A plain-language, continually updated guide from Dr. Matt Chalmers’ clinical reference on hormones and peptides.
SS-31, also known as elamipretide, is a small synthetic peptide designed to concentrate roughly 5,000-fold inside the inner membrane of your mitochondria — the part of the cell responsible for producing energy. It’s the only compound in our reference library that works from inside the mitochondrial membrane itself, developed by researchers at Weill Cornell Medical College.
This is a genuinely exciting update worth knowing: as of September 2025, SS-31 became FDA-approved (under the brand name FORZINITY) for Barth syndrome, a rare genetic mitochondrial disease — making it the first FDA-approved mitochondria-targeting peptide in history. It also has Phase 2 data published in the New England Journal of Medicine for heart failure with preserved ejection fraction (HFpEF), and FDA Breakthrough Therapy Designation for primary mitochondrial myopathy.
SS-31 works by binding tightly to cardiolipin, a specialized fat molecule found only in the inner mitochondrial membrane that’s essential for energy production. By protecting cardiolipin from oxidative damage, SS-31 helps stabilize the machinery mitochondria use to generate ATP, restores healthy mitochondrial structure, and has been shown to reduce damaging free radicals by 40–60% in stressed cell models. Beyond Barth syndrome and heart failure, it’s also been studied for reducing acute kidney injury after cardiac surgery, and it’s used in some functional medicine practices to help protect mitochondria during heavy metal detoxification, since heavy metals are known to damage cardiolipin directly.
“It helps repair and regenerate the inside of the mitochondria which helps produce more ATP. This can help reduce the damage caused by aging to the mitochondria. This should be part of everyone’s longevity program. I run this one every couple of months stacked with MOTS-c.”
— Dr. Matt Chalmers, The Pillars Path: A Root-Cause Guide to Hormones, Peptides, and Metabolic Health
Mitochondrial electron transport chain function — the system SS-31 is studied in connection with — depends on several nutrient cofactors, including CoQ10, B vitamins (particularly riboflavin and niacin), magnesium, and L-carnitine.
SS-31 (elamipretide) is FDA-approved under the brand name FORZINITY specifically for Barth syndrome, a rare genetic mitochondrial condition — approved dosing for that indication is 40 mg/day via a subcutaneous auto-injector. Outside of this specific FDA-approved use, SS-31 is not approved for general wellness or longevity purposes, and use for those goals is considered off-label. Appropriateness is determined through an individualized evaluation with our providers.
Yes, as of September 2025 — but for a specific rare disease (Barth syndrome), under the brand name FORZINITY. It’s not approved for general anti-aging, energy, or wellness use, which remains off-label and is determined through individual evaluation with our providers.
Mitochondrial function broadly declines with age, and SS-31’s studied mechanism targets a core structural component of that system — which is why it’s researched in contexts beyond its specific FDA-approved rare-disease indication, though those broader uses remain off-label.
This page draws on The Pillars Path: A Root-Cause Guide to Hormones, Peptides, and Metabolic Health by Dr. Matt Chalmers — Pillars of Wellness’ clinical reference on hormone and peptide therapy.
