Side-by-side · Research reference

DihexavsMOTS-c

Side-by-side comparison across mechanism, dosage, evidence, side effects, administration, and stack synergies. Citations on every claim where available.

AAnimal-StrongHUMAN-REVIEWED7/28 cited

BAnimal-StrongHUMAN-REVIEWED16/68 cited

Dihexa

Angiotensin IV Analogue · Pre-Clinical

Pre-clinicalDevelopment stage

Rodent onlyEvidence basisBenoist 2014

HGF/c-MetTarget systemWright 2015

Not established — animal studies only

MOTS-c

Mitokine · Mitochondria-Encoded

5–10 mgWeekly doseLee 2015

AnimalEvidence levelLee 2015 Reynolds 2021

Min–hrsHalf-life

SQ · Variable · 2–3×/week

01Mechanism of Action

Parameter

Dihexa

MOTS-c

Primary target

c-Met receptor (HGF receptor tyrosine kinase)

Mitochondrial 12S rRNA sORF → folate-AICAR-AMPK axisLee 2015

Pathway

HGF/c-Met receptor activation → downstream signaling cascade → synaptogenesis and dendritic arborization

Folate cycle inhibition → ↑AICAR → AMPK phosphorylation → PGC-1α upregulationLee 2015 Kim 2018

Downstream effect

Induction of dendritic arborization, synapse formation, neurogenesis, and neuroprotection in rodent models

Enhanced fatty acid oxidation, GLUT4-mediated glucose uptake, mitochondrial bioenergetics, anti-inflammationLee 2015

Feedback intact?

—

Stress-responsive, AMPK-dependent nuclear translocationKim 2018

Origin

Small-molecule angiotensin IV analogue designed to activate HGF/c-Met systemWright 2015

Endogenous 16-AA mitokine; mtDNA-encoded; declines with age; upregulated by exerciseReynolds 2021

Antibody development

—

02Dosage Protocols

Parameter

Dihexa

MOTS-c

Human dosing

Not established — no human trials

—

Animal studies

Mouse/rat models only — dosing not translatable to humans

—

Evidence basis

Pre-clinical / Rodent models

Animal + anecdotalLee 2015 Reynolds 2021 A first-in-human phase 1 study 2021

Phase 1a/1b CB4211 analog trial completed 2021; no native MOTS-c RCT published.

Clinical status

No Phase 1, 2, or 3 trials published

—

Standard dose

—

5–10 mg / weekLee 2015

Experimental, extrapolated from animal data. No human RCT-derived dose.

Frequency

—

2–3× per week

Short half-life may necessitate more frequent dosing for saturation.

Lower / starter dose

—

2.5–5 mg / week

Recommended due to limited human data.

Duration

—

4–12 weeks (experimental)

Optimal cycle length unknown.

Reconstitution

—

Bacteriostatic water, 1–2 mL

10 mg/mL at 1 mL.

Timing

—

Pre-workout or fasted state preferred

Activity-context amplifies AMPK response.

Half-life

—

Minutes to hours (estimated)

Systemically unstable; native MOTS-c PK in humans not fully characterised.

03Metabolic / Fat Loss Evidence

Parameter

Dihexa

MOTS-c

Primary fat target

—

Diet-induced / metabolic obesity; systemic fat utilization

Quantified reduction

—

Significant HFD fat gain ↓Lee 2015

Murine models, dose-dependent (5 & 15 mg/kg).

IGF-1 impact

—

No direct IGF-1 pathway; AMPK-mediated

Effect on lean mass

—

High dose significantly ↑ lean mass in mice

Insulin sensitivity

—

Reversed HFD insulin resistance in 7 days (mice)Lee 2015

Triglycerides

—

AMPK-driven FA oxidation suggests TG benefit (not directly measured)

Glucose metabolism

—

Improved glucose tolerance; GLUT4 upregulationLee 2015

Effect reversibility

—

Unknown — no long-term follow-up data

Context dependency

—

No effect in normal-chow mice; requires metabolic stressReynolds 2021

Key publication

—

Lee Cell Metab 2015 · Reynolds Nat Commun 2021 · Kim Cell Metab 2018Lee 2015 Reynolds 2021 Kim 2018

04Side Effects & Safety

Parameter

Dihexa

MOTS-c

Human safety data

None available — no human clinical trials

—

Theoretical c-Met risks

c-Met receptor activation has been implicated in tumorigenesis; unknown cancer risk profile

—

Pre-clinical tolerability

Not systematically reported in available studies

—

Injection site reaction

—

Mild irritation (reported)

Fluid retention / Edema

—

Not reported

Glucose intolerance

—

Improves glucose toleranceLee 2015

Cardiovascular

—

Heart palpitations (anecdotal); cardiac hypertrophy reversed in diabetic rats

Cancer risk

—

Contradictory data — some models suggest pro-proliferative effects

CNS / Neurological

—

Insomnia, headache (anecdotal reports)

GI symptoms

—

Nausea, stomach discomfort (reported)

Antibody formation

—

No data (no long-term human trials)

Pregnancy / OB

—

Avoid — insufficient safety data

Evidence quality

—

Phase 1 analog (CB4211); preclinical; anecdotal humanA first-in-human phase 1 study 2021

Absolute Contraindications

Dihexa

·Not approved for human use — research compound only

MOTS-c

·Pregnancy / breastfeeding (insufficient data)

Relative Contraindications

Dihexa

·Theoretical contraindication: active or history of malignancy (c-Met pathway involvement in cancer)

MOTS-c

·Active cancer or cancer predisposition
·AMPK pathway deficiency (efficacy nullified)
·Use with cancer-promoting medications (theoretical)

05Administration Protocol

Parameter

Dihexa

MOTS-c

1. Human administration

No established protocol. Dihexa has not been tested in human subjects. Animal studies used various routes (typically subcutaneous or intraperitoneal in rodents) not translatable to clinical use.

Add 1–2 mL bacteriostatic water. At 10 mg/vial, 1 mL gives 10 mg/mL concentration. Roll gently to dissolve.

2. Legal status

Pre-clinical research compound. Not approved by FDA or any regulatory authority for human use.

Subcutaneous — abdomen, thigh, or deltoid. Rotate sites to avoid lipohypertrophy. Pinch fat layer.

3. Timing

—

Pre-workout or fasted state preferred — metabolic context amplifies AMPK response. 2–3× per week.

4. Storage

—

Lyophilised: room temp, protected from light. Reconstituted: refrigerate, use within 21–30 days. Short systemic stability.

5. Needle

—

27–31G insulin syringe. Short needle (4–6 mm) for SQ delivery. Clean technique mandatory.

06Stack Synergy

Dihexa

— no documented stacks

MOTS-c

+ Ipamorelin

Moderate

View Ipamorelin →

MOTS-c activates AMPK/PGC-1α for mitochondrial efficiency and fatty acid oxidation; ipamorelin stimulates GH for anabolic recovery and sleep depth. Pathways are complementary — MOTS-c handles metabolic flexibility and glucose handling while ipamorelin drives recovery and body recomposition through GH. Theoretical synergy is high; clinical data is lacking.

MOTS-c: 5 mg SQ · pre-workout (2–3×/wk)
Ipamorelin: 200–300 mcg SQ · pre-sleep (daily)
Primary benefit: Metabolic flexibility + GH recovery + ROS reduction