In this podcast episode, Dr. Eddy Gutierrez explores innovative approaches to treating Septic Shock with Hydroxocobalamin and Methylene Blue. Emphasizing the need for unconventional strategies due to high mortality rates with current treatments, he discusses the mechanisms of these medications in addressing the overdrive of the immune system in Sepsis. Methylene Blue, with a history dating back to the 1800s, is highlighted for its role in inhibiting inducible nitric oxide synthase and soluble guanylyl cyclase. The "SHOCKEM - Blue" trial results are discussed, indicating benefits such as faster discontinuation of vasopressors and reduced ICU length of stay. Dr. Gutierrez also delves into Hydroxocobalamin, a vitamin B12 variant, sharing findings from a recent Phase 2 study showing promising catecholamine sparing effects. Despite potential side effects, the cost-effectiveness of these treatments is considered, and ongoing clinical trials suggest a growing interest in exploring these mechanisms for Septic Shock management.