SS-31
SS-31 (Elamipretide / Bendavia / MTP-131)
Also called SS-31, elamipretide, Bendavia, MTP-131
A mitochondria-targeted pharmaceutical, also called elamipretide
SS-31 is unusual in that it goes to one specific place: the inner membrane of the mitochondria, the part that actually generates energy. It binds to a fat molecule there called cardiolipin that gets damaged with age and disease, and stabilises it. Think of it as repairing the wiring rather than adding fuel.
A peptide that goes to one specific place: the inner membrane of the mitochondria, where it binds a fat called cardiolipin. It is the rare compound here that is a genuine pharmaceutical, tested in real trials, and its honest record includes a large trial that failed. Also known as elamipretide.
- Half-life
- 3 to 4 hours
- Status
- Approved in the US only for Barth syndrome (Forzinity); otherwise investigational
Studied in people, and well studied in preclinical models
511 papers · 23 clinical trials
What SS-31 has been studied for
The reasons people look it up, roughly in order of how often, and what research exists for each. Interest in a use is not evidence that it works; the evidence is stated under each one.
- Fatigue tied to mitochondria
- The main reason people look it up. It targets energy production in the mitochondria rather than acting as a stimulant, but no trial has tested it for general fatigue.
- Rare mitochondrial disease
- Where the serious clinical work has happened, under the name elamipretide. Results have been mixed and it has had a difficult regulatory path.
- Heart and muscle
- Heart muscle is packed with mitochondria, which is why it has been trialled in heart failure and in Barth syndrome, a rare disease affecting heart and skeletal muscle.
Mechanism of Action
How SS-31 works
Mitochondria have two membranes, and the inner one is folded into deep pleats to pack more surface into the space. Those folds are where energy is actually produced, and they are held in shape by a particular fat called cardiolipin.
Cardiolipin is fragile. It sits right next to where energy production happens, which is also where damaging reactive molecules are produced, so it takes damage first. When it degrades, the folds slump, the machinery bolted to them stops sitting correctly, and energy output falls.
What SS-31 does about it
SS-31 is built to go to exactly that membrane and bind cardiolipin. Not to the cell in general, not to a receptor on the surface, but to one fat in one membrane inside one organelle.
Binding it appears to stabilise the folds and keep the energy machinery properly seated. That is a structural repair rather than a stimulant: it is not pushing mitochondria to work harder, it is trying to fix the shape they work in.
The part that makes this compound credible
Its record includes a failure, and that is worth more than a page of successes. It has been through real clinical trials rather than only preclinical work, and a large one in a broad group of mitochondrial disease patients did not hit its endpoint.
That says two useful things: this is being tested honestly, and a compound targeting one specific defect will not help where the problem lies elsewhere. It is a precise tool, and precise tools miss when pointed at the wrong thing.
SS-31 side effects: what studies reported
The consistent complaint is the injection site rather than anything systemic, and it is more pronounced than with most peptides.
Most commonly reported
- Injection-site reactions: redness, itching, a raised welt that can last a day or more
- Headache
- Nausea
Worth keeping an eye on
- Injection-site reactions were common enough in trials to be a reason participants stopped
Source: Clinical trials of elamipretide. This is a summary of published findings, not a complete safety profile and not medical advice. Questions about SS-31 belong with a licensed clinician who knows your history.
Your Genetics & SS-31
The genes involved in how SS-31 works
SS-31 works through the receptors these genes build, and the genes vary from person to person. Researchers have linked some of that variation to differences in how people respond. A DNA report tells you which versions you carry.
SOD2 · ••
The Val16Ala variant has been associated with differences in how the SOD2 antioxidant enzyme is imported into mitochondria. No study has tested whether it changes response to SS-31.
PPARGC1A · ••
The Gly482Ser variant in PGC-1alpha, a regulator of mitochondrial biogenesis, has been associated with metabolic and exercise traits in human studies. Any link to SS-31 is untested.
Cytochrome c works alongside cardiolipin in the electron transport chain, which SS-31 acts on. Variants near the gene are studied for their effect on expression. Pathway context only.
The -262C>T promoter variant has been associated with differences in catalase levels, an enzyme that neutralises hydrogen peroxide. Pathway context only; untested with SS-31.
The dots after each gene are where your own result goes. Your report fills them in with the two letters you carry at that position.
Which of these variants do you carry?
Your report reads the DNA file you already have against this research.
Often discussed alongside
Compounds that come up next to SS-31 in research and discussion. Each has its own page. None of this is a suggestion to combine them.
MOTS-c
also studied for mitochondrial functionEmerging EvidenceMitochondrial Open Reading Frame of the 12S rRNA Type-c
A peptide written not in the cell's main genome but in the tiny separate one mitochondria carry, a leftover from when they were free-living bacteria. In preclinical work it behaves like an exercise signal, switching on the same fuel-burning pathway a hard workout does. Levels fall with age, which is why it turns up in longevity conversations, and essentially all of the outcome data are preclinical.
3
Gene variants
25+
Studies
Humanin
also a mitochondria-related peptidePreliminary EvidenceHumanin (Mitochondrial-Derived Peptide)
A small peptide encoded inside mitochondrial DNA, one of the first mitochondrial-derived peptides found. In laboratory and preclinical work it acts as a cell-protective and metabolic signal, and higher circulating levels have been associated with longevity in human observational studies. It has never been tested in a human trial.
3
Gene variants
25+
Studies
Access
Access and legal status
SS-31: Approved in the US only for Barth syndrome (Forzinity); otherwise investigational. Decisions about any prescription medicine belong to a prescriber. We don't link to any seller, and nothing on this page is a recommendation to obtain or use it.
Your DNA and SS-31: see which of the variants studied alongside it you carry, and what that research does and does not show. Read my DNA, $99 →
Educational information only, not medical advice. Most peptides are not FDA-approved. Do not start, stop or change any medication or peptide because of this page; talk to a licensed clinician.
Worth knowing about SS-31
Interactions and situations where there is a specific reason to be careful. Where the honest answer is that nobody has studied something, it says so and says what that leaves open.
- The clinical results have been mixed
- This is not a compound with an unbroken run of wins. Some trials missed their targets. That is worth knowing before treating it as established.
- Injection-site reactions are common
- More so than with most peptides, and in trials they were a reason some participants stopped.
The evidence behind SS-31
This is a real pharmaceutical with 23 registered clinical trials, which sets it apart from most of this catalogue. It is also the rare compound whose public record includes a clear failure: a large trial in a broad group of mitochondrial disease patients did not meet its endpoint. That is worth more than a run of positive results, because it shows the testing is honest and that a precise tool misses when pointed at the wrong problem.
The literature, counted
Counted in PubMed on 3 August 2026 for SS-31 OR elamipretide. Every figure links to the search that produced it, so you can re-run it. “Tagged human” is not the same as a human trial: that tag also covers work on human cells and reviews discussing people, which is why the trial count is given separately.
Preclinical studies
1 of 1Preclinical results do not automatically hold in people.Reviews
1 of 2Papers that gather other studies rather than run new ones.Every source behind this page31 more
Everything we cite for SS-31, including preclinical work and early research. Each link goes to the source itself, so you can judge it rather than take our word for it.
Last updated · literature counts verified against PubMed on
Frequently Asked Questions
What has SS-31 been studied for?
SS-31 (elamipretide) has been tested in clinical trials in Barth syndrome, primary mitochondrial myopathy, heart failure and age-related eye disease. It targets the inner mitochondrial membrane where energy production occurs. Results have been mixed: some trials missed their primary endpoints.
Do genes affect SS-31 response?
No study has tested whether any common genotype changes response to SS-31. SOD2, PPARGC1A, CYCS and CAT sit on the mitochondrial and antioxidant pathways it is studied on, and some of their variants have been associated with related traits in human studies. A DNA report can show which versions you carry and what that research does and does not show.
How is SS-31 different from antioxidant supplements?
Most antioxidants (vitamin C, vitamin E, NAC) scavenge free radicals after they are produced. SS-31 is described as acting earlier, by stabilising the membrane where the electron transport chain produces superoxide, and it concentrates in mitochondria rather than spreading through the cell.
Watch
What clinicians and researchers say about SS-31
19 minLearn Peptides So Fast it's UNREALAshley Froese · EducatorGHK-CuKPVThymosin Alpha-1
2 hr 17 minDr. Craig Koniver - The Godfather of Peptides | SRS #330Shawn Ryan Show · PodcastBPC-157NAD+SS-31
47 minDr. Matt Cook: Reversing Age with Peptides, Stem Cells & Gene Therapy | TUH #121Gary Brecka · BiohackerBPC-157TB-500Thymosin Alpha-1Learn more about SS-31
peptide guides
In depthSS-31 (elamipretide) failed its biggest trial, then got FDA approval. Here is why.
9 min read
genetics
APOE4 and peptides: what research on 7 compounds has and has not shown
11 min read
peptide guides
MOTS-c: the mitochondrial peptide that falls with age
8 min read
how it works
What a DNA file can and cannot tell you about peptide research
9 min read
Your DNA and SS-31
What the research says about your variants.
The report
Which SS-31 variants do you carry?
Your report reads the DNA file you already have against the published research on 31 peptides, marker by marker, and says what that research does and does not show.
Read my DNA, $99