The Controversial Biohack: Does Nicotine Microdosing Boost Brain Function?

If you’ve been following me for a while, you know I love exploring a new trend or biohack. Nicotine microdosing is a biohacking strategy that has been getting a lot of attention lately—while the potential cognitive benefits of low dose nicotine have been a subject of research for a few decades, new products like nicotine pouches are bringing the concept to a wider audience for the first time. 

Some people in the wellness world are all over the trend, while others are sounding the alarm about the risk of addiction. Today, I’m going to share my take, how we approach low dose nicotine use in our functional medicine telehealth clinic, and the pros, cons, and science behind this controversial biohack. Let’s jump in. 

What Is Nicotine Microdosing? 

Nicotine microdosing, like microdosing any substance, involves using very small doses in order to achieve effects different from those you’d get with larger quantities (and with fewer risks and side effects). 

In the case of nicotine, the stimulant compound found in tobacco plants, microdosing may help to boost energy levels, cognitive function, memory, and focus. 

For these purposes, nicotine is delivered in different forms including transdermal patches, lozenges or troches, oral pouches, sprays, or chewing gum. Low dose nicotine is also available in inhalers, which require prescriptions and are primarily used to help with smoking cessation. 

Microdoses of nicotine are usually between 1 and 5 mg. In comparison, the average cigarette contains about 10 – 12 mg of nicotine—and while that isn’t all absorbed, it does add up when smoking multiple cigarettes per day. 

Research-Backed Benefits 

Studies have found a number of benefits of nicotine microdosing, showing that small, controlled doses can influence neurotransmitters involved in attention, energy, and mood. Most of the benefits relate to cognition, but some evidence has also demonstrated metabolic effects of nicotine. 

However, we still don’t have much long-term data on the use of low dose nicotine, and studies range significantly in doses and methods of nicotine administration. Overall it seems likely that nicotine treatment can offer cognitive (and maybe other) benefits, but what kinds of benefits may be achieved through responsible, short-term microdosing are not always clear (and higher, longer term dosing is not likely to be healthy or safe). Clinically, we do see benefits at low doses over the short term, and hopefully future studies will help us understand more. 

Attention and Focus

Low dose nicotine has been studied for years for its effects on attention, focus, alertness, and reaction time. It likely works here by activating the acetylcholine pathway (acetylcholine is a neurotransmitter we need for focus, energy, and mental stamina). 

Nicotine has been shown to improve attentiveness for people with ADHD as well as in healthy, non-smoking adults, and several clinical trials have now found that transdermal nicotine can improve cognitive function. (1, 2) 

Memory

Memory enhancement is another one of the most-studied benefits of nicotine. The effect seems to come from nicotine’s ability to stimulate the release of not just acetylcholine but also dopamine, serotonin, and norepinephrine, all of which play roles in working memory and recall as well as mood. Studies have shown that nicotine (though not always in low doses here) can improve short term and working memory. (3) 

Mood and Anxiety 

Nicotine may improve anxiety and mood for some people, again through its influence on various neurotransmitters including acetylcholine, GABA, dopamine, and serotonin. (4, 5) It’s important to note that at higher doses, nicotine can trigger anxiety for some people—bioindividuality and dose both matter here. 

Metabolic Function and Aging 

This is a newer area of research, but some studies have found that nicotine may boost metabolism and improve resting metabolic rate. (6, 7) An interesting 2023 animal study suggests that low dose nicotine may improve accelerated aging, oxidative stress, cellular health, neuroprotection, and metabolism via the NAD+ pathway. (8) 

Downsides and Risks of Nicotine Microdosing 

My number one concern with nicotine microdosing is that I see a lot of people in the health and wellness space who are relying on it way too much. Nicotine is addictive, and it can easily be abused, even when it’s being used for “wellness”. 

For example, I’ve seen a number of people who are constantly “microdosing” (to the point of macrodosing) nicotine throughout the day, and over long periods of time. 

And there are several possible harms associated with this. First, there are the risks associated with nicotine itself. These risks increase with higher doses and longer durations of use, and include nausea, dizziness, anxiety, addiction and dependence, increased blood pressure and heart rate, and increased risk of heart disease and cancer. 

And importantly, when you rely too much on any tool to resolve fatigue, brain fog, and anxiety, you can end up missing the underlying imbalances that are causing these issues in the first place. This can enable you to push your body past its natural limits (for example, operate on less sleep than you actually need for recovery), and further bury the root causes of illness that often get worse behind the scenes. 

I’m not saying this to be harsh or to scare anyone, but I do think it’s so important to consider how we’re using wellness tools, not just which tools we’re using, in order to truly improve our health and facilitate healing. 

How We Approach Nicotine Microdosing

We use low doses of nicotine with some of our functional medicine telehealth patients who are experiencing persistent brain fog and fatigue. It has a nootropic-like effect and can help patients get their head above water, while we work on identifying and healing the underlying cause of their fatigue and brain fog. 

What’s going on behind the scenes that is causing someone to need a tool like nicotine in the first place? Some of the root causes we see include mold toxicity, chronic Lyme, long COVID, mast cell activation syndrome, vagal nerve issues, chronic stress or trauma, and gut microbiome imbalances. We do specialized testing and look at your health history and health profile in detail in order to get to the bottom of it. 

This is really the key. If nicotine microdosing is done responsibly, over the short term, and closely monitored, in conjunction with a root-cause focused approach to restoring health, it can be very beneficial. But if it’s used as a one-stop solution for brain function and energy, it can end up being harmful. 

We typically use troches or sprays with our patients. I’m not usually a big fan of nicotine gums, as they often contain artificial colors, sweeteners, and other wellness-disrupting ingredients. As with anything else, the purest delivery method we can find, the better. 

I also consider other nootropic options for many of my patients before turning to nicotine. There are several great non-addictive options including L-theanine, phosphatidylcholine, creatine, and lion’s mane that can be effective depending on the individual. 

Microdosing Is a Tool, Not a Solution 

Nicotine can help improve brain fog and fatigue for those who are struggling, but remember that nobody has fatigue and brain fog because of a nicotine deficiency. That’s why it’s so important to look at nicotine microdosing as a possible tool within the toolbox, and not fall into the trap of using it as a crutch or a long-term solution. 

To work with our telehealth functional medicine team on finding the root cause of your symptoms, request a consultation here. 

As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe.

Image source: Unsplash.com

Sources

• Levin, E. D., Conners, C. K., Silva, D., Hinton, S. C., Meck, W. H., March, J., & Rose, J. E. (1998). Transdermal nicotine effects on attention. Psychopharmacology, 140(2), 135-141.
• Majdi, A., Sadigh‐Eteghad, S., & Gjedde, A. (2021). Effects of transdermal nicotine delivery on cognitive outcomes: A meta‐analysis. Acta Neurologica Scandinavica, 144(2), 179-191.
• Heishman, S. J., Kleykamp, B. A., & Singleton, E. G. (2010). Meta-analysis of the acute effects of nicotine and smoking on human performance. Psychopharmacology, 210(4), 453-469.
• Picciotto, M. R., Lewis, A. S., van Schalkwyk, G. I., & Mineur, Y. S. (2015). Mood and anxiety regulation by nicotinic acetylcholine receptors: a potential pathway to modulate aggression and related behavioral states. Neuropharmacology, 96, 235-243.
• Gandelman, J. A., Kang, H., Antal, A., Albert, K., Boyd, B. D., Conley, A. C., … & Taylor, W. D. (2018). Transdermal nicotine for the treatment of mood and cognitive symptoms in nonsmokers with late-life depression. J Clin Psychiatry, 79(5), 18m12137.
• Rupprecht, L. E., Kreisler, A. D., Spierling, S. R., de Guglielmo, G., Kallupi, M., George, O., … & Sved, A. F. (2018). Self-administered nicotine increases fat metabolism and suppresses weight gain in male rats. Psychopharmacology, 235(4), 1131-1140.
• Perkins, K. A., Epstein, L. H., Stiller, R. L., Marks, B. L., & Jacob, R. G. (1989). Acute effects of nicotine on resting metabolic rate in cigarette smokers. The American journal of clinical nutrition, 50(3), 545-550.
• Yang, L., Shen, J., Liu, C., Kuang, Z., Tang, Y., Qian, Z., … & Li, X. (2023). Nicotine rebalances NAD+ homeostasis and improves aging-related symptoms in male mice by enhancing NAMPT activity. Nature Communications, 14(1), 900.