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Comment by perrygeo | Hacker News Reader

Given how long it's been around, the promising results, and how many people have been using it for "biohacking" for decades, it was at first a little surprising to hear how little double-blind clinical research exists. Then you realize: methylene blue can't be patented and it's manufacture is no secret. So no one is going to make big money from it, therefore no money goes into clinical research. All too familiar story, and it really calls into question the whole "clinical trials are the arbiter of truth" mentality if the one making that claim also controls the purse strings!

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I'm not sure that "can't be patented / manufacture is no secret" is necessarily the research bottleneck here, because you can make a lot of money selling analogs or derivatives of old, boring drugs. There was an interesting ProPublica story recently about a drug manufacturer raising the price of their (patented) cancer drug to eye-watering levels... and the drug in question is an analog of thalidomide! https://www.propublica.org/article/revlimid-price-cancer-cel...

One of the claims against this company is that they were preventing other companies from getting their hands on generic thalidomide, because they didn't want competitors to do research that might uncover similar analogs.

(I'm also not convinced that the results for methylene blue are especially promising or unique, but that's another matter :P)

In fact, well known grifters are currently making a boatload selling it with huge markups and branding.

Methylene Blue is available as a prescription medication. It’s used in several conditions. You could even get your local compounding pharmacy to produce methylene blue capsules for you if you could find a doctor to write the prescription.

> Then you realize: methylene blue can't be patented and it's manufacture is no secret

This isn’t an impediment at all. There are numerous examples of old, simple drugs being repurposed for new conditions at different doses or different delivery mechanisms with very high price tags attached.

Selegiline is one such example. It was repurposed for depression as a transdermal patch and very high prices.

If methylene blue worked for the conditions claimed, it would be used clinically. The myth that big pharma is ignoring a compound that works doesn’t hold water.

I have only vaguely heard of this substance so I may be missing some important context, but I don't think this attitude really holds up under scrutiny.

There's plenty of research done on things which can't be patented or used to turn a profit in some way. People do research on diet, exercise, vitamins, and pharmaceuticals which are now generic like aspirin etc. just to name a few off the top of my head.

There's also public funding available for research which isn't intended to make money for any particular corporation.

> it was at first a little surprising to hear how little double-blind clinical research exists.

Methylene blue turns your urine blue. How does someone conduct a double-blind studies with a substance that very clearly indicates whether or not you are taking it?

Another issue is it's hard to get grant money to run studies in general. What would the goal of the study be? What would it measure?

Can't the placebo also contain some form of dye?

It'll be a bit more complicated than that since the dye would have to get from your gut to your blood and then into the urine without breaking down and without other side effects. It's possible but probably not the easiest thing.

You'd be looking for a dye that survives in the blood and urinary tract and imparts blue/green colors to the urine and that isn't reactive or toxic.

And generally speaking, when you are looking to treat something in a double-blind test, the control isn't placebo, it's the standard treatment.

It's a tricky enough problem that when double blind studies have been done, the control will generally simply have a lower dose of methylene blue rather than no dose.

This same claim is used all the time, but it is hollow without more evidence.

Do you you think that everybody is cynical and is motivated by dollars? Since it is an inexpensive, readily available compound, what prevents biohackers from doing a small scale (say, N=100) double blind trial against some relatively inert compound that makes your pee blue?

A close cousin to this claim is the old chestnut, "A tinkerer invented a carburetor that allows any care to get over 100 mpg, but then the oil companies bought out and buried the patent!"

You can patent specific therapies using unpatented drugs. For example, if the patent doesn't already exist and there's no prior art, you could patent methylene blue therapy for the treatment of athlete's foot.

I used to subscribe to this argument but there is unlimited research on things that can't be owned.

Complete bullshit. You believe there is absolutely no-one amongst the hundreds of thousands of PhDs who aren't interested in exploring low-cost medicines, years after years, for decades.

There are no "promising results": there is placebo effects, survivorship bias and snake-oil peddlers.

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