Methylene blue in Mold, Low T, hair loss in 20 yr old

[Alison Lechner]

Hello Colleagues~

I have a 20 yr old male whose only complaint is significant hair loss. Labs show mold, + ANA and low-ish  testosterone  at 400.

I was considering adding in methylene blue to his regiment – I typically have dosed in the lower range of 10 mg BID but am reading that higher doses of 50 – 100 mg /day are being used here.

There are old ( 1989) studies that show MB will have negative effects on spermatogenesis and male fertility.

Any guidance on dosing ( and if using higher doses is suggested – are there concerns I need to be aware of , specific labs to follow ) and thoughts on male fertility?

Thank you all in advance!

Warmly,

Alison Lechner

[Stephen Matta, DO, MBA, CAQSM]

Hi Alison,

Methylene blue is great.  I prescribe it all the time.  I usually prescribe a bunch of 10mg caps to start and then quickly have them go from 1 to 2 caps and then usually land at either 25 mg once a day to 50mg once a day.  A few patients prefer a twice a day dosage.  We’ve gone to 100mg a few times, mainly in our Lyme patients.

What are your thoughts on using the Methylene Blue in this patient?  Is it for the mold?

Also, I’m curious about the studies on MB for fertility.  Most of the older studies are on IV doses in the hospital, starting at 1mg/kg and higher, and that’s IV, not oral.  I haven’t heard anything on precautions for fertility myself, and have not held back on prescribing in my younger patients.

Best,

Dr. Steve Matta

[Alison Lechner]

Hi Steve,

Thank you for your thoughts and comments.

I have also not been concerned about using MB in younger patients… I found 1 study from 1989, an in vitro study that showed reduced sperm motility -and another study with the same conclusions from 1999 – nothing about reduction in sperm count. I am thinking that the effects on sperm motility would reverse after cessation of MB ? This information would be enough for my 20 yr old to avoid..

Thanks again for your input.

alison

[Tereza Hubkova]

Do you ever prescribe MT concurrently with testosterone right away? (patient request) – thanks…

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