release seems awesome for a faster recovery time. But the mini open release seems to be what they are mostly doing now and is just as effective (if not more so):
Gemini said:
Feature Endoscopic Mini-Open Incision ~1 cm (Wrist crease) ~2 cm (Palm) Visualization Limited (via Camera) Direct (Best) Return to Work Faster (1–2 weeks) Slower (2–4 weeks) Pillar Pain Minimal Common for 4–8 weeks Cost Higher Lower