Nicotine Patch Therapy for Long Covid

Ok, bare with me on this one:

First, a brief history of me and Long Covid.

I work in the emergency services sector, so when the UK shut down in March 2020, I was still going to work. I was a fit, healthy almost 50 year old, who regularly walked the 7k to work and ran home, did HIIT workouts at least 3 times a week and loved long distance hike on my days off.

Towards the end of the March, I was running home as usual when I experienced a tightness in the chest and a shortness of breath to the extent that I had to stop running and walk the rest of the way. The next morning I woke up with a minor dry cough and shortness of breath; by the next day my shortness of breath was such that even a minor exertion left me out of breath. I sought medical advice and was told this was an asthma attack (I have asthma which has been mild to the point of not needing medication for many years prior to 2020). I was given steroids and told to rest. When symptoms persisted, I had a medical exam and was told I had a chest infection. As I did not have a fever or persistent cough, Covid-19 was dismissed as a possibility.

Six weeks and several courses of antibiotics and steroids later, I was back at work and slowly building back my exercise routine.

I was back to normal by about September 2020, when, again on running home, I experienced the same shortness of breath. I was again told that this was an asthma attack and given steroids. This time they did not work, as my symptoms persisted and now included loss of taste and smell, fatigue, brain fog, and other cognitive issues, doctors conceded that Covid-19 may actually be a factor. More was known about symptoms by now and people with lingering symptoms were appearing, now known as Long Covid, Long Haul Covid (Long Haulers) or Post Covid Fatigue Syndrome. After several more courses of steroids and a long line of different inhalers, I was finally diagnosed with Long Covid.

It was a long road to anything resembling recovery and I was nowhere near fully recovered by December 2021, when I caught Covid-19 once again. This lead to a relapse in the Long Covid symptoms and another long period off work. It has been a long slow road to any kind of recovery. I have had to give up many of the things that I love, such as running and long distance hikes. I am back in full time work, which I just about manage through the sacrifice of most of my pleasures in life. I have Post Exertional Malaise (PEM) if I attempt any vigorous activity, such as exercise, housework, gardening. I struggle with multi-tasking and become mentally overwhelmed in busy, noisy places or when there is a lot going on, which leads to brain fog, short-term memory loss and difficulty communicating. I can manage up to about 2 hours gentle walking with rest breaks. Everything I do has to be managed in small chunks with rest in between. Suffice to say, after 3 years of living with this, there are few lengths I would not go to if there was a chance it would relieve my symptoms and get me back to my former self.

That wasn’t so brief as it turned out!

Onto the Nicotine patches

There has been talk in the Long Covid communities of the use of Nicotine patches as a route to recovery over the past several months with many Long Haulers jumping at the opportunity of what appears to be a miracle cure with many people reporting vast improvements. I looked at this with a sceptical eye at first (and still do), having previously had Chronic Fatigue Syndrome back in the aughts (fully recovered) I am well aware of the scams sold to desperate people hoping for a way out of horrible illnesses. However, as time passed and people were reporting sustained recovery, I decided to delve a little deeper.

It appears that there are currently varying studies about the properties of Nicotine and how they may treat various cognitive ailments. To quote an article that goes back to August 2020: “Nicotine has been shown to be protective in a handful of other diseases, and laboratory studies suggest it may play a part in regulating an enzyme called ACE2, which is thought to be involved in COVID-19.” (Center for Evidence Based Medicine August 2020) Now, some people thought this would mean that smokers would be at a higher risk from COVID-19, however, some studies have appeared to show the opposite effect.

The results of a very small study carried out by Marco Leitzke and published in January 2023 show success in treating 4 patients suffering with Long Covid. Although, only 1 of the patients followed the regime to the letter and completed the 7 day course of treatment, all four of them reported significant improvements to their health, which was sustained after 6 months.

The salient points of the report (full report linked above) are this:

“Following a SARS-CoV-2 infection, many individuals suffer from post-COVID-19 syndrome. It makes them unable to proceed with common everyday activities due to weakness, memory lapses, pain, dyspnea and other unspecific physical complaints. Several investigators could demonstrate that the SARS-CoV-2 related spike glycoprotein (SGP) attaches not only to ACE-2 receptors but also shows DNA sections highly affine to nicotinic acetylcholine receptors (nAChRs). The nAChR is the principal structure of cholinergic neuromodulation and is responsible for coordinated neuronal network interaction. Non-intrinsic viral nAChR attachment compromises integrative interneuronal communication substantially. This explains the cognitive, neuromuscular and mood impairment, as well as the vegetative symptoms, characterizing post-COVID-19 syndrome. The agonist ligand nicotine shows an up to 30-fold higher affinity to nACHRs than acetylcholine (ACh). We therefore hypothesize that this molecule could displace the virus from nAChR attachment and pave the way for unimpaired cholinergic signal transmission. Treating several individuals suffering from post-COVID-19 syndrome with a nicotine patch application, we witnessed improvements ranging from immediate and substantial to complete remission in a matter of days.”

So basically, the thinking being, Covid-19 attaches to ACE-2 receptors and nAChRs (I am not a scientist so I do not really understand what those things are, but I guess I only need to know they exist!), Nicotine also attaches to those things, but Nicotine is bigger and badder than Covid and kicks it off, back into the blood stream, where your immune system can do it’s thing and get rid of it like it bloody well should have in the first place.

Of course, this is an extremely small study, with no placebo group, and no peer-reviews, based on other small studies that have yet to be fully proven. It’s a theory based on some other theories.

Nicotine itself appears to be fairly harmless, if addictive. The treatment is for a very low dose (7.5mg) patch for 24 hours for 7 days. What’s the worst that can happen? I decided I might as well give it a go. At worst, I look a bit silly and, to be fair, this ranks pretty low on the stupidest things I have done list, at the very best, I get rid of this awful, debilitating illness and get back to my old self.

I’m going to blog about this, every day for the next 7 days and then once a week, once a month as time goes on.

Day One:

I started wearing the first patch around 15:00 yesterday (21/06/2023). I initially experienced a little light headedness and headache but nothing too much. The rest of the day I felt pretty “new normal”, it has only been on reflection that I realise I did quite a lot (for me), and what would usually lead to me feeling really fatigued and heading for bed by about 19:00. Instead, I watched 2 hours of TV all of which I was able to follow and did not feel drained afterwards. I swapped the patch for a new one before bed. I had a really bad night, I had a lot of trouble sleeping (Nicotine is a stimulant after all) and woke several times during the night with fever-like sweats. I was also really thirsty and woke up with a very dry mouth and a headache and to find that the patch had come off, sometime during the night.

Watch this space.

Author: admin

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