Morning everyone!

Welcome to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health. 

This week I’m going to take a dive into a supplement/drug/dye called METHYLENE BLUE. I learned a lot about methylene blue while treating people with Covid and Long Covid. It is a fascinating substance. 


What is Methylene Blue?


Methylene blue is a blue dye developed back in the 1860’s by scientists who were working for the textile industry. They were dying cotton and wool blue. Being scientists, they started looking at it under the microscope and interestingly enough they found bacteria, viruses, and parasites! The methylene blue stain allowed them to see things more clearly under the microscope (we did this in medical school). 

Another interesting thing that happened while looking at the stain was that they were able to identify a parasite that causes malaria and note that it was killed. The stain had killed the parasite! So actually, methylene blue was one of the first drugs and definitely the first antibiotic, developed in the late 1860’s. They also treated UTI’s (urinary tract infections) with Methylene Blue. 

Since then, it’s mostly been replaced by other antibacterials and malaria medicines. In fact, hydroxychloroquine (which is used for many things including Covid-19, Malaria, Rheumatoid Arthritis, and Lupus) is actually derived from methylene blue. 


Methylene Blue Today 


They’re circling back around to methylene blue, because there’s a lot of resistant parasites that it will kill. It’s very effective for that. Not only does it kill bacteria, viruses, AND parasites, but it is also very good for intestinal yeast. 

Because of Covid, I started taking a deep dive into anything that will help people breathe. This is how I learned why and how methylene blue works. It’s complex, but I’m going to make it as simple as I can. 

Every ER doctor knows about methylene blue (especially where it’s located in the ER) because it quickly reverses carbon monoxide poisoning and cyanide poisoning. It’s FDA approved for this, which is the reason it’s in every emergency room!  

In my deep dive, I was reading about an ER doctor who described methylene blue as one of his three absolute truths in life: 

  1. No one will ever love you like your mom. 
  2. Nobody will ever be as glad to see you as your dog. 
  3. When your patient is crashing and you don’t know what to do, reach for the Methylene Blue. 

We use methylene blue for septic shock and for when we can’t get a patient’s blood pressure back up. It really saves a lot of lives for a lot of different reasons. 


Uses of Methylene Blue 


Methylene blue is beneficial for virtually all types of chemical poisonings. It’s a great antiviral, especially when used with red light therapy. It improves breathing, which makes it VERY USEFUL FOR COVID. I put a lot of my Covid patients on methylene blue and it seems to help a lot. 

Other uses: 

  • To help with energy (I take it for this)
  • To fight depression
  • To help with Dementia 
  • To help prevent and treat UTI (I recommend it to all of my friends who have moms in nursing homes. A lot of times nursing home patients end up in the ER with confusion and the cause is a UTI (especially in women). Because it also is helpful with Dementia, why wouldn’t you use it on an elderly woman in a nursing home? It’s very safe. 
  • To help with pain (especially neuropathies)


How it Works 


Methylene blue works by increasing mitochondrial respiration. We’re talking about cellular metabolism, which may be the cause of many diseases (along with inflammation). 

Methylene blue has to do with the electron transport chain. It actually can donate or receive electrons. If you’ve studied chemistry, think about redox reactions. It’s one of the few things that can donate electrons or take them up when needed for mitochondrial dysfunction. Note: there are many reasons for that. 

The mitochondria are those energy producing parts of each cell that produces ATP (i.e., energy) by a process called oxidative phosphorylation. Methylene blue inhibits NITRIC OXIDE. Note: we’ve talked about nitric oxide before. There are pros and cons to boosting your nitric oxide. The pros are that it helps with Erectile Dysfunction (ED) and blood pressure. It’s a vasodilator. The con is that it’s also a free radical and methylene blue inhibits nitric oxide. So, there’s uses for both, and I certainly use both for different situations.  

A good 2021 review of methylene blue reported that it’s the only drug known to inhibit excessive production of reactive oxygen species (think cytokine storm). It’s a low cost dye with antiseptic properties and properties that are used to treat malaria, UTIs, septic shock, and methemoglobinemia. 

Note: Methemoglobinemia is a condition where your hemoglobin (which contains iron) is contained in your red blood cells, becomes oxidized, and can’t transport the oxygen. Think carbon monoxide poisoning and cyanide poisoning. Methylene blue turns those patients around really quick because it converts methemoglobin to hemoglobin, and hemoglobin carries the oxygen to all of your tissues. 


Contraindications and Dosing 



  • If you’re on a SSRI (like Prozac or Zoloft) you probably want to wean off that first. 
  • You probably don’t want to use it in pregnant or nursing patients, or babies. 
  • You don’t want to use it if you have that rare G6PD deficiency that we check for if we’re using high dose IV Vitamin C.  

Note: At normal doses of methylene blue you don’t need to check for G6PD, but if you’re going to use it for other things (like cancer) and use it in higher doses, you do want to check a G6PD test. 

Methylene blue comes in drops. Each drop is 0.5mg. I start at 8 drops in 4 ounces of water and drink it once or twice a day. I do this, and it seems to give me energy and help with my breathing during strenuous exercise. 

This is an over-the-counter substance that’s cheap, safe, and has many uses. Where you get methylene blue does matter. You want to get the pharmaceutical grade

It also helps with hormones.

  • Decreases your estrogen if you are estrogen dominant. 
  • Decreases prolactin. 
  • Decreases cortisol. 
  • Decreases nitric oxide that’s chronic. Note: You need nitric oxide and you need cortisol, but just not chronically. 
  • Increases testosterone a bit. 
  • Increases your dopamine and serotonin. 

For people that are chronically fatigued, or post covid, or have acute covid, I think it’s very beneficial. The ER uses it in very high dose IV, so it’s very safe with these drops. Note: It will turn your mouth and urine slightly blue. 


Closing thoughts…


Methylene blue is a great drug we have in the ER and also OTC (over-the-counter) as a supplement in drop form. A lot of diseases are the result of mitochondrial dysfunction. There’s no doubt about that. It’s essential for optimal health and energy. 

Methylene blue is very safe in pharmaceutical grade. Note: there is also a chemical grade and a dye grade (manufacturing grade), but you want the pharmaceutical grade, which again is available over-the-counter. 

It is a very useful substance both for energy and well being, plus it has a lot of other uses (at higher doses) that are off label for diseases, such as: cancer, Alzheimer’s, and maybe some of the other neurodegenerative diseases (i.e., Autism). How it can help with dementia and Parkinson’s really fascinates me. 

Do your own studying. People come to the doctor for one of two reasons: They’re either tired, or they hurt. Methylene blue seems to help with both. 

Till next week.