If you're on GLP-1s and feeling the energy drain, you're not alone. Let's break down four mitochondrial powerhouses that can help restore your cellular energy production.
SS-31 (Elamipretide)
What it does: This is your mitochondrial membrane protector. SS-31 targets cardiolipin in the inner mitochondrial membrane, optimizing the electron transport chain and reducing oxidative stress.
Energy benefits:
- Improves ATP production efficiency by 20-40%
- Reduces mitochondrial dysfunction that causes fatigue
- Particularly effective for exercise capacity
On GLPs: SS-31 can counter the metabolic slowdown some people experience. Since it directly improves mitochondrial function rather than increasing fuel availability, it works synergistically with GLP-1s' metabolic effects.
Injectable Protocol: 1.25-5mg subcutaneous daily for 2-4 weeks, then reassess
MOTS-c
What it does: A mitochondrial-derived peptide that acts like a "mitochondrial stress signal," improving metabolic flexibility and insulin sensitivity.
Energy benefits:
- Enhances glucose uptake independent of insulin
- Improves fat oxidation for sustained energy
- Activates AMPK pathways (your cellular energy sensor)
On GLPs: This is a standout combo. MOTS-c improves insulin sensitivity and metabolic flexibility, which can offset muscle loss concerns and metabolic adaptation on GLP-1s. Many report stable energy throughout the day rather than crashes.
Injectable Protocol: 0.5-1mg subcutaneous daily (note: some protocols use 3-5mg per day, but this isn't typically necessary)
NAD+ Injectable
What it does: Direct NAD+ replenishment for immediate cellular energy support.
Energy benefits:
- Critical cofactor for ATP production
- Required for sirtuin activation (longevity/energy pathways)
- Depletes with age and metabolic stress
On GLPs: NAD+ levels can drop with caloric restriction. Supplementing helps maintain energy production capacity, supports fat oxidation, and may reduce the "flat" feeling some report on GLP-1s.
Injectable Protocol: 50mg subcutaneous 2-3x per week, can increase up to 100mg 3x per week as tolerated
5-Amino-1MQ
What it does: Inhibits NNMT enzyme, which increases NAD+ levels and boosts fat metabolism.
Energy benefits:
- Indirect energy boost through enhanced fat burning
- Increases NAD+ availability for mitochondrial function
- May help preserve metabolic rate during caloric restriction
On GLPs: This is controversial but potentially powerful. 5-Amino-1MQ can help maintain metabolic rate while in a deficit, which is exactly what GLP users need. The increased NAD+ also supports overall cellular energy.
Injectable Protocol: 0.25mg-1mg subcutaneous, 5-7x per week
My Recommended Approach
Order to introduce (start here, then layer in):
- SS-31 - Start with mitochondrial optimization
- MOTS-c - Add metabolic flexibility
- NAD+ - Support energy cofactors
- 5-Amino-1MQ - Advanced metabolic support
Effectiveness ranking (best to good):
- MOTS-c - The MVP for GLP users
- SS-31 - Powerful mitochondrial support
- NAD+ - Solid energy foundation
- 5-Amino-1MQ - Helpful but more niche
Final thoughts: These aren't magic bullets, but they address the ROOT CAUSE of GLP-related fatigue—compromised mitochondrial function and metabolic adaptation. Start with one, assess response, then layer in others as needed.
Anyone here running these while on GLP-1s? What's been your experience?
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