The POWER of Methylene Blue
Methylthioninium chloride, also known as methylene blue (MB), has been researched for over 120 years for biological purposes. It is used both as a medication and a dye. It is a cationic thiazine dye and monoamine oxidase inhibitor (MAOI).
It is known to be antimicrobial, anti-inflammatory, and an antitoxin with a good safety profile. In recent years, there has been significant increased interest in MB because of its possible array of potential health benefits in chronic diseases and use as an antimicrobial.
This blog describes the numerous uses of MB and how it works.
MB Use as a Dye
MB was originally synthesized for the textile industry in 1876. Take a look at your blue jeans; many have been stained blue using MB! Shortly after, scientists began using it as a stain in the lab to identify different microbes.
In medicine, it has been used for injection around polyps to identify tissue planes for removal, sprayed into the GI tract to identify irregular or precancerous lesions, used as a dye to tract lymphatic drainage, injected IV to test the urinary tract for leaks or fistulas, and added to bone cement in orthopedic operations to provide discrimination between native bone and cement.
It has also been used to test for milk freshness and used as a predictor of absorptive capabilities of carbon water filters.
MB Use and FDA Approval for Methemoglobinemia
MB is described as “the first fully synthetic drug used in medicine” and is on the World Health Organization Model List of Essential Medicines.
Clinically, MB is used for a range of indications off-label but is FDA-approved
for treatment of methemoglobinemia, a potentially life-threatening condition in which red blood cells lose the ability to properly deliver oxygen to the body leading to shortness of breath, hypoxemia, cyanosis, seizure and death.
MB as an Anti-Malarial
In 1891, Nobel laureate Paul Ehrlich, also known as the “Father of Chemotherapy,” and who developed the chemical theory of the body’s immune response, discovered dyes inactivated certain microbes but left the surrounding tissues unharmed which led to MB’s use as an anti- malarial medication. MB was one of the first treatments for malaria having been used in World War One’s malaria epidemic with positive results.
Later, the medication hydroxychloroquine, an antimalarial and antirheumatic, was synthesized from MB. Surprisingly, its therapeutic use as an antiviral, antifungal and antibacterial agent became widespread before the discovery of penicillin!
MB as an Antiseptic
MB was the first synthetic antiseptic used in clinical therapy.
You may have heard of it as it is the blue dye used as an antifungal agent in fish tanks. No, don’t drink that!
MB as an Antiviral
In 2021, MB was tested in vitro against H1N1 and Sars-coV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) with and without light activation. It was concluded it was virucidal to both viruses with and without light activation. Based on their results, the authors recommended MB should be tested in clinical studies to confirm preventative and/or therapeutic efficacy against H1N1 and SARS-CoV-2 infections.
A clinical trial in Switzerland using 100 mg of MB every 12 hours for 5 days is currently being done against SARS-CoV-2 and Covid-19 patients with a completion date of December 2023. The following studies have been completed without publication to this date:
- A clinical trial in Russia was completed and pending publication using MB at 1 mg/kg followed by photodynamic therapy for the treatment of COVID.
- A study in Canada pending publication used MB nasal spray followed by red-light therapy to show nasal decolonization of SARS-CoV-2.
- A study in Egypt in which one group of positive COVID patients received MB with red light therapy.
- A study in Spain in which standard medical treatment was compared to convalescent plasma inactivated with MB among patients with mild or moderate COVID illness.
MB as an Antibacterial
MB is commonly used to prevent urinary tract infections in the elderly.
A 2022 in-vitro study showed antibacterial and antifungal effect of MB at higher concentrations when looking at certain bacteria and candida albicans commonly found in orthopedic periprosthetic joint infections.
MB as an Anti-fungal
A 2016 study confirmed MB to be effective against multiple strains of Candida in-vitro making it an effective anti-fungal.
MB Use in Cyanide Poisoning, Carbon Monoxide Poisoning and Septic Shock
MB is used as an antidote in potassium cyanide poisoning, carbon monoxide poisoning, and encephalopathy from too much ifosfamide, a chemotherapeutic drug.
MB is also used in vasoplegic shock from sepsis. When given within 24 hours of diagnosis, MB reduced the number of days needed for vasopressor medications, decreased ICU days, and shortened hospital stays.
MB Use in Alzheimer’s
MB has been studied for Alzheimer’s disease (AD) since 2007. Phase II Clinical trial results have shown improvements in cognitive functions of AD patients after 6 months. A 2011 mouse study also showed improved learning and memory deficits in mice with AD after 16 weeks of MB treatment.
MB Use as an Anti-Psychotic, Antidepressant, Neuroprotective
MB has been used in psychiatry for over a century. The antipsychotic drug, Thorazine, was synthesized from MB.
MB has “antidepressant, anxiolytic (reduces anxiety), and neuroprotective properties documented by both animal and human studies…It was tried successfully in the treatment of psychotic and mood disorders and as a memory enhancer in fear-extinction training. Particularly promising results have been obtained in both short and long-term treatment of bipolar disorder. In these studies, MB produced an antidepressant and anxiolytic effect without risk of a switch into mania. Long term use of methylene blue in bipolar disorder led to a better stabilization and reduction in residual symptoms of the illness.”
There are studies indicating MB may be useful as an adjuvant therapy in schizophrenia but further studies are needed.
How Does It Work?
If we flashback to basic biology, we are reminded the “powerhouse of the cell” is the mitochondria. The mitochondria require an exchange of electrons to produce energy (ATP) via the electron transport chain (ETC). Mitochondrial dysfunction has been implicated as a root cause for almost every chronic disease such as Alzheimer’s, diabetes, cancer, heart disease, Parkinson’s, metabolic disorders, and even aging.
MB cycles electrons, meaning it accepts and donates electrons. MB helps to increase this exchange of electrons in the ETC of the mitochondria producing increased ATP (energy). MB concentrates in the body tissues containing the most mitochondria – brain, liver, kidneys, heart – which is why it is showing such promise for a multitude of conditions.
Mechanisms in the cell in which MB exhibit its beneficial effects are numerous.
- Increases ATP production (energy) and oxygen consumption by accepting electrons and enhancing cytochrome oxidase (complex IV) in the ECT.
- Increases oxygen-carrying capacity of hemoglobin by changing iron (heme) configuration in hemoglobin (why it is used in methemoglobinemia)
- Increases NAD+, a helper molecule imperative to energy production considered the “fountain of youth”
- Neutralizes free radicals, acting as an antioxidant
- Inhibits monoamine oxidase, increasing neurotransmitters (dopamine, serotonin, melatonin) and therefore acts as an antidepressant
Potential Indications for MB
Research is completed or underway looking at MB for use in cancer, infectious diseases, skin conditions, malaria, neurodegenerative disease, viruses, mold, chronic fatigue, chronic neuropathic pain, Lyme disease and more. Early research has shown MB to exhibit potential beneficial effects for many conditions.
- Cognitive decline and neurodegenerative diseases: Alzheimer’s, Parkinson’s, Huntington’s.
- MB increased fMRI brain activity with sustained attention, potentially aiding in memory retrieval and short-term memory loss.
- May diminish skin aging and promote wound healing.
- Offers neuroprotection and antidepressant effect from brain injury (TBI).
- Stabilization and reduction of depression in bipolar disorder and other mood disorders.
- Early promise against Lyme Disease, chronic infections, viruses, chronic fatigue, UTI and COVID.
Dosage Is Important
MB can be given intravenously or taken orally. Studies show low dose MB is safe and therapeutic at 0.5 – 1 mg/kg per day. At moderate (4 – 10 mg/kg) and high doses (>10 mg/kg), MB can be harmful. The half-life of MB is about 5 to 6.5 hours.
The effects of MB may be enhanced when used in combination with red-to-near-infrared light therapy. Getting in sunlight or red light after taking MB is a good idea. Red light therapy has also been shown to upregulate mitochondrial respiration. In combination, both may supercharge the mitochondria. The combination may be especially beneficial for neurodegeneration of the brain, specifically for dementia, Alzheimer’s and Parkinson’s.
Safety of MB
MB is safe at appropriate low doses, 0.5 to 1 mg/kg a day. At high doses over 10 mg/kg, potential side effects include: GI distress, hemolytic anemia in those with glucose-6-phosphate dehydrogenase (G6PD) deficiency, hypertension, methemoglobinemia, dizziness.
MB should be avoided among people taking serotonin-raising psychiatric medications (SSRI, SNRI, MAOI) and 5-HTP supplements due to risk of serotonin syndrome.
The source of MB is important to ensure purity and potency. Many products are contaminated with heavy metals and other impurities. It is important to choose one that is tested for purity and potency with a Certificate of Analysis. Always get USP (pharmaceutical grade) MB.
While this is not a cause for concern, it should be known MB can temporarily cause green to blue urine, stool, and sweat 4-24 hours after ingestion! Be careful, as it can stain clothing and surfaces.
The Power of Blue
Low dose MB has a long history of use for various medical ailments and conditions. New research shows great promise as many chronic conditions improve with MB by targeting the root cause of chronic disease – dysfunctional mitochondria. MB helps increase mitochondrial function which in turn increases energy metabolism and cellular function.
Many are experiencing the power of this blue compound for its antioxidant, antimicrobial, antidepressant and anti-neurodegenerative effects! If you give it a try, ensure it is pharmaceutical grade and tested for purity and potency.