Mitochondrial
SS-31 / Elamipretide
FDA accelerated approval for Barth syndrome only
In simple words: A small peptide that sticks to the inner wall of mitochondria to help them make energy with less damage.
How it works
It binds cardiolipin, a fat in the inner mitochondrial membrane, stabilizing the energy-making machinery and reducing oxidative stress.
Targets: Cardiolipin (inner mitochondrial membrane) · Class: Mitochondria-targeted tetrapeptide
Uses, latest studies & pairings
Typically used for
- Approved: Barth syndrome, a rare inherited heart and muscle disease, in people weighing at least 30 kg (Forzinity).
- Studied: mitochondrial myopathy, heart failure and eye disease, with mixed or negative results.
- Sold online for energy and anti-aging, which is unapproved and unstudied.
Commonly paired with
- Often marketed with MOTS-c, NAD+ or urolithin A for “mitochondrial” stacks. None of these combinations has been studied.
Latest studies & news
- Sep 2025
FDA accelerated approval as Forzinity, the first Barth syndrome treatment, based on better knee-muscle strength. A confirmatory trial is required to keep the approval.
Source: FDA: accelerated approval for first treatment for Barth syndrome (2025)
What the research shows
Human clinical evidence
Human- Studied in human trials for rare mitochondrial diseases with mixed results; one large trial in primary mitochondrial myopathy missed its main goal.
- Received FDA accelerated approval in September 2025 (as Forzinity) only for Barth syndrome, a rare inherited heart and muscle disease, based on improved knee-muscle strength; a confirmatory trial is required.
Animal and lab results suggest what might happen; they don't prove an effect in people.
Safety & what to watch
- Injection-site reactions were the most common side effect in trials.
- Use outside Barth syndrome is unapproved.
Amounts
No dose is given for unapproved substances. If you are considering it, discuss it with a licensed clinician who knows your history and bloodwork.
📦 My peptide supply kit
The supplies I use, in one Amazon list. Only use them for medicines your clinician prescribes. Never share or reuse needles, and put used ones in a sharps container.
Studies & references
Draft profile pending editorial review. Educational only, not medical advice. Never start, stop or change a medicine without your prescriber.