In this solo YouTube video, primary‑care physician Dr. Ashley Frazee explains why many people feel chronically fatigued and how two popular supplements—NAD+ and methylene blue—address different aspects of cellular energy production. She begins with a lay‑friendly overview of mitochondria as an assembly‑line factory that generates ATP, emphasizing that electrons moving along the inner mitochondrial membrane are the true energy carriers. Using analogies, she describes NAD+ as the “cash” that funds the factory’s operations, noting that NAD+ levels halve by age 50, which impairs ATP synthesis, DNA repair, sirtuin activity, and brain health. She outlines ways to boost NAD+ (IV, injections, oral precursors), typical dosing (500‑1000 mg daily), and timing (morning to align with circadian rhythms), and mentions the theoretical cancer‑growth concern at very high levels. Next, she introduces methylene blue as a “electrician” that can shuttle electrons when the wiring (electron flow) is compromised, acting as a redox cycler that bypasses dysfunctional mitochondrial steps. She cites small human studies showing improved memory, attention, and brain oxygen utilization, and recommends micro‑dosing (≈0.5 mg/kg, 20‑40 mg). Safety warnings follow: methylene blue can cause serotonin syndrome when combined with SSRIs, is dangerous for people with G6PD deficiency, and requires pharmaceutical‑grade purity; NAD+ has speculative cancer‑risk concerns. She also notes harmless side effects like blue‑green urine. Finally, Dr. Frazee frames the choice between the two supplements as a matter of whether the problem is “low fuel” (NAD+) or “faulty wiring” (methylene blue), encouraging viewers to assess their own fatigue source before supplementing. The video ends with a call for comments, likes, and subscriptions.
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People are tired of feeling tired. It's just one of the core problems I see every day. As a primary care doctor with an interest in the betterment of health and wellness, I've been reading and researching and trying all sorts of things to help people with fatigue and aging. Because if we can solve our biological energy crisis, you just have more fight in the tank. Today I want to talk to you about 2 very popular supplements that you've probably heard about, NAD+ and and methylene blue, because they're talked about for very similar reasons. It's just that they do very different things, and I want you to really understand what they supposedly do and why people take them so you're not out there trying things without knowledge to back it up. Don't be like me. Kidding, mostly. By the end of this video, you'll know exactly which one of these actually makes sense for your kind of fatigue and why a lot of people might be taking the wrong one. In order for you to understand these supplements, you need to understand where energy actually comes from before any of this makes sense. So here's a quick rundown. Mitochondria are present in every cell of your body. They look like little beans with squiggly lines inside, and those squiggly lines are the inner mitochondrial membrane. And that membrane is basically a factory assembly line that makes your energy. It produces ATP, your cellular energy. Now, this assembly line has a lot of moving parts. I recently visited the BMW factory in South Carolina, and I was watching all of these robots just passing pieces along to each other, but they were doing it in such a way that only their movements could make the car fit. And it honestly blew my mind. And that's a lot like what's happening inside of your cells. You have raw materials, transport systems, checkpoints, repair crews, and an electrical current moving the whole process forward. And because we're human, we are stressed, inflamed, aging, eating processed foods, Exposed to a lot of toxins, and things just start to break down easily. And that can cause fatigue, brain fog, and, you know, your motivation just disappears after that. And this is where we get to the point of me telling you to exercise, and you gently nod and say, I will, and secretly you're thinking, good luck getting me off the couch, doc. I understand. But back to this assembly line. See, the entire process of making energy from food that you eat depends on electrons moving efficiently down this line across the mitochondrial inner membrane. Electrons are like the parts that are being moved down the assembly line, and they are the carriers of energy. If electrons stop flowing for whatever reason, ATP or energy production drops and you start to feel like garbage. Okay, so let's get to what you came for. Why do people take NAD? Well, a fun way to think about it is like this. Imagine NAD as like the money that pays your power bill for your body. If you run out of money, the power goes out and nothing Runs. And even if you bring in repair crews, if the repair crews don't get paid either because you're out of money, well, nothing gets fixed. And that's basically what happens as we age. By the time you're about 50 years old, you've got about half of the NAD that you had when you were 20. So your energy production slows down, your DNA repair slows down, your mitochondrial functioning slows down, and aging just starts to accelerate. We have proteins in our bodies that act as enzymes— they're called sirtuins— that try and repair and regulate this damage. But the catch is that they require NAD to run too. Interesting, right? So we know that NAD is heavily involved in making energy, repairing DNA, and turning on longevity pathways that help cells stay functional. In the brain, it helps support neurons, mitochondrial health, and neurotransmitter balance. So when NAD levels fall, people don't just feel tired, they feel foggy, unmotivated, and worn down in a way that sleep doesn't even fix. So I hope you can see now why people are supplementing with NAD+, basically to slow down aging, keep their energy tanks full, and potentially ward off neuronal decline in the brain. It sells itself. Now, there are different ways you can boost NAD+ levels in your system. IVs and injections will give you a mainline of actual NAD+. You can also eat a very healthy diet, or you can supplement with oral NAD+ precursors that metabolize into NAD+. Most people will take 500 to 1,000 milligrams a day. A pro tip is about timing NAD+ is linked to your body's circadian rhythm, and so taking it in the morning or the first half of the day aligns more with the body's natural peak production. Taking it at night can actually disrupt sleep for some people because it signals to the body that it's, you know, daytime or active time. And this is anecdotal, of course, but what people usually notice isn't like a stimulant effect. It's more subtle than that. They just don't crash as hard, or they don't need a nap in the afternoon, or they feel more durable. But here's the catch, and here's where methylene blue can come into the mix. You can have plenty of money in the bank and still have a factory that doesn't work, because if the wiring goes bad, the electricity still doesn't flow. And that's where methylene blue can come in. If NAD+ is the cash funding for the factory, methylene blue is kind of like the electrician that comes in to fix bad wiring. It does something really unique. It can actually move electrons throughout the mitochondrial membrane when different parts of the system aren't working very well. It's called a redox cycler. When electrons get stuck, which can happen with inflammation, diseases, aging, or even by taking certain prescription medications like statins, methylene blue can pick those electrons up and move them along the line so energy production can keep going. That's why it's so powerful for the brain, because the brain uses more energy than any other organ in the body. And when mitochondrial function drops, you feel it as brain fog, poor focus, low motivation, and mental fatigue. Methylene blue can theoretically help the brain use oxygen more efficiently. It can improve your mitochondrial function, and in some smaller human studies, it's been shown to increase activity in areas related to memory and attention. And that's why people anecdotally describe it as having the ability to lift off their brain fog, or they'll use it for focus. But for methylene blue, more is not better. We usually look at a microdose of about 0.5 milligrams per kilogram of body weight. For most people, that's roughly 20 to 40 milligrams. Now, I would not be a good doctor without telling you the risks, because safety matters here. With NAD+, there's some ongoing debate about cancer because cancer cells use a lot of energy, and some researchers are worried that very high doses of NAD+ could theoretically fuel cancer growth. That doesn't mean that NAD+ causes cancer, and human trials have not proven this risk, but it's why there's some caution around it. With methylene blue, the Big warning is with antidepressants. It can inhibit the metabolism of serotonin. So if you mix it with something like Zoloft or Paxil or Prozac, you put yourself at risk for something called serotonin syndrome, which is very dangerous. Don't do that. Also, there's a condition called G6PD deficiency. It is rare, but it's real. And if you have it, taking methylene blue could literally destroy your red blood cells. And purity also matters here. If you're buying a random dye off of the internet, be very careful. Compound pharmacies will actually make this for you. if you ask your doctor pretty please. But now you should be able to tell them the reason why you want it, right? Oh, and a heads up, if you take methylene blue, you are going to pee blue or green. It's totally normal. It's pretty awesome. It's just the electrician leaving the building through the side door. And for the record, it doesn't dye your insides blue. There's a photo of a blue brain on the internet. That person had a very high dose of methylene blue given IV and then sadly passed away, not from the methylene blue. When the pathologist exposed their brain to the The oxygen in the air caused it to turn blue. That's what happens when you pee it out too. It's blue outside of the body, but not inside the body. So to put this all together, when you zoom out, this is how I think about it. NAD funds the system. You need it to charge your cells up or to pay for things. Methylene blue can make sure the system runs efficiently if there are kinks in it. Most people think fatigue means that they need more caffeine or hormone replacement, but sometimes fatigue is just a power grid problem. Some people are low on fuel, and that's where NAD can come in. Some people have faulty wires. And methylene blue can potentially help that. I'd love it if you've had experience with NAD or methylene blue, if you would drop it in my comments. If you like this video, please hit like for me and subscribe to my channel. I'm Dr. Ashley Frazee. You have the best day.
