MB and PBMT – Are they a match made in mitochondrial heaven?

One of the great icons of popular culture, Tina Turner, died this past year. One of her unforgettable songs is “What’s Love Got to Do with It”. The lyrics simply and powerfully address the issues of attraction, individual identities and emotions, and the necessity of establishing trustworthy and complimentary partnerships in forming relationships that flourish and last.

There is reason to believe that methylene blue (MB) and Photo-bio-modulation Therapy (PBMT) are biologically active partners that can provide a very salutary complimentary partnership in optimizing total-health cellularly.

I have already addressed the clinical role of MB in enhancing mitochondrial function and how to use it, particularly in neurodevelopmental conditions that demonstrate mitochondrial dysfunction such as ADHD. (see Vol. 1 Nos 1-3.)

Let me now address PBMT and how it might dance with MB in optimizing the essential role of energy transduction and the other essential functions of mitochondria in maintaining cellular health throughout the body. PBMT is one term used to refer to the use of technology that directs a stream of photons to an area of the body or brain that might be benefited by their effects on mitochondrial function. Other terms for this in the literature include: photodynamic therapy, photo-bio-stimulation, and low-level-laser therapy. The primary function is for the stream of photons from a low-power laser or light-emitting diodes (LEDs) to stimulate mitochondrial respiration and thus increase ATP production. It does this by stimulating cytochrome oxidase, the enzyme Complex IV at the end of the electron transport chain that is the major source (about 90%) of all the ATP produced by mitochondria. Because the energy of these photons come in the form of electromagnetic waves, the amount of energy delivered depends on the frequency of the waves, the distance to and density of the tissue targeted and the duration of delivery.

1. As a neuropsychiatrist, I am particularly interested in the fact that virtually all psychiatric and many neurological conditions have clear evidence of mitochondrial dysfunction. This dysfunction then has major downstream effects that contribute to chronic disease such as inflammation and oxidative stress. This suggests that optimizing brain energy through boosting mitochondrial function and increasing cellular respiration and ATP production could be both neuroprotective and therapeutic.
2. Interestingly, even though there is robust research to show that both MB and PBMT significantly increase ATP production, they do it by different and mutually synergistic mechanisms. MB readily enters cells and enters mitochondria and does its work of increasing mitochondrial efficiency by providing an alternative source of activated electrons at Complex I but also delivering them directly to Complex IV, bypassing inefficient or defective components of the electron transport chain between them. Because MB is a “redox recycler” that can both donate and receive electrons, they are immediately available to neutralize ROS that are generated by the electron transport chain.  PBMT on the other hand works by way of photons in the red to near infra-red frequencies passing through the skull and into cortical neurons, intersecting with the absorption spectrum of cytochrome oxidase (Complex IV) in mitochondria. This markedly increases cytochrome oxidase activity, oxygen consumption and ATP production. In a sense MB and PBMT are metabolic dance partners, enhancing each other because they have common purpose!
3. The increased ATP production involving both MB and PBMT is associated with increased reactive oxygen species that then stimulate a range of intrinsic antioxidant and anti-inflammatory processes, and reparative functions involving DNA, and “cellular housekeeping” functions on mitochondria and other organelles (mitophagy and autophagy). This should have substantial benefits in reducing chronic diseases of many different kinds. Working in concert they should have an important role in protecting against neurodegenerative diseases such as Alzheimer’s disease, Parkinson’s Disease.
4. Both treatment modalities are clearly safe and well tolerated. PBMT in the frequency range of 600-1200nm can penetrate into the brain parenchyma and stimulate increased cellular respiration that is sustained beyond the immediate treatment with little to no adverse effects. The promise is significant and more research on larger cohorts is needed, but early results are promising. That promise should be significantly greater with the combination of MB using daily oral dosing and continuous effects then combined with PBMT with its intermittent and specific targeting of tissue and its localized impact could result in robust neuroprotection and even therapeutic benefits.

For more extensive and very practical information on PBMT, obtain and read Julia Chatwin’s 2023 first edition book Red Light Therapy.

For more information on the combination with MB see:

Yang L, et.al. “Mitochondria as a target for neuroprotection: role of methylene blue andphotobiomodulation.” Translational Neurodegeneration. 2020. https://doi.org/10.1186/s40035-020-00197

Gonzalez-Lima F. “Protection against neurodegeneration with low-dose methylene blue and near-infraredlight”. Frontiers in Cellular Neuroscience. 2015. Doi:10.3389/fncel.2015.00179.

Noel Gardner M.D., M.Div.