rest of article;

MB, Pathogens, and Photodynamic Therapy (PDT)

Logically, considering its documented impact on advanced septic shock, MB has also been shown to readily kill and/or neutralize a wide range of pathogens. While it can achieve this as a monotherapy, it is enhanced in effectiveness when accompanied by photodynamic therapy (PDT). A protocol using MB with PDT has even been shown to eliminate intracellular pathogens such as prions from the blood. [76] Another MB/PDT approach has shown rapid resolution of moderate to severe COVID in patients who did not require hospitalization. [77] MB has been shown to directly inhibit the initial binding of the COVID spike protein with the ACE2 receptor, a step necessary for the virus to enter the cell. [78-80]
MB and PDT have similar abilities to enhance mitochondrial function.
They both effectively bypass much of the Krebs cycle, producing normal amounts of ATP while generating less oxidative stress in the process of going through the entire cycle. [81] This can result in a complete clinical recovery from mitochondrial dysfunction syndromes.
ATP is produced in the mitochondria due to the shuttling of electrons through the four sequential complexes of the electron transport chain. The fourth complex transfers the electrons to the terminal electron acceptor, oxygen, ultimately resulting in ATP production. MB receives the electrons from the first complex and then directly passes those electrons on to cytochrome c in the fourth complex, bypassing the other complexes. [82] PDT with the photons from near-infrared light also energizes and enables the ability of cytochrome c to donate electrons to oxygen and result in the production of ATP. [83,84]
This bypassing of the earlier complexes of the electron transport chain lowers the production of reactive oxygen species (ROS) that would have been generated by those complexes, decreasing net oxidative stress in the cell. Yet, ATP production continues as though the entire electron transport chain was functioning normally. Less ROS production (mitochondrial oxidative stress) while achieving normal energy production goals is always a desirable, but rarely achieved therapeutic goal, and MB accomplishes this. [85,86] Because of these effects, MB has been promoted as an anti-aging drug. [87] In cultured fibroblasts, MB clearly extends the life span of these cells. [88]
When the mitochondria can be made more efficient in producing energy, every metabolic process in the body is positively impacted. Any of the mitochondrial dysfunction conditions can benefit from MB and PDT, but especially MB due to its antioxidant nature and its ability to be taken regularly in a supplemental fashion without the need to spend time receiving various applications of light therapy. Furthermore, the actions of MB or PDT can also serve to help restore to normal an electron transport chain that had accumulated too much oxidative damage to function with normal efficiency (mitochondrial dysfunction) by decreasing the pro-oxidants (ROS) normally generated in the process of making ATP. [89]
However, there is no need to enhance every MB treatment with PDT to get optimal benefit if the MB is properly-dosed. MB has been shown to inactivate a very large number of viruses and other pathogens in vitro, with and without PDT. [90-96] MB is especially well-suited to dealing with viral infections, as it works

  • directly against the virus, and
  • prevents virus entry into cells, and
  • inhibits viral replication after entry into the cell. [97]

As might be expected, the ability of MB to resolve viral infections indicates its likely positive impact in preventing viral infections as well. During the first wave of COVID-19 infections in France, it was reported that a cohort of 2,500 end-stage cancer patients being treated with a protocol that included 75 mg of MB three times daily had NO reported cases of influenza or COVID. [98]
There is significant research into methylene blue derivatives, which are also highly effective antiviral agents, including against viruses in the smallpox family. [99] Similarly, as MB is of clear-cut benefit in the treatment of depression, MB derivatives are being evaluated for the treatment of depression and neurological disorders. [100] Undoubtedly, the pharmaceutical industry recognizes the incredible abilities of MB, and much effort is going into finding related and effective agents that can be patented in order to generate astronomical profits.
MB and Cancer

On the PubMed website, the entry "cancer methylene blue" results in about 2,500 references. The articles that appear address primarily the role of MB in:

  • Localizing (staining) of cancerous tissues and/or identifying as many involved lymph nodes as possible [101-105]
  • The inhibition, inactivation, or killing of a wide array of different cancer cells in vitro, with and without the application of PDT [106-113]
  • The superiority of MB in treating tumors in mice over traditional chemotherapy [114]
  • In combination with PDT, the complete resolution of AIDS-related Kaposi's sarcoma skin lesions that had been unresponsive to chemotherapy with MB and toluidine blue [115]
  • The direct treatment of cancer in dogs [116]
  • The direct treatment of cancer in humans (only one article). While treating different types of cancer, the author asserted that MB reliably stopped pain secondary to cancer, improved general health, and added years of longevity. This was reported in 1907! [117] Another article asserted that MB was found to have anticancer effects over a century ago. [118] Of note, NO significant clinical applications of methylene blue on cancer patients were found other than the 1907 study cited above.

The efficacy of an inexpensive and safe agent like MB in many different and even advanced medical conditions make it an ideal general add-on or even stand-alone treatment most of the time. Furthermore, its potent anti-cancer effects in vitro make it especially puzzling why straightforward clinical studies on cancer patients with MB alone or in combination with other agents have not been reported. Even the positive effects of the much-ignored vitamin C on cancer patients have been published in many articles, yet the wonderful properties of MB have been known much longer now than vitamin C. The literature even suggests that MB could play a positive role in the treatment of cancer patients. [119]
MB: Safety and Dosing

The main side effect of MB is a blue discoloration of the urine. Rarely, some blue discoloration of the skin might be noticed when an extended administration of highly-dosed MB has occurred. Nevertheless, both effects are completely reversible in hours to a few days as the MB is eliminated out of the body. At very high doses of MB, some of the hemoglobin in the blood can be converted into methemoglobin, which is an abnormal state where MB is the treatment of choice when given at a lower dose. Even higher doses can result in greater toxic side effects, although higher doses can still be warranted for some critically ill patients who are not responding to other measures, as in terminal septic shock. Also, in patients with depression who are on drugs known as serotonin reuptake inhibitors (SSRIs), the addition of MB is not advisable, as some of these patients can develop a potentially life-threatening development known as serotonin syndrome. [120,121] However, MB is an effective anti-depressant by itself at low doses. [122]
Because they are highly effective antioxidants, both MB and vitamin C have been cited to rarely precipitate red blood cell hemolysis in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Nevertheless, closely-monitored administration of these agents in such patients typically avoids such hemolytic problems. In fact, when the G6PD-deficient patient presents with methemoglobinemia, a condition for which MB is typically the indicated treatment, properly-dosed vitamin C can resolve the condition without using MB. [123,124] Of note, G6PD deficiency resulting in hemolytic anemia from MB is very rare. In African children with malaria, MB therapy was shown to be very safe even when G6PD deficiency was present, as was the case with all 24 deficient children in one study. [125] Another study on 74 healthy but G6PD deficient adult men demonstrated no hemolysis when given MB along with chloroquine. [126]
Generally intravenous dosing is not necessary except for the critically ill patient, as in advanced hypotensive shock. There is no standard, fixed regimen of MB recommended in such situations. Boluses of 2 mg/kg of MB can be given, often followed by infusions of various duration depending on the clinical status and response of the patient. Such infusions are often in the range of 0.5 mg MB/kg/hour over an extended period, but as much as 4 mg MB/kg can be infused over an hour. An effective infusion spanning 120 hours has been reported. Others report that infusions can range from 0.25 to 2 mg MB/kg/hour. [127,128]
For less critical patients, as well as for outpatients, oral MB dosing can range from 10 mg to 50 mg, and that dosage can be taken from one to three times daily, adjusted up or down in dose size and frequency depending on clinical response. Even higher doses can be comfortably used for limited times. 200 mg daily to stabilize COVID patients that are not yet critically ill is a very reasonable dose. A reasonable regular supplementation dose can range from 5 to 15 mg daily for general good health if there is no targeted symptom or medical condition.
As a practical point regarding regular supplementation, a dose of 5 to 15 mg of 1% MB solution (0.5 to 1.5 milliliters) can be added to a small amount of water. A teaspoon of ascorbic acid powder (not sodium ascorbate) can then be added. After sitting for 15 minutes or less, the solution will completely clear with just a slight residual blue tint. [129] This can then be quickly consumed with little staining of the tongue that readily occurs with the MB solution alone. Regardless, the staining resolves quickly. But without the added ascorbic acid, it is best to just put the MB straight into something like tomato juice and then drink that.
Methylene blue is not a nutrient. While having some important similarities with vitamin C, there are differences, including a narrower tolerance limit and higher risk safety profile. Less than 2 mg/kg MB is generally regarded as safe; over 7 mg/kg is more likely to induce side effects. MB administration is to be done with the guidance of a qualified health care provider.
Recap

Methylene blue (MB) is an antioxidant with high redox activity, able to rapidly "oscillate" between its oxidized and reduced forms, much like that seen in vitamin C. A small molecule with fat- and water-soluble characteristics, it reaches all areas and cells of the body, and it especially concentrates in the brain and central nervous system. Like vitamin C, MB is highly effective in maintaining a healthy distribution of electrons already in the body, along with the distribution of new electrons assimilated from the nutrients in a healthy dietary regimen.
MB has a unique ability among antioxidants and other biomolecules to relay electrons from the first complex in the energy-generating Krebs cycle in the mitochondria directly to the fourth complex. This allows the energized fourth complex to then produce ATP without the additional expenditure of energy in the steps of the electron transport chain that was bypassed. As such, MB allows dysfunctional mitochondria to produce healthy levels of ATP while producing less oxidative stress in the process, an optimal way both heal those mitochondria while promoting healing anywhere in the body. Photodynamic therapy (PDT) can also directly activate the energy production of the fourth complex in the electron transport chain.
Like vitamin C, MB is also a very powerful anti-pathogen It has been documented to salvage even late-stage COVID patients supported on ventilators with hypotension secondary to septic shock. For viruses in general, MB has the unique ability to attack the circulating virus, to block its binding of the virus to the cells of the body, and to stop the proliferation of the virus inside the infected cell. When administered as recommended, MB is exceptionally well-tolerated, with a safety profile that extends now over a period of more than 100 years of clinical use.
(OMNS Contributing Editor Dr. Thomas E. Levy [televymd@yahoo.com] is board certified in internal medicine and cardiology. He is also an attorney, admitted to the bar in Colorado and in the District of Columbia. The views presented in this article are the author's, and not necessarily those of all members of the Orthomolecular Medicine News Service Editorial Review Board. Readers should work in cooperation with their healthcare professional before and during application of this or any other approach to wellness.)