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A four-phase clinical framework that repairs mitochondrial function, activates AMPK, and moves patients to oral maintenance without dependency.
A comprehensive, multi-phase clinical framework to stabilize mitochondrial bioenergetics, clear accumulated oxidative stress, and restore metabolic homeostasis. The protocol uses targeted peptides, coenzymes, and amino acids to repair cellular energy production, then moves the patient to sustainable, endogenous maintenance.
By targeting the inner mitochondrial membrane (IMM), optimizing the NAD+ salvage pathway, and modulating the folate–AICAR–AMPK axis, this step-by-step approach takes patients from acute exogenous intervention to long-term biological resilience without creating physiological dependency.
| Agent | Route | Dose | Frequency | Duration |
|---|---|---|---|---|
| SS-31 (MTP-131) | Subcutaneous (SubQ) injection | 40 mg per dose, daily | Repeat 2 times per year | 10 days |
| Glutathione | Intravenous (IV) | 600 mg to 1,200 mg per treatment, 1–2 days per week | Repeat as needed | 8 weeks |
| Bioavailable B-complex | Oral capsule | Ongoing | Ongoing | Ongoing |
| TMG (trimethylglycine) | Oral capsule | 250 mg, daily | Ongoing | Ongoing |
Why: Before metabolic pathways are activated, the foundational cellular machinery must be secured. SS-31 binds directly to cardiolipin, sealing leaks in the mitochondrial membrane and restoring ATP production efficiency. At the same time, high-dose IV glutathione acts as a systemic "mop," neutralizing the oxidative stress (ROS) that has accumulated in the cytosol. This phase stops the damage at its source while clearing the existing inflammatory burden.
Why: With the mitochondrial engines repaired, this phase pushes the cells to burn stored energy. MOTS-c acts as an "exercise mimetic," creating a state of metabolic stress through the AMPK pathway. 5-Amino-1MQ inhibits the NNMT enzyme, which prevents the drain of nicotinamide (NAM) and primes the body's salvage pathway to recycle NAD+ more efficiently. Strict cycling of MOTS-c is clinically essential to keep the immune system from forming neutralizing antibodies against the patient's own natural peptides.
Why: Prolonged use of high-dose exogenous antioxidants and peptides can cause the body to downregulate its own production. Stopping IV glutathione and the injected peptides, and giving a single NAD+ IV "loading dose," moves the patient smoothly to oral maintenance. GlyNAC supplies the rate-limiting amino acids that push the cells to synthesize their own glutathione, which supports long-term redox homeostasis.
Why: As the body metabolizes daily NMN, it continually generates nicotinamide (NAM), which requires large amounts of methyl donors. A continuous supply of TMG and B-complex is needed to prevent systemic methyl depletion and the resulting buildup of homocysteine, which protects long-term cardiovascular and metabolic health.
