Post by Nadica (She/Her) on Oct 2, 2024 1:02:44 GMT
Could Nicotine Patches Help Treat Long COVID Symptoms? - Published Sept 6, 2024
By Asmae Fahmy
Key Takeaways
Nicotine patches may alleviate long COVID symptoms by interacting with receptors that regulate inflammation, cognitive function, and the nervous system.
Theories suggest nicotine could “dislodge” the virus or recalibrate receptors, but these ideas require further research.
While nicotine patches offer potential benefits, they still carry significant risks, and their use should be guided by a healthcare professional.
Neuroscientist Janna Moen, PhD, never expected her doctoral research on nicotinic receptor pharmacology to intersect so closely with her health.
Her work—investigating how substances like nicotine interact with the body’s systems—was confined to the realms of academia. However, after she contracted COVID in March 2020 and subsequently developed long COVID, Moen’s scientific expertise became deeply personal.
Long COVID left the 32-year-old struggling with a slew of debilitating symptoms, driving her to explore several avenues for relief. Ultimately, Moen joined a growing cohort of patients experimenting with nicotine patches as a treatment for long COVID.
Why Long COVID Patients Are Turning to Nicotine Patches
At first glance, the idea of using a substance notorious for its addictive properties to treat long COVID might seem counterintuitive, if not outright alarming. However, the smoking cessation aid is offering a glimmer of hope for many long COVID patients.
“It’s a fascinating area of research,” Moen, who is now a postdoctoral fellow at Yale working on the neurobiology of long COVID, told Verywell. “But it’s also fraught with uncertainty. The potential benefits are intriguing, but the science is still very much in its infancy.”
Interest in nicotine patches surged after a 2023 study reported significant symptom improvements in four long COVID patients.1 This research ignited a wave of self-experimentation, which patients are documenting across online chat rooms and support groups.
Daphne Mir, a 33-year-old designer currently sidelined from work due to long COVID, is one such patient. After contracting the virus in December 2022, Mir developed dysautonomia (a malfunction of the autonomic nervous system), mast cell activation syndrome (which triggers the excessive release of histamine and leads to allergy-like symptoms), and cognitive impairment. After some hesitation, Mir eventually decided to try nicotine patches after learning about their potential benefits online.
“My initial reaction was that I didn’t need to add a highly addictive chemical to the mix,” they told Verywell. “But as my health continued to worsen, I realized I was willing to give almost anything a try.”
Mir’s trial of nicotine patches, which began with a low dose and gradually increased, yielded promising results. Mir observed a noticeable improvement in cognitive function and energy levels, with their resting heart rate reverting to pre-COVID levels.
“I still have bad days, but I’m sharper, and my endurance has improved,” they said. “It’s not a cure, but it’s something.”
Months after stopping the patches, Mir said the positive effects linger, prompting them to consider another trial.
Some doctors are also cautiously prescribing nicotine patches as part of their treatment plans for long COVID. Susan Levine, MD, an immunologist specializing in long COVID, told Verywell that nicotine patches are “working wonders” for several of her long COVID patients, particularly those plagued by brain fog and fatigue.
“The patches seem to provide symptomatic relief, but it’s important to remember that this is still very experimental,” Levine said. “Nicotine isn’t a cure, and it needs to be used carefully, ideally in combination with other treatments aimed at addressing underlying inflammation and immune dysregulation.”
Moen echoes this sentiment. While she saw significant improvement in her dysautonomia symptoms and orthostatic intolerance after experimenting with the patches, she acknowledges that her improvement cannot be conclusively attributed to the patches.
“Subjective experiences do not provide enough information to draw any kind of robust conclusion,” she said.
The Scientific Theories Behind Nicotine’s Potential
The potential benefits of nicotine patches for long COVID involve their interaction with the cholinergic anti-inflammatory pathway, a system that regulates inflammation and nervous system responses through a compound called acetylcholine.2 Nicotinic acetylcholine receptors play a crucial role in this process. According to Moen, when these receptors behave properly, they help manage inflammation, autonomic functions like blood pressure and breathing, and cognition.
“Nicotinic receptors are involved in many processes that overlap with long COVID symptoms, such as memory, motor coordination, autonomic functions, and immune and vascular system regulation,” Moen said. “Given that low-dose nicotine has been shown to be neuroprotective in some cases, it’s plausible that nicotine patches could help with certain aspects of long COVID.”
The buzzy 2023 study on nicotine patches for long COVID suggests the virus may bind to nicotinic acetylcholine receptors, blocking their normal signaling and contributing to persistent long COVID symptoms.1 When a person applies a patch, nicotine could potentially displace the virus or its remnants from the receptors, allowing them to resume normal function. This might help alleviate symptoms like fatigue, brain fog, and widespread pain.
Another theory is that nicotine’s interaction with nicotinic acetylcholine receptors could help modulate receptor activity without necessarily displacing anything.3 Nicotine could reduce long COVID symptoms like chronic inflammation and fatigue by enhancing cholinergic anti-inflammatory signaling.
“We still don’t know why nicotine therapy seems to help some patients, but it offers an opportunity to explore the interaction between inflammation and cholinergic signaling,” Moen said.
She cautions that the initial theory of nicotine “dislodging” spike proteins from nicotinic acetylcholine receptors is oversimplified. Some studies suggest small amounts of COVID spike protein could actually make receptors work better when nicotine is present, but using nicotine for too long might make the receptors less effective over time.4
Risks and Potential Downsides of Nicotine Patches
Despite the promising theories, using nicotine patches for long COVID still carries significant risks.
Moen warns that “nicotine is a double-edged sword.” While it might offer short-term benefits like improved cognitive function and reduced fatigue, prolonged use can lead to receptor desensitization, diminishing the receptors’ effectiveness over time. This desensitization could impair the receptors’ ability to respond to acetylcholine and other signals, complicating the condition rather than alleviating it.
Additionally, chronic nicotine patch use can lead to dependency, cardiovascular issues, and side effects such as nausea, headaches, dizziness, and skin irritation, according to the Centers for Disease Control and Prevention (CDC).5
Moen also emphasizes the complexity of nicotine’s interaction with the immune system. While it might reduce inflammation, there’s a risk it could suppress the immune system too much, hindering the body’s ability to clear lingering viral particles or fight off new infections—a significant concern for patients with compromised immune systems.
“Prolonged stimulation of the cholinergic anti-inflammatory pathway can suppress the immune system, and generally speaking, we have no data regarding the safety profile of nicotine therapy in people with long COVID and other complex comorbidities,” Moen said. “As such, I have no plans to use them long-term.”
Mir’s experience with nicotine therapy highlights this complex balance. While they noticed improvements in cognitive function and endurance, they also faced a temporary resurgence of flu-like symptoms, which they say was a reminder of the body’s ongoing battle against the virus.
Why Nicotine Patches Are Safer Than Smoking or Vaping
Nicotine patches provide a safer, more controlled alternative to smoking and vaping, especially for those considering long-term nicotine therapy. According to Moen, cigarettes introduce harmful chemicals such as tar and combustion byproducts, leading to long-term health risks. Vaping, while less dangerous than smoking, still poses health risks and potential dependency.
Moen said that nicotine patches offer a stable, consistent dose of nicotine over 24 hours without the harmful effects of smoking or vaping.
“Nicotine patches remain the least risky option for chronic nicotine treatment,” she said. “This consistent delivery helps avoid the cycle of withdrawal and craving associated with smoking and vaping, making patches a safer and more controlled approach to nicotine therapy.”
Moen emphasizes that while real-world data on smokers with COVID has shown mixed results, there’s no scenario in which the potential benefits of nicotine therapy outweigh the severe consequences of a long-term smoking habit.
What This Means For You
As the medical community continues to study long COVID and search for effective therapies, nicotine patches remain a controversial but intriguing option. While early reports are promising, they are not yet conclusive, and both patients and healthcare providers must navigate this emerging treatment with caution. The benefits, while real for some, are tempered by the risks and unknowns inherent in such an unproven treatment.
Cited references:
bioelecmed.biomedcentral.com/articles/10.1186/s42234-023-00104-7
bioelecmed.biomedcentral.com/articles/10.1186/s42234-020-00058-0
www.mdpi.com/1422-0067/22/9/4912
www.jbc.org/article/S0021-9258%2823%2901735-0/fulltext
www.cdc.gov/tobacco/campaign/tips/quit-smoking/quit-smoking-medications/how-to-use-quit-smoking-medicines/how-to-use-a-nicotine-patch.html#:~:text=Possible%20Side%20Effects%20%28and%20what,%28remove%20patch%20at%20night%29.
By Asmae Fahmy
Key Takeaways
Nicotine patches may alleviate long COVID symptoms by interacting with receptors that regulate inflammation, cognitive function, and the nervous system.
Theories suggest nicotine could “dislodge” the virus or recalibrate receptors, but these ideas require further research.
While nicotine patches offer potential benefits, they still carry significant risks, and their use should be guided by a healthcare professional.
Neuroscientist Janna Moen, PhD, never expected her doctoral research on nicotinic receptor pharmacology to intersect so closely with her health.
Her work—investigating how substances like nicotine interact with the body’s systems—was confined to the realms of academia. However, after she contracted COVID in March 2020 and subsequently developed long COVID, Moen’s scientific expertise became deeply personal.
Long COVID left the 32-year-old struggling with a slew of debilitating symptoms, driving her to explore several avenues for relief. Ultimately, Moen joined a growing cohort of patients experimenting with nicotine patches as a treatment for long COVID.
Why Long COVID Patients Are Turning to Nicotine Patches
At first glance, the idea of using a substance notorious for its addictive properties to treat long COVID might seem counterintuitive, if not outright alarming. However, the smoking cessation aid is offering a glimmer of hope for many long COVID patients.
“It’s a fascinating area of research,” Moen, who is now a postdoctoral fellow at Yale working on the neurobiology of long COVID, told Verywell. “But it’s also fraught with uncertainty. The potential benefits are intriguing, but the science is still very much in its infancy.”
Interest in nicotine patches surged after a 2023 study reported significant symptom improvements in four long COVID patients.1 This research ignited a wave of self-experimentation, which patients are documenting across online chat rooms and support groups.
Daphne Mir, a 33-year-old designer currently sidelined from work due to long COVID, is one such patient. After contracting the virus in December 2022, Mir developed dysautonomia (a malfunction of the autonomic nervous system), mast cell activation syndrome (which triggers the excessive release of histamine and leads to allergy-like symptoms), and cognitive impairment. After some hesitation, Mir eventually decided to try nicotine patches after learning about their potential benefits online.
“My initial reaction was that I didn’t need to add a highly addictive chemical to the mix,” they told Verywell. “But as my health continued to worsen, I realized I was willing to give almost anything a try.”
Mir’s trial of nicotine patches, which began with a low dose and gradually increased, yielded promising results. Mir observed a noticeable improvement in cognitive function and energy levels, with their resting heart rate reverting to pre-COVID levels.
“I still have bad days, but I’m sharper, and my endurance has improved,” they said. “It’s not a cure, but it’s something.”
Months after stopping the patches, Mir said the positive effects linger, prompting them to consider another trial.
Some doctors are also cautiously prescribing nicotine patches as part of their treatment plans for long COVID. Susan Levine, MD, an immunologist specializing in long COVID, told Verywell that nicotine patches are “working wonders” for several of her long COVID patients, particularly those plagued by brain fog and fatigue.
“The patches seem to provide symptomatic relief, but it’s important to remember that this is still very experimental,” Levine said. “Nicotine isn’t a cure, and it needs to be used carefully, ideally in combination with other treatments aimed at addressing underlying inflammation and immune dysregulation.”
Moen echoes this sentiment. While she saw significant improvement in her dysautonomia symptoms and orthostatic intolerance after experimenting with the patches, she acknowledges that her improvement cannot be conclusively attributed to the patches.
“Subjective experiences do not provide enough information to draw any kind of robust conclusion,” she said.
The Scientific Theories Behind Nicotine’s Potential
The potential benefits of nicotine patches for long COVID involve their interaction with the cholinergic anti-inflammatory pathway, a system that regulates inflammation and nervous system responses through a compound called acetylcholine.2 Nicotinic acetylcholine receptors play a crucial role in this process. According to Moen, when these receptors behave properly, they help manage inflammation, autonomic functions like blood pressure and breathing, and cognition.
“Nicotinic receptors are involved in many processes that overlap with long COVID symptoms, such as memory, motor coordination, autonomic functions, and immune and vascular system regulation,” Moen said. “Given that low-dose nicotine has been shown to be neuroprotective in some cases, it’s plausible that nicotine patches could help with certain aspects of long COVID.”
The buzzy 2023 study on nicotine patches for long COVID suggests the virus may bind to nicotinic acetylcholine receptors, blocking their normal signaling and contributing to persistent long COVID symptoms.1 When a person applies a patch, nicotine could potentially displace the virus or its remnants from the receptors, allowing them to resume normal function. This might help alleviate symptoms like fatigue, brain fog, and widespread pain.
Another theory is that nicotine’s interaction with nicotinic acetylcholine receptors could help modulate receptor activity without necessarily displacing anything.3 Nicotine could reduce long COVID symptoms like chronic inflammation and fatigue by enhancing cholinergic anti-inflammatory signaling.
“We still don’t know why nicotine therapy seems to help some patients, but it offers an opportunity to explore the interaction between inflammation and cholinergic signaling,” Moen said.
She cautions that the initial theory of nicotine “dislodging” spike proteins from nicotinic acetylcholine receptors is oversimplified. Some studies suggest small amounts of COVID spike protein could actually make receptors work better when nicotine is present, but using nicotine for too long might make the receptors less effective over time.4
Risks and Potential Downsides of Nicotine Patches
Despite the promising theories, using nicotine patches for long COVID still carries significant risks.
Moen warns that “nicotine is a double-edged sword.” While it might offer short-term benefits like improved cognitive function and reduced fatigue, prolonged use can lead to receptor desensitization, diminishing the receptors’ effectiveness over time. This desensitization could impair the receptors’ ability to respond to acetylcholine and other signals, complicating the condition rather than alleviating it.
Additionally, chronic nicotine patch use can lead to dependency, cardiovascular issues, and side effects such as nausea, headaches, dizziness, and skin irritation, according to the Centers for Disease Control and Prevention (CDC).5
Moen also emphasizes the complexity of nicotine’s interaction with the immune system. While it might reduce inflammation, there’s a risk it could suppress the immune system too much, hindering the body’s ability to clear lingering viral particles or fight off new infections—a significant concern for patients with compromised immune systems.
“Prolonged stimulation of the cholinergic anti-inflammatory pathway can suppress the immune system, and generally speaking, we have no data regarding the safety profile of nicotine therapy in people with long COVID and other complex comorbidities,” Moen said. “As such, I have no plans to use them long-term.”
Mir’s experience with nicotine therapy highlights this complex balance. While they noticed improvements in cognitive function and endurance, they also faced a temporary resurgence of flu-like symptoms, which they say was a reminder of the body’s ongoing battle against the virus.
Why Nicotine Patches Are Safer Than Smoking or Vaping
Nicotine patches provide a safer, more controlled alternative to smoking and vaping, especially for those considering long-term nicotine therapy. According to Moen, cigarettes introduce harmful chemicals such as tar and combustion byproducts, leading to long-term health risks. Vaping, while less dangerous than smoking, still poses health risks and potential dependency.
Moen said that nicotine patches offer a stable, consistent dose of nicotine over 24 hours without the harmful effects of smoking or vaping.
“Nicotine patches remain the least risky option for chronic nicotine treatment,” she said. “This consistent delivery helps avoid the cycle of withdrawal and craving associated with smoking and vaping, making patches a safer and more controlled approach to nicotine therapy.”
Moen emphasizes that while real-world data on smokers with COVID has shown mixed results, there’s no scenario in which the potential benefits of nicotine therapy outweigh the severe consequences of a long-term smoking habit.
What This Means For You
As the medical community continues to study long COVID and search for effective therapies, nicotine patches remain a controversial but intriguing option. While early reports are promising, they are not yet conclusive, and both patients and healthcare providers must navigate this emerging treatment with caution. The benefits, while real for some, are tempered by the risks and unknowns inherent in such an unproven treatment.
Cited references:
bioelecmed.biomedcentral.com/articles/10.1186/s42234-023-00104-7
bioelecmed.biomedcentral.com/articles/10.1186/s42234-020-00058-0
www.mdpi.com/1422-0067/22/9/4912
www.jbc.org/article/S0021-9258%2823%2901735-0/fulltext
www.cdc.gov/tobacco/campaign/tips/quit-smoking/quit-smoking-medications/how-to-use-quit-smoking-medicines/how-to-use-a-nicotine-patch.html#:~:text=Possible%20Side%20Effects%20%28and%20what,%28remove%20patch%20at%20night%29.