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Health Benefits and Risks of Methylene Blue in Medicine

Updated on April 27, 2016
AliciaC profile image

Linda Crampton is a teacher with a first class honors degree in biology. She writes about human biology and the scientific basis of disease.

Reflections in a flask of methylene blue
Reflections in a flask of methylene blue | Source

What is Methylene Blue?

Methylene blue is a dark green powder with important medical and biological uses. When it’s dissolved in water it forms a beautiful blue solution. It's a popular stain in biology labs because it makes the nucleus of a cell visible. It's also used as a dye in medical tests and during surgery because it colors body fluids and tissues, making them easy to see.

Methylene blue is a medicine as well as a dye. It was the first synthetic drug to be created and was originally used as a malaria treatment. Today it's used to treat a blood disorder called methemoglobinemia and neural problems resulting from treatment by ifosfamide, a chemotherapy drug. In addition, methylene blue is a weak antiseptic and helps to treat urinary tract infections. Research suggests that it may also be a useful medication for other health problems.

This is methylene blue powder. On the right, the green powder has dissolved in water drops and become a blue solution.
This is methylene blue powder. On the right, the green powder has dissolved in water drops and become a blue solution. | Source

Methylene Blue - A Biological Stain and a Medical Dye

The green methylene blue powder is actually methylene blue chloride (or more technically, methylthioninium chloride). When this compound is added to water, it breaks up into the positive methylene blue ion, which has a blue color, and the negative chloride ion, which is colorless.

The positive methylene blue ions are attracted to negative particles, such as the nucleic acids (DNA and RNA) in the nuclei of cells. They bind to the nucleic acids and stain them blue, making them more visible than their background.

Methylene blue solutions range from light blue to dark blue in color, depending on their concentration. Concentration is an important topic when considering methylene blue, not only with respect to its ability to act as a biological stain but also with respect to its safety as a medicine.

Methylene blue's ability to color parts of cells is helpful in certain medical tests. The dye gives doctors an improved view of body tissues. Fortunately, doctors are becoming more aware of the fact that methylene blue placed in the body as a dye may also have other effects.

Structure of a methylene blue ion
Structure of a methylene blue ion | Source

Three Blue Biological Stains

New methylene blue and methyl blue are also biological stains. They are not the same chemical as methylene blue, despite their similar names.

Human Cheek Cells Stained With Methylene Blue

Methemoglobinemia

Methylene blue treats health problems as well as acting as a dye. For example, it's very useful for clearing excess methemoglobin from a person's bloodstream. Methemoglobin is a chemically altered form of hemoglobin, the red pigment in our blood that transports oxygen from the lungs to our cells. An excessive amount of methemoglobin in the blood has serious consequences. Unlike normal hemoglobin, methemoglobin can't transport oxygen effectively. Our cells can't survive without the oxygen supplied by hemoglobin.

Methemoglobinemia is a potentially dangerous disorder in which the blood contains a higher amount of methemoglobin than normal. Methemoglobinemia may be inherited, but it's more often acquired during life. Taking certain medications and eating too many foods containing nitrates or nitrites can cause the disorder. In mild cases of methemoglobinemia, the body can heal itself if the trigger for the disorder is avoided. In more serious cases, medical help is needed.

Benzocaine, Methemoglobinemia and Methylene Blue

Benzocaine in Teething Gel and Methemoglobinemia

One cause of acquired methemoglobinemia is giving a baby a large amount of a teething gel containing benzocaine. Benzocaine is a local anesthetic that relieves gum and mouth pain. Rarely, the benzocaine triggers excess methemoglobin production. As the methemoglobin builds up in a baby's blood, the blood may turn brown and the skin may turn grey or blue (cyanosis). Additional symptoms may included shortness of breath and a rapid heartbeat. The condition is a medical emergency.

According to the FDA, the condition most often occurs in children younger than two years of age. It may occasionally affect people of other ages, including adults, though. Adults may report that they have a headache and feel light-headed in addition to having other symptoms.

Thankfully, methemoglobinemia caused by benzocaine is rare. A dilute solution of methylene blue is administered intravenously to the patient, which lowers the methemoglobin level.

Ifosfamide Neurotoxicity

Ifosfamide is a very helpful chemotherapy drug for a variety of cancer types. Unfortunately, like other powerful drugs it can cause side effects. Doctors can help to minimize or eliminate any side effects that develop.

One of the less common side effects of ifosfamide treatment is toxicity to the cental nervous system, causing a brain dysfunction known as encephalopathy. This may result in problems such as confusion, blurred vision, hallucinations and seizures. The administration of a methylene blue infusion may be a helpful treatment for the neurotoxicity.

Multiple white blood cells  in the urine of someone suffering from a urinary tract infection
Multiple white blood cells in the urine of someone suffering from a urinary tract infection | Source

Urinary Tract Infections

Methylene blue isn't a strong enough antimicrobial to fight a urinary tract infection on its own, but it's helpful when combined with other drugs, such as an antibiotic or other antibacterial medications. Methylene blue is sometimes sold under the brand name of Urolene Blue when it's used as a medicine.

Methylene blue shouldn't be given to people with kidney problems because they may have trouble excreting it in the urine. This means that the methylene blue stays in their body for longer than normal.

Psoriasis
Psoriasis | Source

Some Other Possible Uses for Methylene Blue

Other uses of methylene blue are being investigated. Some experiments have been done with isolated human cells or with mice. While the results of these experiments are intriguing, they may or may not apply to the human body.

  • Malaria: Methylene blue was once used to fight malaria. It is an effective treatment, but it hasn't been popular as a preventative medicine due to its ability to color the urine and the whites of the eyes. Researchers are now testing medications that contain methylene blue combined with another drug.
  • Cancer: When certain isolated cancer cells are treated with methylene blue and then exposed to light, the cells die. Methylene blue treatment followed by light treatment has also destroyed tumors transplanted into mice and placed under their skin. The observations are interesting, but they don't necessarily mean that methylene blue can be used to treat human cancer. More research is needed.
  • Psoriasis: Methylene blue has also been successfully used as a photosensitizer in the treatment of psoriasis. The process of sensitizing cells to light exposure with a chemical and then shining light on the cells to treat a health problem is known as photodynamic therapy, or PDT.
  • Alzheimer's Disease: In this disease, plaques made of a protein called beta amyloid build up between nerve cells and tangles of a protein called tau build up within the nerve cells. Preliminary research indicates that at certain doses methylene blue can prevent tau aggregations in mice. Methylene blue has also improved memory in mice and seems to improve the functioning of the mitochondria. Mitochondria are the cell organelles that produce energy.
  • Cyanide Poisoning and Carbon Monoxide Poisoning: In the past methylene blue has been used to treat both of these problems, but newer treatments are generally used today.

Transmission of a Nerve Impulse Across a Synapse

A synapse (the region where the end of one neuron lies close to the start of the next), showing neurotransmitter molecules traveling across the gap between the neurons and joining to receptors on the second neuron
A synapse (the region where the end of one neuron lies close to the start of the next), showing neurotransmitter molecules traveling across the gap between the neurons and joining to receptors on the second neuron | Source

Methylene Blue - A Potent MAO Inhibitor

An excitatory neurotransmitter is a chemical that transmits signals between nerve cells, or neurons. When a nerve impulse reaches the end of a neuron, neurotransmitter molecules are released from storage sacs, travel across the gap between the neuron and a second neuron and then bind to receptors on the second neuron. This causes the appearance of a nerve impulse in the second neuron.

Neurotransmitters are normally broken down or recycled when they've done their job. Monoamine oxidase enzymes break down specific neurotransmitters in the body, including a neurotransmitter called serotonin.

A monoamine oxidase inhibitor (MAO inhibitor) is a medication that inhibits monoamine oxidase enzymes, allowing neurotransmitters such as serotonin to work for longer and raising their level in the body. MAO inhibitors are used to treat some cases of depression and sometimes other disorders too, such as Parkinson's disease and migraines. The FDA (Food and Drug Administration) says that methylene blue is a "potent" MAO inhibitor.

Functions of Serotonin in the Brain

Serotonin is involved in mood, appetite, sleep, memory and learning. Its exact functions are still being investigated. A low level of serotonin is often said to be linked to depression, but some researchers dispute this idea.

MAO inhibitors are sometimes used to treat migraines.
MAO inhibitors are sometimes used to treat migraines. | Source

Methylene Blue and Serotonin Reuptake Inhibitors

Although methylene blue can certainly be helpful in some situations, in others it can be harmful. For example, when methylene blue is taken with a type of medication called a serotonin reuptake inhibitor, or SRI, serotonin may rise to a dangerous level.

What is an SRI?

Some serotonin is reabsorbed into nerve cells after it has performed its function instead of being broken down. A protein called a serotonin transporter moves the serotonin back into the nerve cells. A serotonin reuptake inhibitor is a medication that blocks the activity of the serotonin transporter. The serotonin therefore continues to act as a neurotransmitter in the tiny space between nerve cells. This can be helpful in diseases that may be caused by a lack of serotonin, including (possibly) some types of depression. More serotonin is beneficial - but only up to a point.

The Combination of Methylene Blue and an SRI

Methylene blue - or any other MAO inhibitor - increases the level of serotonin to a dangerous level in people who are also taking certain SRIs. The resulting condition is known as serotonin syndrome. Some of the symptoms of the syndrome include a rapid heartbeat, high blood pressure, sweating, diarrhea, agitation, confusion and lack of muscle coordination. Serotonin syndrome may sometimes be life threatening.

Broad beans, or fava beans, cause hemolytic anemia in some people with G6PD deficiency.
Broad beans, or fava beans, cause hemolytic anemia in some people with G6PD deficiency. | Source

G6PD Enzyme Deficiency

Glucose-6-phosphate-dehydrogenase, or G6PD, is an important enzyme in the life of a red blood cell. Some people have a genetic problem that prevents them from making enough of this enzyme. As a result, the red blood cells may burst when the person ingests certain chemicals or becomes ill with certain infections. The destruction of the red blood cells is known as hemolytic anemia. Methylene blue is one of the triggers of hemolytic anemia in people with a G6PD deficiency.

G6PD deficiency is sometimes known as favism, but the two conditions aren't quite the same. Favism is a condition in which a person experiences hemolytic anemia in response to eating fava beans (which are also called broad beans). People with favism have a G6PD deficiency. However, not everyone with a G6PD deficiency has a problem when they eat fava beans.

Methylene Blue - Helpful and Potentially Dangerous

Methylene blue is a medical dye and a powerful medication that under some conditions is harmful. It should never be administered as a prank.

Methylene Blue Prank

If methylene blue is ingested in sufficient quantities, it turns the urine and the sclera (the white part of the eyes) blue. It's used in pranks to color an unsuspecting person's urine. However, this can be dangerous for people taking an SRI medication and for people with a G6PD deficiency.

The Royal Society of Chemistry has condemned the use of methylene blue in pranks designed to turn urine blue, not only because this use invades someone's personal space but also because of its potential danger. While a small dose of methylene blue may be safe, someone slipping the powder into food as a joke is unaware of the toxic dose or of hidden medical problems or medications in their victim.

Methylene blue is widely used as a biological stain in schools as well as professional laboratories and is a familiar substance for many science students. They may not realize that it can have potent effects in the body.

This is a slide of Clostridium septicum stained with methylene blue. The bacterium lives in our gut and can sometimes cause disease.
This is a slide of Clostridium septicum stained with methylene blue. The bacterium lives in our gut and can sometimes cause disease. | Source

A Versatile Chemical

Methylene blue is very useful in certain medical settings and has important health benefits. It's a powerful chemical that has far more profound effects on our body than simply coloring tissues. It may have even more benefits in the future as scientists learn more about its behavior and discover additional ways to manage methylene blue as a medication. More research is needed, however, especially as methylene blue seems to affect many different molecules and systems in our bodies.

© 2013 Linda Crampton

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    • aviannovice profile image

      Deb Hirt 4 years ago from Stillwater, OK

      This sounds like it could be very good, as well as very bad. You certainly provide great information, thanks.

    • Austinstar profile image

      Austinstar 4 years ago from Somewhere in the universe

      I've used methylene blue for many years in the lab and never thought to wonder about its health benefits. Than you for this enlightening hub!

    • AliciaC profile image
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      Linda Crampton 4 years ago from British Columbia, Canada

      Hi, Deb. Yes, methylene blue does have a dual nature! It's a very interesting substance. Thanks for the comment.

    • AliciaC profile image
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      Linda Crampton 4 years ago from British Columbia, Canada

      Hi, Austinstar. I use methylene blue a lot in the science classes that I teach. It is interesting to think that such a common substance in labs can be used as a medication! Thanks for the visit.

    • unknown spy profile image

      IAmForbidden 4 years ago from Neverland - where children never grow up.

      oh those lab days when we use methylene blue in biology class.. thanks for sharing this useful info.

    • AliciaC profile image
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      Linda Crampton 4 years ago from British Columbia, Canada

      Thank you, unknown spy. I appreciate your visit.

    • drbj profile image

      drbj and sherry 4 years ago from south Florida

      Methylene blue is a fascinating substance, Alicia. Thanks for enlarging my knowledge of both its benefits and its risks.

    • AliciaC profile image
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      Linda Crampton 4 years ago from British Columbia, Canada

      Thank you, drbj. I agree - methylene blue is very interesting!

    • Mama Kim 8 profile image

      Sasha Kim 4 years ago

      I knew Nothing about methylene blue before reading this! What an interesting hub. Thank you for the entertaining read. voting up and useful!

    • AliciaC profile image
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      Linda Crampton 4 years ago from British Columbia, Canada

      Thank you for the visit, Sasha! I appreciate your comment and votes.

    • leahlefler profile image

      leahlefler 4 years ago from Western New York

      Methylene Blue is very useful - I used to use in in my university days (cell bio lab). It was also used as a treatment for the "blue people" of Kentucky, who carry a genetic form of methemoglobinemia. There aren't many "blue people" left (as the population is no longer isolated and consanguineous marriages have ended), but the people were grateful for a treatment to their oddly tinged blue skin!

    • AliciaC profile image
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      Linda Crampton 4 years ago from British Columbia, Canada

      Thanks for the visit and for sharing the very interesting information, leahlefler!

    • teaches12345 profile image

      Dianna Mendez 4 years ago

      Thanks for the interesting educaiton on this drug. I can see how much potential it has to help those with different needs, but also the warnings in usage. Always learn something new when I read your posts.

    • AliciaC profile image
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      Linda Crampton 4 years ago from British Columbia, Canada

      Thanks for the visit, Dianna. Yes, methylene blue does have the ability to be very helpful, as well as harmful!

    • GoodLady profile image

      Penelope Hart 3 years ago from Rome, Italy

      Congratulations on another super duper, fascinating, interesting great Hub. Learned so much and find the uses of this dark green powder. sharing and voting and posting on Pin it too.

      Well done Alicia.

    • Toytasting profile image

      Toy Tasting 3 years ago from Mumbai

      Alicia, this was an awesome read, Thank you so much for making me aware about the benefits and risks of methylene blue.

      Congratulations on HOTD. Well desereved!

    • AliciaC profile image
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      Linda Crampton 3 years ago from British Columbia, Canada

      Thank you so much for such a lovely comment, GoodLady! I very much much appreciate the vote, the share and the pin, too.

    • AliciaC profile image
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      Linda Crampton 3 years ago from British Columbia, Canada

      Thank you very much for the comment, Toytasting. It's nice to meet you!

    • vandynegl profile image

      vandynegl 3 years ago from Ohio Valley

      Amazing and useful information! Thank you for writing about this!

    • AliciaC profile image
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      Linda Crampton 3 years ago from British Columbia, Canada

      Thank you for the visit and comment, vandynegi!

    • whonunuwho profile image

      whonunuwho 3 years ago from United States

      I have an allergy to iodine with some contrasts, and I wonder if this blue formula might be more suitable. Thanks for this interesting work, my friend.

    • pinto2011 profile image

      Subhas 3 years ago from New Delhi, India

      Even being in the medical field I caught a few of its benefits through your hub. A very nice and neatly written hub.

    • AliciaC profile image
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      Linda Crampton 3 years ago from British Columbia, Canada

      That's an interesting thought, whounuwho. Thanks for the comment!

    • AliciaC profile image
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      Linda Crampton 3 years ago from British Columbia, Canada

      Thank you, pinto2011. I appreciate your comment.

    • creativelycc profile image

      Carrie L. Cronkite 3 years ago from Maine

      Very interesting facts and a great educational hub!

    • AliciaC profile image
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      Linda Crampton 3 years ago from British Columbia, Canada

      Hi, creativelycc! Thanks for the comment.

    • Shaddie profile image

      Shaddie 3 years ago from Washington state

      When you go into pet stores and see Betta fish stored in those small cups full of blue water, that water contains Methylene Blue! Cool Hub :) I didn't know it was used in so many other things.

    • anatomynotes profile image

      Edmund Custers 3 years ago

      I have heard about dyes used to stain bacteria and other prokaryotes before viewing them under the microscope. So I guess methylene blue may be one of those dyes. Thanks for sharing this. I certainly learned something.

    • AliciaC profile image
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      Linda Crampton 3 years ago from British Columbia, Canada

      Thanks for the comment, Shaddie. It's interesting that methylene blue has so many uses!

    • AliciaC profile image
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      Linda Crampton 3 years ago from British Columbia, Canada

      Thanks for the visit, anatomynotes. Yes, methylene blue is a biological stain. It's a useful substance in a lab!

    • StephSev108 profile image

      Stephanie Marie Severson 3 years ago from Atlanta, GA

      Very interesting Hub! Congrats on HOTD!

    • AliciaC profile image
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      Linda Crampton 3 years ago from British Columbia, Canada

      Thank you for the comment and the congratulations, StephSev108!

    • rebeccamealey profile image

      Rebecca Mealey 3 years ago from Northeastern Georgia, USA

      Wow, this was really interesting, although a bit over my head. Good job, AliciaC, and congratulations!

    • AliciaC profile image
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      Linda Crampton 3 years ago from British Columbia, Canada

      Thank you, Rebecca. I appreciate the congratulations!

    • RTalloni profile image

      RTalloni 3 years ago from the short journey

      Congrats on your Hub of the Day award for an interesting read!

    • AliciaC profile image
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      Linda Crampton 3 years ago from British Columbia, Canada

      Thank you very much, RTalloni!

    • Scribenet profile image

      Scribenet 3 years ago from Ontario, Canada

      I too have only used methylene blue as an indicator in the lab and never really knew of all it's other uses. Great, informative hub.

    • AliciaC profile image
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      Linda Crampton 3 years ago from British Columbia, Canada

      Thanks for the comment, Scribenet. I appreciate it. Methylene blue is a certainly a versatile substance!

    • KawikaChann profile image

      KawikaChann 3 years ago from Northwest, Hawaii, Anykine place

      AliciaC your hub is chocked full of information. Thanks for a great read, and congrats on HOD!! Awesome job. Peace. Kawi.

    • AliciaC profile image
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      Linda Crampton 3 years ago from British Columbia, Canada

      Thank you very much, Kawi! I appreciate your kind comment and the congratulations.

    • Tom Schumacher profile image

      Tom Schumacher 3 years ago from Huntington Beach, CA

      Congratulations on the "Hub of the Day!" Until now I had never heard of Methylene Blue. It was very interesting to learn about its uses, including practical jokes. However, based on what I read it also sounds potentially dangerous if administered without proper medical supervision. Congrats again! Voted up.

    • AliciaC profile image
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      Linda Crampton 3 years ago from British Columbia, Canada

      Thanks for the comment, the vote and the congratulations, Tom. Yes, methylene blue could be dangerous in some circumstances!

    • MelonieGilchrist profile image

      Gamrgurl 3 years ago

      Interesting information on something I previously knew nothing about. Thanks.

    • AliciaC profile image
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      Linda Crampton 3 years ago from British Columbia, Canada

      Thank you very much for the visit and the comment, Melonie..

    • DDE profile image

      Devika Primić 3 years ago from Dubrovnik, Croatia

      Methylene Blue Uses in Medicine - Health Benefits and Risks another of your great hubs as usual you just know how to catch your reader's eye, well achieved.

    • AliciaC profile image
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      Linda Crampton 3 years ago from British Columbia, Canada

      Thank you for all the comments, DDE. I appreciate them!

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