Nicotine patches for Long COVID
Plus, I'm escaping winter for a few days
Welcome to The Tonic, a light-hearted, heavily resourced newsletter for folks interested in learning about long COVID, ME/CFS, and other chronic illnesses. Come for the info; stay for the whimsy. Or vice versa.
Please note: my posting strategy is changing in response to my ever-shifting availability of energy (often referred to as ‘spoons’). I will generally post once a week on Saturdays or Sundays: a narrative post when my energy allows and resource roundups (known here as The Antidote) at all other times. Occasionally I post more than once a week, usually to announce an event or to push brief, timely info out to you sooner.
Shorter post this week
I’m traveling to the Sunshine State this week thanks to one of my very BFFs (😘😘😘), so this post will be shorter than usual and teed up ahead of time.
Meanwhile, if you came to my post thinking you’d be here for a while as per usual, why not give my pal
’s podcast episode on Florida a listen. Oh, and subscribe to his newsletter while you’re at it because it’s real good fun.
Wish list shout outs!
Yay for gifts! So many of you beauties have chosen to support of my efforts here via the Amazon wish list in lieu of paid subscriptions (which could jeopardize my disability benefits). A big Tonic THANK YOU this week goes to LisaVincentAustin! (a.k.a. one of my favorite families). Here’s a special secret thank you.
If any wish list gifts come in after I’ve departed for a warmer clime, I will include your shout out in my next post.
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Stick ‘em if ya got ‘em
You may recall that a few weeks back I linked to a Health Rising article on the use of nicotine patches for Long COVID and ME/CFS. At least one of you responded to say you used them regularly and that they helped with your ME/CFS energy levels. I decided to give them a go myself.
Before buying the patches and slapping them on, I did my homework first. I highly advise you to do the same if you are contemplating trying these. There are several considerations and some helpful tips to keep in mind, especially if your system is sensitive like mine and like so many other long haulers and pwME (people with ME/CFS). My advice: read the Health Rising article and then check out the patient-led group #TheNicotineTest for all kinds of helpful documents.
After reviewing all of this, I decided to do as suggested and titrate up slowly. I also titrated down on the other end. Here are the notes I kept on my phone of my dosing info, location of patch each day, and any issues or benefits I experienced.
January 12
3.5mg on left calf. Immediate migraine with bad aura. Woozy for first few hours. Headache again at night - drank water and it went away. Left patch on and slept fine.
January 13
3.5mg on right calf. Mild headache and wooziness. Hungry. Developed vertigo overnight.
January 14
~5mg on upper left thigh. Headache, spaciness, vertigo. Felt crappy all day.
January 15
~5mg higher on upper left thigh. Vertigo continues, very lightheaded and fatigued. Sleeping ok each night.
January 16
7mg upper right thigh. No vertigo or dizziness or headache today. Seem to be back to LC baseline.
January 17
7mg upper right thigh. Baseline continues although neuropathy has been worse for a few days now. Still sleeping fine.
January 18
7mg, upper right arm. Slept fitfully last night. Still at baseline with slightly worse neuropathy.
January 19
7mg, upper right arm. Slept well. Felt pretty good today, slightly better than baseline.
January 20
7mg, upper left arm. Pretty good day.
January 21
7mg, upper left arm. Pretty good day. Constipation has been worse this whole time.
January 22
7mg, upper right arm. Pretty good day.
January 23
~5mg, upper right arm. Didn’t sleep well, more tired than usual during the day. Probably not related to the patch.
January 24
3.5 mg, upper right arm. Slept well. Feeling pretty good today.
January 25
3.5 mg, upper right arm. Pretty good. Bad constipation still.
Some things to note:
As it says in the links above, a Herxheimer (‘herxing’) effect is to be expected at the start, and that is what I believe the migraine, headaches, and wooziness I had for the first few days was about. However, herxing is often a sign that whatever you’re doing is working and you’re advised to try to tough it out if the symptoms are not too bad. Mine were not unbearable, so I kept going.
You can’t safely cut nicotine patches without disrupting how the dose gets delivered, but you can cut the backing and then tape the other side down. So for the first few days, I cut half of the backing off a 7mg patch. I stuck that half to my skin, and then I taped down the other side that still had backing on it (or else it would have been sticking up off my skin). So on days three and four, when it says ~5mg, that means I cut away a little more than half the backing to approximate 5mg.
Some people have sleep disturbances on these patches. I changed mine out around 10am each day, so by the time I went to bed (around 11pm), there wasn’t much left to my dosing and I slept fine for the most part.
Pros: overall, these patches wound up improving my fatigue and mental clarity to some degree. I wouldn’t say miraculously so, but it was a noticeable improvement. You do have to be mindful to continue pacing however, so as not to induce PEM.
Cons:
the first few days of herxing kind of sucked. I would definitely plan to try this when you can lay low for a few days in the beginning.
also, while I was on the patches, my peripheral neuropathy and constipation got worse. Not terribly fun. Apparently, nicotine is supposed to make it easier to ‘go’, like coffee does for some people. This did not happen for me; in fact, the opposite happened. Both the neuropathy and the constipation issues went back to baseline once I stopped the patches.
for about 4-5 days after stopping, my brain was foggier and more scrambled than my usual baseline Long COVID brain fog (which hasn’t been so terrible for the past year). I was using incorrect words to describe things and I felt cognitively overwhelmed; I could not keep straight what I needed to get done during those days.
Bringing this in for a landing
Was this worth it? Will I do it again? I’d say yes and yes. First, it’s a ‘low stakes’ experiment. The patches cost about $20-25/box for 14 days (I used CVS brand and took advantage of coupons), and any bad effects go away within 1-2 hours of removing the last patch. The reason you don’t want to go longer than 14 days at first is because your brain gets desensitized to the effects of nicotine over time. The nicotine patch group advises to take 3-5 days completely off of the patch before trying your next round.
Some people experience immediate benefits from their first round. For some, that’s enough to create lasting change in their energy levels and acuity. Others find they need to go a few rounds. And of course, like with anything for Long COVID or ME/CFS, some people are not helped much or at all by these patches. Folks may have to play around a bit with the dosing and the amount of time, too.
I will likely try another round when I get back from Florida to see if I make any additional gains. I would say I’m slightly better than baseline now, once the few days of brain scramble passed. So it would be worth it for me to give it another go.
**Keep in mind, I am not a doctor, and therefore, I’m not YOUR doctor (such impeccable logic). I felt okay not checking with my doctor before trying these patches because I knew I could just rip it off and be back to my LC baseline within an hour or two. But you may be wondering if your sensitive system can handle this experiment, or you may wonder if any of the medications or supplements you’re on will be an issue. I can’t help you with any of that, obviously, so check with your doctor or live on the edge. You do you, my friend.
Was this helpful? Will you give these a try? Or have you already tried them? Meet me in the comments and let’s discuss.
Stick around for…
🥳 The After-party 🥳
Announcements, links to articles and studies, recommendations and shout-outs, and miscellany joy and/or tomfoolery.
🫀 FDA urged to move faster to fix pulse oximeters for darker-skinned patients
💉 Long COVID and Long Vax - very insightful video:
☕ Excellent piece by
making the case against caffeine. Longtime decaf drinker here. Decaf doesn’t taste any different, so don’t try to come at me with that nonsense. Get yourself a nice dark roast decaf (I like Starbucks Decaf Cafe Verona) and keep it moving.
😬 Oopsy: this basketball player didn’t realize he just dissed Morgan Freeman.
🎹 The Piano Man is back with his first new song in forever: Sing Us a New Song, You’re Billy Joel, Man. The Tonic household is made up of two native Long Islanders, so this announcement was required 😎
🤦🏽♂️ Buffoon of the week: I mean, which one is it: you haven’t committed any crimes/this is “the greatest witch hunt of all time” (apologies to my witch friends) OR you need immunity because it’s okay to crime-all-the-time when you’re president? A federal court of appeals unanimously said no, actually this is not okay.
It’s getting harder and harder not to pick the U.S. bronzer-addict-in-chief as the buffoon of every single week. No picture because I’m sick of seeing his stupid orange face.
🏆 Winners of the week: Anyone who got to hear both Joni Mitchell and Tracy Chapman perform at the Grammy’s. It’s us. We are the winners. #LEGENDS
🐈⬛ 💩 And finally, it’s this week’s Cat Dump. Shorthairs being silly edition.
The Sunshine State? That's where I am! :)
Wow - thank you for mentioning my post to your readers :) So glad it resonated with you! Really interesting to see how your experiments with nicotine have gone. I've experimented with the mouth sachets at times, but never the patches