🚨 CRITICAL WARNING: SS-31 (Elamipretide) is a Schedule 4 Prescription-Only medicine in Australia. Unlike most peptides that signal a receptor to “do something,” SS-31 is a structural peptide that physically enters the mitochondria to repair them. While currently considered Permitted by most sporting bodies (as it is not anabolic), athletes should always check the “Metabolic Modulators” section of their federation’s rulebook, as interpretations can change.
✅ Executive Summary: Key Takeaways for SS-31
- What is it? A tetra-peptide that penetrates the inner mitochondrial membrane to stabilize Cardiolipin, a fat molecule essential for energy production.
- Best Use: Treating Chronic Fatigue Syndrome (CFS), protecting kidneys/heart from damage, and “recharging” elderly mitochondria.
- The “Magic”: It reduces “proton leak” in your cellular batteries, making them run cooler and more efficiently (less oxidative stress, more ATP).
- The Catch: It has poor bioavailability and often requires high doses, making it one of the most expensive peptides on the market.
- Cost Estimate: $300 – $500 AUD per month.
The Science Behind “The Battery Fixer”
SS-31 (Szeto-Schiller-31) operates on a deeper level than almost any other peptide. While things like HGH or BPC-157 work on cell receptors outside the cell, SS-31 actually travels inside the cell, and then inside the mitochondria (the cell’s power plant).
Once inside, it binds to a very specific phospholipid called Cardiolipin.
Think of Cardiolipin as the “glue” that holds the Electron Transport Chain (ETC) together. The ETC is the turbine that generates your energy (ATP). As we age, or under stress (toxins, diabetes), Cardiolipin gets damaged and oxidized. The “glue” fails, the turbine falls apart, and electrons leak out. This causes two problems:
- Low Energy: You produce less ATP (Fuel).
- High Exhaust: The leaking electrons become Reactive Oxygen Species (ROS), which rust your cells from the inside out.
SS-31 acts as a structural stabilizer. It binds to Cardiolipin and pulls the turbine back together. This restores the flow of electrons, effectively increasing energy production while simultaneously lowering oxidative stress. It is arguably the only true “Mitochondrial Rejuvenator” in existence.
🧠 Did You Know?
SS-31 is currently in Phase 3 FDA clinical trials for Barth Syndrome (a genetic heart defect) and mitochondrial myopathy. It is one of the few peptides being fast-tracked by mainstream medicine because it targets the root cause of cellular aging: mitochondrial dysfunction.
Who Is Talking About SS-31?
- Dr. Peter Attia: Has discussed mitochondrial health extensively. While cautious about unproven therapies, he acknowledges that the mechanism of stabilizing Cardiolipin is one of the most promising avenues for treating age-related decline and heart failure.
- The “Long COVID” Community: Because Long COVID is increasingly viewed as a mitochondrial metabolic disorder (viral damage to the power plants), SS-31 has become a “Holy Grail” therapeutic in underground forums for restoring baseline energy levels in bedbound patients.
- Ben Greenfield: Stacks SS-31 with NAD+ patches. He describes the effect not as a “stimulant buzz,” but as a removal of the “heavy” feeling in the limbs during endurance exercise.
Disclaimer: These figures discuss the science and their personal protocols. They are not prescribing this to you.
Real World Applications: Why Australians Use It
In Australian clinics, SS-31 is a “Specialist” peptide. It is used when everything else has failed.
The “Burnout” / CFS Patient
This patient has normal blood tests but cannot get out of bed. Their mitochondria are essentially “offline.”
- The Goal: SS-31 is used to physically repair the energy production machinery. Unlike caffeine or stimulants (which just whip a tired horse), SS-31 fixes the horse. Patients often report a slow, steady return of their “battery capacity” over 4-8 weeks.
The “Kidney Health” User
Bodybuilders and elderly patients often have kidney strain (high blood pressure, high protein, or drug toxicity).
- The Goal: SS-31 is nephroprotective. It concentrates in the kidneys and protects the delicate mitochondrial structures in the renal tubules from oxidative damage. It is often used to improve GFR (filtration rate) markers.
The How-To Guide for Using SS-31 Correctly
SS-31 is difficult to dose because the “effective” dose in human trials is huge (40mg/day), but the “clinic” dose is often small (4mg/day) due to cost.
The Kitchen Chemistry: Reconstitution
- Vial: Typically 10mg or 50mg vials.
- Mixing: Add 2ml or 3ml of Bacteriostatic Water.
- Solubility: It dissolves easily.
The Injection Protocol
- Dosage (The Controversy):
- Clinical Trials: 40mg per day (Subcutaneous). This is prohibitively expensive for most people (would cost $1000s).
- Clinic Protocol: 4mg daily or 10mg twice a week. Anecdotally, many users still report benefits at these lower doses, likely due to cumulative effects over time.
- Timing: Morning is best, as it increases ATP production.
- Site: Subcutaneous injection in the stomach.
⚡ Don’t Forget To…
Check your CoQ10. Mitochondrial repair requires raw materials. Taking a high-quality CoEnzyme Q10 (Ubiquinol) and PQQ supplement alongside SS-31 provides the “spark plugs” for the engine you are repairing.
Costs, Legality & Troubleshooting
Cost Analysis
This is arguably the most expensive peptide per milligram.
- Price: A 10mg vial costs $150 – $200 AUD.
- Daily Cost: If you take 4mg/day, a vial lasts 2.5 days. This is unsustainable for many.
- The Fix: Many users treat it like a “course.” They run it for 4 weeks (spending ~$800) to “remodel” the mitochondria, then cycle off for 3 months.
Troubleshooting: “I feel nothing”
SS-31 is silent. It does not give a pump. It does not stop hunger.
- The Sign: The sign it is working is usually Endurance. You realize you walked up the stairs without being winded, or you woke up without the usual brain fog. It is a “subtractive” peptide—it removes fatigue rather than adding stimulation.
Troubleshooting: “Injection Pain”
SS-31 can be slightly irritating at high concentrations.
- The Fix: Dilute it more (add more water) or split the dose into two injections (morning and night).
The Dealbreaker Safety Check
Side Effects
SS-31 is incredibly safe. Because it targets Cardiolipin (which only exists in mitochondria, not on cell surfaces), it has very few “off-target” effects.
- No Hormonal Impact: It does not touch Testosterone, Estrogen, or Thyroid levels.
- Safe for Cancer? Unlike Growth Hormone which fuels cancer, SS-31 reduces oxidative stress. While no cancer patient should take peptides without oncological approval, SS-31 is theoretically one of the safer options as it does not promote cell division (mitosis).
Purity Issues
Because the dose is high (milligrams, not micrograms), purity matters immensely. If your vial is 95% pure, that means 5% is “unknown junk.” At a 40mg dose, you are injecting 2mg of junk. Only buy pharmaceutical grade.
Frequently Asked Questions
Can I stack it with MOTS-c?
Yes. This is the “Mitochondrial Master Stack.”
- SS-31: Repairs the structure of the generator.
- MOTS-c: Turns on the switch (metabolic signaling).
- Result: Comprehensive metabolic restoration.
Is it better than NAD+ injections?
They are partners. NAD+ is the fuel; SS-31 is the engine mechanic. If your engine is broken (damaged cardiolipin), pouring more fuel (NAD+) won’t help. You need SS-31 to fix the engine first.
Can I take it orally?
No. It is a peptide. It will be destroyed in the gut.
How long does it take to work?
Unlike stimulants, it takes time to repair physical membrane structures. Expect to run it for at least 4 weeks before assessing the benefit.
Is it legal in sport?
Currently, Yes (mostly). It is not an anabolic agent. However, WADA bans “Metabolic Modulators.” While SS-31 is rarely tested for, you should exercise caution if you are at the Olympic level. For amateur athletes, it is permitted.