Peptides M-Z, by Nevin Pratt
MOTS-C
"Exercise in a bottle"-- it's an exercise mimetic peptide. Anti-aging. Bone health. MOTS-C is an AMPK upregulator, which boosts glucose uptake. In other words, it tells your cells "it's daytime". It also delays melatonin release. This means it can keep you awake, and give you energy. Only take this in the morning. Taking it late in the day can lead to insomnia.
Research in the American Journal of Physiology confirms that it helps with fat loss by forcing fatty acid oxidation-- i.e., it causes the body to burn fat instead of glucose.
A 2019 study (Hepatology) showed that it reverses fatty liver disease.
A 2022 study in Neuroscience Review indicates that it upregulates BDNF (Brain Derived Nuerotropic Factor), which appears to stall or even reverse alzheimers.
"MOTS-C doesn't make you smarter, it just fixes the energy crises that is making you stupid"
JACC Journals found that it improves heart function after a heart attack in less than 12 hours, by making heart muscles' mitochondria more efficient and reducing cell death, which means you don't get a bunch of fibrotic tissue.
In a 2024 Cell Reports paper, MOTS-c reversed MASH (metabolic dysfunction-associated steatotic liver disease) in mice, leading to less liver fat, less cell death, less inflammation, and less fibrosis.
Another 2025 Scientific Reports study showed MOTS-c plus exercise actually improved diabetic liver fibrosis by activating the Keap1-Nrf2 antioxidant pathway and suppressing TGF-β/Smad pro-fibrotic signaling.
Better mitochondrial function, less scar tissue.
Another peptide, TB-500, can repair fibrotic tissue, while MOTS-C can help insure it doesn't get created to begin with. These seem like a very good pairing if you use them together.
MOTS-c is your “make your liver and muscles act like an athlete” shot.
Dosage: 0.5-1mg 3-5x per week., or 2.5-5mg 1-2x per week. I personally lean towards 3mg every 3 days.
You should start at an even lower dose than the above at the beginning (maybe about half), because about 30% of people will get a histamine reaction for the first couple of shots. So start lower, then titrate up to regular dosage.
10mg vial with 1cc BAC = 1mg per 10 units, or 3mg per 30 units.
If you mix with 2cc BAC then double the units (3mg per 60 units).
NAD+
Increases cognitive clarity and memory. Enhances physical energy and endurance. Increases insulin sensitivity similar to MOTS-C. Mechanism for all of this is believed to be through increased cell oxygenation.
NAD+ is being studied for Seizure, Alzheimer's, Diabetes, Obesity, Chronic Inflammation, Osteoarthritis, Sleep Disorders, Depression, Anxiety, Schizophrenia, Epilepsy, ADHD, Chronic Pain, Exercise Performance, Metabolic Syndrome.
When NAD+ levels are low, several adverse effects can occur due to its essential role in cellular processes. One of the primary consequences is a decline in cellular energy production, as NAD+ is crucial for converting nutrients into ATP, the cell’s main energy currency. This energy deficit can lead to increased fatigue, reduced physical performance, and general lethargy. Additionally, low NAD+ levels impair the function of sirtuins, proteins that regulate inflammation, stress resistance, and cellular repair. This impairment can accelerate aging and increase susceptibility to age-related diseases.
Furthermore, insufficient NAD+ hinders DNA repair processes, leading to genomic instability and a higher risk of mutations and cancers. The decline in NAD+ also affects mitochondrial function, potentially resulting in neurodegenerative diseases and cognitive decline due to reduced brain cell protection and maintenance. Metabolic health can be compromised as well, increasing the risk of conditions such as obesity, diabetes, and cardiovascular diseases. Overall, maintaining adequate NAD+ levels is crucial for sustaining energy production, cellular health, and longevity, and its deficiency can have wide-ranging negative impacts on overall health and well-being.
Can stack NAD+ with Glutathione, 5-Amino-1MQ, Epitalon, SS-31. Also stacks well with MOTS-C and Retatrutide.
American Wellness does 500mg to 1500mg IV infusions. Their website also states:
* Reduced withdrawal symptoms such as fatigue, headaches, nausea, and anxiety.
* Improved cognitive clarity and reduced brain fog
* Support for neurotransmitter balance, especially dopamine and serotonin
* Liver and cellular repair after long-term alcohol use
* Fewer cravings and more emotional stability
* Improved sleep and energy levels during early detox
* Faster recovery time from physical and neurological symptoms
https://www.wellnessandrehabclinic.com/iv-therapy/nad-alcohol-withdrawal
Dosage:
Every other day until vial is empty.
LOW: 125mg per shot. MODERATE: 250mg per shot .
500mg vial with 1.5cc BAC = 125mg per 37.5 units, 250mg per 75 units.
750mg vial with 1.5cc BAC = 125mg per 25 units, 250mg per 50 units.
Retatrutide
Retatrutide (reta) is referred to as a "triple agonist". An "agonist" is a receptor that turns on certain signals in the body, like hunger, insulin release, etc. Reta activates 3 of them: (1) GIP, (2) GLP-1, and (3) Glucagon. The GIP signal helps regulate insulin and appetite. GLP-1 slows digestion and reduces hunger. Glucagon helps influence energy burning and fat metabolism. I think of it as a 3rd generation weight loss peptide, with tirzepatide (Monjouro and Zepbound) the 2nd generation (they only activate GIP and GLP-1), and semaglutide (Ozempic) the 1st generation (it only activates GLP-1).
Reta is currently (Nov 2025) in Phase 3 human trials. Phase 2 trial results were published October 2025 in the New England Journal of Medicine. Here is a link to the phase 2, double-blind, randomized, placebo-controlled trial:
https://www.nejm.org/doi/full/10.1056/NEJMoa2301972
Weight Loss: Results are substantially better than with semaglutide (Ozempic) or tirzepatide (Monjauro). At 48 weeks, a weight reduction of 5% or more, 10% or more, and 15% or more had occurred in 92%, 75%, and 60%, respectively, of the participants who received 4 mg of reta; 100%, 91%, and 75% of those who received 8 mg. The most common adverse events in the reta groups were gastrointestinal; these events were dose-related, were mostly mild to moderate in severity, and were partially mitigated with a lower starting dose (2 mg vs. 4 mg). Dose-dependent increases in heart rate peaked at 24 weeks and declined thereafter.
Other Benefits: Treatment with reta was associated with improvements in cardiometabolic measures (exploratory end points) including systolic and diastolic blood pressure and levels of glycated hemoglobin, fasting glucose, insulin, and lipids (with the exception of high-density lipoprotein [HDL] cholesterol).
Reta has been associated with improvements in lipid profiles, including reductions in triglycerides, LDL, and VLDL cholesterol. It also showed a significant reduction in blood pressure in both T2DM and obese patients.
Reta has also shown potential benefits on kidney function, with significant reductions in urine albumin-to-creatinine ratio (UACR) and increases in estimated glomerular filtration rate (eGFR) in obese patients.
Reta's ability to influence liver triglyceride concentrations forms another critical area of research. In clinical trials, reta has exhibited a capacity to decrease hepatic fat content, confirming its prospect for treating NAFLD and enhancing overall liver function. Such observations underscore the therapeutic implications of reta beyond mere weight loss into essential metabolic health.
Lilly published their TRIUMPH-4 Phase 3 data in December 2025 for retatrutide.
28.7% weight loss. 71 pounds average. At 68 weeks. Here's what happened:
445 people with obesity and knee osteoarthritis. Split into three groups - 9mg retatrutide, 12mg retatrutide, and placebo. The 12mg group lost an average of 71.2 pounds. That's 28.7% of their starting weight. And 8 percentage points higher than tirzepatide's ~21% in Phase 3.
Other Endorsements: A very interesting endorsement is this one by Dr. Trevor Bachmeyer. He states that in his opinion the weight loss aspects of reta are the least important of the benefits, and he gives compelling reasons for that in this video:
https://youtu.be/3Xjn3aIHi3Y?si=Zo5Dl7kCdtVYevCI
He says that in his opinion semaglutide (Ozempic) and tirzepatide (Monjauro) are trash and should be thrown away, and reta used instead. He talks about "why" in this video:
https://www.youtube.com/watch?v=JJZzjJhP2rQ
Both videos cite many different scientific studies, but the last one probably cites the most.
Dosage: Weekly injection (it has a half life of 8 days)
For obesity, the standard protocol is to start at 2mg per week for one month, and then titrate up from there. I recommend 1.5mg the first week so that you can monitor side-effects, and then 2mg for the next 3 to 5 weeks. Slowly titrate up from there (in 0.5mg increments per week), depending on how you feel. Trials peaked at 12mg per week. Many people don't see a lot of results until after around 3mg per week.
Dosage is around 0.5mg weekly for people that are not overweight but want other benefits of retatrutide.
16mg vial with 1.6cc BAC = 1mg per 10 units. 16mg vial with 3.2cc BAC = 500mcg per 10 units.
SS-31
SS-31 is a mitochondria-targeted peptide that binds to cardiolipin in the inner mitochondrial membrane and stabilizes the electron transport chain. That means more ATP, fewer leaks, and less ROS (Reactive Oxygen Species).
In metabolic disease models, SS-31 has been shown to reduce mitochondrial ROS and lipid peroxidation, increase ATP, and preserve mitochondrial structure in liver tissue.
A 2024 review highlighted SS-31 as a key candidate for restoring mitochondrial function and mitigating liver injury by targeting oxidative stress at its source.
Dosage:
Daily for 4 to 6 weeks (for general mitochondrial health). Any time.
LOW: 1-5mg per injection. MODERATE: 5-10mg per injection.
25mg vial with 2.5cc BAC = 1mg per 10 units = 5mg per 50 units.
40mg vial with 3.6cc BAC = 1mg per 9 units = 5mg per 45 units.
TB-500
Soft tissue injury repair. Systemic injection. There's evidence that it can repair fibrotic heart muscle tissue after a heart attack.
TB-500 might help for kidney repair. It is highly angiogenic, and the kidney's are very vascular in nature.
In 2010 there was a study in Circulation that TB-500, following an MI (myocardial infarction, or heart attack) in mice resulted in reversal of the fibrotic tissue damage of the MI.
2012, Journal of Pharmacology and Therapeutics showed TB-500 promotes wound healing.
Annals of the New York Academy of Sciences shows TB-500 inhibits migration and invasion of gleoblastoma cells (gloeblastoma is a highly aggressive brain cancer). In doing so, it interferes with the same actin dynamics that cancer cells use to mestastasize.
TB-500 might also help with ED, by reversing penile fibrotic tissue damage. The penile fibrotic tissue damage can be because of diabetes, high blood pressure, infections, or other various vascular problems.
It also helps with the repair of damaged nerves, by promoting the growth and projections of neurites.
The angiogenic properties of TB-500 can help with diabetic ulcers.
Some people will combine this with BPC-157, in the same syringe. I recommend against that. BPC and TB have different PH's, and different half lifes. They also have different "optimal" dosing schedules. So, inject them separately. However, the two are definitely synergistic in their effect, which means you should put them both in your stack. Some people refer to this as the "Wolverine Stack", because of how well they heal together.
Dosage: I have concluded that TB-500 is best dosed in larger "pulses", not smaller daily microdoses. Smaller doses might not be adequate for proper cell signaling. An analogy is like trying to hear a whisper in a noisy room. If you want to be heard, you need to turn the volume up.
I think I prefer 10mg vial with 1cc BAC, then take 50 units (which would be 5mg) every 5 days. This amount results in using 1/2 of a 10mg vial with each injection. Do this for (maybe) four of the 10mg vials (40 days), then rest for about 4 weeks.
Tesamorelin
Tesamorelin is FDA-approved for medical use. Clinical dosing protocols are well known and offer a well-defined foundation. Does not stimulate Ghrelin, so is preferable to Ipamorelin for overweight people.
1. Visceral Fat Reduction
Tesamorelin is clinically proven to reduce visceral adipose tissue (VAT)—the dangerous fat stored around internal organs, which is linked to insulin resistance, inflammation, and cardiovascular risk.
For physique athletes, this means a tighter midsection, improved vascularity, and a leaner abdominal profile—without compromising muscle mass.
2. Increased IGF-1 and Growth Hormone Activity
Tesamorelin increases endogenous GH and IGF-1, which drive:
* Muscle growth
* Fat metabolism
* Cellular repair
* Skin and connective tissue rejuvenation
3. Muscle Preservation During Fat Loss
Tesamorelin helps maintain lean muscle tissue even in a calorie deficit. This is key for bodybuilders, performance athletes, or anyone entering a cutting phase who wants to preserve size while leaning out.
4. Enhanced Recovery and Sleep Quality
Many users report deeper sleep, better recovery, and reduced inflammation, likely due to Tesamorelin’s role in supporting growth hormone rhythms and systemic repair.
* Improved sleep = better training response
* Faster muscle repair = more frequent training
* Reduced joint pain = longer training longevity
5. Potential Anti-Aging and Cognitive Benefits
Emerging research suggests Tesamorelin may improve mitochondrial function and cognitive performance due to its impact on IGF-1 and neurotrophic factors, although more studies are needed.
Dosage: 1-2mg daily, before bed. Fasted 2-3 hrs before shot.
Typical cycling is 8-12 weeks, then rest for a few weeks.
5mg vial with 2.5cc BAC 50 units daily = 1mg per dose.
5mg vial with 1cc BAC 20 units daily = 1mg per dose.