Methylene Blue
Why an old medication has made a resurgence for brain health
It’s 2025 and I have one goal: to push the limits of how good I can possibly feel this year. Maybe that sounds ambitious, but I’ve (pretty much) checked the boxes of diet, exercise, sleep…so now I’m wondering what else is out there. The world of healthspan optimization is blossoming into a buzzword, so I thought I’d put my money where my mouth is and try something new: a nootropic. A nootropic is just a fancy word for something that improves brain health, something that makes you sharper, more focused, more energized.
Methylene blue is the first nootropic I’ve tried, and I wanted to share the science with you, as well as my personal experience.
If you’re in healthcare, methylene blue will be familiar to you. Way back in the day, it was the original antibiotic to treat malaria and urinary tract infections before we had actual antibiotics. Even now, we use it through patients’ IVs to treat cyanide and carbon monoxide poisoning, to raise heart rate and blood pressure, and to stain the patient’s urine blue during any surgery that involves visualizing a ureter.
What we didn’t know before that we know now is that methylene blue is “hormetic,” meaning that at the high doses we use in the hospital it can be toxic, but at lower doses, it be very beneficial. And fortunately, we don’t need an IV to give methylene blue. It’s very orally bioavailable, meaning that about 80-90% of the methylene blue taken by mouth is actually absorbed into the bloodstream.
How does methylene blue work?
Methylene blue acts as a redox molecule. This means that it can accept and donate electrons in the electron transport chain in the inner membrane of the mitochondria. Wait – don’t stop reading yet! – the point is that our mitochondria produce energy, and their numbers decrease as we get older. So when methylene blue comes in to support mitochondrial energy production, we feel better. We make more energy, and we have fewer reactive oxygen species around to damage our cells.
The beauty of methylene blue specifically for cognition is that it crosses the blood brain barrier. It can easily get into the brain and support our energy production there, which is responsible for its nootropic effects.
Who benefits from methylene blue?
For the average Joe like me, anyone looking to enhance cognitive performance can benefit. Methylene blue is notable for sharpening concentration, focus, mental acuity, and even enhancing overall feelings of wellbeing and mood. It is showing promise in the realms of Alzheimer’s, Parkinson’s, and traumatic brain injury, and even for ADHD. So overall, it seems to be neuroprotective at low doses (we’ll get to that next). But in my personal experience, I noticed the cognitive benefits immediately: I had less brain fog, more motivation, and overall just felt sharper.
Dosing
Methylene blue is a prescription medication that is usually sourced from a compounding pharmacy. Make sure it is pharmaceutical grade (in other words, get it from a doctor, NOT from the internet) because it it is also used as a commercial dye and needs to be purified of heavy metals for human use.
As for dosing, this is not medical advice, so talk to your doctor before starting any dose of any medication. But the doses are LOW! Much lower than is typically given in the hospital setting. A typical regimen would be to start an oral dose of methylene blue somewhere around 5 mg daily for 4-5 days per week. Then you can work up to a 10 mg per day dose for 4-5 days per week. Most of the Alzheimer’s literature is using around 15 mg per day, however that dose is not usually necessary for most of us.
At doses higher than 30 mg per day, methylene blue starts to exert antibiotic effects and can impair the gut microbiome. It’s also recommended to take a break for a few weeks after every month or two just to clear it from your system.
Contraindications to Methylene Blue
The biggest contraindication to methylene blue is a genetic condition called G6PD deficiency. There is a blood test to see if you have this condition, but it is most common in people of Mediterranean and African American ancestry. These people lack a certain protein (enzyme) and can be at risk for hemolytic anemia (the breakdown of red blood cells) at high doses of methylene blue.
Other contraindications include:
Patients taking SSRI’s or MAOI’s – because methylene blue can increase serotonin
Patients with high blood pressure or heart disease – because methylene blue can increase heart rate and blood pressure
Patients taking dapsone
Renal insufficiency
Pregnancy and breastfeeding
Side Effects
Methylene blue can turn your urine an interesting aqua color, and it will stain everything it touches, including your tongue or countertop. It will also increase your blood pressure and heart rate, so it’s recommended that you take it after a morning workout. It’s also a mild stimulant, so it can interfere with your sleep if you take it too late in the day.
At any rate, I have really enjoyed the enhanced mental acuity I’ve experienced while taking methylene blue. I’m pretty sure it makes me more likely to write things that sound smart, like “enhanced mental acuity.” Either way, I have experienced a notable effect, and I would recommend that anyone who is interested consult your physician about it.
In good health,
Gina