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SS-31 (elamipretide)

Targets the cell’s power plants; a US medicine for a rare disease.

StatusUS prescription medicine for Barth syndrome (accelerated approval, 2025); not authorised in EU/UK
How well studied in peopleTested in clinical trials
Experts quoted6 experts

iNot medical advice. We don’t recommend any dose. Every dose below is a quote from the person named, describing their views or their own use. Elamipretide received FDA accelerated approval on 19 September 2025 as Forzinity, for Barth syndrome in patients weighing at least 30 kg. We found no EU or UK authorisation as of October 2026. “SS-31” sold online is not the approved product.

What experts say about dosing

8 statements from 5 people. Each one is word for word: we add punctuation only and mark cuts with […]. The chips repeat the exact words used.

Nicholas TrigiliHuman performance specialist and coach; fitness YouTuber

Daily, for the length of a retatrutide cycle

Dose
“3 to 5 milligrams”
How often
“once a day”
How long
“a full length of your retatrutide cycle”
How taken
“subq”
When
“first thing in the morning”

“SS-31 is typically dosed like this. I would start with 3 to 5 milligrams subq once a day. I like that my clients inject it first thing in the morning so it becomes part of their routine. they don't forget about it and they run it for a full length of your retatrutide cycle.”

Watch at 10:25Top 6 RETATRUTIDE Stacks to Get Shredded in 2026 (Nicholas Trigili) · upload date not confirmed

Context: Note the difference from the “5 to 10 mg per week” in his July 2026 stack video (above). Caption spelling of the compound name corrected: “SS31” → SS-31; “reatrite” → retatrutide. He says in his videos that he is not a doctor.

Own use: current routine

Dose
“5 to 10 mg per week”
How often
“dose the same exact way”
How long
“first two to four weeks by itself”

“And SS-31, 5 to 10 mg per week, dose the same exact way. If I'm cycling together though, I start SS-31 by itself for the first two to four weeks to repair the machine. Then, you can layer MOTS-c on top of that.”

Watch at 11:59I’m 39. Here's everything I'm taking to Beat Aging (Full Stack Breakdown) (Nicholas Trigili) · 20 Jul 2026

Context: “The same exact way” refers to his MOTS-c split (“usually two doses”). The captions’ “[music]” tag is omitted.

Start before MOTS-c

Dose
“2 mg”
How often
“five times per week”
How long
“four weeks … two to four weeks”

“So, here's how I would actually sequence this. I would start with SS-31 on its own. I would start with 2 mg five times per week for four weeks before I would start MOTS-c. Now, you can technically go two to four weeks.”

Watch at 8:10MOTS-C isn’t a fat loss peptide (Here’s what it actually does) (Nicholas Trigili) · 30 Sep 2026

Context: The captions’ “[music]” tag is omitted. He says in his videos that he is not a doctor.

Dr Dean St MartUK educator (SN Education, SN Hub); podcast and panel guest

Own use: three-week run

Dose
“five milligrams”
How often
“five days per week”
How long
“three weeks in a row”

“I do like you have done um five milligrams five days per week for three weeks in a row but that's with everything else in play like Moy SLU metal that did I notice a massive benefit I can't really say”

Watch at 1:50:02PEPTIDES RANKED! Growth Hormone, IGF-1, Insulin, BPC-157, TB-500, Mots-C, MK-677, Follistatin, Etc (Vigorous Steve with Kurt Havens and Dr Dean St Mart) · 16 Dec 2024

Context: Own use. Steve asks “Dean do you have any experience with ss31” just before. “Moy SLU metal” is how the captions render the MOTS-c / SLU-PP-332 / methylene blue stack he was also running.

Vigorous SteveBodybuilding coach and YouTuber (VigorousSteve)

Own use: current dose

Dose
“10 milligrams per day … 2 milligrams right now”

“That's 40 milligrams every single day. That's the problem resolving dose. Um, I ran 10 milligrams per day to see if it would improve kidney markers. It did not. I use 2 milligrams right now. I, I don't notice a difference anywhere between 1 millig to 10 milligrams.”

Watch at 6:16Trenbolone’s Minimum Dose, Generic GH Gone, SS-31 Effective Dose… (VigorousSteve Q&A livestream) · 30 May 2026

Context: Answering a viewer’s question about the minimum effective dose in a solo Q&A livestream. Just before, he says the effective dose in the evidence he reviewed is “40 milligrams, but not in all contexts”. He does not state frequency beyond “every single day” for the 40 mg figure.

Maintenance vs healing dose (his view)

Dose
“1 millig to 2 milligs … 5 milligs, 10 milligrams … 40 milligrams”

“So I'm running 2 milligs right now. Uh, based on my research, it makes sense that 1 millig to 2 milligs is a maintenance dose. 5 milligs, 10 milligrams is like a healing dose and then 40 milligrams is like the full monty dose where your mitochondria are completely and you need it for medical purposes. And still not in all the context.”

Watch at 7:31Trenbolone’s Minimum Dose, Generic GH Gone, SS-31 Effective Dose… (VigorousSteve Q&A livestream) · 30 May 2026

Context: His own interpretation, not a clinical recommendation. The sentence “where your mitochondria are completely” is cut off in the original.

Jay CampbellAuthor and podcaster on hormones and peptides; co-founder of a peptide company

2026 “God Stack”: four weeks in a mitochondrial rotation

Dose
“2-8 mg”
How often
“3 times a week in every-other-day fashion”
How long
“four weeks (no more than one month straight)”
When
“weekends as a break”

“SS-31 (Elamipretide): 2-8 mg 3 times a week in every-other-day fashion for the next four weeks, with weekends being used as a break. […] As indicated, do not run any of these agents for more than one month straight.”

Read the sourceThe 2026 Jay Campbell GOD Stack For High-Performance Men & Women (Jay Campbell’s Substack) · 5 Jun 2026

Context: Part of what he calls “The Mitochondrial Rotation”: four weeks of MOTS-c, then four weeks of SS-31, then four weeks of SLU-PP-332. The route is not stated in this line. The article recommends products from BioLongevity Labs, a company he co-founded.

Dr Alex TatemBoard-certified urologist and men’s health specialist; YouTube educator

Trial dose vs grey-market dose

Dose
“somewhere between 2 and 10”

“none of this is me writing you a prescription. […] Every pivotal human trial dosed this at 40 mg a day. The gray market crowd, mostly because this stuff is expensive, is mostly running at somewhere between 2 and 10. So, when you see all those I tried SS-31 and felt nothing reports, that isn't necessarily the drug failing you. It might be a quarter of the dose that also did nothing in the formal trial.”

Watch at 14:05SS-31: The Most Controversial Anti-Aging Peptide Ever Made (Dr Alex Tatem) · 29 Jul 2026

Context: He compares the trial dose with what people report using. The unit for “2 and 10” is not repeated; from the sentence before, it is mg a day.

What experts say about safety

2 statements from 2 people about risks and how strong the evidence is.

Dr Kent HoltorfPhysician; host of the Peptides and Longevity podcast (Big Doc Energy)

Cost of an effective dose

“ss31, um, is in tons of Trials. It improves mitochondrial function. It's basically an antioxidant inside the mitochondria, uh, for right now it's very expensive to get the dose that works, but a lot of great studies coming out on that”

Watch at 25:27Peptides 101 (Peptides and Longevity podcast / Big Doc Energy, Dr Kent Holtorf) · 5 Feb 2025

Context: He does not state the dose he means.

Vigorous SteveBodybuilding coach and YouTuber (VigorousSteve)

Own use around surgery

“glutamine post surgery, glutathione post surgery, SS31 post surgery very very very beneficial to manage oxidative stress […] I was already on glutamine and glutathione and SS31 pre-surgery so my levels didn't deplete that much”

Watch at 1:41:14BAM15 Vs. ATX-304, Cagrilintide Vs. Eloralintide… (VigorousSteve livestream) · 19 Jun 2026

Context: Answering a viewer in a solo livestream. No dose given.

Go deeper

What the research used

Context, not a dosing guide. These are the conditions used in clinical trials of elamipretide in specific diseases. Several trials missed their main goals. They are not a guide for other uses.

Human trials

StudyStudied inWhat the study usedWhat it found
Karaa et al., 2023, Neurology (MMPOWER-3)PubMed 37268435218 adults with primary mitochondrial myopathy40 mg/day subcutaneous, 24 weeksDid not meet its primary endpoints (6-minute walk, fatigue)
Butler et al., 2020, J Card Fail (PROGRESS-HF)PubMed 3206800271 patients with heart failure with reduced ejection fraction4 mg or 40 mg once daily, 28 daysNo significant change in left-ventricular volume

Reviews

  • Zhao et al., 2026, Drug Discov Ther. PubMed 41260682. Summary of the Barth syndrome approval: the randomised crossover trial showed no significant benefit on walking or fatigue; benefits were seen in the open-label extension; mild injection-site reactions were most common. A confirmatory trial is required.
What we don’t know yet
  • The approved use is narrow: Barth syndrome, under accelerated approval pending a confirmatory trial.
  • Trials in mitochondrial myopathy and heart failure did not meet their primary endpoints.
  • Doses quoted by experts below are far lower than the 40 mg/day used in trials.
  • Grey-market products are unregulated, so identity, purity and dose accuracy vary.
Common questions

Is SS-31 the same as elamipretide?

Yes. SS-31 is the research name for elamipretide, sold in the US as Forzinity.

Is SS-31 approved?

Only in the US, and only for Barth syndrome (accelerated approval, September 2025).

What dose did the trials use?

40 mg once daily by subcutaneous injection in the main trials listed above. Vigorous Steve says he uses 2 mg; see his quote.

Why does the protocol section only contain quotes?

We do not write our own dose ranges. The protocol cards show, word for word, what named people have publicly said, with their caveats and a link to the source.

About this page

Word-for-word statements about how SS-31 is used outside medicine, each with a link to the source. The clinical trials of elamipretide, the drug form of SS-31, are listed separately as context.

Also known as
Elamipretide; Forzinity; MTP-131; Bendavia
Type
Mitochondria-targeted tetrapeptide (cardiolipin binder)
Last updated
11 Oct 2026

Last reviewed 11 Oct 2026 · Compiled by the Peptide Dosing editorial team · How we check quotes