STACK · ↻ Rotation cycle · 4 tiers
Cardiac & Vascular Resilience.
The most clinically validated peptide in the catalogue — paired with the bioregulator lineage.
Cadence · Continuous protocol; cycle duration per physician guidance
Hook facts
The science, in one line each.
SS-31 is the first drug ever approved by the FDA that works by directly binding to the inner membrane of mitochondria — a therapeutic target that was considered largely inaccessible just 20 years ago. It essentially rescues the power plants inside your cells.
When to skip it
Read this first.
Individuals with active unmanaged arrhythmias or those on anticoagulant therapy without physician oversight. Not a substitute for prescribed cardiac medications — this stack is adjunctive, not primary treatment.
Always cleared with your concierge before protocol start.
Why this works
The strongest evidence.
Elamipretide (SS-31) — marketed as FORZINITY and developed by Stealth BioTherapeutics under the compound name Bendavia — is the most clinically validated peptide in this entire catalogue. FDA IND status was granted in May 2010; FORZINITY carries FDA approval for Barth syndrome, a rare inherited cardiomyopathy, and has completed multiple Phase 2 trials in heart failure with reduced ejection fraction (HFrEF). The TAZPOWER Phase 2/3 trial (NCT02788747) demonstrated statistically significant improvements in 6-Minute Walk Test distance and BTHS Symptom Assessment Scale scores at 36 weeks, alongside measurable cardiac stroke volume gains. PROGRESS-HF, RESTORE-HF, and the positive single-dose PREVIEW Phase 2 study extend this evidence base across multiple cardiac phenotypes. No other peptide we carry approaches this level of clinical scrutiny. Cardiogen (Khavinson lineage, H-Ala-Glu-Asp-Arg-OH) adds a well-characterised bioregulator pulse — cardioprotective and regenerative effects in cardiac fibroblast models, sharing the same programme heritage as Epitalon and Thymalin. The rotation architecture sequences these distinct mechanisms to preserve the biological responsiveness that continuous stacking would erode.
Rotation cycle
Cycle through these.
These run in turn, not in parallel — each phase has its own purpose, and pauses between phases are part of the protocol.
Mitochondrial Heart
Cadence — Continuous protocol; cycle duration per physician guidance
SS-31
Foundation-tier cardiac protection — HFrEF patterns, post-MI recovery, ischaemia-reperfusion concerns, and longevity use…
You start with SS-31 (elamipretide / FORZINITY) because it has the strongest evidence base of any peptide in this catalogue — Phase 2/3 RCTs in heart failure, FDA approval for Barth syndrome cardiomyopathy, and a mechanism that nothing else replicates. It binds cardiolipin on the inner mitochondrial membrane to restore the heart's energy machinery: stabilising the cristae structure, reducing ROS generation, and recovering ATP output in ischaemic or age-impaired cardiomyocytes. Phase A establishes this mitochondrial foundation. Once that baseline is set — typically after an 8–12 week cycle — you have the cellular environment that Phase B (Cardiogen) needs to be effective. Running Cardiogen on a mitochondrially-primed tissue produces a different outcome than running it cold.
Who it's for
The starting point for any cardiac mitochondrial protocol. SS-31 alone is the highest-evidence single-agent cardiac peptide available — multiple Phase 2/3 RCTs, FDA approval for Barth syndrome, and ongoing trials in HFrEF. Begin here to establish the mitochondrial baseline before adding the tissue-regenerative or vascular layers.
What to expect
Improved exercise tolerance and reduced perceived exertion within 2 weeks. Measurable cardiac output and diastolic function improvements by week 6–8 in users with pre-existing dysfunction. This phase sets the cardiolipin-stabilisation foundation — the mitochondrial environment that Cardiogen's gene-expression effects will build on in Phase B.
Cardio Resilience
Cadence — SS-31 + Cardiogen pre-blend; rotate with rest periods per protocol
SS-31 + Cardiogen Blend
Standard-tier users who want both axes covered in a single vial without managing two separate protocols. The catalogue's…
Phase B adds Cardiogen to the SS-31 foundation — not as a replacement, but as the tissue-regenerative complement. While SS-31 stabilises the mitochondrial architecture of cardiomyocytes, Cardiogen works at the cardiac fibroblast level: suppressing scar formation, supporting myocardial gene expression, and driving cardioprotective effects documented in the Khavinson bioregulator programme (the same lineage as Epitalon and Thymalin). The pre-blended vial covers both axes simultaneously, which makes sense at this phase of the rotation: you're not choosing one mechanism over the other, you're applying them in concert to primed tissue. Cardiogen's effects are not instantaneous — they build across the cycle. The 8–12 week duration matters here.
Who it's for
Users who have completed or are ready to bypass the standalone SS-31 phase and want both the mitochondrial and tissue-regenerative axes covered together. The pre-blended product simplifies the protocol without sacrificing mechanistic depth.
What to expect
SS-31 benefits continue; Cardiogen's gene-expression effects on cardiac fibroblasts add a tissue-regenerative layer that takes 2–3 weeks to express. Run the full 8–12 week cycle — the blend's value is cumulative, not acute. Anti-fibrotic effects become relevant around week 6–8 for users with prior remodelling history.
Heart-Brain Resilience
Cadence — Full rotation with vascular and metabolic depth added
SS-31 + Cardiogen Blend
Standard-tier users who want both axes covered in a single vial without managing two separate protocols. The catalogue's…
VIP + MOTS-c Blend
Pro-tier users with crossover cognitive-cardiac inflammation patterns (post-COVID, chronic cerebrovascular insufficiency…
Phase C closes the rotation with the vascular and metabolic-inflammatory axes that SS-31 and Cardiogen don't directly address. VIP hits VPAC1/2 receptors on vascular smooth muscle and endothelium — direct vasodilation, anti-inflammatory suppression of TNF-α and IL-6, and pulmonary vascular support. MOTS-c adds the mitochondrial metabolic signal: AMPK activation, improved substrate switching, metabolic flexibility that SS-31's structural work alone doesn't provide. Together they target the cardiovascular system from a third angle — neither mitochondrial structure nor tissue regeneration, but vascular tone and cardiometabolic regulation. When Phase C completes, the rotation resets. Annual cycling through all three phases produces comprehensive cardiac coverage across the full mechanistic landscape: mitochondrial integrity (Phase A), tissue regeneration (Phase B), vascular resilience (Phase C).
Who it's for
Users with crossover cognitive-cardiac inflammation patterns: post-COVID cardiac sequelae, chronic cerebrovascular insufficiency, vascular-stiffness concerns alongside cardiac mitochondrial issues, or those whose inflammatory markers remain elevated despite the mitochondrial and bioregulator phases.
What to expect
VIP's vasodilatory effect is typically expressed within 1–2 weeks. MOTS-c adds a metabolic resilience layer that compounds over 4–8 weeks. Full cognitive-cardiac crossover benefits (reduced vascular inflammation, improved cerebrovascular tone, normalised cardiometabolic substrate flexibility) compound over the full rotation phase. This tier completes the cycle — after it runs, the annual rotation returns to Phase A.
Bioregulator Pulse
Cadence — 10-20 day pulse, 1-2x per year alongside Longevity Bioregulator rotation
+ sits on top of any tier above
Cardiogen
Bioregulator pulse cycles (10–20 days, 1–2× per year) alongside the Longevity Bioregulator rotation (Epitalon + Thymalin…
Cardiogen is the cardiac member of the Khavinson bioregulator family — synthesised alongside Epitalon (pineal) and Thymalin (thymic) from the same Military Medical Academy programme. The pulse pattern is the same: 10–20 days active, once or twice a year, no continuous dosing required. If you're already running the longevity bioregulator rotation, Cardiogen slots in without disrupting the Epitalon + Thymalin rhythm. You're adding the cardiac axis to a protocol that already covers circadian and immune regulation — the three-way bioregulator pulse that covers the Khavinson programme's core longevity targets.
Who it's for
Users already running the Longevity Bioregulator rotation (Epitalon + Thymalin) who want to add the cardiac axis to their annual pulse cycle. Cardiogen is the cardiac member of the Khavinson tetrapeptide family and is designed for precisely this use pattern.
What to expect
Cardiogen's cardioprotective effects accumulate across 2–3 annual cycles. This is a pulse protocol, not a continuous one — 10–20 days per course is the validated bioregulator pattern from the Khavinson programme. Paired with Epitalon (pineal/circadian axis) and Thymalin (immune axis), it provides comprehensive bioregulator coverage of cardiac, immune, and longevity pathways in a single annual cycle.
Compound roster
Every compound, briefed.
Each compound in this stack — what it does and where it fits.
SS-31 (elamipretide / FORZINITY / Bendavia) binds cardiolipin on the inner mitochondrial membrane — the phospholipid anchor that cristae integrity depends on. By stabilising cardiolipin, SS-31 preserves electron transport chain geometry, reduces mitochondrial ROS generation, and restores ATP production in ischaemic or dysfunctional cardiomyocytes. Developed by Stealth BioTherapeutics (SBT-272 series); FDA IND May 2010; FORZINITY is FDA-approved for Barth syndrome cardiomyopathy. Phase 2 HFrEF data from NCT02788747, TAZPOWER (36-wk significant 6MWT gains), PROGRESS-HF, RESTORE-HF, and PREVIEW make this the single strongest evidence anchor in the catalogue.
Best for · Foundation-tier cardiac protection — HFrEF patterns, post-MI recovery, ischaemia-reperfusion concerns, and longevity users who want the highest-evidence single-agent cardiac protocol available.
Pre-mixed SS-31 + Cardiogen in a single vial — covers acute mitochondrial protection (cardiolipin stabilisation, ROS reduction, ATP restoration via SS-31) and tissue-regenerative pulse (cardiac fibroblast gene expression, anti-fibrotic effects via Cardiogen) simultaneously. The blend is mechanistically additive: SS-31 operates at the inner mitochondrial membrane of cardiomyocytes; Cardiogen acts at the nucleus of cardiac fibroblasts. Different cell compartments, different targets, no pathway competition.
Best for · Standard-tier users who want both axes covered in a single vial without managing two separate protocols. The catalogue's flagship cardiac product — ideal for Phase B of the rotation once the SS-31-only foundation phase has established mitochondrial baseline.
Cardiogen (H-Ala-Glu-Asp-Arg-OH) is a short tetrapeptide bioregulator from the Khavinson programme (Military Medical Academy of S.M. Kirov / St Petersburg Institute of Bioregulation) — the same lineage that produced Epitalon, Thymalin, and Pinealon. It acts at the gene-expression level in cardiac fibroblasts and cardiomyocytes: cardioprotective against oxidative damage, anti-fibrotic (suppresses scar formation), and regenerative for myocardial tissue. Mechanistically complementary to SS-31 — SS-31 targets the cardiomyocyte's energy machinery, while Cardiogen targets the fibroblast-mediated structural environment around it.
Best for · Bioregulator pulse cycles (10–20 days, 1–2× per year) alongside the Longevity Bioregulator rotation (Epitalon + Thymalin), or as Phase B in the cardiac rotation to add tissue-regenerative depth after an SS-31 mitochondrial baseline has been established.
Pre-mixed VIP + MOTS-c addressing two distinct but synergistic axes: VIP's VPAC1/2-mediated vasodilation and anti-inflammatory signalling; MOTS-c's mitochondrial-encoded metabolic regulation (AMPK activation, metabolic flexibility, mitochondrial biogenesis support). Together they form a dual-axis cardiometabolic protection layer — vascular/inflammation from VIP, mitochondrial metabolic substrate from MOTS-c. MOTS-c's primary framing is in the metabolic stack, but its cardio-metabolic role here is additive to VIP's vascular effects without pathway overlap.
Best for · Pro-tier users with crossover cognitive-cardiac inflammation patterns (post-COVID, chronic cerebrovascular insufficiency, vascular-stiffness + mitochondrial metabolic concerns). The vascular completion phase in a full cardiac rotation cycle.
Vasoactive intestinal peptide (VIP) acts via VPAC1 and VPAC2 G-protein-coupled receptors expressed on vascular smooth muscle, endothelium, and immune cells. Primary cardiovascular effects: direct vasodilation (smooth muscle relaxation), anti-inflammatory signalling (suppresses TNF-α, IL-6), and pulmonary vascular support. PMC9674582 documents its cardiometabolic relevance. In the cardiac rotation context, VIP addresses the vascular-stiffness and endothelial inflammation axis that SS-31 and Cardiogen do not directly target.
Best for · Users with endothelial dysfunction, vascular stiffness, post-illness cardiac inflammation, or pulmonary vascular concerns. Best deployed as Phase C of the rotation — the vascular completion layer after mitochondrial and tissue-regenerative phases.
MOTS-c is a mitochondria-derived peptide encoded in the 12S rRNA region of the mitochondrial genome. It activates AMPK and regulates metabolic flexibility — improving insulin sensitivity, mitochondrial biogenesis, and energy substrate switching. In the cardiac context it functions as a mitochondrial metabolic substrate signal: improving the cardiomyocyte's ability to shift between glucose and fatty acid oxidation under stress, complementing SS-31's structural cardiolipin stabilisation with dynamic metabolic regulation.
Best for · Pro-tier metabolic extension; or standalone cardio-metabolic support for users whose primary pattern is mitochondrial metabolic dysfunction (insulin resistance, post-exercise metabolic fatigue) rather than structural cardiac pathology.
The science
Peer-reviewed findings.
Key research findings from the compounds in this stack.
SS-31 received FDA approval as FORZINITY™ for Barth syndrome based on a clinical trial demonstrating improved six-minute walk distance (average +96.1 meters over baseline), improved cardiac stroke volume, normalized cardiolipin levels, and reduced fatigue — the first FDA-approved mitochondria-targeted therapeutic
SOURCE · Stealth BioTherapeutics / Johns Hopkins clinical trial; FDA approval 2025
SS-31 binds cardiolipin with high affinity and the SS-31/cardiolipin complex specifically inhibits cytochrome c peroxidase activity — the enzymatic function that catalyzes cardiolipin peroxidation — thereby protecting the inner mitochondrial membrane from oxidative degradation
SOURCE · Szeto HH et al., Journal of the American Society of Nephrology; International Peptide Society monograph
Protocol
How to run it.
Frequency
SS-31: 5–20 mg daily via subcutaneous injection; Cardiogen: 10–20 mg daily oral/sublingual
Duration
8–12 weeks per phase; Cardiogen pulse cycles: 10–20 days, 1–2× per year
Timing
SS-31 in the morning before activity; Cardiogen on an empty stomach, preferably morning
Cycling
Rotation model: Phase A (SS-31 foundation, 8–12 wk) → Phase B (SS-31 + Cardiogen blend, 8–12 wk) → Phase C (VIP + MOTS-c vascular pulse, 4–8 wk) → rest and repeat annually. Each phase targets a distinct biological window; rotating ensures each mechanism is applied when the tissue is most responsive, rather than saturating any single receptor pathway.
Who it's for
Your profile.
Adults over 45 with documented cardiovascular risk factors — elevated inflammatory markers, prior cardiac events, heart failure with reduced ejection fraction, or age-related diastolic dysfunction. Ideal for individuals with high mitochondrial demand (endurance athletes, executives under chronic stress) who want proactive cellular protection before symptoms emerge. Those recovering from myocardial ischemia or cardiac surgery seeking to accelerate tissue repair and reduce remodelling risk. Well-suited for longevity-focused patients whose cardiac biomarkers suggest early decline but who are not yet candidates for aggressive pharmaceutical intervention.
Timeline
What to expect.
- 01
Week 1–2
Subtle but measurable improvements in exercise tolerance and reduction in perceived exertion during moderate activity. Some users report reduced post-exertion fatigue and improved energy consistency. Mitochondrial stabilisation begins at the cellular level — objective markers may precede subjective experience.
- 02
Week 6
Meaningful improvement in cardiac output efficiency and diastolic function markers in those with pre-existing dysfunction. Better recovery between training sessions or demanding workdays. Reduction in inflammatory markers (CRP, IL-6) in those with elevated baseline levels. Resting heart rate may normalise in chronically elevated individuals.
- 03
Week 12
Substantial cardiac remodelling benefit for those with prior ischaemic events — reduced scar fibrosis and improved ejection fraction trends. Significantly improved exercise tolerance and VO₂ recovery. Cardiogen's tissue-regenerative effects become measurable via echocardiographic improvements where applicable. Overall sense of cardiovascular resilience and energy stability.
Stacking notes
How this combines.
This stack is built for rotation, not continuous co-administration. SS-31, Cardiogen, and VIP each occupy distinct biological windows — SS-31 sets the mitochondrial baseline, Cardiogen's gene-expression effects build on that primed state, and VIP + MOTS-c complete the cycle at the vascular and metabolic layer. Running all three simultaneously would saturate different receptor pathways at once, losing the sequential amplification that makes each phase effective. The rotation model also prevents receptor desensitisation and ensures each compound is applied to tissues that are receptive, not already saturated from a prior layer. NMN complements SS-31 by independently restoring systolic function via NAD⁺ pathways (additive in aged cardiac tissue, not redundant). Avoid combining with mitochondrial uncouplers or other cardioactive peptides outside physician guidance.