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June 21, 2025 20 mins
Karen unpacks the hype surrounding methylene blue, a vivid cobalt dye that's gained popularity as a trendy wellness supplement. From its historical use as a textile dye and medical treatment to modern claims about boosting brain power, energy, and longevity, Karen breaks down what the science actually says—and what it doesn’t. With potential risks ranging from drug interactions to serotonin toxicity, she urges listeners to think twice before adding this unregulated supplement to their daily routine.

Visit our website itchyandbitchy.com to read blog posts on the many topics we have covered on the show.
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Episode Transcript

Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
The content of this podcast is provided for general informational
purposes only and is not intended as nor should it
be considered a substitute for professional medical advice. Hello everyone,

(00:21):
This is Karen Nickel, family nurse practitioner, and this is
Itchy and Bitchy, a podcast that provides answers to your
many unanswered health questions. You probably get questions from friends
and family, like where do you get your dry cleaning done?
Do you have a plumber? You can recommend? What's your
favorite plant food for your flowers. I don't get those questions.

(00:46):
I get questions about supplements or tests nearly every day.
Should I take this supplement or that supplement? Should I
have this urine or blood test done? So? The latest
question I got was should I take methylene blue? When
I get a question like that, I immediately think social media

(01:08):
must be flooded with advertisements for this supplement, And sure enough,
there it is all over social media. It even pops
up in an ad in my Solitaire game. Yes, oh my, Well,
when this person asked me the question, they texted these
exact words, should I take methylene blue? That's all the

(01:31):
info I got. So I asked, why do you want
to take the supplement, what do you think it will
do for you? And the response was the question brain health.
So I thought maybe I should talk about this. So
what is methylene blue? Well, let's start with the history
of this substance that is being pedled across social media

(01:54):
right now. Methylene blue is a vibrantly colored coalbalt bl
blue dye that was first used in eighteen seventy six
as a textile dye. As a matter of fact, it
is one of the world's oldest synthetic dyes. A few
years after it was used as a fabric dye, scientists

(02:17):
started using it to stain microorganisms to help diagnose certain
infections when examining them under a microscope. In eighteen ninety one,
it was found to be useful to treat malaria. Yes,
it was used to treat malaria. As a matter of fact,
it was the first synthetic compound ever used as an

(02:38):
aniseptic dye to treat disease. In addition to treating malaria,
there is a long history of using it to treat
a rare blood disorder called methema globinemia. The only FDA
approved use for methylene blue is for the treatment of
methema globinemia, a rare condition rare. Not everybody has this,

(03:02):
a rare condition that restricts the ability of red blood
cells to deliver oxygen throughout the body. Methemoglobinemia is typically
caused by exposure to certain medications, chemicals, or recreational drugs.
Methylene blue primarily treats it by increasing hemoglobin's oxygen binding capacity.

(03:23):
People who have this disorder have blue tinged skin because
of inadequate levels of oxygen in the blood, so it
is somewhat ironic that the treatment is one that is
shockingly blue. Methylene blue is also used off label for
several medical conditions, including vasodilatory shock. This is a medical

(03:45):
emergency in which the body can't distribute sufficient blood to
the heart, brain, and kidneys. It's also used as an
antidote to cyanide poisoning in light therapy for disorders such
as psoriasis or chrome wounds. It is used to help diagnose, manage,
or improve the treatment of various types of cancers, including

(04:07):
cancers of the breast, mouth, and skin, by using it
to stain the tissue samples that are viewed under a microscope,
so it doesn't treat these cancers better, it helps us
better understand what is going on with the cancer so
it can be adequately treated. Also, some gastroentrologists use it
by applying methylene blue to the colon lining during a colonoscopy,

(04:31):
creating an excellent contrast so that polyps or precancerous growths
can be seen more clearly. It's especially helpful when doing
a colonoscopy on someone with chronic bowel inflammation because of
their increased risk of colorectal cancer. It is also used
to ease the pain of inflamed oral mucous membranes that

(04:52):
often occurs with either radiation therapy to the head and
neck or with chemotherapy. Methylene blue is all so found
in some prescription medications that help with urinary pain and
urgency that are associated with UTIs. One product is called Urabelle.
These don't treat the UTI, just the symptoms of the UTI.

(05:14):
But all of the uses I've shared with you thus
far are the short term use of a pharmaceutical grade
product in a controlled setting under the supervision of a
skilled medical provider. That usage is very different than buying

(05:34):
an unregulated supplement off the internet. And taking it every
day because of the benefits you've heard about. I will
share with you the claims of over the counter use
of methylene blue, any science behind those claims, and the
risks of taking this supplement After this quick break, Hello again,

(06:00):
So is methylene blue meant for the masses? Since there
is increased attention being paid to this stunningly blue liquid,
it makes sense to me for us to learn a
bit about how methylene blue works and whether its various
health claims stand up to closer scrutiny. The public continues

(06:21):
to grow hungrier and hungrier for anti aging products in
the hopes that they will increase not just lifespan, but
health span. Meaning we're looking for better energy, better brain function,
and better mood, to name a few goals. Many supplements
have been advertised to provide all of those benefits, and

(06:42):
methylene blue has been added to the list of these supplements.
Although evidence of some proposed health benefits are inconclusive, advocates
of methylene blue suggest that it can slow aging, improve energy,
enhance memory, improve mood and focus, prevent cancer, and reduce

(07:04):
the risk of incurable neurological disorders like Alzheimer's disease. Methylene
blue supplements are typically sold as a liquid, or it
can be found in the form of capsules, gummies, or
orally dissolving strips. They are promoted for anti aging as
well as increasing energy or improving memory and brain health

(07:26):
if taken as suggested over the countermethylene blue supplements thankfully
tend to provide much lower doses than used in clinical trials,
so usually the over the counter doses are in the
range of five to twenty milligrams per day. Let's look
at each of the claimed benefits, starting with the improved

(07:49):
energy claim. I first need to explain what mitochondria are.
They are the tiny structures in our cells that serve
as the energy producing powerhouses of ourselves that weaken as
we age. Claims that taking methylene blue as a supplement
might increase energy may be based on animal and laboratory studies,

(08:14):
not human, studies, that show this compound has a high
affinity for the mitochondria of cells and increases energy production
in mitochondria in the absence of oxygen. High oral doses
of about fifty to two hundred and fifty milligrams a
day of methylene blue under medical supervision have been used

(08:37):
to treat fatigue and other symptoms of cyanosis that's when
we don't have enough oxygen in our blood in people
with hereditary methemoglobinemia. However, there do not appear to be
any studies that investigate the effects of taking methylene blue
on energy or fatigue in people without this condition, especially

(09:01):
at the lower doses of five to twenty milligrams daily.
So the fact that someone with methemoglobinemia has reduction of
fatigue symptoms when taking two hundred and fifty milligrams a
day of methylene blue doesn't mean that fatigue will be
relieved in someone without that blood disorder. And by taking

(09:23):
over the counter doses of five to twenty milligrams of
methylene blue daily apples and oranges. Because it's shown promise
in protecting mitochondria, it's been proposed that methylene blue might
reduce the signs of aging or slow the aging process.

(09:44):
In laboratory studies, skin cells taken from older adults and
exposed to methylene blue showed increased scavenging of oxidative byproducts
and a decrease in certain markers of cellular aging. But
these studies are on skin cells, not on entire human

(10:06):
beings skin cells. Despite earlier laboratory studies suggesting methylene blue
might reduce oxidative stress and prevent bone loss due to age,
a methylene blue enriched diet in a twenty twenty three
study of mice did not reduce age related bone loss.

(10:27):
There apparently are not any published clinical trials on the
effects of methylene blue on aging skin or age related
bone loss in people. Let's move on to the brain
fog and memory improvement claim. A twenty fourteen publication discusses
laboratory and animal studies, again not human studies, that have

(10:50):
suggested that methylene blue may have a neuroprotective effect and
might reduce the abnormal clumping of a protein in nerve
cells called tau aggregation that is associated with Alzheimer's disease
and other dementias. However, evidence of any cognitive benefit in
people is mixed. A study in the United Kingdom of

(11:14):
two hundred and thirty eight men and women with moderate
Alzheimer's disease who were not on prescription medicine for the
disease had modest improvement compared to placebo when taking high
doses of methylene blue daily for twenty four weeks. However,
those with mild disease showed no benefit on low or

(11:37):
high doses of methylene blue. A pharmaceutical drug that is
still in clinical trials called Rember I think that's supposed
to be like a shortened version of remember Rember by
tao X Therapeutics contains a more stable, reduced form of
methylene blue has been studied among people with Alzheimer's disease.

(12:00):
These clinical trials use lower doses eight to sixteen milligrams
per day of methylene blue derivatives, not methylene blue, but
methylene blue derivatives, and these trials have shown potential benefit
for cognitive decline and brain atrophy in mild to moderate
Alzheimer's disease. It is not known at this point if

(12:21):
there is a sustained benefit, and so far it appears
that the most benefit is achieved if the MID is
initiated early in the disease process. Remember that we are
talking about a methylene blue derivative, and that is not
what you will find over the counter. One thing we
absolutely do not know is whether or not taking methylene

(12:46):
blue as an over the counter supplement would have similar effects. Honestly,
more high quality studies are needed to determine if methylene
blue is beneficial for Alzheimer's disease or other dementias. This
supplement is also supposed to help moods. Methylene blue is
a monoamine oxidase inhibitor an MIAOI. This class of med

(13:11):
was the first type of antidepressants developed. They're effective, but
they've generally been replaced by other antidepressants that are safer
and cause fewer side effects. Mois work by slowing the
breakdown of our neurotransmitters so that we have more neurotransmitters
in our brain, and that provides an easing of depression.

(13:34):
That all sounds good, but if you are taking a
prescription med like Prozac, Lexapro, or effectsor or an over
the counter supplement like five HTP or SAMY that raise
serotonin levels to help with depression, and you add methylene
blue to your routine, it can result in a dangerous

(13:56):
and sometimes fatal interaction called xerotonin toxicity. Also MAOIs like
methylene blue interact with dozens of medications, including antidepressants, antipsychotics, antibiotics,
synthetic pain medications, and cold medicines. This is why we

(14:17):
don't use MAOIs very much anymore when treating depression. Other
possible side effects when taking methylene blue orally in doses
ranging anywhere from fifteen to seven hundred and eighty milligrams
per day include urinary frequency and gastro intestinal symptoms such
as diarrhea, constipation, nausea, and vomiting, as well as dizziness, headache,

(14:41):
and feeling unsteady. Another thing to consider before you run
out and buy and over the countermethylene blue to add
to your regimen is that researchers have pointed out that
even pharmaceutical grade methylene blue can contain impurities, and that
in vestrial grade or chemical grade methylene blue like that

(15:04):
sold as a stain or dye should not should not
be used in humans or animals. If you order the
wrong type of methylene blue off the internet, you could
end up quite ill. As an example, if you search
for methylene blue on Amazon, you could end up accidentally

(15:25):
purchasing fish tank cleaner. Yeah, fish tank cleaner. Since methylene
blue is also used as an anti fungal aquarium disinfectant
and I don't want you to do that. There are
some products that state that they are third party tested
for heavy metals which can often be found in methylene blue,

(15:46):
and also tested for organisms, and they display their reports
on their websites. I am not recommending adding methylene blue
to your daily regimen, but I do want you to
know that you can check for products that have undergone
third party independent lab testing in an effort to avoid
buying fish tank cleaner or fabric dye. Examples of companies

(16:10):
that provide this information are Healthletic and Maraki. I'm not
sure if I'm pronouncing that correctly, but it's Meeraki, Healthletic
and Maraki. Another more minor downside of using methylene blue
liquid is it is bitter tasting and leaves your tongue
and teeth blue, which supposedly fades in about an hour. Also,

(16:34):
your urine will be blue and your stool will be discolored.
Although this may seem harmless from a cosmetic standpoint and
may seem to be a minor irritation of taking the supplement,
it can also mask symptoms of infection and cause confusion
during medical diagnosis if you're having a problem. Other warnings

(16:55):
pregnant or breastfeeding women should never use it, it can
cross the placenta and is associated with fetal harm, and
it may also be passed into breast milk with unknown
effects on infants. Here's the bottom line in the race
to see who can live the longest and healthiest. Over

(17:19):
the counter compounds like methylene blue often gain intense attention,
but they should also warrant intense scrutiny. It's critical to
keep in mind that just because a particular drug or
supplement works in a highly specific clinical setting like breast

(17:40):
cancer detection, that doesn't necessarily mean that it can or
should be used by the general population. Other medical professionals
and I personally want to emphasize that there are significant
risks in taking a medication like this without proper guy.

(18:01):
Methylene blue can affect different body systems, especially the brain
and cardiovascular system, depending on the dose and interaction with
other substances. Despite its resurgence as a wellness trend, methylene
blue is not a wellness supplement. It is not a

(18:21):
harmless cognitive enhancer. It is a high risk chemical that
should only be used under the guidance of a qualified
medical professional and only for approved medical conditions. The dangers
far outweigh the rumored benefits. For most people, using it
could cost you your health or your life. If you

(18:44):
are considering using methylene blue, consult with a medical professional
before doing so. I am urging you to take caution,
particularly given the lack of robust clinical evidence for its
use outside of specific medical health contexts. With its growing popularity,
online health authorities may soon need to step in with

(19:08):
clearer regulations and public guidance. Thank you all for listening.
Wherever you listen to this podcast, please leave a review
and rate the podcast. Your reviews and ratings matter. Also,
make sure you follow the show so that it will
be automatically downloaded. That really really matters. I encourage you
to visit our Facebook page imb Podcast, where you can

(19:30):
give us a like and leave comments or questions for me.
Our website is itchymbitchi dot com, where there are blogs
with some of our subjects available for you to read.
As always, thanks to Forrest winsl my son, our producer
and composer of our theme music, and the person who
does all the behind the scenes work to make this
podcast possible. Thank you so much. Forest Forest has the

(19:55):
summer off. He's going to Michigan for a summer Composer's Program,
So proud of him. Remember your health is in your hands.

(20:18):
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