Tro+ Blue

Ingredients
50 mg Methylene Blue USP

Delivery mechanism
Troscriptions’ buccal troches are scored for easy titration and are typically placed between the upper cheek and gums. However, due to the dose of methylene blue in Tro+ Blue, this troche should be swallowed

Dosing
To be discussed with your practitioner, needs practitioner consultation prior to prescription. Book an appointment here.

Mechanismofaction

• Mitochondria:
  • Increases ATP production (donates electrons to complex IV on ETC)
  • Increases antioxidant reserve (accepts electrons to neutralize ROS)
  • Increases NAD+ production via enhanced glycolysis and NADPH oxidation
• Mild MAOI ➔ Increases serotonin, dopamine, and norepinephrine
• Benefits include enhanced:
  • Energy
  • Neuroprotection
  • Endurance
  • Mood Boosting

Interactions

• SSRI and SNRI medications: Symptoms are unlikely but should be monitored closely at doses >50 mg per day of MB.
• Serotonergic psychedelics (LSD, psilocybin). Abstain from Tro+Blue for 24 hours prior to and after.
• Caution with dopaminergic drugs (Sinement for PD) as MB increases dopamine slightly, symptoms unlikely
• Caution with serotonergic supplementation (i.e., high dose 5-HTP), symptoms unlikely.

Contraindications

• Pregnant or breastfeeding
• Hepatic or renal impairment
• Any known sensitivity to methylene blue or thiazine dyes

Possible side effects

• Blue urine: Methylene Blue concentrates in the urine. This is a benign side effect.
• Blue tongue/teeth: Also benign, lasts 4 to 6 hours. Here are some remedies to help it go away faster if needed. Do NOT use if plastic veneers are in place. ConsuIt a dentist for any concerns.
• Some users report mild headaches. When it does occur, it is usually mild and resolves after the first few doses. If this occurs, we suggest starting with 1/4 or even 1/8 troche and slowly titrating up.
• Numbness/tingling of tongue or cheek: due to peppermint in the formula. If it occurs, troches can be swallowed on an empty stomach with the same benefits.
• Higher doses of MB (>1 mg/kg)–much higher than in our formula–can lead to GI biofilm disruption, oxidative stress, and gastric ulceration. See this article for more information.
• Normal biofilm disruption
• Gastric Ulceration
• G6PD deficiency and induced hemolysis (very unlikely at this dosing) but if using >50 mg for a long period, consider getting this test on your patients
• Oxidative stress
• HTN: Some patients will have an increase in their blood pressure transiently although those with an inflammatory component to their HTN may see an improvement.

Inactive ingredients
Polyethylene Glycol (PEG), stevia extract, luo han extract, peppermint, silica, Bitter-Bloc.