Mitochondrial and longevity peptides
Only SS-31 is approved for a mitochondrial disease, as Forzinity for Barth syndrome, and glutathione is approved in Italy for nerve damage from chemotherapy. The rest range from tiny human studies to compounds never given to a person, and none has trial evidence for energy or lifespan in healthy people.
- Compounds
- 8
- Approved drug
- 2
- Human studies
- 1
- Preclinical
- 5
Members
Mitochondrial peptides
MOTS-c and humanin are written in mitochondrial DNA; SS-31 is a synthetic peptide that collects in mitochondria.
| Compound | What it is | Approval | Evidence | How often | Half-life | Sport |
|---|---|---|---|---|---|---|
| MOTS-c | Mitochondrial-derived peptide | Not approved | Preclinical | 1–3× per week | Not measured | Banned |
| SS-31 | Mitochondria-targeted peptide | Approved in the US | Approved drug | Once daily | Not measured | Not banned |
| Humanin | Mitochondrial-derived peptide | Not approved | Preclinical | Not established | Not measured | Likely banned |
Senolytic and antioxidant peptides
FOXO4-DRI is built to make worn-out cells self-destruct; glutathione is the body’s main antioxidant inside cells.
| Compound | What it is | Approval | Evidence | How often | Half-life | Sport |
|---|---|---|---|---|---|---|
| FOXO4-DRI | Experimental senolytic peptide | Not approved | Preclinical | Not established | Not measured | Likely banned |
| Glutathione | Antioxidant tripeptide | Approved outside the US | Approved drug | 2–3× per week | about 14 minutes Label | Restricted |
Sold alongside them, not peptides
None of these is a peptide: NAD+ is a coenzyme, and 5-Amino-1MQ and SLU-PP-332 are small synthetic molecules.
| Compound | What it is | Approval | Evidence | How often | Half-life | Sport |
|---|---|---|---|---|---|---|
| NAD+ | Coenzyme | Not approved | Human studies | 2–3× per week | Not measured | Restricted |
| 5-Amino-1MQ | NNMT inhibitor (small molecule) | Not approved | Preclinical | Once daily | about 4 to 7 hours in rats Animal | Likely banned |
| SLU-PP-332 | Estrogen-related receptor agonist (small molecule) | Not approved | Preclinical | 1–2× daily | Not measured | Likely banned |
Approval, evidence, half-life and sport status restate each compound’s own page, where the sources are listed. Select a name for doses, side effects and studies.
How they work
Mitochondria are the parts of cells that turn food into usable energy, and they carry a small set of genes of their own. MOTS-c (16 amino acids) and humanin (24) are written in that mitochondrial DNA. In cells and mice, MOTS-c switches on AMPK, the enzyme cells use when energy runs short, and improved insulin response and running capacity. Humanin blocks Bax, a protein that starts cell death, and improved insulin action in rats. Animal
FOXO4-DRI, built from mirror-image amino acids that the body’s enzymes can’t break down, frees p53, the protein that decides whether a damaged cell dies, in worn-out (senescent) cells, which then self-destruct; in old mice it improved fitness, fur density and kidney function. Of the non-peptides, NAD+ is a coenzyme, a helper molecule in energy reactions. 5-Amino-1MQ blocks NNMT, an enzyme in fat cells, and SLU-PP-332 switches on estrogen-related receptors, gene switches for building mitochondria; both limited fat gain in mice. Animal
Two members have labels. SS-31 (elamipretide) collects in the inner membrane of mitochondria and binds cardiolipin, a fat that holds that membrane in its folded shape; its US label says this improves mitochondrial shape and function. Glutathione, a three-amino-acid peptide cells make for themselves, is described in its Italian label as neutralizing reactive oxygen and keeping platinum chemotherapy from building up in the nerve-root clusters where it causes nerve damage. Label
In people, SS-31’s approval rests on 12 male patients with Barth syndrome: the knee-strength gain came from an uncontrolled extension in eight of them, after the randomized part missed its goals, and larger trials in mitochondrial muscle disease and heart failure found no benefit. In chemotherapy trials of about 50–185 patients, glutathione cut nerve damage in two but not in the largest. In the one NAD+ infusion study, blood NAD+ didn’t rise for two hours. Trial
How they differ
Approval
SS-31 is FDA-approved as Forzinity (accelerated approval, 2025) for muscle strength in Barth syndrome, from 30 kg. Glutathione is approved in Italy as TAD to help prevent nerve damage from cisplatin. The rest are unapproved; NAD+ and glutathione are under FDA evaluation for US pharmacy compounding.
Label doses
LabelForzinity: 40 mg under the skin once daily, or 20 mg with severe kidney impairment when not on dialysis. TAD: 600 mg into muscle or by slow IV for ongoing therapy, and about 2.5 g by IV before each cisplatin dose.
Community doses
CommunityMOTS-c: 5 mg one to three times a week. NAD+: 50–100 mg two to three times a week by injection. 5-Amino-1MQ: 50–150 mg a day by mouth. SLU-PP-332: 500 mcg–1 mg a day. Humanin and FOXO4-DRI have no tested dose at all.
What they are
Glutathione and SS-31 are tiny peptides of three and four amino acids, MOTS-c and humanin have 16 and 24, and FOXO4-DRI is a 46-amino-acid mirror-image peptide. NAD+ is a coenzyme, and 5-Amino-1MQ and SLU-PP-332 are small synthetic molecules, not peptides.
Human evidence
TrialSS-31 and glutathione have randomized trials. NAD+ has two small studies, one an industry-funded preprint. MOTS-c has only an unpublished Phase 1 program of a modified version, and humanin, FOXO4-DRI, 5-Amino-1MQ and SLU-PP-332 have cell and animal data only.
History
- 2001Researchers in Tokyo identify humanin, a short peptide that protected nerve cells from Alzheimer’s-linked damage in culture.
- 2004Cornell researchers report cell-permeable peptide antioxidants, the family SS-31 belongs to, that concentrate about 1,000-fold in the inner mitochondrial membrane.
- 2015MOTS-c is described as a peptide written in mitochondrial DNA that reduced diet-induced obesity and insulin resistance in mice.
- 2017FOXO4-DRI is reported to clear senescent cells in mice and to improve fitness, fur density and kidney function in old animals.
- 2025On September 19, FDA grants elamipretide (Forzinity) accelerated approval, the first disease-specific treatment for Barth syndrome.
Comparisons and guides
Questions
What are mitochondrial peptides?
Peptides that act on mitochondria, the parts of cells that make usable energy. MOTS-c and humanin are written in mitochondrial DNA itself, and SS-31 is a synthetic peptide that collects in the mitochondrial membrane. Only SS-31 is an approved drug, for Barth syndrome; the other two have animal data only.
Is SS-31 FDA-approved?
Yes, as Forzinity (elamipretide), under accelerated approval in September 2025, to improve muscle strength in people with Barth syndrome weighing at least 30 kg. The label dose is 40 mg under the skin once daily. The 1–10 mg doses used for general ‘mito’ support have no trial behind them.
Is NAD+ a peptide?
No. NAD+ is a coenzyme, a helper molecule built from two nucleotides, used in energy production and by DNA-repair enzymes. 5-Amino-1MQ and SLU-PP-332 aren’t peptides either; they are small synthetic molecules. They’re listed here because they are sold and stacked alongside the mitochondrial peptides.
Do any of these slow aging in people?
No human trial has shown that. The case rests on cell and mouse studies, such as FOXO4-DRI clearing worn-out cells in old mice, and on blood levels that don’t always fit: humanin, for instance, is higher in very old people, not lower.
Is MOTS-c banned in sport?
Yes. WADA’s 2026 list names MOTS-c under S4.4.1, metabolic modulators that activate AMPK, banned at all times. Humanin, FOXO4-DRI, 5-Amino-1MQ and SLU-PP-332 aren’t named, but with no approval anywhere they fall under S0 and are likely banned too.
Sources
- Forzinity (elamipretide) prescribing information (DailyMed, label of December 2025)
- Shirley, elamipretide: first approval (Drugs 2026) PMID 41335372
- TAD (glutathione) summary of product characteristics (AIFA, Italy)
- FDA compounding risk alert: do not use dietary supplement grade glutathione for injectables (August 27, 2026)
- CDC: adverse events linked to injectable glutathione compounded with a dietary supplement grade ingredient (updated September 11, 2026)
- Hashimoto et al., humanin, a rescue factor against Alzheimer’s-linked nerve cell death (Proc Natl Acad Sci U S A 2001) PMID 11371646
- Zhao et al., cell-permeable peptide antioxidants targeted to the inner mitochondrial membrane (J Biol Chem 2004) PMID 15178689
- Lee et al., MOTS-c promotes metabolic homeostasis and reduces obesity and insulin resistance (Cell Metab 2015) PMID 25738459
- Baar et al., targeted apoptosis of senescent cells restores tissue homeostasis (Cell 2017) PMID 28340339
- Grant et al., NAD+ metabolome during a 6-hour IV infusion (Front Aging Neurosci 2019) PMID 31572171
Each compound’s page lists the sources for its own doses, status and studies.