NO “BLUES” WITH METHYLENE BLUE
Presented by Peter Rambo, AGPCNP-BC
Reviewed by JP Saleeby, MD
CONFLICT OF INTEREST
I currently work at Carolina Holistic Medicine and Dr.Yusuf Saleeby is my collaborating physician.
I am the CHM Director of Education (CEdO –chief educational officer)
Neither he nor myself have any financial ties, incentives, or conflict of interests regarding this topic.
INTRODUCTION TO METHYLENE BLUE (MB)
Made in the late 1800s as first fully synthetic drug and used as research dye [1]
Found to have medicinal properties and was used to treat malaria in the early 1900s [1]
Current therapeutic indications of Methylene Blue:
Inherited or Acute Methemoglobinemia [2,3]
Prevention of UTIs in elderly patients [2]
Vasoplegic Adrenaline-Resistant Shock [4]
Pediatric Malaria [2]
REPURPOSING MB FOR OTHER DISEASES
The following will be discussed in deeper detail:
Lyme Disease
COVID-19
Mental Heath Conditions
Anxiety
Depression
Cancer Dementia/Alzheimer’s Disease
HIV/AIDS
LYME DISEASE AND COINFECTIONS
Lyme disease is the most common vector borne illness in the U.S. caused by the B. burgdorferi species normally transmitted by the Ixodes tick [5]
Symptoms can vary from flu-like symptoms to cardiovascular involvement and neurological/cognitive changes. [6,7]
Mainstream treatment generally is 2-4 weeks of antibiotic monotherapy consisting of doxycycline, amoxicillin, or cefuroxime. [8]
Despite this, any where from 10% to 20% (which is likely underrated) of patients using this treatment will still experience chronic symptoms [9,10]
Methylene blue is found to have good activity against stationary phase of B. Burgdorferi and the persisters. [11]
Methylene blue has been found to be effective at eradicating Bartonella henselae whether used in combination with other antibiotics, particularly Azithromycin and Rifampin. [12]
COVID-19
Methylene blue can inhibit the formation of ROS, counteract the synthesis of nitric oxide, and inhibit cytokine expression via attenuation of NF-kB signaling [13]
According to the above study, those expressions develop when ARDS occurs and MB can inhibit each of them. [13]
Methylene blue may have preventative protection against COVID-19 [14]
Phase 2 Clinical Trial showed MB used in addition to treatment protocols significantly improved SpO2 and respiratory distress in COVID-19. It also resulted in decrease hospital stay and mortality [15]
Methylene blue has been shown to inhibit the viral attachment and entry of SARS-CoV-2 [16]
BRAIN HEALTH CONDITIONS
“Low dose methylene blue can increase function magnetic resonance imaging activity during sustained attention and short-term memory tasks and enhance memory retrieval” [17]
Low dose methylene blue has been shown to have anti-depressant properties and can be used as an adjuvant treatment to help treat the depression portion of bipolar disorder or MDD [18,20, 21]
Jiang and Duong (2016) drafted and published an interesting mini-review how MB could help protect at-risk brain tissue after an ischemic stroke [19]
“Methylene blue enhances memory and the retention of fear extinction when administered after a successful exposure session.” [22]
BRAIN HEALTH CONDITIONS CONT.
MB may be helpful in neurovascular diseases that are as a result of chronic hypoperfusion (vascular dementia, mild cognitive impairment, Alzheimer’s Disease, etc.) [23]
“MB can cross the blood-brain barrier and has been shown to have high bioavailability to the brain.” [24]
MB can be used shortly after a TBI to reduce cerebral edema and inflammation as well as improve neurological scoring [25]
In Huntington Disease models, MB “inhibited recombinant protein aggregation in vitro, even when added to preformed oligomers and fibrils. MB also decreased oligomer number and size and decreased accumulation of insoluble mutant Htt in cells. In functional assays, MB increased survival of primary cortical neurons transduced with mutant Htt, reduced neurodegeneration and aggregation…” [26]
OTHER POSSIBLE TREATMENTS?
Cancer:
“Methylene blue enhances photodynamic therapy (PDT) induced apoptosis in human lung adenocarcinoma cells.” [27]
MB-PDT was observed to differentially induce massive cell death of tumor cells in a 2017 study looking at breast cancer cells [28]
HIV/AIDS:
MB in combination with PDT may have an impact on HIV and Hepatitis C [29]
MB and photoactivation might lead to HIV inactivation [30,31]
SIDE EFFECTS AND CAUTIONS
Cautions/Contraindications to MB [32]:
Contraindicated in G6PD deficiency as this can lead to hemolytic anemia
Relative contraindication to patients on serotonergic drugs
Toxicity has been reported if dosed >5mg/kg. Sx include “cardiac arrhythmias, coronary vasoconstriction, decreased cardiac output, renal blood flow and mesenteric blood flow; increased pulmonary vascular pressure & pulmonary vascular resistance and gas exchange deterioration.”
Caution in renal and hepatic impairment
Contraindicated in pregnancy and breast feeding
Side effects from MB generally consist of:
Blue to blue-green colored urine (generally goes away after D/C for 24 hours)
Elevated or high blood pressure depending on dose
Herxing is a possibility, if patient has Lyme disease or mold toxicity
Headache
EXCERPT FROM POST -VAX
PROTOCOL
“Low-dose methylene blue (MB) stimulates mitochondrial respiration by donating electrons to the electron transport chain. MB and photobiomodulation (PBM) have similar beneficial effects on mitochondrial function, oxidative damage, and inflammation. Treatment with MB is therefore often combined with PBM therapy.[33, 34]. However, because PBM and MB exert beneficial effects through distinct mechanisms, combining the use of these two therapies is expected to improve therapeutic outcomes in a synergistic manner. MB easily crosses the BBB and preferentially enter neuronal mitochondria. Numerous studies indicate an improvement of brain mitochondrial function and neurological function following treatment with MB and PBM for a spectrum of neurological diseases.[33] Low dose methylene blue (LDMB) is a therapeutic option in patients with brain fog and other neurological symptoms; this can be combined with transcranial photobiomodulation (PBM).”
OVERVIEW
Recommend this book for “crash course” on benefits of MB
MB is a viable option to help with mental health disorders, COVID-19, and Lyme disease.
More research is needed to utilize MB for other viral disorders, however, it has much potential to aid in other areas that impact patients with viral diseases (mental health, antibacterial coverage, etc.).
Online distributers:
WHERE CAN YOU SOURCE IT?
https://www.bphchem.com/product/methylene-blue-1-usp-grade-50-ml-1-drop-contains-0-5-mgof-methylene-blue/ BioPharm, Inc. BpH is one internet source of medicinal USP grade (watch out for industrial or research grades, they are not safe for human consumption)
Compounding Pharmacy: Wellness; Tailor Made; Olympia and others
THANKYOU! If you have any questions, comments, or concerns, please feel free to reach out to info@carolinaholisticmedicine.com or you can call our office at 1 (800) 965-8482 www.CarolinaHolisticMedicine.com Special thanks to: Dr.Yusuf Saleeby Staff at CHM Patients at CHM Family/Friends FLCCC
RESOURCES
1) Coulibaly, B., Zoungrana, A., Mockenhaupt, F.P., Schirmer, R.H., Klose,C., Mansmann, U., Meissner, P.E., Müller, O., 2009. Strong gameto-cytocidal effect of methylene blue-based combination therapy against falciparum malaria: a randomised controlled trial. PLoS One 4, e5318.
2) Schirmer, R. H., Adler, H., Pickhardt, M., & Mandelkow, E. (2011, December).
“Lest we forget you — methylene blue . . ..” Neurobiology of Aging, 32(12), 2325.e7-2325.e16. https://doi.org/10.1016/j.neurobiolaging.2010.12.012
3) Cawein, M., Behlen, C.H. 2nd, Lappat, E.J., Cohn, J.E., 1964. Hereditary diaphorase deficiency and methemoglobinemia. Arch. Intern. Med.113, 578–585.
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