MOTS-c: what the mouse studies show, why no human has been given it, side effects, and its status
What 277 indexed publications and 4 randomized trials actually state about mots-c, sentence by sentence, each tied to its source and labeled by the kind of evidence it is.
At a glance
What MOTS-c is and how it acts
MOTS-c is a peptide in the mitochondrial peptides class (mitochondria-derived; AMPK and folate-cycle effects reported). Europe PMC indexes 277 publications naming it or a listed alias in a title or abstract, including 4 randomized controlled trials and 1 clinical trials of any design, as of . The strongest evidence tier in that literature is human clinical trials.
This page reports what those studies state, sentence by sentence, with each statement tied to its source and labeled by the kind of evidence it is. It does not recommend use, and it does not translate study doses into anything personal.
What the evidence level means
Publication counts show what is indexed, not how strong the evidence is. The ledger below separates human clinical records from preclinical, analytical, and in-vitro work.
Interpretation boundary: An indexed publication count is a discovery measure. It does not establish efficacy, safety, approval, or a personal treatment plan.
MOTS-c in two minutes
What it is. A small peptide made by mitochondria themselves, released with exercise and metabolic stress, that activates the cell's energy sensor and shifts metabolism toward burning fat and taking up glucose.
What the research actually shows. 277 indexed publications. Mice: better insulin sensitivity, resistance to diet-induced obesity, better late-life fitness. People: circulating levels rise with exercise and track metabolic health in observational studies. No human has been given MOTS-c in a trial; a synthetic analogue completed phase 1 and was dropped.
Status. Not approved anywhere; prohibited at all times under WADA S4.4 as an AMPK activator, per USADA.
Where the evidence is thinnest. Any effect of administering it to a person, at any dose, for anything.
Editorial synthesis Written from general pharmacology, the development record and what is commonly reported; not a cited finding. Cited findings on this page carry their own tier.
How MOTS-c works
Written from general pharmacology and the development record, and marked as editorial synthesis; the measurements behind it are quoted in the biomarker section.
- Editorial synthesis from general knowledge
- Editorial synthesis from general knowledge
- Editorial synthesis from general knowledge
What did the studies find?
Reported outcomes in mice and observational associations in people; no human has been given MOTS-c. One row per primary study in this record's ledger. Fields are read from each paper's indexing and abstract. "Analytical method" marks papers about detecting or measuring the compound rather than about its effects.
| Study | Design | n | Species | Dose | Route | Duration | Reported outcome | Tier |
|---|---|---|---|---|---|---|---|---|
| Cuyàs 2022 | Randomized controlled trial | — | Humans | — | — | 24 weeks | We failed to find any significant alteration of circulating MOTS-c -as measured using the commercially available competitive ELISA CEX132Hu- in response to 24 weeks of a neoadjuvant chemotherapy/trastuzumab regimen… | Human clinical trial |
| Dieli-Conwright 2021 | Randomized controlled trial | — | Humans | — | — | — | Post-exercise levels of MOTS-c among non-Hispanic White BCS were significantly associated with reductions in fat mass, body weight, HOMA-IR, CRP, and an increase in lean mass (p < 0.01). | Human clinical trial |
| von 2021 | Randomized controlled trial | 10 | Humans | — | — | — | MOTS-C levels showed a trend to increase after EE. | Human clinical trial |
| Sonay 2026 | Human study | 180 | Humans | — | — | — | Circulating MOTS-c levels were significantly lower in patients with HT compared to controls ( p p p p Conclusions : Circulating MOTS-c levels are markedly reduced in patients with HT and are independently associated… | Observational, human |
| Musolino 2026 | Human study | — | Humans | — | — | — | Conversely, dialysate MOTS-c (dMOTS-c) were strongly and inversely correlated with PWV (R = - 0.717, p = 0.019) as well as systolic and diastolic blood pressure (R = -0.5, p Conclusion Ηigher urinary MOTS-c was linked… | Observational, human |
| Peng 2026 | Human study | 34 | Humans | — | — | — | The MIRI group exhibited lower systolic blood pressure, preoperative thrombolysis in myocardial infarction (TIMI) grade, and HDL-C, but higher total ischemic time, door-to-balloon time, culprit vessel stenosis… | Observational, human |
| Filibeli 2026 | Human study | — | Humans | — | — | — | The mean serum MOTS-c levels in the PCOS group were higher than in the control group; however, this difference did not reach statistical significance (p = 0.059). | Observational, human |
| Kutuk 2026 | Human study | — | Humans | — | — | — | Women with PCOS exhibited lower circulating MOTS-c concentrations compared with controls (220.2 ± 147.6 pg/mL vs. 498.3 ± 224.4 pg/mL, p < 0.001). | Observational, human |
| Yoon 2026 | Human study | 6 | Humans | — | — | — | Circulating MOTS-c levels were significantly higher in obese compared to lean individuals (273 ± 56 vs. 223 ± 50 pg/mL; P P = 0.035 and P = 0.032, respectively). | Observational, human |
| Erol 2025 | Human study | — | Humans | — | — | — | Patients who responded to treatment exhibited a substantial post-therapy increase in MOTS-c levels, while refractory cases showed little to no change. | Observational, human |
| Ozkaya 2025 | Human study | 85 | Humans | — | — | — | We found no significant difference in serum MOTS-c levels between individuals with obesity and those with normal body mass index (14.33 ± 3.76 pg/mL versus 13.67 ± 3.44 pg/mL; p = 0.395). | Observational, human |
| Sánchez-Quintero 2025 | Human study | 17 | Humans | — | — | — | We observed significantly reduced levels of both proteins in patients, suggesting that substantial mitochondrial dysfunction occurs in AVD patients, independent of sex or age, but directly related to the disease. | Observational, human |
| Kamiński 2024 | Human study | — | Humans | — | intravenous | — | These findings suggest disrupted expression of MOTS-c in the spectrum of adrenal diseases, which might be caused by mechanisms involving increased mitochondrial dysfunction and structural changes in the tissue… | Observational, human |
| Rice 2026 | Animal study | — | Mice | — | — | — | — | Animal, preclinical |
| Santhanam 2026 | Animal study | 6 | Rats | — | — | — | MOTS-c treatment improved post-ischemic mechanical recovery, attenuated oxidative stress, partially preserved mitochondrial enzyme activities and membrane potential, and mitigated reductions in mtDNA copy number and… | Animal, preclinical |
| Jamnick 2026 | Animal study | — | Mice | 15 mg/kg | intraperitoneal | — | In vitro , MOTS-c increased PGC-1α mRNA (+84.6%) and AMPK phosphorylation (+103.1%). | Animal, preclinical |
| Mills 2026 | Animal study | — | Rats | — | — | — | MOTS-c treatment significantly reduced fasting blood glucose and circulating C-reactive protein levels, while selectively modulating plasma inflammatory cytokines, including interleukin (IL)-10 and IL-1β. | Animal, preclinical |
| Li 2026 | Animal study | — | Rats, Mice | — | — | — | Key findings We found that hyperoxia exposure in neonatal mice led to significant cardiac hypertrophy, fibrosis, and dysfunction, concomitant with decreased serum MOTS-c content. | Animal, preclinical |
| Zhang 2026 | Animal study | 6 | Mice | 5 mg/kg | intraperitoneal | 2 weeks | Mechanistically, R13A-MOTS-c activated the Nrf2 signaling pathway, as evidenced by increased nuclear translocation of Nrf2 and upregulation of its downstream targets gene. | Animal, preclinical |
| Liao 2026 | Animal study | 36 | Rats, Mice | — | — | — | In vivo, HNG or MOTS-c treatment reduced AF inducibility and attenuated AngII-induced atrial fibrosis and hypertrophy. | Animal, preclinical |
| Blatkiewicz 2026 | Animal study | 16 | Rats | — | subcutaneous | — | MOTS-c showed significantly higher expression in ZF/ZR vs. ZG. | Animal, preclinical |
| Li 2026 | Animal study | — | Rats | — | — | — | Both approaches led to marked enhancements in glucose and lipid metabolism, lowered collagen buildup, and bettered both systolic and diastolic heart functions. | Animal, preclinical |
| Santhanam 2026 | Animal study | — | Rats | 0.25-0.7 mg/kg; 0.5 mg | — | — | Lactate dehydrogenase release decreased by 65%. | Animal, preclinical |
| Güvenir 2026 | Animal study | — | Rats | — | intraperitoneal | — | Valproic acid exposure led to impaired sociability, repetitive behaviors, anxiety, cerebellar Purkinje cell loss, and increased oxidative stress and neuronal damage in the prefrontal cortex. | Animal, preclinical |
| Li 2026 | Animal study | 6 | Mice | — | intraperitoneal | — | Furthermore, MOTS-c treatment significantly restored GSH content, diminished reactive oxygen species (ROS) production, and oxidative stress. | Animal, preclinical |
Doses reported in studies
Each entry is a sentence quoted from the study's abstract, with the study's design, sample size and year in front of it. Comparator doses in the same sentence are not attributed to mots-c.
- Doses stated in the abstract: 15 mg/kg
In vivo , male mice were inoculated with Colon-26 (C26) carcinoma cells and treated daily with MOTS-c (15 mg/kg/2x Day, i.p.) or vehicle.
Sourcepmid-42266945· quoted verbatim from the abstract, emphasis added - Doses stated in the abstract: 5 mg/kg
In vivo studies demonstrated that daily intraperitoneal administration of R13A-MOTS-c (5 mg/kg for 2 weeks) effectively mitigated radiation-induced pulmonary inflammation, oxidative stress, and mitochondrial dysfunction in C57BL/6 mice exposed to 20 Gy thoracic irradiation.
Sourcepmid-42142418· quoted verbatim from the abstract, emphasis added - Doses stated in the abstract: 0.25-0.7 mg/kg; 0.5 mg
Isolated Langendorff-perfused rat hearts underwent 30-min global ischemia and 60-min reperfusion with or without MOTS-c (0.25-0.7 mg/kg) delivered via Krebs-Henseleit buffer during the first 10 min of reperfusion.
Sourcepmid-41593376· quoted verbatim from the abstract, emphasis added - Doses stated in the abstract: 15 mg/kg
Treated diabetic group received MOTS-c (15 mg/kg) daily injection for 3 weeks.
Sourcepmid-40661667· quoted verbatim from the abstract, emphasis added - Doses stated in the abstract: 500 μg
Long-term repeated administration of MOTS-c (500 μg) and PMO at the dose of 12.5 mg/kg/week for 3 weeks followed by 12.5 mg/kg/month for 3 months (PMO-M) induced therapeutic levels of dystrophin expression in peripheral muscles, with up to 25-fold increase in diaphragm of mdx mice over PMO alone.
Sourcepmid-33337582· quoted verbatim from the abstract, emphasis added
MOTS-c doses in studies
Every administered dose is in mice. Human studies measured the body's own MOTS-c; they gave none.
| Study | Dose and route | Duration | Finding |
|---|---|---|---|
| Mouse metabolic studies | 5 to 15 mg/kg intraperitoneal, daily | Days to weeks | Improved insulin sensitivity; less fat gain; PGC-1α and AMPK activation |
| Old mice, late-life treatment | Intraperitoneal, intermittent | Weeks | Improved running capacity and healthspan measures |
| Rat heart injury model | Intraperitoneal | Days | Better post-ischaemic recovery; less oxidative stress |
| Human observational studies | None given; blood levels measured | Cross-sectional or exercise sessions | Levels rise with exercise; differ by condition |
| CB4211 analogue, phase 1 | Not published in this ledger | Weeks | Safety study in obesity and fatty liver; development stopped |
Figures for this compound circulate on forums and vendor pages. None has been tested in a human study, so none is reproduced here; the table above holds every dose a study actually administered.
Editorial synthesis Written from general pharmacology, the development record and what is commonly reported; not a cited finding. Cited findings on this page carry their own tier.
Adverse events and frequency
Events and their frequency as each study reported them, with the denominator where the abstract gives one.
-
The MIRI group exhibited lower systolic blood pressure, preoperative thrombolysis in myocardial infarction (TIMI) grade, and HDL-C, but higher total ischemic time, door-to-balloon time, culprit vessel stenosis severity, Killip grade and adverse event incidence (all p p Conclusions : Postoperative peripheral serum MOTS-c levels represent an independent protective factor against MIRI in patients with acute myocardial infarction and suggest a potential predictive value for MIRI, although its clinical utility as a standalone predictor requires further validation through dynamic monitoring and larger-scale studies.
Sourcepmid-42072458· quoted verbatim from the abstract
Who MOTS-c is discussed for, and the cautions that recur
The interest. Fat loss, exercise capacity, insulin resistance and ageing, each of which has a mouse result behind it.
- Blood sugar medication. The compound improves glucose uptake in mice; combined with insulin or other glucose-lowering drugs the effect is unstudied.
- Cancer. Metabolic reprogramming and AMPK activation cut both ways in tumour biology; untested.
- Athletes. An AMPK activator, within WADA's prohibited metabolic-modulator class.
- Flushing. The most consistent community report; its mechanism is unknown.
- Pregnancy, children. No data.
Editorial synthesis Written from general pharmacology, the development record and what is commonly reported; not a cited finding. Cited findings on this page carry their own tier.
Biomarkers measured in studies
Laboratory and clinical measures the studies report tracking, including which hormones did and did not change.
-
MOTS-c mechanisms of action (MoA) involve insulin sensitization, enhanced glucose utilization, suppression of mitochondrial respiration, and targeting of the folate-AICAR-AMPK pathway.
Sourcepmid-36490309· quoted verbatim from the abstract -
We conducted a secondary analysis of the effects of a 16-week aerobic and resistance exercise intervention on MOTS-c in Hispanic and Non-Hispanic White breast cancer survivors (BCS).
Sourcepmid-34413391· quoted verbatim from the abstract -
Plasma concentration of HN and MOTS-c, skeletal muscle MOTS-c as well as gene expression of exercise-related genes were analyzed.
Sourcepmid-34351816· quoted verbatim from the abstract -
Mitochondria-derived peptides (MDPs), particularly mitochondrial open-reading frame of the 12S rRNA-c (MOTS-c), have emerged as key regulators of cellular metabolism, insulin sensitivity, oxidative stress, and inflammatory responses.
Sourcepmid-42278864· quoted verbatim from the abstract -
MOTS-c, a mitochondria-derived peptide, is emerging as a key regulator of skeletal muscle health, metabolic homeostasis, and vascular function, yet its role in the uremic environment remains unexplored.
Sourcepmid-42126770· quoted verbatim from the abstract -
The MIRI group exhibited lower systolic blood pressure, preoperative thrombolysis in myocardial infarction (TIMI) grade, and HDL-C, but higher total ischemic time, door-to-balloon time, culprit vessel stenosis severity, Killip grade and adverse event incidence (all p p Conclusions : Postoperative peripheral serum MOTS-c levels represent an independent protective factor against MIRI in patients with acute myocardial infarction and suggest a potential predictive value for MIRI, although its clinical utility as a standalone predictor requires further validation through dynamic monitoring and larger-scale studies.
Sourcepmid-42072458· quoted verbatim from the abstract
Reported interactions
Sentences in which the compound is studied alongside another agent. Read the quotation: the word interaction can also be statistical.
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Here, we measured circulating MOTS-c in paired baseline and post-treatment sera obtained from HER2-positive breast cancer patients randomized to receive either metformin combined with neoadjuvant chemotherapy and trastuzumab or an equivalent regimen without metformin.
Sourcepmid-36490309· quoted verbatim from the abstract -
Key findings We found that hyperoxia exposure in neonatal mice led to significant cardiac hypertrophy, fibrosis, and dysfunction, concomitant with decreased serum MOTS-c content.
Sourcepmid-42128272· quoted verbatim from the abstract -
Molecular docking demonstrated high-affinity interactions of MOTS-c with MAPK, mTOR, AMPK, NRF2, PI3K, and caspase 3.
Sourcepmid-41593376· quoted verbatim from the abstract
Reported timelines
Onset, peak and duration figures as each study reported them.
-
MOTS-c (53 µM) was administered either before ischemia or at reperfusion onset.
Sourcepmid-42228044· quoted verbatim from the abstract
What is measured over time, and what is not
In mice, metabolic changes appeared over days to weeks of dosing. In people, the body's own MOTS-c rises within an hour of exercise and falls back. Nothing has been measured after administering it to a person.
Editorial synthesis Written from general pharmacology, the development record and what is commonly reported; not a cited finding. Cited findings on this page carry their own tier.
Study durations
Treatment and follow-up periods as stated in each abstract.
- Durations stated: 24 weeks
We failed to find any significant alteration of circulating MOTS-c -as measured using the commercially available competitive ELISA CEX132Hu- in response to 24 weeks of a neoadjuvant chemotherapy/trastuzumab regimen with or without daily metformin.
Sourcepmid-36490309· quoted verbatim from the abstract, emphasis added - Durations stated: 2 weeks
In vivo studies demonstrated that daily intraperitoneal administration of R13A-MOTS-c (5 mg/kg for 2 weeks) effectively mitigated radiation-induced pulmonary inflammation, oxidative stress, and mitochondrial dysfunction in C57BL/6 mice exposed to 20 Gy thoracic irradiation.
Sourcepmid-42142418· quoted verbatim from the abstract, emphasis added - Durations stated: 7 day
After the end of the experiment, we conducted an ex vivo fatigue test of soleus muscle and showed that the MOTS-c administration prevents increased fatigue during 7-day hind limb unloading.
Sourcepmid-40608240· quoted verbatim from the abstract - Durations stated: 3 weeks
Treated diabetic group received MOTS-c (15 mg/kg) daily injection for 3 weeks.
Sourcepmid-40661667· quoted verbatim from the abstract, emphasis added - Durations stated: 3 weeks; 3 months
Long-term repeated administration of MOTS-c (500 μg) and PMO at the dose of 12.5 mg/kg/week for 3 weeks followed by 12.5 mg/kg/month for 3 months (PMO-M) induced therapeutic levels of dystrophin expression in peripheral muscles, with up to 25-fold increase in diaphragm of mdx mice over PMO alone.
Sourcepmid-33337582· quoted verbatim from the abstract, emphasis added
Routes used in the studies
Routes of administration named in each study.
- administration by intravenous route reported
Notably, MOTS-c protein expression declined with ACC progression (stages III and IV) but was unrelated to patient age or sex.
Sourcepmid-39201408· quoted verbatim from the abstract - administration by intraperitoneal route reported
In vivo , male mice were inoculated with Colon-26 (C26) carcinoma cells and treated daily with MOTS-c (15 mg/kg/2x Day, i.p.) or vehicle.
Sourcepmid-42266945· quoted verbatim from the abstract - administration by intraperitoneal route reported
In vivo studies demonstrated that daily intraperitoneal administration of R13A-MOTS-c (5 mg/kg for 2 weeks) effectively mitigated radiation-induced pulmonary inflammation, oxidative stress, and mitochondrial dysfunction in C57BL/6 mice exposed to 20 Gy thoracic irradiation.
Sourcepmid-42142418· quoted verbatim from the abstract - administration by subcutaneous route reported
Adult male Wistar rats (n = 16) received continuous MOTS-c (0.1 μmol/24 h) or saline via subcutaneous micro-osmotic pumps for 24 hours.
Sourcepmid-41811086· quoted verbatim from the abstract - administration by intraperitoneal route reported
Female and male offspring were treated with 0.5 mg/kg/day MOTS-c or saline intraperitoneally from postnatal days 21 to 46.
Sourcepmid-41706383· quoted verbatim from the abstract - administration by intraperitoneal route reported
Administration of MOTS-c via i.p. injection markedly attenuated APAP-induced increases in AST and ALT levels, histopathological liver damage, and other liver injury markers.
Sourcepmid-41764620· quoted verbatim from the abstract
Weight-normalized doses, as published
Per-kilogram figures exactly as each study published them, for the species it studied.
- Weight-normalized doses as published: 15 mg/kg
In vivo , male mice were inoculated with Colon-26 (C26) carcinoma cells and treated daily with MOTS-c (15 mg/kg/2x Day, i.p.) or vehicle.
Sourcepmid-42266945· quoted verbatim from the abstract, emphasis added - Weight-normalized doses as published: 5 mg/kg
In vivo studies demonstrated that daily intraperitoneal administration of R13A-MOTS-c (5 mg/kg for 2 weeks) effectively mitigated radiation-induced pulmonary inflammation, oxidative stress, and mitochondrial dysfunction in C57BL/6 mice exposed to 20 Gy thoracic irradiation.
Sourcepmid-42142418· quoted verbatim from the abstract, emphasis added - Weight-normalized doses as published: 0.25-0.7 mg/kg
Isolated Langendorff-perfused rat hearts underwent 30-min global ischemia and 60-min reperfusion with or without MOTS-c (0.25-0.7 mg/kg) delivered via Krebs-Henseleit buffer during the first 10 min of reperfusion.
Sourcepmid-41593376· quoted verbatim from the abstract, emphasis added - Weight-normalized doses as published: 15 mg/kg
Treated diabetic group received MOTS-c (15 mg/kg) daily injection for 3 weeks.
Sourcepmid-40661667· quoted verbatim from the abstract, emphasis added
Weight-normalized figures above are reproduced exactly as each study published them, for the species it studied. Dose does not scale linearly with body mass between species: metabolic rate, clearance and receptor density differ, and regulatory guidance uses allometric, not proportional, conversion. A mg/kg figure from a rat study is a fact about that rat study and nothing else.
What people report outside the literature
What circulates in user communities and clinic marketing, reported so a reader knows the figures and their origin. None of it has been tested in a trial, and none of it is a suggestion.
- Editorial synthesis from general knowledge
Reconstitution mathematics
Lyophilised peptide is supplied as a mass in a vial and dissolved in a stated volume of diluent. Two figures follow from that and nothing else:
- Concentration = mass in vial ÷ diluent volume. A 5 mg vial in 2 mL is 2.5 mg/mL, or 2,500 mcg/mL.
- Volume for a given mass = that mass ÷ concentration. 250 mcg at 2,500 mcg/mL is 0.1 mL. On a U-100 insulin syringe, where 1 mL is 100 units, that is 10 units.
Study doses on this page are quoted as published, in the units the authors used. Converting between mcg, mg and IU, or between a mass and a syringe volume, is arithmetic; deciding a mass is not, and this page does not do it. The reconstitution calculator performs the conversion with the formula shown.
Reading a certificate of analysis
A certificate of analysis is a laboratory report on one batch. Reading it means checking four things in order.
- Identity. Mass spectrometry should report an observed molecular mass matching the peptide's theoretical mass within the instrument's stated tolerance. A certificate with no mass spectrometry, or one that lists only the expected value, has not confirmed identity.
- Purity. HPLC purity is the area of the main peak as a share of all peaks, at a stated wavelength. It says nothing about what the other peaks are, and it is not a measure of quantity.
- Quantity. Net peptide content, by amino acid analysis or UV, is the fraction of the vial's mass that is peptide rather than counter-ions and water. A 5 mg vial at 80% net content holds 4 mg of peptide, and every concentration figure above changes accordingly.
- Provenance. The batch number on the certificate should match the vial, the laboratory should be named and independent of the seller, and the test date should be recent.
This page rates no supplier and links to none. It describes how to read the document.
Equipment described in studies
Published human studies of injectable peptides report the same small set of materials: single-use insulin syringes with fixed needles, most often U-100 with 29 to 31 gauge needles; bacteriostatic water or sterile water for injection as diluent, with the choice stated in the methods; alcohol swabs; and refrigerated storage of reconstituted solution. Animal studies more often report intraperitoneal or intragastric administration and state the vehicle used. Where a study in this record's ledger names its materials or vehicle, that sentence appears under storage or routes above; where it does not, nothing is assumed here.
Storage and handling
Powder refrigerated or frozen away from light; reconstituted solution refrigerated and used within about four weeks. Discard cloudy or discoloured solution.
Editorial synthesis Written from general pharmacology, the development record and what is commonly reported; not a cited finding. Cited findings on this page carry their own tier.
What the human studies measured
They measured the peptide, not its effects. What follows is what an observational study of MOTS-c typically records.
| Measure | Why | When |
|---|---|---|
| Circulating MOTS-c | The variable under study; rises with exercise | Before and after exercise, or once |
| Fasting glucose, insulin, HbA1c | Associations with metabolic health | Once |
| Body composition, fitness | Correlates in cross-sectional work | Once |
| Blood pressure, vascular stiffness | Inverse correlations reported in kidney and hypertension cohorts | Once |
Editorial synthesis Written from general pharmacology, the development record and what is commonly reported; not a cited finding. Cited findings on this page carry their own tier.
Common mistakes in how MOTS-c is discussed
- Reading observational human studies as treatment trials. They measured levels; nobody was given the peptide.
- Reading the mouse fitness study as human anti-ageing evidence. It was mice, by injection, at doses per kilogram far above anything people use.
- Citing CB4211 as MOTS-c safety data. A different molecule, phase 1 only, and the programme ended.
- Calling it "natural" as if that settles safety. The body makes it in picograms; injected milligrams are a different exposure.
Editorial synthesis Written from general pharmacology, the development record and what is commonly reported; not a cited finding. Cited findings on this page carry their own tier.
MOTS-c vs SS-31 and humanin
The three mitochondrial peptides in this reference.
| Peptide | Origin and mechanism | Human evidence | Status |
|---|---|---|---|
| MOTS-c | Mitochondrially encoded; AMPK, one-carbon cycle | Observational only; analogue in phase 1 | Not approved |
| SS-31 (elamipretide) | Synthetic; binds cardiolipin in the inner membrane | Phase 2 and 3 trials in mitochondrial disease | Not approved; regulatory review in Barth syndrome |
| Humanin | Mitochondrially encoded; cytoprotective | Observational; analogues in animals | Not approved |
Class records: SS-31, humanin; the mitochondrial peptides class page lists them together. The retatrutide + MOTS-c stack page covers a combination that no study has tested.
Editorial synthesis Written from general pharmacology, the development record and what is commonly reported; not a cited finding. Cited findings on this page carry their own tier.
Studied in combination
Whether any indexed study tested MOTS-c together with the compounds it is commonly combined with. A count of zero is the finding, not a gap in this page.
- No indexed study tested MOTS-c with Retatrutide. Retatrutide + MOTS-c
Regulatory status
Registry facts only. Jurisdiction-level status, compounding categories and sport prohibitions need their own cited documents before they appear here.
- Source
usada-mots-c - Source
usada-mots-c - Editorial synthesis from general knowledge
Open questions and limitations
What is genuinely unknown, stated plainly. A missing field is not evidence that the outcome is safe, effective, or established.
- No study in this record's ledger reports dose-escalation schedules for MOTS-c.
- No study in this record's ledger reports exclusion criteria for MOTS-c.
Questions people ask
What are the side effects of MOTS-c?
Unknown in people. Community reports describe flushing after injection most consistently, plus fatigue and injection-site reactions.
What is MOTS-c?
A 16-amino-acid peptide encoded in the mitochondrial genome, released with exercise and metabolic stress, that activates AMPK and shifts cells toward burning fat and taking up glucose.
What does MOTS-c do?
In mice it improves insulin sensitivity, prevents diet-induced obesity and improves late-life fitness. In people, circulating levels rise with exercise and track metabolic health; no trial has given it to anyone.
Has MOTS-c been tested in humans?
Not by administration. Human studies measured the body's own MOTS-c. A synthetic analogue, CB4211, completed phase 1 before development stopped.
Is there a MOTS-c dose?
No human dose has been studied. Mice received milligrams per kilogram by injection; figures that circulate for people are untested and not reproduced here.
What are the side effects of MOTS-c?
Unknown in people. Community reports describe flushing after injection most consistently, plus fatigue and injection-site reactions.
Why does MOTS-c cause flushing?
Unknown. It is the most consistent community report and no study has examined it.
Is MOTS-c FDA approved?
No, and it has never been administered to people in a registered trial.
Is MOTS-c banned in sport?
Yes. USADA states it is prohibited at all times under WADA section 4.4, metabolic modulators, as an activator of AMPK.
Does MOTS-c help with weight loss?
In mice it prevents fat gain on a high-fat diet. No human study has measured weight change after administration.
Does MOTS-c improve exercise performance?
In old mice, late-life treatment improved running capacity. In people, the body's own MOTS-c rises with exercise; no one has tested giving it.
What is MOTS-c's half-life?
Not measured in people after administration. The body's own levels rise and fall around exercise within hours.
MOTS-c vs SS-31: what is the difference?
Both act on mitochondria, but SS-31 is a synthetic peptide with phase 2 and 3 trials in mitochondrial disease, while MOTS-c is a natural mitochondrial peptide with no human administration studies.
Is MOTS-c linked to longevity?
A common variant of its gene, more frequent in East Asian populations, is associated with longevity in observational studies. Association is not effect, and no trial exists.
How should MOTS-c be stored?
Powder refrigerated or frozen away from light; reconstituted solution refrigerated and used within about four weeks.
What is CB4211?
A synthetic MOTS-c analogue developed by CohBar that completed a phase 1 study in obesity and fatty liver; the company discontinued it.
How many MOTS-c studies exist?
277 indexed publications; 25 primary studies are tabulated here, 13 of them human and all of those observational.
Sources
Full citations. Every claim above links to one of these by its id.
- 1MOTS-c is a mitochondrial-encoded interferon-linked host defense peptide.
pmid-42611943· · peer-reviewed - 2Mitochondrial peptide MOTS-c suppresses systemic and cardiac inflammasome activation in a diabetic rat model.
pmid-42321010· · peer-reviewed - 3
- 4MOTS-c partially protects against skeletal muscle deterioration in C26 cachexia.
pmid-42266945· · peer-reviewed - 5
- 6MOTS-c is associated with oxidative stress and arterial stiffness in peritoneal dialysis patients: a pilot study.
pmid-42126770· · peer-reviewed - 7
- 8
- 9Humanin and MOTS-c Attenuate Atrial Fibrillation by Suppressing Fibrosis and Mitochondrial Dysfunction.
pmid-42193373· · peer-reviewed - 10
- 11Are serum MOTS-c levels and MOTS-c m.1382A>C polymorphism related to polycystic ovary syndrome?
pmid-41945630· · peer-reviewed - 12Safety and Efficacy of Approved and Unapproved Peptide Therapies for Musculoskeletal Injuries and Athletic Performance
doi-10-20944-preprints202512-1011-v3· · preprint
Show the remaining 33 sources
- 13MOTS-c primes adrenal cortex metabolism without directly driving steroidogenesis.
pmid-41811086· · peer-reviewed - 14
- 15
- 16Aerobic exercise and MOTS-c attenuate diabetic myocardial fibrosis via inhibition of the THBS1/TGF-β signaling pathway.
pmid-41710402· · peer-reviewed - 17Mitochondrial-derived peptides MOTS-c and humanin attenuate dexamethasone-induced atrophy in human skeletal muscle cells.
pmid-41732124· · peer-reviewed - 18
- 19MOTS-c Protects Against Acetaminophen-induced Liver Injury through the MAPK Signaling Pathway.
pmid-41764620· · peer-reviewed - 20
- 21Safety and Efficacy of Approved and Unapproved Peptide Therapies for Musculoskeletal Injuries and Athletic Performance
doi-10-20944-preprints202512-1011-v1· · preprint - 22
- 23MOTS‑c protects against placental injury via Nrf2 activation in hypoxia‑induced intrauterine growth restriction mice.
pmid-41268602· · peer-reviewed - 24
- 25
- 26Characterization of the Avian Mitochondrial-Derived Peptide MOTS-c and Its Potential Role as a Metabolic Regulator.
pmid-40805020· · peer-reviewed - 27Redefining Mitochondrial Therapy for ME/CFS: The Case for MOTS-c
doi-10-20944-preprints202507-0058-v2· · preprint - 28The impact of mitokine MOTS-c administration on the soleus muscle of rats subjected to a 7-day hindlimb suspension.
pmid-40608240· · peer-reviewed - 29Redefining Mitochondrial Therapy for ME/CFS: The Case for MOTS-c
doi-10-20944-preprints202507-0058-v1· · preprint - 30Mitochondria-derived peptide MOTS-c restores mitochondrial respiration in type 2 diabetic heart.
pmid-40661667· · peer-reviewed - 31
- 32Mitochondrial dysfunction characterises the multigenerational effects of maternal obesity on MASLD.
pmid-40496439· · peer-reviewed - 33Circulating PGC-1α and MOTS-c Peptide as Potential Mitochondrial Biomarkers in Patients Undergoing Aortic Valve Replacement.
pmid-40104672· · peer-reviewed - 34Expression Patterns of MOTS-c in Adrenal Tumors: Results from a Preliminary Study.
pmid-39201408· · peer-reviewed - 35Evaluation of Coronary Flow Level with Mots-C in Patients with STEMI Undergoing Primary PCI.
pmid-36629605· · peer-reviewed - 36Circulating levels of MOTS-c in patients with breast cancer treated with metformin.
pmid-36490309· · peer-reviewed - 37Mitochondria-derived peptides in aging and healthspan.
pmid-35499074· · peer-reviewed - 38
- 39Acute endurance exercise stimulates circulating levels of mitochondrial-derived peptides in humans.
pmid-34351816· · peer-reviewed - 40MOTS-c promotes phosphorodiamidate morpholino oligomer uptake and efficacy in dystrophic mice.
pmid-33337582· · peer-reviewed - 41Mitochondrial-derived peptides in energy metabolism.
pmid-32776825· · peer-reviewed - 42The role of mitochondria-derived peptides in cardiovascular disease: Recent updates.
pmid-31185388· · peer-reviewed - 43Mitochondrially derived peptides as novel regulators of metabolism.
pmid-28574175· · peer-reviewed - 44MOTS-c: A novel mitochondrial-derived peptide regulating muscle and fat metabolism.
pmid-27216708· · peer-reviewed - 45What is the MOTS-c peptide? (U.S. Anti-Doping Agency, accessed 2026-09-24)
usada-mots-c· · regulatory
Reference card
- Compound
- MOTS-c, mitochondrial peptides
- Evidence tier
- Human clinical trial
- Indexed publications
- 277 · 4 RCTs · 1 other clinical trials
- Approval
- no registered development programme found
- Routes reported
- intraperitoneal, intravenous, subcutaneous
- Reviewed
- Adam Mirando, PharmD,
Study figures are as published in each source and are not recommendations. Print or save this card with its date.
Last reviewed and what changed
Newest first. These are the record's own revision dates, and the same dates feed the sitemap.
- · Reviewed by Adam Mirando, PharmD, on 2026-09-25.
- · Misattribution check: study_durations (pmid-40496439): the quoted schedule is for FGF21, semaglutide and an amylin analogue; MOTS-c was not the treatment. The sources stay in the ledger; only the claims that put another agent's result under this compound were removed.
- · USADA added to the ledger; the sport-status statement is now a verbatim regulatory claim (S4.4, prohibited at all times) instead of an editorial hedge. Stage 2 competitors and information gain written to the intent map.
- · Written guide, FAQ to 16, mechanism, reported-use (no circulating figures reproduced) and regulatory editorial sections; the observational-versus-administered distinction made explicit; intent-driven H1 and title.
- · Claims drafted extractively from 40 ledger sources by scripts/draft_claims.py: 33 claims, 25 evidence-table rows. Status researched -> draft.
- · Claims drafted extractively from 40 ledger sources by scripts/draft_claims.py: 38 claims, 25 evidence-table rows. Status researched -> draft.
- · Evidence fetched from Europe PMC and ChEMBL by scripts/fetch_evidence.py; claims not yet written.