Red, White, and Methylene Blue: Is it an Anti Aging Cure?

The TLDR:

• Methylene blue is a synthetic compound originally used as a dye, which also has FDA-approved medical uses as an intravenous drug (ProvayBlue) to raise blood pressure in critical care situations by suppressing nitric oxide pathways.
• It is now being marketed as a supplement for anti-aging, energy, and cognitive enhancement, but current research shows minimal and inconclusive evidence for these benefits, with only a small, potentially placebo-level boost in short-term memory.
• A significant risk is that methylene blue acts as an MAO inhibitor and can cause life-threatening serotonin syndrome if taken with common antidepressant medications like SSRIs, making it crucial for individuals, especially those on such medications, to consult a physician before use.
  
  

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Transcript:

Hello everyone, Dr. Wells here from nutritionalphysicaltherapy.com. Happy 4th of July. I've got my USA garb on and I hope you guys are having a great one. I got a new research update for us and this one is actually about something that's blue, called methylene blue.

There's been some purported talks about certain individuals taking methylene blue and possible reasons why. I know in the anti-aging space this has become a huge topic of discussion and we as physical therapists need to be armed with the knowledge of what this compound is. Does it really work and are there risks and are there benefits? Well, methylene blue is actually a synthetic fat soluble compound.

It's dark blue green. It was actually developed in the 1800s for the textile industry to help dye things like jeans. So how does it end up in medicine? Well, obviously with some of the tinkering and some of the trials and things, they found that it has some anti-malarial types of effects.

It has some anti-viral types of effects, but more importantly, I would say in the FDA approved version, which is called provia blue, which is given intravenously, it can actually have a very similar effect as pressors. For all my critical care PTs and people that are a little more medically inclined, pressors raise the blood pressure, right? So when this compound's injected, oftentimes like in emergency care situations, post-surgical situations where the patient's blood pressure is crashing, using intravenous methyl blue can help increase the blood pressure in the patient, typically by suppressing nitric oxide pathways. So as we know, NO pathways tend to cause vasodilation, which drops our blood pressure.

So that's the FDA approved version, but now we're seeing supplements typically sold like in liquids, gummies, capsules, some even dissolvable strips, typically lower doses, five to 20 milligrams, and some are purported for improving health, improving aging. Well, what's the evidence on that? Well, there was a study looking at increased aging overall. There's not a lot of robust evidence on improvement in, excuse me, energy.

There was a study published in 2022 by Busca and Toxicology Reserves showing it really helped to increase energy absorption and helped to increase things cellularly, but overall the translation into overall physical functioning and fatigue hasn't really panned out. Anti-aging, again, as I mentioned, it has some of these antiviral type effects and things. It does also have some antioxidant type effects.

However, I don't know if it's any better than some of the other compounds that are naturally on the market, like eating your fruits and vegetables, getting your vitamin C, vitamin E from nuts and seeds. So at this point, there's not a lot of robust data out there to show that it's significantly reducing aging. Now, one area where we could see some perks or benefits is in terms of the effects on the central nervous system.

There are some people that argue that they have better memory and cognition while using it. However, the study showed that this effect on a memory study was like 7% boost. So I don't know if that's placebo.

I feel like a 7% boost in memory is decent, but for short-term memory, I wouldn't say it's significant or probably beyond those testable limits. But the biggest area in the central nervous system where it affects, it seems to help with depression quite a bit. And so high doses of methylene blue, around 100 milligrams, two to three times per day, supposedly improves depression, specifically bipolar depression.

Some argue that it's actually the similar effects as like tricyclic antidepressants. So that seems to be pretty strong, but at the end of the day, we have to be careful. You can't take these with SSRIs because it's actually an MAOI inhibitor.

And I'm sure some of you have seen those warnings on labels and things, but effectively taking this with an SSRI can produce serotonin syndrome or the patient has way too much floating serotonin. So if your patients are on SSRIs, hear about methylene blue. As a PT, you should advise them, obviously, don't start taking something without talking to your physician.

However, this stuff is on the market everywhere now. And people are seeing political leaders and people dropping things in the water and drinking blue compounds and viral videos on social media. If they're already having depression and they have SSRI on board and they take methylene blue, they can end up with some serious issues, some serious side effects.

So my recommendation at this time is methylene blue has some potential benefits and things, but I would recommend other interventions before tackling or utilizing methylene blue. If you have depression and obviously seeing a counselor, exercise, diet, lifestyle factors, those are all really important. And obviously there are some other treatments and drugs that are out there.

So at this point, methylene blue won't be in my wheelhouse, but hopefully you now as an informed physical therapist like this and check out our courses and sign up today. Thanks. Happy 4th!