Mitochondrial Augmentation Stack
"Mitochondrial exercise" through biochemistry — growing and fueling new mitochondria at the cellular level.
Stack Overview
About This Stack
MOTS-c, NAD+, PQQ, and CoQ10 form the "Mitochondrial Augmentation" stack — named explicitly in Dr. Emer's protocols. Each agent targets a different level of mitochondrial function: MOTS-c signals mitochondria (AMPK activation), NAD+ fuels mitochondria (Krebs cycle and sirtuin substrates), PQQ grows mitochondria (stimulates mitochondrial biogenesis via PGC-1α), and CoQ10 improves mitochondrial electron transport. PQQ is an antioxidant that stimulates mitochondrial biogenesis — essentially encouraging the growth of new mitochondria in cells. Emer often recommends PQQ as an oral supplement (10–20 mg daily) alongside peptide regimens, especially for those focused on brain health or muscle endurance.
Composition
What's In This Stack
Signals mitochondria via AMPK pathway — the mitochondrial "on-switch." Activates AMPK via the folate-purine pathway to enhance insulin sensitivity and fat oxidation. Acts as exercise mimetic; especially useful for patients over 40 whose mitochondrial output is declining.
Dose: 5–10 mg SC injection 2–3× per week for 4–6 weeks
Route: Subcutaneous
Fuels mitochondria — central metabolic coenzyme for ATP generation and longevity enzymes (sirtuins, PARPs). Declines roughly by half by age 50–60. Restoring NAD levels is key strategy to "recharge" cells. Pairing NAD IV with MOTS-c or 1-MQ can more effectively improve insulin sensitivity.
Dose: 250–500 mg IV (slow drip) or oral precursors (NR, NMN) or subcutaneous
Route: IV infusion (slow drip over 2–4 hours) or oral/subcutaneous
Grows mitochondria — antioxidant that stimulates mitochondrial biogenesis by elevating PGC-1α (the master regulator of mitochondrial creation), leading to increased number of mitochondria and improved mitochondrial function. In mice, PQQ reduced triglycerides and improved fertility and brain function. In humans, small studies found improved VO₂ max and endurance. Provides a bit of the "mitochondrial exercise" stimulus chemically.
Dose: 10–20 mg oral daily
Route: Oral supplement
Improves mitochondrial electron transport — a redox cofactor naturally present in kiwi and human breast milk. Completes the mitochondrial quartet alongside MOTS-c, NAD, and PQQ. Reduces oxidative stress. Found in foods but supplemented at therapeutic doses for clinical effect.
Dose: 100–300 mg oral daily
Route: Oral supplement
Protocol
Treatment Protocol
MOTS-c 5–10 mg SC 2–3×/week for 4–6 week cycles; NAD+ IV monthly or bimonthly (or oral NR/NMN daily); PQQ 10–20 mg oral daily ongoing; CoQ10 100–300 mg oral daily ongoing. Pairs well with exercise protocols (exercise + SS-31 together dramatically improve mitochondrial biogenesis). Ideal for older patients with low endurance or high inflammatory burden; patients who cannot exercise much get PQQ as a "mitochondrial exercise stimulus chemically." Cycles run in RE:STORE™ phases.
Patient Fit
Ideal For
- Patients over 40 with declining mitochondrial output
- Executives battling brain fog and muscle fatigue
- Older patients with low endurance or high inflammatory burden
- Patients who cannot exercise much (PQQ provides mitochondrial stimulus)
- Biohackers seeking peak mitochondrial performance
Results
Clinical Outcomes
Patients on the Mitochondrial Augmentation stack report improved energy production, better VO₂ max and endurance, reduced fatigue, and sharper cognition. MOTS-c increases energy and exercise tolerance. NAD+ patients describe a mental clarity "energy light switch." PQQ elevates PGC-1α for new mitochondrial biogenesis — a long-term investment in cellular energy infrastructure. CoQ10 ensures the electron transport chain runs efficiently. Together they address different angles of mitochondrial dysfunction: one at the enzymatic level (CoQ10/PQQ), one at AMPK level (MOTS-c), one at the substrate level (NAD+).
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All peptide stacks are physician-supervised and custom-tailored.
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