Why most methylene blue cases came from anesthesia, not pills

Most patients on antidepressants are told they can't take methylene blue, even for brain fog. Steven E. Warren, a physician and longevity medicine clinician, joins Kevin to discuss his KevinMD article "51 cases that reframe methylene blue serotonin syndrome." You'll hear why 50 of the 51 published serotonin-syndrome cases involved high-dose IV methylene blue given under anesthesia, mostly during parathyroid surgery, rather than the low oral doses used in outpatient longevity practice. Steven walks through the Goldilocks dosing posture he uses for patients with brain fog, why he screens every patient's full medication list for interactions before starting, and why he tells every patient there are no randomized trials behind methylene blue. He also describes the broader longevity practice he sees daily: patients stacking peptides from the gym, megadosing vitamin D from podcasts, and ordering supplements off Amazon without quality control. If you're a clinician fielding methylene blue questions or a patient considering it, listen for the questions Steven thinks should be asked before starting any unstudied supplement. True team-based care starts with you. At ChenMed, we believe the best way to care for patients is to change the way we practice medicine. When you join our team, you are empowered to lead. We've moved beyond the traditional volume-heavy model to focus on true value-based care. Our model gives you the time and resources to manage complex cases and make a lasting impact on your community. Whether you are applying for a primary care physician, nurse practitioner, or medical director position, you will feel supported by a physician-led culture that understands your challenges. Your dedication doesn't go unnoticed here. You'll be rewarded with a career that offers both professional fulfillment and a better quality of life. Visit ChenMed.com/physicians-KevinMD to learn more. VISIT SPONSOR → https://ChenMed.com/physicians-KevinMD Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended