SS-31 for Energy: What the Evidence Shows
What human and animal studies show about SS-31 for energy, how strong that evidence is, and what is still unproven.
- Strongest evidence
- Human RCT
- Human studies
- 8
- with an outcome for energy, in our evidence file (PubMed search, 11 Oct 2026)
- Animal studies
- 1
- with an outcome for energy, in our evidence file (PubMed search, 11 Oct 2026)
- Studies we summarised
- 10
- with an outcome for energy
Evidence for energy
Each row is an outcome related to energy from a published study, strongest design first. Animal and cell results are labelled and are not human results. User reports are not counted as evidence here.
| Outcome | Result | Study type | Source |
|---|---|---|---|
| 6MWT in CPEO subgroup (post hoc) | In a post hoc subgroup with CPEO, walk distance changed by 37.3 m on elamipretide versus -8.0 m on placebo (p = 0.0024). | Human RCT | Orphanet journal of rare diseases 2024, PMID 39574155 |
| 6-minute walk and fatigue at week 24 | The pivotal randomized trial did not meet its primary endpoints (6-minute walk and fatigue score). | Human RCTn = 218 | Neurology 2023, PMID 37268435 |
| Walk distance difference | Walk distance difference versus placebo was -3.2 m (p = 0.69). | Human RCTn = 218 | Neurology 2023, PMID 37268435 |
| Primary endpoints (6MWT, BTHS-SA) in part 1 | Neither primary endpoint was met in the randomized crossover part. | Human RCTn = 12 | Genetics in medicine 2021, PMID 33077895 |
| Open-label extension, 36 weeks | In the uncontrolled extension at 36 weeks, 6-minute walk improved by 95.9 m and symptom score fell by 2.1 points. | Human RCTn = 12 | Genetics in medicine 2021, PMID 33077895 |
| Muscle mitochondrial capacity | Mitochondrial capacity rose right after a single 2-hour infusion (P = 0.055 and P = 0.045); the abstract reports no difference one week later. | Human RCTn = 39 | PloS one 2021, PMID 34264994 |
| Fatigue resistance | No significant effect on muscle fatigue resistance. | Human RCTn = 39 | PloS one 2021, PMID 34264994 |
| 6-minute walk | Walk distance was 19.8 m longer on elamipretide (398.3 vs 378.5 m), not statistically significant (P = 0.0833). | Human RCTn = 30 | Journal of cachexia, sarcopenia and muscle 2020, PMID 32096613 |
| Fatigue symptoms | Patient-reported fatigue and muscle complaints were lower on elamipretide (P = 0.0006 and P = 0.0018). | Human RCTn = 30 | Journal of cachexia, sarcopenia and muscle 2020, PMID 32096613 |
| 6-minute walk after 5 days | Highest-dose participants walked 64.5 m farther versus 20.4 m for placebo at day 5 (p = 0.053). | Human RCTn = 36 | Neurology 2018, PMID 29500292 |
| 6-minute walk at week 168 | Walk distance improved at every extension time point, by a cumulative 96.1 m at week 168. | Human uncontrolled trialn = 10 | Genetics in medicine 2024, PMID 38602181 |
| 6-minute walk vs natural history | Treated patients walked 79.7 m further at week 64 and 91.0 m further at week 76 than natural-history controls. | Human observationaln = 27 | Orphanet journal of rare diseases 2022, PMID 36056411 |
| Skeletal muscle fibre type | Elamipretide restored a near-normal skeletal muscle fibre-type composition in heart-failure dogs. | Animal · dog (not a human result)n = 14 | ESC heart failure 2019, PMID 30688415 |
| Mitochondrial function | Elamipretide improved mitochondrial function in explanted failing human heart tissue. | In vitro (not a human result) | JACC. Basic to translational science 2019, PMID 31061916 |
SS-31 and energy are not in our PubMed count ledger yet; the rows above come from our evidence file (PubMed search, 11 Oct 2026). Grades follow our .
How strong is it?
A human randomized trial outweighs any number of animal studies. Animal and cell results show a mechanism worth testing, not that it works in people.
What fatigue is
MedlinePlus says overwhelming fatigue is part of a disorder called myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).[11]
Fatigue as a registered outcome
The phase 3 mitochondrial myopathy record NCT03323749 registers the total fatigue score on the PMMSA as a primary outcome.[12]
Fatigue results in people with mitochondrial disease
In MMPOWER-3 the total fatigue score difference between elamipretide and placebo was -0.07 at week 24 (p = 0.37).[2]
In the MMPOWER-2 crossover study, participants on elamipretide reported less fatigue and muscle complaints than on placebo.[5]
In Barth syndrome, mean fatigue scores on the BTHS-SA were below baseline (improved) at all open-label extension time points.[7]
A post hoc analysis found the 6-minute walk improved in people with a CPEO subtype, not in the full population.[1]
Mitochondrial energy in animals
In dogs with heart failure, skeletal muscle mitochondria from the diseased animals showed lower ATP synthesis, and exposing them to elamipretide improved every measure in a dose-dependent way. This is animal tissue data.[9]
Other peptides people research for energy
All peptides for energy, comparedCommon questions
Does SS-31 help with energy?
The strongest study we summarise for energy is human rct evidence, across 10 studies with an outcome for energy. A trial result is not an approval; see the legal status.
Is SS-31 approved for energy?
SS-31 is FDA accelerated approval for Barth syndrome (Sep 2025). Which conditions that approval covers is set by the label; use for anything else is off-label.
What is the best peptide for energy?
There is no single answer. Our energy overview compares each candidate by evidence grade and legal status rather than by popularity.
Does SS-31 increase energy?
No trial cited measures general energy; the fatigue-specific data come from mitochondrial myopathy, where the phase 3 trial reported no improvement over placebo.[2]
More on SS-31
Sources
- 1Genotype-specific effects of elamipretide in patients with primary mitochondrial myopathy: a post hoc analysis of the MMPOWER-3 trial.Orphanet journal of rare diseases · 2024PMID 39574155Accessed 2 Oct 2026
- 2Efficacy and Safety of Elamipretide in Individuals With Primary Mitochondrial Myopathy: The MMPOWER-3 Randomized Clinical Trial.Neurology · 2023PMID 37268435Accessed 2 Oct 2026
- 3A phase 2/3 randomized clinical trial followed by an open-label extension to evaluate the effectiveness of elamipretide in Barth syndrome, a genetic disorder of mitochondrial cardiolipin metabolism.Genetics in medicine : official journal of the American College of Medical Genetics · 2021PMID 33077895Accessed 2 Oct 2026
- 4In vivo mitochondrial ATP production is improved in older adult skeletal muscle after a single dose of elamipretide in a randomized trial.PloS one · 2021PMID 34264994Accessed 2 Oct 2026
- 5A randomized crossover trial of elamipretide in adults with primary mitochondrial myopathy.Journal of cachexia, sarcopenia and muscle · 2020PMID 32096613Accessed 2 Oct 2026
- 6Randomized dose-escalation trial of elamipretide in adults with primary mitochondrial myopathy.Neurology · 2018PMID 29500292Accessed 2 Oct 2026
- 7Long-term efficacy and safety of elamipretide in patients with Barth syndrome: 168-week open-label extension results of TAZPOWER.Genetics in medicine : official journal of the American College of Medical Genetics · 2024PMID 38602181Accessed 2 Oct 2026
- 8Natural history comparison study to assess the efficacy of elamipretide in patients with Barth syndrome.Orphanet journal of rare diseases · 2022PMID 36056411Accessed 2 Oct 2026
- 9Effects of elamipretide on skeletal muscle in dogs with experimentally induced heart failure.ESC heart failure · 2019PMID 30688415Accessed 2 Oct 2026
- 10Elamipretide Improves Mitochondrial Function in the Failing Human Heart.JACC. Basic to translational science · 2019PMID 31061916Accessed 2 Oct 2026
- 11Official web pageOfficial web page · web page
- 12A Phase 3 Randomized, Placebo-Controlled Trial to Evaluate the Efficacy and Safety of Daily Subcutaneous Injections of Elamipretide in Subjects With Primary Mitochondrial Myopathy Followed by an Open-Label Treatment ExtensionClinicalTrials.gov (U.S. National Library of Medicine) · 2017clinicaltrials.govAccessed 11 Oct 2026
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