Transcription
Dr. Scott Sher, people talk about this substance that's out there, turns your mouth blue. It has all these different mitochondrial benefits. Um, I just kind of wanted to do a deep dive because I'm curious to learn a little bit more about methylene blue, what it is, what its sort of use cases is, but most importantly, like, what is this mechanism? How do things work? This is a, this is a how does it work channel. So, yeah, I put a link down below for a 30% off discount link for Thrive Market, which is an online grocery store. Like, you can get dairy, snacks, you could literally get like cheese crisps, you can get all kinds of things, right? They are a quote-unquote better-for-you option online grocery store. So you can do all your grocery shopping online. Plus, when you're using that link down below, that's saving you 30% off your entire first grocery order. So everything you load up in your cart, 30% off, plus a free $60 gift. But the thing is, is it makes it easy. You're not going to the grocery store and trying to find things, having to spend two hours. You can search, you can search by diet type, you could search by type of food, by dairy, you could search by sugar-free. It really makes doing the more complicated type of healthy shopping really easy, and it makes it much more affordable, and makes it accessible. And I know that people are not always keen on online shopping for groceries, but I suggest you try it because it is a game-changer.
Yeah, so there's lots of history when it comes to methylene blue. In fact, it was first synthesized back in the mid-1800s, and it was used as a textile dye, actually. So it was used to dye blue jeans blue initially. And they somehow figured out that high doses of this particular compound could kill malaria. I don't know how they figured out that a textile dye could do this, but there was some scientists that were looking at these various types of dyes during that time. So it got this name as a "magic bullet." And the cool thing about a magic bullet, as it was described at that time, is that you could give very high doses of this particular compound, and it would kill pathogens, but it would leave the normal cells fine, like undeterred, safe, and healthy. And so it got this name. And so before there were antimicrobials around, they would use higher doses of this methylene blue as an antimicrobial. It's been very well studied as something that helps with urinary tract infections with gram-negative bacteria. It's also in more recent times, more viral stuff as well, but even in fungal infections. So like the World War II pilots that were in the Pacific Theater had to take methylene blue while they were there in the jungles fighting to prevent fungal infections as well. So they had all these songs about taking methylene blue because methylene blue is a very blue pigment, dye, blue jeans, blue. It also concentrates in the urine. So if you take it orally, you will urinate, you will urinate blue. So you'll have blue urine as a result of that. All these songs about how methylene blue was this, you know, this compound that made your urine blue and etc., etc.
So, but as antimicrobials came around in the 1950s, methylene blue became out of favor because it was had these, you know, quote-unquote side effects of causing the urine to be blue. At very, very high doses, it would also cause other secretions to turn blue as well, including your poop. But again, very, very high doses. We're talking like, very high dose, like over 10 milligrams per kilogram, which is a huge amount. But from an antimicrobial perspective, it became out of favor. Um, around that time is when it started to start have its own evolution outside of the antimicrobial world. The first way it was as an antipsychotic because methylene blue has this capacity to increase some neurotransmitters like norepinephrine, dopamine, and serotonin. So the first antipsychotic was derived from methylene blue. This is back in the 1950s as well. From there, it became a cellular stain. So it started being used in chemistry labs. And so that's where I first learned about methylene blue. But the cool part about this, and this kind of gets to what we'll probably talk about most, but you have questions that we can, we can talk about any of it. But the methylene blue concentrates in a part of our cell called our mitochondria. And so over the last several decades, there's been a lot of interest in how methylene blue concentrates there and what it does when it's there. And that's really the power of, of methylene blue from almost all of us.
Okay, so what, what the heck does it do in there? Yeah, so, so our mitochondria are very intricate organelles, right? They may have come from a bacterial species many, many millions of years ago and co-opted by our cells. They help us make energy, as you know. And so what methylene blue does is helps, what I tell my patients in very brief terms and like high levels, that increases energy and increases resilience. It does that by increasing the amount of ATP or energy you can make in your mitochondria. At the same time, it works just like an antioxidant in your mitochondria and it can kind of mop up free electrons or reactive oxygen species or reactive or oxidative stress. So most compounds that we take will either do one or the other. They'll increase the amount of energy you make, or they'll increase the amount of antioxidant capacity that you have. So I think most of us know that when we make energy, we make ATP, we make these waste products of, of energy metabolism. We make water, we make carbon dioxide, and we also make these small amounts of the reactive oxygen species, these ROS or oxidative molecules. These are signaling molecules. They help tell the whole electron transport chain whether to work or to stop or to enhance function in various ways. But too much of them can cause a lot of stress on the system. And we have these antioxidants like your vitamin C, your melatonin. Actually, melatonin is produced in your mitochondria to help combat oxidative stress. Vitamin D, for example, that combat or that neutralize this oxidative load. But a lot of us are depleted in those. And so a lot of us have too much oxidative stress in the system, and then we don't have enough antioxidants to kind of neutralize that. And so the more energy we make, actually, the worse we feel. This is common for people that have exercise-induced fatigue, or they have brain fog at the end of the day, or they have concentration problems, or they have, you know, even cardiac issues because, you know, we have so many mitochondria in our cells, especially in particular organs. And do you know where we have the most mitochondria per cell? It's a good trivia question. See, liver or brain? So those are definitely two of them. But actually, the most is in our ovaries or eggs and our sperm. So they have the most mitochondria per cell. But after that, it's your brain, it's your heart, and your liver, like you said, and then of course, your skeletal muscle as well. So if you have mitochondrial dysfunction, you're likely going to have symptoms in those realms. So infertility, huge issue, right? Makes biological sense too. Like if you're metabolically unhealthy, then why would you procreate? Exactly. But then you need the most mitochondria per cell working efficiently. Your ovaries, your yourmate. Why infertility such an issue? Sperm doesn't work very well. The, the eggs aren't working as well as they used to because of mitochondrial dysfunction, right? So, so what methylene blue can do here is it can compensate for any area in the mitochondria where it's not working very well, and it can help make more energy even if you're not able to do it on your own. And that's very, very rare as a, a molecule to be able to do that. And at the same time, help you increase your capacity to neutralize the products of energy metabolism, like those reactive oxygen species. So those inflammatory, you know, cascades can't happen as much potentially because you have it there.
Too dang, that's interesting. So the first thing that comes to mind for me is, okay, is there a downside when you start looking at, like, okay, adding, you know, exogenous antioxidants? Right? Do you downregulate endogenous sort of antioxidant, you know, superoxide dismutases, gluts, anything like that? Um, I could see, and this is just poking holes, just because I'm curious, not because I'm bashing it, but like, if someone is metabolically healthy and they don't necessarily need methylene blue, is there a downside in someone that is metabolically healthy taking it, or is it more for people that are sort of metabolically, mitochondrially damaged?
Well, so, I mean, the first thing to say is that 95% of the US population has metabolic dysfunction. Fair. And as a result of that, has mitochondrial dysfunction. So what is that from? It's from insulin resistance, it's from drugs, it's from toxins in the environment, it's from hyper-stress. It's so many different things. But the biggest one is insulin resistance that causes mitochondrial dysfunction. So saying that there first. Um, that I do think that as a result of 95% of the US population having metabolic dysfunction, that I do think that methylene blue might be helpful in a lot of those cases, not all of them, but in a lot of those cases. And when it comes down, at least initially, while you're trying to support the mitochondria to work better, the idea is that of course, we want our mitochondria to work better. We want to have optimized levels of vitamins, minerals, nutrients, and and antioxidants. You mentioned, for example, um, antioxidants and like giving too much of them and causing depletion of our own body's natural antioxidant capacity. Like, that can happen if you're taking too many. Yeah, but it won't happen if you're deficient in them and you're taking them because you need them, right? And so with, with methylene blue, which is interesting, it doesn't actually, it works kind of like an adaptogen, is the best way to say it. So if you need it to help you make more energy, it can do that. In fact, it can help even people that are very metabolically active and healthy because it can work just like oxygen. So what that means is that if you have less oxygen around, say you come to Colorado with me and you're coming to train at altitude, or you're just going for a long run, and then you're kind of depleting your, your energy supplies, methylene blue can act just like oxygen at the final site of the electron transport chain called complex 4 and allow electrons to donate itself to it so that it can maintain energy production even if there's not enough oxygen around. So when people come to Colorado with me, or they go, you know, travel and go on mountains, I'm always giving them methylene blue because it can help on that process to help maintain energy metabolism even if they don't have as much oxygen around.
And same goes with, you know, flying on airplanes too. Can it protect from hypoxia in that same sense? So someone's like going to high elevation or extreme activity or extreme activity at high elevation where, you know, there's risk of hypoxia, things like that? Yes, I think so. We don't have, there's no research here to say this, but the, the mechanisms make a lot of sense because if you're hypoxic, you're also causing more inflammation in the system, right? So if you're less hypoxic, you're going to cause less inflammation because you have more of this methylene blue around to maintain energy production even if you have less oxygen around. At the same time, like if you're on an airplane, for example, you have more stress on the system because of the ionizing radiation of being on an airplane. And maybe even at altitude to some degree, but certainly when you're 35,000 feet up, um, you're going to have more of that. And so you're actually protecting yourselves from the stress of the ionizing radiation with methylene blue around. And there's some good studies on this actually.
Is that what I mean? Let's actually double-click on that for a second. I find that really fascinating. So, you know, I guess I've never really thought about it. You, I've thought about like, you know, the cabin of an airplane is pressurized to what is it? Like 6 to 8,000 feet somewhere in there? 8,000 feet for regular, and then 6,000 feet if it's a Dreamliner. Okay. So you're, so you're already like in a moderately stressed state, and you're getting about 14% oxygen. Okay. Yeah, 14, 14 to 16% somewhere around there. Yeah. Holy crap. So when you're at 8,000 feet, when at 5,000 feet where I'm at, where I live in Colorado, it's 16% oxygen, right? So I think at 8,000, I think it's around 13% oxygen. What is it at sea level? 21%. Okay. So, I mean, you're taking a, taking at least a 25 to 30% haircut. Yes. Okay. But then the ionized radiation, I've never really thought of this. I've never looked into it. So like, if I were to ask you, and this, this is your opinion, so I'm not holding you to anything on this. Sure. Why do we feel like crap after we fly? I mean, there's so many different things that go into it, but the hypoxia is a huge piece of that. So having less oxygen than you're used to. And then as a result of having the less oxygen, you're not making energy as well, you're making more oxidative stress in the system, or more inflammation. Then you also have the ionizing radiation from being up there that's also contributing to some of that oxidative stress. Then of course, you have time zones and circadian rhythms. And then you have your gut as well, that's also involved in when you're changing time zones. But the big thing for most people is the hypoxia overall because that depresses your immune system, it causes a stress response, um, it throws you into more inflammation. And so I'm actually at a benefit when I fly because I live in Colorado at 5,000 feet. Going on an airplane to to 8,000 feet is not a big of a jump as it is for somebody that lives at sea level that's going from 21% oxygen in the air to, you know, 13 or 14% oxygen at 8,000 feet. And that's, that's a big difference. And that's one of the main reasons that I use a lot of methylene blue when people travel. Um, I also use hyperbaric oxygen therapy as as well, if people have the option, the option as well. But in general, like there's great jet lag protocols that I've developed with with our team that that do a lot of great work to help prevent or at least mitigate a lot of those symptoms.
It's interesting. I mean, talk just like, have you seen some of the, there's some interesting like epigenetic stuff that's been going on talking about like, like people that live at altitude to begin with, um, you know, sweet spot, right? Yeah. So I know it's a little bit of a digression, but like, that's, I find that really interesting. It's almost like having that slight level of hormetic stress, but also, I think just epigenetically what what changes and just your ability to tolerate, um, and tolerate sort of the fluctuations that we have in life. And with, uh, I think we have to also have to factor in that in today's day and age, like we are traveling to different zones and different altitudes much more than we ever would have years ago. To you also remember too, a lot of these people that live at elevations at these sweet spots also do a lot of activity. So like, a lot of your quote-unquote Blue Zone places are also places where there are lots of hills and lots of places to climb. All so like, I live in Colorado, like there's tons of hills and mountains and all this stuff. So we're people are doing this stuff from a cardiovascular fitness perspective at the same time as living at altitude. So I don't know. I mean, because you certainly have more red blood cells in circulation when you're at 5,000 feet as opposed to when you're at sea level because red blood cells will compensate for the less oxygen in the air. So you have more of them available. That hormone erythropoietin, that you know, everybody loves and you know, injects, you know, before races, that's, you know, doping, as you know. And so I do think I've seen the same research as you as far as like, that sweet spot being around the 4,000, 5,000 foot elevation. I don't know if it's the elevation itself, or is it because people are more active? Healthy user bias, a little bit. Healthy user bias, that those are elevations too. I don't know. I mean, I think there's something to say about like, you said, some flexibility, which I think is an interesting idea where like, we know metabolic flexibility is really important, right? Why wouldn't it be the same for altitude flexibility, I guess, in the sense that you can go down, we can go up, and, you know, I can go on a mountain to 14,000 feet tomorrow, and I'll be okay because I've been at 5,000 feet. At least I have a higher prop, I have there's a greater chance that I'm going to be better than somebody that starts off at sea level, right? So that's the idea.
Yeah, I mean, it's, it's so wild to think about just from the side of, um, if you're, if you're living in altitude, if you're living at 5,000 feet, then you're constantly in this state of sort of stress, but also your resting metabolic rate was probably going to be slightly higher too, wouldn't it? Or it compensates over time. That's the thing. It's like, once you're, once you're at altitude for about 90 days, you make enough red blood cells to compensate for the metabolic stress in general. But I don't think that the hormetic stress is that significant because the body compensates. That's what the body does. And so we're very, very, we're very able as humans to acclimatize to very different situations. So we can live in like the tundra of Siberia, we can live, uh, on the equator, and we can do this because we're very, very adaptable. That's why, uh, that's why Homo sapiens kind of took over the planet because of the adaptability that we have. But again, we live in a synthetic world now. We're not immediately supposed to go from 21% to 13% oxygen. That's not supposed to happen, right? And so the body has to figure out ways to compensate for that, and it doesn't do a very good job of it overall unless we're really acknowledging and having intentional ways of thinking about it. And and so methylene blue is one of those things that I use because I really do find that it can help compensate for some of that huge shift that's happening on, on the hypoxic stress, especially is some of the stress that occurs with something like that. Also, a lack of metabolic flexibility. Like you think about if you're going up to altitude and you're becoming hypoxic, is there less efficiency to be able to substrate switch? You know, like I, I have this theory, and it may or may not be correct, that someone that is more fat-adapted but also metabolically flexible might have an easier time shifting back and forth. Um, you know, fuel partitioning, you know, so like someone that's metabolically flexible can like shift from a sprint to a run really well, or they can go up to altitude and probably acclimate a little bit easier because there's a little bit of an easier shift. It could be entirely wrong. But either way, I'm interested how methylene blue could affect metabolic flexibility in that sense.
Let's look at it from even like an athletic perspective, like someone that's trying to squeeze more out of performance out of something. Yeah, I mean, I, I worked with a guy recently that did the Leadville ultramarathon, 100-mile race. And and I've worked with a bunch of marathoners. And the problem is, especially if they're not, most, you know, males are not, you know, fat-adapted like that. They don't have the capacity to do what, you know, what you can do or have that metabolic flexibility. If they can do that, they often find that they don't feel like they have those walls when they do these longer, these longer things, like the 20 miles or marathons or whatever. But what I found is that methylene blue can be really great as a way to compensate for some of that stress that's happening, um, and continue to have the capacity to continue to make more energy at the same time as they're getting depleted because of, you know, these long, long distance kinds of runs. So I was giving him 32 milligrams of methylene blue every four hours, and he beat his race time by three hours the following year. Now, we were also working on his GI system and doing things with, uh, glutamine as well, which gets depleted by the small intestine, but that's a different story, but important. But I think I've seen this across the board that if you can give people that are doing especially endurance, methylene blue, they do better. They have better outcomes overall. And I think the primary one is just related to the continued capacity to create aerobic metabolism. So they shift over to anaerobic metabolism is further downstream than it would be if they have methylene blue on board. That's what I think is happening. And I have some even some of my patients that refuse to exercise without methylene blue because they can keep their heart rate up higher for longer when they have it on board.
Interesting. What about from a, a mood stabilization standpoint? Is that still coming back to the mitochondria? Like it kind of impacts there?
Well, I think there's two different things here. Like, certainly when you have, you know, mental health disorders, things like bipolar, depression, schizophrenia, these all have significant components of mitochondrial dysfunction. So I think methylene blue can help with that aspect and help improve mitochondrial function and do that in a very supportive way. There's, of course, also the neurotransmitter aspects of things. And so methylene blue works as a, a mild monoamine oxidase inhibitor, which is a way that helps prevent the breakdown of certain neurotransmitters, including norepinephrine, dopamine, and serotonin. So it does give you a mood boost simply because it's a monoamine oxidase inhibitor as well. So there's kind of two components, right? So if you have a mental health issue, if your mood stability is an issue, there's been studies looking at methylene blue just for depression or bipolar and seeing benefit overall, and very, very low doses of it overall. So the key really with methylene blue is that there's mitochondrial doses of it, and there's infectious doses of it. And you don't want to go to the, like, the higher dose infectious doses right away if you're just looking at something more chronic or something more supportive. And that's really where I think a lot of the, uh, the research is going now, which is like these lower doses of methylene blue can be much more supportive for mitochondrial function. So chronic inflammatory disorders, autoimmune problems, um, you know, long infectious, long symptoms, those kinds of things, like where they don't go away, that's because there's significant issues with mitochondrial dysfunction. If we get very low doses of it, we can see significant benefit and help rebooting and regenerating the mitochondria. And then hopefully supporting them otherwise with, you know, lifestyle, diet, behavior, vitamins, minerals, and nutrients to kind of support the mitochondria for the long term too.
What about, I mean, any evidence from the side of insulin resistance? Or is it all just like, hey, if you get the mitochondria functioning better, then, you know, fuel utilization is better?
Exactly. Yeah. So actually, I have a lot of patients that were formerly taking metformin, which actually destroys complex one in the mitochondria. So that's, so what supposedly not completely destroys, but definitely makes it dysfunctional to a significant degree. And what's supposed to happen with metformin specifically is that it, as a result of that, helps or forces your, your body or your cells to make more mitochondria so that you can compensate for the deficiency. And as a result of that, you make, you make yourself more insulin-sensitive because you have more mitochondria that are increasing your metabolic rate. Okay. But the problem with metformin, especially if you're very active, is that it can cause you to feel fatigue and it depletes vitamins and like B12 and things like that over time too. But what methylene blue can do actually is it can compensate for that because it can actually bypass any blockages that you have on that first complex and maintain electron flow to a higher degree through your electron transport chain and help you continue to make energy. So metformin is a whole big, you know, wall of wax on its own, but it's, it's just a demonstration of what methylene blue can do. Is it can compensate for especially complex one and complex two, which are our main drivers on our electron transport chain that that are coming from the food that we eat and our citric acid cycle. So and how we have electrons that are coming on on NAD and FAD specifically that are getting donated to those two complexes. And those are often the ones that get damaged when we have toxin exposure, infection, um, medications like metformin, etc.
Interesting. So what's, you know, if someone was kind of testing out methylene blue, like what's sort of the, what could they expect to feel?
It depends on what they're using it for in general. But if they're using it because they have a chronic inflammatory issue, say they have chronic fatigue, or they have brain fog, or exercise-induced fatigue, or significant joint pain or inflammation, then it's often a titration game. You want to start off with very low doses, and you want to slowly increase your dose every three to five days. I typically say. So I usually have people start off around four or eight milligrams, or pretty low dose, very, very low dose. And then I increase the dose every three to five days. And so they start feeling better. And depending on how much they feel better and kind of when they feel better, maybe we continue on that same dose for a while, or we actually continue to increase the dose until they actually start feeling significantly better. It depends on the situation. But that's what I would do for more people that have more chronic issues. If it's more, um, somebody that's coming in from more for like a performance-related kind of thing, then it's a little bit different. Then it's like looking at a dose for a particular performance measure. So I have a friend of mine that's doing a lot of hypoxic training all the time. And so we, we're looking at using methylene blue as a way to help improve aerobic threshold. And so we're working on some of that now. So that one day we're trying 8 milligrams, next time we're trying 16, next time we're trying 32, and see what the difference is. Because what it comes down to is that if you have a chronic issue or if you're trying to support the mitochondria over the long term, you need a lower dose. But if you're doing more like acute activity, like acute stress, acute trauma, that's why you need a higher dose overall to support the system, or if you have an acute infection. So like, for example, I make sure all of my patients have higher strength methylene blue in their medicine cabinets at home because there's good studies on viral infections, there's good studies on at least in animals in traumatic brain injury, in stroke, in severe trauma because if you can maintain the ability to make energy even if you don't have as much oxygen around, you can prevent tissue from dying, right? So I give higher doses in those cases. It's experimental, it's investigational, it's not, you know, studied in the, like, proven at this point, but it's a very safe drug given high doses, very short periods of time overall. So low doses typically for more chronic people that are also looking to support mitochondrial function primarily. Higher doses for infection, for for acute stress overall.
And is this something can, does it get destroyed if you take it in like a capsule form? So is that like why people like post pictures with their blue mouths and stuff?
Well, the nice thing about a troche delivery device is that it dissolving up here is it's going to be very fast. So with the troche, it's a dissolvable lozenge, does make your mouth blue. But what's nice about it is that it's going to go faster into the bloodstream because it's bypassing digestion. And as a result of that, you're going to feel it faster. You know, methylene blue is very, uh, bioavailable though. So if you dissolve it in your mouth versus if you swallow it, most of that actually is going to get into the system, almost 100% of it actually. So, uh, so if you decide you want to swallow it, it's okay too. But it's just going to work slower that way. And I typically have most people swallow it because they don't want a blue mouth and it's totally fine. But if you have a lot of chronic cognitive things, if you have a brain that's not working very well, like because you have concentration issues or brain fog, like dissolving in the mouth may be beneficial for you compared to swallowing.
Gotcha. Man, well, and I'll put a link down below. I know Transcenders has some of those troche forms, which I've used before. Yeah, but they can be swallowed as well. And most of my patients will swallow them, especially on an empty stomach. The best way I tell people to do it is have it on an empty stomach and then eat about 10 or 15 minutes later because what that'll typically do is kind of push it through a little bit faster, you'll get the effects a little bit faster that way. So, but that's how I do it and that's how I do it most days. But when I travel, when I'm under more stress, like I'm taking it pretty regularly myself. And I find that it's been transformative for things like jet lag, for just overall stressful events, like, you know, being at a conference and, you know, the lighting of being at a conference for three days and having to do that as well, which is just, you know, not fun for anybody's health. So, but I, I, I think that the key that I always try to remember and try to convey about methylene blue is that it was called a magic bullet for a reason. It has fantastic capacity. Okay, but it doesn't mean you want to take it all the time and forever. The idea is that if you're using methylene blue, it's often because you're compensating for something. You know, you're compensating for the stress of travel, then you take it. Or if it's the stress of the mitochondria that really need good foundational work, and that's what, you know, our nonprofit's all about. It's called Health Optimization Medicine and Practice, which is a foundational framework that looks at optimizing especially mitochondrial function and gut function because the goal would be that you don't need methylene blue very often. You just need it periodically when you're under more stress, but not every day. But sometimes in the beginning, when I work with patients and they've been sick in bed, wheelchairs, just terrible situations, I can start methylene blue very, very early on in the process, and they start feeling better. And as they're starting to feel better, we can see them be able to do all the other things that we want them to do, to start walking more, start exercising a little bit, start eating a little bit better. It could be really difficult to eat well if you feel like crap all the time. So it's kind of that chicken before the egg. So methylene blue is a great way to support the system early and as a result of that, be able to help people kind of make the changes over the long term for sure.
We, I'll link out to that down below. And where can everyone find you? So I can be found on Instagram mostly, I guess at this point, at Dr. Scott Sher, D R S C O T T S H E R. And, uh, Transcenders is the, the company that has some of the products that are in the methylene blue space. We were one of the first companies that came out with methylene blue in a commercial product in 2020. Just be careful what you guys get out there otherwise, because a lot of products are contaminated with heavy metals, lead, mercury, cadmium, and arsenic, specifically. So those don't sound awesome, and nobody really should be having those in their body. So I don't recommend anybody, anybody buy any supplements on Amazon because you don't know what you're getting. But just be careful if you're looking at other sources out there because they can be contaminated. So perfect, man. Well, thanks, brother. Good to see you. Thank you.