What methylene blue can (and can’t) do for the brain

Appeal of methylene blue in “biohacking” circles

• Seen as a long‑lived underground favorite in nootropics/alternative medicine communities.
• Pattern described: people discover it, expect a miracle, then either feel nothing, get mild short‑lived benefits (possibly placebo), or side effects; most stop using it.
• Compared to selegiline and other MAO inhibitors that attract “more dopamine = better” enthusiasts, with similar disappointment and confusion about fatigue/tolerance.

Access, legality, and “gatekeepers”

• One reason for its popularity: easy to buy (even from lab or dish‑supply stores), old enough to predate modern regulation, no prescription needed in many contexts.
• Debate over whether ordering prescription meds (e.g., rasagiline, selegiline) from overseas is “easy” vs risky and gatekept; legality varies by jurisdiction and controlled‑substance status.
• Some argue trust in foreign subsidiaries/European labs is often similar to domestic pharma; others warn about unregulated Chinese suppliers and contamination risks.

Efficacy and user experiences

• One commenter took daily oral doses for months and noticed no cognitive change; main issues were intense staining of counters, teeth, and blue/green urine.
• Others emphasize that homeostasis makes lasting performance boosts from any psychoactive drug hard to achieve without side effects and tolerance.
• Skeptical view: supposed “promising results” are largely placebo, survivorship bias, and marketing by supplement grifters.

Risks and pharmacology

• Acknowledged as a powerful MAO inhibitor at some doses; warnings about serotonin syndrome and one reported fatal outcome when self‑treating depression.
• Classic MAOI dietary issues are raised; a user on another MAOI clarifies that the highest risk is with large amounts of aged/fermented foods, not casual chocolate/coffee.
• Caution for people with G6PD deficiency, especially from Mediterranean, African, or SE Asian backgrounds, due to risk of hemolysis (similar to other antimalarials).
• Discussion of high‑dose hospital use, tissue staining (brain/heart), and dose ranges considered “safe” vs clearly excessive.

Clinical use and research obstacles

• Known medical roles mentioned: vasopressor in vasoplegia after cardiopulmonary bypass; treatment for fish parasites.
• Some claim lack of double‑blind trials is due to no patent incentive; others counter that plenty of non‑patentable interventions are heavily studied and that repurposed, old drugs can still be highly profitable.
• Practical challenge for blinding trials: blue/green urine; suggested workaround is a similarly colored placebo dye, though technically nontrivial.

Broader critique of nootropics and self‑medication

• Several commenters argue that sleep, exercise, hydration, diet, and removing harmful exposures outperform nearly all “stacks.”
• Cautionary parallels drawn to St. John’s Wort and ADHD stimulants: initial euphoria or relief is often misinterpreted, tolerance develops, and underlying neuropharmacology is more complex than “boost chemical X.”