Athletes should be extremely wary of experimental peptides, including the prohibited peptide MOTS-c, which can be found on many websites with the label “for research purposes only” or in compounded medications. Currently, MOTS-c is not approved by the Food and Drug Administration (FDA) for use in humans or in compounded medications.
Keep reading to learn more about the health and anti-doping risks related to MOTS-c.
What is MOTS-c?
MOTS-c is a 16 amino acid peptide that comes from the mitochondria. The mitochondria are the “power generators” in cells that convert chemical energy from food into a form that cells can use. According to new research, mitochondrial-derived peptides such as MOTS-c seem to have a role in protecting cells under different stresses1. It has been shown that exercise causes MOTS-c levels to go up in humans. Furthermore, it has been shown in mice that MOTS-c treatment improves physical performance in mice of all ages and seems to regulate skeletal muscle1.
Are there medical uses for MOTS-c?
No, MOTS-c is still an experimental peptide being explored for therapeutic purposes related to aging and obesity. It is not approved by the FDA for use in humans.
Recently, the FDA was asked to evaluate MOTS-c for compounding purposes, and there was a public hearing on the matter. The FDA briefing on MOTS-c highlights the lack of clinical data to indicate efficacy or safety. During the evaluation process, there is no legal basis to include MOTS-c in any compounded medication.
Is MOTs-c prohibited in sport?
Yes, MOTS-c is prohibited at all times under Section 4.4 Metabolic Modulators, 4.4.1. Activators of the AMP-activated protein kinase (AMPK) on the World Anti-Doping Agency Prohibited List. It is explicitly listed as mitochondrial open reading frame of the 12S rRNA-c (MOTS-c).
Can athletes get a Therapeutic Use Exemption (TUE) for MOTS-c?
It is highly unlikely an athlete would get a TUE approved for MOTS-c because there is no approved therapeutic use for this experimental drug.
Is MOTS-c available online?
Yes, there are many websites and social media influencers that promote MOTS-c as an injectable weight loss and body building peptide drug. However, just because it’s available for sale online doesn’t mean it is safe or effective.
Is MOTS-c safe to use?
Currently, it is unknown under what conditions (if any) it is safe to use MOTS-c because there are no completed human clinical trials. However, among people who claim to purchase MOTS-c online, there are many reported side effects, including increased heart rate or heart palpitations, injection site irritation, insomnia, local or generalized immune reactions, and fever. There is also no data available on what happens with long-term use of MOTS-c.
More questions?
For questions about specific products, substances, and methods, contact USADA’s Drug Reference Line at DrugReference@USADA.org or call (719) 785-2000, option 2.
References
1. FDA (2026). July 23-24, 2026: Meeting of the Pharmacy Compounding Advisory Committee.
2. Reynolds, J.C., Lai, R.W., Woodhead, J.S.T., Joly, J.H., Mitchell, C.J., Cameron-Smith, D., Lu, R., Cohen, P., Graham, N.A., Benayoun, B.A., et al. (2021). MOTS-c is an exercise-induced mitochondrial-encoded regulator of age-dependent physical decline and muscle homeostasis. Nat Commun 12, 470. 10.1038/s41467-020-20790-0.
3. FDA (2023). Safety Risks Associated with Certain Bulk Drug Substances Nominated for Use in Compounding. https://www.fda.gov/drugs/human-drug-compounding/safety-risks-associated-certain-bulk-drug-substances-nominated-use-compounding.
4. FDA Briefing Document MOTSc- Pharmacy Compounding Advisory Committee (PCAC) https://www.fda.gov/media/193347/download.
