Methylene Blue in the Treatment of Chronic Lyme Disease

The reason that symptoms differ is that Lyme disease changes over time. Two theories have been proposed to explain why:

• According on one theory, initial treatment with antibiotics kills the bacteria that causes Lyme disease (Borrelia burgdorferi). However, while the disease starts as a simple bacterial infection, that infection can trigger an autoimmune condition, which is responsible for later symptoms. Proponents of this theory attribute the lingering symptoms to a condition they call Post Treatment Lyme Disease Syndrome (PTLDS).
• The other theory is that the antibiotics fail to eradicate the bacteria, which then enter a different growth phase, during which they’re much more resistant to the antibiotics typically used to kill them. Proponents of this theory attribute the lingering symptoms to a condition they call Chronic Lyme Disease (CLD).

Here at Restoration Healthcare, we think that both theories are valid, which explains our reasoning for testing patients who suffer from Lyme disease for signs of the bacteria and for autoimmunity. That’s because our treatment plans are personalized to address all underlying and contributing factors.

What’s interesting and most relevant to this post is that antibiotics that are effective in killing the bacteria in their early growth phase aren’t especially effective in killing them in their late growth phase.

Fortunately, methylene blue has been proven in some studies to be very effective in killing the bacteria in their late phase of growth, and that’s the focus of this post. But first, we need to address the biological progression of bacteria.

The Four Phases of Bacterial Growth

Below are the phases through which bacteria develop:

• Lag, a time when bacteria gear up for growth but don’t reproduce at a high rate.
• Log, which is an exponential growth phase where each bacterial cell divides — one becomes two, two become four, four become eight, and so on.
• Stationary, during which the bacteria’s population levels off, a phase made possible because bacteria reproduce at about the same rate as they die. During this phase, bacteria may also form biofilm — colonies of bacteria that secrete a gooey substance that protects them your immune system and antimicrobials.
• Death, during which the bacteria die at a rate that exceeds their reproduction.

Antibiotic medications and supplements differ not only in their effectiveness at killing different types of bacteria, but also in their effectiveness at killing those bacteria during the different phases of their growth.

In 2018, researchers at John Hopkins University examined the severity of arthritis among patients when the bacteria that causes Lyme disease was in different growth phases. They discovered that the arthritis was more severe in the stationary stages and when the bacteria were encased in biofilm. They also discovered that the antibiotics used to kill the bacteria during the early growth phases are less effective in the stationary phase and when the bacteria are protected by biofilm.

What Is Methylene Blue?

Methylene blue was developed in the late 1800s as a dye for use in textile manufacturing — its claim to fame is that it put the blue in blue jeans. Soon thereafter, it was synthesized and discovered to be useful as an antifungal, antiviral, and antibacterial agent. It’s still a popular antifungal, commonly used to clean fish tanks. But don’t even think of obtaining your methylene blue from fish tank cleaner, because it may contain many other potentially harmful chemicals.

In an earlier study, Johns Hopkins University researchers reviewed the FDA’s drug library for activity against Borrelia burgdorferi. The researchers identified 165 drugs with more activity against Lyme disease than amoxicillin and doxycycline. Later, they narrowed that list by nearly two thirds, leaving 52 drugs that effectively kill at least 65 percent of stationary phase Borrelia burgdorferi. And near the top of that list was methylene blue.

Two years ago, another team of researchers at Johns Hopkins University evaluated 25 different combinations of those top-performing drugs for effectiveness in treating stationary phase and biofilm Bartonella, which is a bacteria commonly transmitted through the bites of fleas, body lice, and sand fleas. Of the 25 combinations of antibiotics, four were able to completely eradicate stationary phase Bartonella in 24 hours. These included azithromycin / ciprofloxacin, azithromycin / methylene blue, rifampin / ciprofloxacin, and rifampin / methylene blue.

Other Potential Benefits of Methylene Blue

Methylene blue only has FDA approval to treat a condition called methemoglobinemia, which occurs when too much hemoglobin is oxidized, preventing it from carrying oxygen in the blood. Methylene blue helps oxygen bind to hemoglobin, and is also used to treat carbon monoxide poisoning.

Other potential benefits of methylene blue include the following:

• Neuroprotective properties — it may slow the formation of amyloid plaques and neurofibrillary tangles — which could make it useful in preventing Alzheimer’s disease and other forms of dementia
• Learning and memory enhancement
• Antiviral, especially when used in combination with ultraviolet light
• Mood enhancement
• Anti-psychotic

Use Caution

While you can buy methylene blue over the counter, we strongly discourage any attempt to self-medicate. Taking a poor-quality product, taking too much, or using methylene with other medications or supplements can do more harm than good.

Specifically, don’t take methylene if any of the following applies to you:

• You’re pregnant or planning to get pregnant
• You take acetaminophen (Tylenol)
• You take any drug that raises serotonin levels in the brain, such as a selective serotonin reuptake inhibitor (SSRI), serotonin and norepinephrine reuptake inhibitor (SNRI), tricyclic antidepressant (TCA), norepinephrine-dopamine reuptake inhibitor (NDRI), triptan, or ergot alkaloid — methylene blue is a potent monoamine oxidase inhibitor (MAOI) and may cause potentially fatal serotonin toxicity (serotonin syndrome) when combined with any medication that raises serotonin levels
• You have a G6PD deficiency
• You have a renal impairment

Even if you don’t fall into one of those groups, we recommend that you take methylene blue only under a doctor’s supervision.

Note that methylene blue is not a cure-all, nor is it likely to be all you need if you suffer from Chronic Lyme Disease or Post Treatment Lyme Disease Syndrome. Most patients with long-term Lyme disease have several health issues that need to be addressed, including autoimmunity, inflammation, gut dysbiosis (an imbalance of microorganisms in the gut, which may result from multiple courses of antibiotics), leaky gut (damage to the lining of the gut), and nutritional deficiencies.

If you think you have Lyme disease or you’re experiencing any unexplained symptoms that other doctors haven’t been able to diagnose or treat successfully, we encourage you to consult a functional medicine and integrative healthcare clinic for testing, diagnosis, and treatment.

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Disclaimer: The information in this blog post about methylene blue is provided for general informational purposes only and may not reflect current medical thinking or practices. No information contained in this post should be construed as medical advice from the medical staff at Restoration Healthcare, Inc., nor is this post intended to be a substitute for medical counsel on any subject matter. No reader of this post should act or refrain from acting on the basis of any information included in, or accessible through, this post without seeking the appropriate medical advice on the particular facts and circumstances at issue from a licensed medical professional in the recipient’s state, country or other appropriate licensing jurisdiction.