How Your Vagus Nerve Influences Your Gut Wellbeing

How Your Vagus Nerve Influences Your Gut Wellbeing

Would it surprise you to learn that your vagus nerve can influence things like your gut motility, your stomach acid levels, your enzyme production and your heart rate?

In today’s episode, we are joined by Emrys Goldworthy. Emry’s is a musculoskeletal expert with a special interest in the vagus nerve. He’s is also a published author, having recently released his first book “The Vagus Nerve: Unleashing the Body’s Secret Weapon Against Disease”. 

In this episode, Emrys joins Bec to discuss the profound impact of the vagus nerve on our health and wellbeing. He explains the role of the vagus nerve in various bodily functions, including heart rate, digestion, inflammation, and mental health. Emrys shares insights on how low and high vagal tone can affect our overall health and provides strategies for improving vagal tone. He also highlights the connection between the vagus nerve and gut health, discussing the role of the microbiome and enzyme function. Emrys also offers practical tips for optimising vagus nerve function, such as breathwork, cold water immersion, and strengthening the neck muscles.

Key Takeaways:

  • The vagus nerve plays a crucial role in regulating various bodily functions, including heart rate, digestion, inflammation, and mental health.
  • Low vagal tone can lead to symptoms such as elevated heart rate, digestive issues, and increased inflammation, while high vagal tone can cause problems like excessive acid secretion and constipation.
  • The vagus nerve is closely connected to gut health, influencing gut motility, enzyme function, and the microbiome.
  • Strategies for improving vagal tone include breathwork exercises, cold water immersion, and strengthening the neck muscles.
  • The vagus nerve can be affected by factors such as compression, weak neck muscles, and environmental toxins.

Episode Timestamps

00:00 Introducing Emrys Goldsworthy

01:50 How Emrys became interested in using vagus nerve interventions in therapy

06:05 Vagus nerve physiology 101

08:28 Vagal tone and the gut-brain connection

15:40 Clues your vagus nerve isn’t functioning optimally

16:45 Vagus nerve relationship with allergies and histamine response

19:07 The link between asthma and vagus nerve

21:36 The role of vagus nerve in cortisol regulation

26:19 The vagus nerve influences your gut and microbiome

30:49 The role of the vagus nerve in toxin elimination

37:25 How we breathe influences the vagus nerve

40:27 Balancing the sympathetic and parasympathetic nervous system response

44:56 Compressions on the vagus nerve

51:52 Learn more: Emrys’ book: The Vagus Nerve - Unleashing the Body’s Secret Weapon Against Disease

53:53 The top three things everyone can do to care for their vagus nerve

Episode Transcript

0:00:00 - (Bec): My guest today is Emrys Goldsworthy. Emrys has been a clinician and educator for over 16 years. He has a background in chiropractic myotherapy and photobiomodulation and a special clinical interest in working with the vagus nerve to improve patient outcomes. 

Emrys is a pioneer in holistic healthcare and has developed a distinctive method of treatment known as functional neuroarticular system, or FNAS, which puts the nervous system at the forefront of therapy to address things like pain states, systemic inflammation, autoimmune conditions and much more. 

Emrys is a sought-after expert on the vagus nerve, and he has poured this expertise into authoring a book titled The Vagus Nerve, Unleashing The Body's Secret Weapon Against Disease. A brilliant book for anyone who wishes to gain a deeper understanding of this most intriguing nerve. 

I've invited Emrys on today to share his expertise on the myriad of ways that the vagus nerve underpins our health and well-being, and in particular to share with us the surprising ways that it influences our gut health. I warmly welcome Emrys Goldsworthy. 

Welcome, Emrys. Thank you so much for joining me. I can't tell you how excited I am to discuss the vagus nerve with you as someone who I have learned so much from over the few years that we've known each other, but also because I'm really excited about the fact that you've now authored a book on this subject as something that I think more people need to know about, particularly from a scientific perspective. So thank you so much for taking the time out of your schedule to join and to share your knowledge with us.

(Emrys): Thank you for having me on.

01:50:00 (Bec): So the profound impact of the vagus nerve kind of feels like it's becoming more mainstream, and it's a bit more accepted than I think it probably was a few years ago, which I would have thought it was more fringe, but there's actually a lot of science behind it and a lot of information coming out about how effective it is. So what first got you interested in the vagus nerve? Because you've been doing work within this sphere for a while?

(Emrys): Yeah. In the past, I primarily worked with pain conditions with patients. So chronic pain, fibromyalgia, neuropathy, that kind of thing. More clinical states of pain and dysfunction in that regard. And as part of that, I would treat a lot of nerve dysfunction, and a lot of the therapies I use related to manipulation of nerves, various therapies in regards to that, and also electrical stimulation of nerves as part of general protocols for nerve problems.

As part of conversations I have with other clinicians, it was clear to me that there was possibilities that we could look at nerves that affected the gut and other organs as well. And the vagus nerve was one that kept coming up - for obvious reasons. And through a bit of study and understanding, it wasn't really that difficult to implement pretty much all the same protocols to the nerve, because it was not different to any other nerve. It's just that it has different innovations. It goes to different structures, lots of organs and lots of other tissues that normal nerves don't generally do. So it is an anomaly, this nerve. It has a lot of very strange innervations. In other words, where the nerve goes and gives it sensitivity city or activates something in an organ or a gland.

So its functions are very different. So that means that the conditions that people present with were very different. So I started to see people for the therapies that had gut problems, brain problems, heart rhythm problems, systemic inflammation, autoimmune disease, and the list goes on. And as a result, I kind of refined the therapy over time and referenced research in regards to electrical stimulation, and there is a lot of research on that. And it's getting to the point now where with at least three different conditions, we have very large cohort, randomised controlled trials, so we can at least say for epilepsy, for depression, and for migraine, that we have very credible evidence. 

The rest of the conditions are less specific. So they're like gastroparesis, a weakness in gut motility, heart arrhythmia, although there are many good studies for that that are pretty compelling. And it does not feel as though we are on the wrong track there. 

Cognitive decline, that's early days, but the fundamental underpinning/ understanding of how the vagus nerve works in the brain when it comes to neurodegenerative conditions is pretty sound, and we can talk a bit about that.

Beyond that, the systemic inflammatory-type conditions like rheumatoid arthritis has had a lot of research done, but that's predominantly with this thing called the implanted vagus nerve stimulator. And you'll read about this online. Basically, what it is - it's not what I use, but in Australia, the United States, and other countries, there is a procedure in which you can put a wire wrapped around your left vagus nerve in the neck and with a little battery that sits just in your chest, just like any other medical device that you implant. It's generally pretty safe. But the problem is that the battery needs to be replaced, and it's electrically stimulating it on and off. Throughout the whole day, so you can't really change that. 

Whereas therapies I use, they're done in a clinical situation. or from home, and they're done in sessions rather than over the whole day. And it's a little bit more able to be utilised without any potential risk of side effects, which the implant, unfortunately, does have some.

00:06:05 - (Bec): Right, and so you've touched on a lot of things that I'm sure would surprise some people that the vagus nerve is involved in. But so for those who don't know or understand what the vagus nerve is, let's go into a bit of a physiology 101, because it does run through the body and through multiple organ systems. That's one of the things that makes it really unique. So let's talk about that and the role, therefore, that it plays in sort of physical, well as mental/ emotional wellbeing.

(Emrys): Okay, so the pathway is from what's called the medulla oblongata. There are numerous things called nuclei there. They're basically nerve cells where the nerves start, and then they send out what's called an axon. An axon is like a superhighway, and they go down from that point in the brain stem, which is just in the back of the cranium, and they come through a thing called the jugular foramen, it's a hole in the back of the head on both sides, all the way down the neck in a few different pathways. It's not just one on each side, but both sides. We have cardiac vagal pathways, we have standard vagal pathways and others that go to throat, muscles and muscles relating to speaking.

And then it goes into the chest region, and innervates the heart in order to reduce heart rate. When it elevates, it goes to the lungs and has an effect on mucus production, constriction, cough, reflexes, things like that.

(Bec): Wow.

(Emrys): We can go into that.

And then it goes into stomach, oesophagus, liver, and many other organs. The only ones that, at this stage, we don't believe that it directly innervates are the sex organs, the bladder, and the lower part of the large intestine. So basically right at the end of the large intestine, and that's it. But that doesn't mean it hasn't got an influence on those structures through the parasympathetic system, by and large.

(Bec): Yeah. The domino effect of all those. Yeah. 

(Emrys): All right, so what was the other question in regards to mind?

(Bec): Yeah, you touched on some of the aspects that it influences, like systemic inflammation and the gut, and sort of, therefore, it has spillover over effect into our emotional and our mental well-being as well. 

(Emrys): Yes. 

00:08:28 - (Bec): We were talking about this offline, but you can have the quality, or I guess the rhythm of your vagus nerve would be described as vagal tone. And that can be high or low. And with that can come some identifiable symptoms that might give you clues to what your vagus nerve is doing. So do you want to talk about those?

(Emrys): Yep. So the way that low, high vagal tone affect the brain is very.. it’s debatable. Right? So I'll go into that in a moment, but let's just start with what is low vagal tone. 

So, basically what that is indicative of is that the activity in the vagal system, you could call it the vagal system because so many nerves as part of it, so many wires. That could be lower in activity, it could have reduced activity, and it may not be the entire system. It may only be one of the cardiac nerves, it may only be one of them going to the gut. You know? And that's where it gets a bit more complicated because many people have normal vagal function in one part and not in another. So you don't always have every symptom of low vagal tone. 

So the basics of low vagal tone is we go through the different organs, right? So when it comes to the heart, it tends to create arrhythmia, so abnormal rhythm and elevated heart rate, so tachycardia. 

When it comes to the gut, it tends to reduce your acid secretion. So parietal cells are not as stimulated. Gastrin releases lower. And throughout the small intestine, a lot of the enzymatic releases is reduced as well.

(Bec): Right.

(Emrys): When it comes to contractility of structures, say, for example, oesophagus, the lower oesophageal sphincter will tend to be a little bit sitting open and not contracted, as it's vagal innervated. So a lot of the functions of reflux that you will see is that people will get coming up, and it could be that the sphincter is not closing. Ok? And that could be vagal, and there'll be low vagal tone. There is an instance where high vagal tone can cause it, but what that is from is from excessive acid secretion. It's not from the sphincter specifically. Well, at least we believe in theory that's what the case is. 

But basically reduced digestive processes. So that can lead to constipation, poor absorption of food. And one of the other interesting things about low vagal tone is that when your vagus nerve stops working properly, you actually have an increase in inflammation because the vagus nerve is the control centre of system wide inflammation levels and immune system function. 

And a lot of people aren't aware of that. They think that the immune system is just this sort of system that is in isolation, or at least in part connected to the endocrine system. But no, if you were to really look at it properly, more holistically, the vagus nerve rules the entire system. So if the vagus nerve is underactive, you will see autoimmune disease, you will see inflammation, you will see a lot of things that are going to elevate.

But again, like anything, it may not be the entire system, right? So that's in certain circumstances that occurs. And if it's only a small proportion of the vagus nerve affected, you may not get that symptom. Right? 

Some people come in with a problem with swallowing, and that's to do with your pharyngeal branch of your vagus nerve normally. And that can mean just a problem of swallowing, nothing else.

(Bec): Yep. 

(Emrys): But some others have that plus this, plus this, plus this and so on, right? So it gets a little bit more complicated the more that the nerve is involved and less complicated, the less fibres are involved, if that makes sense. 

(Bec): Yep

(Emrys): The role of that beyond the gut and the viscera is the brain. There are pathways into the brain from the vagus nerve, and they go to key nuclei that are involved in the production and release of neurons that have serotonin, dopamine and noradrenaline, or norepinephrine.

These are our main, what's called neuromodulators. They go to neurons in the brain and parts of the brain in the gray matter, and they make those areas more sensitive to activation, because maybe some of your listeners are aware; Activation in the brain generally is done by glutamate and inhibition is done by GABA. So it makes all those systems more active and perform better, basically. 

So, for example, that's why the dopamine system is heavily involved with conditions such as ADHD. So you might well see someone considering using vagus nerve work to improve symptoms of ADHD through dopamine systems. That's why we're experimenting with schizophrenia right now, because dopamine systems are involved there. 

And when it comes to things like depression, anxiety, well, we know that these neuromodulators are involved in some ways. Maybe we don't think serotonin quite to the extent it used to be, but at least we know that if these systems work better, often depression decreases and anxiety decreases and the vagus nerve has been utilised - vagus nerve stimulation -  for major depressive disorder with people who are non-responsive to SSRIs and has a clinically significant positive effect. So we know that it is definitely effective for depression and more than likely anxiety.There’s preliminary studies for anxiety, and it's very, very positive.

(Bec): It would be less invasive. Right. Because you're not messing around with those complicated neurotransmitter systems.

(Emrys): That's right. And the side effects, the potential huge reduction in side effects and let alone getting off the SSRI.

(Bec): Yeah. There was an interesting study, which I thought was great about how science is now proven that depression isn't just a lack of serotonin. I think we're starting to get to the place where we're really realising that things like this, mood disorders, you know, we're missing parts of the puzzle. And it does sound like vagus nerve is something that perhaps has been overlooked.

(Emrys): Yes. Well, it seems as though a lot of people get depression for very credible reasons. Someone dies, there's some kind of trauma, but then they go deep into depression from that, or they just have a general level of anhedonia or some kind of level of apathy that is there. But those deep depressive states, it's almost as if the vagus nerve hasn't lifted you out of it. And that's where I see it working. I see it getting people out of the deeper states, maybe from major depression to medium or mild. It probably won't completely eliminate it, because often there are other factors, lifestyle factors, that get in the way of that. But as part of a multimodal approach. I see it working.

00:15:40 - (Bec): Fascinating. It's so fascinating. So what kind of things could the average person be on the lookout for to understand what their vagus nerve is or isn't doing?

(Emrys): Well, I would start with heart rate and just general gut function. So if you're someone who you test your heart rate, you can go and get a simple heart rate monitor from the pharmacy, and they can just be placed on the finger, and you can see your general heart rate and see if it sits over 70, over 80 most of the time, then you're probably looking at a problem there. It's not the only reason for that. But then you tie that in with constipation, with diarrhoea, or some kind of abnormal gut function, and it's starting to look more vagal, okay?

And you might have a mood issue as well. On top of that, you might also have changes in your voice, which might indicate a vagus nerve problem, and you might be very allergic to things, either breathing in aerosolised allergens or eating things that make you react, you know? 

00:16:45 - (Bec): So, allergies? Allergies are related to the vagus nerve? Wow.

(Emrys): Allergies are heavily linked to vagal problems. We don't know exactly how. I mean, there are some ideas that it works through mast cells or the…

(Bec): Or the gut’s influence on DAO and histamine? Interesting. 

(Emrys): Yeah, all these things. But at this point, I would say the main overarching principle would be that if the vagus nerve is underactive, it means that it doesn't sense enough of the information in the gut, what's going on in there. And that includes the lung, because the lung microbiome is a thing -  the microbiome of the lung -  and the gut microbiome tend to be the same, and they're very similar. So you breathe in something, the vagus nerve, nerve endings in the lung and the gut will determine whether that thing in there is something to be worried about, you know? That you've consumed in some way or breathed in, and then it will react, okay? And it'll either react by trying to get rid of it or mounting allergic response, or a number of things, right? 

And cough reflexes, mucus production, that kind of thing. They're all vagal, right? So you can see how it's involved in excretion. And it'll activate diarrhea, activate vomiting. These are all vagal too, but the allergic reactions are part of that. Right. So if you have IgE, IgG, whatever it might be, type reactions, you can at least put a link with the vagus nerve to start with. And what I found is that people who have vagus nerve stimulation, their reactions to food greatly diminish over time as their vagal tone goes up. That's anecdotal, but that's my experience.

(Bec): That's absolutely fascinating, because, as anyone who's listening would understand, one of the most complicated things, and it's a massive stressor on somebody as well, is that constant fight or flight they're probably playing at when they just want to do something simple like eat food, at a restaurant, or you have to go to a friends for dinner or something like that. It's stressful. If you are a person who reacts to food or has food allergies, or if you're a parent of a child with those kinds of conditions, that's a fascinating avenue of exploration.

00:19:07 - (Emrys): Well, the other interesting thing you know, asthma is heavily linked to vagus nerve dysfunction. So asthma, as you can be aware, asthma is where you get bronchoconstriction, mucus production, bronchospasm, things like that. 

(Bec): Yep. 

(Emrys): Those processes are actually where the vagus nerve is very active. So it's possible that asthma is excessive vagal tone. That's a bit of an area of contention, because the excess vagal tone is not a lot. It's not talked about a lot, and I see it all the time clinically. For many years, I was seeing. It's not an issue. I saw it as a dysfunctional vagal tone. But what it really is is that it's another type of vagus nerve dysfunction. And so asthmatics do more than likely have excess vagal tone. 

(Bec): Right. 

(Emrys): Hence why you give them something like adrenaline or an adrenaline based substance like ventilant, and it suppresses vagal tone and they get better. 

(Bec): Interesting. 

(Emrys): Right. And all these things that are elevated in sympathetic nervous system can often reduce asthma, which does suggest that it's excessive vagal tone.

And you can have people out there who have excessive vagal tone, and it might actually be underactive sympathetic tone. And this is a big one. It's one that I want to write about in the future and how the sympathetic nervous system tone actually is very important to resolve. And people always think that it's elevated, but that's actually inaccurate. 

So a system of low and high vagal tone, if you have this one being the sympathetic nervous system, it could be high, and it makes your vagus nerve look low, but the sympathetic is high, and it could be the other way around. This could be low, and this looks high. 

(Bec): Right.

(Emrys): And the other way around. So the trick is to figure out, is it an issue of the sympathetic nerve system, or is it an issue of the parasympathetic nervous system? And it's very difficult sometimes to grasp.

(Bec): It would be. You discussing that reminds me of some of the issues around determining with women and their hormones. Is it really high oestrogen, or is it low progesterone, or is one masking the other? Sometimes it takes a while to get to the bottom of these things where one makes something look high, when in fact, maybe one is not high, it's low.

00:21:36 - (Emrys): Yeah. And you see that with cortisol, not quite in the same way. I'll make mention of this quite interesting for you, for your listeners, is that cortisol has a tendency, just like leptin or insulin, to become resistant. And it's possible that adrenaline is similar. But at this rate, we know cortisol is right. 

So people who have elevated stress over a period of time can have high levels of cortisol, and cortisol. The main function of cortisol is to keep you alert and to recruit energy substrates such as glucose out of the fat cells and out of the liver. Storage, essentially to put into the bloodstream. That's his main role. That's why it really is released. Elevates throughout the day to keep you alert, keep you energised, and it comes down at night so that melatonin can rise.

(Bec): Or it should come down at night.

(Emrys): It should come down. It should come down. Now, you'll see a lot of people with high, high or relatively high cortisol, but do not have any of the symptoms of normal cortisol. They are tired, they have excess inflammation, they don't seem to have low energy reserves, and they're not alert, and they have elevated inflammation because cortisol is anti-inflammatory. Cortisol is very similar to cortisone, another endogenous corticosteroid, and it suppresses inflammation, right?

(Bec): Yes.

(Emrys): It's another way that vagus nerve actually suppresses inflammation. Through cortisol.

(Bec):, Through it influence, like, so a direct influence? 

(Emrys): The vagus nerve can release cortisol. Yeah, a lot of people think it suppresses. This is why I forgot to clarify this. A lot of people think cortisol bad, and they oversimplify. Most of the problem is that people don't have enough cortisol binding. Now, this gets complicated. 

When cortisol looks high or normal, yet you don't have symptoms of normal cortisol, meaning what I just said, then it's likely cortisol receptors are not working.

(Bec): Makes sense. I mean, like any other hormone. Just like diabetes, and insulin. Similar kind of…

(Emrys): Same principle. And, in fact diabetes can induce it because, as you know, elevated insulin over a period of time, it leads to. Because you can't get energy in the cells. Cortisol raises to try to recruit more energy, and then you get leptin resistance. You get the triad, the cortisol, leptin and insulin resistant cases. 

(Bec): Yep. 

(Emrys): And they tend to have a lot of adipose tissue in the abdomen. They have all the appearances of fatty tissue building up in the back of their neck, and they're round faced and things like that. They look like Cushing's, which is excess cortisol. But the truth is that cortisol is not binding. 

If cortisol was bound to receptors, what you would see is the turning off of cortisol. But you don't get that. So the vagus nerve stimulation actually normalises the level of cortisol. It's been seen in numerous depression studies where they test your salivary cortisol. And in these studies, thankfully, they did that as well as part of these research papers on depression, we were able to analyse cortisol.

(Bec): Yep. 

(Emrys): And what they found is that at a baseline level, from baseline, everyone's cortisol, on average, normalised. So it either went from low to high or higher to normal, or from high to normal, which suggests that it has huge neuromodulatory effects on cortisol. We knew that. But you got proof now. So if someone had elevated or abnormal cortisol, vagus nerve treatments might be an option.

(Bec): That's so interesting. Yeah, because… and sometimes that's hard to detect, it's hard to test for. Like often we are looking at a symptom picture and to have something other than just your adrenals to look at.

(Emrys): Yeah, that's right. And it's very downstream. The adrenals are very downstream in the whole problem. And some people focus on intermediaries like ACTH. I think it's all mostly unnecessary because these are effects of something much, much higher. 

Focusing too much on the neurobiochemistry or the endocrine chemistry, it gets a little bit lost because things happen from… something, must instigate it. And that cascade of effects leads to some kind of biochemical change. And then you're only analysing that downstream change. That's problematic because it doesn't tell you why necessarily. 

00:26:19 - (Bec): Well, yeah, it could change moment to moment. But depending on your surroundings, and what you’re exposed to. 

(Emrys): Well it does. That’s right. That's why. Like the gut microbiome is a very interesting topic. That's why one test for gut microbiome in one day, Mmmm. You know, every day can change, and every moment it can change quite dramatically. I've seen numerous papers where they've done it on a day-to-day basis. And those microbes, they change quite quickly based on the needs of the organism, the human body.

(Bec): Yeah. And I'm guessing, like anything within the gut, you've already kind of touched on the vagus nerve has an influence, I'm guessing, on the microbiome, but also on enzyme function. And you talked about motility as well. So I'm guessing that's both constipation and diarrhoea-type states.

(Emrys): Yeah. So the process of digestion and absorption, breakdown of food and so on, is quite cascading. It's dependent on something else going right previously, ok? And if something breaks down in that pathway, well, then thereafter gets affected. 

So, for example, if we don't have adequate enzyme release or hydrochloric acid release, then the acidity of that bolus or that food is not adequate to get, then bicarbonate response in the small intestine, duodenum. So you're not going to get all the cascading pancreatic enzyme releases to the same degree. But the pancreas is also innovative by the vagus nerve. So a lot of it is still vagal, but it's also already just happening. You know, so a lot of people say that the gut brain, right, the enteric nervous system is its own brain. This is a little bit misleading, because what happens if that gut brain is just left to its own devices is it does not do its job. It is not in isolation of the brain. It is completely and utterly dependent on the brain. So if you hear that, I wouldn't consider it too accurate. The better way to describe it is that you need a conductor. Otherwise the orchestra doesn't play in timing or in tune or whatever. And that's pretty much how the vagus nerve works. It's the conductor of an orchestra, and the gut is the orchestra.

(Bec): Love that. What a great visual.

(Emrys): Not quite the same, but it certainly is your analogy. Now, you mentioned the gut microbiome. So the interesting thing about the gut microbiome is everyone always says that the microbiome reports to the vagus nerve, well that’s actually a little bit inaccurate. The vagus nerve is able to change, at will, what bacteria are present. Now, that sounds very strange, because the bacteria in your gut are all really there for a reason. Okay? 

Now, I have a very strange theory on this as to why a lot of people will have so-called bad bacteria. I don’t believe in good or bad bacteria. So I see bacteria as having a function. We now know that a large amount of niacin and B12 are produced by bacteria in the gut, possibly predominantly determined by that. Okay? So there are possibly more and more will know about this. 

But bacteria seem to have one role is nourishing the organism, maintaining the gut lining, things like that. You know. But then you have these abnormal bacteria and possibly putting parasites there as well, where they're kind of a bit, you know ‘baddies’.

(Emrys): They've got machinery that's a little bit more aggressive. 

(Bec): Aggressive. Yep. 

(Emrys): Now, the way I see them is a bit different. I see that they only come about when the vagus nerve is determined, so that they need to. They are like, the role is your bifidobacteria lactobacilli. Things like that are your ‘farmers’. An invading army comes. They come into the castle. There's a lot of theories as to how this happens, but we won't go there. Then all of a sudden you have bad bacteria that just appear.

(Bec): Yep. They're opportunistic, often. Yes.

00:30:49 - (Emrys): Often, yes, but the way I would see them is that they are there for defense. They are defensive units.

(Bec): Interesting.

(Emrys): And yes, maybe they have side effects for being defensive. Just like anything, you have to weigh it up. Well, what's worse, being defensive and protecting the organism from certain doom? Or is it they're like soldiers? Or is it that you're going to get a little bit of side effect from that? Maybe some nausea, some other discomfort, other cognitive changes, like increased sympathetic nervous system activation. Well, that's no surprise when you intake something that's toxic. So I see them as a ‘toxin defense system’. 

That's how I see them, because there are some weird studies, like we've seen studies done where people have very, very elevated levels of parasites, and it's nearly always analogous with or connected with their levels of heavy metals. So there's something going on there that's a bit more complicated. But for me, the way I would look at it is that the sensory receptors in the gut are aware that there is a toxin present.

(Bec): Yep. 

(Emrys): It then changes the microbiome. Because there are studies showing if you damage the vagus nerve, the microbiome changes within minutes.

(Bec): Yep. 

(Emrys): Within minutes of damage to the vagus nerve and or to the brain. And there's other ones where if you stimulate the vagus nerve, the gut microbiome changes within minutes, not hours, minutes.

(Bec): Minutes, wow. 

(Emrys):  It's very fast. Okay. Once the receptors in the lining of the gut are aware that there's a toxin there, because it has all the hallmarks of it, then the vagus nerve responds. It responds by changing the microbiome. This is my theory. Into a more pathogenic, but the pathogenic ones are very, very good at inducing diarrhea and inducing a whole raft of other things that eliminate. And there we go. We start the process, and we're off. And the gut motility increases. Water gets pushed in, and we excrete. Elimination pathway.

(Bec): Yep. 

(Emrys): The same goes for fever, for me, elimination pathway. The same goes for vomiting. Elimination pathway and so on. Coughing. These are all excretion methods that are just relative to the area, to the place. 

(Bec): Yep. 

(Emrys): And the better your vagus works, the better you are doing it. We live in an environment where there's a lot of toxins. Unfortunately, even the consumption of organophosphates for some people, like inorganic food, may be enough to cause low grade levels of this. And I do wonder, you know, like the role of antibiotics, like a lot of people don't like antibiotics, and I understand, but they do have a role to play in my opinion. 

There's something that people with vagus syndrome problems often will seem to get alleviation of these problems that look like vagus problems, often they are, when they take antibiotics.

(Bec): Right. So what's the relationship there?

(Emrys): I think that we got to be very careful with looking at a symptom that it's actually the body resolving something and it's not actually a symptom of disease, it's a symptom of resolution. Right? So for example, I get diarrhoea. Is that a disease? I get lots of diarrhoea, or is it just lots of excretion, lots of elimination?

(Bec): Of something that needs to be out, yeah.

(Emrys): Yes.

(Bec): So I guess by that thought process, yes, if we intervene too aggressively into something, like with the diarrhoea, vomiting, or as we've done for years with fever, then also that's having a spillover effect by the sounds of things into our vagal tone?

(Emrys): That's exactly right. So the way that I would look at it. Right, because you look up the symptoms of organophosphate exposure, meaning pesticide, herbicides. This is everywhere in the environment now.

(Bec): Well, they're often neurotoxic, toxic.

(Emrys): They are indeed. And they're toxic to the gut as well. And plastics and phthalates and any other heavy metals. There are numerous other toxins in the environment. Take your pick. And what our body generally wants to do is eliminate them. Okay? And it does that via, like I mentioned, diarrhoea, excretion, urination, sometimes to some extent. Sweating through fever or just generally sweating, vomiting and mucus production. Because mucus in the lungs, like an aerosolised toxin. The toxin is on the lung lining, the mucus is produced, it comes out and it grabs the toxin. And then you have these hair-like cells that flick it, flick it up and then it comes up to your throat and you cough it out. This is the mechanism of excretion of the lungs. And everyone always thinks it's to do with just bacteria or viruses. It doesn't even make sense. 

The better explanation. And it's hence why asthmatics tend to have allergens. It's a very similar mechanism. You have to excrete it. Okay? So I would say let's enhance that. Let's make that work better rather than suppressing it.

(Bec): Right.

(Emrys): So what do we do? We give them a cough syrup. Suppress the cough. We give them things to stop the diarrhoea, stop the this, stop the fever. Now I understand that there is a certain point where it gets a bit dangerous.

(Bec): Yeah. There needs to be a balance struck between allowing the body to do what it needs to do, but not at the behest of the host.

(Emrys): That's right. But we can be intelligent about this. And the part of this, it could be just understanding the role of the vagus nerve is to conduct this process. 

So if your vagus nerve is not adequately working, then you're going to have problems, okay? You're going to be underperforming it. So it never really gets to the point where it gets to a critical point where everything, the effect has occurred. You haven't excreted adequately and it will just go on for weeks or days and so on.

So lots of water, because you see that excretion involves a lot of water, things that are fluid, and so we need to get the fluids going in the body. That's why hydration is always a part of treating someone who'sick.

(Bec): Something that you've made me think of though, too, is like, it doesn't matter what illness you come down with, whether it's a chest infection, a cough, or even more like a gastritis or anything like that, a feature of that is often like a change to your breathing. You'll often breathe more shallow so as to not aggravate the condition. 

(Emrys): Exactly.

(Bec): Like if you deep breathe, you'll cough more. If you deep breathe, you'll more likely need to go to the toilet. If you deep breathe, when you feel like you need to vomit, you will vomit. So there's a, there's, which I'm sure you'll touch on, like a connection there with vagus nerve and like breathing. You've already mentioned the respiratory system, and that's one of the strategies around supporting the vagus nerve.

(Emrys): Yeah. So the vagus nerve is a bronchoconstrictor. So when it's active, it constricts the bronchii. Bronchi. And it does that to prevent you breathing in too much. So if you breathe in a toxin, let's say you're in an environment where there's toxins in the air..

(Bec:) Mmm, mould.

(Emrys): It makes your breathing shallow through the vagus nerve, almost like an asthmatic response. And that's part of protection mode. And it produces mucus and cough reflexes - are all vagal. Okay, so you know that this just makes sense, right?

(Bec): Yeah.

(Emrys): And then you get out of that and you go back to normal breathing. Well, that's your sympathetic nervous system. And what's really strange is that the sympathetic nervous system can be active during parasympathetic. In fact, they tend to work hand in hand more than they work in isolation. This is why I'm not a big believer in pushing down the sympathetic nervous system and saying it's ‘bad’. 

In fact, exercise is sympathetic. Deep, hyperventilation type breathing, such as Wim Hof breathing is that. Cold immersion - is sympathetic nervous system. Like anything, or really, really hot saunas are sympathetic. They've got a lot of positives, and stressing the system makes the system stronger, and it's able to mount a better response, and it works better with the vagus nerve. 

Conversely, people who are, they would say they're stressed. It's possible that they just don't have a good enough sympathetic response, and that means..

(Bec): To counter-balance?

(Emrys): They can't mount it. So they kind of sit in limbo, feeling anxiety, but can't mount the response required to deal with it.

(Bec): Yes. 

(Emrys): And there are more complexities to it, but that is possibly a big part of it. And I've seen it many times. People will come in, they'll say, oh, they've got really elevated sympathetic nervous system. Fight or flight? And it turns out, no, they're actually low. They're not fight or flight at all. Like, they're just not elevating it. And maybe they have low vagal tone, but they don't have enough sympathetic nervous system either. And so a lot of people mistake those, too.

00:40:27 - (Bec): So what do you do? What do you implement for the sympathetic /parasympathetic balance? I mean, vagus nerve, is it obvious? But what else?

(Emrys): I think a combination of different things does work quite well. So as part of my book, I put in things in there that are easily implemented at home, not electrical stimulation. All these other things I use in clinic, because you need proper clinical supervision.

(Bec): For access. Yes. 

(Emrys):  But a lot, in fact, I would say 80 percent of people who have problems, if they implemented what I've got in here, they would get better significantly. But the problem is people don't implement things properly. They do it for a little bit and don't get a result, and they move on.

Okay, so let's start with the vagus nerve. Implementing a program for the vagus nerve. Well, it has to include some level of breathwork. Because you can induce a change in your heart rate through breath. So if you slow down your breathing and you can do diaphragmatic, there's box breathing, where you're counting into numbers, into even numbers of breathing in and out and so on. There's lots of different styles of breathing, but you're basically slowing down your breath.

And then there's the contrary to that, which is the Wim Hof breathing, which is hyperventilation. It's 30 fast breaths, then a breath hold on the out-breath and breath hold on the in-breath, and you repeat that, and that ramps up sympathetic activity quite a lot. But I've also found that they work really well hand in hand.

(Bec): Okay.

(Emrys): Doing a combination of both is very effective, because what you're doing is you're stimulating both systems like this. And every time you do this one one, no, the other. No, the other. No, the other, you're giving the body the chance to switch. 

It's a little bit like, imagine your eyes when you're looking far away. Your lenses change to accommodate seeing that far away. Then you look close up, and you look far away. And that's an exercise to improve your ability to see close up and far away right by one to the other.

(Bec): Or even, like, the work that you might do with muscle function and bodybuilding. Like, similar vein of thought in that you stress or you load and deload and that kind of thing.

(Emrys): You turn, turn off. You turn on, you turn off. And that process of doing that can be very effective. The other one for the vagus nerve, which a lot of people don't do, for obvious reasons, is singing. And I put a lot about singing in here because there are a significant amount of people who resolve their problems through singing, which sounds strange, but they go and join a singing group and their symptoms improve.

(Bec): Or also it makes sense why people who go to church, where there's singing and gospel and all of that, it's got to activate the vagus nerve so they feel great when they come out of church. They feel rejuvenated or uplifted. It's actually quite clever.

(Emrys): And actually, the kind of music that they do sing in church does tend to have lows and highs in tone and so on. And so that's kind of perfect. A monotone song doesn't do it so well. But those are great options. There's other things that I use, too. 

The cold immersion one is really interesting. So my understanding, based on the evidence that we have, is that when you immerse yourself up to the neck, you're activating the sympathetic nerves. As soon as you bring your head under, you activate the vagus nerve, and they work together.

(Bec): Right.

(Emrys): Your heart rate drops once your head's underwater.

(Bec): This is why, as well. I've seen people talk about just immersing just the face into cold or icy cold water. So that's more vagus nerve, and the other is sympathetic.

(Emrys): That's right. And you can do both, but you'll see just a lot of people just sitting in the water with up to their neck and not immersing face. But you won't get the vagal response until you immerse your face.

Bec): Wow, I didn't know that.

(Emrys): No, you won't. And it's in marine mammals, including humans, even though we're not marine. And what it does is to conserve energy, because we're going underwater and it's cold, and you have to keep body temperature up so we conserve energy to do that. When our face is immersed underwater, it's only the receptors in the face, the skin in the front of the face, that does it. When they've got pressure and cold together, then your heart rate drops, and that is a potent vagal stimulant. So there's that.

00:44:56 - There are a lot of other things with the vagus nerve that are really important. So the vagal pathway needs to be really normalised now or resolved. If there's any compressions on the nerve now, in any other nerve, the way to treat them is to stop there being any compression sites of the nerve. And often that's what causes the problem to begin with. And a lot of people who do come in, that's why they have vagus nerve problems, because they have nerve compression. And it tends to happen in the neck around this zone here [pointing to jugular locations, left and right] on either side. And that zone is where you have pressure, either from muscles guarding, not necessarily tight muscles, but muscles that are guarding. And one of the main reasons muscles guard is they're weak. When you have a really weak neck, particularly at the front of the neck, is weak, muscles here, people guard more. Their muscle tone goes up to compensate for the weakness. Muscle tightness is an indication of weakness. People don't really know that, but that's well established.

So what I often do with people as part of a protocol in clinic is I get them to strengthen their neck. And we do a lot of work around neck nerve manipulation and strengthening. And this is often the key, the key to resolving the vagus nerve problem. But then you've got to improve vagal tone over time. And once that nerve is free to move normally and is not being impeded by pressure in the neck, then you can start to work on - in concurrence concurrently, work on breath work. Everything was said. The other one, I would imagine….

(Bec): Obviously, that's posture. And so all of us staring down at our phones and devices probably is not helpful?

(Emrys): Well, maybe posture. Interesting thing about posture is that the more forward our head is, the less likely likely we are to have neck pain. We think that forward head posture causes problems, but actually the body's very clever. When you’ve got a weak neck, you're more likely to get a forward head. It's not that the forward head weakens your neck. So as your neck gets weaker, your head goes forward. Okay? And why it does that is because the more forward your head is, the more stable it is. The joints change their position, and all of a sudden, it's easier for the neck to stabilise. The further back it is, everything's more open, and it's actually harder for it to stabilise. Hence why a lot of people, when you correct their head posture, they feel worse, they feel better forward. Not all people. But that's informative because a lot of people think that they just have to hold their head back. But it's not that simple. You need to strengthen your neck, and then it will just return to normal. Okay?

(Bec): Oh wow. 

(Emrys): That's important.

(Bec): Neck, vagus nerve. Very interesting. Love it.

(Emrys): Big part of it. But manipulation of the nerve pathway is key. Yeah.

(Bec): And so you mentioned that one of the things that affects it, obviously, is compression. And given how many channels of the body it passes through, how do you even determine that? I'm sure there's a million and five reasons, like carrying extra weight, the movement of certain organs, structural dysfunction. That’s a lot of things.

(Emrys): In the neck, it can be simple as you feel it. So as you're palpating the nerve, you can actually feel a congestion, just like anywhere else in the nervous system. It feels very similar. And sometimes it's adhesions. Adhesions build up like connective tissue bound to the nerve. It's built up over time. 

Sometimes it's from swollen glands like lymph nodes and things like that. They can put a lot of pressure on it. Sometimes the bony abnormalities in the neck, the actual bone, protrudes, and there's a few ways to deal with that. It's a bit complicated over this kind of discussion, but that's not as common. 

I've had patients who've had goiters, and the goiter, the swelling of the thyroid, was pushing on the nerve. Often, though, a lot of people get problems after surgery. So surgical procedures often cause damage. They have to accidentally nick the nerve or get close to it, and you get problems from that.

If it's entrapped lower than the neck, well, then you're getting into a bit more serious things. So aneurysms in the aortic arch, like tumors in the lungs, so lung cancer can put pressure on the nerve. Tumors in general, in the region. So in that area in the chest and below, we're starting to get into more serious reasons. Whereas in the neck, it's an Achilles heel for it, it's just an area where it's susceptible because it's exposed. It's really the only exposed area of the nerve, and it's not protected by something bony.

(Bec): Right. 

(Emrys): It's possible to have tumors in the brain that cause it in the medulla or around the jugular foramen and some people have, there's one type called a schwannoma that can do that, but those aren't very common. And you tend to know the way you know that it's something like that is you get a scan, if you're concerned, it's something quite serious. 

And if it is one-sided, often it is. You need to determine, is there a tumor in the way? Is there some structure in the way? Or is it simply something to do with stability? And by and large, it's stability because people who are hypermobile are far more likely to get vagus nerve problems. So there is a huge connection between hypermobile, excessive motion in their joints and getting vagus problems, because the neck is one of the key areas of hypermobility in these people, and you strengthen their neck and they improve. 

So this is how I've determined that as well. It's not just through what's in different research papers, but there's a large group of people who have been getting this procedure where they fuse their C1, C2, and their occiput together, and they get huge symptomatic relief. But the problem with that is you've just fused your neck and you can't turn it, and it's going to lead to more degeneration in the neck and further replacements. So I don't see that as a real option unless it's an extreme, extreme case.

(Bec): Well, who knew that so many rabbit holes we could dive down, like, we could talk for days about the vagus nerve. Just before we probably wrap up, because I've probably taken up enough of your time, but let's talk a little bit about your book. So you know, someone is going, I want to learn more about the vagus nerve and what can they hope to get out of it?

(Emrys): So here it is. Oops, I can't see it. 

(Bec): Oh, it’s because you’ve got a virtual background. 

(Emrys): It's called The Vagus Nerve, unleashing the body's secret weapon against disease

(Bec): I will put a visual up. 

(Emrys): It's available on Amazon. And so basically, the book is a combination of clinician textbook, patient self-help guide. A lot of conditions will not be able to be resolved through self-help means, and you will need to seek out a clinician who's trained in the methods that I'm referring to. But at least it will clarify many things for people. 

A lot of people are being misled online by various groups and social media. Unfortunately, it can lead down the wrong track, and they could be doing the wrong treatment, and they may not be vagus nerve at all. And it is a bit of a buzzword, the vagus nerve. Now, I hope this book really, really clarifies. It's incredibly in depth, and a lot of the information there is basically covering every part that it does. Every single part. Okay. I hope that nothing is left unturned in this. And that's the whole aim, so that people are well versed in the vagus nerve’s function. But it also includes, like I said, self-help. And there's numerous portions of the book devoted to that.

(Bec): I saw you share a couple of pages from your chapters. They are very informative. I was just blown away by the amount of things that the vagus nerve does. I mean, I knew a little bit, but every time we speak, I'm even more enamoured by the vagus nerve. 

00:56:53 - So, just to finish up, what's, like, your top three things that you suggest that people could do just to make sure that their vagus nerve is being looked after?

(Emrys): Yeah, I would say the cold water immersion, the face cold water immersion, look up the mammalian dive reflex. That's what it's called. 

(Bec): Okay. 

(Emrys): Have a daily breathing routine. So give yourself 5 minutes a day to do slow diaphragmatic breathing alongside Wim Hof breathing. If it's appropriate for you, you can look these up online. There's plenty. Or read the book. 

If you have problems with digestion, you need to make sure that you do things in a certain way, right? So you need to make sure that you chew for longer. You need to make sure that you're tasting your food. So you activate your vagus nerve through these processes. You just want to take things slower. Eating foods that have high levels of fat and protein make the vagus nerve activate more, because they have to go through a lot more processes to be digested. And you do see a lot of vagal activity with them. And so no matter what, you need to make sure that you're adequately going through the process of breaking down food from the mouth first. 

Some people use gargling, and that can be an effective tool, but not everyone loves to use that because it takes a lot of effort to gargle for more than a minute. But that is another option.

(Bec): More than a minute. Like, that's the goal for vagus nerve?

(Emrys): Well, I mean, it's like any exercise, like, what's enough start. Start with 30 seconds. You can build it up to a few minutes, not in one go, but over the whole day.

(Bec): Interesting, because, I mean, we're getting a little off topic. But there is a connection. Right. As well, with the shape of the uvula in the back of the mouth and the vagus nerve, that can kind of give you some clues as well?

(Emrys): The uvula, the little thing that dangles at the back of the throat, is controlled by vagal muscles. So when the vagus nerve doesn't work, at least in that portion, the pharyngeal portion, it doesn't elevate symmetrically or it doesn't elevate at all if both are affected. Yeah. And so when you gargle, all these muscles are being activated. And so it's a great motor recruitment pattern to activate the vagus nerve.

(Bec): So awesome. I love all of this. Thank you so much for taking the time to chat. I really appreciate it. I'm sure it won't be the last time we chat. I think this will be a popular discussion. So, yeah, I can't thank you enough.

(Emrys): Thank you. Thanks for having me on. 

Back to blog