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A primary mechanism is its role as a redox agent: MB can accept electrons and undergo reduction to leucomethylene blue, and in doing so it helps convert oxidized hemoglobin (methemoglobin, Fe) back to functional hemoglobin (Fe)

Surprisingly, GSH depletion did not lead to global increase in protein oxidation but instead selectively enhanced oxidation at specific cysteine sites (Figure 5B and Supplemental Figure 4, AD)

Acta 1840 (1), 209218

Shifting your dose early can increase nausea, vomiting, fatigue, and stomach upset in some patients