MOTS-c
A 16-amino-acid signaling peptide encoded within mitochondrial DNA. Most findings come from cultured cells and mice; human research measures naturally circulating MOTS-c rather than testing it as a medicine.
Last reviewed September 22, 2026
The short version
MOTS-c is a short peptide made from instructions inside mitochondrial DNA. Researchers study it as a signal between mitochondrial metabolism and the rest of the cell. Experiments in cells and mice cover metabolism, stress responses and physical function. Human work is mainly observational: it measures the body’s own MOTS-c and looks for associations.
MOTS-c is not FDA-approved. Its compounding nomination was withdrawn, but FDA’s published safety note remains, and human interventional safety and effectiveness are not established. Any prescription decision belongs with a licensed provider.
What it is
MOTS-c stands for mitochondrial open reading frame of the 12S rRNA type-c. Unlike most peptides, whose instructions are in nuclear DNA, MOTS-c is encoded within the mitochondrial 12S ribosomal RNA gene, MT-RNR1. It is detectable in human plasma and skeletal muscle. The peptide is endogenous, meaning the human body can make it, but a lab-made preparation is an external substance.
MOTS-c contains 16 amino acids with the sequence Met-Arg-Trp-Gln-Glu-Met-Gly-Tyr-Ile-Phe-Tyr-Pro-Arg-Lys-Leu-Arg. The cited discovery paper supports the sequence.1
Where the research stands
The foundational work is preclinical. It describes metabolic signaling in cultured cells and mouse models, including how MOTS-c can move into the nucleus during cellular stress. The human studies cited here measured naturally occurring MOTS-c; they did not test it as a treatment.
How far the evidence has climbed
- Cell studiesYesHuman and mouse cells under metabolic stress
- Animal studiesYesMetabolic and muscle research in mice
- Small human pilotsLimitedObservational biomarker studies only
- Controlled human trialsNoneNo human efficacy trial identified in the cited research
- FDA approvalNoNot approved for any use
Here is what some of the most-cited studies looked at. Each names its species, because a result in a mouse is not a result in a person.
The founding metabolism study
Researchers identified the mitochondrial sequence and studied folate-cycle, purine and AMPK signaling in cultured cells. In mice, they measured responses to a high-fat diet. These were not human treatment findings.1
Movement into the nucleus
The study measured movement into the nucleus and stress-response gene expression in cultured human and mouse cells under metabolic stress. It did not test a treatment in people.2
Exercise and aging models
In humans, the study measured endogenous MOTS-c expression in skeletal muscle and circulation after exercise. Separate mouse experiments measured running, grip and gait after exogenous MOTS-c; they did not test a human treatment.3
Stress and metabolism review
A review integrated the cell, animal and human biomarker literature and emphasized the peptide’s proposed signaling roles. It did not identify controlled human treatment evidence.4
A proposed direct target
Cell-free assays measured binding to casein kinase 2, while mouse experiments examined muscle glucose uptake and disuse-related muscle changes. The work did not test a human treatment.5
The human reports
A prospective cohort measured circulating MOTS-c in 94 people receiving chronic hemodialysis and tested its association with later clinical events. Because it was observational, it cannot show that giving MOTS-c changes risk.6
What the research can’t tell you
No human treatment trial
The cited research does not include a controlled human treatment trial of MOTS-c. Biomarker associations cannot answer that question.6
Mouse results stay in mice
Metabolic and muscle treatment findings came from mouse models. The human exercise finding concerned endogenous MOTS-c, not administration as a treatment.35
Human handling is unknown
The cited research does not establish human half-life, bioavailability or exposure-response relationships. Animal protocols cannot fill that gap.
Sport rules add another limit
MOTS-c is prohibited under WADA’s anti-doping rules. Anti-doping rules are separate from FDA approval and clinical decisions.10
FDA status
Not FDA-approved for any use
FDA’s page, content current as of April 22, 2026, lists MOTS-c under “nominated but withdrawn” while retaining the published safety note. Withdrawal does not change the other requirements that apply to compounding.7
MOTS-c is not on FDA’s finalized list of additional bulk substances for patient-specific compounding.8 Before a July 2026 advisory meeting, FDA staff proposed against adding it; FDA had posted no official vote record as of September 17, 2026.9
Promise Peptides is currently taking waitlist sign-ups. Joining is not a medical request and no prescription comes from it.
A prescription route
Promise is currently accepting waitlist signups. Joining is not a treatment request and does not result in a prescription. If treatment visits open, any treatment request would require clinical review; prescribing and pharmacy fulfillment would remain separate decisions.
Start on Promise’s MOTS-c page
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Answer the MOTS-c questionnaire
A licensed provider reviews health history, medicines and goals, and can decline. Not everyone qualifies.
Pharmacy review is a separate step
A prescription does not guarantee preparation or dispensing. A pharmacy must separately determine whether it can fulfill the prescription under the applicable requirements.
A prescription does not make MOTS-c FDA-approved or turn mouse experiments into human evidence; it means a clinician reviewed the individual case.
MOTS-c at Promise
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Questions
What is MOTS-c?
It is a 16-amino-acid peptide encoded within mitochondrial DNA. The body makes endogenous MOTS-c, while research preparations are synthesized outside the body.1
Has MOTS-c been tested as a medicine in people?
No controlled human treatment trial is identified in the sources cited here. Human work measures natural MOTS-c rather than administering it.6
Sources
- Lee C, et al. The mitochondrial-derived peptide MOTS-c promotes metabolic homeostasis and reduces obesity and insulin resistance. Cell Metab. 2015;21:443-454. PubMed 25738459
- Kim KH, et al. The mitochondrial-encoded peptide MOTS-c translocates to the nucleus to regulate nuclear gene expression in response to metabolic stress. Cell Metab. 2018;28:516-524.e7. PubMed 29983246
- Reynolds JC, et al. MOTS-c is an exercise-induced mitochondrial-encoded regulator of age-dependent physical decline and muscle homeostasis. Nat Commun. 2021;12:470. PubMed 33473109
- Wan W, et al. Mitochondria-derived peptide MOTS-c: effects and mechanisms related to stress, metabolism and aging. J Transl Med. 2023;21:36. PubMed 36670507
- Kumagai H, et al. MOTS-c modulates skeletal muscle function by directly binding and activating CK2. iScience. 2024;27:111212. PubMed 39559755
- Bolignano D, et al. The mitochondrial-derived peptide MOTS-c may refine mortality and cardiovascular risk prediction in chronic hemodialysis patients. Blood Purif. 2024;53:824-837. PubMed 39111290
- U.S. Food and Drug Administration. Certain bulk drug substances for use in compounding that may present significant safety risks. Content current as of April 22, 2026.
- U.S. Food and Drug Administration. Bulk drug substances used in compounding under section 503A of the FD&C Act.
- U.S. Food and Drug Administration. July 23-24, 2026: Meeting of the Pharmacy Compounding Advisory Committee.
- World Anti-Doping Agency. The 2026 Prohibited List (S4.4.1).