From the Guidelines
Methylene blue should not be used as a supplement without medical supervision due to its potential risks and side effects, particularly in certain patient populations. When considering its use, it's crucial to weigh the potential benefits against the risks. The typical dose for medical treatment, as seen in studies like 1, is 1–2 mg/kg, which is significantly higher than what might be considered for supplemental use. However, for those interested in its potential cognitive and energy benefits, a dose ranging from 0.5-4 mg per kilogram of body weight is sometimes discussed, with most people starting at the lower end (around 50-100 mg daily for adults) 1.
Important Considerations
- G6PD Deficiency: Individuals with this condition should avoid methylene blue entirely due to the risk of hemolytic anemia, as it can induce hemolysis and worsen methemoglobinemia 1.
- Serotonin Syndrome: It should never be taken with SSRIs, MAOIs, or other serotonergic medications due to this risk 1.
- Pregnancy and Renal Failure: Methylene blue should be used with caution in pregnant women and patients with renal failure, considering potential teratogenicity and effects on renal function 1.
- Quality of Methylene Blue: Only pharmaceutical-grade methylene blue should be used, avoiding aquarium or laboratory grades.
Side Effects and Interactions
Common side effects include blue discoloration of urine and stool, mild nausea, and potential skin irritation. It can also interfere with certain medical tests. The risk of serotonin syndrome, hemolytic anemia in G6PD-deficient individuals, and potential teratogenic effects are critical considerations when deciding to use methylene blue as a supplement.
Given the potential risks and the need for careful consideration of individual health status, medical supervision is strongly advised for anyone considering methylene blue as a supplement. This ensures that the decision is made with a full understanding of the potential benefits and risks, tailored to the individual's specific health circumstances, as highlighted in studies such as 1 and 1.
From the Research
Methylene Blue as a Supplement
- Methylene blue has been used for over a century in psychiatry, with applications in the treatment of psychotic and mood disorders, as well as a memory enhancer in fear-extinction training 2.
- It has been shown to have antidepressant, anxiolytic, and neuroprotective properties, with potential benefits in the treatment of bipolar disorder 2, 3.
- The use of methylene blue as a supplement is controversial, with reports of severe adverse effects, including hemolysis, methemoglobinemia, nausea, and vomiting 4.
- A study found that methylene blue improved symptoms of depression and anxiety in patients with bipolar disorder, with minimal side effects 3.
- However, another study reported a case of serotonin syndrome following methylene blue administration for vasoplegic syndrome, highlighting the potential risks of using this substance 5.
- Recent research has also explored the use of methylene blue as a neurometabolic/hemodynamic modulator, with findings suggesting an altered oxidative neurometabolic response to methylene blue in patients with bipolar disorder 6.
Potential Benefits and Risks
- Potential benefits of methylene blue as a supplement include:
- Antidepressant and anxiolytic effects
- Neuroprotective properties
- Improvement in symptoms of bipolar disorder
- Potential risks of methylene blue as a supplement include:
- Severe adverse effects, such as hemolysis and methemoglobinemia
- Serotonin syndrome
- Interactions with other medications
- Unknown toxicological characteristics
Mechanisms of Action
- Methylene blue has complex pharmacology and multiple clinical indications, with mechanisms of action that are not fully understood 2.
- It has been shown to have a stabilizing effect on mitochondrial function and a dose-dependent effect on the generation of reactive oxygen species 2.
- The substance may also have an impact on cerebral oxygen metabolism, with findings suggesting an altered neurometabolic response to methylene blue in patients with bipolar disorder 6.