MOTS-c vs Cerebrolysin
Sold as a way to get the benefits of exercise without training. Mice given it stayed lean and ran longer, but it has not been tested in people. It is an injection promoted for stroke recovery, memory and brain injury. Trials point both ways, and the biggest review found no fewer deaths and more serious side effects.
Cerebrolysin has the stronger evidence, grade B (some human evidence) against grade C for MOTS-c. Neither is FDA approved.
Evidence
CAnimal and cell studies
BSome human evidence
Human studies cited
Animal or cell studies cited
Why the grade
The efficacy data are in mice: the 2015 discovery paper showing protection from diet-induced obesity and insulin resistance, and a 2021 paper showing better physical performance in young and old mice. The only human data measure the body's own MOTS-c rising in muscle and blood after exercise. No human has received MOTS-c in a published trial, so C.
For the stroke-recovery use there are randomized placebo-controlled trials, but they point in different directions. A Cochrane review pooled six RCTs with 1,501 participants and found no reduction in deaths and more non-fatal serious adverse events; the CARS trial (208 patients) and the two CAPTAIN trials in brain injury (185 patients pooled) reported modest functional benefits. Several trials were manufacturer-supported and had high risk of bias, so the grade stops at B.
FDA
Not approved
Not approved by the FDA for any use and sold as a research chemical. MOTS-c was placed in Category 2 (significant safety risk) in 2023; the nomination was withdrawn, the FDA removed it from that category in April 2026, and the Pharmacy Compounding Advisory Committee voted in July 2026 to recommend it for the compounding list. On 28 October 2026 HHS issued an enforcement discretion policy covering injectable MOTS-c acetate compounded by licensed pharmacies and physicians for named patients under sourcing, testing, labeling and reporting conditions. That is not an approval. It is also on the 2026 WADA Prohibited List.
Not approved
Cerebrolysin is not approved by the FDA for any use. It is a licensed medicine in more than 50 other countries, mainly in Eastern Europe, Russia and Asia, for stroke, dementia and brain injury.
Sold for
MOTS-c is sold as an 'exercise mimetic', a mitochondrial peptide said to burn fat, improve insulin sensitivity, and boost endurance the way training does.
Cerebrolysin is promoted in nootropic and longevity circles as a brain-repair injection that speeds stroke recovery, sharpens cognition and treats dementia.
Studies say
Mice given MOTS-c resisted obesity and ran longer, and humans make more of it after exercise, but no trial has given it to people, so the evidence is grade C.
Randomized trials exist, which earns a B, but the largest independent synthesis found no effect on death or dependence after stroke and a rise in serious adverse events, while smaller manufacturer-backed trials found small functional gains.
Class
Mitochondrial-derived peptide
Neuropeptide preparation (porcine brain)
Route
Injection
Intravenous