Methylene Blue, Fully Explained | Dr. Scott Sherr

This comprehensive discussion with Dr. Scott Sherr covers everything about methylene blue—from its 150-year history as the first FDA-registered drug to its modern applications for mitochondrial support. The key takeaway: 94% of US adults have mitochondrial dysfunction, and low-dose methylene blue (4-25mg) can help with energy, brain fog, and inflammation without the risks associated with higher doses.

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1. The Current State of Methylene Blue Interest

Dr. Scott Sherr opens by expressing his continued excitement about methylene blue's capacity to support, enhance, and regenerate mitochondrial function. He sees remarkable results daily in his clinical practice:

"I see this on an everyday basis in my clinical practice where we start low doses of methylene blue and see fantastic benefit across the board. Anything from pain, inflammation, brain fog, mental health disorders, and all these other kinds of things because it's all at the edge base related to mitochondrial dysfunction."

However, 2025 brought both signal and noise to the methylene blue conversation. While interest surged, misinformation spread just as quickly. Dr. Sherr shares a telling example: in 2020, the New York Post ran a clickbait headline about "biohackers drinking fish tank cleaner to reverse their age." Fast forward to September 2025, and the same publication ran a story praising methylene blue—but linked to one of the worst quality products on Amazon, contaminated with heavy metals like lead, mercury, cadmium, and arsenic.

"This is where we've gone, right? Where the fish tank cleaner clickbait headline to everybody should be taking methylene blue, but then linking out to an affiliate where they were making money on a very cheap liquid methylene blue."

His hope for 2026 is to help people dial in that signal and understand what methylene blue can actually do.

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2. The Fascinating History of Methylene Blue

From Textile Dye to Medical Breakthrough

Methylene blue was developed in the 1870s as a textile dye. Its striking blue color made it valuable for manufacturing, but scientists soon discovered something far more interesting—it had remarkable antimicrobial properties.

In an era before antibiotics (which didn't arrive until the 1950s), this was revolutionary. A simple toe infection could travel up your leg and kill you through septic shock. Methylene blue offered a solution:

"They found out that methylene blue specifically had very interesting antimicrobial capacity. And you could give it at very very high doses, and you would actually kill pathogens, but you wouldn't harm the normal host, the human host."

This earned it the nickname "the magic bullet" around the turn of the century. In 1897, it became the first drug registered with the FDA—specifically for treating malaria. It was also the first fully synthetic drug, meaning it doesn't come from plants or fungi but from biochemical pathways.

The "Natural vs. Synthetic" Debate

Dr. Sherr addresses common objections to synthetic compounds head-on:

"Living in a synthetic world, we do. If you're a diabetic, a type 1 diabetic, and you're taking insulin, guess what? You're taking something synthetic to keep you alive."

He also reminds us that not everything natural is safe either—foraging the wrong mushrooms can cause fatal liver failure. The dose makes the therapeutic benefit, whether natural or synthetic.

The Chapters of Methylene Blue History

Chapter 1: Antimicrobial Era (1897-1950s) Methylene blue served as one of the primary antimicrobials worldwide, treating urinary tract infections, fungal infections, and bacterial infections. World War II soldiers heading to the Pacific took prophylactic methylene blue to prevent jungle fungal infections. They even had songs about urinating blue!

Chapter 2: Fish Tank Cleaner Era When antibiotics like penicillin emerged in the 1950s, methylene blue got relegated to fish tank care. The "fish tank cleaner" in pet stores contains methylene blue as an antiseptic for fish—not for cleaning tanks.

"Fun fact, just to get this out of the way, nobody should be drinking fish tank cleaner."

Fish tank cleaner often contains dangerous levels of heavy metals alongside the methylene blue.

Chapter 3: Psychiatric Applications Scientists discovered that methylene blue acts as a monoamine oxidase inhibitor, preventing the breakdown of neurotransmitters like serotonin, norepinephrine, and (at higher doses) dopamine. The first antipsychotics were actually derived from methylene blue!

Doctors would compound methylene blue with antipsychotic medications to ensure psychiatric patients were taking their pills—if their urine turned blue, they were compliant.

Chapter 4: Mitochondrial Discovery When researchers dropped methylene blue on cells under a microscope, they noticed it concentrated specifically in the mitochondria. This sparked decades of research into its mechanisms at the cellular level.

Modern Medical Uses Today, methylene blue is still used in emergency rooms for:

• Cyanide poisoning antidote
• Methemoglobinemia treatment (a condition where cells can't carry oxygen effectively)
• Medical marking for biopsies and surgical procedures

Dr. Sherr's friend, a transplant surgeon, infuses methylene blue into the bladder after surgery to check for any accidental nicks that might cause urine to leak into the abdominal cavity.

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3. How Dr. Sherr Discovered Methylene Blue's Potential

Dr. Sherr works with Dr. Ted Achacoso, founder of Troscriptions and creator of the Health Optimization Medicine and Practice (HOMeHOPe) framework. While developing this approach to optimizing health rather than treating disease, Dr. Achacoso discovered studies using methylene blue for stroke, traumatic brain injury, Alzheimer's, and Parkinson's disease.

One study particularly caught his attention: it used methylene blue on normal adults and performed MRI scans before and after, showing significant improvements in attention, memory, focus, and cognition.

"We didn't think initially actually that people would want a pure methylene blue product because it doesn't have a stimulatory effect. It's not like a nootropic per se."

Their first product combined methylene blue with caffeine, nicotine, and CBD. But within six months, customers requested a pure methylene blue option, leading to the creation of "Just Blue."

Early Patient Stories That Changed Everything

Dr. Sherr admits he was initially skeptical. But the stories rolled in quickly:

• A practitioner friend with chronic pain and mold illness saw her pain completely disappear within weeks
• A grandmother with mild cognitive impairment started telling childhood stories from Mexico that no one in the family had ever heard
• Reports flooded in about brain fog clearing, mental health improvements, and reduced inflammation

"I was pretty well converted very quickly that this is going to be something that was going to be truly truly helpful."

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4. Methylene Blue and the Gut Microbiome

Dosing Makes All the Difference

The antimicrobial effects of methylene blue are dose-dependent. At higher doses (around 1mg/kg or about 50-70mg), methylene blue begins showing antimicrobial properties. This can affect your microbiota.

"If you're taking four to 25 milligrams of methylene blue on a regular basis, we haven't seen any major changes to the microbiome."

When Higher Doses Make Sense

Sometimes antimicrobial effects are actually the goal:

• Gut dysbiosis
• Parasitic infections
• Bacterial overgrowth
• Gut biofilms (where pathogens like Bartonella hide)
• Interstitial cystitis (infections hiding in bladder walls)

Dr. Sherr uses dosing between 50-100mg for chronic infections, but always for short periods with careful monitoring, followed by gut rebuilding.

The Tick Bite Example

When Dr. Sherr's mother in New York was bitten by a tick (a high-risk area for Lyme disease), they combined 150mg of methylene blue for 5 days with doxycycline antibiotics:

"She felt like a million bucks actually. She felt fantastic. And she had no symptoms and no issues afterwards."

Methylene Blue vs. Antibiotics

"A lot of antibiotics are nuclear bombs, right? They're just going to completely destroy your microbiota."

Methylene blue at moderate doses (50-70mg) doesn't cause complete annihilation of gut bacteria—just a decrease that can be rebuilt over time.

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5. Route of Administration: Mouth vs. Swallowing

The Bioavailability Advantage

Unlike most supplements that lose significant potency when taken orally versus IV, methylene blue maintains high bioavailability regardless of how you take it. Whether dissolved in the mouth or swallowed, absorption remains excellent.

When to Dissolve in the Mouth

Dr. Sherr now typically recommends swallowing methylene blue because most people don't want a blue mouth. However, two groups might benefit from oral dissolution:

1. People with significant brain fog, concentration, and memory issues - The effect kicks in faster (15-20 minutes vs. 30-45 minutes when swallowed)
2. Dental applications - Some dentists are exploring higher doses during teeth cleaning procedures for antimicrobial and anti-plaque effects

"I typically don't recommend dissolving more than about 8 milligrams of methylene blue in your mouth at a time."

Optimal Timing for Absorption

For best results when swallowing:

• Take on an empty stomach
• Eat about 15-20 minutes later - This activates peristaltic movement, speeding up metabolism
• Don't wait hours on an empty stomach

Taking it with food is still absorbed, just slower with potentially lower peak blood levels. For extremely sensitive individuals, starting with food can help them acclimate.

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6. Timing for Performance

Peak Effect Window

Whether dissolved in mouth or swallowed, peak effect occurs around 1-2 hours after ingestion. The half-life is 4-6 hours, but you won't feel a crash—it's more of a gentle descent.

"It's a sustained kind of feeling. It's not something where you feel like you're really high and then go down. It's more like you come up and you stay there for a while."

Daily Dosing Recommendations

• Morning dose: Around 7-8 AM
• Second dose (if needed): Around 12-1 PM
• Avoid late afternoon/evening: Some people experience difficulty sleeping

Interestingly, some patients actually take it before bed because it helps them sleep better—sleep is metabolically active, and mitochondrial support can enhance sleep quality.

The "Rearview Mirror Effect"

Unlike stimulants that give you an immediate "I'm on something" feeling, methylene blue often works more subtly:

"It's more like a rearview mirror effect, which is like after the day's gone, you're like, 'Oh, wow. I had a better day today than I would typically if I hadn't taken the methylene blue.'"

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7. Dosage Accumulation and Breaks

When Does It Build Up?

At doses below 80-100mg per day, methylene blue clears the system within 24 hours (assuming normal kidney function). Above this threshold, accumulation becomes a concern.

At very high doses, methylene blue can actually cause conditions it treats at lower doses—like methemoglobinemia.

Break Recommendations

"It's pretty rare that I have people on those higher doses for longer periods of time."

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8. The Vitamin C Question: Blue Bottle Experiment

Redux Cycling Explained

Methylene blue is a redux cycler—it can both accept and donate electrons. This is how it works in the mitochondria:

• Oxidized form (blue) = Can accept electrons
• Reduced form (colorless) = Can donate electrons

What Happens with Vitamin C?

Vitamin C is an antioxidant that donates electrons. When combined with methylene blue, vitamin C donates electrons to the methylene blue, changing it from blue to colorless. This is called the "blue bottle experiment."

Is this good or bad? Dr. Sherr's perspective:

"My general sense and clinical experience over the years is that it seems to be better if you use methylene blue as a blue compound and then allow it to do its thing in the body and take vitamin C separately."

The reasoning: most people need more mitochondrial cleanup initially than energy production. If methylene blue arrives already reduced (colorless), it can't act as an antioxidant directly.

Recommendation: Take antioxidants and methylene blue at separate times—a couple hours apart.

Practical Tip: Cleaning Up Spills 🧹

"I have buffered vitamin C at my house because if it gets on a surface, you can scrub it out of the surface very very quickly."

Dr. Sherr admits to saving his marriage a couple times this way after getting methylene blue on sinks, washing machines, and floors!

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9. The Liquid Methylene Blue Problem

Dr. Sherr has strong opinions about liquid methylene blue products:

Problems with liquids:

1. Messy - Gets everywhere
2. Difficult to dose accurately - Droppers vary, bottles vary
3. Potency issues - Often about half of what's claimed on the label
4. Quality concerns - Contamination with heavy metals common

"One of my biggest pet peeves is that somebody tells me, 'Hey, doc, I've been taking methylene blue and it's made me feel terrible.' I'm like, 'Well, what are you taking? I'm taking liquid.' 'Well, how much are you taking?' 'I'm taking 10 drops twice a day.' I'm like, 'Well, how much is that in milligram dosing?' 'I don't know. I'm just taking drops, right?'"

For precision dosing, troches (dissolvable lozenges) that can be cut into quarters or halves provide much better accuracy.

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10. Understanding Mitochondrial Dysfunction

A Quick Biochemistry Lesson 🔬

Dr. Sherr's ninth-grade daughter just finished studying oxidative phosphorylation, so he keeps this accessible:

Mitochondria are the engines of our cells, producing about 150 pounds of ATP (energy currency) every single day.

Cells with the most mitochondria:

1. Eggs and sperm 🥚 (fertility implications!)
2. Brain 🧠
3. Heart ❤️
4. Liver
5. Musculoskeletal tissue
6. Kidneys

"94% of US adults have mitochondrial dysfunction."

What Causes Mitochondrial Dysfunction?

1. Insulin Resistance High blood sugars create inflammation. More glucose to mitochondria = more energy production = more waste = more antioxidants needed = depletion.

2. The Sympathetic Spiral of Doom 😰 Chronic fight-or-flight mode releases cortisol, epinephrine, and norepinephrine, putting constant stress on mitochondria.

"Most people are living here more of the time than they realize."

3. Environmental Factors

• Toxins
• Infections
• Medications

How the Electron Transport Chain Works

1. Electrons from food (carbs and fats) are carried by NAD and FAD
2. Electrons flow through Complexes 1, 2, 3, and 4
3. This creates a proton gradient
4. Releasing the gradient makes ATP
5. Byproducts: water, carbon dioxide, and reactive oxygen species (free radicals)
6. Oxygen is the final electron acceptor (making structured, deuterium-depleted water)

The problem: Electrons leak, creating reactive oxygen species. As we age, this worsens. Without enough antioxidants, stress builds up.

"We're more like a gasoline powered car than we are an electric car because we make waste products."

Metabolic Health = Mitochondrial Health

"If you're metabolically healthy, it means that you can make energy effectively from the food that you eat and you can then neutralize the stress of making energy in your mitochondria effectively."

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11. How Methylene Blue Works in the Mitochondria

The Dual Mechanism

Methylene blue is unique because it can:

1. Enhance energy production (donating electrons)
2. Support detoxification (accepting electrons as an antioxidant)

"There is no other compounds out there that really do this in the same capacity."

Bypassing Dysfunctional Complexes

The most common sites of mitochondrial dysfunction are Complex 1 and Complex 2—the entry points for electrons from food. If these don't work properly:

"You're not going to make energy effectively. You're not going to feel good."

Methylene blue can bypass these broken complexes, allowing electrons to flow further down the chain. It also:

• Recycles and renews protein complexes
• Replenishes NAD supply (potentially eliminating the need for NAD supplements)

The Electric Car Analogy 🚗⚡

"I like to think of it more like an electric powered car where you have energy going in but there's no exhaust because it works as its own exhaust."

Low doses are key—higher doses create hydrogen peroxide, adding stress the mitochondria may not tolerate.

The Titration Protocol

1. Start at 4mg
2. Stay for 3-5 days, assess how you feel
3. If no effect, increase by 4mg
4. Repeat until you find your effective dose (usually 4-25mg range)
5. If you try going higher and don't see additional benefit, return to your effective dose

"It's important to realize that methylene blue is not one of those things that builds up in your system over time and starts working. It's not like you take it for 30 days and see how it feels."

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12. Does Methylene Blue "Fix" Mitochondria Permanently?

Temporary Support vs. Lasting Change

There's some evidence methylene blue can increase the density of certain mitochondrial complexes, providing lasting benefit. However, Dr. Sherr is realistic:

"This is not for the most part for most people a long-term solution to support mitochondrial function as the only thing that you want to do."

If someone takes methylene blue without addressing underlying issues and then stops, symptoms typically return.

The Gateway Effect

"Think about it as like a gateway into understanding how well your cells are working right now."

Methylene blue can support you while you work on longer-term health optimization:

• Why are you stressed all the time?
• Do you need to leave a toxic relationship?
• Should you sleep in a different room from your snoring spouse?
• Do you need to change jobs?
• How can you activate your parasympathetic nervous system?

"Please don't tell your spouse or partner to calm down. It never works. Believe me, many of you have tried as have I."

Why Antioxidants Alone Aren't Enough

A practitioner friend was on a detox protocol with binders, antioxidants, and sauna—but felt completely washed out. Adding methylene blue changed everything:

"She still had energy production capacity enhancing because she had methylene blue on board. So even if she was getting detoxification, she wasn't getting enough energy support."

The Garbage Collection Analogy 🗑️

"Think about a city where garbage collection stops. The garbage just starts piling up and then starts smelling and then there's animals—that's what's happening in your cells if you don't have enough antioxidant capacity."

But you also need working garbage trucks with fuel (energy production). Methylene blue provides both.

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13. Synergizing Methylene Blue with Red Light Therapy

How It Works

Red light therapy (around 680nm wavelength) and methylene blue both work on Complex 4 of the mitochondria:

• Methylene blue donates electrons
• Red light donates photonic energy

Combined, they create a synergistic boost in ATP production.

Practical Application

Take methylene blue, then 30-60 minutes later use a red light panel or go outside in sunlight (which contains red light). You'll notice:

• Increased energy
• Better focus
• Mental clarity

High-Dose Applications

At antimicrobial doses (1-1.5mg/kg) combined with high-intensity red light lasers (called photodynamic therapy), methylene blue becomes a photosensitizer. This dramatically increases production of hydrogen peroxide, hydroxyl radicals, and singlet oxygen—which are:

• Antimicrobial
• Anti-cancer

Some clinics outside the US are using intratumoral lasers (lasers placed inside tumors) combined with methylene blue, seeing fantastic results.

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14. Other Beneficial Combinations

Co-factors for Energy Metabolism

• B vitamins
• Minerals
• Antioxidants (taken at separate times)

NAD and Its Precursors

Some people combine methylene blue with NAD, but Dr. Sherr doesn't think it's necessary:

"I usually use vitamin B3 specifically which turns into niacin and then that'll help regulate your NAD supply. I don't usually give direct NAD."

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15. Methylene Blue and Nitric Oxide: The Full Story

Two Types of Nitric Oxide

1. Endogenous Nitric Oxide

• Released in vascular walls and mitochondria
• Keeps cardiovascular system healthy
• Helps with energy production in mitochondria and brain

2. Inducible Nitric Oxide

• Released during infection, inflammation, and severe stress
• Causes pain, inflammation, and low blood pressure
• Often dysregulated in conditions like POTS (Postural Orthostatic Tachycardia Syndrome)

How Methylene Blue Affects Each Type

All doses of methylene blue neutralize inducible nitric oxide—this is a good thing:

"Less inducible nitric oxide around, you have less pain, less inflammation, less low blood pressure."

Higher doses (above 50-70mg, especially approaching 2mg/kg) may affect endogenous nitric oxide supply.

When to Supplement with Nitric Oxide

"The major studies out there really don't show any major effect on endogenous supply until you get to about 2 milligrams per kilogram orally."

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16. The Blue Brain Myth vs. Reality

What Actually Happened

A paper circulated in mid-2025 showing autopsies with blue brains, claiming methylene blue users would have blue brains. The reality:

"These patients were getting very very high doses of IV methylene blue as a rescue agent, a last-ditch agent to try to save their life."

These were patients in septic shock or cardiopulmonary arrest who received around 300mg of methylene blue IV over 3-4 hours—and then died. The autopsies were performed just hours later.

Would the Blue Have Disappeared?

"Yes, in my opinion is that if they had lived, their brains would not have been stained blue. It would have come out as all methylene blue does out of the urine in the kidneys no problem."

At normal doses (4-25mg, even up to 200mg), your brain redux cycles the methylene blue (blue → colorless → blue → colorless) until it's eliminated through urine.

The Real Clinical Picture

Dr. Sherr uses up to 150mg (2mg/kg) for 3-5 days for acute infections, injuries, and even traumatic brain injuries. All his patients keep higher doses in their medicine cabinet for emergencies.

"Nobody has to worry about getting or having a blue brain when you're taking methylene blue, especially at doses that we're talking about here."

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17. Serotonin Syndrome: Separating Fact from Fear

The Claim

Some critics argue that methylene blue only works because it increases serotonin, and combining it with SSRIs causes dangerous serotonin syndrome.

The Reality About Serotonin Syndrome

Serotonin syndrome does exist and involves hemodynamic instability (blood pressure and heart rate going haywire). It can be dangerous, even deadly. However:

"If you ask a room full of doctors that have been in clinical practice for 20 years, how many have seen serotonin syndrome? Maybe one or two will raise their hands and one of those people will actually not have seen serotonin syndrome."

It's extremely rare and has only been described with IV methylene blue, not oral.

Real Concerns for SSRI/SNRI Users

Rather than serotonin syndrome, Dr. Sherr watches for:

• GI distress/diarrhea (95% of serotonin is made in the gut!)
• Headaches (slightly higher risk when starting)
• Blood pressure increases (especially if already on antihypertensives)

"If you have high blood pressure on its own or if you have high blood pressure on SSRI, you should definitely work with a provider."

The Bigger Picture on Depression

Dr. Sherr gets passionate here:

"The serotonin is not the cause of depression. If you have low serotonin levels, that's not correlated to depression. People with depression have no lower levels of serotonin than anybody else."

Many integrative psychiatrists are now weaning patients off SSRIs and using methylene blue instead—not just for serotonin but for mitochondrial support, which addresses the root cause of many mental health disorders.

"There's even more of a correlation with depression with GABA levels than there are with serotonin levels."

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18. Special Populations and Considerations

Children 👶

"Most children shouldn't need methylene blue."

Children are generally more mitochondrially optimized and more resilient. When they do have issues (attention, hyperactivity, neurodevelopmental challenges), some practitioners use methylene blue with significant benefits—but always under supervision.

Once through puberty, adolescents have essentially adult physiology and can benefit the same way adults do.

Pregnancy and Breastfeeding 🤰

Methylene blue is contraindicated during pregnancy and breastfeeding. However, Dr. Sherr has an interesting theory about fertility:

"Could methylene blue come in and potentially be a support for mitochondrial function in the eggs themselves and help with fertility rates?"

He's working with fertility doctors to explore this, but recommends stopping methylene blue 48-72 hours before conception just to be safe.

Kidney Function 🫘

Methylene blue is excreted through the kidneys, so:

• Dialysis patients: Cannot use methylene blue
• Chronic kidney disease: May be able to use it, but methylene blue will stay in the system longer as kidney function declines

Dr. Sherr theorizes methylene blue might actually help kidney function over time through mitochondrial support, but this hasn't been substantiated yet.

High Blood Pressure

People with high blood pressure or prehypertension may see blood pressure increases with methylene blue due to:

• Potential inducible nitric oxide effects
• Increased norepinephrine

This is dose-dependent. Work closely with a provider and monitor blood pressure.

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19. Addressing the "Healthy Mitochondria" Objection

The Claim

Some researchers argue you shouldn't take methylene blue if you have healthy mitochondria because it will cause dysfunction.

The Evidence

This claim comes from animal studies using 4-5mg/kg—enormous doses with no clinical relevance. In those studies:

• Animals with induced strokes showed significant benefit from methylene blue
• Normal brain areas showed some mitochondrial stress

Clinical Reality

"94% of US adults have some element of mitochondrial dysfunction. So, it's very unlikely that you have optimized mitochondria to start off with."

For the 6% who are optimized, Dr. Sherr uses methylene blue periodically during:

• Travel
• High stress periods
• Endurance racing
• High cognitive load
• Illness in the household

A friend tracks his recovery with Oura ring and Whoop:

"His capacity to recover is better at a higher heart rate than it was before. He actually can maintain energy production at a higher capacity for longer."

At doses of 4-25mg, there's no clinical evidence of harm in people with healthy mitochondria.

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20. Methylene Blue and Fasting

Does It Break a Fast?

No. Methylene blue will work without food—just slightly slower absorption.

Enhanced Fasting Benefits

"It's going to help with the cleanup. It's going to clean you up faster."

Methylene blue during fasting:

• Helps tolerate fasting better
• Gets you into ketosis faster
• Supports energy metabolism and detoxification

Many people Dr. Sherr knows use methylene blue specifically during fasts to enhance their results.

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21. Final Thoughts: Is Methylene Blue Right for You?

Dr. Sherr's closing message for anyone on the fence:

"It's one of those things where once you start taking it, you will realize that you probably needed it all along."

Signs You Might Benefit

• Afternoons aren't as good as they used to be
• You're yelling at your kids and don't know why
• Recovery from the gym isn't what it was
• Airplane travel takes days to recover from instead of one day
• You're drinking more coffee than you used to
• Brain fog has been slowly building
• You want that extra edge for athletic performance

The Gateway to Optimization

"Think about it as like a gateway into understanding how well your cells are working right now."

If low-dose methylene blue makes a dramatic difference, that's information—it tells you there's more capacity to unlock through health optimization.

Quality Matters ⚠️

"Get good stuff. If you're not getting good stuff, you might be getting contamination with heavy metals. You might be getting less than you think you are. You might be making a huge mess in the process."

Red flags for questionable products:

• Liquid form from unknown Amazon sellers
• Ships from "United States" but takes 3 weeks through customs
• No third-party testing verification

Troscriptions tests their certificates of analysis from manufacturers again with an independent lab before use—a rare practice in the supplement industry.

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Conclusion

Methylene blue represents one of the most fascinating compounds in modern biohacking—a 150-year-old molecule with applications ranging from fish tank care to emergency medicine to daily mitochondrial support. The key takeaways:

1. 94% of adults have mitochondrial dysfunction—most people can benefit
2. Low doses (4-25mg) support energy and detoxification without antimicrobial effects
3. Higher doses (50-100mg+) have antimicrobial properties but require more caution
4. Quality matters enormously—avoid cheap liquids and test for heavy metals
5. It's not a permanent fix—use it while working on underlying health optimization
6. Synergies exist with red light therapy, proper co-factors, and fasting protocols

As Dr. Sherr emphasizes, the goal is to separate signal from noise. The signal is clear: for most people dealing with the modern epidemic of mitochondrial stress, properly-dosed, high-quality methylene blue can be a powerful tool for reclaiming energy, focus, and vitality.