The sequence of repairing mitochondria first and then stimulating them with MOTS-c is an appealing story, but it is not a validated clinical treatment sequence. The words repair and stimulate make a complicated biological proposal sound more settled than it is.
A combination requires its own evidence
Evidence about one compound does not establish the effectiveness of two compounds used together. Even if separate studies show interesting effects, a sequence needs direct testing of order, comparison groups, outcomes and harms.
The MOTS-c exercise paper does not test the proposed human SS-31-to-MOTS-c sequence. A mechanistic discussion cannot fill in that missing comparison.
Keep approval attached to the specific medicine
Elamipretide has an FDA-approved product, Forzinity, for a defined Barth syndrome population. Its accelerated approval announcement does not approve MOTS-c, a combination regimen or general mitochondrial optimization.
A catalog item labeled SS-31 is also not automatically the finished product covered by that approval. Carrying the same familiar name is not enough to establish formulation, manufacturing, identity or clinical equivalence.
What would a sequence study need to show
A convincing comparison would separate each compound alone from the combination and distinguish order effects from simply receiving more interventions. Investigators would need to define the condition being treated and measure a meaningful benefit, not merely a change in a pathway marker.
Starting several things at different times may make a personal story feel like an experiment, but it does not create a reliable control group. Symptoms can change for reasons unrelated to the sequence, and adverse effects may be difficult to attribute.
If a clinician is treating a diagnosed mitochondrial disorder, the discussion should center on that diagnosis, authorized medicines, clinical-trial options and monitoring. If the goal is unexplained fatigue or fitness, do not assume the same evidence applies. There is no established home-use order supplied by the sources reviewed here.