
Ever heard of Methylene Blue? It might be your new BFF for tackling your midlife blahs and blues. Tune in to my latest discussion with Dr. Scott Sherr, where we delve into its impressive role in improving energy and mental clarity for women like us. Watch the full episode at https://youtu.be/rCtbBauRPJk
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A
This compound actually has been around for a long, long time. It was actually synthesized back in the 1870s. 1870s, not 1970s, 1870s. And it was actually synthesized as a textile dye to dye blue jeans blue at that time. But somehow they figured out that this particular compound actually treated a particular type of infection called malaria. And so in 1897, it actually became the first drug registered with our FDA for the treatment of malaria. And from about 1897 until about 1950, when Penicill and penicillin, like drugs came around, it was one of the premier antimicrobials around. It treated urinary tract infections, fungal infections, other types of bacterial infections, even viral infections.
B
Hello and welcome to another episode of better with Dr. Stephanie. It's me, your host, Dr. Stephanie Estima. Have you been hearing about methylene blue? Have you been seeing pictures of blue mouths on airplanes, famous celebrities, and you're like, what is this stuff? Is this some sort of biohacking garbage trick? Well, that is what I thought until I started researching it. So in this episode we are talking all about methylene blue. What is it, how to use it, and why you should be considering this as a perimenopausal woman. My guest today is Dr. Scott Share. He is a board certified internal medicine physician, certified to practice health optimization medicine, and a specialist in hyperbaric oxygen therapy and the COO of troscriptions. He has a clinical telepractice which includes homey as its foundation alongside an integrative approach to hyperbaric oxygen therapy that includes HBOT protocols, testing, supplementation, personal practices, synergistic technologies and more. And in this conversation we are talking all about methylene blue. So we are talking about what is it, why menopausal and perimenopausal women need to think about it. What are some of the hormonal changes, insulin changes, metabolic changes, mitochondrial changes, brain fog, energy, you name it, all the things that happen in midlife and how methylene blue can be a bridge to help you feeling better. So we talk about the mechanisms of how it works, how to take it acutely if you're injured, how to take it chronically if you've been dealing with a chronic injury, how it can augment performance, how it can help with energy and sleep and all the things I, in the preparation for this conversation went on a, you know, geeky magic carpet ride in terms of looking up the science. And the science is very, very exciting and very, very promising. So I hope that enjoy this conversation that you are going to potentially find new ways to help augment and improve your own energy. And so, without further delay, please enjoy my conversation with Dr. Scott Sher. If there's one thing that I know, it's that women need to feel safe and secure in order to heal. And that is why I am genuinely obsessed with Apollo Neuro for stress and for better sleep. It's literally like having a remote control for your nervous system. Originally developed for veterans with ptsd, Apollo sends gentle and silent vibrations throughout your body that signal safety to your brain and to your nervous system. It helps your body shift out of that fight or flight mode and into a state of calm and restoration. I love it because it's non invasive, there's no medication, it's totally silent and you feel the shift to calm almost immediately. If you are one of those women who have trouble falling asleep because your mind is racing, you feel tired but wired, you're dealing with a lot of stress or you're struggling to sleep, this is going to help you fall asleep faster and stay asleep longer. It's backed by clinical research, it's used by thousands, including myself, and it really works. Go to ApolloNeuro.com better to check it out and receive $60 off of your purchase. That's a P O L l o n e u r-o.com better B-E-T dash t e r and use code better to save $60. All right, and we're live. Dr. Scott Sher, welcome to the show. I'm so happy to have you here today.
A
Happy to be here, Stephanie. Thank you for having me.
B
So we are going to discuss something I was saying to you in the pre chat. We have never talked about this before. In the five plus years that I have been doing this show, we have never talked about methylene blue. I have seen lots of pictures of people on airplanes with blue mouths and blue tongues and I always just thought these people are crazy. I don't know who. I don't know if this is like the return of Avatar. Like I don't know what this is, but I don't like it.
A
Hopefully I'm blue here.
B
Yeah, exactly, exactly. And then so, you know, after really diving into the science, I was like, oh, this is really interesting. And you were kind enough to send me some methylene blue. I am noticing a really big change in my own energy and so I wanted to bring this conversation to my community because I think that this is something, particularly in perimenopause and menopause, that can be potentially useful. So with that big preamble, let's just what is. What am I talking about? To give us a maybe in this, in the simplest. And if you want to go a little more detailed terms, what is methylene blue and what is the primary job that it has in the human body?
A
Right. So, well, thank you for having me again. And there's a lot to kind of unpack here. There was a lot of press earlier this year when a number of prominent people started taking methylene blue and things kind of went bonkers. And that's why a lot of people that are listening, a lot of. A lot of your listeners are probably like, well, I've heard of methylene blue. I saw, as you described, various people doing it in various locations and things like that. But this compound actually has been around for a long, long time. It was actually synthesized back in the 1870s. 1870s, not 1970s, 1870s. And it was actually synthesized as a textile dye to dye blue jeans blue at that time. So if you're wearing Levi Strauss in the 1818, 70s, I think they were around about that time. They started like your blue jeans would have been blue. But somehow they figured out that this particular compound actually treated a particular type of infection called malaria. Malaria was kind of a scourge at that time. It still is. But significantly, at that point, there are really no antimicrobials, really no medications that we had that could actually work against malaria or really any other microbe very well. And so they figured out that methane blue, actually, at higher doses, higher doses than we use now for energy and endurance and inflammation and things we'll talk about, but at higher doses, actually a significant impact on treating malaria and other infections. And so in 1897, it actually became the first drug registered with our FDA, our nascent FDA at that time for the treatment of malaria. And from about 1897 until about 1950, when penicillin and penicillin like drugs came around, it was one of the premier antimicrobials around. It treated urinary tract infections, fungal infections, other types of bacterial infections, even viral infections. But in the 1950s, it became less. Less prominent because you had these other antibiotics coming around that kind of take its place, because there were a couple of benign but. But shocking kind of side effects of taking methylene blue, especially at higher doses. I mean, even at lower doses, you're going to get this as well, but some blue urine. So methylene blue concentrates in the. In the urine. So back During World War II, there are actually stories and songs sung about, you know, going. Going blue in the loo you know, Lou being the toilet in. In English speak. And so, so blue urine was not a favorite for everybody. And even at very high doses of methane, blue would take. It would actually make other secretions blue as well, like your tears. But this is not something we have to worry about it. The doses we use into the 1970s and 80s, actually, if you lived in Eastern Europe, you were actually still getting methylene blue as a kid. If you had a viral infection, especially a sore throat, your mom or your dad probably your mom, would actually paint the back of your throat with methylene blue because it actually would treat the viral infections, the coughs, colds and congestions, normal kinds of viral things. And so. But after 1950, it actually stopped becoming an antimicrobial and became more involved in the world of chemistry and the world of psychotherapy and psychiatry. Because the first antipsychotic drugs were actually direct derived from methylene blue. Because it actually has this other property called being a monoamine oxidase inhibitor, short story. It increases norepinephrine, dopamine and serotonin, some of your neurotransmitters. And so we have to talk about that later when we talk about some of the things you have to be aware of when you're taking methylene blue. But after that, really, the main thing that we want to chat about today is that now we really understand that it has this fantastic way of improving our mitochondria. Our mitochondria, the part of our cell that make lots of energy. About 94% of U.S. adults have some element of mitochondrial dysfunction, especially during significant life transitions. Death, divorce, trauma, you know, menopause, those kinds of things. Menopause, it's a big one too, right? And so we know now that methylene blue has this amazing capacity to concentrate in the mitochondria and compensate for this mitochondrial dysfunction. And maybe I'll stop there and, and ask you what questions you'd like to go from.
B
No, this is a. This is a great start because I think, you know, I like you. I was seeing, you know, friends, and I even. I think I saw like, RFK K Jr. Was Tate. I think I saw him. I was like, okay, what is. Yeah, what is this? And I. And just, you know, with your story about blue and the loo, I remember when I first, when I was just saying to my AV producer before you came on, like, when I first was taking it last week, I was like, am I what? So I would go to the bathroom, I was like, my. My urine was green and I was like, oh my God, what is. So, you know, you're like, is it cancer?
A
Yeah, no, it's the first thing, you.
B
Know, the first thing that you know you have beats and you're like, oh my God, my, my pee is orange. Am I dying? So same thing with. And I was like, oh, no, no, no. I took the methylene blue earlier today. Like I'd completely forgotten about it.
A
If you combine it with like B vitamins for example, and you're getting like B vitamins are quite yellow, especially like B1 and B2. And then you'd have like your bright yellow versus the blue. So you'll have some green if you're less hydrated. You're also going to have more, you know, kind of greenish type of urine as well. So yeah, these are, these are things that, you know, definitely have to be, you have to be aware of. And the thing I was just going to mention to your response there, Stephanie, is that we've known about methylene blue now for at least five years it in clinical practice. And it's been interesting, right, because now everybody's hearing about it with RFK and others. And of course when we started with the, with the products five years ago, nobody else knew about it. There was maybe a few other companies that were making it up until 2024 and now there's about 60 companies out there that are making various varieties of methylene blue now. So it's a, it's a, it's a brave new world. And I'm happy to kind of dig in to that mitochondrial aspect or, you know, wherever else you'd like to go.
B
Yeah, I think the mitochondrial aspect is where I'd like to focus. And I want to relate it back to like, why should women in perimenopause and menopause actually care about this? So let's talk about how it concentrates in the mitochondria, what it's doing and then some of the, you know, some of the knock on effects that you can expect from taking it.
A
Yeah, I mean, so I've been thinking about this a lot lately as well because I just gave a talk on something that I'm calling the sympathetic spiral of doom. It sounds kind of ominous and it kind of is in some ways. But when you have a, the combination of a nervous system that's overactive, that's in sympathetic or fight or flight all the time, and then you have all these neurotransmitters and hormones that are being released, you have significant impact on the mitochondria itself. And how the mitochondria actually are working. And the mitochondria, the part of the cell that we make energy from. Right. So if we can't make energy efficiently, we don't have the capacity to make energy efficiently. And as I was mentioning earlier, about 94% of U.S. adults have some element of mitochondrial dysfunction. And there's a lot of different reasons for this. One of the biggest ones is this sympathet overdrive, this fight or flight state that you have a hard time getting out of, which happens a lot during the perimenopausal period because of those hormone shifts, especially progesterone going down, you can't sleep as well, you don't have as much gaba, which is a neurotransmitter that kind of calms you down. And so you have this sympathetic overdrive. That's a big part of it. There's also insulin resistance is a big additional reason why people have mitochondrial dysfunction. Certain medications will do it, toxins in our environment, cosmetics will do it. Certain cosmetics, heavy metals will do it. Which would include toxins, of course, would be in that category. Then infection like, or a post infectious kind of syndrome like long Covid or fibromyalgia, chronic fatigue. There's sometimes are these post viral kinds of things causing significant mitochondrial dysfunction. And we think about mitochondrial dysfunction, it's kind of important to kind of delineate what that means. Right? You have this mitochondria in your cell. Fun fact. Actually, then the place where you have the most mitochondria per cell is actually in eggs. In your eggs as a female sperm are just, you know, right behind. And then you have your brain, your heart, your liver, your muscle, skeletal tissue. And so you have irritability, you have mood changes, you have exercise induced intolerance, you have infertility issues, you have inflammation and pain. These can all be related to mitochondrial dysfunction. So that's the back, the backdrop of it. And then you have the mitochondria itself, which help you make energy. And then when you make energy, you don't just make energy. We are kind of like a gasoline powered car. We have what are called, quote unquote waste products of, of making energy. So we, we make energy. This is called our ATP or adenosine triphosphate. That's our energy currency. And actually, you know another fun fact, we make it about 150 pounds of energy every single day of that ATP. But we recycle it really fast. But as we make it, we also make carbon dioxide as a waste product, water and then something also called reactive oxygen species, or ros. These are small reactive molecules that signal the mitochondria and other things to give you a sense of how much energy to make or how much energy to maybe slow down. But we need antioxidants to be able to neutralize the capacity of us, you know, to make more energy. So if you're making more energy, you feel like crap afterwards. Like, say you exercise and then you feel like crap for like three days. Like, that's because your mitochondria were super stressed and didn't have the capacity to kind of neutralize the stress that happened after making that energy. So with all that being said, what, what methylene blue can do, which is super cool, is that it concentrates in the mitochondria and it can compensate for the capacity for you to make energy if you're having a hard time doing that. And at the same time, it can help and compensate for any capacity you have on the antioxidant side, meaning that it can neutralize that oxidative stress, that reactive oxygen species that's happening from making energy at the same time.
B
Fantastic. So for a woman in perimenopause, obviously we and menopause, one of the big things that we see is brain fog. We see cognitive decline, we see memory loss. Like, I walked into the room and I don't know why I'm here, you know, or where is my phone? Where are my keys? So, so talk to us a little bit about how and maybe we can come back to this maoi. So how methylene blue acts as a monoamine oxidase inhibitor. How can this up regulate brain function? Understanding certainly that ovarian function and the ovaries have the largest density of mitochondria in the ooh site. I think it's like 100,000, something like that, mitochondria per cell. And then when you get into the brain, heart, liver, you're probably looking at like something like 3 to 5,000 mitochondria per, you know, if it's hepatocyte, myocyte, whatever, talk to us. How, how can this help our brain function? How can this help us think clearly and get rid of some of those common ailments that we see in. In midlife.
A
Yeah. So, I mean, brain fog is such a common, common challenge for so many. And a lot of this has to do with the fact that our brain actually requires a ton of energy on a regular basis. So it takes about 20% of your oxygen on any, any minute to minute basis of Any organ. It's by far the most that's required. And that's because you, you have a lot of brain tissue that requires perfusion of blood and oxygen. So you can maintain this over time. And what can happen is if the mitochondria are dysfunctional in the brain, whether they can't make energy well or they can't detox well because of the energy that you make, then you start getting challenges with brain fog and also this inflammation in the, in the, in the brain as well. And so what methane blue can do at, you know, at low doses, at, you know, very small, 4, 8, 16 milligrams. We can talk more about the dos as well. Like, you can just see that you're starting to rebuild and regenerate and make the mitochondria more efficient here. And it's, it's one of the things where, like I always say, like, I'm a clinician, right? I'm an internal medicine doc by training. Like, I work with patients over long periods of time. And the goal, of course, is to optimize diet, lifestyle, health entirely as an ecosystem. I like to use the word. It's kind of a cool word. It's called. It's, but it's a hard one to say. It's called the holobiont. H, O, L, O, B, I, O, N and T. And this is a word that really basically describes you as this holo organism. You're not just human cells. You're made of bacteria, fungus and virus. Actually, they outnumber you in your body compared to the human host that all of them live in, which is you. So the question always becomes like, who's running who if there's more of the other.
B
Yeah, we are just a carrier, just.
A
A carrier of microbiome and other things, right? And so we're trying to optimize all of these things and. But it takes time. That's the challenge. It's not like you can 50 years and you want to feel better tomorrow. Like, it's going to be. It took you 50 years to get to where you are. It's going to take some time for you to get better. And so this is where methylene blue really does work well, where it can start getting low doses, very, very small amounts and build that up over time to find the right dose for you to start making you feel better right now while you're on that longer path of optimizing your health and also, you know, give you the motivation to be like, okay, now I have a little bit more energy I can take that walk, or I can, you know, change that diet a little bit, or I can sleep a little bit longer, or I can take that nap that I always want to take in the middle of the day, but I always push through with coffee or whatever, right. And so I think it's really important that when we're thinking about brain fog, it's kind of like this universal signal that your brain needs more energy and needs more detox, probably together. Right. And. And so the key there is that it may just be what happens oftentimes. I. I think the way I would frame this is that many of us like, well, I just need more energy. I need more energy. And so you drink more. You drink more caffeine, for example, right? And you feel like a little bit more energy, then you crash, right? And the nice thing about methylene blue is that it not only does it give you that additional energy, but it also gives you that detox. So you're not kind of, you know, just doing one thing to kind of pay for it on the other end, right? Which is like that come down or crash after drinking your caffeine. And that's what's so beautiful about with methylene blue. And. And it's, you know, it's. I know it's. It's strange. It's this blue color. It makes your urine blue. It's. It's a little crazy. And I. I definitely agree with all that. When I first heard about it in 2019, when we started using it, I saw the studies on cognitive function. I saw the studies that were being done in Alzheimer's and Parkinson's autoimmune conditions and things. I was like, this is still crazy because it's very blue, right? And I didn't think anybody was going to really sign on to it for a while, but we've been pleasantly surprised because. And I was actually pleasantly surprised, honestly, in the beginning, because I had people reach out to me after starting it, and great stories. I remember one initial story. I was a grandmother, mild cognitive impairment. The granddaughter had given it to her, and she started telling all these stories that she hadn't told ever to her full family about growing up in Mexico or another lady that had severe mold issues that had recovered from the mold, but still felt really terrible. Brain fog wise, couldn't go back to work. She was, you know, still out of work after a couple years. And after two or three weeks of methylene boost, she was back to work. Her brain was back online. And I saw pain go away. I saw inflammation go away. And I see it in my patients and all day long.
B
I want to ask you what I would call a dark roast betty question. So in. In our community, our fan, you know, our fans are called our Betties. And so we got light roast Bettys that are like, just tell me what to do. And the dark roast is like, tell me the mechanism. I want to know pathways. Okay, so. So let's talk a little bit about electron cycling in the mitochondria. Like, is this how. I'm very curious in terms of what's the mechanism of action here? So is methylene blue, when it's concentrating in the mitochondria, is it upcycling electric? What is it doing in the process of the ATP? When we're looking at the electron transport chain, what is it doing there?
A
Oh, I'm so happy you asked this question. I wasn't sure we were going to go here, but the electron transport chain is this chain of proteins in your mitochondria that are. They're paired, that are. They're all together. There's complex 1, 2, 3, and 4. And the idea is that electrons flow through them, creating this gradient in the mitochondria. The gradient basically pushes what's called a proton against a gradient, so that when it comes back down with the gradient, it creates energy. And so actually, we eat, especially our carbohydrates and our fat, for these electrons, primarily, these electrons, they come into our cells and the part of our. Are mitochondria. And. And they go through this cycle called the Krebs cycle. And you have. You've heard of ketones, of course, right? The ketones do this. If you're eating fat, if carbohydrate, there's gonna be glucose and go into the carbohydrate. They go into the. The crib, the mitochondria, and into the Krebs cycle, or the citric acid cycle. And you can actually measure all these things, which is super cool. You can measure all the intermediate steps in the process of creating electrons. And then everybody's heard of these carriers, at least one of them, what's called nad, and the other one's called fad. So NADH and fadh are you. When these. These carriers pick up these electrons from your food and they bring these electrons over to your mitochondria, and then these mitochondria. Well, the part of the mitochondria called the electron transport chain. And then these electrons basically donate to either Complex 1 or Complex 2, and then they get shuttled across into Complex 3 by something called CoQ10. And you have Complex 3 and Complex 4 that help. These help the whole process through. And at the end on complex four, these electrons actually get, get carried by oxygen. So that's why we actually breathe oxygen. We need oxygen because it becomes the final electron acceptor in complex four. Okay. And then you have those protons that are coming back down the gradient through ATP synthase, which is actually also sometimes called Complex 5. But that's this rotor, that's actually a 6,000 RPM motor that actually makes your energy this ATP. Now, okay, so there's a couple different things here. So what methylene blue does, what it can do, is that oftentimes many of us are walking around with complex one or complex two dysfunction. Okay, so complex one is our NAD carrier, right? So it brings nad. Well, it takes the electrons from NAD and brings them into the electron transport chain. But many of us, if you've had chronic infections, if you have chronic inflammation, chronic complex medical illness, sympathetic overdrive. So it's like fight or flight all the time and can't get out of it. Doom.
B
What did you call it?
A
Sympathetic spiral of doom. Yes. Yeah, exactly. Yes, exactly. So, and then insulin resistance does the same thing actually. If you're, if you're high blood sugars, you're making too much energy and actually because you have too much glucose, and then it actually causes a lot of stress, reactive oxygen species, stress on complex one itself. So what Methylene, which is a natural.
B
Sorry to interrupt you. Which is a natural function of aging, we also see an improve, we see an increase, a stepwise increase in insulin resistance as we age. Because of what you're describing, right, there's.
A
Kind of like this chicken before the egg cycle, where we become less efficient at using glucose for energy as we get older, are more efficient using ketone bodies. Actually, ketones burn cleaner than, than glucose does, typically, especially in the brain and especially as we get older as well. So the key with methylene blue here is that on that electron transport chain, what it can do is it can compensate for any dysfunction that might be happening. So it can actually help recycle that NAD and fad, so it can go back to the citric acid cycle if complex one and two aren't working very well and actually can bypass those complexes and donate electrons directly down the chain to like three or four if needed. And so that you can maintain electron flow even if complex one and two aren't working very well. So it can basically compensate for the dysfunction in those two complexes or really Any complex on the mitochondria. And the classic example of this is actually something called cyanide poisoning, which I don't recommend anybody get or have, but cyanide actually destroys the fourth complex in the mitochondria. And when that happens under almost all circumstances, you wouldn't be able to make any energy because everything sort of upstream or end, downstream will not work. And, but with methylene blue around, it actually has a capacity to have, you have electron flow through some of those early protein, protein complexes on the mitochondria and there's electron sync that happens using hydrogen peroxide. So it's, it's a kind of, kind of complicated mechanisms. But in, but in essence what's happening on the energy side is that you can compensate for any of those electron transport chain protein complexes that aren't working well. And a lot of us are walking around with dysfunctional complexes, complex one and complex two especially. And on the other side of things, when we make that energy, right, we may, we talked about making carbon dioxide water reactive oxygen species, which can cause stress on the system if you don't have enough antioxidants around. And what methylene blue can do is work just like an antioxidant. So it can basically mop up free electrons, mop up that oxidative reactive oxygen species and neutralize it so you have less stress on the mitochondria. And even at a little bit of a higher dose, methylene blue actually increases your glutathione production as well, which is one of your master antioxidants that helps also do the same kinds of things.
B
So walk me through how this is different. So I hear, you know, a lot of people in the longevity space like to take metformin because of some of the, and maybe you can explain the difference between what's happening mechanistically at the complex, like complex 1 through to 4 with metformin. Because I know that metformin can make people feel tired, but my understanding is that it also upcycles mitochondrial production.
A
So do you know why? So meth, so what metformin does, it actually destroys complex one in the mitochondria. It destroys it. And the reason why we think that this is helpful is that the mitochondria are then forced to make new mitochondria. So basically with metformin around, you're forcing your mitochondria to continue to recycle in a minute, much faster rate because that complex one is being destroyed. And so that's why people that take metformin actually feel tired is because that complex one isn't working very well. So I'm not a big fan of metformin unless you have diabetes or maybe insulin resistance and maybe, maybe that could be a reason why. But as a longevity drug, I just can't imagine it's a good idea to destroy this complex over time. I think it's better to build it back up and optimize, you know, your vitamins, minerals, nutrients, co factors, your lifestyle. But methylene blue can really be helpful here. And I've actually used it in this context, right. Where people have been taking this, you know, metformin from like a longevity perspective and they feel tired all the time. I have them cycle off of it, at least if they want to continue to take it. And then while they're off of it, we give them some methylene blue to help compensate for that dysfunction as well. So it's interesting, right? So proton pump inhibitors are another one that's most very common. So your prilosex, omeprazole, protonics, pantopraz, all these are also destroying complex two on the mitochondria. And complex two is your, is actually what's actually donating. It's called fad. So FAD donates electrons from your electron, from your citric acid cycle into your electron transport chain here as well. So this is another reason why people take these drugs and don't feel very good when they take them. So. And there's other drugs that do this.
B
Especially if you're active, right? Like, especially if you're someone who's already exercising and you're running or you're doing whatever, because, yeah, like the demand on the mitochondria is just going to be that much higher.
A
Yeah. So I always say if, if you're forcing, if you really want to take metformin as a longevity drug, do not take it on the days that you exercise, at least when you exercise hard.
B
Yeah, yeah. Is there any habituation that happens with methylene blue? Like, do you have to cycle, you know, you mentioned cycling off of metformin as you're introducing methylene blue. Is there any habituation that happens? Like, is there a time where your body's like, oh, this, this thing again, methylene blue? Like, I'm not going to respond in the same way that, that I did two weeks ago or two months ago.
A
The way I would frame that conversation is it depends on what else you're doing at the same time. So, for example, there's not a dependence per se, but if you're using methylene blue to compensate for mitochondrial dysfunction and you stop using methylene blue. But you didn't actually work on why you were having mitochondrial dysfunction. At the same time, you're going to find that a lot of your symptoms might return. There is a little bit of evidence, actually, from a researcher down in Texas at the University of Texas, Austin, that his name is Francisco Gonzalez Lima. And it does show that there's some efficiency of one of the complexes complex for cytochrome oxidase and making it, actually making more of them when you have methylene blue around. So you can make energy more efficiently if you have more of that particular complex. But in essence, what I always tell my patients is like, look, if you just take methylene blue and we do nothing else, you're going to feel better. But when you stop methylene blue, your symptoms are likely going to return. The idea, as I was describing earlier, is that you want to do this in the context of, well, let's optimize your health, let's optimize your diet, your lifestyle, like, let's get you on some good hrt if you're going through perimenopause and like, let's do all this stuff while you're doing your methylene blue at the same time. And then hopefully over time, you can actually then bring the amount of methane blue down that you're taking. And what I often say here, Stephanie, is that what I often the, the, the, the construct is this. I think some people need methylene blue some of the time, and I think some of the, some people need methylene blue some of the time, for a period of time, depending on what else they're doing at the same time as taking the methylene blue. So in that context, what I mean is that if you're pretty well optimized already, you can use a methylene blue for performance, endurance, aerobic capacity. We can talk about that. But for if you're really kind of on your journey at really starting to feel better and you know it's been a little while since you felt good, then, you know, probably you need to titrate and find your dose of methylene blue. That's going to work for you. And once you're on that, you may need to be on it for two, for six weeks, sometimes even as long as six months, depending on what's going on foundationally. And then over time, as you optimize your diet, your lifestyle, et cetera, you optimize your, your foundational biomarkers. I use a science called metabolomics for that, which is you know, small, small molecules that optimize with cellular energy detox, fatty acids, minerals, heavy metals, things like that. And, but that can take a while. That can take, you know, six months in some cases. Right. And so, and depending on where at you're, where you need to go and where you're starting from. Like what I'll often do is start, you know, on methylene boo, find a good dose and then keep them on that for a period of time and then wean it off as, as we're kind of building up that foundation. And if the dose is low, like typically less than about 30 milligrams a day, I don't necessarily think you need to cycle it. But if it's going to be above that, you very likely need to take at least a couple days off a week or at least one day off a week. If 30mg are above and over 70mg I typically recommend and two days off per week. But the majority of people, majority do not need more than A, between 4 and 25 milligrams of methylene blue on a, on, on a, to feel better and then on a regular basis if they need to take it for a long, for a longer period of time.
B
Okay, let's talk about something super important. How your digestion changes in perimenopause. If you want more energy, better focus, less stress and and to stop bloating after each and every meal. This starts in your gut. When your gut is out of whack, just everything feels off. Your mood, your digestion, your sleep, everything. And this is why I use and I love the Just Thrive probiotic. Most probiotics never make it to your gut alive. They are dead on arrival. But Just Thrive is clinically proven to arrive in your gut 100% alive and actually do what it is supposed to for you. That means less bloating, better immunity and that steady feel good energy. To tackle your day. Here's my challenge for you. Try the Just thrive probiotic for 90 days and it is 100% risk free. And just see how much better you feel. Head over to justthrivehealth.com better and you're going to save 20% on your first time order and and start your 90 day just thrive challenge today. If you don't love the way you feel, if you don't see any changes in your gut health, you can ask for a full product refund, no questions asked. So again, that is justthrivehealth.com better. As we age, our ability to Digest complex foods like protein declines. This is because our body produces fewer enzymes which are the proteins responsible for digesting food. Food, even organic foods won't provide enough enzymes to properly digest them. This is especially true if you cook any of your food because cooking and the heat kills those enzymes that are responsible for digestion. This is where supplementing with a high quality enzyme supplement can be a huge help. I personally recommend Mastxymes by Bioptimizers. It's the best in class supplement loaded with a full spectrum of enzymes for digesting proteins, starches, sugars, fibers and fats. Taking Mazzymes daily helps to top off your enzyme levels and replace the enzymes in your body that your body is no longer producing. This means that you'll be able to eat all sorts of delicious foods and digest them quickly and effortlessly. After you start taking Mazzymes, you may notice that you no longer feel bloated after meals. That's a huge bonus. And that your belly might even feel flatter too. If you have leaky gut, Mazymes can reduce that gut irritation and help you absorb, absorb more nutrients. Listen, life is too short to suffer from digestive problems. If you want freedom from your food, try masszymes risk free and experience for yourself the magic of high quality enzymes. For an exclusive offer for my listeners, Please go to buyoptimizers.com forward/better and use code BETTER at checkout to get 10% off your order. That's B I O P T I m I z E-R-S.com better and make sure you use better at checkout. Yeah, I mean it's sort of like the Ozempic or the hormone therapy conversation, right? It's like you can take Ozempic to lose weight, but if you in, in the interim, it can help you, you know, lose weight and become motivated as you're implementing some of these other things. So you're learning how to weight train, you're learning how to build a plate of nutritious foods, you're learning how to manage your stress. Same with, you know, hormone therapy, right? You can take hormone therapy, but hormone therapy therapy is not going to build the plate, it's not going to strength train, it's not going to set boundaries with your mother, you know.
A
Totally.
B
You have to, you have to do those things.
A
Yes, totally.
B
Right. So it, so I love the idea of it almost being a bridge, right? So if you are completely bagged, you have no energy. It's like you have a brain like you're walking around in a haze. You're depressed, you know, don't have the energy to get up and work out. The methylene blue can be a bridge for you to give you enough energy as you're making some of these changes, and then you can continue to keep on a maintenance level. Like you were saying, maybe one or two days off a week, if you like, or, or maybe there will be a time where you don't necessarily need it. Like it would be, you know, I've heard you say, you know, I would love it if you don't need my products.
A
Right, right. Which.
B
Which I think is such an honorable sort of way and, you know, in integrity way to run a business.
A
Yeah.
B
You know, it's like, I would love it if nobody needed my products, but they do.
A
Yeah.
B
This is why, you know, this is why the company exists.
A
Yeah, I mean, so, I mean, on that, on that front, and one thing we get a lot of is that, you know, methane blue is actually a fully synthetic compound. So that's important for people to realize. Right. It didn't come from the ground naturally, didn't come from a plant per se. And there's a lot of arguments against taking synthetic things. But guess what, everybody, we live in a very synthetic world, and not everything synthetic is bad for us. And methylene blue is actually one of these things now. It's a dose response.
B
Cancer is also organic and natural.
A
I haven't actually, actually used that as an example, actually, but I like that that as an example. The corollary I typically use is foraging for the wrong mushrooms. And if you forage for the wrong mushrooms in, you know, in the forest, you will potentially die of liver failure. And I've seen this happen. So not everything natural is good for you. Not everything synthetic is bad for you. And we live in synthetic worlds, right? And so we need sometimes synthetic things to help us. And the key with methylene blue is that the dosing matters. Like low doses are really important. And the other aspect of it just. I want to reflect on what you just mentioned, Stephanie, is that that as you get more optimized, you don't need methane blue as often. No doubt about it. But you will have more times when you have more mitochondrial stress. If you're traveling on an airplane, for example, or if you're stressed at home and you're not getting as much sleep, or if you have a big day at work and you know it's going to be a huge cognitive workload. We know that even not moving for a day and playing chess, you burn 4,000 calories as a Master chess player. Right. So that's a huge amount of. Of energy, just that your mitochondria need, need for your brain with not moving. Right. And so what I typically do is as somebody gets more optimized, maybe they're taking maybe three days a week. That's kind of what I typically do when I'm home and stable, is that I'm taking it stable meaning mentally? No, I'm just kidding. I mean, stable, like in one location for, like, at least a couple weeks, is that I'm usually taking maybe three days a week on average. And like, and, and. But I will take it on the days that I have bigger cognitive workloads, bigger exercise workloads, because we know that methane can. Bethany and Blue, can act just like oxygen in your cells. And this is very important, right, because oxygen is required for us to make energy, the main type of energy that we make. And so this reflects on aerobic capacity. So you can run longer and cycle longer without having to stop at a higher heart rate because of methylene blue being around, at least anecdotally, we don't have clinical evidence in research yet, but we see this. In fact, there's a couple of cyclists that I know that refuse to actually dissolve any methylene blue in their mouth. They just swallow it because they don't want anybody to know they're taking methylene blue and increasing and improving their times as a result of it. But on the other end of it, on the airplane side, it's the same kind of deal, right? Because when you're on an airplane, you're pressurized on an airplane. I don't think most people know this, but when you, when the cabin door closes, when you got on an airplane, all of a sudden you've gone from zero feet of seawater if you're at sea level, right? Then when you're getting on the plane to about 6,000 to 8,000ft of seawater equivalent, because you are. Are pressurized in a cabin, in an airplane at that level so that you're lighter, so you can fly easier. And. But the problem with that is that at sea level, you have 21% oxygen. That's how much you're breathing. I'm actually in Colorado right now. That's where I live. And my O2 percentage, we're about 5,000ft here, is about 16%, not 21. But when you go on an airplane, all of a sudden you're pressurized to 8,000ft on average. So those dreamliners that many, many of you have heard about before for those Dreamliner planes are actually at 6,000 foot pressurization. And that's why you have less jet lag when you get to your location. But because you're at 8,000ft all of a sudden, this is why you get tired as soon as they close the cabin door. Many of you that are listening probably know this like you start, excuse me, you guys start yawning, you start feeling tired because you start getting low oxygen. So methane blue, what it can do is it can compensate for that by helping you make energy even if there's less oxygen around down. So protecting your mitochondria from having more stress when you're flying. And so you feel less stress when you're flying, less inflammation. You also are protected from the radiation of being closer to the sun, the UV that's up there as well. And, and so as a result of this, you have less jet lag when you get to your location. And so we figured out various programs, various protocols over the years to how to optimize those, these sort of methylene blue protocols while you're on an airplane to help prevent as much jet lag. But the other secret to all of this is I live in Colorado. And so my change from going from 5,500ft where I live now to 8,000 on a plane is not that big a deal for me because I'm already at 5,500. So. And so when I, when I travel, I get very much less jet lag than I used to traveling when I used to live in California for many years because I get off the plane, I was already at 5,500ft when I got on the plane. So I'm not that bad bad that delta is not that change isn't too bad. And then also I'm coming to sea level typically, so I'm at 21% and feeling amazing. So I have those, but the methane, but can be a great supportive for that, for that more sort of intermittent use, as you were describing Stephanie. And that's how I use it over time with most people, not everybody. Some people do need regular dosing for longer periods of time because of, you know, chronic autoimmune issues or chronic inflammatory issues in my long COVID patients. Fibromyalgia, chronic fatigue, like even during the menopausal perimenopausal timeframe. Like there's a lot that's going on there and it's sometimes difficult to manage, you know, just by peeling it off. Like I find that just even smaller doses, even a couple days a Week can go a long way for many women.
B
Yeah, I love that. And you know, short of everybody moving to Colorado come visit, that makes, yeah.
A
I don't have room in my house.
B
It makes a lot of sense to do that. You know, if I remember and this is sort of a bit of a off the cuff question, this may not even apply. But when I was in, it was either Denver or Colorado. I forget I was in Colorado and I could not. One of the things that everyone was saying is make sure you drink. Like, make sure you drink. You're going to get dehydrated, you're not going to feel it, but you are going to become very, it's very easy to become dehydrated. So do we know if oxygen saturation, does that change our hunger cues and, or thirst cues? Are you aware of anything like that? And can methylene blue potentially overcome that?
A
That's a very interesting one. One. So you are, when you come to altitude, anywhere you go to altitude, it's going to be drier. So you're going to have less humidity in the air when you come to Colorado as as opposed to being in Toronto or you know, any other place that has, you know, that's at sea level.
B
At sea level in general.
A
But, but yeah. So even so, when I lived in California, I think the average humidity level is around 50 to 70% somewhere around there, here in Colorado it's about 30 to 50% and actually even less than that in the winter. So when there's less, when there's less humidity in the air, you're gonna suck up a lot more air. So you're gonna suck up a lot more moisture from whatever you have. So you're gonna feel and actually you're gonna be, you are gonna get more dehydrated as a result of that. This is what the classic example is that you go into a high heat sauna, you don't sweat right away. It takes a little while. As opposed if you're in like 100 degree weather in the jungle, like, oh, you start just sweating profusely trying to get rid of water. Right. It's, it's like, it's a little bit of a different kind of thing when it comes to oxygen. And on an oxygen and oxygen amounts at various humidities, there's really no indication where methylene blue has a very, is a very specific effect there. But it's important that people realize that that low amount of oxygen is going to cause more stress on the system. So overall the system's going to be more under More inflammation. And as a result of that, that's one of the reasons why methylene blue can be very helpful here, is it. It helps compensate for that inflammation and also compliment. Compensates for that low oxygen state. But there's, there's probably a small humidity effect there related to oxygen dissociation as far as how much oxygen gets dumped into tissue versus how much stays on the red blood cell. But it's probably not, you know, that relevant, I think, to the conversation. Yeah.
B
Okay, so let's, let's switch then. So we know that we should probably be taking it if we're flying, especially if you're someone who lives at sea level, which is like the entire Eastern seaboard and you know, California, as you remember, most everybody. Yeah, most everybody. How does this, how might it. And you mentioned, I think it was a cyclist who's just swallowing it, which is also good to know, by the way, that you don't have to, to always walk around with a blue mouth. Like, you can just take, you can just take methylene and no one's gonna know. Talk to us a little bit about performance. I was personally just taking up sprinting again on the track, and I think I did something weird to my toe and my toe. You know, like whenever you're injured, there's more energy that needs to be directed to whatever the injury site is so that you can heal and adapt. I would love your thoughts, clinical, if there's any evidence in the literature or otherwise on the effects that methylene blue might have on performance, what those might be. So whether that's endurance activities or maybe even strength training, which is, I'm a big advocate for, and in terms of recovery as well, and then if you're someone who's dealing with an injury, whether it's an acute injury like my toe right now, or it's a, it's a chronic injury, maybe it's like a low back, something you have, you know, knees are not what they used to be. Shoulders is going, going awry. What are some ways that we can think about, about using this compound as a way to augment performance, but also to potentially speed up injury?
A
Yeah. So from a performance perspective, as I was alluding to earlier, there's evidence that methylene blue increases what's called aerobic capacity. So your ability to go longer, with a capacity to go longer without actually having to stop. And that's a big problem. Right. Of course, if, if you're trying to go far and you have to stop, well, that, that the end of your race or you have to slow down at least. And so a good example of this is I work with a guy that, that raced what's called the Leadville Race here in, in Colorado. It's one of the most famous ultra marathon races in the world. It's a hundred miles around twelve and thirteen thousand foot peaks. And so it's not for the faint of heart. And so this particular gentleman was interested in increasing his, his capacity and decreasing his time. And he actually, so what we did is we gave him 32 milligrams of methane blue every four hours and he decreased his time by three hours. So it was his capacity. Yeah, and, and, and then on a different example, like, and so that's just because he was able to run farther, faster without having to slow down. Right. And so the other aspect of this is, let me give you a corollary example, this is a more common one, is that I have a patient that she, she goes on her, on her StairMaster bike, treadmill, I can't, some combination of those things every morning. And she refuses to not use her methylene blue. And I'm, I asked her why and she's like, well, I can, I can maintain my heart rate up for 20% longer while I have methylene blue on, on board, as opposed to if I don't. So she has to stop if she doesn't have it on 20% in a shorter. Right. So she has 20% more capacity as a result of having the methylene blue on board. So that's, that's pretty significant. And, and the other aspect of this, which is interesting, is that there's been some studies in animals actually where, and this actually kind of goes along with the aerobic capacity is that you reach your lactate threshold later when you have methylene blue on board, meaning that you go from producing energy from what's called aerobic respiration to what's called anaerobic respiration or fermentation when you make more lactate. It takes longer to get there if you have methylene blue on board. So that's the, the reason why these particular people, the, the ultra marathoner and the one of my patients that loves, you know, working out in the morning, like, love their, their use of methylene blue as a way to help perform better. And, and there's some indication here too, Stephanie. We're still kind of working on this with a friend of mine, his name is Thomas DeLauer, that, you know, he's big into exercise and performance. And his thought here is that very likely with methylene blue on board, you actually can recover during an anaerobic workout, just during a strength training workout between sets faster when you have methylene blue on board because you can recover at a higher heart rate, basically because you're recycling energy, you're detoxing faster as well as, as well as, as if you can down, down regulate your nervous system in between sets. And this is kind of like that parasympathetic activation. So if you can like relax and do take good breaths before sets or between sets. And this is kind of a different conversation. But the idea here is that down railing your nervous system is how you're going to get better performance when you're actually trying to strength chain. Right. So if you do a big set of heavy weight, you want to be recovered enough that you can do another big set of heavy weight. And so there's indications here that using methylene book can help you get back to being ready for that next set faster along with doing some parasympathetic things as well like, you know, breathing and posture changes and things like that. So that's from a performance perspective. I don't know if you have any questions about that before I go over to the injury.
B
Well, that's, well, first of all that is super exciting. And then my, I guess for women we talk about this on the show almost ad nauseam at this point, but I will still, this is the hill I will die on is women need to be lifting, they need to be strength training, they need to get their form right and then we add load afterwards. The other area that I think a lot of women typically avoid, if this, if at least my community in terms of data is, is sprinting is like all not just, you know, I'm not talking about the orange theory, you know, 45 minute, you know, air quote, hit class. I'm talking about all out 100 effort, a robe like anaerobic. You are going anaerobic for 10 seconds or you know, whatever it is, 10, 12, 15 seconds max before you start switching to that glycolic to another energy system. So I guess my other question is do we know with sprinting like you were mentioning, the aerobic capacity seems to be improved with, you know, doing the StairMaster, which like God bless your patient because the StairMaster is a special kind of torture. But if we're talking about all out sprinting, let's say on a track, on a treadmill, on a bike, whatever, on a rower, erg machine, blah, are we seeing any improvements at least clinically? Maybe there's no RCT at this point. But do we see any clinical improvements with capacity, like recovery, like if you're doing a six to eight sprint session, let's say like in between those sprints, if you're using methylene blue prior to the session, are we seeing any, any changes there as well?
A
So we don't really know yet. This is an interesting question, right. And I think that I have two answers to this question. I think my sense of this is that it's going to be very individual. Some people will feel a significant benefit doing this and others maybe won't. I think it'll, I think actually will actually depend on how optimized they are ahead of time and what the capacity is for them to do this in the first place. I think if they, if they are kind of on their early stages of working on this and starting just with the sprinting, I think that's when methylene is going to help a ton as they're just starting to get going. But as they're getting to that sort of performance edge, my theoretic mind is going well, you may want to make sure that they get an as much anaerobic capacity as possible. So getting as much lactate buildup as possible. So you could either argue that, well, if you're, Bill, if you're, if you're reaching your lactate threshold later, then maybe you're not actually getting the same benefit. Right. If you're doing that 15 second sprint. So the idea would be that you'd have to probably do more for longer to benefit. Meaning like, so, for example, like if you did your 15 second sprint, sprint, right, but you, you didn't hit your, hit your hit your laptic threshold, you'd have to do a longer sprint to hit it. But that could be very beneficial over the long term.
B
Well, that's, that's like a beneficial. Yes, you're going to drive up testosterone and IGF1 and all the things that you want.
A
Yeah, exactly. Yeah. So I think it's, it's a nuanced discussion there. Right. I've been actually working on some protocols using like what's called hypoxia as well. So hypoxic training alongside methylene blue as a way to help kind of flood the system with more oxygen and more capacity after doing like low oxygen training. And there's some evidence there that nothing boo can at least anecdotally increase VO2 max that way. So doing hypoxic training and then going for walks, doing more aerobic work is actually another combination that seems very interesting. So These are all very, you know, nuanced kinds of things. But I think like high level methane book can help with endurance for sure and keep your heart rate higher for longer because you're gonna reach that lactate threshold later. So hypothetically as a result of that, you can do more work. You can, can create more muscle, you know, increase those growth hormone, testosterone stimuli more because you can go longer without having to stop. But my only sort of caveat to all this is just, you know, where are you starting biochemically, how, how well are your mitochondria doing? And so knowing that it's important as you're kind of thinking about like do you start methylene blue or do you start without it? And so this is more of a nuanced discussion but, but in essence the more optimized you are, probably the more you can benefit from using it to help know, improve your training and you make your gains faster. Is my sense.
B
Talk to me about injury as well. I was saying to you I did something weird to my toe track on Monday. Tell me about how we might think about whether this, it's an acute injury as I've sustained or it's a chronic injury that somebody might be dealing with. What are some of the at least clinical impressions that you might have around its potential to augment injury recovery?
A
Yeah, so from a, an injury perspective, it's very important to make that delineation whether it's acute, acute or chronic because very different things are happening on the cellular side as a result of that. I think maybe starting off with the acute injury would be good. And so when there's an acute injury, there's an acute inflammatory process. If you hurt your toe, for example, for me about, about a month ago I partially tore my calf as I was playing. I was just juggling a soccer ball with my daughter. It was quite surprising to say the least. And so, but as a result of that there was a profound amount of inflammation. Inflammation. And so what we've been talking about so far is these low doses of methylene blue 4 to like 25 milligrams or so being great for mitochondrial support. But actually higher doses of it around a milligram per kilogram which is about 50 to 70 milligrams or so of methylene blue is a fantastic antimicrobial. So you can use it as something as for an infection, but it's also really great for acute inflammation. So these higher doses of methylene blue are great for acute inflammation and acute mitochondrial stress. Stress. Acute severe mitochondrial stress. So I would Include at a hundred mile ultramarathon as acute severe mitochondrial stress. Oh yeah, that's why I was giving that particular guy 32 milligrams every four hours as he was running to maintain that capacity to make energy but also helping on the detox side as well. So we know that methylene blue actually has really kind of this cool way of actually working like what's what I would call like an adaptogen. You know adaptogens are things we take like rodeo, Rhodiola, ashwagandha, things like that that can kind of help the system do what it needs to do depending on what's required. And when methylene blue comes in at these higher amounts, it can work just profoundly as an anti inflammatory and decrease that, that reactive oxygen stress that those oxidative stress free radical kinds of things. And so you have these higher doses of methylene blue that are profoundly anti inflammatory and they down regulate all these inflammatory pathways in the body and upregulate things like you know, your antioxidant capacity, like even increasing your glutathione production production. There's a couple good studies showing that like a high dose of methylene blue between 50 and 100 milligrams or so like increases your glutathione production by like 4x or something like that. And so it's, it's high. And so from an anti inflammatory perspective, if you have an acute injury bringing in methylene blue at these higher amounts for five to seven days can be really, really helpful. I mean if of course it's not the only thing that you're going to do. Many of the things that I've done for recovery for the calf as well but, but really, really amazing as an anti inflammatory there as well. And the thing is like not everybody can tolerate those high doses of methylene blue right away if you have a chronic issue, chronic injury, chronic infection, chronic issues. So the problem with a lot of the methylene blue products out there is that they're too high of a dose. So you take it, you feel like crap. Well it could be because the methylene blue quality was crap and that's another story entirely. But it could also be is your system just wasn't ready for such a high amount of methylene blue because it's too much stress on the system. You can't make enough antioxidants, you don't have enough energy capacity even with methane blue around. And so what, what I've seen over the years to be, be actually interesting here that is that that from when there's an acute inflammation or acute inflammatory process, you actually can tolerate higher amounts of methylene blue than you would have if you had a chronic issue. Okay. And, and so from a chronic perspective, if you have a chronic injury, a long term injury, what's happening really there is that there's mitochondrial dysfunction ongoing, right. And as a result of that, and there's all this sort of dysfunctional tissue around. And as a result you need to really go low doses of methylene blue, typically somewhere between 4 and 25 milligrams. And that's where you're gonna see the most benefit because you're gonna start increasing the, the, about the ability of your, your tissue to make more energy, increasing the capacity for you to actually detoxify as well. You know, while you're doing other, other things. Of course, maybe you're shining some red light on your calf or your Tibetan in your case, in my case. And, and as a result that red light, actually, red light therapy or near infrared, actually it's red light 680 nanometers. So the ones you get on your panels, for example, red light panels or sunlight of course has red light as well that synergizes with methylene blue and you can actually combine synergistic effect. Low doses of methylene blue and low doses of red light are fantastic for energy production. And actually very high doses of methylene blue over that milligram per kilogram along with high intensity laser is actually fantastic anti infective as well. So just as a corollary there, so from an acute injury perspective, to sum up, higher doses of methyl blue are often required somewhere around a milligram per kilogram. If you're taking that kind of methylene blue though, I do recommend working with a practitioner just to kind of know exactly how much you're taking and why and for how long. And then for more of a chronic injury, you may need to get to that same dosing honestly, but you want to go slower to get there. You want to start off at 4, 8, 8, 16 milligrams and then increase your dose. Typically people increase their dose every three to five days or so until they start feeling they'd like they're getting a significant improvement.
B
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A
So the only absolute contraindication is if you're pregnant or if you're breastfeeding.
B
Okay.
A
So that if you're pregnant or breastfeeding, you shouldn't be taking methane blue at this time. So methylene blue, as I mentioned earlier, does increase serotonin, norepinephrine and dopamine. It works by increasing these by because it has a property called being a monoamine oxidase inhibitor inhibitor. And so if you're on serotonergic drugs like SSRIs, SNRIs, for example, there is a relative increase in serotonin in combination because you have those, those antidepressants and things on board. Now the theoretical risk is here, something called serotonin syndrome, which is extremely, extremely rare. This is basically where the body gets too much serotonin and goes into this like hypertensive hemodynamic instability kind of thing. It's extremely rare. It's never been shown with the use of oral methylene blue and methylene. Sorry, yeah, oral methylene blue and any, any antidepressant. It's only been shown by the use of using IV methylene blue and these Particular drugs. That being said, if you are taking a serotonergic medicine, like an antidepressant, ssri, snri, then I would recommend, if you're going to take methylene blue, you only do it very slowly and only do it. So what I mean by that is by starting with very low doses and increasing dose over time. Time, but only under the supervision of a healthcare practitioner, just to make sure you're okay. In my experience, I do this all the time. People do very well typically. Also, I have integrative psychiatrists that I work with that are actually weaning their patients off of their antidepressants and giving them methylene blue instead. Slowly. And doing this under healthcare supervision, knowing that, you know, depression is not a serotonin issue, typically, like, we know this now over the last. Last several years. And so, you know. But actually, what depression can often be is a mitochondrial issue for a lot of. A lot of people. So you optimize mitochondrial function, you optimize the gut, for example, and, you know, overall systemic inflammation. And you can see the brain get better. I mean, there's lots of books on this, right? You see that you change your diet and your depression gets better. You know, these kinds of things are common. And so you can use the methylene blue there to help with the mitochondrial part and also the neurotransmitter part part as well. But again, if you're on a serotonin drug, please work with a healthcare practitioner. If you're on a Parkinson's medication that increases dopamine, same thing. Okay? But in essence, the other major category of people that I, that I consider here are people with high blood pressure. So if you have high blood pressure, you're taking medications, there's some evidence that methylene blue might increase your blood pressure. Now, this is a dose response thing. So if you start off at 4 or 8 milligrams, it's unlikely to do a significant amount if your blood pressure is controlled. But if you're taking blood pressure medications, you should be working with the healthcare practitioner to make sure it's safe for you to take. And if you decide to take it, make sure you're watching your blood pressure carefully while you're taking it. So, like, low doses are extremely safe. Those are the three main things that I like to point out there. The fourth would be blue urine. You're gonna have blue urine if you take methylene blue most of the time. And then number five is that other category that I mentioned, at least kind of in passing briefly, called detox. Symptoms. This is when you start taking methylene blue and you start getting detoxification kinds of symptoms. This could be a little bit of headache, a little bit of irritability, a little bit of GI distress, inflammation. This is uncommon. If you start off at low doses and increase your dose over time. If you start off at a high dose, this may be something you find, you find out you have immediately. Now just the final thing. I would say you're just the higher doses of methylene blood flu, like over a milligram per kilogram. This is over 50 to 70 milligrams. This is when I recommend you cycle it. At least take off at least one day a week or maybe twice a week if depending on your dose. Higher, higher doses are, they will decrease the amount of gut, gut microbiota that you have because it's an antimicrobial. So you have to be aware of that. There's also a risk of gastric ulceration if you're taking high doses. And there's a higher risk of things like serotonin syndrome if you are taking these higher doses with, with the antidepressants. But again, that has, hasn't been described with oral methylene blue before. And then the other potential is something called G6PD deficiency. This is a hereditary disorder where your red blood cells have a higher risk of, of breaking under stress. And so higher doses of methylene blue over about a milligram per kilogram, you should probably get a GP G6PD test with your doc. If you're gonna take it for longer periods of time. That's an easy test to get.
B
Okay, so 1 milligram per kilogram is considered high dose. What is considered low dose? You've mentioned when we were talking about, about the chronic, like 4-16mg and then slowly titrating up like what, what, how would you categorize low dose?
A
For me, low dose is anything below about 40 to 50 milligrams. Anything above 50 is, is I, I start, start, start classifying as a higher dose for most people. Some people need those doses for long periods of time and that's totally okay. But if you are using a low, like a higher dose like that for a long period of time, then it's probably good to work with your document and think about getting a G6PD test. I don't typically use it in clinical practice very often because just from my clinical experience, it's extremely rare to have an issue if you're keeping the dose really below 2 milligrams per kilogram. But again, just for safety's sake, if you're gonna take a higher dose for long periods of time, it may be something to get checked out.
B
And talk to us a little bit about sourcing. So I know you've often talked about the importance of, you know, clinical grade methylene blue. Like, why should we not be just going to our local aquarium store.
A
Yes.
B
And picking up, you know, the methylene or whatever that they put in the, in the fish tanks? Like, talk to us a little bit about what a consumer should be looking for when they're looking for purity. How do they. How can we evaluate whether or not a company or a product is going to be suitable for consumption for us?
A
So methylene blue fish tank cleaner, please do not treat drink fish tank cleaner. I don't think I can say that.
B
Out loud, but psa, just in case. You never know.
A
There was a great headline about six months into the pandemic. Biohackers drinking Fish tank cleaner to reverse their age. So great clickbait headline. So the issue here is that methylene blue is made in a lab. Right. It's a synthetic compound. And so as part of the synthesis process, there's a potential for contamination with heavy metals, including lead, mercury, arsenic and cadmium. So you don't want those. Nobody wants those, especially at high amounts. And so what you're trying to do with methylene blue is optimize mitochondrial function. But if you lot of heavy metals around, it's not going to go well. Right. So the idea is that there's been a lot of companies that have come out, as I mentioned earlier, over the last year or so because of the popularity went from maybe three or four companies, maybe six by the end of 2024 now, to about six, 60 or so at the beginning in the middle of 2025. And the challenge is that of course, you don't want to drink fish tank cleaner. Or there's a couple other types of categories. There's industrial grade and there's chemical grade. You don't want to drink those, of course. But there's other category that all these other products supposedly fit into. We called usp. USP is basically a pharmaceutical grade amount of methylene blue. And the challenge is that even pharmaceutical grade methylene blue has purity and potency all over the map. So purity, what does that mean? So purity is heavy metals. So meaning they have contamination with lead, mercury, cadmium and arsenic. And the potency is that it doesn't meet their label claim. Meaning that it says it's, you know, A milligram per whatever. And it's not, it could be like a half a milligram or something like that. And the, the challenge here is that the biggest culprits tend to be the liquids. The liquid methylene blues out there are not as potent as they say on the label. We've tested a lot of, of them and what I've also seen is that, so what happens when you get an ingredient from another manufacturer? So at my company Transcriptions, for example, we have, we get methylene blue from Japan and Korea and we've been using the same source for four or five years now. Every time it comes in from the manufacturer, it comes with something called a certificate of analysis. This is a certificate of analysis and independent, in quotes, it's supposed to be independent analysis of the material saying it's what it's supposed to be. The specs are purity and potency as it's supposed to be for a USP product. The problem is that a lot of these companies that are bringing a methylene blue into the US are not checking the CFA to see if it's actually real. And this is actually something that just came out recently with creatine. Creatine gummies, actually. I don't know if you saw this story, but there's this whole thing about creatine gummies now having no creatine in them because these manufacturers are producing the creatine gummies, supposedly giving these C of A from outside the US and then these companies in the US are picking up or purchasing the product and selling it as creatine gummies, trusting that certificate of analysis. So, so what we do what, and what we've done for a long time is we verify, we trust but verify. Because we've, we've been using the same source for a long time. So we get that certificate of analysis and we go, okay, that's great. We're going to do it ourselves with another independent lab in the US and there's a number of companies out there that have forged certificates of analysis. It's very easy to do with AI now too. So it's not that it's a very difficult thing to do. And so this is not just methylene blue, by the way, Stephanie. This is a lot of different things that are coming into the United States. So this is, it's a big deal. And so we care about quality a lot. And so. And in the beginning we had to throw out thousands of dollars worth of methylene blue that didn't meet our spec. We've been better over the years now, because we have a good manufacturer. But so when you're looking at quality to kind of high level here, right? So there's purity, which is heavy metal toxicity or heavy metal amounts in methylene blue. So lead, mercury, cadmium, and arsenic. Arsenic. So you don't want those as. Or have as small amounts as possible. And then there's the potency aspect of it, which is how much is in the methane blue that they say that. That there's in there and versus Actually. How much is actually in there.
B
Does the label match what's inside?
A
Exactly. And so we've done some of the testing here on liquids don't typically meet label claim. They're usually about 60 to 80% of what they say. And the biggest challenge with liquids overall is that it's in a dropper. And so I. My biggest pet peeve is I asked somebody there how much they're taking of methylene blue when they have a liquid dropper. They're like, oh, I'm taking two droppers full. I'm like, do you have any idea how much that is? They're like, oh, I have no idea. So I haven't met maybe more than two people out of maybe a hundred that are taking the liquid methylene blue have any idea how much they're taking. And they take it in a different form. So, you know, my company, Transcriptions makes it in a trochee form, which is a dissolvable lozenge. Like, they take our amount. They take 4 milligrams of our stuff versus they take 4 milligrams of a liquid. And it's like, entirely different experience because they actually are getting the amount that we say on the label in our products that we make. And so it's been a. It's a big journey for people. And I know it's super hard, but I think the big. The big thing here additionally, is like, please don't buy your supplements on Amazon. I know this is hard, everybody, okay? But do not buy your supplements on Amazon. You don't know what you're getting. There's tons of counterfeit stuff out there, even if it looks like it's coming from the company that you think it's coming from. There's been tons of stories showing that there's tons of counterfeit of all your favorite brands on Amazon. So if you're gonna do it, I always recommend buying directly from the manufacturer from their website. Right. That's what we do. We're not on Amazon, for example, for that reason, or at least if they're going to be on Amazon, they're being, they're fulfilling it themselves and not like an Amazon fulfillment, because, like those warehouses, you have no idea what's going on. But I know that's hard for people, but, like, it's a super important point.
B
I know, but we got to get back to supporting local, too. I mean, Amazon, I get it. I get the convenience. Listen, like, I order stuff on Amazon all the time, but I do think that there, I do think that there's a value in supporting local Mom Paw shops as well. Or just directly from the, from the manufacturer, like directly from the company that you're, that you're looking for.
A
I want to take a big cut, too. They take a big cut of everybody's profits, too, so.
B
Right. Yeah, right, right. I want to talk about the trochee, actually, because you do like troscriptions uses. It's almost like a lozenge. And that's what kind of gives you the blue mouth. And I remember when you had very generously sent some samples for me to try, I was like, listen, I can't. I can't have blue. Like, I'm on camera. Like, I can't do. And you know, the. Your team was like, just swallow it. It's fine. So can you talk to us about the difference in terms of efficacy, let's say, between a lozenge that might dissolve in your mouth, that gives you the blue mouth look or whatever, versus something that's swallowed? Is there a time where you recommend one over the other? Like, I just had to do it for necessity because I was interviewing just on camera and just can't have a blue mouth. But is there. And I'm sure other people might be like, yeah, I can't show up to work course, you know, blue, blue mouth or whatever. But is there a superiority to allowing it to dissolve in the mouth to get versus, versus swallowing it? And if so, can you outline, like, how one might take it?
A
So Bethlehem blue is what's called a hundred percent bioavailable no matter how you take it, which is actually almost a hundred percent, which is. Which means that when you take a particular compound, a supplement, typically what happens as it gets through the body, through the stomach, the small intestine, the liver, less of it becomes bioavailable, less of it becomes. Becomes active. Okay. And so methylene blue is actually an anomaly here where whether you swallow it as, as used as a buckle trochee, or whether you swallow it or even get in as an iv, of course, IV is going to be a hundred percent. Most of it's getting into the body, so that's rare. So like for example, another supplement that I often Talk about is NAC. NAC. NAC is about 10% bioavailable. So as a result of that, you take a hundred milligrams of NAC, only 10 milligrams of that are getting in the body. If you take 16 milligrams of methylene blue in as a trochee or you swallow it, just about 16 milligrams is actually getting into the body, which is super cool. The difference is that. And wait, may. And maybe the reason why you want to use it in the mouth if, is if you have lots of brain issues, like brain fog, concentration issues, because methylene blue in the mouth is going to work faster. The, the nice thing about the troches that we make at transcriptions is that they're, as you mentioned, they're dissolvable oxygen, just that go between your upper cheek and gum, typically. And then what's nice about that is that they bypass what's called first pass metabolism in the liver and that's what actually makes things less bioavailable. In the methylene blues case, it's not an issue though, because actually most of that is a hundred percent bioavailable, as I mentioned. But the other aspect that's nice about the troche is that it's faster because it has to. When we swallow things, it goes through your stomach, you know, your small intestine, your liver. Not only that, does that potentially make things less bioavailable? But it actually takes time and for women, it takes about 20% longer for this to happen than men. When. Because of progesterone. Actually, progesterone slows down digestion. This is why when you're at your final stages of pregnancy, you have tons of reflux and everything like, like that because your gastric emptying is so slow. So that's, that's progesterone. Okay. And so what, what's happening with a trochee is that you're bypassing that whole process, so it's going to work faster. And then the nice thing additionally about a trochee is the, that they come as these scored lozenges. So they basically could be broken up into quarters, halves or fulls, depending on what you need. And so you can titrate your dose, you can start off with a low dose and then increase it from there. I mean, I'm the worst, like when it comes to capsules, like I'M always the person that responds like hyper responds to it, like I'm oversensitive. And so I'm breaking up my capsules and taking out like half of the stuff and trying it when I first try something. I'm sure many of you listeners know what this, this means. And so the nice thing about the troche is that you can really cut it up into quarters, halves or fulls. And so those are the nice things about using a trochee. But all that being said, in the case of methylene blue, you can just swallow it under most circumstances and you don't have to have a blue mouth. The only caveat to that is if you have more brain fog, concentration attention issues, you may want to try it dissolved in the mouth because it will work faster that way. And if you need the faster relief, then maybe that's what you need to do. But again, most people kind of the, the happy medium is what I'll call it is I have people swallow it on an empty stomach and then eat about 15 to 20 minutes later. And that's really a great combination for most people because it's gonna make it work relatively fast and they're not gonna have a blue mouth in the process.
B
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A
It depends on how much methane blue you take. The more methane blue you take, the longer your mouth is going to be blue. But in essence, you can get it off your teeth pretty quick. You just let it fully dissolve and then you can brush your teeth. You can use hot liquids like coffee, Matcha, even some baking soda will actually work pretty well. The mucus membranes. So your, your, your, your gums and your, your mucus membrane in your mouth, those will stay blue for longer though because it just takes longer for that, the blue to go away there.
B
So are there any other lifestyle practices? So you've mentioned, you know, we've been talking a little bit about nad. We've been talking about, you mentioned ketones, mentioned light, like getting out in the sunlight. Are these things, when you pair them with methylene blue supplementation, do they amplify the, the effects of methylene blue in the body?
A
Anytime you're going to make the mitochondria more efficient and add methylene blue at the same time, it's going to be a synergistic capacity that you're going to see and you're going to see an amplified effect. And so from a red light perspective, as we were talking about earlier, red light donates electrons directly to that complex four in the mitochondria. And methylene blue can help at the same location or any location really, that's necessary. But under relatively optimized conditions, it's going to donate directly to Complex 4. So if you take your methylene blue and then 45 minutes later, either go in the sun or go and go in front of your red light panel, you are going to feel a synergistic effect. And it's, it's not subtle actually, if you, if you feel it and it could be very, very helpful to kind of get your exercise done, give you a little bit of an energy lift, a cognitive boost, that kind of thing. And then from the other perspective, anything that's going to support mitochondrial function, like so, your vitamins, your minerals, your nutrients, even some NAD can be helpful there because you need additional NAD supply. Methylene boost can help that, that and Recycle that and make it work better. If you didn't have methylene blue around, it wouldn't work as well as if you had methylene blue around in those capacities. So I'm always telling my patients, you know, when we're starting methylene blue, it's not just methylene blue. We're going to, you know, get some dietary changes going, optimize your light exposure, improve your capacity overall to decrease your stress response. Right. And that's, that's a big one. Back to that sympathetic spiral of doom. Because if you're not downregulating your nervous system, no matter how much mitochondrial support I give you, you're not gonna see a huge benefit over the long term. So that's kind of the main sort of overarching for my clinical practice these days, is that you have to optimize mitochondria, that's great. But if you have these, these inputs that you're not changing, like insulin resistance, like high blood sugars or the biggest one, really sort of the high sort of Meta1, is this the, the stress level, the fight or flight that your body's under if you don't down regulate that, you know, have a better relationship with your mother, as you said earlier, or maybe you have to address, you know, your boundaries with your, with your spouse or your kids or whatever it might be, or trauma when you were a child. Like it can be a number of different things. Like all those things really didn't be addressed. But it can take time to do that. And I totally understand it. There's long term things like, you know, therapy and, you know, mindfulness meditation, even exercise can help here to some degree. But I like to leverage the GABA system in that capacity, which is our, the brakes of our brain to kind of calm things down. But in essence, for me, it's not like always. There's no, like, no one thing that I do on its own typically. It's like if I'm optimizing mitochondrial function, I have to really be addressing those inputs that are causing the mitochondrial dysfunction as much as I can and then supporting the mitochondrial function as I do that. So that's, I think that's kind of like the rounded out way of thinking about it maybe.
B
I love that. It's very, very vitalistic of you, you as well. So let's, so you have, let's just, you know, we have lots of women who are listening today, perimenopausal, menopausal women who are struggling with a whole host of like the hormonal changes, as you mentioned, that chronic, that stress sandwich, you know, a lot of chronic stress, a lot of extra stress and pressure in midlife. What is the one big takeaway that you would like her to have as she's maybe exploring potentially taking methylene blue for herself?
A
We all need help, okay, Even the caregivers around, and to be our best, we really have to be as healthy as we can. And I think that a lot of times, you know, I see this, I have four kids at my house and my wife here, and I. And I always have to remind her that she has to take care of my wife, has to take care of herself, too, or else, you know, if you're burning the candle on both ends, right? And so it's not always easy to make huge shifts in everything that you're doing. I mean, I, I'm a perfect example of this, right? I'm basically a chauffeur tour between 3pm and 7pm every single day with my wife and, like, trying to get work done and doing every, like, like, and then, you know, sleeping and then taking care of yourself and spending time with your spouse. And like, you can't shift everything all at the same time. It's like it's. It's freaking impossible. And, and so where methylene blue comes in is that it can give you something that gives you that support throughout the day to give you a little more energy, a little more detoxification, a little more of a boost where you're not going to feel overstimulated using it. You're not going to feel like you're on. On three glasses of coffee or three cups of coffee. It doesn't give you that stimulated effect. It just gives you this sustained energy rising effect. And maybe, Stephanie, you can talk about your experience a little bit about how it makes you feel to give. Give people a sense. But the way I think about using methylene blue is it's that bridge that we talked about for sure. But, you know, just get started with it and see how you feel. And then as you start feeling better, even if you didn't think you needed a bridge, or you weren't ready for that bridge, or you weren't ready to make that transition, then all of a sudden it's like, okay, well, maybe, maybe I can do a couple more things. Maybe I can set another couple hours a week out for me. You know, when people are not awake and sleeping in their naps or they're, you know, they're at school, whatever it might be, right, Instead of taking a lunch Break and you know, scrolling on my phone. I can take 30 minutes of meditation, but that's not always easy to start off with. Right. But nothing blue is one of the things that I found clinically that I work with patients. I'm like, look, start off at a small dose, see how you feel. Let's titrate your dose every three to five days and when you feel better, that's it, that's the dose that you have and that's what you're going to take as needed. Or let's try you on it for a couple weeks and let's see if you can start thinking about doing some other things to kind of, you know, work on, you know, the edges of things if you need to. And then over time then you make those big shifts slowly. Right. Because it's not always easy to change everything. And, and that's where I think, where I think methylene book can be super, super helpful.
B
Yeah, I think I've been taking a quarter of the tro, so I've been breaking it into fourths and just taking a quarter of the, of the trochee. And I can tell you that the way that it feels is almost like, you know when you have like a really great sleep and you wake up and you're like, wow, is that what it feels like to have to feel so refreshed and energized because you've gotten used to sort of crappy sleep and it's just become your new norm? That's sort of how it feels. Like you just are like, wow, I just have all this clean, non jittery, you know, energy and it's like, oh, yeah, this is what I have. I used to feel like this. So that's sort of my, that's been my experience is like, I haven't noticed, I haven't noticed. I mean, I don't think I've been taking it long enough yet to say, okay, it's definitely improving my recovery. It's definitely improving my performance. Like I was saying, I've just injured my toe just sprinting on the track earlier this week. So I'm going to be actually maybe trying to even take a half.
A
Yeah, take more trophy.
B
Yeah, take a little bit more to, to, to quicken up the, the injury. But I, it just feels like, oh, this is what I used to, I used to have all this energy and this is, this is what it feels like. So it's just a very refreshing.
A
Yeah, clean is the word I often get is like it's a clean energy. Refreshing and it's not over stimulating because it has that capacity, both energy and detox at the same time. So. I know, I know it's very blue and I know and there's been a lot of press about it. So, you know, we try to make as much information available on our website at the company at triscriptions. We have our troches which make it super easy to use, super easy to carry with you. You, you don't have to dissolve in your mouth. You don't have to have a blue mouth. You don't have to do that. Again, if you have a lot of brain fog, you might want to try it that way and use some, some hot liquids afterwards to get it off your teeth. At least have a fancy blue tongue but nice white teeth. It's, it's, you know, it's a, it's a cool combination. It works good for socials but not everybody wants it. I totally understand. But in essence.
B
So where's. Tell us where, where. Troscription. Where can we find more information on. On you and, and troscription?
A
Yeah. So we were the first company that came out with a clinical, a commercial product for methylene blue or with methylene Blue back in 2020. And it was actually a combination of methylene blue with caffeine, nicotine and cbd. And that's called our Blue Canadine. That one is for focus. That's our. Basically one that will help you make you feel like you're on a certain type of medication that you may have been taking from your friend at college to help you study kind of thing. It's like that without the jitters for about three to five hours. And so it's a nootropic basically it really works for brain function. Really does work. Work for that stimulated kind of feel so, you know, ripping off the cobwebs kind of thing. And so that was, that's called Blue Canadine. And then we have another one that we came out about six months later with called Just Blue. And that's mainly what we've been talking about is pure methylene blue here today.
B
Yeah, that's the same I've been taking.
A
That's the 16 milligrams per trochee. A quarter is a four milligrams and you can increase your dose as you need to. I like the Blue Canadine for focus, productivity. I love the, the just Blue for, you know, daily sort of energy, sustainability, endurance, those kinds of things. And we have a lot of research and a lot of blogs on our website@troscriptions.com that's where we do all of our long form there. If you go on our YouTube channel at Triscriptions, you can find a ton of videos. We had one that went viral earlier this year. It was just me doing a Q and A on methylene blue and talking about stacks and in combinations. Well, it's just a stacks and also things to consider in and out and around using methylene blue. So you can check those out. It's also on Instagram at, at transcriptions. Those are the main places that you can find a lot of information. And again, we've been doing this much longer than just, just about everybody else except for the people in chemistry class, I guess.
B
There's also a sleep. I haven't tried it yet, but there's also a sleep product. Is that right?
A
Yeah. So I was mentioning that sympathetic spiral of doom and it's very ominous. But the idea kind of breaking that spiral, the easiest and the fastest way is leveraging that, that GABA system. So GABA is that that neurotransmitter or brain, that is the brakes that calms down our neurotransmitter and firing. And so we have a sleep product called TRO Z&A and a calming product called Trocom that help break that spiral very quickly. They leverage the GABA system by enhancing the way that GABA works and modulating the receptor in a very cool and novel way. If you're taking GABA supplements, you know GABA supplements are on the market. GAB is too big of a molecule to get across into the brain unless you have a leaky brain or a leaky gut really is corresponding to the that. And so if you take GABA and you feel better, it's oftentimes you have a leaky gut that needs to be addressed. So be aware of that. But there's lots of other, lots of compounds that, that enhance the GABA system, that being GABA itself. Things like Kava, CBD and CBG which are all in our Trocom, along with something called nicotinel GABA or vitamin B3 GABA. Then we have a TRO Z which has something called Agarin, which is from a psychedelic mushroom called the Amanita muscaria mushroom. But it's non psychedelic at low doses.
B
That's the, the one that you see in Mary. Like Super Mario Brothers.
A
Yeah, yeah, Super Mario Brothers.
B
The white and blue one, right?
A
Yeah, white and red. Yeah. And then Christmas, Northern Siberia, like this.
B
Oh yeah.
A
And then also in, in Alice In Wonderland. And so it's psychedelic at high doses. The ingredient that's psychedelic that make it psychedelic. Psychedelic is not what's in our product. The other one is called Agarin and it's a long acting one that works on the GABA system. We also something called Han from magnolia bark in the troz along with with six other ingredients that are comprehensively supporting sleep. But the goal for me as a clinician, you know, again, meta view here everybody is that we need to break that spiral now, right? Breaking that by, you know, breaking that sympathetic dominance, sympathetic overdrive, that fight or flight, GABA is the way to go. Just not GABA supplementation, but enhancing the GABA system and then addition that mitochondrial support. How can you help right now? Methylene blue. Methylene blue is going to help you, you lower doses, titrate that dose over time, find what's right for you and you're going to see the difference. It's not something that builds up in the system either. I should mention as far as when it comes to how it makes you feel energetically, it should make you feel energetically at the dose that works for you. So it's not like you keep on 4 milligrams for 30 days. No. If it doesn't work after about three to five days, go up on your dose, it doesn't work for another three to five days, go up on your dose even further. And when you know, you feel better, that's your dose.
B
Love it. Thank you so much, Dr. Scher. This has been so enlightening for me. I've learned so much about Methylene blue just in the preparation for this conversation and of course through the conversation as well. I just want to thank you for your time and your focus today. Love it.
A
My pleasure. Thank you for having me, Stephanie. It's been a pleasure.
B
Welcome Bettys, to the after party where I tell you what I really thought of the episode. And if you don't know if this is your first time listening to the after party, we name the after party after menopause because that is the goal. The goal is everybody wants to be invited to the after party, baby. And so we are trying to reframe menopause as a positive thing, not just this doom and gloom and terrible thing. So welcome to the afterparty. I really enjoyed this conversation. Like I was saying to him, I have just been hearing about methylene blue. I've seen people with blue mouths on planes and it's like, what is this nonsense? And, and it just sort of struck me as this kind of like biohacker, you know, it's like people avoiding the real work. It's like what you gotta do is you gotta lift weights, you gotta eat well and you gotta sleep. Anything other than that is dumb. And I was like, okay, these blue mouth people, no, this is not, not for me. But really after digging into the science, I am very much trying it myself, very much intrigued. And I think it has a lot of applications, particularly to my Betty's, particularly to the perimenopausal and menopausal women who are dealing with the brain fog, with the energy, with the mood, with the stress, all the things that come along with midlife. So a couple of my favorite moments. I really, I mean, y', all, I'm a dark rose Betty. Okay, so I'm just going to classify myself here. I loved the geeky stuff about the electron transport chain when we were talking about complex 1, 2, 3 and 4 and how methylene blue concentrates and actually helps that gradient. It actually helps to concentrate and move those electrons along that gradient to create more ATP. Like that's how your girl's brain works. I'm like, okay, I understand how it works now. Like, don't show me a blue mouth RFK on a plane. I don't care. I wanna know what happens at the level of the mitochondria. So I understand why and how it's providing benefits. So I think he actually did a bang up job, like a wonderful job explaining that. I also really liked the part where we were talking about performance enhancement and injury. So for me, I mean, y' all know I love to lift weights and I'm trying to encourage all of you, if you are not already lifting weight weights, to be lifting weights and to, you know, being applying the principles of progressive overload, et cetera. So I really get excited about this idea that methylene blue can act as a potential agent to bring you back into parasympathetics in between sets. Like everybody knows, like you know, when you are lift, when you're doing a squat, like that is a, you got weight on your back or you're holding dumbbells or whatever it is, it is a stressful thing to move your legs very close to an approximate failure. So after that, that's why your heart rate goes up, that's why your blood pressure goes up, that's why, why you know, you're sweating and all the things that happen when you're doing a squat or a lunge or whatever it is. So I really like this idea that as a potential mechanism, as a potential way that it's affecting and augmenting strength training is to actually help you reset quicker so that you can get back to the next set faster. And then of course, the aerobic capacity, I thought that that was a really interesting aerobic and anaerobic capacity. I really love that. So the whole idea around why it can help with your aerobic capacity, he was talking about the, his patient on the Stairmaster is that it can delay the onset of that lactic threshold so you can actually go further for longer. And longtime listeners of the show will remember my conversation with Phil Maffetone where he was saying, when you can no longer control your heart rate, that's when you need to stop. That's when you need to cut the cardio activity so that you prevent injury. Well now if you use this, I mean that was a couple years ago now. So maybe we'll put a link in the show notes, notes for you if you want to go back. It's still like one of my all time favorite conversations with like Fat Max and all that stuff. But now when you pair that information from Phil Matone with what we were talking today with Scott Share. If you are able to now use methylene blue, you can delay that onset of lactate threshold, meaning that you can continue and do your aerobic. Your aerobic capacity essentially gets bigger, gets larger so that you can have more load, you can have more workload that's done in that single session session. So love that. And then interestingly with the sprinting, which is something I've always sprinted, but I've just recently, as you probably heard in the show, like recently just got back to sprinting on a track, which is like I used to do that when I was in, in grade school and I used to DO relay and 200 meter, 400 meter, the whole thing. And then just with children and life, et cetera, just wasn't sprinting on a track. I was just doing it in the gym. But now I'm back on the track again and I'm loving it and hurt my toe. But I love, I love the idea that in an anaerobic aerobic situation where you are like all out max, like you are all out, you know, 100% effort for the 10 seconds or so or 15 seconds that you're sprinting that you can delay the, again, delaying that onset of that lactic threshold, which you would think would be a bad thing. But that means that you can actually sprint for longer. So for me that's sort of a net a net positive. So I really, really loved that. And personally, I'll tell you, I will, I will tell you about my toe, if any. Anyone. Not, not because we're, you know, doing anything on like feet finders or anything like that, but if anybody is really interested in the rehabbing of my toe, I am going to be using methylene blue to make sure that I actually can get back to sprinting because I've just realized how much I love it and I acutely, I'm acutely injured right now, so I definitely want to get back to sprinting as quickly as possible. Overall, I've really changed my opinion on this from something that looks silly and just as a social media opportunity to show your blue teeth to something that is actually really beneficial, particularly for women in perimenopause. So you can still teach this old dog new tricks. And I will be using methylene blue in my own protocol as well. So I hope that you enjoyed this conversation. I hope that you learned from it. Let me know what you thought about it in if you want to leave us a comment on Spotify, on itunes, all the places we read them all. And it helps direct direct our future content for our wonderful Betty's, which is you. So I bid you adieu and we'll talk soon. All right? All right. I hope you enjoyed today's episode and I must give you the obligatory legal and medical disclaimer here. This podcast, Better with Dr. Stephanie, is for general information only and the advice recommendations we discuss do not replace medicine, chiropractic or any other primary health care provider's advice, treatment or care in the consumption of this podcast. There is no doctor patient relationship that has been formed and the use and implementation of the information discussed are at the sole discretion of the listener. The information and opinions shared on this podcast are not intended to be a substitute for primary care diagnosis or treatment. In other words, guys, be smart about this. Take it with a grain of salt. Take this information to your primary healthcare provider and have a discussion with him or her to make the best choice. That is for you. Remember, I am a doctor, but I am not your doctor and these conversations are meant for educational purposes only.
Released: October 6, 2025
Host: Dr. Stephanie Estima
Guest: Dr. Scott Sherr
Duration (Main Conversation): 04:12–86:11 (timestamps referenced in MM:SS format)
Episode Focus: Methylene blue as a tool for energy, brain fog, menopause support, performance, and recovery.
This illuminating episode explores the science and practical applications of methylene blue. Dr. Stephanie and physician Dr. Scott Sherr discuss how this century-old compound can be a bridge for women—especially those in perimenopause and menopause—who struggle with energy, brain fog, metabolic changes, and performance. The conversation dives deep into mitochondrial health, dosing protocols, evidence, safety, sourcing, and practical tips, all with a clear focus on actionable steps for women in midlife.
“It was actually synthesized as a textile dye to dye blue jeans blue...but somehow they figured out that this particular compound actually treated malaria.”
– Dr. Scott Sherr (05:17)
"About 94% of U.S. adults have some element of mitochondrial dysfunction, especially during significant life transitions...menopause, it's a big one too."
– Dr. Scott Sherr (10:44)
"It can basically compensate for the dysfunction in [mitochondrial] complexes...a lot of us are walking around with dysfunctional complexes."
– Dr. Scott Sherr (22:26)
Dr. Steph asks for the deep science:
"I want to know pathways. Let's talk a little about electron cycling in the mitochondria."
– Dr. Stephanie Estima (19:43)
"I think some people need methylene blue some of the time, and I think some people need methylene blue some of the time for a period of time..."
– Dr. Scott Sherr (27:06)
Performance:
“He decreased his time by three hours. So it was his capacity...because he was able to run farther, faster without having to slow down.”
– Dr. Scott Sherr (42:50)
Strength Training Nuance:
Injury and Recovery:
“Higher doses of methylene blue are great for acute inflammation...they down regulate all these inflammatory pathways in the body and upregulate things like your antioxidant capacity.”
– Dr. Scott Sherr (50:18)
“We care about quality a lot. In the beginning we had to throw out thousands of dollars worth of methylene blue that didn’t meet our spec.”
– Dr. Scott Sherr (62:18)
“It just gives you this sustained energy rising effect...it’s that bridge that we talked about for sure. But, you know, just get started with it and see how you feel.”
– Dr. Scott Sherr (77:43)
On Chronic Overwhelm in Women:
“It’s not always easy to make huge shifts in everything you’re doing. ...you can’t shift everything all at the same time. It’s freaking impossible. ...where methylene blue comes in is that it can give you that support to give you a little more energy, a little more detox, a little more of a boost while you’re making those changes.”
– Dr. Scott Sherr (77:43)
On the Experience:
“It feels almost like...you have like a really great sleep and you wake up and you’re like, wow, is that what it feels like to feel so refreshed and energized? ...it’s just clean, non-jittery energy.”
– Dr. Stephanie Estima (79:58)
On Sourcing:
“Please don’t buy your supplements on Amazon. ...do not buy your supplements on Amazon. You don’t know what you’re getting.”
– Dr. Scott Sherr (67:45)
On Stigma and Science:
“I always just thought these people are crazy. I don’t know if this is like the return of Avatar. Like I don’t know what this is, but I don’t like it...after really diving into the science, I was like, oh, this is really interesting."
– Dr. Stephanie Estima (04:15, 86:11)
For Women in Perimenopause/Menopause:
For Performance and Recovery:
Safety:
Final Thought: The blue-mouthed biohacker image may be off-putting, but the real magic of methylene blue lies in its science-backed capacity to energize, detox, and support adaptation for women in the thick of midlife change.
For further resources, practitioner downloads, and in-depth blogs, visit Troscriptions.com or follow Dr. Scott Sherr and Dr. Stephanie Estima on their platforms.
“It isn’t about being perfect, it’s about being better.”
– Dr. Stephanie Estima