"Energy" peptides get pitched as a fix for fatigue, slow workouts and midlife slowdown. The five most commonly sold in this category work through entirely different mechanisms: one binds a lipid inside the mitochondrial membrane, one is the coenzyme cells use to run their own energy reactions, one is coded in mitochondrial DNA itself, and two are small molecules that switch on genes tied to exercise metabolism. The evidence behind them ranges from a real drug approval to mouse-only data that has never touched a person. This guide separates what was measured in people from what was measured on a mouse running wheel, and ranks each compound by which kind of evidence it actually has.
Summary
| Compound | Best evidence | Stage |
|---|---|---|
| SS-31 | FDA accelerated approval (Forzinity) for Barth syndrome, based on a human trial of muscle strength | Approved for one rare disease; other uses still in trials |
| NAD+ Stocked locally | Small randomised human trials of oral precursors (NMN, NR); IV NAD+ has only pilot and retrospective data | Human trials exist, but outcomes are modest and IV and oral forms are not equivalent |
| MOTS-c Stocked locally | Human exercise measurement (native peptide) plus a phase 1 trial of an analogue, CB4211 | Mouse treatment data; human data is observational or from a modified drug candidate |
| 5-Amino-1MQ | Dose-dependent metabolic and body-composition effects in obese mice | Preclinical only; no published human trial |
| SLU-PP-332 | Increased running endurance and oxidative muscle fibre type in mice | Preclinical only; the sole human-tissue work is cultured muscle cells in a dish |
SS-31: the only one with an actual approval, for a narrow disease
SS-31, drug name elamipretide, binds cardiolipin, a lipid in the inner mitochondrial membrane that holds the ATP-making machinery in place. On 19 September 2025 the US FDA granted it accelerated approval as Forzinity for Barth syndrome, an ultra-rare inherited disorder that causes muscle weakness and heart disease in males. The approval rested on knee extensor muscle strength gains seen during a long open-label extension of the TAZPOWER trial, after the drug missed its primary endpoint in the initial randomised phase. That is a genuine regulatory approval, the strongest evidence tier any compound on this page reaches, but it is specific to Barth syndrome. A separate trial, MMPOWER-3, tested elamipretide in a broader group of adults with primary mitochondrial myopathy and missed both primary endpoints. Full trial history is on the SS-31 page.
NAD+: human trials exist, but IV and oral are not the same story
NAD+ is a coenzyme, not a peptide, but it circulates in this market alongside mitochondrial peptides. The evidence splits sharply by route. Oral precursors, nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN), have several small randomised, placebo-controlled human trials: a 2018 trial gave NR to adults aged 55 to 79 for six weeks and raised blood NAD+ markers by about 60%, and a 2021 trial gave NMN to postmenopausal women with prediabetes for ten weeks and found improved muscle insulin sensitivity, though blood glucose and other markers did not change.
Injected or IV NAD+ has much thinner data. A 2019 pilot infused 750 mg over six hours in eight healthy men and found plasma NAD+ did not rise for the first two hours, meaning much of it left the bloodstream almost as fast as it went in. A small 2026 retrospective clinic review found IV NAD+ caused more gut symptoms, faster heart rate and chest pressure than a comparator IV. No controlled trial has shown IV or subcutaneous NAD+ improves energy, fatigue or any measured outcome. See the NAD+ page for the full breakdown.
MOTS-c: a real human measurement, but not a treatment trial
MOTS-c is a 16 amino acid peptide encoded inside mitochondrial DNA, discovered in 2015. In mice, giving MOTS-c improved insulin resistance, obesity and, in a 2021 study, physical performance across young, middle-aged and old animals, including compression of age-related decline when treatment started very late in life.
The human evidence is different in kind. The same 2021 study measured MOTS-c in 10 sedentary young men during a session of stationary cycling: muscle MOTS-c rose about 11.9-fold after exercise, and blood levels rose about 1.6-fold, both returning toward baseline within four hours. That shows the body makes more of its own MOTS-c during exercise. It does not show that an injected dose of the peptide changes energy or endurance in a person, because that has never been tested for native MOTS-c. A modified version, CB4211, has been through a phase 1a/1b trial for fatty liver and obesity rather than for energy, with lower liver enzymes and glucose reported by the company but no significant change in liver fat or body weight. Full detail on the MOTS-c page.
5-Amino-1MQ: mouse metabolic data, no human study
5-Amino-1MQ is a small molecule that blocks NNMT, an enzyme that consumes nicotinamide and lowers the raw material available for making NAD+ inside cells. In a 2024 study, obese mice given daily subcutaneous 5A1MQ for 28 days gained less weight and fat, had better glucose tolerance and insulin sensitivity, and had lower liver enzymes, in a dose-dependent pattern. Earlier work from the same research group showed similar fat-reduction effects with related NNMT inhibitors and, in old mice, better muscle stem cell activity after injury. None of this has been tested in a published human trial, and there is no data on whether the oral capsules sold to people reach the tissue levels used in the mouse studies. More on the 5-Amino-1MQ page.
SLU-PP-332: an "exercise mimetic" tested entirely in mice
SLU-PP-332 activates the estrogen-related receptors, a family of proteins that switch on genes for building mitochondria and running aerobic metabolism. In mice, it increased the proportion of fatigue-resistant muscle fibres and improved running endurance, and separately reduced fat mass and improved insulin sensitivity in obese and genetically obese mice. Removing the ERR-alpha receptor blunted the endurance effect, pointing to that receptor as the main route.
No human trial has been published. The closest thing to human data is a 2025 pilot study that took muscle biopsies from 20 older women during hip surgery, grew the cells in a dish, and added SLU-PP-332 to the culture for 48 hours, reporting lower oxidative stress markers and better muscle fibre formation. Nobody received the compound; that is laboratory work on human tissue, not a treatment trial. Full detail on the SLU-PP-332 page.
Human data vs mouse endurance data, side by side
The pattern across all five is the same: mouse and cell studies report metabolic and endurance benefits fairly consistently, while human data is absent, observational, or from a different population than the one buying these compounds for energy. SS-31's approval rests on a genetic-disease trial. NAD+'s human trials cover oral precursors, not the injections and IV drips sold locally. MOTS-c's only native-peptide human data is what exercise already does to the body on its own. 5-Amino-1MQ and SLU-PP-332 have no human treatment data at all.
Safety notes
SS-31 causes injection-site reactions in nearly everyone treated in its pivotal trial, including redness, pain and skin hardening, and the label warns of allergic reactions that can appear from minutes to months after starting. IV NAD+ has been linked to nausea, a faster heart rate and chest pressure during infusion in the small clinic review above; subcutaneous NAD+ is widely described as painful at the injection site, though this has not been formally studied. MOTS-c's only human safety data comes from the CB4211 analogue trial, not the native peptide. 5-Amino-1MQ and SLU-PP-332 have no human safety data of any kind. See the side effect management guide and bloodwork in the Philippines for what monitoring looks like when trying any of these.
Status in the Philippines
Forzinity's US approval does not extend here: no FDA Philippines registration for it was found, so SS-31 sold locally comes through research-chemical channels, not the approved, sterile-manufactured product. NAD+, MOTS-c, 5-Amino-1MQ and SLU-PP-332 are all sold locally as unregistered research compounds, none is a scheduled controlled substance under RA 9165, and none has FDA Philippines approval as a medicine. IV NAD+ is also offered by wellness clinics in Metro Manila; any injectable made outside a registered, sterile process carries contamination risk that matters more for an infused product than for most things discussed on this site.
