Methylene Blue: Nootropic nonsense

On March 13th Dr. Darren Saunders (Associate Professor of Medicine at UNSW, Cancer Biologist) made international headlines for his takedown of a new trend hitting social media: Methylene Blue.

(Trouches of Methylene Blue | Source)

Influencers have been ingesting trouches of methylene blue in the belief that it will improve overall brain function and slow the process of ageing. A trouche is a fancy name for a lozenge that you hold in your mouth for 30 minutes until it has dissolved; similar to how one would use a nicotine lozenge. Thus far, the only thing that has changed is the uptick in rather silly photos.

(Source)

It would be easy to dismiss this as Ivermectin 2.0; the media certainly did, with its focus on methylene blue's antifungal application in aquaculture. But, as Dr. Saunders highlighted in a subsequent tweet that did not reach the news cycle, methylene blue is an incredibly useful dye that has multiple useful applications for humans, animals, and in the laboratory.

Methylene blue has been around since 1876, and was one of the first synthetic compounds to be used as an antiseptic in clinical therapy. It has earned its spot on the World Health Organisation's List of Essential Medications for its use as an antidote, while also being useful in treating malaria, methemoglobinemia, and carbon monoxide poisoning.

Methylene blue has been approved for use in NZ by Medsafe, and is funded by Pharmac. Intravenous access is the preferred means of administration, although oral dosing is also possible with significant dilution. Nevertheless, not only can the subjects' tongues turn blue, but urine and skin can as well. It was this side effect that made methylene blue fall out of favour as a malaria treatment until recently, when its affordability and new evidence regarding efficacy made the drug worthy of re-evaluation.

Nootropics are a class of substances called ‘smart drugs' which aim to boost brain performance. This can include prescription medications, such as those that manage ADHD, as well as non-prescription substances like caffeine. The reason why methylene blue has been drawn into the world of nootropics may have to do with studies such as “Neurometabolic mechanisms for memory enhancement and neuroprotection of methylene blue”, as well as a misinterpretation and misattribution of legitimate studies that investigated how methylene blue can be used to treat bipolar disorder and Alzheimer's. It is unlikely that our blue-tinged icons are dosing this product under the supervision of a trained medical professional. Ironically, an overdose of methylene blue can cause confusion, hypertension, anxiety, and tachycardia; hardly the makings of a long life with a clear and carefree mind. There is also risk of serotonin syndrome as Methylene blue is a monoamine oxidase inhibitor (MAOI), meaning that it can cause significant sickness in those taking a wide range of antidepressants and pain medications.

In the end, the ultimate bottom line is money. While the social media influencers receive free promos, the rest of us plebes can expect to pay in the ballpark of $69.95 for a pack of 16 trouches from one NZ distributor for the company Troscriptions, the popular provider of methylene blue products such as Just Blue and Blue Cannatine.