Mitochondrial Stack: SS-31, MOTS-c, NAD+ and the Mito-Genesis, MitoBoost and MitoStack Blends

What is the mitochondrial stack?

The mitochondrial stack is SS-31, MOTS-c and NAD+ used together, often called the mito stack. Some people add 5-Amino-1MQ or methylene blue, and premixed versions are sold as Mito-Genesis, MitoBoost and MitoStack. People use it hoping for more energy and healthier aging. No human trial has tested it. [8], [9], [19]

The parts are very different. Only SS-31 has large human trials, and those failed outside one rare disease; it and IV methylene blue are the only approved medicines, each for one condition. MOTS-c has never been given to people. NAD+ is a coenzyme with small human studies in specific diseases. 5-Amino-1MQ and methylene blue are not peptides. [20], [21], [5]

In community education groups, SS-31, MOTS-c and NAD+ together are taught as the default mitochondrial template, and many people using it are also taking a GLP-1 weight-loss drug such as tirzepatide or retatrutide. That makes reports of better energy hard to credit to any one part.

What's in it, and what else is it called?

The core is SS-31, MOTS-c and NAD+. Two optional parts come up most: 5-Amino-1MQ, often when weight loss is a second aim, and methylene blue, swallowed rather than injected. Protocol pages describe the three core parts as separate vials, usually started one after another. [8], [18]

A name does not fix what is in the vial. "MitoBoost" is also used for unrelated supplements, the Mito-Genesis seller's US page calls the same batch "MitoPrime", and the MitoStack test certificate describes a 40 mg sample for a 50 mg product. Only the label's amount for each part tells you what a dose contains. [14], [11], [16]

What is in each blend in this stack?

The most common premixed vials are NAD+ with 5-Amino-1MQ and MOTS-c (Mito-Genesis) and SS-31 with MOTS-c and NAD+ (MitoBoost). MitoStack pairs SS-31 with MOTS-c. Blazer is a name community education groups use for NAD+ with MOTS-c. No blend has been tested in people, and no regulator notice we found names any of them.

Amounts below are what labels state. They are not doses, and not proof of contents.

Mito-Genesis and other NAD+, 5-Amino-1MQ and MOTS-c vials

NAD+ 100 mg with 5-Amino-1MQ and MOTS-c at 10 mg each, freeze-dried together (10:1:1). So 1 mg of powder holds about 833 mcg of NAD+ and 83 mcg of each other part.

• Where sellers disagree: the three pages we checked list the same amounts, but not the same test details. The same batch shows a July 3 result on the Canadian page and July 21 on the US page. The US page also swaps which part measured 11.43 mg and which 11.14 mg. A MOTS-c and 5-Amino-1MQ vial without NAD+ belongs to the non-incretin fat-loss stack. [10], [11]
• What 5-Amino-1MQ is claimed to add: it blocks NNMT, an enzyme that uses up a building block of NAD+, so it is said to spare NAD+. A 2025 review proposes testing such blockers with NAD+ precursors, which means it has not been done. Its guide finds no human studies at all. Injection pages use 150 mcg to 5 mg a day; the 50–150 mg amounts are for capsules. [22], [6], [23]
• Stated amounts: none. The seller says the combination "is a formulation choice, not a studied entity" and gives no dosing guidance. [10]
• Regulators: no notice names Mito-Genesis. In January 2026 FDA told a compounding facility that 5-Amino-1MQ is not eligible for bulk compounding, and cited contaminated NAD+ from the same facility that sent three patients to an emergency room. [24]
• Related stacks: 5-Amino-1MQ is also paired with SLU-PP-332 for fat loss; see the non-incretin fat-loss stack.

MitoBoost and other SS-31, MOTS-c and NAD+ pens

The three core parts in one ready-mixed 2 mL pen: SS-31 10 mg, MOTS-c 10 mg and NAD+ 200 mg (1:1:20). NAD+ is about 91% of the contents.

• Where sellers disagree: on units. MitoBoost's page counts about 200 units a pen, so 1 unit holds 50 mcg each of SS-31 and MOTS-c and 1 mg of NAD+. The unbranded pen counts 300 units and labels "733 mcg" per unit, which is the whole blend, not each part. The same dial setting delivers different amounts. [13], [14]
• What the pen is claimed to add: all three parts at once, "repair" with SS-31 plus "fuel" with NAD+. The order sources teach, SS-31 first, is impossible with a premix, and no study has tested any order. [9]
• Stated amounts: MitoBoost's page suggests 5 units a day for two weeks, then 10 units a day, for 6–8 weeks: 500 mcg each of SS-31 and MOTS-c and 10 mg of NAD+ at 10 units. That is a tenth or less of the SS-31 and MOTS-c amounts on solo dosing pages. [13]
• Regulators: none name MitoBoost.

MitoStack and other SS-31 and MOTS-c vials

SS-31 and MOTS-c at 1:1, without NAD+.

• Where the label and the test disagree: the certificate names a 40 mg product, yet its vials held about 53–55 mg, with MOTS-c up to 17% above the 25 mg label. A dose worked out from the label would carry more MOTS-c than planned. [16]
• What each part is claimed to add: SS-31 for the mitochondrial membrane, MOTS-c as a metabolic signal. Neither claim has been tested together. [9]
• Stated amounts and regulators: no dose on the page, and no notice names MitoStack.

Blazer

Community education groups describe Blazer, or Blazer Blend, as NAD+ with MOTS-c. We found no open page confirming the name or the amount of each part, so we do not print any. If you have a vial, the label and its certificate are the only guide to what a dose contains.

• What MOTS-c is claimed to add to NAD+: a signal to build and use mitochondria, with NAD+ as "fuel". A protocol page for the pair as separate vials is in the combination schedules. [25]
• Community interest: Blazer is often discussed in community education groups; that interest is not evidence that it works.
• Regulators: no notice names Blazer.

Other names you may see

Nexus is listed only as a "mitochondrial research blend" without its parts. [17] Mitochondrial Powerhouse is one compounded formula of PEG-modified MOTS-c and SS-31 (chemically altered versions) with NAD+ and "exosomes", named in an FDA inspection record (see legal status). [26], [27] Methylene blue is not in any blend we found. SHRED contains MOTS-c but is a fat-loss blend, covered in the non-incretin fat-loss stack. MOTS-c, SS-31 and NAD+ added to a GLP-1 drug are covered in the GLP-1 support stack.

Why do people combine SS-31, MOTS-c and NAD+?

People combine them because each is said to help mitochondria in a different way, and they hope the effects add up. That is a rationale built on separate animal, cell and disease studies, not proof. [9]

• "Repair, build, fuel." Protocol pages describe SS-31 as protecting the inner membrane, MOTS-c as a signal to build and use mitochondria, and NAD+ as the fuel both need. One page says its own plan is a "synthesis", not a tested protocol. [8], [18]
• Tiredness on weight-loss drugs. One protocol page says the case is strongest for fatigue on semaglutide, tirzepatide or retatrutide. [8] In community education groups, that is the most common reason people start.
• Add-ons. 5-Amino-1MQ is added to "spare" NAD+, and methylene blue as an alternative electron carrier, an idea from lab chemistry. [22], [28]
• Fewer injections. A premixed pen or vial replaces three schedules with one. [13]

In community education groups, members disagree on whether SS-31 must come first, whether NAD+ and 5-Amino-1MQ overlap, and whether any of it works: energy gains are usually reported alongside a GLP-1 drug and other changes.

What does the evidence show?

No human study has tested any two parts together, and only SS-31 has large human trials on its own.

SS-31

Approved as Forzinity for Barth syndrome, a rare inherited disease, based on knee-strength gains in 8–10 people without a comparison group. Randomized trials, mostly of 40 mg a day, missed their main goals in Barth syndrome, mitochondrial muscle disease (218 people), heart failure and dry macular degeneration. [29], [30], [20], [31], [32] Full SS-31 evidence

MOTS-c

FDA found no published study that gave MOTS-c to people. The only human data are for a modified version, CB4211, in one short trial. The positive results are in mice and cells. [21], [33], [4] Full MOTS-c evidence

NAD+

About a dozen small human studies. A 180-person trial in heart failure found better heart pumping at one month with 10 mg IV a day for a week. No controlled trial has reported results for energy or aging, and no human study has yet reported blood levels after a subcutaneous injection. [5], [34] Full NAD+ evidence

5-Amino-1MQ

No human studies, case reports or registered trials. The fat-loss findings come from mice, mostly from one research group. [6], [35], [36] Full 5-Amino-1MQ evidence

Methylene blue

Established only for methemoglobinemia, a blood disorder, given by IV. For memory, one single 280 mg dose did not differ significantly from placebo. No trial has tested daily low doses in healthy people. [7], [37] Full methylene blue evidence

The combination

• Old mice, 2020. 24-month-old mice received SS-31 (from an implanted pump), NMN (in drinking water) or both for 8 weeks. SS-31 partly restored how the heart relaxes and NMN restored its pumping under strain. The pair gave both of these separate gains at once but no extra gain on either measure, and only the pair raised resting NAD levels, which the authors called synergistic. NMN is an oral NAD+ precursor, not injected NAD+. [1]
• Mouse stroke model, 2026. SS-31 plus NMN reduced brain damage and improved neurological scores more than either alone. Only the abstract was available, without doses. [2]
• Nothing else. Searches found no study of MOTS-c with any other part, of 5-Amino-1MQ with NAD+, or of methylene blue with any part, and no registered trial of any pair. [19], [38]

How do the mitochondrial stack protocols line up?

These are each part's most common protocol from its own guide. They are not a stack protocol: no source tested them together, and the SS-31 label dose is for one rare disease. [9]

Schedules published for the combination

Each row is a complete schedule from one page, with that page's amounts kept together.

The MOTS-c amounts range from 50 mcg to 10 mg per dose, and SS-31 from under 1 mg to 30 mg a day. The Mitochondrial Reset page also says SS-31 "did not receive final approval", which overlooks its 2025 accelerated approval as Forzinity. [18], [29]

How people line them up

Most pages start SS-31 alone, add MOTS-c from the second week or later, and run NAD+ throughout or later. Some pages start SS-31 and MOTS-c on the same day; a premixed pen gives all three at once. No study has compared any order. [8], [43], [39], [9] In community education groups, amounts inside a stack are often lower than solo amounts, and NAD+ is commonly moved to different days or sites from MOTS-c after reports of poor sleep, flushing and low-sugar feelings.

Plan it once. Three parts that start in different weeks, plus a swallowed add-on, are easy to mix up.

What are the overlapping risks and interactions?

The combination has never been safety-tested. The risks that add up are injection-site and allergic reactions, low blood sugar or blood pressure, a serious drug interaction with methylene blue, and vials that do not match the label. [3], [33], [7]

• Injection-site reactions add up. All 12 people on SS-31 in the Barth trial had one, CB4211 (the MOTS-c analogue) caused them in 79% of people versus 33% on placebo, and NAD+ injections often sting or leave welts. With a premix, you cannot tell which part caused one. [3], [33], [47]
• Allergic reactions. Forzinity's label warns of serious allergic reactions and rises in eosinophils, a type of white blood cell. People describe allergic-type reactions to MOTS-c, often after restarting. [3], [48]
• Low blood sugar. 5-Amino-1MQ lowered blood sugar after a sugar dose in mice, and GLP-1 drugs raise the risk of lows when combined with insulin or a sulfonylurea. [49], [50] In community education groups, low-sugar episodes, and low blood pressure with fainting, are reported on multi-compound stacks; the cause could not be assigned.
• NAD+ drips. In a small clinic study, all six people given 500 mg IV drips had nausea, cramps, a racing heart and chest pressure during the drips. [51]
• Wrong or unsafe contents. FDA has warned about non-sterile NAD+ ingredients, and in 2026 described three patients sent to an emergency room after contaminated NAD+ from one compounded vial. Blend labels can miss too: the MitoStack test found more MOTS-c than labelled. [52], [24], [16]

Interactions.

• Methylene blue and serotonergic drugs. Its boxed warning is for serotonin syndrome, which can be fatal, with SSRI, SNRI or MAOI antidepressants and opioids. The label sets no safe low dose and asks for 72 hours after the last dose before starting those drugs. Do not stop a prescribed antidepressant to make room for it. It must not be used with G6PD deficiency. [7], [53]
• Methylene blue and NAD. In solution, methylene blue reacts directly with NADH, the other form of NAD. No study has tested it mixed with NAD+ or any peptide, and it is swallowed in this stack, not injected. [54]
• SS-31 and metformin. SS-31 blocks MATE1, a kidney transporter that clears the diabetes medicine metformin. FDA required a study; no results are published. [3], [55]
• Same syringe. Forzinity's label says not to mix it with other medicines in the same syringe. [3]

Be especially cautious or avoid them in pregnancy, breastfeeding or when trying to conceive; under 18; with severe kidney disease (the SS-31 label halves the dose when eGFR is below 30); on antidepressants or opioids (methylene blue); with diabetes medicines or a GLP-1 drug; with past allergic reactions; and in tested sport.

Legal and sport status (checked September 2026):

• United States: SS-31 is approved only as Forzinity for Barth syndrome, and FDA has called research-market SS-31 an unapproved new drug. MOTS-c and NAD+ are not approved; an FDA advisory committee voted 7 to 5 in July 2026 to allow compounding MOTS-c, with no rule since, and NAD+ is still under review. In January 2026 FDA told a compounding facility that 5-Amino-1MQ is not eligible for bulk compounding and cited contaminated NAD+ from it. Only injected methylene blue is approved. [29], [56], [57], [58], [24], [7]
• The one blend a regulator named: a July 2025 FDA inspection record (Form 483) for a compounding facility lists a "Mitochondrial Powerhouse" vial of PEG-modified MOTS-c and SS-31 with NAD+ 500 mg. It is the same facility as the January 2026 warning letter. A Form 483 records inspectors' observations, not a final FDA decision. No notice we found names MitoBoost, Blazer, Mito-Genesis or Nexus. [26]
• Canada: Health Canada's advisory on peptides bought online, updated April 2026, lists MOTS-c, NAD+ and SS-31 among seized unauthorized products, each separately. No SS-31 medicine is authorized. [59], [60]
• Australia: the TGA warns against importing unapproved peptides, restricts NAD+ products, and has proposed making swallowed methylene blue prescription-only. [61], [62], [63]
• Sport: WADA names MOTS-c as banned at all times (S4.4.1), so every blend containing it is banned for tested athletes. Treat 5-Amino-1MQ as banned; NAD+ drips over 100 mL in 12 hours are prohibited. SS-31 and methylene blue are not named. [64], [65], [66], [67]

What should be monitored?

No official monitoring guidance exists for the stack. What the parts' trials and labels measured:

• Injection sites and allergy: redness, lumps, rashes and hives; eosinophil count (blood count) on SS-31. [3], [33]
• Kidney function: eGFR, because SS-31 leaves in the urine and its dose halves with severe kidney impairment. [3]
• Blood sugar: fasting glucose and HbA1c, especially with 5-Amino-1MQ, diabetes medicines or a GLP-1 drug. [49], [50]
• Heart rate and blood pressure: raised during NAD+ drips; low readings reported on multi-compound stacks. [51]
• Liver enzymes: checked in the CB4211 trial. [33]
• Methylene blue: confusion, fever, shaking or a racing heart can signal serotonin syndrome and need urgent care; methylene blue also turns urine blue or green. [7]
• Energy and sleep: the main reasons people start, and easy to confuse with a GLP-1 drug or other changes.

What happens when you stop?

Stopping has barely been studied for any part, and nobody has studied stopping one part while continuing another. [21]

• SS-31: in a short trial, less fatigue on the drug was gone two weeks after stopping. Eosinophil rises return to normal after stopping. [68], [3]
• MOTS-c, NAD+ and 5-Amino-1MQ: no study has looked at what happens after stopping. [21], [6]
• Methylene blue: with a half-life of about a day it lingers for days, so the 72-hour gap before serotonergic drugs still applies. [7]

Premixed blend or separate vials?

A premix is simpler to inject, but it fixes the ratio, hides which part caused a side effect, and has never been tested for stability with NAD+ and peptides mixed together. Separate vials take more steps but keep each dose adjustable and traceable.

• Mixing and stability. No stability data exist for any NAD+ and peptide mixture. NAD+ alone breaks down in solution at rates that depend on the buffer and temperature. The Forzinity label says not to share a syringe with other medicines. [69], [3]
• The ratio is locked. In MitoBoost, taking 5 mg of MOTS-c, the most common solo amount, means 1 mL of the pen and 100 mg of NAD+. In Mito-Genesis, the same 5 mg of MOTS-c brings 5 mg of 5-Amino-1MQ, the top of its injected range, and 50 mg of NAD+. If NAD+ stings or disturbs sleep, lowering it lowers everything. [13], [10], [40], [6]
• Tracking and troubleshooting. With separate vials, a site reaction or poor sleep can be narrowed to one part, and the usual order (SS-31 first) is possible. With a blend, neither is.
• Units. "10 mg of Mito-Genesis" is about 8.3 mg of NAD+ and 0.83 mg each of MOTS-c and 5-Amino-1MQ, not 10 mg of anything. Pen "units" differ by pen. Work out syringe units for your own vial with the reconstitution calculator. [10], [14]

Common questions about the mitochondrial stack

What is in MitoBoost?

SS-31 10 mg, MOTS-c 10 mg and NAD+ 200 mg in a 2 mL pen. Another seller sells the same formula unbranded as a 300-unit pen, where a unit holds a different amount. No study has tested the combination. [13], [14]

Should SS-31 come before MOTS-c and NAD+?

Nobody has shown that it matters. Most protocol pages start SS-31 a week or more before MOTS-c, and community education groups teach the same, but no study has compared any order. Some pages start both together, and premixed pens give all three at once. [8], [39], [9]

Can I take methylene blue with this stack if I'm on an antidepressant?

Not without your prescriber. Methylene blue's boxed warning is for serotonin syndrome with SSRI, SNRI or MAOI antidepressants and opioids, and the label sets no safe low dose. It also lingers for days after the last dose. In community education groups, many people using this stack take such medicines. [7], [53]

Does SS-31 with NAD+ work better than either alone?

Not shown in people. No human study has tested it. In old mice given SS-31 with NMN, an NAD+ precursor, the pair gave both drugs' separate heart gains (SS-31's on relaxation, NMN's on pumping under strain) but no extra gain on either measure, and only the pair raised resting NAD levels. [1]

Related guides

How this guide was researched

How this guide was made

This stack guide re-cites the original sources verified for the SS-31, MOTS-c, NAD+, 5-Amino-1MQ and methylene blue guides. New research covered what the combination raises: studies of the parts together, blend names and contents (seller pages and lab certificates), stability after mixing, interactions and regulator notices. Community education groups informed how use is described; no private post is quoted or linked, and one personal post was left out for privacy.

The research file holds 93 records, 92 verified against the original page; this guide cites 69. Seller pages are cited only for listed contents and their own claims, never as evidence of purity or effect. Drafting used AI assistance under Doserly's editorial rules, followed by source checks and editorial review. It is general education, not medical advice.

Explore the sources