
Untreated Lyme disease can result in dysfunction of the immune system that affects the quality of life of an individual. There is no specific protocol for treating the disease, particularly severe cases. The prognosis depends on their past medical history & response of the immune system to both the intervention and infection.
Generally, antibiotics are used for the treatment of Lyme disease. But, the problem arises when the bacteria become resistant to antibiotics. Apart from antibiotics, what are the alternative treatment options?
Methylene blue, an aniline-based dye has antimicrobial, antioxidant and neuroprotective properties. Do these properties help in improving the prognosis of Lyme disease patients? What is the link between methylene blue and Lyme disease? In this blog, we will explore the efficacy of this dye in treating Lyme disease.
What is methylene blue?
Methylene blue is an aniline-based dye that was approved by the FDA to treat various disorders, such as methemoglobinemia. It can improve clinical symptoms, such as brain fog, fatigue, anxiety, etc. Initially, methylene blue was used as a textile dye in 1876. Scientists also used methylene dye for staining microorganisms to diagnose infections.
Indications:
- Used in photodynamic therapy to treat various conditions, such as psoriasis.
- To treat various types of cancers
- To ease the pain and inflammation of oral mucous membrane
- To manage vasodilatory shock
- Due to the neuroprotective properties, it can reduce the risk of neurological conditions like Alzheimer’s disease.
How are methylene blue and Lyme disease related?
At the beginning stage, bacteria will be in the growth phase and establish the infection. The bacterial growth becomes slow when it reaches the stationary phase. Antibiotic treatment works against the bacteria in the growth phase.
When the bacteria reaches the stationary phase, these antibiotics become ineffective. After conducting several studies, methylene blue was proven to be an effective treatment strategy against Lyme disease.
Methylene blue can help in managing the clinical symptoms of Lyme disease, such as
- Cognitive dysfunction
- Fatigue
- Mood variations
- Brain fog
Can methylene blue help in eliminating both the active and persister forms of bacteria?
Usually, a 2-4 week course of antibiotic therapy is used for curing the majority of the Lyme disease patients. Even after the antibiotic treatment, some patients suffer from post-treatment Lyme disease syndrome.
Lyme disease is a condition triggered by the bacteria, and its treatment is an extremely challenging issue, as the organism has a variety of morphological forms. Conventional antibiotics such as doxycycline, amoxicillin, etc., kill the active, growing bacteria but usually do not act against persister populations. These forms can resist antibiotic exposure and can result in post-treatment Lyme disease syndrome (PTLDS).
Studies have indicated that methylene blue has antimicrobial activity against both the active and persister forms of the bacteria. It interferes with bacterial respiration, induces a greater amount of oxidative stress in the cells, and enters biofilms.
How does methylene blue help in eliminating bacterial biofilms?
Due to its antimicrobial properties, methylene blue can help in eradicating the bacteria. Methylene blue has the ability to inhibit the proliferation and cellular processes of the bacteria, which helps in relieving the symptoms.
Borrelia burgdorferi forms certain biofilms that protect the bacteria from antibiotics. Methylene blue disrupts the biofilms and makes the bacteria susceptible to treatment. Biofilm disruption can help in addressing chronic infections.
What is the route of administration of methylene blue for Lyme disease patients?
Mostly, antibiotics are administered orally for Lyme disease patients. Oral administration of the drug can result in systemic absorption. To treat the chronic symptoms of Lyme disease patients, intravenous administration is mostly preferred. Due to its anti-inflammatory and neuroprotective properties, methylene blue can reduce the clinical symptoms.
How does methylene blue support brain function in patients with neurological Lyme disease?
Neurological Lyme disease, also known as neuroborreliosis, develops when the bacteria penetrate the central nervous system and result in clinical symptoms such as brain fog, memory failures, sleeping disturbances, cognitive impairment, etc.
Methylene blue helps in protecting the neurons from oxidative stress and neuroinflammation. It helps in restoring mitochondrial function and prevents the deposition of amyloid proteins. In Lyme disease patients, inflammatory and oxidative stress often affect the structure of mitochondria and lead to energy imbalance in neurons. Methylene blue enhances the efficiency of the mitochondria. Methylene blue is also a potent antioxidant, which slows down oxidative harm in brain tissues.
What are the current studies related to methylene blue?
Methylene blue acts against persistent forms of pathogens that cause Lyme disease. Studies conducted by Feng et al. have shown that methylene blue reduced Borrelia colonies by 60%. These findings highlight the importance of methylene blue as a potent antimicrobial drug against Lyme disease.
The recommended oral dosage for Lyme disease patients ranges from 40 to 50 mg twice daily. But the drug must be used with caution in pregnant women and patients with G6PD deficiency.
Conclusion:
Lyme disease is a complex illness that requires prompt treatment to eradicate the bacteria. Methylene blue has emerged as a promising treatment strategy for improving the clinical signs of Lyme disease patients. It can help Lyme disease patients who are facing neurological manifestations. Hence, methylene blue can represent a novel strategy in managing Lyme disease.
References:
- Global Lyme Alliance. Use of methylene blue for Lyme disease [Internet]. Montclair (NJ): Global Lyme Alliance; [cited 2025 Jul 1]. Available from: https://www.globallymealliance.org/blog/use-of-methylene-blue-for-lyme-disease
- Goldman L, Shmerling RH. What to know about methylene blue. Harv Health [Internet]. 2025 Apr 24 [cited 2025 Jul 1]. Available from: https://www.health.harvard.edu/diseases-and-conditions/what-to-know-about-methylene-blue
- Hannemann K. What are the benefits of methylene blue? Drugs.com [Internet]. Medically reviewed by KristianneHannemann, PharmD; Last updated May 5, 2025 [cited 2025 Jul 1]. Available from: https://www.drugs.com/medical-answers/what-benefits-methylene-blue-3579794/
- Brio‑Medical. Lyme Disease Methylene Blue Treatment Guide 2024 [Internet]. Scottsdale, AZ: Brio‑Medical; 2024 Nov 8 [cited 2025 Jul 1]. Available from: https://brio‑medical.com/lyme‑disease‑methlyene‑blue/