Research use only. This article summarises dosing figures reported in the published scientific literature for SS-31 (elamipretide), MOTS-c and NAD+. It is an educational review of what has been studied — it is not a dosing guide, a protocol, or medical advice. Every figure below describes a specific study in a specific population or model. Numbers used in one clinical trial do not transfer to other people, other purposes, or other compounds. Nothing here should be read as an instruction to dose yourself or anyone else.
A recurring problem in this space is that a dose from a single trial — or worse, a dose from a mouse study — gets repeated online until it looks like a “standard.” This article deliberately separates four very different tiers of evidence:
- Doses used in published human clinical trials — the strongest evidence.
- Doses used in animal / preclinical studies — informative, but not translatable to humans.
- Experimental protocols — early-phase, safety-focused, or single pilot studies.
- Unverified dosing schedules circulating online — not scientific evidence at all.
We do not convert animal doses into human-equivalent doses anywhere in this article.
Dosage & Cycle Protocols Used in Research
Below, each compound is reported using only what appears in the primary literature: the exact dose, the units, the route, the frequency, the duration, whether a washout period was used, the participant or model type, the study phase where applicable, the citation, and the outcome that was being investigated.
SS-31 / Elamipretide — human clinical-trial dosing exists
Of the three compounds, elamipretide (research code SS-31; also “MTP-131”) has by far the most human clinical-trial evidence. Across multiple randomised trials the dose has been remarkably consistent: 40 mg per day, subcutaneous, once daily.
- MMPOWER-2 (Karaa et al., 2020) — A Phase 2, randomised, double-blind, placebo-controlled crossover trial in 30 adults with genetically confirmed primary mitochondrial myopathy (PMM). Participants received 40 mg/day subcutaneous elamipretide for 4 weeks and placebo for 4 weeks, in randomised order, separated by a 4-week washout period. Primary outcome: distance on the 6-minute walk test (6MWT), which did not reach statistical significance (difference 19.8 m; P = 0.083); several patient-reported fatigue measures did improve. Outcome investigated: exercise capacity and fatigue in mitochondrial myopathy.
- MMPOWER-3 (Karaa et al., 2023) — A Phase 3 randomised placebo-controlled trial using the same 40 mg/day subcutaneous dose for 24 weeks in primary mitochondrial myopathy. It did not meet its primary endpoints. Outcome investigated: 6MWT and total fatigue over longer-term treatment.
- TAZPOWER (Reid Thompson et al., 2021; NCT03098797) — A Phase 2/3 randomised placebo-controlled crossover trial of 40 mg/day subcutaneous elamipretide in Barth syndrome, with each arm ~12 weeks, followed by a long open-label extension reported out to 168 weeks. Outcome investigated: muscle strength and cardiac function in Barth syndrome.
In September 2025 the US FDA granted accelerated approval to elamipretide HCl (brand name FORZINITY, Stealth BioTherapeutics) — the first approved therapy for Barth syndrome in patients weighing at least 30 kg. This is important context, but note carefully: the approval is for a specific ultra-rare genetic disease under medical supervision. It is not an approval of SS-31 as a general performance, longevity or “energy” compound, and the research material sold as SS-31 is not the approved medicine.
Key point. The 40 mg/day subcutaneous figure is a genuine clinical-trial dose — but it was established for defined patient populations with mitochondrial disease, measured against disease endpoints. It is not a universal SS-31 dosage recommendation, and it has never been validated for healthy individuals or for anti-ageing/performance use.
MOTS-c — no established human research dose
No established human research dosing protocol has been identified for native MOTS-c. Despite how frequently “MOTS-c protocols” appear online, there is no published, controlled human clinical trial that establishes a dose, frequency and duration for the native MOTS-c peptide.
What has been investigated:
- Preclinical (animal) research. The peptide was characterised by Lee et al. (2015, Cell Metabolism) in mice. Reported protocols used intraperitoneal (IP) injection at 5 mg/kg/day for ~7 days (insulin-sensitivity clamp studies) and 15 mg/kg/day for ~5 weeks in high-fat-diet mice to prevent obesity and insulin resistance. These are mouse doses in mg per kg of body weight. We are not converting them into a human dose, and neither should anyone else — interspecies dose translation for peptides is not established here.
- A MOTS-c analog (a different molecule), CB4211. CohBar's CB4211 is an engineered analog of MOTS-c, not native MOTS-c. Its Phase 1a/1b study (topline results 2021) tested 25 mg/day subcutaneous for 4 weeks in 20 obese subjects with non-alcoholic fatty liver disease (NAFLD), after a Phase 1a single/multiple-ascending-dose stage in 65 healthy adults. It met its primary safety endpoint with exploratory signals (reduced ALT/AST, lower glucose). Because CB4211 is a distinct engineered peptide, this does not establish a dose for native MOTS-c.
Research Dosing vs Online Protocols (MOTS-c)
Online sources — peptide clinics, bodybuilding forums, Reddit threads and vendor pages — commonly circulate MOTS-c schedules such as fixed daily microgram/milligram amounts cycled over weeks. None of these constitute scientific evidence. They are not derived from controlled human trials of native MOTS-c, because such trials establishing a dosing protocol have not been published. Where an online “protocol” states a confident human dose, it is presenting an assumption — often extrapolated from mouse studies or from the CB4211 analog — as if it were established fact. The honest scientific position for native MOTS-c remains: no established human research dosing protocol has been identified.
NAD+ — three different things people call “NAD+”
“NAD+” is used loosely to describe at least three non-interchangeable approaches with different molecules, routes and evidence bases:
- Direct NAD+ administration (usually intravenous). Human data is limited and largely from small pilot/pharmacokinetic studies. A frequently cited pilot administered 750 mg NAD+ intravenously over a 6-hour infusion (~3 µmol/min) to track the plasma/urine NAD+ metabolome (Grant et al., 2019). Real-world tolerability reports describe regimens such as 500 mg IV on consecutive days. Oral direct-NAD+ absorption is poorly characterised. Outcome investigated: pharmacokinetics/tolerability, not a defined clinical benefit.
- Nicotinamide riboside (NR) — an NAD+ precursor, taken orally. This has multiple RCTs. The largest (Conze et al., 2019, “NIAGEN”) gave 100, 300 or 1000 mg/day orally for 8 weeks to 140 healthy overweight adults and raised whole-blood NAD+ dose-dependently (up to ~+140% at 1000 mg). Others (NADPARK, NICE) used 1000 mg/day. Outcome investigated: blood NAD+ elevation and safety.
- Nicotinamide mononucleotide (NMN) — another NAD+ precursor, taken orally. RCTs have used roughly 250–1200 mg/day for 6–12 weeks (e.g. 250 mg/day in older men; 300/600/1200 mg/day dose-ranging). Outcome investigated: blood NAD+, physical performance, metabolic markers.
These are not the same thing. Direct IV NAD+ is a molecule delivered into the bloodstream; NR and NMN are oral precursors the body converts toward NAD+. Evidence for raising blood NAD+ is strongest for the oral precursors (NR, NMN); direct NAD+ infusion human evidence is comparatively thin. Treating a precursor RCT as if it validated IV NAD+ (or vice versa) is a category error.
Summary table — doses actually reported in research
| Compound | Research dose | Frequency | Route | Duration | Study type | Source |
|---|---|---|---|---|---|---|
| SS-31 / Elamipretide | 40 mg/day | Once daily | Subcutaneous | 4 wks/arm + 4-wk washout | Phase 2 RCT crossover, primary mitochondrial myopathy (n=30) | Karaa et al. 2020, J Cachexia Sarcopenia Muscle (MMPOWER-2) |
| SS-31 / Elamipretide | 40 mg/day | Once daily | Subcutaneous | 24 weeks | Phase 3 RCT, primary mitochondrial myopathy | Karaa et al. 2023, Neurology (MMPOWER-3) |
| SS-31 / Elamipretide | 40 mg/day | Once daily | Subcutaneous | ~12 wks/arm + open-label ext. | Phase 2/3 crossover, Barth syndrome | Reid Thompson et al. 2021 (TAZPOWER, NCT03098797) |
| MOTS-c (native) | No established human dose identified | — | — | — | No controlled human trial of native MOTS-c identified | — (see text) |
| MOTS-c (native) — preclinical only | 5–15 mg/kg/day (mouse) | Daily | Intraperitoneal | 7 days – 5 weeks | Preclinical (mice) — not translatable to humans | Lee et al. 2015, Cell Metabolism |
| CB4211 (MOTS-c analog, different molecule) | 25 mg/day | Once daily | Subcutaneous | 4 weeks | Phase 1b RCT, obese NAFLD (n=20) | CohBar topline results, 2021 |
| NAD+ (direct) | 750 mg | Single 6-hour infusion | Intravenous | 6 hours | Human pilot / pharmacokinetic study | Grant et al. 2019 (6-h IV NAD+ PK pilot) |
| Nicotinamide riboside (NR) — NAD+ precursor | 100 / 300 / 1000 mg/day | Once daily | Oral | 8 weeks | RCT, healthy overweight adults (n=140) | Conze et al. 2019, Sci Rep (NIAGEN) |
| Nicotinamide mononucleotide (NMN) — NAD+ precursor | 250–1200 mg/day | Once daily | Oral | 6–12 weeks | Multiple RCTs | e.g. Igarashi et al. 2022, npj Aging; RCT systematic reviews |
Doses are reported as they appear in the cited studies. Animal (mg/kg) figures are shown only to describe the preclinical work and are deliberately not converted to human doses.
What Does a Research Cycle Actually Look Like?
Rather than invent one universal “stack,” here is a plain map of the durations actually used in the published studies above. Notice that these are separate studies of separate compounds — they were never run as a single combined cycle.
SS-31 / Elamipretide
Research period → 4 weeks per arm (MMPOWER-2) — up to 24 weeks continuous (MMPOWER-3)
Washout → 4 weeks (used in the MMPOWER-2 crossover design)
MOTS-c
Human evidence → None for native MOTS-c (no established human dose or duration)
Nearest human data → analog CB4211, 4 weeks (different molecule); native MOTS-c preclinical only
NAD+
Direct NAD+ → single ~6-hour IV infusion (pilot); real-world regimens over a few consecutive days
Precursors (NR / NMN) → 8 weeks (NR RCT) / 6–12 weeks (NMN RCTs), oral
Can These Studies Be Combined Into One SS-31 + MOTS-c + NAD+ Cycle?
No published clinical study has evaluated the SS-31 + MOTS-c + NAD+ combination. Each figure above comes from a separate trial, in a separate population or model, measuring a separate outcome, with no interaction data between the three.
Combining the endpoints of three unrelated studies does not establish that using them together is safe or effective. Drug–drug and peptide interactions, additive effects, and combined safety can only be established by studying the combination directly — which, for this trio, has not been done. Assuming that “each has been studied, so the stack is validated” is precisely the reasoning error this article is written to prevent.
The 15-Week “Energy Revival” Protocol: What Does the Evidence Say?
A schedule circulating on social media proposes a roughly 15-week programme. We reproduce it here solely to analyse it against the evidence — not to endorse or recommend it:
- Weeks 1–2: SS-31 started
- Week 3 onward: MOTS-c added
- Later weeks: NAD+ added
- Week 12: SS-31 and MOTS-c stopped
- Weeks 12–15: NAD+ continued alone
Assessing each component against the published literature:
PARTIALLY SUPPORTED SS-31 dose (40 mg/day SC)
The dose itself is supported by human research — but only in mitochondrial-disease populations, measured against disease endpoints. Its use here (healthy individuals, a 2-week start then stop at week 12, for “energy”) has no direct evidence. Supported dose, unsupported context.
NO DIRECT EVIDENCE IDENTIFIED MOTS-c component
Native MOTS-c has no established human dose or cycle. The timing (“add at week 3, stop at week 12”) is not derived from any human trial. Nearest human data is the CB4211 analog (a different molecule), which is early-phase and safety-focused — at best preclinical/emerging for the MOTS-c concept, not validation of this schedule.
PRECLINICAL / EMERGING NAD+ component
Evidence depends entirely on which NAD+ is meant. Oral precursors (NR, NMN) have human RCTs for raising blood NAD+ over 8–12 weeks; direct IV NAD+ has only small pilot data. Neither was studied as the tail-end of a peptide cycle, so the specific “continue NAD+ to week 15” step is not evidence-based even though the ingredient class has some human data.
NO DIRECT EVIDENCE IDENTIFIED The combined 15-week cycle as a whole
No trial has tested this sequence, these overlaps, or this combination. The 15-week structure is a social-media construct, not a studied protocol.
The fact that each individual compound has been studied does not make the combined social-media protocol scientifically validated. A reader should leave with both halves of the picture clearly separated: what doses have actually been studied (the verified figures and table above), and how strong the evidence is for those doses and for any cycle built from them (strong for SS-31's dose in disease populations; absent for native MOTS-c human dosing; precursor-dependent for NAD+; and non-existent for the three-compound cycle).
Research protocols are study-specific and should not be interpreted as dosing instructions or medical advice.
Primary sources: Karaa et al. 2020, Journal of Cachexia, Sarcopenia and Muscle (MMPOWER-2); Karaa et al. 2023, Neurology (MMPOWER-3); Reid Thompson et al. 2021 (TAZPOWER / NCT03098797); FDA accelerated approval of elamipretide HCl (FORZINITY), September 2025; Lee et al. 2015, Cell Metabolism (MOTS-c); CohBar CB4211 Phase 1a/1b topline results, 2021; Grant et al. 2019 (6-hour IV NAD+ pharmacokinetic pilot); Conze et al. 2019, Scientific Reports (NR / NIAGEN); Igarashi et al. 2022, npj Aging and RCT systematic reviews (NMN).