How it works
Concentrates in the inner mitochondrial membrane where it binds cardiolipin, stabilising cristae architecture, improving electron-transport efficiency and reducing reactive oxygen species leakage.
Structure: Tetrapeptide (D-Arg-dimethylTyr-Lys-Phe-NH2)
Reported benefits
- Improved mitochondrial ATP output
- Reduced oxidative stress markers
- Fatigue improvement in mitochondrial disease trials
Practical considerations
- Human evidence exists but for disease populations, not healthy performance
- Costly and typically injected daily
- Trial results have been mixed on primary endpoints
Side effects and risks
- Injection-site reactions are common and can be significant
- Headache
- Dizziness
SS-31 dosing overview
Trial dosing around 40 mg daily; community protocols use less
| Context | Amount | Frequency | Route |
|---|---|---|---|
| Clinical trial dosing (elamipretide) | ~40 mg | Once daily | Subcutaneous |
| Community protocols | Lower, variable | Daily cycles | Subcutaneous |
This describes doses reported in published literature and community protocols. It is not a recommendation, and it is not a substitute for clinical supervision.
SS-31 FAQ
What is SS-31?
Also called elamipretide, it is a mitochondria-targeting peptide that binds cardiolipin in the inner mitochondrial membrane and improves the efficiency of electron transport.
What has it been trialled for?
Primary mitochondrial myopathy, Barth syndrome, heart failure and dry AMD. Results have been mixed — some functional endpoints improved, several pivotal endpoints were missed.
Is it approved?
It remains investigational. Regulatory review has been ongoing in specific rare-disease indications rather than for general use.
Research references
- Karaa et al., 2018 — Elamipretide in primary mitochondrial myopathy