OnePin Peptide Library · Mitochondrial
SS-31
Elamipretide · MTP-131 · Bendavia
SS-31 (also known as Elamipretide, Bendavia, MTP-131) is a synthetic cell-permeable tetrapeptide (D-Arg-Dmt-Lys-Phe-NH2) that selectively targets and stabilizes cardiolipin in the inner mitochondrial membrane. Cardiolipin is a phospholipid essential for electron transport chain efficiency, cristae structure maintenance, and ATP production. SS-31 is the only FDA-approved compound specifically targeting mitochondrial inner membrane function (approved as ELPINEO for Barth syndrome). It has been studied in clinical trials for heart failure, renal ischemia, age-related macular degeneration, primary mitochondrial myopathy, and Barth syndrome. SS-31 represents a direct approach to mitochondrial optimization that complements upstream metabolic activators like MOTS-c.
Any time of day. No fasting required. Targets inner mitochondrial membrane cardiolipin.
Start here. Every protocol below is ordered lowest-first. Begin at the smallest effective dose, hold about a week to assess tolerance, and step up only if needed.
How it works
SS-31 concentrates approximately 1000-fold in the inner mitochondrial membrane due to its aromatic-cationic structure, which electrostatically interacts with cardiolipin's negatively charged phosphate groups. By stabilizing cardiolipin, SS-31 preserves the cristae architecture necessary for proper electron transport chain (ETC) complex organization, prevents cytochrome c detachment (reducing apoptotic signaling), maintains efficient electron transfer between complexes III and IV, and reduces electron leak that generates reactive oxygen species (ROS). The net effect is improved ATP production efficiency and reduced oxidative stress at the source. SS-31 does not act as a traditional antioxidant (scavenging ROS after formation) but rather prevents excessive ROS generation by maintaining ETC integrity. This upstream mechanism distinguishes it from all other mitochondrial supplements.
SS-31 concentrates approximately 1000-fold in the inner mitochondrial membrane due to its aromatic-cationic structure, which electrostatically interacts with cardiolipin's negatively charged phosphate groups. By stabilizing cardiolipin, SS-31 preserves the cristae architecture necessary for proper electron transport chain (ETC) complex organization, prevents cytochrome c detachment (reducing apoptotic signaling), maintains efficient electron transfer between complexes III and IV, and reduces electron leak that generates reactive oxygen species (ROS). The net effect is improved ATP production efficiency and reduced oxidative stress at the source. SS-31 does not act as a traditional antioxidant (scavenging ROS after formation) but rather prevents excessive ROS generation by maintaining ETC integrity. This upstream mechanism distinguishes it from all other mitochondrial supplements.
What to expect
Days 1-14: Minimal perceptible changes in most users. SS-31 works at the mitochondrial membrane level, and functional improvements take time. Some users report subtle energy improvements.
Weeks 2-6: Exercise tolerance improvements become noticeable. Recovery between sessions improves. HRV may show improvement (mitochondrial function affects autonomic regulation). Fatigue levels decrease.
Weeks 6-12: Cumulative mitochondrial protection and optimization. Clinical trials showed functional improvements at 4-12 weeks. Cardiac function markers may improve. Best assessed through repeat testing (6-minute walk test, HRV, exercise capacity).
Evidence
The honest take
Mitochondrial optimization
Strongest claim. FDA-approved for Barth syndrome (mitochondrial disease). Mechanism (cardiolipin stabilization) is definitively established. One of the only compounds with direct, proven mitochondrial membrane activity.
Phase 2 data in HFpEF showed improvements in cardiac function markers. Animal data in cardiac ischemia-reperfusion is robust. Promising but not FDA-approved for cardiac indications.
Mitochondrial decline is a hallmark of aging. SS-31 directly addresses this mechanism. Animal studies show reversal of age-related mitochondrial dysfunction. Conceptually one of the best-supported anti-aging mechanisms but not proven in human longevity trials.
Interactions & stacking
What's safe to combine, and what belongs in a separate pin.
Safe & synergistic
Keep separate
Side effects & safety
Commonly reported
- Mild injection site reactions
- Generally very well tolerated in clinical trials
- Rare headache
- Rare nausea
Less common & notes
- Clinical trial safety data shows favorable tolerability across multiple studies.
- No significant organ toxicity identified.
- Renal excretion means monitoring kidney function is prudent, especially with concurrent nephrotoxic medications.
- No significant drug interactions identified in clinical programs beyond renal considerations.
Pharmacokinetics
Storage. Store unreconstituted vials frozen (-20C) or refrigerated (2-8C). After reconstitution with BAC water, refrigerate at 2-8C. Stable for 28 days. FDA-approved formulation is well-characterized for stability. Protect from light.
Regulatory status
FDA-approved as ELPINEO for Barth syndrome. Phase 2 studies completed for HFpEF, renal ischemia, AMD, and primary mitochondrial myopathy. Off-label use at physician discretion. WADA status: Not specifically listed. Available through compounding pharmacies and research channels.
Put it to work
Calculate, log & track
Open SS-31 straight into OnePin with your vial and dose pre-filled, then let it handle the syringe math and remind you before the vial runs out.
Open SS-31 in the app →Go deeper
The guide & community
The complete SS-31 walkthrough, real protocol discussion and coaching live inside the BlessUp community on Skool.
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