a theory of German anesthetist Dr. Marco Leitzke is tested and preliminary reports seem show significant improvements in LongCovid and ME/CFS symptoms with nicotine patches


about LongCovid and ME/CFS

following points are now my own observations in practice. The “differentiation” of the disease subtypes is helpful because the individual conditions require completely different treatments

Long Covid and ME/CFS are rather similar

In my practice, I see at least 3 types of illnesses that look similar in terms of fatigue and inability to work, but may have different backgrounds.

Mitochondriopathies + adrenal insufficiency: always long-lasting stress in advance, stress-associated: vegetative symptoms, palpitations, panic attacks – responds well to hydrocortisone and adaptogens. Better with HBO (hyperbaric oxygen)

Chronic Cell Danger Response: probably EBV and HERV, also Covid, HHS6 and HZV triggered, sometimes also Lyme disease. Presumably Antibodies against extracellular G-proteins (adenosine/AMP/ADP receptors) which keep the cells in a permanent oxy-stress to fight off viruses “cell danger response” according to Prof. Navioux.

This kind will slowly get better on its own over the months. Some of the long-Covid cases fall under this subtype – better with antivirals (e.g. Ivermectin, Nigella sativa). Better with HBO (hyperbaric oxygen).

Real ME/CFS: the most typicall sign of this subtype is  the PEM (post-exertion mallaise) – like an outbreak of flu after mild exertion, total exhaustion for days – start of this disease mostly typical inflammatory onset after Covid, mRNA vaccination, influenza vaccination, EBV always present, also as an initial trigger.

It often only builds up slowly over months, gets worse with every infection and immune stimulation. Quite some LongCovid cases fall under this group. Responds sluggishly to hydrocortisone, presumably Coimbra protocol well. HELP- or immune-adsorption-apharesis produce often a quick recovery. NOT responding to HBO.

Ongoing Microthrombosis and Microclot-complexes: one subtype of LongCovid that I hardly saw in my office – I just learned today about it from  Dr. John Vaughn who does some anti-clot tripple therapy using blood thinner after diagnosing D-Dimer with seemingly huge success
Maybe I didn’t see it because we put all Covid-Patients with slight D-Dimer on Apixaban – until we discovered that Apixaban messes up Lung circulation and breathing in about 20% of the Patients, now we use Dagiparan.

DD chron. Neuroborreliosis + coinfection: this one is actually quite different: yes, fatigue and brain fag, but often also paralysis, wandering pains and dysesthesia and no PEM -> Borrelia-positive in the DCL laboratory, slightly better with HBO (often with Herxheimer after HBO)

DD Fibromyalgia: not a typical PEM, responds well to subcutaneous ozone, so presumably an infection with anaerobes, presumably better with HBO.

By the way: the real “polyneuropathy” is still unresolved for me, e.g. after chemotherapy or in old age, if you know anything please comment or email. CAVE alpha lipoic acid in PNP after chemo -> forbidden !!!!

Regarding Diagnostics

The most important diagnosis is the anamnesis !!!!

Laboratory: we do not make any great biomarkers ourselves – because we are here in countryside and have no good access to the large laboratories in Germany – apart from “standard laboratory” and the viruses and parasites.

Besides: in Austria you cannot get reliable Lyme disease results in any laboratory, about 50% of chronic lyme tests fail in our lab, this is why I love DCL-Lab in Germany where I can send in serum with regular postage.

Finally: many of our patients have been ill for a long time and have seen many doctors and have got already many lab-results. These specialists are often excellent doctors across the board and have made part of an exclusion process using their often comprehensive analyzes and treatment trials. If the patients visit us their therapies were unsusccessful though. That is just the way such unclear undifferentiated diseases are treated – as long as we – and the patients – are just “trying around” because we dont fully understand the pathophysiology of the process. I am sure, also many unimproved patients will come from our practice to other colleagues.

Our main first test is …

We usually differentiate with our bioenergetic RAC test or treat ex juvantibus (= “try it out”), which is much easier if the patient has been diagnosed and treated for years, we just need to fill what has been overlooked or yet untried.


in the USA we know that Dr. Simon Yu in St. Louis is a genius in testing. He developed his unique bioenergetic test which he calls “AMA” = advanced meridianal accessment

Dr. Yu is using the capacitative resistancy of specific acupuncture points and measures all 12 meridians plus lymphatic system with his special device. Most interestingly the device reading changes if the patient contacts medication like antibotics or parasite drugs. If necessary for the patient due to some infection the stressed meridian is immediatly improved. This is synthesis of ancient knowledge (acupucture meridians) with modern scientific methods (drugs and pathophysology).


Here in Europe Dr. Simon Yu is well known among us physicians as the only real parasite expert living and we see again and again patients that travelled to St. Louis to get his assessment.


Our bioenergetic test result can be confirmed in 50-70% of cases in the laboratory or with imaging, which is in the same order of magnitude of other conventional medical examinations, but our test is very quick and costs nothing.


new clues to the pathophysiology of these diseases

  • thanks to Prof. Navioux we think we understand mitochondriopathy and cell danger response – a permanent switch into high oxidation as a antiviral response of cells – triggered by exgtracellular G-Protein-Receptors – probably an autoimmune disease.
  • thanks to Prof. Carmen Scheibenbogen we think we know ME/CFS much better – an autoimmune disease with antibodies against certain blood flow-regulating and energy-regulating receptors in the body: β-adrenergic receptors, muscarinic acetylcholine receptors (mAChR), G-protein-coupled receptors GPCR-AAk

the two most important lectures from the ME/CFS Conference Berlin 2023

Superstar Jehuda Shoenfeld – Induction of multiple autoimmune CHs all very similar e.g. through breast implants, covid or vaccinations


Prof. Carmen Scheibenbogen shows the autoimmune component of ME/CFS



Dr Marco Leitzke – LongCovid and Nicotine

Dr Leitzke is a German anesthetist and scientist who has published a study on the topic of NICOTIN and acetylcholine receptors that are incredibly densely referenced.

here is his study from 2023

Thesis by Dr Leitzke

Nicotine increases the density / frequency of nACR

nicotinerge acetylcholine receptors = nACR are increased by nicotine administration without them being down-regulated or wearing off, which modulates the whole brain in a positive sense, especially via the inflammatory microglia cells.

Nicotine acts against Inflammation

the nACR affect the pro-inflammatory milieu in the brain and body by inhibiting the inflammation master gene: NFkB

Nicotine binds 30x more strongly than acetylcholine to the nACR

SPIKE contains sequences very similar to cobra venom and rabies virus that bind to these nAC-receptors and block the receptors: Nicotine displaces SPIKE from the n-acetylcholine receptors with >30x affinity

unblocked spike leads to Herxheimer

Due to the antibodies circulating in the blood, the SPIKE that is liberated by nicotine is immediately bound away from these antibodies, but this in turn triggers “general inflammatory reactions”.Leitz

Presumably because of this specific activities of nicotine (NFkB inhibition, much less inflammation), smokers had much lighter Covid infections and a better outcome

ERGO -> Nicotine could be positive for post-Covid debilitating states triggered by SPIKE protein (also PostVac).

For this above linked study, Dr. Leitzke presented 4 cases with prompt improvement in their post-Covid symptoms with nicotine patches.

Community Research – case observation study in the USA

patients are taking research in their own hand: a broader clinical study is carried out on Twitter in a self-experiment – there are 63 participants, about 1/4 of them are ME/CFS, half of them Long Covid. The ongoing study can be found under the hashtag #TheNicotineTest

@TheNicotinTest on Twitter

at the beginning of this treatment

20% participants have energy between 0 – 20%
40% of participants report having “energy” < 30% (i.e. 20% is 20-30% energy)
60% have energy below 40% (i.e. 20% is energy 30-40%)

@TheNicotinTest on Twitter


after the nicotine challenge are only

10% in the lowest energy level of < 20%
30% of participants < 30% energy
35% of participants < 40% energy


@TheNicotinTest on Twitter


This means that you notice an improvement and the energy goes up by at least 10-20%. In several specific cases we can see long-haulers that actually get 90% better within one month!

The interesting result: ME/CFS patients also react to it.

This cannot really be explained with the currently official thesis that ME/CFS is triggered by antibodies against “muscarinic” acetylcholine receptors, so “nicotinic acetylcholine receptors” must also be affected – unless the mechanism of action is completely different ( Downregulation of NFkB etc. etc.).

We only find antibodies in 30% of ME/CFS patients, for the other 70% the pathomechanism of their KH is still unclear.

By the way, we like to measure this AK, costs about 120,-


How does this nicotine treatment work

you buy 7mg nicotine patches

Phase 1 – “sneak in and treat”

Day 1 + 2 only 3.5mg – i.e. half the cover film is not pulled down, you stick the patch on the inside of the upper arm (biceps)

Day 3-7 then a whole patch

In the first week, the symptoms worsen due to the SPIKE = Herxheimer reaction that is released

Evidence that this therapy could be successful:

  • nausea
  • soft stool
  • Strange body odor
  • The sense of smell returns
  • Herx/Sick reaction (old ailments getting worse)
  • much energy
  • Resting heart rate changes, HRV improvements
  • yawning

stage 2

Day 8-12 a break is taken

what usually happens here
  • remission (= healthy)
  • much energy
  • very very tired
  • Herxheimer stops


stage 3

Day 13-16 PACE to test again you baseline

if worse than before, go back to phase 1, otherwise continue to phase 4


stage 4

take the nicotine patch daily


Results are partly spectacular

just 2 tweets as an example – these are patients who have only been in bed for 2-3 years and now report several hours of work per day without PEM after about 1 month on nicotine

But – the plaster is not always a miracle cure

according to the participants, it is just another piece of the puzzle. 

On the other hand …

its worthwhile trying



video of dr Marco Leitzke’s Linked-In Account

copyright of course with Dr. Marco Leitzke



CAVE: I would of course only do all this under medical supervision or background (e.g. HRV measurement, laboratory, ….)

oh one more thing: the Nicotinelle plasters don’t last bathing, because they’re so great for the brain, I started sticking them myself, maybe one of the readers knows better plasters.

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