[teebSQAD9]

I’ve had long covid for a couple of years now. It’s a really difficult disease, in part because different people react very differently, and there may even be multiple mechanisms so it’s not exactly a single disease.

What has really helped me has been wearing a nicotine patch occasionally. I was never a smoker, but I came across this very small study [1] and thought it was worth a go because a) I was getting desperate and b) nicotine in such low doses is not that risky (7mg patch, worn for 2 weeks).

I know there’s counter-studies suggesting nicotine doesn’t help with resistance. My experience is anecdotal, but I saw rapid improvement in cognition and fatigue level (particularly post-exercise). My guess is that for some people the particular mechanism behind their long covid is one that this can help with, but not for everyone.

[1] https://pubmed.ncbi.nlm.nih.gov/36650574/

[armchairdweller]

That nicotine patches help with focus is no surprise if you have been naive to nicotine before. I have been using patches on and off (like years of no usage in-between) for focus, and 7mg is actually a lot. Is there anything indicating that it is not just the effect of nicotine, and truly helps against whatever lingers inside your body (the spike protein)?

Given other people around me talking about treating their long covid with nicotine since it went through social media last year, I suppose you don't know about / didn't try the Natto (nattokinase) [1] / NAC route [2] (for which there were early studies showing they can dissolve the SARS-Cov2 spike protein)..? Or does the community consider that a dead end by now?

That there is a political echo chamber-driven division between those routes is a bit strange and dangerous, isn't it. With nicotine you will need to be careful about its effects on blood pressure, and it would be better to not even think about vaping (some of the flavoured products could be equally/more addictive to/than cigarettes [3]).

[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC9458005/

[2] https://pmc.ncbi.nlm.nih.gov/articles/PMC9663386/

[3] https://pubmed.ncbi.nlm.nih.gov/31536738/

[teebSQAD9]

Good questions, and I don’t have great answers.

7mg was the weakest patch I could get at a pharmacy (in the UK), and as I understand it that’s the release over 24 hours; I wore them only during the day so it’s a lower dose. If it’s proportional it’s ~5mg, which is 2-3 cigarettes, but cigarettes deliver it much faster, I believe. I have since spoken to a doctor who suggested that if I relapse I should cut them in half to lower the dose. Did you do something like that?

The main reasons I think it had more than just a concentration-enhancing effect are a) the effect after 2 weeks of patches seems to be long-lasting (months, at least) and b) my post-exertional fatigue, which was fairly severe (going for a light jog would leave me partially bedridden for a couple of days) has also gone. But to be fair, if the fatigue is caused by nervous system dysregulation then perhaps that somehow accounts for it, and it’s equally possible both these effects will wear off in time.

I have not seen nattokinase mentioned before, thanks. Interesting that, aside from the effect on the spike protein, it’s also supposed to help prevent blood clots. A friend with long covid was enrolled in a study which treated micro blood clots and she saw significant improvement from that. But I was tested a couple of times for micro blood clots and it came back negative, so again I think the long covid mechanism is not consistent.

[armchairdweller]

I've always bought the flat matrix patches so I could cut them into pieces — worked well for keeping things in limits. If it works for you this is good to hear of course – I wanted to share my2c of skepticism since for above reasons I was suspicious about the hype around it. Btw, if you google a bit deeper you will find a 2020 trial on clinical personell wearing the patches since there were signs it reduces covid infections, so there were early signs that nicotine might help.

As for nattokinase, I'd recommend looking around for diverse real-life experiences (I believe actual studies on long-COVID patients are still lacking). I'm not up to date, but I remember many people went straight for (Amazon-sourced) nattokinase supplements, and for some, it was too much and it made them feel ill.

Otherwise (not sure whether this would deliver the therapeutic dose you might need) natto itself makes a good breakfast — traditionally on rice with a runny egg, but it works as beans on toast too. Good Asian markets carry it in their freezers, imported directly from Japan (buy the versions with soy sauce / mustard). I had it regularly while I was over there, and there’s no difference in taste or effect (comparable to a small dose of aspirin). To the best of my knowledge, deep freezing isn’t an issue with the ingredients.

[teebSQAD9]

I think skepticism is really sensible with all of this – if there’s multiple mechanisms and confounding factors this is all going to take a lot more study to tease out. I was skeptical myself, but tried it because the downside risk didn’t seem too high, and I’m very grateful that it worked so well for me personally.

That’s cool – I’ll definitely try adding some natto to my diet!