What We’ve Missed About the Vagus Nerve

Welcome to the Gordon Medical Forum. The Vegas nerve may be one of the most talked about topics in integrative health, but most of what's being said barely scratches the surface. In this episode, Dr. Eric Gordon sits down with Dr. Novaz Habib to explore what's really happening inside this remarkable nerve and why restoring its signal may be one of the most powerful things you can do for chronic illness. Thank you for joining us and here's Dr. Eric Gordon and Dr. Novaz Habib. Welcome everyone. Today I'm speaking with Dr. Novaz Habib. Dr. Habib is someone who really knows a lot about the autonomic nervous system. So Dr. Habib, welcome. It's a pleasure to be here Dr. Gordon. So tell us about you know just how your just overview of the Vegas nerve and then we're going to some of the details. Absolutely. It's the funny thing that kind of brought me to understanding and kind of having my focus on the Vegas nerve had everything to do with the fact that it was completely misunderstood and it was even named the Vegas nerve. It actually came from the root word vague. Really truly we didn't know what it did when we were looking at the macro anatomical level. Once we finally started looking micro anatomically to understand the type of cell that it was trying to connect with that it was trying to communicate via that was really the driving force that brought my attention towards why this was such an important nerve. That and the fact that anatomically there's nothing like the Vegas nerve in the rest of our body. The Vegas nerve is unique. It is the only cranial nerve that leaves the cranial cavity. It's the only of the 12 cranial nerves we have. This is the only one that leaves and goes to the rest of the body and then it connects to virtually every single organ in our viscera and thorax in the abdomen. What was so unique? What information needed to be relayed through this unique nerve that couldn't be relayed through every other spinal nerve or sympathetic chain nerve that was available. That was really my curiosity peaked when I started digging into what the Vegas nerve was and what it was actually really doing. What type of cell was it truly trying to communicate with? That was my introduction to it for sure. There's so much noise about the Vegas and the gut but you know it really goes throughout the organ system. So I mean you know can you talk a little bit about you know the different organs that it inner dates and you emphasize the cell type. We have a direct physical connection between our Vegas nerve connecting directly from the brainstem to the heart, the lungs, the esophagus, the trachea, the stomach, gallbladder, the liver, the pancreas, not directly to the spleen but has an indirect and very important connection to the spleen, to the kidneys, to the small intestine and to a good chunk of the large intestine. And I'd probably left something out in there as well. It literally is the connecting point to every one of these visceral organs. So for me I was always trying to understand what was going on here. We've always kind of been taught in medical school and chiropractic college. It's the autonomic nervous system. It runs the parasympathetic component of the autonomic nervous system. So it's rest and digest information that's being sent to these organs so that we can go into rest mode and digest mode. Really truly I think that's a very significant oversimplification because we didn't understand the micro anatomical level previously. And we didn't understand that 80% of the signals on the Vegas nerve are afferent meaning they're coming up from the organs to the brain. So the vast majority of the signaling on the Vegas nerve is actually telling the brain what's happening in the rest of the body. Four out of every five signals on the Vegas nerve is going up. So it's telling the brain what's actually happening. It's sending a signal up to the brain stem to say, hey there's some sort of dysfunction or some sort of challenge occurring in the microbiome that's causing increased inflammatory reactivity within the gut or you know we're really burdened with a lot of toxins in the liver and we're trying to clear it all out and these cut for cells are hyperactivated and we need to get this information up to the brain. So the brain knows what's happening in each of these organs. We're getting these status updates and the brain is acting like the CEO of the body. So it's taking in all of this important information and it's executing its cognitive processes, some subconscious, some conscious and it's sending information down to the rest of the body via the Vegas nerve via the sympathetic chain via the HPA, HPT and HPG axes through the hormonal pathways and it's relaying all this information out dictating whether we want to enter more of a sympathetic fight or flight states or if we want to enter more of a parasympathetic rest digest and recover state. And so getting that information up is very very important. Only 15% of the information on the Vegas nerve is brain to body is parasympathetic rest and digest information. The vast majority is getting the information up. So you can understand or you can probably guess if there is a dysfunction in this nerve, if the nerve signaling capacity decreases for whatever reason and there are quite a few good reasons that we can discuss. What it's going to do is it's going to decrease the level of good communication that and information that the brain gets. Meaning that the brain can't make as good decisions. It's not going to be capable of taking in such important information as to what's going in the liver, what's going on in the gut and the lungs and the heart up to the brain so that it can't then make good decisions. In the same way that a business that has a CEO that can't make a good decision because it doesn't have good communication or it doesn't have good relay of information up there, that CEO is not going to be capable of making the right decisions on marketing and sales and HR and whatnot. The same idea is occurring within the body so we really need to get that information up and when we can't problems are going to persist, challenges are going to occur. So what is causing the failure or maybe the the corruption of the information flow? It's a great question and for me it all comes down to a single word that needs to be teased apart pretty significantly and that word is stress. Stress is the driving force or the driving factor that's causing the biggest nerve dysfunction in the first place. Now stress we have good stress and we have bad stress, right? We have good stress known as U stress, EU stress and we have bad stress which is known as distress and for me just the definition of this is U stress or EU stress, good stress, the stress that's driving you towards a goal. It's the stress of sitting down and working productively on your entrepreneurial endeavor or it's the exercise that you're doing to build up muscle to help maintain your longevity and your metabolic function or things like that versus distress is stressors that are occurring that are holding you back or pushing you away from achieving your goal. So these can be any type of things and on the distress side of things I like to look at four different areas. The first is daily stressors. These are relationship challenges, challenges of financial stress, getting the kids out of the house in the mornings. Your normal day-to-day habits of sitting on the couch for a couple of hours before you go to bed and you know, munching on something here or there or having these challenges of poor habitual response. So your daily habits play a huge role there. Number two is psychological stressors and these are challenges and major stressors that your body has experienced in the past that scuff the lens through which you see the world. So you've been a victim of a crime or you've experienced adverse childhood trauma or you know lost a loved one. A lot of my clients sadly lose a parent or lose a child and those are major psychological stressors that affect their mental health. I recently had a wonderful discussion with Dr. Amy Epigian that really brought in a lot of Gabber Matay's work and brought in a lot of the psychological side of things into the polyvagal theory side of understanding as well. So psychological stressors essentially what they do is they take us out of a feeling of safety and safety is the driving force that turns on the vagus nerve. The third area of stress that we need to look at is biochemical stress. We need to look at toxins that are entering our body. Are we being exposed to EMFs at a very high level? Are we being under nutrient or are we nutrient depleted in the food that we're taking in? Do we enter a state of dehydration far more readily? Are we getting the right electrolytes or the magnesium or the specific minerals that our body needs to be able to function at a high level? So cellular nutrient depletion is a major biochemical stressor and then it's either too much of a bad thing or too little of the good things on the biochemical side of stressors. And then the last one is physical stressors. Physical stressors, I believe, are overlooked pretty significantly. And being a chiropractor, I tend to look at structure and function working really intertwined in how we are present. And I'll talk a lot about this when we get into the idea of how to improve this and breathing mechanics are huge when it comes to Vegas, nerve function and physical stressors. So we need to look at, are you exercising well? Are you moving enough? Are you sitting too much? Are you injured because of overuse or overuse injuries or did you maybe have a concussion or a whiplash or some sort of car accident physical traumatic event that could have affected physically how your body is handling things. So these four areas really need to be looked at. And then on the structural side of the things, your breathing mechanics, are you breathing correctly? Are you breathing in a way that's going to drive you towards a parasympathetic activation or into more of a sympathetic activation? And so your breath actually will dictate whether you go in either of these areas and physically breathing in a sympathetic pattern is going to drive your body into more of a sympathetic neurological state and prime the cells that the vagus nerve is trying to signal to to be more in a cell danger style response as you've worked on with your patients and understanding the cell danger response is a direct manifestation of sympathetic overdrive through the neurological systems into the immune system. And the immune system cells is exactly what the vagus nerve is trying to put the brakes on and signal to. And we'll talk about that. I imagine in a moment. But those four stressors are where you need to look to understand what's causing the vagus nerve to become dysfunctional in the first place. Stay with us. We'll be right back. The Gordon Medical Forum is now online. Join us for events, workshops and webinars with medicines most innovative minds, giving you exclusive access to groundbreaking conversations, insights and solutions from leading pioneers in chronic illness treatment. Learn more at Gordon Medical Forum. You know, looking through my favorite lenses that that's a cell danger story is it's just the idea that you laid out pretty beautifully is that when stress has a beginning and an end, that's life. That's the, that's the use stress. That's the good things. That's the challenges that you have and you can deal with. But the bad stress, the distress are the things that don't go away and that you can't and that every attempt to improve, you wind up just recreating that cycle of new. You know, and that goes because for most of us, that's where the psychological issues come in because, you know, I said, we all have our neurotic tendencies and that just means you keep doing the same thing that didn't work over and over again as a solution. So I like that. So here we are trying to improve this communication because as you're getting back to your, I think the really important point is that when the Vegas is getting information that it can't manage is that when the Vegas nerve is not able to just make sense out of all the information or that being too simplistic. I think it's, remember, it's a nerve, right? The Vegas nerve is a nerve. And so it is simply a signaling wire, a signaling conduit. It's not actually processing information within the Vegas nerve. If the information can't get signaled or communicated to the area where the processing needs to occur, which is in the central nervous system, in the brain particularly, then we're not going to be able to make those good decisions. But I like to think of it almost like if you ever have a wire in your home, charging your cell phone, charging your laptop, if that wire becomes frayed, if the outer insulation layers become frayed because mice come by and they're biting off the end of these wires, or you're overbending them and your kids are bending these wires and breaking them and all of these things. Those are physically breaking down the capacity for the signal to be passed along that wire. Stress has the same effect on the Vegas nerve. I like to just think of it in that simple terms that, yes, the information should be capable of getting between the gut and the brain or from different organs to the brain and back down. But if the signaling capacity of that nerve is decreased, then the information can get passed. So it simply comes down to, can you build up the insulation again around that wire to maintain signaling capacity? That's what I think Vagal tone is. It's not so much that the information, let's say, the simple thing we always think about is the dysbiosis in the gut. That's one level of information, but it's the fact that the communication conduit, as you say, the wire itself, because of the chronic inflammation or stress, is no longer conducting that information is clearly. The simplest analogy I can give is it's broken telephone. Yeah. If people have the information when it's repeated is corrupted, it's no longer clear. This is a, give me food for thought, because I said, it's so often, I was just thinking of like, well, all the information that's getting to the Vegas is inflammatory in itself, but it's actually also the wiring system is also being degraded by the constant stress. Okay. So I think that's, I mean, for myself, that's an important new concept to think about, you know? And you've mentioned inflammation. We'll get into that because that's really what we're trying to control the Vegas nerve signaling. Right. That is the circle. Exactly. Hopefully the upward circle, but unfortunately, and chronic illness is often the self-reinforcing downward cycle. Okay. So if I understand, Crippie, so you think a lot of this issues with the, so it's almost the, there's a hardware issue that you're talking about in a way. Okay. This can be a bit of both. It can be a bit of hardware and software combination. As a component, I understand. It's a component. We're not talking. This is not, not black and white. These are all shaped gray. But as far as, yeah, so you can talk a little bit more about the, the, the detail pathway that can cause the, as you say, the insulation to fray a bit. Yeah. Exactly. So those are the four stressors that we need to look at the daily psychological, physical and biochemical stressors. And that information's being relayed, but you can almost think of these stressors as filling up a bucket of stress that proverbial bucket of stress that we each have and each of us has a different size of bucket, depending on what we've experienced in the past, how full that bucket, bucket becomes, how we experience buckets, our perceived stressors are going to play a huge role. And if we're putting enough holes at the bottom of that bucket, then we're going to be able to empty that bucket out using stress management style tools. The unfortunate situation is most of us don't have enough holes or strong enough stress management practices that are positive, that are helpful. And so that's the stress bucket fills up far more easily. And that accumulation of stress is going to have an effect. Now, as we build up these stressors, the effect within the body is actually felt at the level of the immune system. These immune cells are present in every single organ of the body. This is the target cell. This is the cell type that now through microscopic anatomy, we're actually able to identify as being the target of vagus nerve interaction. These are immune cells called tissue resident macrophages. So tissue resident macrophages are the immune cell of the innate immune system that are actually the first cell in our body to differentiate from our multimodal stem cells when we're a fetus. So as we're growing as a clump of cells, the first cell type to differentiate is our all immune cells, but the first one is the tissue resident macrophage. And that actually goes to areas to help build the cell mites around which each of our organs grows. And those tissue resident macrophages regulate the growth and production of each of those organs through our fetal development. And so once we exit the room and we enter our life as we know it, those immune cells, those tissue resident macrophages remain in those organs for virtually our entire lives. And they need to communicate with the brain. And so the vagus nerve is the communication pathway between these immune cells and the brain. Now these tissue resident macrophages have different names in every organ of our body. And mention the cut for cells in the liver. These are tissue resident macrophages. We have tissue resident macrophages in the gut, in the lining of the gut. These are the interstitial macrophages in the interstitial layer of the intestinal tract, both small and large intestine. We have tissue resident macrophages in the heart. And in the brain, they're called microglial cells in the brain. They are present in every organ, alveolar macrophages in the lungs, pancreatic macrophages in the eyelid cells. And these are all coordinating and regulating the function of these organs, making sure that there isn't a threat to the optimal function of those organs at any given time. And if there is, it's going to relay that information up to the brain, letting it know, hey, something's going on here. We're going into an inflammatory mode to protect ourselves from this threat to our response. Now if you've experienced trauma in the past, excessive stressors, and almost a priming into a sympathetic fight or flight state, those immune cells are hypervigilant. And that's what we call the cell danger response, is these hypervigilant immune cells that are ready to react almost too quickly. And so they'll enter the sympathetic fight or flight inflammatory state very, very quickly. And the reason why they'll do that is they don't have the signals coming from the vagus nerve effectively to down-regulate those inflammatory signals, to down-regulate those hypervigilant tendencies that those cells have. Vagus nerve signals via a neurotransmitter known as acetylcholine, ACH. It's the only neurotransmitter that the vagus nerve uses. So a Cidil Collian will be sent out through the e-fair in pathways, that's the brain to body pathways, where acetylcholine will be sent out, and it attaches to a very important receptor on these tissue resident macrophages, known as the alpha-7 nicotinic acetylcholine receptor. That specific receptor, when it becomes activated, because we have either acetylcholine or nicotine, nicotine does have very similar effects to acetylcholine, but we maybe don't want to go down that nicotine pathway as much as it may be out there for other ways or other reasons. Acetylcholine is the primary way that we can go down this pathway endogenously, and what we're going to do is activate a down-regulation in inflammation, so it's going to protect the mitochondria in those cells. It's going to send direct signals through the Jack 2-Stat 3 pathway, to the nucleus, and to, I forget the other pathway off the top of my head, but, or the NF cap, I'd be pathway, that's the one. So these two pathways are going to go to the nucleus and down-regulate the proteins that are creating inflammatory cytokines, and we're not going to release these inflammatory cytokines nearly as much. What that does is it puts the brakes on this immune activation. It puts the brakes on the inflammatory pathway. It's controlled for the inflammation. When we don't have vagus nerve signals coming in due to the fraying, due to the stressors that are building up and causing vagal tone to decrease, the signaling capacity to decrease, then we're not going to get that acetylcholine to the immune cell activation. We're not going to be able to down-regulate those immune cells. That's really what's happening in so many chronic diseases, where we have hyper-inflammatory low-grade inflammation that's constantly building up, building up, building up. We don't have enough of these vagus nerve signals coming in to down-regulate that inflammatory reaction. That's what needs to occur here. We need to build up vagal tone, which is the signaling capacity of the vagus nerve. We need to build up the acetylcholine levels through acetylchoy and choline in our nutrition to help to maintain that neurotransmitter for signaling capacity. There's tools, devices, and free practices that we all should be able to bring into our day-to-day lives to help build up this vagal tone or vagal capacity to send these signals down and down-regulate this inflammatory reaction. That is fascinating because the inflammation at the tissue level is the story. I didn't realize how the vagus has that where people talk a lot about how the vagal affects the immune system through that same pathway when it talks to the spleen in lowering inflammation, but realizing that that's happening in every organ in the body directly. Yeah. So, vagus nerve has direct physical connections to all of those organs where it sends acetylcholine, and you mentioned the spleen. This is the vagal reflex that goes through the spleen to amplify that effect out to all of the other tissues that vagus nerve does not have direct connection with. So via the bloodstream, we can amplify the effect. And so what it's doing when it goes through the spleen, we have this pathway of the vagus nerve that accesses a very important sympathetic ganglia, and it sends a signal through the splenic nerve then. So that's the indirect splenic connection that's going to turn on what's called chat cells. These are CD4+T cells that go out in the bloodstream that release acetylcholine. So acetylcholine is not only released as a neurotransmitter, but it's going to be released via the bloodstream through these immune cells that are basically acting as an amplifier of that effect. This whole pathway is known as a colonergic anti-inflammatory pathway, and the entirety of it is known as the inflammatory reflex. This was developed or finally understood about 30 years ago at the fine scene institute by Dr. Kevin Tracy and his team. So this is really why the vagus nerve is so important. It's the linchpin in ensuring that we can send out these anti-inflammatory signals of acetylcholine through both direct vagal signals and the amplified signal via the spleen. Wow. And what is so amazing is a lot of the things that you work with is how we're able to actually just be quiet in our own bodies and amplify that signal. I mean, I think that's that, but, you know, we don't need another supplement or another drug. This is something that we can do on some level for everyone. I mean, yeah, it depends on the level of sympathetic arousal that's happening from the stuff that's going on in your body. But I mean, I just want to have you go over that one more time, because I think it's just so critical. Because to be honest, I don't, I mean, I don't think we talk about enough about how the vagus nerve is on one hand, getting all this information from your body, but it's really talking back to your system through immune cells. Yes. You know, which is, again, it goes back to my point to remind people that there's no immune system and there's no any system. We broke them up to talk about them, but they they work in one big bag of soup. Exactly. So the vagal signal into most of our visceral organs, which are organs, think of it that way, you know, all the solid tissue in your body. You have these tissue resident macrophages, which, you know, people have been looking at forever. That's going, oh, these guys must be important. And that is the chemical signal that the vagus nerve gives after it's kind of excess what the information that's coming from your body, it then is feeding this back. Yes, exactly. So, relaying the information up, that's 80% of the information is being relayed up to the brainstem. That information gets relayed through the central nervous system. In fact, there's a relay pathway for acetylcholine to be released within the central nervous system at a spot called the nucleus bacillus of maynard. There's no tests on all this. I know I'm going heavy into the the names of things, but it's just for people to understand that there are real scientific factors behind all of these that we've understood. And acetylcholine is then released volumetrically through the central nervous system to regulate the microglial cells. So, one of the big things, one of the bigger symptoms that a lot of people that have immune activation or immune hypervigilance that are that they're dealing with is brain activation and shut down of brain functions. Almost fogginess, lack of clear thinking, memory issues, leading slowly towards neurodegeneration, leading slowly towards Alzheimer's dementia and Parkinson's. And these are inflammatory conditions within the brain because those microglial cells are not being primed down into a parasympathetic rest, I just recover mode. So, those immune cells can either go into that cell danger response and be in sympathetic state chronically or they can be downregulated when the Vegas nervous active when we have these signals being sent to essentially have we think of the autonomic nervous system as turning us into rest digest recover, but it's the immune cells that need to go into that state. Just like you said, we're this one big bowl of soup that everything is interacting with. And yes, we've broken it apart just to be able to talk about it. But really, there's no systems, right? We're all one holistic human. Yeah. And so this ability to relax is crucial for the system to function. Well, I mean, because the beauty of the body is that you can function unwell for a very, very long time, but it's a function well. And so just, you know, I was gonna wait, but I think we'll go right to it. Like, what are the techniques that are available and some devices that you have found helpful to get this to work a little bit better so we can begin to prime that that system that lets us know that the danger might not be as big as we think it is. I'll start with the foundational stuff and the foundational stuff is generally all free. All of this is this is where the Vegas nerve gets to do its work and where what we do actually impacts whether we go sympathetic or parasympathetic. And we're always going to be balancing between these two, but your this particular practice, your breath is the driving force, which determines whether you're going to go sympathetic or parasympathetic more in that moment. Okay. So the breath is the key here. How you breathe your breathing pattern, your breath rate, and the breathing mechanics that are around this are going to dictate whether you're going to be more parasympathetic or more sympathetic. Our breath is something that 70, 80, I would almost say 90% of people are doing in a very sympathetic way almost all the time. What we're doing is we're breathing with our mouth. We're generally breathing with our accessory breathing muscles, which as a chiropractor, I used to see all these tight traps, upper back muscles, raw emboids, all these people that are we used to attribute it entirely to just pure postural issues being on our cell phones all the time. That's a big component, but how you breathe is going to dictate if you're using the right muscles for the breath pattern or not. And we tend to spend more time and inhale than we do in exhale. So I'll go through each of those three things. Number one, we should be breathing through our nose. Our noses are breathing tube, our mouth is our eating tube. We don't have teeth in our nose. We don't have nose hairs in our mouth. We need to breathe in and out ideally through our nose. For speaking, obviously we're not going to speak through our nose, but ideally breathing through your nose is the key. We have a filter built in through the nose hairs. That air is then filtered, circulated in via the sinuses where it's humidified and warmed. And that clean warm, humidified air goes down into our lungs and it's far more easily accessible to be transfused basically across into the bloodstream so that we can get oxygen into our bloodstream throughout the entirety of our body. So that oxygen that comes in through the nose is far more readily available. In addition, when we breathe through our nose, we're actually activating more nitric oxide activation and nitric oxide is very important for that vasodilatory effect for that calming, relaxing, smooth muscle response that needs to occur throughout the entire of the body. So nasal breathing number one, number two, we need to breathe with our primary breathing muscle, which is our diaphragm. The diaphragm is the primary breathing muscle and it's the one that we've generally all forgotten to utilize. Now the diaphragm is a muscle that lies between the chest to the thorax area and the abdominal organs. So it separates out the chest from the abdomen or the chest from the belly. And it's a large muscle that overlies this entire area, but that is the primary breathing muscle. Now, really simple way to identify if you're using your diaphragm or not is to put one hand on your chest, put one hand on your belly and take three breaths and check to see, are you breathing more with your chest? Do you have more movement on the hand that's on your chest or do you have more movement with the hand that's on your belly? For most people, you'll identify, especially after being out and about and active or stressed during work or with the kids, you're probably breathing with your chest. You're probably doing a lot more upper back chest breathing. These practices, you need to train yourself to have more belly breathing occurring. We should feel more of an expansion and contraction on the hand that's on our belly with our inhales and exhales. So that's really important to understand. Our breath should be nasal, it should be diaphragmatic, so belly breath, and it needs to be ideally longer exhales. So the way this works is if you ever hear a loud sound and it's a big bang and you're trying to figure out what's going on, you immediately go, you breathe in and you get ready to prepare to fight or run away from a potential threat to your survival. This is going to drive you quickly into a sympathetic mode, but what happens is you inhale during that moment. The inhalation, as we breathe in, is actually driving our heartbeats closer together and our heart rate up. That's putting our bodies into a sympathetic mode. But once you realize it wasn't a big deal, it's not a threat to your survival. You go, and you do a sigh of relief and you exhale. And as you exhale, your body goes into a parasympathetic state. So every breath that we take is a very mild push towards sympathetic. It's almost like pushing the accelerator in your car. And then every exhale is like pushing the brakes and slowing the car down. And we have this constant flow occur. And if we're in a more inhalation focused mouth breathing, accessory breathing muscle using inhalation focus breath pattern, that's going to drive our breathing and our autonomic state towards sympathetic, fighter flight state. So if we then start breathing through our nose using our diaphragm and focus on a longer exhale, more time on exhale is going to help drive us towards parasympathetic, turning on our vagus nerve. The breath is the key. And yes, it is very simple. But if you're not using these three things, nasal, diaphragmatic longer exhales, you're not doing your body a great service, you're actually putting your body into a state where sympathetic activation can occur. And then the signals through the vagus nerve are not going to be relayed as effectively. We need to turn on the vagus nerve using our breath. These three things are the keys to making that happen. And what happens as we breathe with longer exhale, so a simple pattern, start with the box breath four seconds in, four second hold, four seconds out, four second hold. For most people, we're probably doing one and a half to two seconds in, one to two seconds out. We're really quickly breathing. And our breath rate is generally quite high. What we need to do is slow it down and what we need to do is go towards longer exhale. So start with the box breath and then enter three seconds in, six seconds out. Try that pattern out. What that's going to do is it's going to spend half the time and inhale and double the time in exhale. So that's an easy tool. And then a really great tool that's been used by Navy SEALs for a long time to help them get to sleep very quickly. It's called four seven eight breathing patterns. The four second inhale through the nose, seven second hold, eight second exhale, slows everything down, really helps them get into that state. Here's a really quick key thing. If you're not sleeping well, you're not turning your vagus nerve on. Sleep is where the vagus nerve does its work. If you're not sleeping well, you're not giving your body the opportunity to turn on the vagus nerve and to have those signals go down and relay to all of those immune cells. So tissue resident macrophages to repair from the damage that's occurred through the day. So a nice little tip there as well. You know, he said we talk a lot about this, but you just did a wonderful explanation and how important it is. These are the simple things, but hard to do a lifetime of training of that tight mouth breathing. And people tell me all the time, I don't hyperventilate because they think of hyperventilating as panting. And of course, just persistent mouth breathing is hyperventilating. Yes, exactly. And all the downstream effects. So that's you said, those are the basic ones. What's your next step up for trying to corral the system into a little more expansion? I like something. The basics of breath are key and then it's you're exactly right. You want to build up on top of this. You want to build the ability to have that parasympathetic nasal diaphragmatic longer exhale style breath or slower breath rate while under stress. So adding in the stress piece. So how are you breathing when you exercise? How are you breathing when you're going for a walk? How are you breathing when you're doing a yoga pose? That's pretty uncomfortable or challenging to be in. Yoga is built on breathing patterns. It's actually focused very much on how are you breathing while you're in this challenging position? So teaching your body to handle those challenges of a little bit of good stress while learning to breathe through that. Building resilience, building autonomic flexibility, the flexibility to go into sympathetic state as necessary and come out of sympathetic state as necessary and be able to shift your nervous system. This is what's known as nervous system regulation. So let's start building on this. Humming, chanting, gargling, singing, phenomenal ways to simply activate through your breathing pattern as to where you're going to go. Okay. So to turn on the vagus nerve, add in any two or three of those practices in addition to the breathing pattern. Now if you're not dealing with a rain-outs phenomenon or living in a very hot temperature, cold exposure is a really great way to help to put your body into a sympathetic state and then to train your body to enter the parasympathetic state accordingly. There's a really great set of papers on this on the mammalian dive response that very cold water, although it immediately puts you into a sympathetic state, as you train your body to be able to handle that through your breathing pattern, through the mammalian dive response, what we're actually doing is we're shifting our body towards parasympathetic. Our breath rate has no choice but to lower. Our heart rate has no choice but to lower when we're in these mammalian dive responses. So even just cold water on the face or putting your hand or putting your face into cold water for a few seconds is actually going to have a very strong and very powerful effect on pushing you towards parasympathetic state. And then if we're dealing with chronic health conditions and we're already in a state where inflammation level is pretty high to begin with dealing with gut issues, having a lot of difficulty sleeping, rumination, almost anxious, anxiety style challenges. This is where electrical vagus nerve stimulation devices can come in and have a really profound effect in a very short term. So handheld cervical devices, I'm a big fan of a couple of them. They're really wonderful in helping to bring your body towards that state when paired to your breathing practices. Because what we're trying to do is build up that nerve capacity. And because the vagus nerve is a nerve, we can use the principles of neuroplasticity to get that working again. So the principles of neuroplasticity are electricity paired to a breathing pattern that is meant to activate that nerve is going to accelerate or catalyze that shift towards vagal activation. So handheld device, I don't know if I'm good to mention names of devices. I really like the Truvega device, Truvega Plus, which I've got with me over here. There's an curricular device that I'm very intrigued by called Zenbud, which is really interesting. It's an curricular ultrasound based device that has some really interesting research coming out on that. I also am a big fan of the VE relief from Hulist, a much smaller device easier to travel with. That said, all of these for the most part are pretty easy to take with you wherever you need to go. Electrical vagus nerve stimulation or biggest nerve stimulation devices, I believe are truly a gift to help catalyze that shift in combination with the foundational tools and regulatory factors that we should be doing on our own already. Yeah. Yeah. What I have found in the people who, I said, this is a very small population, but it's had us to be our population, the really long term chronic complex illness folks, you know, those devices are wonderful, but if you try them, start them literally two seconds because whatever your body is, in not near that state forever, it's not going to feel good. And it doesn't mean it's bad for you. It means do more breathing, do the foundational work, more and come back to them because they will help, don't be afraid of them, but just know that it might not feel good the first time and you just have to build yourself up. But with Dr. Hubby outline the breath work and the hummin and just beginning to accept cold because I think again, there's one of the things that people, you know, you'll notice that people walk outside, it's cold and our first thing is it's cold. And if you could just play with even if it's just a little cool, do the breath and let yourself feel the cold because we have developed the story in our head that stress is bad. And so you go out and you feel cold and you like you kind of panic that how I'm going to get warm instead of going, wait, this isn't going to kill me. And if you can remember that you've been there, it don't let you don't like it, but it won't kill you. If you can keep going back to that, stop because we have developed a culture where we think discomfort is going to kill us. And I might myself and one of those people, it's very hard to push past that point of discovery because oh my god, but it does it. And if we can remember that we build up a much wider repertoire of what's acceptable to our system. And then all these tools just keep building. I mean, that is just a beautiful explanation. I would love to do this again with you and actually do it for our professional audience and go really deeper into the the rounding round of immune system meets the nervous system and go through that because there's just inflammation when we don't control it is our problem. If we don't have it, we're going to die. But if we have too much of it, we're going to be miserable. And so, you know, learning to work with the Vegas nerve and modulate this life saving, life saving system, but it'd be used appropriately. So to the point earlier that you mentioned, starting slow with electrical or biggest nerve stimulation devices, could not agree with you more. I start people with 10 seconds. I start people very, very low. You have to remember adding something like that into your into your routine. It's not like a light switch that you can click on and be able to utilize right away. It's not your body has been trained to not utilize it effectively. So we have to work on it like it's a dimmer switch and slowly increase the light until you get to the point where it can be utilized far more readily. So you're absolutely correct. Start slow. Give yourself time. Give yourself patience. I think patience is completely underrated here on this in particular. People want change now and you didn't end up in this situation at the flick of a switch. It took years and months and time to get into the situation you're in. It's going to take time to get out. So train your body to be aware of this. Give your body space. Give your mind space to say, "I'm working and progress is better than nothing." So let's work on progress first. And so tell us how can people find you and your work and learn a little bit more details on it? I have an online community that people can take a look at. There's a free component which is a 10-day Vegas nerve jumpstart mini course that anybody can take. So look us up at healthupgraded.com. I'm sure there's links nearby. And you can check out my books Upgrade your Vegas nerve is the second one. I've got Activate your Vegas nerve as well, which is the first. And you can follow me on Instagram @doctornavazabute. Yeah, and this will all be in the show notes so we'll be available. So again, thank you so much. I just love the work you've done and the focus that you've had on this very important part of being alive. Thank you so much. And that's a wrap for today's episode. We hope you enjoyed the conversation as much as we did. We love hearing from our listeners and one of the best ways to show your support is by leaving us a review on your favorite podcast platform. (gentle music)