Transcription
Methylene Blue. It's one of the oldest compounds in modern medicine and vastly misunderstood, even though it's been around for over a hundred years. Is it a drug? Is it a dye? Is it a mitochondrial enhancer? Does it help with energy production? Does it help with detoxification? The answer is all of the above.
Welcome to our show, Don't Look Up, where we ask you to look up, a space for real conversations about health, powered by your curiosity and grounded in science. My name is Dr. Scott Sherr, and I'm one of the four practitioners on the Troscriptions team, and today we're going to dive deep into the science and history and fun of methylene blue.
Methylene blue is a compound that was synthesized back in the 1870s. It was synthesized actually as a textile dye to dye things blue, like blue jeans back in that time. Somehow they figured out in 1897 that it treated malaria. It became the first drug registered with FDA back in 1897. From there, methylene blue became the only real antimicrobial around. It was used for fungal infections, viral infections, bacterial infections, especially urinary tract infections. During World War II, soldiers had to take methylene blue prophylactically when they were in the Pacific theater, so when they were closer to Japan and the South Pacific. And there's all these stories and songs about methylene blue, actually, because methylene blue had this very novel, benign side effect, which is making your urine blue.
After World War II, when antibiotics and antimicrobials came around like penicillin, which didn't exist until the 1950s, by the way, methylene blue became out of favor as an antimicrobial, but it was used in many different ways after that. The first antipsychotics were derived from methylene blue, because methylene blue has a property called being a monoamine oxidase inhibitor (MAOI), which means it prevents the breakdown of norepinephrine, serotonin, and dopamine, so it makes people feel better. In fact, there have been studies showing methylene blue improving mental health conditions like depression, for example.
So from there, methylene blue became a stain that you'd use in chemistry class. Some of you that are listening probably used it in chemistry class. And what's interesting about that is it actually concentrates in part of the cell called the mitochondria. We know this now because of many studies showing how methylene blue can compensate for mitochondrial dysfunction. The idea here is that mitochondria are the powerhouse. They make energy, but many of us have dysfunctional mitochondria. This could be from insulin resistance, toxins in our environment, infections, medications, stress, poor sleep, and then the list goes on and on. So methylene blue has this amazing ability to reboot, regenerate, and compensate for mitochondrial dysfunction.
Now let's get into the questions. We have it in the operating room, but we usually just use it to mark skin or fill the bladder to make sure there's no leak after the total hysterectomy. Is this the same methylene blue you're referring to? Yes. This is the same methylene blue that we're using for medical marking in surgeries. I have a transplant surgery colleague that uses methylene blue. He puts methylene blue into the bladder after he's done to make sure that he doesn't have any leakage from the bladder itself because of accidentally nicking it with a blade. And so yes, it's the same methylene blue. Methylene blue has still significant uses in the medical ecosystem, and this includes medical marking in the bladder. It's also used as an antidote in the emergency room for something called methemoglobinemia, which is when you cannot carry oxygen on your red blood cells, and it's also used for cyanide poisoning. So it's on the World Health Organization's list of essential medications because of this. So yes, it's the same compound that you're using in surgery to make sure you didn't nick the bladder with a blade.
Does methylene blue help with autoimmune disorders? Autoimmune disorders are a challenge. They are a huge challenge, and I've worked with many in my own clinical practice over the years when I was working as a hospitalist, which means a doctor that's in the hospital working primarily with tons of patients with autoimmune issues. The challenge with autoimmune issues is that they cause significant inflammation in the system, and cause deterioration or a lack of antioxidants in the system, and also, they cause mitochondrial dysfunction from an energy production perspective. So the good news is that methylene blue is doing all the things that it's doing. It's rebooting mitochondrial function, it's decreasing inflammation, it's improving detoxification, so potentially it could help with the physiology that's not working so well in an autoimmune condition. It's not a treatment for the autoimmune condition directly. Let's be clear about that. We're talking about the physiology behind the autoimmune disorder and what's happening as a result of the autoimmunity, so the difficulty making energy because of mitochondrial dysfunction, the difficulty with detoxification, the issues with inflammation, methylene blue can help in those capacities.
What are the options for taking it? Is it liquid, drops? So methylene blue does come in different flavors in the sense of how it's going to be delivered to you. The most common way is actually in liquid, but the problem with liquids in general is that they're very difficult to dose. You don't really understand how much you're getting per drop, and I've gotten asked so many times over the last couple of months. I'm taking X amount of drops. How much am I taking? And I always answer, I have no clue, and the problem with liquid in general is that we tested most liquids out there. None of them meet the label claim, so they say it's 10 drops per mL or whatever they're saying. Oftentimes they're about 80% or less of what they say on the label claim, so you're getting weaker methylene blue in general in liquid, and liquid also deteriorates faster, so I do not recommend liquid for that reason. I do know some people like liquid and that's fine, but in general you just don't really know what you're getting, and over the years we've had people transition from their liquids to our troches, which we developed because a troche is fantastic. It's easy to be precision dosed. You can take a quarter, a half or full. You know exactly how much you're getting every single time, and pound for pound, 4mg of methylene blue from us is going to feel very different than 4mg of liquid, because ours is going to be actually 4mg in dose. So yes, you can get it in liquid. I do not recommend it just because you don't really understand the potency. The other piece of it that I didn't mention that's important too is that most liquids we tested also did have some heavy metal contamination, so the thing about methylene blue, even if it's USP (which is actually pharmaceutical grade overall), you can still get heavy metals in there, and you just don't know what you're getting if you buy things on Amazon and things like that, so in general, you want to go with clean methylene blue that's not contaminated with heavy metals like cadmium, mercury, arsenic and lead, or at least very, very low amounts of those, and so if you're going to buy methylene blue, make sure you get the certificate of analysis from the company, and we have ours available anytime at Troscriptions.
Interested if methylene blue can help intense cycling training or tempo rides by taking it as a pre-workout. Also after the workout, taking it will help recovery? And what about the dosages before? This is a fantastic question about exercise, cycling, endurance, dosing, and understanding how best to use methylene blue in this capacity. Methylene blue can act just like oxygen in the mitochondria, which means that it can help you make energy for longer from an aerobic perspective, meaning that you can maintain a heart rate longer, typically with methylene blue on board compared to having it not on board, and we've seen this clinically and anecdotally. It hasn't been studied in research yet, but it's not subtle if you get the dosing right. The interesting thing about having methylene blue on board too, which we're just understanding now from people that are high performers, is that typically when we recover from exercise, we have to get our heart rate down to a certain amount or certain beats per minute to actually have that recovery, but with methylene blue on board, it seems that you can recover at a higher heart rate overall, which is a fantastic thing because you can recover faster that way if you don't have to get your heart rate down as much to do it. So from an endurance training perspective, we think methylene blue has fantastic potential to help people, especially because they can increase their aerobic capacity. When it comes to dosing for cycling and endurance training, it really just depends on how much you're going to be doing, but starting off at 8 to 16mg of methylene blue is likely the best place to start, and then seeing how you feel and re-dosing every 3 to 5 hours if you have a very long endurance training ongoing.
So would you say, even without knowing, it's worth generally taking low-dose methylene blue? Also, thoughts for women in perimenopause? This is a great question about how often you should take methylene blue. This really depends on the person. This is what I've developed in my own clinical practice over the last five years using methylene blue. What I typically do is have people start off at a lower dose, 4 or 8mg, and I increase their dose every 3 to 5 days by 4mg, which is a quarter troche, until they start feeling better. What does that mean? Does it mean that their mood is better? Does it mean that their inflammation is better? Pain, brain fog, all these things are possible, but once you find that right dose for you, that's your dose. You can take it up to twice daily, usually 8 a.m. in the morning and about 1:00 in the afternoon, and depending on why you're using it, you can use it more intermittently when you have more stress or you need more support, like when you're on an airplane, for example, or if you have a chronic, complex medical illness, you may want to be taking it regularly for a period of time. It could be two weeks, four weeks. It could be longer. This all really depends on what your goals are with the methylene blue, but in general, most of us are stressed on a regular basis, under poor lighting on a regular basis, not sleeping well, have kids that are screaming at you, and the list goes on. And so I find, at least in clinical practice, that most people benefit from a small amount of methylene blue multiple days in the week. That could be Monday through Friday for some people. That's how it is for me, typically in my house, and I find that just that little bit of methylene blue, so for me, I take 4mg twice daily when I'm home five days a week, and that really does do a great job just helping overall with my energy, with my focus, and just my ability to also recover from exercise too. The other aspect of this question was in perimenopause, in somebody that's in their 50s, should they think about taking methylene blue? And the answer is that I absolutely think it could be something to try, and the reason for that is that when going through perimenopause, your mitochondria, the part of your cell that make energy, are under a lot more stress, and that stress can manifest in a number of different ways. Of course, there's hormones that are going down and up and moving all side to side and all that craziness, but having methylene blue on board can improve your mood, so it has a little bit of serotonin, norepinephrine and dopamine. These are your neurotransmitters that make you feel better, and also it's supporting your mitochondria, and in addition to that, also supporting detoxification.
Any evidence of it helping with dementia or Alzheimer's? So methylene blue has been studied in Alzheimer's patients, and very interesting study actually. They did three doses of methylene blue: 8mg twice daily, 75mg twice daily, and 150mg twice daily. The 8mg twice daily was actually the sham or the placebo part of the trial, but interestingly enough, it was actually the sham or the placebo group that did the best in the study. Why is that? Well, it's because methylene blue at these higher doses, 75mg, 150mg twice daily, is a huge amount of methylene blue. This is up to about 2mg/kg or more, actually, and the problem with this higher dose is it may put more stress on the system, especially a brain that already is compromised because of Alzheimer's or mild cognitive impairment, so the 8mg twice daily they did better, and by the way, why did they do an 8mg twice daily as the sham? They wanted everybody in the study to have blue urine, and as a result of needing that, that's why they did the 8mg twice daily as their sham control, so there's a very interesting body of literature as well where methylene blue might help with amyloid plaques, and of course, we now know that the amyloid plaque hypothesis is bunk because all the research was forged back in the early 2000s, but we do know that amyloid is there, and the question is why is the amyloid there? And what I think methylene blue is doing in this capacity is decreasing inflammation in the brain, which is obviously really, really important, but it also may be working as an anti-infective in the brain too, and what we think amyloid is often being released for or produced for is because of inflammation or infection, so I do see a potential benefit overall despite the amyloid hypothesis not being a thing anymore, so if you have somebody in your family with mild cognitive impairment with Alzheimer's, you potentially could consider using methylene blue. If they do have a medical condition or a medical diagnosis, it's always better to work with a practitioner and not just pick up something from us or anybody else, and make sure you're following them closely, because there are potential interactions with other medications, especially in elderly people that tend to be on I think the average is about five medications or more after the age of 60 years old. The major thing you have to think about here is if they're on SSRIs or SNRIs. These medications also increase serotonin and norepinephrine, and methylene blue does the same. When we first started the company in 2020, we had a lady in her mid-20s buy our product, buy our Just Blue, and she gave it to her grandmother with mild cognitive impairment. Her grandmother started telling stories that nobody in her family had heard, ever. They gathered around her, she was animated, she was telling stories, and this lady who had bought the product reached out and she was crying, so happy that this had helped her. So methylene blue has fantastic power to help with cognitive function, and we know this from stories like that and from studies as well.
Should you only take it in the morning? When you're first starting methylene blue, I do recommend starting it in the morning. That's because people that take it when they find their right dose often will feel more elevated. They'll feel more energized, but not in a stimulated way, more in just an elevated kind of way. This is because we're increasing energy production. We're actually increasing some of those neurotransmitters that help you feel more awake, like norepinephrine, dopamine and serotonin, which makes you feel a little bit happier, so best to start it off in the morning. I often dose my patients twice daily, 8:00 in the morning and about 1 or 2:00 in the afternoon. This is because methylene blue has a half-life of about 4 to 6 hours, and so sometimes that second dose can go a long way to really making the rest of the day smooth and sustained with your energy, with your focus, with your power and drive to keep on going, so there are some people that can take methylene blue before they go to bed, and they actually report that they sleep better. This is probably because methylene blue is supporting mitochondrial function while they're highly metabolic at night in REM sleep or rapid eye movement sleep. Many of these people also report that their poops are great in the morning, and I think this is on the detoxification side of things, so in general, when you're starting methylene blue, start it in the morning, see how you feel, and then modulate your dose timing depending on what you need and how you feel.
Is there anything you need to avoid eating or drinking when starting to take methylene blue? Going to order, but not sure when I should order, and if coffee is still okay to drink or not. Methylene blue is a monoamine oxidase inhibitor, and so in essence, there are foods that are higher in something called tyramine, which is something that also blocks the monoamine oxidase enzyme, and you may want to think about not having as much of them when you're taking methylene blue. Most people aren't that sensitive to this because we're using very low doses, but things like cheese, wine, and chocolate are things that you may want to think about not having a huge amount while you're having your methylene blue. Some people have these together and do fine and have no issues at all, but just something to be aware of overall, with regards to coffee specifically, coffee is a stimulant. Coffee is going to increase energy production, is going to increase some of your neurotransmitters. Methylene blue is also going to do the same thing, so in general, if you're thinking about combining coffee with methylene blue, just go slowly with your methylene blue dosing. That's all I ask, and find what dose might be right for you as a result of that, so if you already have your latte in the morning, then add just a little bit of methylene blue, maybe a quarter of a troche like 4mg, and see how you feel. Oftentimes it's a different type of feeling. It's not a stimulating feeling taking methylene blue, so it oftentimes can be very synergistic to have methylene blue and caffeine together, and in fact we have a product called Blue Cannatine that has methylene blue with nicotine, caffeine, and CBD. It has the stimulants there, the nicotine and the caffeine, and it has the methylene blue, which is also increasing energy. That's also supporting the brain, and that's so essential about methylene blue in general is that it's supporting the brain. It's helping with energy production. It's helping with detoxification, and as a result of that, you feel better, you're more detoxed, and your mood is better too.
How long do you know to take it before your mitochondria is optimized? Should you cycle off and back on? If so, for how long? This is a great question as well on whether you should cycle on and off your methylene blue, depending on how optimize your mitochondria are, and the answer is that the more optimize that you are, the less methylene blue that you're going to need on a regular basis. I found this is not always across the board, but it's pretty common, and so. In somebody like this that's really working on their diet, their lifestyle, their supplementation, their overall mitochondrial health, they'll find oftentimes that they can peel methylene blue off over time, meaning that they may have started off taking it regularly, maybe daily, maybe five days a week, but then they don't need it that many days. Maybe they need less milligram dosage. The days that they take it, maybe they need it three days a week instead of 5 or 7, and then also the really important thing here is that methylene blue also reboots the mitochondria, so not only is it just supporting the mitochondria right the powerhouse of your cell, but it's also rebooting and regenerating it. It's allowing you to make energy more effectively. It's allowing you to detox as well from the energy that you make. Most of us forget that when we make energy in our cells, we're also making what are called waste products, quote unquote. This would be carbon dioxide, water and in small amounts, reactive oxygen species or ROS or oxidative stress, and so we need to. Have. Something in our body. Usually it's antioxidants that help neutralize this ROS signal once it gets produced. By making ATP, Methylene blue can actually work directly as an antioxidant in this capacity and neutralize oxidative stress, so for all these reasons, I think methylene blue could be fantastic overall for somebody that's on their journey no matter where they are, but especially in the beginning, and as people are getting more optimized not only from the methylene blue itself, but also from hopefully doing things with their diet, lifestyle, supplementation, etc., as you're getting more optimized, you're going to need it. Less Is what it comes down to.
Planning to begin Troscriptions in December. Here's about the blue mouth from the troches. How much does it cover? Okay, and how long does it go to mouth? Yes, so the way we've developed our methylene blue product at Troscriptions is in a buccal troche. That's a dissolvable lozenge that goes between your upper taken gum and takes about 15 to 30 minutes to fully dissolve and get into the system. Now, the issue with methylene blue is that it's a fantastically shocking blue color, and so as a result of that, we understand that not everybody wants to have a blue mouth, and if you do have a blue mouth, you don't want to have blue mouth for very long. In essence, this is the deal. Methylene blue is highly bioavailable, which means that whether you dissolve it in a troche form up here, or if you swallow it best on an empty stomach, you're going to get almost all of that methylene blue into the system and active and available for the body to use. The difference is that up here in the cheek, it's going to be faster, and so if you have more brain fog, concentration problems, attention issues, these are reasons why you may want to think about using it as a buckle troche and not swallowing it. If you're doing it more for a overall full body experience or for full body support, than swallowing it on an empty stomach is completely okay. Nice thing about a buckle troche, though, is that you can take a quarter, or you can take a half and fall and you know exactly how much you're getting every single time, so if you do end up dissolving it in your mouth, there are a couple things you can do to make the blue go away a little bit faster or keep it under wraps. The first and most important thing is to park it, and by park it, what I mean is to keep it in one place in your mouth, let it dissolve and do not move. It also, do not talk while it's in your mouth. Your mouth will get a lot bluer that way as well. Now, if your mouth is blue because you've dissolved in the mouth, this is what you can do a couple things. The first one is hot beverages. Hot beverages go really a long way to clearing up the teeth and getting the blue off of your teeth. We found that matcha latte is actually a matcha green tea is actually one of the best ways to get the blue to go away faster. How long is that blue going to last? I mean, you can use the matcha, you can use the hot liquids. You can also use baking soda as well, which can be really helpful, but in essence, more methylene blue you take. The longer your mouth is going to be blue.
Any concerns with oral methylene blue negatively impacting sperm quality for men aiming for partners pregnancy, I saw some older studies that indicate that IV methylene blue decreased sperm mobility. Sperm motility is kind of a big deal. That's what we want our sperm to be doing, is to be motile and going to the places or to the place it needs to go. Right, and so there is some concern that this study showed IV methylene blue caused a decrease in sperm motility, but the deal with this study that we're referring to here is that extremely high dose of methylene blue over about 3mg/kg, which is about a dose of 250 to 275mg of methylene blue, methylene blue has a hermetic dose response curve, meaning at low doses it supports mitochondrial function and enhances energy production. Detoxification, but at high doses it has the opposite effect. It actually causes stress on the mitochondria, and that's what I think we're seeing here, is that you have stress on the mitochondria, so sperm have a ton of mitochondria. Per cell the only second to ovaries that have more mitochondria cell in the body. This is why we're seeing so many fertility issues now is because the mitochondria aren't working very well, and we need the most in sperm and ovaries to make babies, and so I do think that these low doses of methylene blue could be supportive. Now, are there studies on fertility and methylene blue at low doses? We don't have those yet, but I strongly feel that at low doses it can be very supportive for the mitochondria and overall very safe. Just to be aware, if you're pregnant or breastfeeding, you should not take methylene blue as it is contraindicated meaning that you should not ingest it during those times. There were some studies showing that methylene blue in the third trimester, specifically when you were doing an amniocentesis, which is a procedure, could cause issues, but in general, methylene blue was extremely safe. Very low doses support mitochondrial function. That's what we want, isn't it?
Thanks so much for tuning in to "Don't Look Up," where we encourage you to look up. A space for real conversations about health. Powered by your curiosity and grounded in science.