It came to my attention that people's been trying nicotine patch for MECFS and long COVID. The theory goes: the virus antagonizes the nicotine receptors, impairing cholinergic transmission. I don't buy the theory. If the theory is true, people should recover once the virus is gone. Besides, no neuro-impairment does explain Post-Exertional Malaise. But nicotine turned out to be strongly dopaminergic. And dopamine is what downregulates activated microglia. So, I figure it should work at least as well as Sudafed.
I bought a box of no-name nicotine patch from Amazon and tried 35mg for 6 days. As expected, the effect did not last long. It was effective exactly for 2 days. It was super effective though, while the effect lasted. It's not a viable long-term treatment, but I could use it tactically: with Sudafed, I may be able to keep PEM under control for up to 3 days. My PEM these days usually last less than a day. 3 days at the most after a backpacking, which resembles a normal recovery. (It's more like between normal recovery and PEM). If I can keep PEM under control, I should be able to exercise to my heart's content at home. I already tried it after biking to REI on the 21st, and it appears to be successful. I'll continue the tactic and see if I can keep PEM under control for good.
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