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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!

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.

I’ve had it for a few years too, it’s really hard, hang in there!

If you want another thing to try, I found that temporarily wearing a nicotine patch [1] helped a lot. But it seems like it doesn’t work for everyone.

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

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/