#365 Supercharge Your Cells with Methylene Blue featuring Dr. Scott Sherr, MD

This week on The Less Stressed Life Podcast, I had the pleasure of chatting with the brilliant Dr. Scott Sherr, who’s here to give us the lowdown on a little-known powerhouse called methylene blue. This isn’t your average health talk—Dr. Sherr dives into how this vibrant blue compound can supercharge your cells, boost your energy, and even support fertility!

We’re covering everything from the science behind methylene blue to its amazing benefits for chronic conditions like fatigue, long COVID, and mold toxicity. If you’ve been curious about how to optimize your mitochondria and up your energy game, this episode is packed with juicy details you don’t want to miss. Plus, we get into the nitty-gritty of why dosing matters and how to make methylene blue work for you.

KEY TAKEAWAYS:

• What is methylene blue & where does it come from?
• How methylene blue boosts mitochondrial energy & resilience
• Optimal dosing is crucial—too much can cause oxidative stress. 
• Long-term, high doses may affect gut flora, so monitor and adjust as needed
• Safe for most but watch with high blood pressure
• Effective for chronic issues like Lyme and mold illness 

!! For a discount on Troscriptions Methylene Blue use code LESSSTRESSED
at troscriptions.com

ABOUT GUEST:
Dr. Scott Sherr is a Board Certified Internal Medicine Physician specializing in Health Optimization Medicine (HOMe) and Hyperbaric Oxygen Therapy (HBOT). As the COO of Troscriptions, he develops physician-formulated buccal troches for energy, focus, sleep, and more. He also leads Health Optimization Medicine and Practice (HOMe/HOPe), a nonprofit that trains practitioners in health optimization. Dr. Sherr's clinical practice integrates HOMe principles with advanced HBOT protocols, comprehensive lab testing, and targeted supplementation. 

WHERE TO FIND:
Website: https://hbot.plus/integrativehbot
Instagram: https://www.instagram.com/drscottsherr/
Website: https://troscriptions.com/
Instagram: https://www.instagram.com/troscriptions/
Nonprofit: https://homehope.org/

WHERE TO FIND CHRISTA:
Website: https://www.christabiegler.com/
Instagram: @anti.inflammatory.nutritionist
Podcast Instagram: @lessstressedlife
YouTube: https://www.youtube.com/@lessstressedlife

EPISODE SPONSOR:
A huge shoutout to Jigsaw Health for sponsoring this episode! Grab a discount on any of their fantastic products. Use the code lessstressed10

Transcript

[00:00:00] Scott Sherr, MD: So there's different spectrums of dosing for methylene blue on the lower doses.

[00:00:04] Scott Sherr, MD: You're getting this mitochondrial redox, you're getting the energy and detox. But as you increase the dose, you can compensate for more significant potential mitochondrial dysfunction.

[00:00:14] Christa Biegler, RD: I'm your host, Christa Biegler, and I'm going to guess we have at least one thing in common that we're both in pursuit of a less stressed life. On this show, I'll be interviewing experts and sharing clinical pearls from my years of practice to support high performing health savvy women in pursuit of abundance and a less stressed life.

[00:00:44] Christa Biegler, RD: One of my beliefs is that we always have options for getting the results we want. So let's see what's out there together.

[00:01:02] Christa Biegler, RD: Today on The Less Stressed Life, I have Dr. Scott Sherr, who is a board certified internal medicine physician certified to practice health optimization medicine and a specialist in hyperbaric oxygen therapy. He is the COO of Troscriptions, a line of physician formulated pharmaceutical grade and precision dosed buccal troches containing novel ingredients like methylene blue agarin and others in formulas for energy focus, sleep, stress, immune support, and more.

[00:01:27] Christa Biegler, RD: These are all my literal favorite topics. So I told him off air there's probably more than one podcast episode here because we need a tangent on hyperbaric oxygen therapy another day. But today we are talking about methylene blue, which is Maybe one of the sexy things of the last couple of years. So welcome to the show, Dr.

[00:01:48] Christa Biegler, RD: Scott. 

[00:01:48] Scott Sherr, MD: So 

[00:01:49] Christa Biegler, RD: Yeah. 

[00:01:50] Scott Sherr, MD: It's very blue. Yes. 

[00:01:51] Scott Sherr, MD: But 

[00:01:51] Scott Sherr, MD: it's, yeah, it's a fantastic topic and I'm excited to dive in with you. 

[00:01:54] Christa Biegler, RD: Yeah. I want to hear about how you got into product development. I especially always enjoy. Stories of how people end up kind of diverging off of their traditional path and how they land in something.

[00:02:08] Christa Biegler, RD: And I do think product development is a different beast, honestly. I don't think you just wake up one morning. You're like, there is this gap in the market. I'm going to do it. I think there's actually a little bit of a mountain to climb there and especially, and I can tell from the delivery systems that there's some real intentionality behind this.

[00:02:24] Christa Biegler, RD: I think that, I think with the. The we've only really covered delivery system here once or twice, like majorly. And so I think there's going to be a conversation for that as well. So just give us a little bit of the background and the story and how you went from being I don't know, maybe an MD practicing to getting into product development and the supplement industry, which is, feels you're a black sheep.

[00:02:45] Scott Sherr, MD: I have a pretty interesting story, I guess my dad's a chiropractor. So I grew up very out of the box and he sells supplements in his office. So they've always been in and around my ecosystem since I was a kid. And so it was always great for him. He'd have people come into the office and have. The ability to immediately give them some supplements that would help them very quickly along the way.

[00:03:05] Scott Sherr, MD: So I grew up very out of the box in the chiropractic framework, which is the body can heal itself if you give it the right tools. And oftentimes pharmaceuticals are not necessary, especially if you're doing more preventative care. So I thought about becoming a chiropractor actually for a little while, but I ended up deciding to go into medical school because I had the high minded idea that I could bridge this huge gap or the chasm between at that point.

[00:03:28] Scott Sherr, MD: There was no such thing as functional medicine. It was just either conventional medicine, or it was. Alternative medicine, there was like no in between. So I always call people like my dad and others in the chiropractic world that, that were like him, although there's very few as intensively crazy as he is in a lot of cool ways.

[00:03:46] Scott Sherr, MD: The, when it comes to functional, integrative medicine, really. And so I had this high minded idea that I could do this product they really weren't in my view at that point. When I went through medical school and residency, I gravitated to our field called hyperbaric oxygen therapy, as you mentioned earlier.

[00:04:02] Scott Sherr, MD: So this is a technology that helps with healing, optimization, performance, et cetera. And so I got into the world of hyperbaric medicine. Then I got into the world of understanding that hyperbaric medicine was a great tool. The chambers were fantastic, but you really needed a foundation to be able to do that.

[00:04:16] Scott Sherr, MD: And so I was initially referring out to people, my friends and colleagues, but then I met a colleague. In 2017 that had started a nonprofit called health optimization, medicine and practice, and this was a nonprofit that was training practitioners still is now on how to optimize health rather than treat disease.

[00:04:33] Scott Sherr, MD: So instead of functional medicine, which focuses on, root causes of illness, the, Framework shift here was that health optimization focuses on the root causes of health and that disease is managed and health is optimized. And those are good slogans. But the idea really is that you're looking at foundational biology, foundational health markers, cellular health, gut health, immune system health, neurotransmitter health, hormones, and then looking at circadian rhythms and toxins in our environment.

[00:04:57] Scott Sherr, MD: And I can go on. But that became the foundation of my clinical practice. And I A lot of that clinical practice became focused on optimizing lifestyle, behavior, and supplementation. And that company health optimization, medicine, and practice, I signed on to be the COO of it. And it's a nonprofit organization.

[00:05:14] Scott Sherr, MD: And that company we decided we need to, we needed to start creating products that can help people right now while they're on the longer path to optimizing their health. What we need help with right now is pretty obvious for many of us is that we need help with our energy. We need help with our focus.

[00:05:28] Scott Sherr, MD: We need help with our sleep. We need help with our anxiety. We'd help with our immune system. And because the path of optimizing our health takes a long time for most people, it's not like it's tomorrow that you feel better. It's a process of what are the things you can do along the way to help? And that's where transcriptions came about.

[00:05:46] Scott Sherr, MD: That's where methylene blue became our first sort of main products that we've developed and that's how we designed and developed the dosage form called the buckle trochee, which is the way we deliver the ingredients in our products. 

[00:06:00] Christa Biegler, RD: Was this all somewhat recent? 

[00:06:03] Scott Sherr, MD: So the nonprofit got started in 2017 and the that's health optimization medicine and practice or home hope for short.

[00:06:11] Scott Sherr, MD: And I'm a faculty over there. We do education for practitioners and licensed and non licensed as well. And then in 2020. A month before the pandemic, released our first product at transcriptions. And that was a focus product called blue canteen, which is a combination of methylene blue with nicotine, caffeine, and CBD, which is like your Adderall without the jitters for about three to five hours of focus without come down or crash.

[00:06:37] Scott Sherr, MD: And these were developed for Our patients for, and then for us personally, who are doing a lot of traveling, a lot of speaking and always needed to be on, et cetera, but wanted something that was going to be more supportive. And that's where nothing really came into play significantly. 

[00:06:51] Christa Biegler, RD: All right. and you were in private practice before it sounds like.

[00:06:54] Christa Biegler, RD: From the beginning, I've done 

[00:06:54] Scott Sherr, MD: a lot of private practice in various ways over the years. I do a lot of consulting on the hyperbaric side. I used to work in various clinics as medical directors. I work with clinics all over the world that are looking to integrate hyperbaric therapy as part of their ecosystem in some way.

[00:07:09] Scott Sherr, MD: And then I have my own concierge medical practice that I do remotely from my town outside of Boulder, where I see patients doing telepractice in the context of the nonprofit and that framework that we use. 

[00:07:21] Christa Biegler, RD: Very fun. Keep it interesting, right? 

[00:07:24] Scott Sherr, MD: I try to. I also have four kids and, three other jobs and I keep it busy.

[00:07:28] Scott Sherr, MD: You're like, 

[00:07:29] Christa Biegler, RD: I think I should put a lid on how many more things I want to say yes to right now. 

[00:07:32] Scott Sherr, MD: I said that four years ago and I've done a pretty good job, but the challenge with it is that since that time, the things that I've committed to four years ago, I've gotten a lot bigger, including transcriptions and my clinical practice and that's all good.

[00:07:45] Scott Sherr, MD: It's all good stuff. I really enjoy what I do. 

[00:07:48] Christa Biegler, RD: That's what happens sometimes. And especially I feel like I don't know this a hundred percent. My bias is I do feel like you're feeling like a novel niche a little bit. Like you're certainly not the only methylene blue provider, but I think your delivery format is a bit interesting.

[00:08:03] Christa Biegler, RD: And I would also say when we were looking for someone on methylene blue, you kept coming up. And what do you do? So of course you're out in this. You're speaking about it. So here we are. I have friends that have developed product lines, one that does a really, also a really novel job.

[00:08:19] Christa Biegler, RD: And I always hear about I used to be very in the know on all of those sort of things that came up. So I'm sure it was really fun to launch right before COVID, but also. Probably worked itself out, gave you really an opportunity to focus on it at that time. And I know, you just told us about your first product.

[00:08:33] Christa Biegler, RD: Is that still a product that you use now? 

[00:08:35] Scott Sherr, MD: Oh, yeah. I'm still, yeah. Yeah. We 

[00:08:37] Scott Sherr, MD: still have, we have six or seven, I think on the market now, but yeah, our focus in the beginning, we were the first product company to develop a consumer facing methylene blue product is what it comes down to, and that was in. Again, in early 2020 before the pandemic, but certainly because of the pandemic, there's a lot more interest in what we were doing because of methylene blue and what it does in the cellular side.

[00:09:01] Scott Sherr, MD: Low doses, high doses has and we'll talk about all that. I'm sure the challenge with methylene blue. It took us actually 9 or 10 months longer to actually release our 1st product because it took us that long to find a clean source of methane blue. The challenge with methylene blue is that it can be contaminated, even USP, even what's called pharmaceutical grade.

[00:09:23] Scott Sherr, MD: Methylene blue can be contaminated. And so it took us a long time to find one that we could really trust. And that's, that's really what it comes down to is that there is a lot of nothing blue on the market now. There wasn't when we first started, we've tested a lot of this other stuff and we're always the best stuff on there.

[00:09:38] Scott Sherr, MD: And we always, and the purity. Number one, and then also potency, the potency in liquid, especially is across the board. But it's not very consistent when you're getting a dropper of methylene blue, as opposed to developing into the way we have, which is in a buckle 

[00:09:52] Scott Sherr, MD: trochee. 

[00:09:53] Christa Biegler, RD: Yeah, cool. All right. So let's pretend someone's coming to this podcast because they're like, I've heard of methylene blue, but I have no freaking idea what it is, what is methylene blue?

[00:10:01] Christa Biegler, RD: What are its other names? And where did it start? 

[00:10:05] Scott Sherr, MD: So methylene blue started as a dye. So it's a textile dye that was developed in the 18, mid 1800s. He used to dye blue jeans blue actually. And they actually realized that the class of dyes that nothing blue belongs to had antimicrobial properties. And this is in South Africa actually.

[00:10:22] Scott Sherr, MD: And in , 1897. It was the first drug registered with the FDA as a pure synthetic ingredient. So this is not a natural compound. And some people don't like that. They're like it's not natural. I don't want to take it, but the dose makes the poison always. And whatever you're taking and synthetic things are, there's a spectrum there along with natural things, of course, as well, if you're foraging mushrooms, you eat the wrong ones, you can end up with liver failure.

[00:10:44] Scott Sherr, MD: So not just because something's natural doesn't mean it's good for you either. Just to throw that out there, because I know some people have a problem with something that's synthetic, but so I think it was the first drug register with the FDA. And the indication was actually from malaria and it, because it was really interesting about it.

[00:10:58] Scott Sherr, MD: And it got this moniker at the time called the magic bullet, because what you could do is you could give very high doses of methylene blue and you could kill off organisms like malaria, but you would the human cells untouched. Or without any challenges or detrimental effect to them. And that was like the Holy Grail for in treatment at the time.

[00:11:18] Scott Sherr, MD: And, really is to some degree now where you can give something that will affect what you want it to affect in this case something like malaria, but it wouldn't have a detrimental effect on the body itself. So it came in that realm and then it was like really the primary antimicrobial around until the 1950s.

[00:11:33] Scott Sherr, MD: So World War II pilots used to have to fly with it in the Pacific theater when they were fighting the war. It was used for urinary tract infections. It was used obviously for malaria and other bugs as well. Antifungal, it's a fantastic antifungal, but in the 1950s, all that, went by the wayside because antibiotics and antimicrobials came around that were prescribed.

[00:11:51] Scott Sherr, MD: And so the main side effect of taking methane blue is that your urine turns blue. And so people didn't like their urine turning blue, and that's why it fell a little bit wide by the wayside, except in the world of aquariums. If you're an aquarium person, you would know that methane blue is used as an anti fungal, as an antiseptic in aquariums and still is now.

[00:12:14] Scott Sherr, MD: And So it was used in that capacity. And then it's also been used over the last, now over 60 or 70 years as a cellular stain. What happens is that you can use methylene blue and I used it in chemistry class back in college because it actually concentrates the methylene blue in certain areas of the cell.

[00:12:30] Scott Sherr, MD: And this is where it becomes interesting. It actually concentrates in areas where you have a part of your cell called your mitochondria. Your mitochondria are your cell. Organelle that help you make energy. And then over the last couple of decades, we now know exactly what's happening in our mitochondria when you give methylene blue.

[00:12:49] Scott Sherr, MD: And there's a spectrum at very low doses. You have certain effects in a very high doses. You have different effects depending on, what you're looking to do. 

[00:12:56] Christa Biegler, RD: Okay. So we'll talk about what happens to mitochondria when you give methylene blue, but before, because it's synthetic, how is it made?

[00:13:03] Christa Biegler, RD: Where does it come from? 

[00:13:04] Christa Biegler, RD: You 

[00:13:05] Christa Biegler, RD: mentioned something about south America, but then you really get synthetic. And so I was expecting it to come from a plant. I have no idea where it comes from. Where does it come from? 

[00:13:13] Scott Sherr, MD: It's a dye that's synthetically manufactured from other chemicals as precursors.

[00:13:20] Scott Sherr, MD: Yeah. So it's not made from a plant directly at all. 

[00:13:22] Christa Biegler, RD: How do you think it is so intriguing that they dosed this for so long? And just continue to find uses for it. If you were one of the first people to use it as a supplement mitochondria, what was the inspiration that you were going from?

[00:13:38] Christa Biegler, RD: And maybe that kind of also lends itself to what happened. We'll, the next thing will be, let's talk about the mitochondrial impacts, but like, how did you decide, man, this dye that no one uses seems like a great thing to put in our supplement. Like how, what was the inspiration there? 

[00:13:52] Scott Sherr, MD: As I was alluding to, there was new research in the last couple of decades showing that nothing but concentrates in the mitochondria.

[00:13:58] Scott Sherr, MD: And that concentration is not just so that we can see it on slides. We're looking at it with microscopes, but they're actually significant things that are happening in the mitochondria that are Allowing the cell to work at a more efficient capacity and some of the work that was done specifically on certain types of emergency conditions, what would became very interesting.

[00:14:20] Scott Sherr, MD: And these are things that would happen in emergency rooms. People would show up and they'd have something called met hemoglobin, which is a condition where you can't carry oxygen on your red blood cells. And they found out that if you give nothing blue in these cases, you can actually. Make that happen.

[00:14:37] Scott Sherr, MD: You can actually it's the antidote for this particular condition. And what's happening here? This is happening in the red blood cells. And there's another one that's very interesting that I hope nobody ever gets called cyanide poisoning. Cyanide is a poison that poisons one of the complexes on your mitochondria.

[00:14:52] Scott Sherr, MD: And somehow they figured out that methylene blue is a, an antidote for this. It is a rescue. So that if you get poisoned with cyanide, what happens is you're complete, you're dead. Electron transport chain in your mitochondria shuts down. But what methylene blue can do is can compensate for that shutdown and maintain energy production, not at a max capacity, but at a lessened capacity, but still enough to keep those cells alive long enough for the cyanide to wear off if you get it obviously early enough.

[00:15:20] Scott Sherr, MD: So there is this initial Interest in some of these emergency indications. And then there is a researcher down at the University of Texas, Austin named Dr. Francisco Gonzalez Lima, who has done a lot of great work on methylene blue for neurodegenerative types of conditions and combining it with red or near infrared light as well, because there's synergistic capacity using those two things together in clinical practice. 

[00:15:43] Christa Biegler, RD: Yeah. How, what a weird thing to end up researching. It's They're like, this, we're just going to go for it. It's just a little bit of surprise. That's all. 

[00:15:49] Scott Sherr, MD: And the big thing of it too, is that there's, it's so far off patent, right? So the thing about nothing blue is that you can never come out with a blockbuster drug with nothing blue because it's been around such a long time.

[00:16:02] Scott Sherr, MD: So studying things like this is not easy for researchers to do because there's no blockbuster drug at the end of the rainbow here. But. Because there has been his model, Francisco Gonzalez, Lima is an Alzheimer's model. And there's been some studies using methylene blue in Alzheimer's with some compelling benefits which is very interesting.

[00:16:21] Scott Sherr, MD: And I think happening in multiple ways where I think this is actually working. And this is where we can get into the details. If you want to like, how exactly it's working mitochondria. 

[00:16:29] Christa Biegler, RD: Yeah. Let's go exactly. How is it working on the mitochondria and tell us also what are the benefits that they're seeing in Alzheimer's models?

[00:16:36] Scott Sherr, MD: Yeah. So On the microscopic level on what's happening in the mitochondria, nothing is what's called a redox cycler. And what that means is that it has this very cool ability to both donate electrons and accept electrons. Most things will do 1 or the other. They'll either donate electrons to electron transport chain.

[00:16:55] Scott Sherr, MD: These are things like taking an ad, for example, right? You take an ad that's what you're doing. You're donating more to your electron transport chain, and you're creating more energy. Either you're giving more energy to the electron transport chain or you're on the other side of things, you're an antioxidant.

[00:17:10] Scott Sherr, MD: So you're picking up what are called free radicals, reactive oxygen species, oxidative stress, whatever you want to call it. It's all the same thing. But when we make energy, we also make more oxidative stress. And so typically things are either helping you make more energy or they're giving you more capacity to be like an antioxidant, like your vitamin C or 

[00:17:29] Scott Sherr, MD: vitamin D or zinc or something like that. So these are all antioxidants in some ways. So what methane blue has the capacity to do is both at the same time. So if you need more energy, it can help you do that. If you need more detoxification and oxidative stress neutralization, you can do that using methane blue as well.

[00:17:46] Scott Sherr, MD: And the cool thing about methane blue on the energy production side is that it can compensate for any Okay. Dysfunction in the complexes that are a part of the electron transport chain in the mitochondria to help make energy And so there's four complexes complex one two, three and four complex one and two are the ones that are using That are getting electrons directly from our food nad and fad specifically.

[00:18:10] Scott Sherr, MD: So you have a citric acid cycle, which is how we process our macro nutrients into electrons so that they can go to the electron transport chain and make energy. So you have NAD and you have FAD. So if there is a blockage in either of these two complexes, you're not going to make energy effectively. But if you have methylene blue around, you can actually compensate for some of those blockages in various ways by donating electrons Further down the process to complex three or complex four.

[00:18:37] Scott Sherr, MD: So that you maintain electron flow and you maintain the proton gradient in the electron in the mitochondria itself, excuse me, and then as a result of maintaining that proton gradient, you're able to continue to make energy. That's why I think it's so effective for, and it's been studied now, actually, and things like traumatic brain injury and stroke models, mostly in animals, where if you give methylene blue Acutely after you have one of these things, you can potentially rescue brain tissue or other tissue as a result of that.

[00:19:05] Scott Sherr, MD: And we, I always tell my patients, the ones that I work with, that they should have a higher strength, nothing blue available just in case they have one of the, an acute trauma and acute episode like this, because there is a possibility that can rescue some of the mitochondrial function and prevent those cells from breaking down.

[00:19:23] Scott Sherr, MD: And I think the final point there I would make is that Methylene blue can act just like oxygen in the mitochondria as well. So oxygen is the final electron acceptor in the electron transport chain on complex four. So methane blue can do that same thing. So if you have less oxygen around, say, like an ischemic event or you're traveling to Colorado and you're visiting me and you're at 5, 000 feet, there's less oxygen around.

[00:19:44] Scott Sherr, MD: So you're not going to feel as good because you don't have as much of that electronic scepter. Methylene boot can compensate for that. And so we're using it in those contexts in clinical practice and really seeing some fantastic benefits. 

[00:19:55] Christa Biegler, RD: Yeah. It does make sense where it would get the name magic bullet.

[00:19:58] Christa Biegler, RD: As I think about that, I'm like, yeah, I also use this and this for that, but it's I think the big thing is that it's doing two things at once, potentially, right? So it is Improving energy while also compensating for drainage, detox, oxidative stress, essentially, so it's acting like an antioxidant in the body a little bit.

[00:20:15] Scott Sherr, MD: It does 

[00:20:15] Scott Sherr, MD: both. I tell my patients all the time is energy and resilience. It's energy and resilience. So you get extra energy and you get extra resilience, which is your detoxification pathways. And then at the higher doses, it's. So there's different spectrums of dosing for methylene blue on the lower doses.

[00:20:30] Scott Sherr, MD: You're getting this mitochondrial redox, you're getting the energy and detox. But as you increase the dose, you can compensate for more significant potential mitochondrial dysfunction. But at the same time, it becomes, as I was alluding to earlier, significant anti infective as well. So there's no resistance patterns to methylene blue, and which means that there's no bacteria, fungus, or virus that's resistant to methylene blue.

[00:20:53] Scott Sherr, MD: And the reason why that's the case is that in the body, what methylene blue does at higher doses is it increased the amount of hydrogen peroxide that's produced now hydrogen peroxide. We all know about what that is. If you would, you buy it at the store, but our body actually produces hydrogen peroxide to kill organisms.

[00:21:10] Scott Sherr, MD: And it does this in a very defined, in a very specialized way. So at higher doses of methylene blue, you get more hydrogen peroxide production, and you get more anti infective capacity. Now, and at the same time, the more hydrogen peroxide that you produce, the more glutathione, your master antioxidant in your body that you actually spur the release of because hydrogen peroxide stimulates glutathione production.

[00:21:33] Scott Sherr, MD: So you get a massive bump in glutathione production at higher doses of methylene blue as well. So there's a spectrum of dosing, lower doses, like less than a half a milligram per kilogram, like four, eight, 12, 16 milligrams for many people can have significant improvements in the redox. And who has mitochondrial dysfunction?

[00:21:53] Scott Sherr, MD: Christa, everybody does, right? 95 percent of the U S population, most likely. And this is, Not severe all the time, but it could be mild to moderate. If you've had an infection, you still feel fatigue. If you have inflammation in the body and it's not getting better, if you have an autoimmune problem.

[00:22:09] Scott Sherr, MD: So we've just seen fantastic things in people with chronic fatigue and fibromyalgia and long COVID and, conditions like that, that are really difficult to treat that where you bring methylene blue into the picture, fantastic. And I've seen people get better in three days that have been sick for three years in some cases.

[00:22:28] Scott Sherr, MD: And that's not always the case, but when you find the right dose, which is, can take a little bit of time, that's when you can really see things shift very quickly in a lot of people. 

[00:22:37] Christa Biegler, RD: Yeah. I've got so many questions, which is great. But first, since we're on dosing, I want to talk about dosing a little bit.

[00:22:43] Christa Biegler, RD: And is there a negative to starting to high? I had a past client. 

[00:22:48] Scott Sherr, MD: It can be. Yeah. 

[00:22:49] Christa Biegler, RD: Yeah. Who I just cannot remember the details around it, but I feel like there's something you have to watch out for with dosing with methylene blue. What is it? 

[00:22:56] Scott Sherr, MD: Yeah. 

[00:22:56] Christa Biegler, RD: If you're urinating a lot when you're drinking water, maybe you're not actually hydrating that much. Or, in other words, getting the fluid and nutrients into the cell. Electrolytes are minerals that help fluid and nutrients get into the cell. I recommend all of my clients start by drinking electrolytes when we begin our work together, so to improve energy.

[00:23:16] Christa Biegler, RD: And then we get even more strategic with our electrolyte recommendations as test results come in. Now, generally electrolytes are potassium, sodium, and chloride. One of my favorite electrolyte products is pickleball cocktail from jigsaw health, because it's one of the only products you can get with an adequate dose of potassium to meet my recommendations, which is critical for blood sugar, which everyone should care about hormone health.

[00:23:39] Christa Biegler, RD: And digestion huge thing for relapsing digestive issues. Jigsaw health is also maker of the famous adrenal cocktail made popular by the pro metabolic corner of the internet and root cause protocol, as well as a multi mineral electrolyte for recovery called electrolyte supreme. You can get a discount on all of jigsaw's amazing products, including pickleball, electrolyte, supreme, and adrenal cocktail at jigsawhealth.

[00:24:02] Christa Biegler, RD: com with the code less stressed 10. That's three S's less stressed. Ten.

[00:24:09] Scott Sherr, MD: So the one thing I didn't mention is that On the history of methylene blue, they found out that it had what's called a monoamine oxidase inhibition properties, which means that it could work to increase.

[00:24:21] Scott Sherr, MD: It does increase norepinephrine dopamine and serotonin in the brain. The first antipsychotic chlorpromazine was actually derived from methylene blue for this reason. Now, because it has that MAOA MAI capacity, some people, when they start taking it may feel. It's a very non medical term funny, right?

[00:24:41] Scott Sherr, MD: Because the brain neurochemistry is going to change a little bit, but that's the word that I typically hear from clients. 

[00:24:46] Christa Biegler, RD: I understand completely. I feel funny. 

[00:24:53] Scott Sherr, MD: Something's just funny. So that's one thing you have to consider it. Now, if you have patients that are on SSRIs, for example, there is a relative contraindication to using methylene blue, but that's really only the case if you're using IV methylene blue.

[00:25:06] Scott Sherr, MD: If you're using oral methylene blue. It's very safe. Again, you have to go slowly with the dosing. And I, if you're going to use methylene blue with SSRIs, I just recommend you do it with a practitioner being involved in your care and not doing it on your own that way. Now, where do we make most of our serotonin?

[00:25:23] Scott Sherr, MD: Of course, it's not in our brain, but in our gut. So what will typically happen is these patients may have some, G. I. Related stress if they start off with too high a dose. Start out on a 2 higher dose and they're not used to that. Those neurotransmitters being released.

[00:25:36] Scott Sherr, MD: That's that funny feeling that people might get. The other thing that might happen as well is that if you started too high of a dose, you may get more of a detox reaction than you're really wanting to have right away. And that's because yeah. I find methylene blue is very interesting that it's almost like an adaptogen in various ways.

[00:25:52] Scott Sherr, MD: If you have more cleanup to do, it's going to do the cleanup first. If you have more energy enhancement compensation for electron transport changes function required, it's going to do that first. So detox symptoms are not uncommon. 

[00:26:04] Christa Biegler, RD: So this could be my 

[00:26:05] Christa Biegler, RD: questions. 

[00:26:06] Scott Sherr, MD: Yes, 

[00:26:06] Christa Biegler, RD: I was like, there's no possible way that this I'm, I was like, Oh, what about die off?

[00:26:10] Christa Biegler, RD: If this thing does all this other stuff, plus it's also acting as an antimicrobial of sorts. How could it not have this? 

[00:26:17] Scott Sherr, MD: But the key, and that's why the key is to start off at low dosing for most people. And you titrate the dose. What I would what I do as a clinician here is I titrate the dose every three to five days, depending on their response.

[00:26:28] Scott Sherr, MD: So start off pretty low, sometimes four milligrams, eight milligrams, sometimes a little bit like 12. 5, but I usually don't start off at a higher dose than that. If somebody's had a chronic complex medical issue now, if they have an acute infection. It's a different story because the body will require more in general to see the benefit, and it will eat up that benefit quickly.

[00:26:48] Scott Sherr, MD: And I think a good example of this is actually my mom, like about a month ago was bitten by a tick. Okay. And so if you're bitten by a tick, this is, obviously she lives in New York and there's a lot of lime ticks there. So we wanted to be. Give an antimicrobial dose here. So an antimicrobial dose of methylene blue is at least one milligram per kilogram and or maybe higher, up to three milligrams per kilogram.

[00:27:09] Scott Sherr, MD: So it was a, I gave her two milligrams per kilogram, which is 150 milligrams of methylene blue, and I was. Actually, frankly, scared because it was 5 o'clock or 6 o'clock in the evening. And I was like she's not going to sleep because the norepinephrine that's going to be released because she's taking an m. A. O. I. A little bit. But she felt great. She had no problem sleeping because she had, an acute inflammatory. Episode with an acute infection. She needed the extra methylene blue and she did great. She had a fantastic four or five days on it. I didn't keep her on that high a dose. I went down to 1 milligram per kilogram after that, just after that first dose.

[00:27:42] Scott Sherr, MD: So from an acute perspective. Most people can tolerate more if they have an acute inflammatory condition, whatever it might be, but if it's a chronic issue, usually starting off a lower dose is going to be better tolerated and you go slowly and titrate up the dose over time as they start seeing benefit.

[00:28:04] Scott Sherr, MD: You can keep them at that dose, or if you think that there might be a further way to go, then you keep going, it depends on what the goals are symptomatically. For example, it's more mitochondrial function, then you're probably going to stay pretty low dose and see a benefit, but if it's more as an anti infective, you may have to go, higher overall.

[00:28:20] Scott Sherr, MD: And that's why we developed two products at transcription, one called Just Blue, which is 16 milligrams, and one called Tro Plus Blue, which is 50 milligrams, 5 0. And the Tro Plus is only available if you're a practitioner. So it's not available to the consumer because there's higher risks for taking the higher dose immediately.

[00:28:38] Scott Sherr, MD: If you're not ready for it, as you were describing or taking it long term, there may be some detrimental benefits as well, which I can talk about mostly the detrimental benefit for higher doses over the long term is that we worry about. Your gut actually, because it's an anti infective, right? So you're also gonna be killing off gut bacteria which may be a good thing in the short term.

[00:28:58] Scott Sherr, MD: But in the long term, maybe not what you want to do, right? It's decreasing, your microbial diversity. There's also some potential that if you're taking too high doses for long periods of time, methane blue has this what's called a. Hormetic dose response curve, where it works really well up into a certain point.

[00:29:13] Scott Sherr, MD: Then you go over that point over about 3 milligrams per kilogram. Then you become more, it's purely oxidative. So purely causing, oxidative stress to the system, as opposed to energy and detox. It doesn't do that anymore. So those are some things with long term higher doses that we have to think about in general, it's a very safe and very well tolerated.

[00:29:32] Scott Sherr, MD: The only other group that I would, I do have some concern when I start Methylene Blue is those with significantly difficult to control hypertension because their blood pressure can go up slightly when they take methylene blue sometimes more than slightly if it's a higher dose. That's why certainly starting at a lower dose can be helpful.

[00:29:48] Scott Sherr, MD: But on the reverse of that, if you have hypotension or positional hypotension, like pods, for example, I have a lot of clinicians that are using methylene blue because it helps with it. The blood pressure in these cases, and I think that this is multifactorial, but but certainly one of the cases, one of the reasons I think is that norepinephrine that's being released as another is that it's binding something called inducible nitric oxide in the in the blood vascular system itself, which gets released with infection and inflammation. 

[00:30:18] Christa Biegler, RD: Yeah. Okay. That makes sense. And just to give different words to him talking about hypotension or POTS, which is much more common post COVID also. I also want to just speak to the person that's really frequent and was me, which has to do with your adrenals sucking which is getting accolades at the doctor.

[00:30:36] Christa Biegler, RD: Cause they're like, Oh, your blood pressure is low, which is exactly what he's saying. But often it's considered normal. So it's not necessarily that you are lightheaded when you stand, that's the more severe version. But if you're just generally a little bit lower might be really awesome, which would make sense because the main treatment for me to make it for adrenal is mitochondrial support regardless.

[00:30:55] Scott Sherr, MD: Almost everybody. Yeah. Yeah. Most everybody needs money. Your adrenals are Highly concentrated with mitochondria. Like you have your most mitochondria there. You have your most mitochondria in your brain, in your heart, in your liver, and in your ovaries. If you have ovaries or your sperm or so eggs and sperm, actually, eggs are the most mitochondria per cell of any cell in the female body or anybody really, or any human.

[00:31:18] Scott Sherr, MD: Form. And this is one of the reasons why fertility has become such a huge challenge is that they're so mitochondrial dense and they need such significant mitochondrial support to grow a new human. And if you don't have that, you're going to see it in places where, you know, where you have the most 

[00:31:33] Scott Sherr, MD: care. 

[00:31:34] Christa Biegler, RD: It's I actually need it for all these other places where you were depleting my mitochondria. 

[00:31:39] Scott Sherr, MD: Exactly. Yeah. So we've had a number of stories of women telling us they got pregnant after, starting methylene blue now being Pregnant, you should not take methylene blue if you are pregnant because it's not something you're supposed to take, but like in the lead up and like the fertility, that side of things we've seen, we've had a lot of great reports there, which is necessary.

[00:31:56] Scott Sherr, MD: Surprising to me. Then, of course, it shouldn't be surprising, right? If you're optimizing mitochondrial function, everything is going to get better, especially the place that need the most. 

[00:32:03] Christa Biegler, RD: Yeah, super, 

[00:32:04] Christa Biegler, RD: super interesting. Would you say in general, you could dose at any time of the day, but dosing in the first half of the day might work better. 

[00:32:12] Scott Sherr, MD: I usually have people start in the beginning of the day because it has these oxidase effects. So the mild norepinephrine, dopamine and serotonin release, I can take it before bed and I have no problem. But some people will take it at nine o'clock in the morning and feel like they're.

[00:32:27] Scott Sherr, MD: Just flying until five o'clock at night or longer. And this is just with pure methylene blue. So some people are just hyper responders. And I find this to be the case. People have better overall mitochondrial function. And they're pretty well optimized. They'll find that pure methylene blue is just going to give them this bump.

[00:32:43] Scott Sherr, MD: So we have a lot of athletes that use it for endurance, for recovery. I use it a lot in those capacities. And then for exercise, I have a couple of clients that Refuse to work out without nothing blue, actually, because it'll help them keep their heart rate up for longer when they're doing, there are various types of endurance or their phase two training or whatever it might be, because again, you don't hit that wall as quickly if you have nothing blue around, because they're still going to be.

[00:33:09] Scott Sherr, MD: Something like oxygen in your cells working, which is the methylene blue working like your final electron acceptor of like oxygen would. So we're a lot of our marathon runners are using it. And a lot of our other endurance athletes as well. So they'll actually use a combination of our methylene blue products, pure ones, the just blue and the true plus along with our blue canteen, which is what I was Initially talking about is our first product at transcriptions, which is our combination of the Bethlehem blue with nicotine, caffeine and CBD, which is great for focus and exercise boost and really just gets things rolling.

[00:33:46] Scott Sherr, MD: It's got that stimulating capacity, but the Methylene blue in there is very supportive because remember, because nothing we can act like an antioxidant at the same time. It's just a very versatile compound and. Scary for people to because I know it's not, something that comes from the ground per se, but we don't live in a natural world anymore.

[00:34:03] Scott Sherr, MD: We live in a synthetic world and sometimes synthetic things are really helpful along that path. And I've just found clinically over the years, Christa, that it is just so profoundly helpful. I can just think about, five patients off the top of my head, one with a traumatic brain injury that was just having a really hard time recovering.

[00:34:20] Scott Sherr, MD: And we just slowly started increasing the methylene blue and his brain just turned back on. It was just, and he was just so grateful because he'd been doing this for three years to try to get better. Yeah. I had another lady with severe incapacitating joint pain post COVID. And Everything. And then finally, she tried methylene blue and three days later, her pain was gone and she was back to work.

[00:34:44] Scott Sherr, MD: It was just insane. Another lady with really bad mold. That had gotten better from the mold, like the mold was gone in her system, but her mitochondria just were trashed because of having mold exposure for such a long time. So we gave her methylene blue and again, the same thing for her. It took a little while to find the right dosing.

[00:35:04] Scott Sherr, MD: But once we got to about 16 milligrams, that's when things just started shifting for her. Her brain was just, she was no longer having that fatigue in the morning that was making it really difficult for her to wake up. Her. Concentration was better. So I've just been really impressed overall. But, the hope, of course, in all these capacities is that we can help revitalize the system with flight, with diet, with lifestyle, with nutrition, with vitamins, minerals, nutrients, and co factors.

[00:35:31] Scott Sherr, MD: And so health optimization, medicine and practice, the nonprofit. And then the practice that I have that's based on that is looking at foundational biomarkers and doing all that work. And then the whole, the goal of course, is to take people off of things like nothing blue, unless they have more stress on the system.

[00:35:46] Scott Sherr, MD: Which I could argue is a lot in normal people, even if you're going on an airplane, if you're not sleeping good the night before sun sleeping well, because you have children. There's a lot of reasons we all have stress, but my goal with. Most of my patients as well is to get them off of these products as much as I can and just use it more targeted.

[00:36:04] Scott Sherr, MD: But in the beginning it might require more, constant therapy to see the benefit. 

[00:36:08] Christa Biegler, RD: Yeah. Okay. So we talked a little bit about high doses. If you're trying to use that for an acute infective purpose, maybe you could tolerate more one milligram per kilogram up to three milligrams per kilogram.

[00:36:19] Christa Biegler, RD: Earlier you were talking about a half milligram per kilogram, but then you just mentioned this woman being on 16. I think milligrams, which is not very much. So talk about the low dose dosing because you mentioned, I think, increasing every three days. So just let's talk about the low dose dosing. 

[00:36:40] Scott Sherr, MD: Yeah, so what I was alluding to is that we found a lot of benefit in dosing of less than 0.

[00:36:46] Scott Sherr, MD: 5 milligrams per kilogram, and that can start off as a benefit as low as 4 milligrams in some people for example, and I've seen it significantly in especially younger kids that are working with practitioners or that are my patients as well. You can use it in younger kids and see significant benefit at these very low doses.

[00:37:04] Scott Sherr, MD: When it comes to low dose, four milligrams is a low dose, very low dose, but it can be significantly beneficial. But what I will typically do is that I'll increase the dose every three to five days. So four milligrams to eight milligrams to maybe 12 and a half milligrams to 25 milligrams, in that order.

[00:37:22] Scott Sherr, MD: So sometimes it's four, eight, 12, 16, then 25. It just depends on the person, but I try to do it. Relatively fast, but not super fast. It really depends on the person. If they're super sensitive to everything, then I'll start off at four milligrams. Then I'll wait seven days. This also plays into the delivery system that we have a transcriptions, which is called the buckle trochee that we've been describing.

[00:37:44] Scott Sherr, MD: So a buckle trochee is a dissolvable lozenge that goes between your upper cheek and gum, and it dissolves over about 15 or 30 minutes typically. And the nice thing about a buckle trochee, there's a couple of nice things about it. The first is that. It bypasses what's called first pass metabolism in the liver, which is a detriment to the bioavailability of many different compounds.

[00:38:06] Scott Sherr, MD: One exception to that actually is methylene blue. Methylene blue, the bioavailability of methylene blue, whether you use it as a trochee or you swallow it is almost a hundred percent, which is actually pretty crazy. It's pretty unusual. Most supplements, a common example would be something like knack and acetyl cysteine that has about a 10 percent bioavailability.

[00:38:24] Scott Sherr, MD: So you take a hundred milligrams of it, you get 10 milligrams in the body. Okay. But with methane blue, almost a hundred percent is bioavailable, but buckle trochees are great for ingredients that have a bioavailability. That's going to degrade through first pass metabolism, which is most of the other ingredients out there, including the ones in our other products and some of our products.

[00:38:42] Scott Sherr, MD: So number one, it bypasses first pass metabolism. And number two, It is faster, right? Because if it's going to dissolve between here, your upper cheek and gums, it start, it's going to dissolve directly into the venous system of your cheek mucosa, which is extremely vascular, and you're going to start seeing an effect within about 15 to 30 minutes.

[00:39:01] Scott Sherr, MD: So that's great, especially if you need focus. Now, you have, you need anxiety relief and some of the other things that we have. The challenge with methylene blue, though, is that it's extremely fast. Blue. We talked about it being a dye. It is a very blue dye. So if you dissolve it in your mouth is going to turn blue.

[00:39:18] Scott Sherr, MD: And depending on how much methylene blue you put in your mouth, the longer it's going to turn blue. Not everybody wants a blue mouth. I completely understand that. However, if you have a chronic complex medical condition, illness or conditions that have been going on for a while. We have found that dissolving in the mouth is better overall.

[00:39:33] Scott Sherr, MD: Oh, the other thing about trochee is that I forgot is that the trochee is, it comes scored, which means that it's got the capacity for you to cut it up into little quarters. So it's got four. It's a square that you can cut up into quarters. So I can take a quarter, you can take a half, or you can take a full.

[00:39:49] Scott Sherr, MD: And then depending on your dose, you can titrate that dose up, slowly over time using a quarter, half, or full. With Methylene Blue, or just Blue Nitro Plus, What I would say here is that most people are swallowing it and that's okay because they don't want a blue mouth.

[00:40:03] Scott Sherr, MD: The onset of actions is going to be slower. If you swallow it, it's going to be maybe 30 minutes to 60 minutes, sometimes longer on an empty stomach. If you dissolve it in your mouth, it's going to be about 15 to 30 minutes overall. The higher doses of methane blue, especially anything above 16 milligrams should be swallowed for sure, because that's going to make your mouth blue for a couple of days.

[00:40:21] Scott Sherr, MD: If you do that, anything more than that. Four milligrams. 8 mg. That's going to be your mouth is going to be blue for several hours. You can do this. We have a couple of remedies for that. posted on our website, if people are looking at that, but in general, the nice thing about methane blue is that so highly bioavailable, you can take it either way.

[00:40:40] Scott Sherr, MD: It's just about how fast it's going to be the onset of action. 

[00:40:43] Christa Biegler, RD: Yeah, cool. That answered all of those questions because we've done some on liposomal delivery and similar, right? It's faster, but the bioavailability is much higher with liposomal, whereas here it looks like it's going to be the same regardless. 

[00:40:56] Scott Sherr, MD: For Methane Blue, yes. 

[00:40:58] Scott Sherr, MD: But , the challenge with a lot of the products out there is it's very difficult to know exactly what you're getting 

[00:41:03] Scott Sherr, MD: in your 

[00:41:04] Scott Sherr, MD: dosing. 

[00:41:04] Christa Biegler, RD: That was one of my questions also, comparing these troches, is that what it is? Because I call it troches. Yeah, troches. 

[00:41:13] Scott Sherr, MD: Yeah, we call it troches.

[00:41:13] Scott Sherr, MD: In 

[00:41:14] Christa Biegler, RD: my brain, I got it already programmed in my brain. You say it? 

[00:41:17] Scott Sherr, MD: No, troches is the other way people say it. So it's all good. Yeah. 

[00:41:19] Christa Biegler, RD: Okay, got it. Yeah. I think about this delivery method versus liquid and liquid would still be 100 percent bioavailability if there's actually what people say is in it, which is the question with every single supplement.

[00:41:31] Christa Biegler, RD: Yeah. 

[00:41:32] Scott Sherr, MD: I'm a clinician. There's four docs on my team at transcriptions and I've really cared. We all really cared about quality and we all really cared about purity and potency. And we've done testing with other Products on the market. Okay. And none of them, maybe except one that we checked actually lived up to label claims in their droppers that they said were a certain amount of methylene blue.

[00:41:52] Scott Sherr, MD: And that's not surprising to me because if you put nothing blue in a liquid, it's going to concentrate in various, it's just not going to be completely homogeneous in that liquid. And you're not going to know exactly how much you're getting. So most of them were underdosing. A couple were overdosing overall with the other, with the liquids that we checked.

[00:42:07] Scott Sherr, MD: And the cool thing about the true key is that. The form itself is done in a way that everything's homogenized. And then the trochee is always going to have the exact amount of ingredients that we say it's going to have in there. So if it has 16 milligrams, it says it on the label, that's what it has in there.

[00:42:23] Scott Sherr, MD: And that's something we test every batch to make sure that's the case. And. We throw out, unfortunately, more than I'd like to when it doesn't meet our claims and it doesn't meet the specs that we wanted to make, and that's very unusual for supplement companies to self regulate like that, as 

[00:42:37] Christa Biegler, RD: for sure. And you covered so many of my questions about methylene blue. We talked about Where it comes from the dosing, honestly, at length, we talked about potential contraindications. One of my questions was about taking breaks. And like you said, your goal is to actually get people to a good place, but then get them off, which I think is a really smart thing.

[00:42:57] Christa Biegler, RD: Also, we talked about how it's got these antimicrobial properties, but also these Almost antioxidant type properties where it also accounts for drainage and detox burden as well. The contraindications being primarily high blood pressure and maybe the fact that it's an antimicrobial to the gut.

[00:43:13] Christa Biegler, RD: That's the concern. As far as longevity or even long term research, what's the longest you've had. Or seeing someone on methylene blue, because that would be probably a really easy question that people would have what happens if they just stay on these doses? Cause that's the challenge with humans is let me just keep doing this thing. 

[00:43:33] Scott Sherr, MD: Yeah. So I met. Anecdotally, at least, I've met people that have been on 2 milligrams per kilogram of methylene blue for 3 to 5 years, and they've had really no problems overall, but it's a risk versus benefit in that case, or these people are using it for significant microbial reasons, oftentimes. Will there.

[00:43:51] Scott Sherr, MD: Gut flora likely take a hit as a result of being on that for that long. Yes. But will it be more beneficial because they're treating Lyme or Bartonella or chronic fungal infections or mold? Then the answer is, it's a risk versus benefit. Now. With much lower doses, four, eight milligrams, six milligrams, 10, these are so low that I do think that they're very likely safe over the long term.

[00:44:14] Scott Sherr, MD: I don't see a major benefit a major detriment from being on them for long term, but I think that as with anything, if you can wean somebody off of this, is it likely a good idea and have them take breaks over time. So do I have patients that are on these lower doses for very long periods of time? Yes, I've had people on for years now and they do great.

[00:44:33] Scott Sherr, MD: I checked their labs and they're doing okay, especially at these lower doses. So but my goal always, as I mentioned, is to wean patients off. And so I'll usually have people stay at a dose that works for them for 4 to 6 weeks, depending on the situation. And then at that point, we start trying to wean it down to maybe instead of 7 days a week, let's see if we can go to 4 days a week and see if we can get the same benefit.

[00:44:52] Scott Sherr, MD: And we can go to 3 days a week and see if we can get the same benefit and that kind of thing. Overall, I think the very low doses. are very safe. The higher doses need to be monitored more carefully, but even those can be very safe over the long term if they're monitored carefully. 

[00:45:03] Christa Biegler, RD: When you say monitored carefully with high doses, are there any lab markers that you've seen that change from high doses? 

[00:45:12] Scott Sherr, MD: Yeah, I've seen some Antioxidant deficiencies happen as a result of this, because what's happening is that you are forcing the body to produce more glutathione specifically over time. So you can see glutathione go down over time in patients that are on high doses. So they just have to be compensated for that by giving them exogenous, glutathione or NAC, if you give the precursors, for example. I have seen other markers of oxidative stress go up over time in people on very high doses. In general, the low doses, you just don't see it. People do well overall, and you don't see their markers really change. At least anecdotally, this hasn't been done.

[00:45:47] Scott Sherr, MD: We've had, Back in like the 1910s and 20s and 30s, you had people that were on very high doses of methylene blue for malaria. And these people did well for a very long time, dosing wise. I'm pretty convinced that it's very safe for most people. These potential effects I just think should be monitored because I think they may be not effects that you see immediately.

[00:46:08] Scott Sherr, MD: When you're taking it like glutathione deficiency or oxidative stress that's going up. You may not see that for years and years after taking it at very high doses. So that's why they should be monitored over time. 

[00:46:19] Christa Biegler, RD: Since it's synthetic, does it lose potency after being on the shelf for a while or does it expire officially? 

[00:46:25] Scott Sherr, MD: So yeah, we do see a a decrease in the potency after about a couple of years. We do that's why our expressions are no longer than 2 years with all the methylene would contain products for that reason, 

[00:46:38] Christa Biegler, RD: man, you nailed a lot of my questions accidentally. They just filled in as we went you covered a lot of.

[00:46:46] Christa Biegler, RD: Kind of anecdotal evidence for a lot of conditions. I was wondering, I forgot Alzheimer's. 

[00:46:50] Scott Sherr, MD: I forgot. You mentioned briefly, 

[00:46:53] Christa Biegler, RD: a lot of 

[00:46:53] Christa Biegler, RD: immunity and some other things, but go back to Alzheimer's. 

[00:46:55] Scott Sherr, MD: Yeah. Just real quick on that is that there was a study that was done looking at three doses of methylene blue.

[00:47:00] Scott Sherr, MD: One was eight milligrams twice a day. One was 75 milligrams twice a day, and one was 150 milligrams twice a day. So eight milligrams twice a day was the placebo group. This is the one that wasn't supposed to have any effect. Okay. But they wanted everybody's urine to turn blue because that. This is the other side effect of taking methylene blue.

[00:47:17] Scott Sherr, MD: And as a result, they had to give them some, right? So they gave him a milligrams BID, the group that did the best in that study, the eight milligrams BID, the other two groups didn't do as well. And I think the reason why is that the brains of an Alzheimer's patient is already under significant stress and you're giving them a high dose of methylene blue that's forcing the body to create more hydrogen peroxide, forcing the body to increase their glutathione production, which it may not be able to do.

[00:47:43] Scott Sherr, MD: Especially if it's a very, it's a, if it's a brain that's under significant stress already. So that's why I think, and that's why actually we developed the dosing of just blue at 16 milligrams, because it was equating to the dose that was in that study that saw benefit. And we've been very.

[00:48:02] Scott Sherr, MD: Happy and, it's been a great experience to use that dose for so many people, but some people do need the higher doses, the 50 milligrams. And this is why we created the tro plus blue, which is just for practitioners. And we have a transcriptions. We have a full practitioner portal. If you're a practitioner, you can go to transcriptions dot com and go to the practitioner link and sign up.

[00:48:21] Scott Sherr, MD: And we have webinars that I've done on all of our products, including methylene blue interviews with clinicians that are using it in clinical practice. And clinical resources on dosing and various other things you can give to your patients as well. So I would encourage people that are interested that are clinicians that are listening to take a look.

[00:48:38] Scott Sherr, MD: But the 50 milligrams can be really helpful to for some of these more acute things and for the more significant chronic things that require higher doses. But again, as I mentioned earlier, if it's a significant chronic thing, titrate. You got it. 

[00:48:51] Christa Biegler, RD: Yeah. You don't want to be causing die off. You bring up a point that we didn't talk about because we talked about dosing first thing in the morning, but in their study, they were doing it twice a day.

[00:49:00] Christa Biegler, RD: Do you think, a lot of times that it is okay to divide things. Do you think it really matters? Do you just do it once in the morning? 

[00:49:07] Scott Sherr, MD: What I typically do is I'll start off with once a day and then because the half life of nothing blue orally is about 4 to 6 hours of 4 to 6 hours. If people say, I felt great doc in the morning, but about 1 or 2 o'clock, I started feeling like I was going back then.

[00:49:20] Scott Sherr, MD: That's usually when I'll dose them twice daily. I'll have them do the dose in the morning when they first wake up and then about 1 or 2 o'clock in the afternoon. 

[00:49:27] Christa Biegler, RD: Perfect. Cool. Where can people learn more? You've mentioned it, but if someone wants to follow you online, where can they find you?

[00:49:34] Christa Biegler, RD: Yeah. 

[00:49:34] Scott Sherr, MD: Yeah. So our website, our company is called transcriptions. It's the word troche and the word prescription mashed up together. So true descriptions. Okay. And it's just descriptions. com. It's also on Instagram at transcriptions. My personal Instagram is at dr. Scott, sure. D R S C O T S H E R R. So I do a lot of posting there as well.

[00:49:53] Scott Sherr, MD: Those are the major locations. We also have the nonprofit it's called health optimization, medicine and practice. The website there is home. Hope. Dot org, and it's a nonprofit, like I said, and it's a seven module certification course. The first module is something called metabolomics, which is a focus on cellular metabolism, vitamins, minerals, nutrients, cofactors.

[00:50:13] Scott Sherr, MD: And we run cohorts every twice a year, typically where students can go through and learn metabolomics, which has been called the 21st century equivalent of a stethoscope, basically. So very cool. I really. Use it robustly in my clinical practice a lot. And then I integrate methylene blue along the process as I'm optimizing somebody's cellular metabolism and their gut function, et cetera.

[00:50:35] Scott Sherr, MD: I think those are the major places. And then, yeah, if you're a practitioner, as I mentioned, you can go over to our website and sign up to be for our practitioner portal, you get access to practitioner discounts along with resources, as I mentioned. 

[00:50:48] Christa Biegler, RD: Perfect. Thank you so much for coming on today.

[00:50:50] Christa Biegler, RD: I look forward to doing HBOT in a future episode. 

[00:50:54] Scott Sherr, MD: Let's do it. Love to.