This may be the most important podcast I’ve ever published. In this episode, I am speaking with Scott Antoine, MD—a board-certified emergency physician and a functional and integrative medicine doctor. We will talk about the latest findings on COVID-19 and a potential breakthrough on COVID-19 treatment.
IMPORTANT WARNING AND DISCLAIMER: This is entirely the realm of speculation and self-experimentation. This is mainly a call for more research to be done to see if this really works. This is NOT any claim of medical advice, and certainly NOT any claim that these strategies can treat, prevent or cure ANY illness. Again, this is SPECULATIVE (based on emerging, early research), and the goal is to advance the state of research, with the hope this may be a genuine breakthrough. Any action you do or do not take based on this information is done at your own risk. You should always consult with your doctor before performing any form of self-experimentation.
Table of Contents
Studies and Resources mentioned in the podcast:
- Coronavirus Disease 2019: Coronaviruses and Blood Safety, ScienceDirect
- COVID-19: Attacks the 1-Beta Chain of Hemoglobin and Captures the Porphyrin to Inhibit Human Heme Metabolism
- Methylene blue photoinactivation abolishes West Nile virus infectivity in vivo
- Inhibiting the NLRP3 Inflammasome With Methylene Blue as Treatment Adjunct in Myelodysplasia
- Methylene blue photochemical treatment as a reliable SARS-CoV-2 plasma virus inactivation method for blood safety and convalescent plasma therapy for the COVID-19 outbreak
Methylene blue sources: Anywhere selling “pharmaceutical grade” methylene blue. This category of compounds is technically labelled as “not for human consumption” so I cannot advise anyone to take this. Sources I’ve found are http://science.bio and www.healthnatura.com. (Please note that I do NOT receive any kind of affiliate commissions if you purchase any products from these stores. Again, any self-experimentation you do is at your own risk. Always consult your doctor before any self-experimentation.)
In this podcast, Dr. Antoine will cover:
- • The new emerging paradigm on COVID-19
- • Why the world’s oldest pharmaceutical, methylene blue may be a game-changer for COVID-19
- • A tool that may combine and synergize with methylene blue to create powerful results
- • The two fantastic therapies to use to treat COVID-19 (one of them is a favorite of mine)
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Listen outside iTunes
Ari: Hey, everyone. Welcome back to The Energy Blueprint Podcast. I’m your host, Ari Whitten. Today, I have with me my friend, Dr. Scott Antoine, who is a board-certified emergency physician who served for seven years on active duty with the United States Army as an emergency physician. In addition to his background in emergency medicine, Dr. Antoine completed a fellowship in metabolic, nutritional, and functional medicine through the Metabolic Medical Institute, which is affiliated with George Washington University and the University of South Florida. In 2016, he was one of only 121 physicians nationwide to achieve board certification in integrative medicine through the newly-formed American Board of Integrative Medicine. He also holds a certification in functional medicine through the Institute for Functional Medicine. Welcome to the show, Dr. Scott Antoine. Such a pleasure to have you.
Dr. Antoine: Thanks very much. Good to be here.
The difference between ARDS and COVID-19
Ari: Yes. I’m incredibly excited for this episode. I was just saying to you before we started recording, I don’t think I’ve maybe ever been this excited to get into material. I think this is really urgent material. Potentially, there’s lots of layers of speculation. I’m sure you’ll do a good job of explaining the caveats and where you’re speculating. I do think that this has real potential to make a difference in this whole fight against coronavirus. I think there’s a really fascinating new shift in the way the paradigm of how this is being viewed. I’m really excited to have you on to explain all of these layers, the story, and hopefully put some information out there that may lead to some new findings. To start with, how about we dig into the typical model of ARDS, acute respiratory distress syndrome, and the flu and the whole cytokine storm, and what’s happening with coronavirus while it was initially thought to be kind of the same thing, how the paradigm seems to be shifting to a different model? Can you explain that and I’ll let you start wherever in that big mess of stuff you want to start with?
Dr. Antoine: Absolutely. I think, as an emergency physician, the first place I’d start is where I learned about this oxygenation, ventilation, shock, and death. Oxygenation is caused by– There’s a lot of factors that go into whether you can oxygenate. First of all, is there oxygen in the environment? Secondly, do you have the ability to get it into your body? Also, you need a certain amount of red blood cell mass to be able to do that. Ventilation is a little bit different. Ventilation is actually the physical ability to get oxygen in and get it into the red blood cells through the capillary membrane. In your lungs, you have these little balloons, millions of them called alveoli, and so you have to be able to get the oxygen through that membrane and into your red blood cells to be able to oxygenate your cells. The reason that’s important is because oxygen is required, as you know, to make ATP, that fundamental energy molecule for life that runs the whole machine in the mitochondria. You need oxygen to be able to do that. You also need to be able to get rid of waste products, carbon dioxide and other things through exhalation. When you have an issue like an infection or pneumonia or ARDS, you actually get fluid in the airways that then prevents you from ventilating well and getting oxygen in. Ventilation is a little bit tricky because it’s a muscular exercise. If you’re really panting or working, you’re having a hard time getting that oxygenation in. After a while, you’re going to give up and your body’s going to relax. You can get a false sense of security with a critically-ill patient because, eventually, their respiratory rate will drop. You can look at them and think, “Maybe they’re getting better,” but then they’ll start getting tired. When you can’t get enough oxygen in, what happens is you have what’s called shock. Shock is not getting enough oxygen to the tissues. When that happens, tissues die and then you can get failure of your kidneys, your heart, everything else in your body and then, ultimately, your brain. When you shut off oxygen to the brain, that process of brain death can happen pretty quickly. It’s one of the things we worry about. If people have a sudden cardiac arrest or stop breathing or drown, they lose oxygen to the brain. If that goes on for more than about three minutes, you start having what’s called anoxic injury to your brain. Sometimes people don’t come back for that. If they do, they’re profoundly affected. In this illness, what we’re seeing is we’re seeing people that are coming in initially, a lot of times having issues where their oxygen levels are low. They actually don’t look sick yet. After a period of time, they become progressively more short of breath and then develop issues. Their chest X-ray actually changes. Actually, you’ll see white streaks on the chest X-ray or on the CAT scan, indicating there’s some fluid in the alveoli. You’ll have issues, ventilating and oxygenation, getting the oxygenation through. It’s trying to push oxygen through fluid. When that happens, people then get progressively more short of breath. If they progress, then you have to intervene. The first step is flooding the system with oxygen. Put on a nasal cannula or add pressure to that to help push the oxygen into the bloodstream. Sometimes that works and sometimes it doesn’t. Ultimately, if people cannot ventilate, you really don’t have a whole lot left that you can do other than put a breathing tube in and really increase the airway pressures and try and push oxygen into the cell. It’s a fine line when folks come in the decision to intubate or put a breathing tube in. It’s really dependent on their oxygen levels and also the effort that they have. What’s happening with these patients is they will come in and a lot of people recover. I don’t want to make it seem all like doom and gloom because the majority of patients have actually recovered. The ones that don’t, they get progressively more shortness of breath, actually have this pattern on their X-ray and it looks like ARDS, which is adult respiratory distress syndrome. It’s got a characteristic look. One of the hallmarks of ARDS is a loss of lung compliance. A balloon is pretty compliant. You can blow into a balloon and it easily inflates. If you were trying to blow into a loofah [chuckles] sponge, there would be some resistance to that. There’s the loss of compliance. Usually, in ARDS, there’s a loss of compliance in lungs and lungs are stiff. It’s super hard to oxygenate. In this disease, we’re getting reports from pulmonologists and critical care doctors that are running the vents in the unit that compliance does not seem to be high. That’s, A, and then B–
Ari: Just to translate that last bit that compliance doesn’t seem to be high. What does that mean in simple terms?
Dr. Antoine: The lungs don’t seem to be as stiff as we would normally expect in adult respiratory distress syndrome. The lung, it’s easier to ventilate. That’s a little odd in a model of ARDS. ARDS can happen in response to a lot of things. It can happen in response to a terrible infection, autoimmune disease. There’s a lot of things that can trigger it. Usually, it’s a brief stop on the pathway to death. It’s hard to recover from ARDS because, ultimately, in addition to problems ventilating, you can’t oxygenate and then you go into shock. Your organs shut down and you die. That’s really what we’re seeing in folks with coronavirus. In addition, we’re seeing a second spike of deaths in the second week that’s associated with what we call cytokine storm. There’s a release of all these inflammatory chemicals. Your body’s trying to kill the virus, but it just gets overwhelmed and sends all the soldiers out. Interleukin 6, an inflammatory cytokine. Tumor necrosis factor-alpha, TNF alpha. These things are released and then overwhelming an already stressed body and then some people tend to look good after maybe the first week. You can get them then decrease their oxygen requirement. They look like they’re getting better. In the midst of the second week, they just really deteriorate.
Ari: I have a few questions.
Dr. Antoine: Yes, sir.
Ari: If this is a good point to interject in what you just said, I want to unpack some of it.
Dr. Antoine: Sure.
The danger of the cytokine storm
Ari: First thing is it sounds like based on what you just said that there’s almost two causes of death or two potential causes of death. One is the low oxygen saturation from what’s going on with the lungs or as we’ll talk about later, the red blood cells and the oxygen issue. The other is the cytokine storm, which maybe happens later as a second wave. Just out of curiosity, first of all, is that correct? The second piece is, is there one of those two that seems to be the primary cause of death for most people who are the people dying from this?
Dr. Antoine: The causes of death in a lot of cases end up being cardiac people. When you are profoundly in shock and you can’t oxygenate or ventilate, carbon dioxide builds up, then that causes some acidity changes in your blood. You release potassium, which stops your heart. There are some cardiac deaths. There are also some unusual cardiac deaths when we talk about oxygenation and some other things. Later, I’ll talk about those. We’re seeing deaths from inability to oxygenate or ventilate. We are seeing this second spike in the second week we believe due to the cytokine storm. People are now measuring interleukin 6 and C-reactive protein, ferritin, some other inflammatory markers and finding they’re quite elevated at that time. When your body releases all these cytokines, it’s almost like when you have an allergic reaction. Your body’s trying to protect you, but it can go a little bit overboard and then just it’s so overwhelmed and it’s giving it its last kick and people then will get suddenly sick. The cytokine storm is really a massive inflammation situation. Ultimately, if you were to trace every biochemical process, death is always inflammatory. That’s why it’s so dangerous for folks to be inflamed in general as they live. We look at things like obesity, lack of exercise. Stress is inflammatory. There are inflammatory diets. We always talk about an anti-inflammatory diet. Anything that’s going to cause inflammation like that is going to put you in a worse place. Indeed, these are people that we’re seeing doing worse with the coronavirus.
Ari: To that point, there was some stats that that just came out in the United States where I believe they said 86% of people who have died have at least one preexisting condition. The data from Italy was, I think, 99% of people that had died were, I think, over the age of 50 or 60 and had at least one preexisting condition. Typically, cardiovascular disease or diabetes or hypertension.
Dr. Antoine: That’s right. One of my favorites, Mark Houston, who teaches a lot about hypertension and cardiac issues, talks about the big three, the three final endpoints. They’re inflammation, oxidation, and an abnormal immune response. You can search the literature. That’s really the cause of cardiovascular disease. Alzheimer’s, any significant disease, cancer. Those factors and indeed in this disease, same thing. You’re trying to manage the immune system response to the cytokine storm. You’re trying to manage oxidative stress, which we can talk about in a bit. You’re trying to manage inflammation. You’re right. All chronic disease really comes with some element of those three. The more you got and especially if it’s not well-managed, poorly managed diabetes, et cetera, that’s where you’re going to get in trouble.
Ari: Got it. The other thing I wanted to come back to is the idea that this seems to be in a typical ARDS. There’s people who are talking about the scans. I think their CT scans or chest X-rays, maybe that there’s– I think they’re calling it a ground-glass appearance. It’s always on both sides. It’s a very distinct pattern that is different from what they see on chest X-rays with influenza, pneumonia, and ARDS. There was a video that went viral from this doctor in New York saying, “Hey, this is really atypical. The ventilator doesn’t seem to be fixing this for people.” As you said, there’s a point at which you have to ventilate, but he was basically saying that they have very low oxygen saturation in the blood, but maybe ventilation isn’t the right path because it’s more akin to altitude sickness than true like a failure of the respiratory muscles and the ability to breathe. What are your thoughts on all of that?
Dr. Antoine: That’s right. The ground-glass opacities, it’s just a cloudy look on a CAT scan or even on a chest X-ray. That’s something you can see on ARDS and you are seeing it in this instance. In influenza, I can just say, I periodically would see a super sick patient in the ER with influenza that we’d have to hospitalize. It’s very rare where they have to be intubated. Typically, they’d have what looks like a viral pneumonitis. Just like streaks on both sides. Whereas the COVID-19 patients who are coming in that are super sick, it’s almost immediately a severe finding. It’s usually bilateral, which suggests some central process. The video you’re talking about was probably, I guess that came maybe a week ago, maybe five days ago, from a critical care physician. I think that may have been in New York, but talking about, “Hey, this isn’t like what we’re seeing. In fact, the ventilator parameters are different.” When you’re setting the ventilator, you have to set a bunch of things. You have to set the volume of gas you’re going to put in. That changes depending on the size of the person. Little people get little amounts of tidal volume. If you set that too high, you can cause a pneumothorax like a pressure injury to the lung. You have to set that. You also have to set how many times they’re going to breathe in and out. You do that by checking oxygen in the blood. You also have to set pressures. What we’re finding in this is that we have to set what’s called PEEP, positive end-expiratory pressure. Think of it like if you were breathing through a tube and there was a continuous jet of oxygen or gas coming towards you. As you’re breathing in and even as you’re breathing out, it’s holding your alveoli, those little sacs open so that you’re just pushing oxygen through. Because if you don’t hold them open and you have a lot of inflammation in the lung, they can get stuck shut. That’s called atelectasis. If that persists, you lose that amount of lung to function. It can then cause a secondary bacterial pneumonia. You’re always trying to keep the alveoli open. Those are some things you’re setting. This critical care physician from New York said the ventilator settings are a little bit different from what we normally see with ARDS. This is more like high-altitude pulmonary edema, HAPE. When you’re at altitude, there’s less oxygen in the air. If you ascend too quickly without being acclimatized, you can actually develop fluid in your lungs and difficulty breathing can actually be fatal and also develop fluid in your brain. He said this is really more like high-altitude pulmonary edema. Pivoting off of that, there was another physician also from New York who published a lesser-known open access journal, published an article on using some of the therapies that you use for high-altitude pulmonary edema using those in COVID-19 pneumonia. He did a really nice job of paralleling high-altitude pulmonary edema and COVID in the ventilatory parameters were very similar and then postulated we could use some of those same medicines.
How COVID-19 may not be just a respiratory condition
Ari: Got it. That’s a nice segue, I think, into this new paradigm of what’s going on with this condition if it’s not atypical pneumonia and why these people seem to have low oxygen saturation in the blood, even though there doesn’t seem to be the characteristic respiratory muscle failure and exhaustion that would normally exceed those low oxygen saturation. My understanding is that patients, they’re showing very low oxygen saturation in the blood, but they don’t seem super distressed and they seem to be doing fine. Maybe that’s an exaggeration, obviously, in the earlier stages, but they seem to have these extremely low oxygen saturations where, normally, at those levels, people would be very distressed or having lots of symptoms. In this case, they don’t seem to be. What is this new paradigm that’s emerging of what this virus is doing in our body?
Dr. Antoine: Right, so I stopped working clinically in the year back in November after 27 years. My wife and I are both still in contact with our emergency physician colleagues. I was hearing reports just sort of make you say, “Huh,” from our colleagues. Typically, when people come in the ER, put the little pulse oximeter on your finger and we measure that. A normal pulse oximeter reading might be above 93 or 94%. By the time the pulse oximetry gets below 90%, people start struggling a little bit. They don’t feel good. Oxygen decreases to their brain. Sometimes they can get confused and a little combative even as it drops lower. You start seeing issues with shock and death if it persists. Normally, if you were to see someone with an oxygen saturation less than 90 on their pulse oximeter, if they had, say, asthma or just to run in the middle of pneumonia, they’d be working. They’d be breathing quickly. They wouldn’t feel good. They’d be gasping for air. We started hearing reports. A few of my colleagues here in Indianapolis emailed to our attending group at large and said, “Yes, weird. I saw a guy the other day with an oxygen saturation of 70% and he actually walked into the hospital with his wife.” He was older. He got worse in the ER and they ended up intubating him. They said, “Well, isn’t that weird? He came in and he actually was able to walk with that saturation,” and then I started hearing–
Ari: Just for reference, that level of oxygen saturation might be with someone would have like at the top of Mount Everest at 25,000, 28,000 feet.
Dr. Antoine: You’re exactly right. There’s actually graphs that show your oxygen saturation decreases as you climb to altitude. When that happens, you actually get an increase in red blood cells in your body that allows you to deal but chronically. I started hearing anecdotal reports from critical care doctors and people around the country saying the same thing. People coming in and they look comfortable, but their oxygen’s really low. I put out an email to a large listserv that was an email listserv. I get about 15, 20 emails a day, emergency physicians all over the country. I asked them this question. I said, “Hey, are you guys seeing patients come in that have an oxygen saturation that’s low and they don’t look that bad?” “Yes, yes, yes.” All over the country, “Yes, yes, yes.” “Gee, I wonder why that is?” I started thinking, “That’s interesting.” In addition to being at altitude, the other time that we see a falsely low pulse oximetry where people look comfortable is when they have an abnormal type of hemoglobin. Carbon monoxide poisoning, also something called methemoglobinemia. Oxygen. Normally, hemoglobin carries oxygen. There are some compounds that can interfere with that and kick the oxygen off. When that happens, you lose oxygen. When you test initially, they still have oxygen in their blood. You can do a blood gas in their wrist and see, “Oh yes, they have a normal amount of oxygen in their blood, but their oxygen saturation on their finger pulse ox is low.” One of the things we see in the ER, it was the result of some medicines. There’s a congenital version of it. Usually, we see it in the air from medications. People will develop methemoglobinemia where they will have abnormal hemoglobin. It won’t carry oxygen. If it continues, if their oxygen continues, saturation continues to drop and they get more and more of that abnormal hemoglobin. Eventually, by the time it gets to 30 or 40%, start gasping. When it gets to 70%, people actually die due to shock once again. We would see this in the ER. The two cases that I think I saw in 27 years were people that took AZO for urine infection. AZO is a dye. It’s available over the counter. The prescription forms Pyridium and it stops bladder spasms. People, especially women when they get a lot of urinary infection, they get a lot of bladder spasm. People will take it. You’re not supposed to take it for more than three days. Over the counter, people will just continue. It is a known cause along with some other medications of methemoglobinemia. I saw a girl come in one time. She said, “I don’t feel really well,” and then they put her on the monitor. Her oxygen saturation was 70%. She was looking and talking to her friend and said, “That’s really strange.” They ran a blood gas. It was normal. I sent a different type of blood gas. Sure enough, her methemoglobin level was high. Once we gave her the antidote for that, the methemoglobin came down. She pinked up. When those folks with methemoglobinemia come in too, they’re blue. They have a bluish tint. They look like they have low oxygen. You can look at that and say, “Wow, their oxygen is low. They don’t look so good,” and end up in that situation. We looked at this a few days ago. My wife and I just started thinking about this and talking through it, “Yes, that sounds a lot like that.” Did a pretty extensive literature review and found some sort of support for that. In the interim, an article came out also in an open-access journal. Well, lesser-known journal. I’d never heard of this journal, but there was a publication out where someone did a– It’s so complex. You can barely read the article, but it’s a computer-generated model that looks at binding sites of hemoglobin and viruses and how they interact and produces this model. What this paper basically said was that coronavirus attacks hemoglobin, displaces iron, and then that causes oxygen that would cause exactly what methemoglobinemia does. It causes a saturation to go down even though you have plenty of oxygen in your blood.
Ari: Just explain one layer of detail more there.
Dr. Antoine: Sure.
Ari: The oxygen is still in the blood, but it is not on the hemoglobin in the red blood cells?
Dr. Antoine: Right. Your red blood cells have, inside of them, hemoglobin that carries oxygen. When the red blood cell gets to a tissue, brain, kidney, whatever, it releases the oxygen from the hemoglobin. It picks up carbon dioxide, then gets transported back to your lungs. You exhale the carbon dioxide. It’s what’s supposed to happen. If you have someone with an abnormal hemoglobin and they can’t carry oxygen on it, they may still be breathing oxygen in. If you’re measuring their bloodstream, you’re like, “Wow, there’s some oxygen getting in, but it’s not being carried to the tissues very well.” There’s specific types of measurement you can do to look and see if someone has methemoglobinemia. Getting back to this paper, the paper came out. It’s now widely circulating on the internet that basically said the coronavirus attacks part of the hemoglobin, pulls the iron off so it can’t carry oxygen any longer, and this is how it’s causing part of the issue. Now, the paper is super technical. I can’t find any evidence that’s specifically peer-reviewed, but I searched down each of the references in the paper. They all make sense. They’re all good. If that were the case, then the coronavirus is almost doing what methemoglobin does where you lose the capacity to carry oxygen. It’s just a theory we came up with about this. I started researching and thinking and looking into it. Whether it actually attacks the beta subunit of hemoglobin, beta-1 subunit of hemoglobin, according to their analysis, it could. It’s just a super technical article and I know nothing about it. Looking at it, it looks plausible. It fits what we’ve been talking about.
Ari: Right. That’s what I was going to say. This mechanism and this emerging new paradigm of what this is doing in our body seem to match up with this atypical presentation that ER docs are seeing as far as these low blood oxygen saturations but being relatively comfortable.
Dr. Antoine: It does. The other part of this paper is there’s this hypothesis in the paper that says when that iron is removed, it becomes a more corrosive type of iron with a different chemical charge on it, which then itself induces damage. We know that free iron in the body is damaging. There are certain diseases, hemochromatosis and other genetic disorders where iron builds up. If you take an iron overdose acutely, you can die from that. Free iron in the body, as well as other free metals, can certainly be harmful. Their hypothesis is that this free iron then damages the lungs and that’s what’s actually making these characteristic findings. It’s not fluid and pus from the infection, from the viral infection, but it’s actually the liberation of these metals. Now, it’s an interesting hypothesis. I couldn’t find any other evidence of that in the other medical literature about the release of iron due to, say, methemoglobinemia or carbon monoxide or other things. I don’t know. Certainly, interesting. Maybe there are more studies, but there are some other things that are really interesting. When you go down that road and then you look at methemoglobinemia and the treatments we use for methemoglobinemia, something very interesting emerges that also has direct virucidal activity. That’s where I think we may beat this. Once you get to the point [clears throat] where folks are not ventilating, they’re not oxygenating, they’re in shock, they have organ failure, they’re intubated, you’re way behind the eight ball. Those are the folks that have between a 40 and 70% mortality. It’s really hard to recover unless you’re young and they do things exactly right. One of the comments I wanted to make earlier on was that when you could get into pulmonary mechanics, they’re laying people prone now upside down in the bed to improve the ability to ventilate. They’re doing a lot of interesting studies with changing ventilator pressures and oxygen. There was a few things developed a few days ago that I know we had talked about where people had said, “Look, ventilators are harming patients.” The reality is those folks are so critically ill, they’re probably going to die anyway. If you don’t institute a ventilator, when you’re not ventilating and your oxygen level is low and you’re in shock, the person’s just going to die. Unfortunately, that’s what’s happening in some places where they’re having to ration ventilators. They’re making decisions and saying, “Listen, if people are above 70 or they have a lot of other medical conditions, maybe we won’t use the ventilator there. It’s a terrible decision. Maybe we’ll use it in the 22-year-old or the 40-year-old that comes in.” It’s not the ventilator that’s harming people. I think the critical care docs that run ventilators all day are doing an amazing job. They quickly figured out they need to prone these patients. They figured out unique things. They’ve also made a policy statement that I reviewed yesterday that I thought was interesting, which was decreasing the amount of oxygen as soon as you can because oxygen is toxic. If you run people at 100% oxygen for a period of time, it’s injurious to a lot of other tissues and to the brain. They’ve made a rule that you should not try and get the oxygen above a certain level. That, I think, is an awesome idea.
Ari: One quick thing on the ventilators and then I want to shift into the real stuff about where all of this stuff leads to, which has, I think, a lot of potential, really exciting potential. On the ventilators, obviously, you and I have discussed some of the data that really looks pretty disheartening around the survival rates on these ventilators. Chinese data was something like 92 to 97% of people being put on ventilators don’t survive. What I take from that is, as you said, there’s a point at which the severity of this thing in order to try to save that person’s life, you got to put them on the ventilator. I think you said in one comment as we were discussing, you either put them on a ventilator or you code, which is meaning, you, I guess, fill out their death certificate.
Dr. Antoine: Right. You can trial, but a lot of people now aren’t doing CPR on these folks. Because at that point when they’re ventilated and their heart stops, there’s really an abysmally low chance that they’re going to survive at all. People are making that decision right now, which is tough. When you’re making the decision to intubate, you’re not always getting a blood gas and checking labs and sitting down, making a decision, looking at the chest X-ray. There are a few reasons. When you see someone and they come in after you’ve worked in the ER for a while, you have this gestalt. You look at them and say, “This is madness. This is going downhill quick.” If you have someone who has low oxygen and they’re combative, there’s not a lot you can do because if you give them a sedative, that will lower their respiratory drive. You’ve then, in effect, killed them. In those cases, we have to use paralytic agents to carefully put them to sleep while maintaining their airway and then putting the breathing tube in. You’re right about that. When you get to that point, there’s not a lot of choice you have, but wouldn’t it be nice if we could three steps back from that, get to the root, and stop it before it gets—
Why Methylene blue + Phototherapy may be a game changer for COVID-19
Ari: That’s exactly what I was going to say. With these really disheartening statistics on survival rates around ventilators and so much of the conversation has been centered around, “Hey, we have a ventilator shortage,” of course, we need to fix that and save as many lives as possible in that very severe stage. My interpretation of this is, as you just said, that we really need to be looking more upstream about what we can do to prevent people from getting to that stage of severity where they need to be put on a ventilator. I think that’s where this new stuff comes in. What’s exciting to me is as I was hearing about hydroxychloroquine and the anti-malaria aspect, it’s like, “Well, why does a malaria drug work against a virus? That’s kind of weird.” Just out of curiosity, very randomly, I had this thought, this memory from one of my courses of methylene blue as an anti-malaria drug. Methylene blue is this compound that I’ve been playing around with since I was a kid because I used to treat my fish in my aquarium with it when I was starting when I was 12, 13 years old. I always just thought it was fascinating. It has these amazing patterns that it forms that are just beautiful when it interacts with water. In recent years, I’ve used it as a mitochondrial enhancer in nootropics. It’s kind of this compound has been around forever. It’s cheap. I just randomly looked up methylene blue and coronavirus and started digging a little bit. I found some really fascinating stuff. I posted about it and you’re like, “Yes. Actually, I’ve been digging into this for the last two weeks.” I was like, “Cool. We need to do a podcast and talk about that.” Let’s shift now into that. What is the story with how methylene blue and maybe hydroxychloroquine and some of these other compounds fit into this story of the methemoglobinemia and how this coronavirus apparently is interacting with our red blood cells?
Dr. Antoine: Your body always produces methemoglobin. It happens as a result of normal biochemical processes, but your body has a few enzymes that break that down and restore normal oxygenation of the hemoglobin. There’s two different pathways that do that. There’s the main pathway, cytochrome b5, that takes the methemoglobin and then converts it to normal hemoglobin, which can then carry oxygen. That happens all the time every day unless you have a genetic defect and there are some. In most folks, that occurs constantly. There’s another lesser-known pathway that your body typically doesn’t use. If you’re overwhelmed and you’re having issues, the methemoglobin, what you can do is you can use methylene blue. That’s actually what we use, what I’ve used in the emergency department when people have methemoglobinemia. You do an infusion of the dye, methylene blue. Methylene blue, it displaces the methemoglobin and restores normal oxygenation. It’s 20 minutes into the infusion and it’s gone. If you have someone that has a fairly low methemoglobin level, you might watch them for a few hours. Six hours is standard and then discharge them. Other times if it’s an older person with other medical problems, you might admit them to the hospital and do treatment overnight and keep checking their methemoglobin levels. [clears throat] That’s one thing. I started looking at it and thinking, “Well, isn’t that interesting?” We have this gap with the falsely low– I’m positing falsely low saturation. We have a suggestion that this virus may be pulling iron out of the hemoglobin for its own use. The article that actually talks about the virus-hunting [chuckles] iron. Viruses aren’t really living, so I don’t know that that’s the case. Anyway, methemoglobin tends to dissociate that. Taking that back a step further, I’ve known about methemoglobinemia and methylene blue for years. I started going back and thinking, “Let me learn a little bit about methemoglobin.” Sure enough, hydroxychloroquine and chloroquine have been derived from methylene blue. Methylene blue came out in the late 1800s and it was one of the first, if not the first, commercially-prepared drug. At that time, it was called a chemotherapy and it was recognized that it was a great antibacterial. In fact, actually, I have a paper from 1933 about anti-virucidal properties of methylene blue. They actually tested against herpes virus and certain things and found that it was active. Methylene blue, in addition, has been studied in the SARS-CoV-2 virus, the COVID-19 producing virus, and found that in the blood supply, if you give methylene blue, methylene blue is typically given and then patients are exposed to some wavelength of light, that’s sort of [unintelligible], but they’re exposed to some wavelength of light called photobiomodulation and then that seems to activate the methylene blue and work. Now, in the 1900s, early 1900s, they gave people methylene blue and orally and then put them outside. That was their method of light exposure and found that the cells they were testing or people that they were testing tended to improve. Then it was used against malaria and it was used until other alternatives were made. People in the- soldiers in the 1940s in the South Pacific started complaining because it makes your urine blue and the whitest part of your eyes, blue, it’s reversible, but people didn’t like that, and can also cause some burning with urination, occasionally nausea, but very low incidence of side effects. So methylene blue fell away. It’s used as we talked about yesterday in chemistry, obviously methylene blue slides, tuberculosis, they will stain with methylene blue. I started digging more into methylene blue and I found that there are studies just recently in transfusion journals where they took blood that had the SARS-CoV-2 virus, the COVID-19 virus, and they gave it photobiomodulation plus methylene blue and it killed all of the virus.
Ari: Yes, that’s what it said. One of these studies that [unintelligible 00:37:30] that I was like shocked to find, especially this is a brand new virus and I was like, here I was thinking, hey, I’m the first person in the world who think methylene blue might have some role to play here and then I go and find a study, I find you, you’ve already been thinking about it for two weeks and then I find that this study that you’re referring to, which is called Coronavirus Disease 2019: Coronaviruses and Blood Safety. There’s one specific line that they said in their methylene blue plus visible light has the ability to inactivate coronaviruses in plasma. I was like, wow, mind blown. Then sure enough, you look up the absorption spectrum of methylene blue, and it’s 550 to 700 nanometers is where it absorbs light, which is almost specifically the red spectrum of light. I wrote a book a year and a half ago on red light therapy in The Ultimate Guide to Red Light Therapy and that’s been an area of interest of mine for 10 years now.
Dr. Antoine: Great book by the way.
Ari: Thank you [crosstalk].
Dr. Antoine: I highly recommend it. I recommend it to my patients.
Ari: Thank you. It was just like, “Whoa,” I didn’t even know. I’ve been studying this for so long and then here it was like red light therapy and methylene blue, these two things that I’ve been playing with for a decade might have some interesting role to play here.
Dr. Antoine: Methylene blue and chloroquine and hydroxychloroquine, they’ve been studied against various viruses. They’ve been studied- in the case of methylene blue, it’s antibacterial and there’s a lot of properties. It’s also a super strong antioxidant. There was another paper actually, which talked about methylene blue and it described it as a pyromaniac firefighter. In that, it can induce oxidation at certain points and be an antioxidant at certain points and is a super strong most potent antioxidant. They described it as second other than glutathione. What they found with methylene blue and with chloroquine and hydroxychloroquine is the way that they work against viruses and specifically against the coronavirus, is that the coronavirus lyses with human cells and then it actually injects its RNA, its genetic material and it makes your cells make more of it until your cells die and then release inflammatory chemicals, et cetera. So, in order to reproduce, the coronavirus needs an acidic environment, and methylene blue as well as chloroquine, hydroxychloroquine increase the pH, meaning make it more alkaline, less acidic, in these [unintelligible], these little organs in your cell that the coronavirus uses. It uses them to reproduce the genetic material. It also uses other enzymes that are chemicals that make- the proteins that make something happen quicker, but it uses other enzymes in your cells to reassemble itself, and methylene blue, hydroxychloroquine and chloroquine inhibit that. They inhibit that process. So really interesting, as pH changes, they directly attack these enzymes while not seeming to harm human tissues in human cells at the same time.
Ari: At that point, there’s a whole bunch of research on the photodynamic therapy, which is basically using methylene blue as a photosensitizing agent, combining it as you mentioned earlier, with light, could be a red light therapy device, could be sunlight, as they did in the olden days, people outdoors just roll their hospital card outdoors, and then there’s a whole bunch of research basically showing that this seems to have the ability to be selectively toxic. Two, there’s research in context of cancer too, it’s selectively toxic to cancer cells and then selectively toxic to viruses in this particular case.
Dr. Antoine: Also, in malaria. Malaria is an intracellular parasite and it does- hydroxychloroquine and chloroquine work in a very similar fashion where they make things acidic and they actually deplete the parasite of oxygen and glutathione. At which point the parasite can’t detoxify [unintelligible] and other things and just dies off. Fascinating stuff.
Ari: There seems to be, by my count, maybe four relevant mechanisms with how methylene blue might have a role to play here. One is it’s interaction with hemoglobin. Other one is the interaction with light and the selective phototoxicity to the virus where it inactivates the virus. There’s some research already, as I mentioned before, to support that. Then there’s the alkalinity element, which is what you just explained. Then I’ve also read that the- and maybe this is really the same as the inactivating viruses, but I guess the way that that happens is methylene blue apparently delivers a single oxygen, like a free radical to the virus that destroys it or inactivates it. At the same time, it seems to be an antioxidant to our cells. At the mitochondrial level, it’s also a pro-oxidant selectively to the viruses.
Dr. Antoine: That’s right and that’s why it’s been used in cancer. There’s actually a pretty interesting article from Italy where they talked about a cohort of 2,500 patients. Now this was done back in March, we’d need to take a look again at these 2,500 patients and see how they’re faring because things got very bad, in Italy since then, and even before then, but this physician wrote, I’m not sure if he’s an oncologist, but he wrote about his patients and he had them on methylene blue. He also had them on hydroxycitrate, he had them on alpha-lipoic acid, another antioxidant, and a low carb diet.
That was their cancer regimen. Had nothing to do with COVID. He then published at least at the end of March, that none of them, and we would consider cancer patients to be immune compromised, none of them had the virus and the virus was wreaking havoc. I’d love to follow up on that. That article itself actually contains an amazing amount of information in how methylene blue works and why this happens. I think it’s interesting they were on a low carb diet, which tends to be more anti-inflammatory than higher proc- especially processed carbs. That’s an interesting part of it. Once again, I don’t recall if that was a peer-reviewed study, and so we get into the situation, a lot of what we’re talking about is bench research. It’s either in vitro, meaning just cells, or it’s basic science research, looking at how things work, the boring kinds of science that physicians don’t always read. What’s really interesting is that’s a fantastic thing that happened in this disease is people took that and said, “Hey, what do you know? What if we use that?” and speculated and now we’re seeing some benefit growing out of it. There was a lot of opposition among some physicians. We can only use these things if there’s been 10,000 patients study and it’s been a randomized double blind placebo controlled study. What I tell people sometimes when I lecture is really sick patients, whether it’s chronically ill or acutely ill, it’s an emergency. You have to fix them. When you’re in that situation, you don’t always have time for the 10,000 patients study. This is a serious illness. Those are the times when we use medication, what’s called off-label. There was a big push and people got a little bit incensed, “When will the FDA approve hydroxychloroquine for use in COVID?” The reality is, you’re allowed as a physician, on your own liability, but you’re allowed to use the medications off-label whenever you want and people do. So, if you’re pregnant and vomiting and you get Zofran or Phenergan, no FDA indication for that, but we’ve done that for years. If you get an epidural steroid injection, no FDA indication for steroids in anywhere near the spine. We do those things, but people are starting to come around and these large physician groups, in fact, people are starting to ask questions, “Hey, should I be taking glutathione before my shift? What about zinc? What about vitamin C?” It’s interesting to me because those are the folks that a year ago might’ve scoffed and said, “Zinc doesn’t do anything. It’s just you’re making expensive urine,” and that kind thing. I’m actually happy that physicians are treating patients clinically with that and I’m not saying be a cowboy and just administer all sorts of stuff, but gosh, if there’s that much basic science and it makes sense, because what we’re seeing with methylene blue, hydroxychloroquine and chloroquine, is that it was all very active against the original SARS virus, which shares about 82% of the genetic material with the current SARS virus. SARS occurred back in 2002, 2003, was also started in China, and that had a 10% mortality rate. Fortunately, they stopped that before it got out with antivirals and I believe they used hydroxychloroquine. There was a Middle Eastern version of that that was about 2012, thank goodness that never got to the United States, it had a mortality of 35%, also a coronavirus.
Ari: Just for reference to put those numbers in context, the best estimates of experts that I’m seeing on the mortality rate of this novel coronavirus are between about 0.2% to maybe 1%. Maybe the highest estimates are maybe 2%.
Dr. Antoine: Absolutely. Now, obviously changes if you’re older or sicker. People will look at that sometimes and think, “Well, that’s about the same mortality as the flu.” That’s true, but at the same time, there are different molecular mechanisms that make this virus much more likely to spread between people. As I said, thank goodness the MERS virus and the original SARS virus in the early 2000s wasn’t this infective or we would have lost millions of people, likely.
Other potential factors that could help COVID-19 treatment
Ari: We talked about methylene blue, I want to almost emphasize that- to me, I’m looking at some of this data, this quote from this research, methylene blue plus visible light also has the ability to completely inactivate coronaviruses in plasma. There’s all of these layers of mechanisms that seems lining up. This is a relatively, I wouldn’t even maybe go so far, I’m curious if you would agree with me but goes so far as to say this is an extremely safe drug unless you’re using very, very high doses. I guess I just want to emphasize that I really think methylene blue might very well be a big breakthrough here. Obviously, it needs more study to confirm, but I’m curious if you agree with me on that excitement.
Dr. Antoine: I really do. I became even more excited after our talk the other day and started really researching more and was up almost all night. Just the more you look, you just think, “Gosh, why didn’t we think of this?” Or actually, I’m thinking why don’t we use methylene blue more often and they use it. The other interesting thing about methylene blue, hydroxychloroquine and chloroquine, is that they all reduce levels of interleukin 6 and TNF alpha, which are what’s involved in the cytokine storm that’s killing people.
Ari: What are the other layers was this research showing that it inhibits the NLRP3 inflammasome, which is this specific inflammasome that’s implicated in the cytokine storm. There’s, I guess another whatever, that is the fourth or fifth mechanism.
Dr. Antoine: The other thing is, these patients are really dying of sepsis. They’re dying of multi-organ system failure. When you have sepsis, there’s two chemicals that are produced in your body, nitric oxide, and also what’s produced is cyclic GMP. Both of those dilate blood vessels. If you’re already dehydrated and sick and failing and your oxygen saturation is dropping and you’re not getting enough oxygen in your brain, now drop your blood pressure, at that point, patients are dying. What’s interesting is that methylene blue inhibits nitric oxide synthase and cyclic GMP enzymes. They’ve studied and I probably pulled six or seven articles from the American thoracic surgery journals, which showed that sometimes when people have a heart bypass, when you have a heart bypass surgery, they actually stop your heart. They give you something to stop your heart, and then they restart it. Sometimes when they restart it, they lower your temperature, they actually put ice inside your chest and lower the temperature, and when they restart your heart, and you’re coming out of that, there’s a whole host of biochemical stuff that I may not even completely understand. A lot of patients get what’s called cardioplegia or cardioplegic hypotension, where their heart and their blood vessels are not keeping up with it. The therapy they use, methylene blue IV, and it works very well. Then they’ve studied it in sepsis and found that methylene blue maintains blood pressure parameters and urine output in patients with sepsis, so you go, wow, antiviral helps with blood pressure, helps with oxygenation in the body. One of the things people may say, and I made it pretty clear, I’m working on a monograph on this ahead of trying to- we’re working on coming up with a protocol to suggest. One of the things I mentioned in there, people may look at this and say, “Well, it may not be methemoglobin. Let’s check the level and if the hemoglobin levels are normal and maybe it doesn’t make sense to give methylene blue.” But when you look at all the rest of this, you say, “Gosh, why not?” You mentioned side effects, there really aren’t a ton. It is a category X agent for pregnant women, meaning it’s known to definitely cause birth defects, although most of the literature says, if the benefit outweighs the risk, you give it anyway. Secondly, if patients have issues with kidney, renal insufficiency, you’re giving them a dye and dye can make renal issues worse. It also can sometimes cause nausea and vomiting. If you give it at a high dose, normally we’ll start maybe one milligram per kilogram or half your body weight in milligrams, but if you give higher doses like five milligrams per kilogram and up, it can actually become very pro-oxidant and make the methemoglobinemia worse. It’s just a parameter that you would need to know about. Obviously there are oral forms as well, but in these patients, my suggestion obviously is this is a protocol for three steps before you’re intubated, hopefully then not intubating you.
Ari: Yes. Two more warnings that I think are worth mentioning from what I’ve seen. I know you mentioned these to me the other day. G6PD, the glucose-6-phosphate deficiency seems to be- if you have that, which I don’t know how common that is, maybe 1% of the population, [unintelligible], that is a contraindication for using methylene blue and then also I think SSRI antidepressants are as well.
Dr. Antoine: Great. I’m glad you mentioned that. To talk about, there are two types of medications used in psychiatry that are probably relative of not absolute contraindications to using methylene blue and they are MAO oxidase inhibitors, just because it is as well, methylene blue [inaudible] as well. It doesn’t matter exactly what those are, but a lot of people are familiar with SSRIs, selective serotonin reuptake inhibitors, medications that people on for depression. Basically methylene blue has some of those same actions. Just as if you took two or three antidepressants, at the same time, you can get something called serotonin syndrome, which can cause seizures, rapid heart rate, hypertension, those things can be a medical emergency. Those are some indications and it doesn’t necessarily mean it would be absolutely contraindicated, it may be relatively contraindicated. In other words, lower dose, watch the patient discontinue the other medication before you give it. You’d have to look at that and play with that, it’s part of clinical medicine, and figure out what the best thing is to do. Then you mentioned G6PD, so glucose-6-phosphate dehydrogenase deficiency. Some people have it, it’s higher in darker-skinned patients. African-American patients, patients of Mediterranean origin. It’s a genetic defect where you lack a certain enzyme and you have to be careful when you eat certain foods or take certain medications, including if you can give actually high dose IV vitamin C or IV ozone in patients with G6PD, they can hemolyze, break their blood cells down and become super anemic. So, that is something, and the literature is wishy-washy on this with methylene blue. I saw three different opinions. I saw one that said it’s probably not a big deal. I saw another opinion that said, don’t ever do it. It is a big deal. I saw a third opinion that said G6PD is required the pathway by which methylene blue inactivates methemoglobinemia, also requires G6PD, as if it may just not be effective. I don’t know, I think that’s probably a relative or an absolute contraindication, it would defend. I need to look a little bit more at that, but those are the three things that I saw.
How Vitamin C works in COVID-19 treatment
Ari: Got it. Having said again, methylene blue to me they’re very exciting. Are there any other things worth mentioning, vitamin C or any other supplement or medication that might have relevance given this emerging new paradigm of what coronavirus is doing in our bodies?
Dr. Antoine: There are, so there are a few things. I think I’d probably start with zinc. There’s been some literature and there are some ongoing clinical trials using zinc with hydroxychloroquine and chloroquine. The reason is because the zinc itself is virucidal and there are numerous studies on that, whether it’s the common cold or influenza. If you give enough of the right zinc at the right time, it seems to be helpful. What hydroxychloroquine does in a fascinating move is that the zinc ionophore, meaning it moves zinc into the cell to battle the virus. Fascinating. So zinc is definitely important and we do that just to boost the immune system. It’s not a great term, but, so zinc. You mentioned vitamin C and vitamin C is interesting. Obviously we hear about people giving high dose IV vitamin C, either 25 or 50 grams intravenously. The reason you give it intravenously is if you took that much orally, you would have diarrhea for a month. Very hard on your GI system. It’s an acidic. But vitamin C at very high doses is pro-oxidant. We think about it, and there’s actually in the National Institute of Cancer, part of the government has some studies on there about the use of high dose vitamin C, I think for pancreatic cancer and prostate cancer, endorses its use. It’s pretty safe. Once again, you wouldn’t want to give it with G6PD deficiency. People talk about high dose IV vitamin C, and then a little bit lower doses. What was really interesting was, back to methylene blue, back to methemoglobinemia, as I was looking into that, I said, “Geez, I better go back and review methemoglobinemia.” If the methylene blue does not work for that, the next recommended thing is vitamin C, including IV vitamin C, and they mentioned giving about 10 grams of IV vitamin C orally if you’re creating long-term in a patient with genetic methemoglobinemia. If that doesn’t work, they mentioned hyperbaric oxygen, riboflavin, and glutathione, and this was an allopathic source was talking about this. Isn’t it interesting that those things that we think of are virucidal that are at times pro-oxidant? Vitamin C is really interesting. I was just researching that a little bit this morning and people typically say, you know what, oral doses of 1,000, 1500, 3 grams, it’s probably antioxidant, and at higher doses like IV, high dose IV vitamin C is probably pro-oxidant. People say that and that’s partially true. What’s interesting is there have been a few studies done, which have shown, even at doses of 500 milligrams, there’s some pro-oxidant activity of vitamin C for cancers and several other cell lines if you’re doing an in vitro or test tube type study.
Ari: Is it pro-oxidant activity in any way?
Dr. Antoine: It tends to follow iron, there’s something called the Fenton reactions chemical reaction. When vitamin C and oxygen are mixed with metals in the body, you can make reactive oxygen species. So, they actually think although we hear pro-oxidant we think fried fatty foods, junk foods that are going to increase oxidative stress, but in reality, what’s likely happening, as you see with methylene blue and hydroxychloroquine is, there’s a number of oxidations made that does the job, and then your body takes care of the rest. Fortunately, we eat antioxidants if we have a good diet, and we don’t eat a lot of oxidized food if we have a good diet, healthy diet. It’s really interesting you mentioned vitamin C, and we’ve mentioned hyperbaric oxygen, glutathione, methylene blue also increases glutathione. It involves glutathione reductase, enzyme [unintelligible 00:59:31] regulates that, so it helps your body make more glutathione. If methylene blue is an oxidant and it’s killing things, it’s also got its own mechanism to clean, mop up the floor with antioxidants.
Ari: Fascinating, fascinating stuff. I’m just bursting with excitement about sharing this information. I’m actually going to rush this podcast to get it out to [unintelligible 00:59:55]. I really do honestly feel this information might be a game-changer in our fight against this, and if people are hearing this, researchers can hopefully run with some of these ideas and hopefully have some light bulbs going off and start doing some research on ways that some of these things that you’ve mentioned might be a major tool to, as we mentioned earlier, prevent people from developing so far progressing in the severity of this condition that then needs to be ventilated. Hopefully, we can find something that really fights this effectively, in a much earlier phase of the sickness. That hopefully is readily available and safe and pretty side effect-free. That would be pretty amazing if that happened.
Dr. Antoine: It would be. It’s great. We’re in communication with some academic faculty at the University of Michigan and still have quite a few folks that I’m in contact with within the allopathic world if that’s what you’d want to say. It always helped me, I said, once I went into functional and integrative medicine, I’d go to work and I’d talk to the patients with chronic abdominal pain in the ER about, hey, why don’t you change your diet? My initial co-workers coughed a little bit but they knew me for years. They knew I could do the job and I could take care of critically ill patients in shock and at the same time it’s amazing after a few months they’d come to me and said “Hey, my wife has migraines, what do you think we can do about that?” Fortunately, I have a little bit and my wife too, we have our foot in the allopathic world a bit and I think have some respect there so that we can say some of these things. We’re looking into additional adjunctive therapies but for right now, these make a lot of sense.
Ari: Beautiful. Well, thank you, Dr. Antoine, for sharing this with everybody listening. I really hope and a message like to everybody listening, I hope that you will help this information go viral, share it with your family, share it with your friends. I’ve said this a couple of times, but I really genuinely feel like this information might be a game-changer in our fight against this thing. Do everybody a favor and help this information go viral by sharing it far and wide, share it on social media, share it with your family and friends, and hopefully, this really does make a difference. I also think maybe it’s worth mentioning some disclaimer here because methylene blue, and obviously red light therapy and vitamin C, are readily available. People can get them just a quick purchase online. I think it’s worth a disclaimer of saying, first of all, none of this is medical advice. You should obviously consult with your doctor about whether to experiment with any of this information. We’re all clearly coming from a place of speculation, we’re not claiming that there exists a well-done randomized controlled study with a thousand people that proved that methylene blue cures coronavirus or something like that. We’re trying to put the pieces together, speculate on what may be a helpful treatment for anybody inclined to self-experimentation or “biohacking,” and you want to start experimenting with some of this stuff as I certainly am. Keep in mind, again note medical advice. I’m going to try to provide links on the page for this episode of recommended products. If you do want to buy a Red light therapy device or something like that, I’ll put my links, direct recommendation there. Keep in mind also sunlight provides red light therapy and it’s free. I’m not trying to force anybody to buy anything. Methylene blue is something that I believe, and Scott, maybe you know more about this than I do, but I’m under the impression that there are different grades of it, there’s pharmaceutical or region grade of it and then there are lower grades that are used for histological staining of tissues to look under a microscope. Some of the lower grades I think have significant levels of contamination with heavy metals, maybe mercury and lead. If somebody does buy methylene blue, definitely, make sure it’s a pure source. Ideally, third-party certificates of analysis showing its pure pharmaceutical grade. I believe that’s the highest grade. Those are my thoughts and caveats and warnings. Scott, do you want to share anything in that same vein?
Dr. Antoine: I think that’s a great thing to say. None of these things are FDA-approved or have been studied like any supplements, but we’re looking at the basic science. We’re looking at a theory, we’re looking forwarding thing. Just like people initially said, “Hey, maybe we should try hydrochloroquine,” wasn’t FDA-approved, was just a thought, not meant to have folks go out and eat aquarium cleaner like someone did and they got really sick and died. I think the gentleman died and his wife ended up in the ICU. So you’re right, you always have to be careful when you’re getting supplements because you can either get something that can harm or you can get a pill full of, who knows what, that may not do anything at all or have anything. Certainly of course, as you know, with fish oil and other things. All is important to get clean sources. I’m not quite ready to make the leap yet on some of these things, certainly, I’m taking zinc and vitamin C and glutathione and some of those other things, well, some herbals. So that’s something we’ll talk about in the next iteration of this is as some additional things that we know about astragalus, other things that can be helpful in the immune system. I think I appreciate you saying that. It’s something I think you should always check with your doctor before taking any supplement or medication or doing anything else. This is not quite ready for prime time recommendation from the CDC yet. What we’re hoping to get information into the hands of the right people who are dealing with these patients who are getting super sick super fast and that’s the thing about this disease. There’s a lot of things we treat in the ER that are serious. There’s a lot that is sudden. There’s a lot that is unpredictable. There are very few diseases that are all three and this is all three. It’s really hard to deal with in an organized manner, especially when you’ve got multiple patients like we’re seeing in New York and Detroit and several other places.
Ari: Beautiful, my friend, thank you so, so much for sharing your wisdom on this topic. I really appreciate your level of expertise and knowledge and the nuance in which you convey everything, and the clarity that you explain these ideas, and most of all, I appreciate your heart and your desire to help people. I think that really comes through in a big way. Really appreciate my friend.
To everybody listening, I hope you enjoyed this episode and share it far and wide, help me make it go viral, and hopefully, there’s a lot of health professionals listening that can take some of this information, run with it, do the research, and hopefully this really does turn out to be a game-changer in our fight against coronavirus. Thank you again, Dr. Antoine, such a pleasure and I look forward to our next conversation.
Dr. Antoine: Thanks so much. We get back to work.
Ari: Hey there. This is Ari again. I hope you enjoyed this episode. I want to mention, the resources for this episode can be found at theenergyblueprint.com/blue. If you’re interested in looking at some of the studies we mentioned, getting some of the products, getting your hands on some methylene blue, or getting your hands on red light therapy devices, I’m going to put some links there for recommendations. Keep in mind, there are many sources of methylene blue out there. One thing I want to mention on that is, as I said, that there may be issues with contamination, heavy metals in particular, in some of the lower grades of methylene blue that are available. You don’t necessarily want to use the ones for staining, for microscopy, or for use in aquariums. It’s important, if you’re going to do any self experimentation here, to use a very pure non-contaminated source of methylene blue. I also will put links at theenergyblueprint.com/blue as far as my recommendations for red light therapy devices, which I genuinely do think will turn out to be majorly beneficial in this context. Of course, there’s over 5,000 other studies for a wide variety of health benefits of red light therapy. Of course, you don’t need to buy a device. Sunlight is free and will likely have many of the same benefits in this context. Of course, dozens of proven benefits and thousands of studies support the use of red light therapy. Even outside of the context of use in the context of infections, there are literally dozens. I was going to say countless, but you’ll probably count them. Dozens of benefits of red light therapy, and it is just an enormously powerful and beneficial thing that I highly, highly recommend. We’ll put links to that on this page. Again, it’s theenergyblueprint.com/blue. I want to be clear, this is entirely the realm of speculation and self experimentation. This is not any claim of medical advice. This is certainly not any claim of, “Hey, go do this thing because it’s a cure or it’s going to prevent you from getting this particular infection.” Nothing like that is going on, and I just want to be very clear and explicit. My intention, and Dr. Antoine’s intention, was basically to put out some information that is speculative, still based on some of the research that he’s been analyzing, and to hopefully encourage people to do formal research, which eventually, hopefully, will prove that this is indeed a game changer. Of course, I’m optimistic and very hopeful that that will turn out to be the case. I just want to provide recommendations and resources for people who are inclined towards self experimentation to do it in a safe way. Again, hope you enjoyed this episode. I hope you will share it far and wide with your friends and families, especially those amongst you who are in the healthcare field. I hope that you will share this with your colleagues, and hopefully we can get some research done on this relatively quickly and see if it really is a game changer as I think it might be. Again, hope you enjoyed this episode, and I will see you in the next one.
The difference between ARDS and COVID-19 (0:59)
The danger of the cytokine storm (8:28)
How COVID-19 may not be a respiratory condition (16:20)
The pros and cons of ventilators (25:13)
Why Methylene blue shows promise for treating COVID-19 (31:00)
Other potential factors that could help COVID-19 treatment (47:33)
How Vitamin C works in COVID-19 treatment (55:09)