Methylene Blue: From Lab Dye to Modern Health Intervention
Written by Barbara Ford; Edited by Nicki Steinberger, Ph.D.
Originally published by A Voice For Choice Advocacy on June 26, 2025.
EDITOR’S SUMMARY: Methylene blue shows promise for treating malaria and supporting neurological health, partly due to its ability to enhance mitochondrial function and improve cellular energy production. However, as a synthetic compound, it carries potential side effects and contraindications that shouldn’t be overlooked. Understanding both its benefits and risks equips you to make an informed decision about whether methylene blue fits into your personal health plan. In the complex world of supplements, knowledge is your most powerful tool.
The new favorite color of the modern health-seeker might just be blue—methylene blue (MB), that is. A synthetic chemical compound discovered in the 19th century, MB started out as fabric dye, with uses in biology and chemistry. From there, it found its way into both allopathic and natural medicine circles as a viable healing agent. It can be taken intravenously, orally, or topically. According to Dr. Robert Malone, biochemist and medical doctor:
”Its role as a medicinal is well established, and it has been used to treat methemoglobinemia, malaria and neurological conditions such as Alzheimer’s. MB’s role in improving mitochondrial efficiency has become well established in the scientific literature.”
The World Health Organization includes methylene blue on its Model List of Essential Medicines—recognizing its clinical value in treating methemoglobinemia, a blood disorder in which iron in hemoglobin becomes oxidized. However, its use requires careful medical oversight. Some historians of medicine describe methylene blue as marking the beginning of modern pharmacology, citing its early use as one of the first synthetic drugs. It was originally used to treat malaria and is now being explored for its neuroprotective effects, memory enhancement potential, and possible role in managing bipolar disorder. Yet beneath its eye-catching hue, methylene blue carries a story still unfolding.
Methylene blue is historically linked to coal tar, a byproduct of coal processing. Chemicals like naphthalene and benzene were later extracted from this residue and used in household and industrial products. Unlike traditional dyes made from natural plant sources, these petroleum-based derivatives offered a cheaper way to produce synthetic dyes for clothing and other goods. The resulting blue color, though originally derived from these compounds, is now commercially synthesized. Like methylene blue, many synthetic drugs originate from natural or complex compounds but are now produced in labs through chemical synthesis. Don Bottoni, RPh, a PCCA clinical compounding pharmacist, explains how methylene blue (also called methylthioninium chloride) works in your body:
“Methylene blue is a unique derivative of phenothiazines [class of synthetic compounds]. In an oxidized state, it is blue and is an electron donor. In its colorless state (leucomethylene blue), it is in a reduced state and will accept electrons. These two molecules comprise an ‘autoxidizing redox’ system, which is reversible oxidation-reduction system. This complex allows methylene blue to support the mitochondrial electron chain inside our cells, which supports respiration inside our cells. It is this ability to transport electrons, and thus oxygen inside our cells, which allows it to be used as a treatment for methemoglobinemia, cyanide poisoning and carbon dioxide poisoning. Methylene blue can serve as an oxygen transport system while our hemoglobin is not functioning properly.”
Beyond its potential neuroprotective properties, methylene blue is being studied for its ability to reduce the impact of Alzheimer’s disease, stroke, traumatic brain injury, and other degenerative brain disorders. It also shows antimicrobial, antifungal, and antiviral activity, with clinical studies currently underway exploring its use for the following:
Bipolar disorder: Involves intense mood swings between depressive lows and manic highs, often disrupting daily functioning.
Post-traumatic stress disorder (PTSD): Triggered by exposure to traumatic events, leading to symptoms like flashbacks, heightened anxiety, and emotional numbness.
Blood and lymphatic system: Includes disorders that affect blood cells, bone marrow, or lymph nodes—impacting immunity, oxygen transport, and clotting.
Heart and circulatory system: Refers to conditions that impair the function of the heart and blood vessels, such as hypertension, heart failure, and stroke.
Cancer: A broad category of diseases marked by uncontrolled cell growth, which can spread and interfere with normal body functions.
The Mitochondria Conversation
To understand why methylene blue has gained attention, it helps to first explore how experts describe the role of mitochondria—and why these microscopic structures are central to discussions about cellular health. At the heart of many chronic health challenges lies a common thread: impaired function of these cellular energy centers. These powerhouses within your cells drive energy production essential to every bodily system. When they falter, the fallout can touch everything—from neurological performance to metabolism and the aging process—areas where methylene blue has drawn increasing interest. Notably, the conditions in which methylene blue shows therapeutic potential often mirror the biological signatures of dysfunction in these vital organelles. Mitochondria are, quite literally, the energy factories of your body. Doctors from UCLA’s School of Medicine describe them like this:
“Much like trains deliver cargo and passengers from one place to another, mitochondria deliver fuel (energy converted from food) to different parts of a cell. …mitochondria move around cells like trains, then the fragmentation of mitochondria into smaller segments is like trains dividing to avoid obstacles on the tracks. In the mitochondrial world, each fragmented train car can move around independently as its own autonomous vehicle.”
Mitochondrial health influences how well you age, as well as your ability to overcome disease. Poor mitochondrial health can negatively impact nervous, endocrine, and immune systems. And unnervingly, mitochondria can become damaged in a number of ways, resulting in DNA damage and ill health:
“When mitochondria stop functioning, the cell they are in is starved of energy. So, depending on the type of cell, symptoms can vary widely. As a general rule, cells that need the largest amounts of energy, such as heart muscle cells and nerves are affected most by faulty mitochondria.”
This is where methylene blue comes into focus. Research suggests it acts like a molecular “battery booster”: it enhances energy production by improving mitochondrial respiration and reducing oxidative stress. In simpler terms, methylene blue helps your mitochondria work more efficiently while protecting them from damage—an effect that may explain its therapeutic potential in a range of conditions tied to mitochondrial dysfunction. If you notice loss of muscle coordination or weakness, or are having problems with vision, hearing, digestion, or brain function, you may be experiencing mitochondrial impairment. Heart, liver, or kidney disease could also signal mitochondrial abnormalities. Other conditions thought to involve some level of mitochondrial dysfunction include:
Parkinson’s disease: Progressive damage to the nervous system that disrupts movement, leading to tremors, muscle stiffness, and coordination issues.
Alzheimer’s disease: Involves gradual memory loss, confusion, and cognitive decline due to the degeneration of brain cells.
Schizophrenia: Manifests through hallucinations, delusions, and disorganized thinking, affecting perception and behavior.
Chronic fatigue syndrome: Marked by persistent, unexplained fatigue that worsens with activity and doesn’t improve with rest.
Huntington’s disease: A genetic condition that causes nerve cell degeneration in the brain, impairing movement, thinking, and mood.
Type 2 diabetes: Disrupts how the body processes blood sugar, leading to elevated glucose levels and long-term health complications.
Autism: Affects communication, behavior, and social interaction, often involving repetitive patterns and sensory sensitivity.
Serotonin Signals
Alongside its therapeutic applications, methylene blue isn’t without risks. Like many pharmacological agents, it carries side effects and may not be appropriate for everyone. One of the most serious concerns? Serotonin syndrome—a potentially life-threatening condition caused by dangerously high levels of serotonin in the nervous system. Mild symptoms include nausea and diarrhea, while more severe cases may lead to fever, muscle rigidity, and seizures. Methylene blue inhibits monoamine oxidase A (MAO-A), an enzyme that breaks down serotonin in the brain. By blocking MAO-A, methylene blue can cause serotonin to accumulate to toxic levels, especially when combined with selective serotonin reuptake inhibitors (SSRIs) or other serotonergic drugs. Because it crosses the blood-brain barrier, methylene blue’s effect on serotonin metabolism is significant, requiring careful medical supervision, particularly for patients already on antidepressants. That said, Dr. Annette Bosworth, M.D. wants you to keep this in mind:
“The warning is only against combining this [MB] in high doses with SSRIs, migraine meds, or other illicit drugs. The truth is there are only a few published case studies in over 150 years of this commonly used drug connecting methylene blue to serotonin syndrome. The warnings are way overblown …”
Hemolytic anemia is another potentially serious side effect of methylene blue, involving the premature destruction of red blood cells. Symptoms may include yellowing of the skin and eyes, fatigue, shortness of breath during exercise, lightheadedness or dizziness, irregular heartbeat, and dark urine. In addition, multiple studies have documented neurotoxic effects on the developing nervous system, particularly at higher doses. From Sage Journals, “Adverse effects of methylene blue in peripheral neurons: An in vitro electrophysiology and cell culture study”:
“Increasing concentrations of MB (0.3–10 μM) were associated with neurotoxicity as shown by a substantial loss of cells with neurite formation, particularly at 10 μM. In parallel experiments, cultured rat DRG neurons were treated with MB (100 μM) to examine how MB affects electrical membrane properties of small-diameter sensory neurons.”
Methylene blue should be avoided during pregnancy and lactation due to insufficient evidence about its safety for developing infants. While it is sometimes used in carefully controlled clinical situations during pregnancy, these are exceptions rather than the rule. As noted, it should not be combined with serotonergic medications or certain anesthetics, and caution is advised prior to surgery. Methylene blue can cause hypersensitivity reactions and hemolysis, particularly in people with G6PD deficiency (a genetic disorder affecting red blood cell function).
Additionally, methylene blue may interfere with medical assessments by skewing oxygen level readings and staining tissues. This can complicate patient monitoring and lead to misinterpretation of lab test results, especially since it may change the color of bodily fluids. Other reported symptoms include confusion, dizziness, and visual disturbances. According to RxList, extra caution is recommended if you experience renal impairment or hypersensitivity to thiazine dyes. Certain health conditions—including unresolved or atypical forms of methemoglobinemia, such as congenital methemoglobinemia (sometimes called “blue baby syndrome”), and impaired liver or kidney function—may be medically incompatible with methylene blue. Reported methylene blue side effects in 1% to 10% of cases include chest pain, syncope (a temporary loss of consciousness), and pain at the injection site. At high doses, methylene blue has also been shown to raise blood pressure. For carefully monitored dosing recommendations, BRC Healthcare provides valuable resources and clinical guidance.
A Nutrient-Dense Ally in Cellular Function
If you’re looking for a natural catalyst that supports your body’s cellular function—helping cells communicate, manage oxidative stress, and maintain energy production—spirulina deserves your attention. It offers antioxidant and neuroprotective effects similar to methylene blue but in a gentler, more nourishing way. This blue-green algae contains phycocyanin, a pigment-protein known for its powerful antioxidant and anti-inflammatory properties that assist cells in working efficiently and defending against damage. As the study, “Exploring the Benefits of Phycocyanin: From Spirulina Cultivation to Its Widespread Applications,” published in the journal Pharmaceuticals explains:
“[Spirulina] is considered a safe and high-quality food and is used as a substitute for animal or plant foods due to its impressive nutritional profile, especially its high protein content. In addition, several of its biological properties are attributed to its high phycocyanin content. This pigment-protein complex is used in the food, cosmetic, and pharmaceutical industries due to its excellent biological activities.”
Spirulina supports your body’s natural defenses by activating enzymes that shield cells from internal damage and disruption—factors that contribute to aging and chronic disease. Taken from the study published in the journal Archives of Toxicology, “The antioxidant, immunomodulatory, and anti-inflammatory activities of Spirulina: an overview”:
“Spirulina activates cellular antioxidant enzymes, inhibits lipid peroxidation and DNA damage, scavenges free radicals, and increases the activity of superoxide dismutase and catalase.”
According to The Vigilant Fox, in “The Blue Brain Effect: Methylene Blue’s Dark Side & What You Should Be Using Instead,” phycocyanin shares a “spectral overlap” with methylene blue:
“This means that phycocyanin can serve the same purpose as Methylene Blue in many therapeutic applications, including photodynamic therapy (PDT) and photobiomodulation (light therapy), while avoiding Methylene Blue’s synthetic toxicity.”
Compared to methylene blue, spirulina—available in powder, capsule, or tablet form—has a low toxicity profile. However, even though the U.S. Food and Drug Administration generally recognizes it as safe, side effects have been reported. According to WebMD, spirulina products can be contaminated with heavy metals and bacteria, so it’s important to choose a trustworthy source. To lower the risk of contamination, look for spirulina that’s organic, third-party tested, and grown in controlled environments—preferably in the U.S., Taiwan, or Hawaii, where quality standards are stricter. Trusted products often carry certifications such as USDA Organic, NSF Certified, or USP Verified. Spirulina grown in natural lakes may be exposed to heavy metals, harmful bacteria, or toxic algae—conditions that are difficult to control and test. Choosing spirulina from closed, regulated systems helps ensure a cleaner, safer product.
When taken as directed, spirulina is generally well tolerated; however, it is not recommended for pregnant or lactating women due to potential contamination risks and limited research on its safety during these stages. Reported side effects include headache, mild diarrhea, bloating, and gas. Patients with certain bleeding disorders or autoimmune diseases should avoid spirulina. If you have diabetes, monitor your blood sugar closely, as spirulina may lower blood glucose levels. Spirulina may also interact with or counteract certain medications, such as immunosuppressants, blood thinners, and diabetes drugs.
As research advances, methylene blue continues to be explored for a range of medical applications. It shows therapeutic promise, particularly for conditions like malaria and certain neurological issues. Yet despite its growing popularity, it remains a synthetic coal tar derivative with a complex side effect profile and various contraindications that should be carefully weighed—especially for general or preventive use. Your body often recognizes the difference between synthetic and natural compounds, and nature-first options may offer benefits with fewer trade-offs. Ultimately, an informed, personalized approach is essential. Scientists continue to explore how to maximize benefits while minimizing risks. If you’re considering methylene blue, consulting a qualified medical provider is recommended to determine what’s right for you.
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