The Vagus Protocol and Conclusion

Welcome to Everyday Wellness podcast. I'm your host, nurse practitioner, Cynthia Thurlow. This podcast is designed to educate, empower and inspire you to achieve your health and wellness goals. My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives the honor Habim He is the Vegas nerve Doc, bestselling author. host of the Health Upgrade podcast Today we spoke about what upgrading your vagus nerve is all about, how the vagus nerve is regulated through the brainstem all the way through our digestive system, the role of vagal tone and how it can be damaged with chronic stress, the impact of allastatic load and dysregulation How are midlife physiology forces us to address vagal tone proactively, the impact of acetylcholine and other neurotransmitters, why specific nutrients like choline and omega three sI are so important for proper vagal tone, meeasuring HRV and vagal tone The role of hormmetic stressors and safety specific ways and strategies that we can improve our vagus nerve functioning Dr. Habim's Vegas program that specifically addresses how to improve Vagal tone. This is a fascinating conversation. I will be bringing Dr. Habi back to further this discussion. This is one of those podcasts you'll probably likely listen to more than once I Dctor Habib, suchuch a pleasure to have you on the podcast. Welcome to Everyday Wellness Thank you so much for having me, Cynthia. I'm really excited to be here with you. Yeah, you know, one of the things I really appreciated, we met in realal life in April and then recorded for your podcast that you co host I'd love for you to give listeners some perspective What is the vagus nerves' role? Why is it so important? Because we'll start the conversation there and then we'll kind of weave through why the vagus nerve is so critically important, especially for women as they're navigating midlife no doubt. Really ultimately The vaggest nerve is a nerve Every nerve's function is communications, right? We need to be able to send a signal from one place to another so that ultimately, that information can be consolidated into workable decisions as to what to do about it, what to do about the current situation. So when it comes to the vagus nerve, and for those people who don't truly understand what the vagus nerve is, it is the tent cranial nerve. So we've got twelve pairs of cranial nerves We like to call it the Veagus nerve wave two. One on the left, one on the right They come out of the brainstemem anatomically macro anatomically speaking. There's a couple connections in the ear, connections in the throat, vocal cords areas, muscles, in the airway, really important things down there. comes down alongside your carotid artery and your jugular vein. So it's literally there with the blood vessels that bring blood to the brain and from the brain back to the heart kind of important structures there that the vagus nerve is alongside in the neck, and then it goes and it connects to virtually every organ connect to your heart lungs goes down through Your diaphragm doesn't connect directly, but there is a strong association with the diaphragm. continues on down into the abdomen where it connects to virtually every single organ there. The only one that it doesn't have a direct connection to is the spleen, but it has an indirect connection to the spleen and a very important one at that But ultimately and when we finally started to look at this nerve as to what it was doing, we like to think of things as going brain down But only fifteen percent of the information on the vagus nerve is brained down. It's actually getting the information from the organs up to the brain. That's the communication pathway that this particular nerve The Veagus, AKA wandering nerve is because it's trying to get that information to the brain so the brain can consolidate and make a good decisions. and then send out information that is going to regulate the immune system and put our body into a state of rest, digest and recover. And so I like to analogize very simply that the vagus nerve is the brake line of the body. It works to turn on the brakes. If the sympathetics that drive, the fight or flight response is kind of like the accelerator in your car the vagus nerves's role is the brakes And we need to have these two systems functioning. s the sympathetic nervous system is not a bad system. We need it to be able to go and takeake our kids to school and manage the house and be able to handle the stressors of work and be able to show up when the time is necessary but we also need to be able to push the brakes and slow down. And that's really important because a lot of us in our modern day society have forgotten how to do that. We've forgotten how to slow down. We've forgotten how to put our body in a state where it can heal So the really simple take home here is you can't repair a car when it's still driving When it's moving, mechanic can't go in and fix any issue. They can't do an oil change, can't change your tires car needs to be stopped And we need to go into that stopped breraaks on state. And that's the role of the vagus nerve, pututting the brakes on the system, A, getting the information up to the brain There is inflammation, there is something going on with the immune system. And how do we put the brakes on this So this is where the healing can actually take place. Well, and I think that explanation is so important because a lot of the things that stimulate the vagus nerve innervated. So you were talking about, you know, it starts, you know, the brain stem innerovates down. so the gargling, the humming, the singing, it makes a great deal of sense of why these well, simple, they're not simple. But these fairly simple activities can actually foster and support the vagus nerve. And I think from a lot of different perspectives when I'm thinking about the Veagus nerve, it's helpeling women understand that in our modern day lifestyle, so many of us are just stuck in this fight or flight response. whether it's a byproduct of how we grew up or how we're wired I jokingly say that a lot of women appear to be calm on the outside, but actually they're like that duck kind of paddling furiously. You don't see at the surface level, the duck looks calm. but underneath the surface, that duck is paddling furiously. And I think for a lot of women, especially women that follow this podcast, myself included For many of us, we've been in this sympathetic dominant state for such a long period of time that we think the five minutes of meditation on a Tuesday are going to do enough to decompress. And we start to realize as we're getting older as our hormones and neurotransmitters are starting to change that Vagal nerve training becomes that much more important. I think it's interesting that you know, for many people these kind of chronic stressors, whether it's, you know, the terrible commute, you don't like your boss, you don't like your spouse, you're yelling at your kids I think for a lot of people, the kind of daily inflection points that can permanently alter that vagal tone Let's talk a little bit about this because it's beyond just the daily stressors, what are other things that we could be unknowingly doing that could be potentially impacting that we use the tone, and we're not talking about like toning a muscle spepeaking specifically to being able to activate this vagus nerve in a proper, appropriate manner. Yeah. When we talk about vagal tone just really simply, I love to break it down to what is the signaling capability or the capacity of that nerve, right? So very simple analogy again, of a wire. And we all have these charging cables all over our houses and our cars And these things are, you can see the difference between a really thin narrow wire, one that's gotten all bent up and out of shape and It's got some fraying on the insulation. or we've got these really nice thick wires that are nice and structured. And the signaling capability of, let's say a wire on an electric car, for example, is much thicker, right? becausecause a lot more power can pass through that versus like a small USB cable that's all frayed and bent up. Vagal tone, what we want is the thickest wire possible with the best insulation and the least frame. And so we want to be able to get that signaling capacity up. So when we talk about what are the things that are causing it to get worn down, to get frayed, to get bent very simple visual that we can kind of utilize here We have to break it down to four areas of stress. We've talked about one. The first one is that daily stressors, right? L For me, and my aur ring tells me this every single morning, but getting my children out of the house is the bane of my existence. That in bedtime usually is tough seeven to eight AM, getting my kids up, dressed to breakfast, lunch out That's My stress level goes up. It's pretty tough That's a daily stressor, right? Same idea as commuting to work or getting to you know answer your multiple emails and things happening with your boss. and relelationship challenges, these are all going to add up, but these are the daily stressors that we tend to think about as stress and lifestyle based things. We have to look at the other three areas The first one I want to get into, one that you're very aware of is the biochemical side of things,? What's happening in our environment chemically, right? What's going into our body through nutrition what is coming out of our body? Are we hydrating effectively? Are the nutrients getting in What's happening with the microbiome, the gut microbiome as kind of the primary source of potential biochemical triggers or biochemical inflammatory issues leading to the stress inside and your body doesn't know how to differentiate between a biochemical stressor and a day to day stress is stress to the body. It turns on an inflammatory style response, the cortisol goes up, the same kind of resesponse mode happens regardless of the type of stress. So the same thing will happen Obviously when it comes to a microbiome that's disbiotic and we have excessive levels of pathogenic bacteria and not enough good keystone bacteria present We're going to have the load is greater. The amount of negative that can occur is very high Then we have to get into the physical stressors. So that's number three here. Physical stressors are what's happening with your movement muscle function. Are you moving daily? Is it nice low level movement? Are you maybe overdoing it? like I did this weekend when I bike sixty kilometers uphill, which was a whole lot Are you pushing too hard? Are you not pushing enough What's going on with physical movement. and in the physical realm There's a really big piece that we forget about, and that's the breath. and we'll get into the breathing practices. but most of us And I'm sure not a lot of people know this. We're not breathing correctly. You would think, I breathe sixteen to twenty four thousand times per day. Why would I not be breathing correctly? The answer is mechanically, you're probably not. And we've been trained into a negative breathing pattern due to various reasons. We'll get into that, but physical stressors Breath pattern is a huge component of that How sedentary are you? How many steps are you getting on a daily basis Getting to know what's happening in your physical environment Are you feeling safe in your physical environment What's happening with this feeling of safety? and we'll get into that as kind of the overarching goal of feeling safe ultimately The fourth area is psychological stress. And this is things that happened in the past. that have affected the way I see the world. There's scuffs on the lens through which you see the world. and in some cases there's scratches and lenses If you were ever the victim of a crime, if you experienced big te childhood trauma if you had some sort of major adverse life event, loss of a loved one unexpectedly, things like this are major traumatic stressors. and depending on how you perceive it it will act very heavily on that autonomic balance and really push you out of parasympathetic, vagus nerve activated state and into this fight or flight mode far more than people realize. This I've been working with people now for aboutbout sixteen years in practice and Wout a doubt, I can say that the single greatest dress response that's most common to creating vagus nerve dysfunction is actually on the psychological side We really need to understand that what we've experienced in the past determines whether or not we see something as stressful or fear inducing or not something that is more objectively triggered and doesn't have the severity of our emotions blowing up And that's going to dictate how all the daily stressors are responded to and whatnot All of these stressors together are pouring into a bucket. and our bucket, depending on our genetics, is going to be larger or smaller The flow of these stressors coming in is going to be larger or smaller, depending on how we perceive things And how quickly that bucket fills up determines whether we're being pushed towards a sympathetic state or a parasympathetic state If it's filling quickly, it's really driving towards a fight or flight state. and when that bucket overflows is where chronic disease really occurs The model here is built on something called allostatic load as we build up allastatic load, as we build up these moments of allastasis autonomic nervous system, the balance between sympathetic and parasympathetic, the balance between accelerator and brake. really drives towards the sympathetic, really drives towards the accelerator being pushed. It's almost like there's a brick being placed on the accelerator and we're not consciously under stress, but our body is feeling stressed And we're going towards this what what we now know as cell danger response mode And that's where the real chronic disease occurs because What's effectively happened is the vagus nerve And the signaling capacity of getting the information of the immune system to the brain and then back down to those immune cells has decreased significantly. The wire has frayed down into something that is easily bent, broken, and not effective This is autonomic deregulation. This is the overall breakdown that leads to accelerated aging. It leads to reduced health spans, it leads to the chronic disease epidemic that we're in right now Something I hear constantly from women in our community and something I understand personally is this Nothing about your effort has changed and yet our bodies are responding differently Your midsection feels different. 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Go to wWW dot mitoQ dot com slash Cynthia and get ten percent off your first order Again, that's M IT OQ com slash Cynthia to get ten percent off your first order Yeah, you know, it's interesting as I was writing the menopause gut There two things that really hit me hard and one of them was the understanding of how adverse childhood events. And I trained inner city Baltimore. so it was like the big te trauma, rape, murder, suicide. No one would question how corrosive these things are to experience or just be witnessed to When you're talking about little T trauma, this is what I find that is so pervasive, problematic, abuse, neglect being exposed to a parent that was addicted how impactful these things can be because for these Men and women or young children. how it rewires your autonomic nervous system, I found really fascinating. And then making the connection that that dysregulation leads to faster ovarian aging. So thinking about it from the perspective of this is significant and profound. I would make the argument that This whole vagus nerve conversation is one that has not been had enough And yet, I think for so many of us, we can't do anything about how we grew up or what we were exposed to. We can only look forward But it helps us better understand our bodies. You know the autoimmune disease that we see in a young woman's teens or twenties in many instances can be a reflection. It doesn't mean that there's a direct correlation, but it can be a reflection of that rewired autonomic nervous system. And I think for A lot of people they're surprised to know, they're like, I'm very high functioning. I'm very high achieving. You know, I've been able to understand that achieve, achieve, achieve has been the way that I've gotten away from what I grew up with in, it catches up with us. Have you found in working in the past sixteen years with your patient population that middle age is when a lot of people start to unwind? I mean, that's been my clinical experience that this is when it even happened to me in perienopause with an a score of nine I had a much harder time navigating life with less hormones and my changes in my neurotransmitters, but what has been your clinical experience working with women at this stage of life? We're seeing breakdown of people happen sooner and sooner our ability to procreate. Fertility rates are decreasing significantly. and then the window is shrinking because people are having kids later in life, because we're so much more focused early on in our twenties, early thirties on getting to a certain place in our careers before having kids. And I know this because my wife experienced exactly that same type of issue and What we're doing is we're shrinking it down, but then biologically, our bodies aren't capable of doing a lot past thirty five to forty and we're seeing the fertility rates really kick up a notch or kick down a notch in those timezones or timelines So I think what is likely happening around that midlife stage is a couple different things During that midlife stage, our physiology starts to slow down in terms of our metabolic capabilities, number one. potential bad decisions or lifestyle factors or the traumas are starting to catch up with our ability to handle them Sinly The stressors of midlife are pretty significant We're having kids having a kid in itself is not an easy experience, but it's one that is incredibly rewarding At the same time, the stress of raising children and hoping not to pass on generational trauma through you into what your kids are doing. And the pressure that the parents are taking on in their midlife stages is incredibly high, right? And then for those who are unable to have children or had fertility challenges or chose not to there's other stressors that are popping up because now you're getting to forty forty five and you're like, oh, what's going on with my life and my world? And there's a lot of questioning occurring. What I like to think about is the idea of how those little T traumas during the earlier times in our lives, those psychological triggers rewired our neurophysiology and our self talk how we speak to ourselves And what we're realizing is How our parent spoke to us is how we end up speaking to ourselves we do when we don't realize the mindfulness that's behind it, right? When we're doing so, not by any negative intent, but not realizing the effect that it was having and we're just kind of letting it kind of come in almost ignorantly in a passive way when we start to identify those stressors and you kind of said it there earlier that when we identify that these challenges that occurred in the past that we can't do anything about now So what we can start to do is realize that we had applied meaning to those instances in our lives without consciously knowing it. My parents said this to me, so that must mean this. And that's how we start talking to ourselves, Oh, I can't do this because of this or that we start to have this negative self talk loop And that repetition of that negative self talk in combination with high emotional strain or high emotional pressure. creates neuroplastic loops of these thought processes And the only way to break out of that negative thought process or these negative self talk loops is to A become mindful of those negative self talk loops and realize What we're saying is a meaning that we've applied to something that happened a long time ago that may not objectively be true. There was subjective meaning that we created was either stated to us when our brain was developing during childhood or something that we experience pretty significantly, that then informs how we make decisions down the line And so what we're trying to do now is navigate not letting those stressors come into our kids' lives, not come into how we're going to live over the next twenty, thirty years, we start to see we're closer to the finish line of life than we are to the start line of life. and Biology is changing in the middle of all of this. The hormones are really starting to get messy. I remember the image that I saw at a conference that I went to, Stacy Sims had put up what goes on with the hormones during perimenopause those five to ten years and I never understood it until that she showed me this and it just looked like a roller coter. N o chaos Right? tootally five to ten year zone of chaos. that's going to dysregulate everything completely because how you responded to things between twelve and thirty five is not the same as how you respond to things between thirty five and fifty and Every week every month is going to be a little different because everything's a little bit chaotic. I all of those pieces together that is what's causing this kind of challenging maneuvering through life in midl where the stress bucket is filling at a greater rate and it's starting to overflow for a lot of people. And that's where the chronic disease diagnoses tend to start to happen in that period because we're sitting in that stress mode prettyrety much all the time It's really this kind of zone of vulnerability that I think about where it's the perfect storm. Women are losing muscle The hormones are changing sometimes day to day, week to week. Then you layer in the sandwich generation. Many of us have aging parents. We right now I just my youngest just graduated from high school. So when you're talking about that seven to eight AM, I'm sure if you were to have if I were to have worn an O ring at that stage of life, that probably would have been like my sticky time That being said, now they get up and get out the door. But I think for a lot of people, it's this zone of vulnerability and helping women understand, there's a lot we can do. You know, we're not just speaking like doom and gloom. It's just building awareness around this. What are some of the nutritional deficiencies that can actually be destructive to the vagus nerve? Because I found this really interesting. Knowing that we're living this ultra processed food zone right now, there are I think it's seventy percent of Americans eat ultra processed foods every day. You know, we're conditioned by the processed food industry that cooking is complicated, therefore let them, you know let them their box bagged or canned stuff is superlative than anything we can make at home But how do nutritional deficiencies play a role in this vagal tone dysregulation? Convenience is slowly killing us, right? Like This is really and it's challenge of life right now. and to be completely honest Like There's a reasonable percentage, sadly, even in my house where there is a reasonable amount of processed food that does show up, just because we do need to be able to live in the world We do our best to minimize. and that's really, I think the way to kind of go about this. Live around the eighty twenty rule But where I will talk about nutritional specific deficiencies that are leading to vagus nerve dysfunction are the capability of the vagus nerve decreasing in terms of functionality Number one, the neurotransmitter that is utilized by the vagus nerve. is acetylcholine. It is the only one that is utilized by the vagus nerve Now most people haven't heard of acetylcholine. And for me, this is actually the molecule of resilience. This molecule is necessary We kind of know serotonin as kind of the mood molecule that manages our emotional regulation to some capacity and we feel good when we have a good amount of serotonin ninety fivecent, ninety six percent of our serotonin is produced in the gut And so that's an important piece to sending that signal up through the vagus nerve to regulate what's happening above Dpamine, we kind of know as a motivation drive, the push molecule, get you to go where you want to go Most people don't know about acetylcholine. Acetylcholine is necessary for regulating the immune system. It's actually what I like to call the language of the vagus nerve. This is The signal that's being sent goes to a couple different types of receptors at different areas. But the one that really is important is the nicotineic acetylcholine receptors when it comes to immune regulation and acetylcholine comes from two nutrients, acetyl cooA and choline ninety percent of American diets are deficient in choline intake That is The stat that nobody realizes and what we're seeing is a lack of resilience. We're seeing a lack of capability to shift From sympathetic mode to parasympathetic mode To me, that deficiency is the single most overlooked and easily affected positive in terms of the nutritional side of things Choline Where do we get choline egg yolks. Egg yolks are the easiest highigh source of choline And yet for how many years eggs were completely vilified in terms of being able to be eaten, right? And yes, some people do have an allergy or some sort of sensitivity to eggs. I get that. So there's many other options that are out there if you're not on the vegan vegetarian side of things Organ meats have a huge amount of choline in them. They're a great source of it And for a lot of people, they're like, I don't want to add organ meats into my day to day. Like my kids aren't going to eat liver and kidney Here's a quick little hack for you I get this blend of ground beef, that's eighty percent ground beef. twenty percent organ meats combination. I love that blend because you barely taste it. you do a little bit. it's not the same as one hundred percent ground beef that option gets some of that organ meat in and it's a great way to get that choline in alongside numerous B vitamins and other nutrients that the organs provide for us Those are huge on the choline side On the acetl CoA side, the production of acetyl CoA comes down to the effective breakdown of carbs and fats at the initial stages of metabolism and that has a huge role in kind of the mitochondrial function side of things and B vitamins play a huge role in the regulation of creating acetyl coA. So then acetyl cooA plus choline can come together create acetyl choololine. And that neurotransmitter then binds to all of these different receptors And when it binds to that specific one, the alpha seven nicotineic acetylcholine receptor. guy shuts off inflammation. is its role And so if we don't have enough acetyl choline And we don't have enough vagal tone. The signaling capacity of the vagus nerve is down because of all the stress that we've experienced and we lack this nutrient combination of acetyl CoA and choline, We're not going to be able to send that signal We're not going to be able to down reggulate the inflammatory process. What then results inflammatory cytokines are running wild mitochondria are breaking down. And this is the unit of life where When it breaks down, disease is going to occur. So this is the pathophysiology. If we lack The ability to turn off the inflammatory signal, inflammation is going to run wide And that's what so many people are experiencing. So for me, it comes down to acetyl cooA and choline. as the two biggest nutrients when it comes to vagus nerve signaling And then in terms of other nutrients that are supportive to this process Omega thes by far are top top of my list And I love the anti inflammatory tools that have been around for thousands of years in the aurtic medicine, traditional Chinese medicine space. Term Ric is really, really good A Mediterranean style diet has actually been shown to have a higher HRV output We didn't get into HRV yet, but we can But what we're seeing with a higher HRV is better vagus nerve function, better tone. And this was a twin study that was done showing Tw twins, so genetically identical but one whenin adhered more towards a Mediterranean diet and the other one more towards a standard American diet. And this was done across multiple twins. And the Mediterranean Diet twin had a higher HRV across the board significant, not to the point where I like one was at one hundred and one was at thirty. pretty positive shift in terms of the amount of negatives that were coming in was lower and the amount of positives that were coming in was higher And that's ultimately that wholeo foods kind of focus. So if you can go towards that eighty percent Whole Foods diet Make sure you're getting enough choline, makeake sure you're getting enough B vitamins. Make sure that you're getting in enough Omega three's fish oils. If you can't eat the fish, then supplement with sources of that used turmeric if inflammation levels are high This is a great combination, a great way to reduce the inflammatory burden and support vagus nerve function. No, I think that interrelationship between the vagus nerve and immune system function is one that, again, not a lot of people are talking about yet so critically important Now, back in my past life, I was an ER and trauma nurse and we used to see a lot of patients that came in with Cervical spine injuries or back injuries or they had a bad motor vehicle accident, and then later subsequently developing veagus dysfunction, talkalk to me about how these kinds of injuries, and you talked, I mean, you spoke a lot about carotid arteries, vertebraal I mean, all these arteries that are in the neck and how they help support blood flow into the brain. But how do injuries, upper back injuries, even thoracic injuries have the potential to influence the vagus nerve I'm sure everybody has at some point experienced some sort of postural type of dysfunction neck pain, upper back pain, shoulder, even low back pain When you're in pain, you're under stress. like there's an internal pressure that's created Just because you're in pain, I'm feeling it right now with my quads This pain experience and this postural experience changes the way we move when we change the way we move, and I'm a chiropractor by profession. So for me, this is like Bread and butter, this is what I learned. When we are dysfunctional posturally or movement related, our muscles work differently. They don't work as effectively. They're constantly either firing or completely weak And because of that, the energy breakdown is going to be different. The energy production and breakdown and the need is higher. When there's a high energy need because of postural dysfunction, because of physical trauma to an area That leads towards this inflammatory state in the muscle That's not a great thing to have happen long term. And then what it does down the road is it changes the way we breathe. It changes our breath mechanics So in combination with having this physical strain of postural dysfunction and muscular dysfunction because the muscles are not functioning their highest, most efficient level what we then experience is We all kind of are aware of this posture of cell phones and iPads and laptops and teechnC. kind exactly. TechnC and being in this really crunched over terrible position and then come Combine that with our poor breathing mechanics Our breath mechanics are huge here We should have three very important things happening when we breathe. Number one We should be breathing through our nose Our nose is our breathing tube, ourur mouth is our eating tube needs to be nasal We only have nose hairs in our nose. They filter the air that comes in The air flows into the sinuses where it's warmed, it's humidified and then it enters into the lungs through the pharynx, through the back of the throat actually, all the way down into the lungs warmed, humidified and filtered air gets into the lungs and gets absorbed far more easily. The oxygen passes far more easily Then cold Unfiltered. and not humidified air that would come in through our mouth. So if we're breathing through our mouth, we're doing a real disservice. We only have teeth in our mouth That's the eating tube We got to make sure that we you have it as a backup, right? Like Worst case scenario or your heavy exercise, go to your mouth if you need to. But in an ideal world, we're breathing through our nose. So nose is number one two. Diaphragm. We need to be breathing with our diaphragm. Most people don't even know they have a diaphragm It is the muscle that underlies the lungs overles, it's the separation point between the chest, the thorax, and the abdomen It's a huge dome, double sided muscle. Right at the bottom of the ribs, Okaykay And this dome muscle, when it contracts, it actually flattens out. And what that does is it creates a vacuum effect in the lungs and that draws the air in. So what we're actually doing when we diaphragmatically breathe is we're causing a vacuum in the lungs that draws air in through the tubes, ideally the nose in combination with creating the vacuum effect in the lungs as the diaphragm Down and compresses the abdominal organs, the organs in the gut actually creating a motion pattern with repeated breaths in the abdominal organs These are the stomach The lung or the stomach, excuse me, the small intestine, the pancreas, the liver Sleen, the kidneys The uterus, right? these organs all are getting a bit of a pump And what that does with slow, repeated pumping of those abdominal organs, turnurns on the vagus nerve Because remember, eighty percent of the signals on the vagus nerve are coming up from the organs to the brain The diaphragm is not innervated by the vagus nerve. Vagus nerve passes through the diaphragm alongside the esophagus. So as the esophagus goes down into the abdomen and goes to the stomach We've got this web of the vagus nerve. around it and it goes through The phrenic nerve is the nerve that innervates the iaphg So as the diaphragm is being utilized in that repeated calm slow breath pattern We're getting this massaging effect of the organs below. I have this great video that I show when I go up on stage And you can see the organs getting compressed and relaxed and pulsating, slow pulsating effect only happens when the diaphragm is being utilized as the primary breath muscles. But the majority of us are utilizing our traps and our scalenes and our upper back muscles as the breathing muscles. And what do we do? We start to have these tight muscles which lead to headaches and we have this tech neck and we have this postural dysfunction that secondarily breaks it down. We're using accessory breathing muscles rather than the primary driver of the breath, which is the diaphragm. So breath should be nasal Diaphgm related. So the way to know whether your diaphragm is being used I like to have patients put one hand on their chest, one hand on their belly. and assess. Just take three breaths and see which hand is moving? Is it more on my chest, the hand that's on my chest? when I inhale and exhale? Or is it the hand that's on my belly? And ideally, it's the hand that's on the belly because that to me is a parasympathetic belly breath. Okay Third is the ratio of inhales to exhalle Now as we inhale our heartbeats actually get a little bit closer together. And It's almost like we're pushing the accelerator ever so slightly as we inhale And then as we exhale, our heartbeats actually spread out Just a little bit And what that does as we exhale, we're pushing the brakes And that means that the heart rate slows down. And what we're creating is a shift of heart rate variability, HRV This is called respiratory sinus arrhythmia or resonance sinus arrhythmia How we breathe the ratio of time and effort that we spend on inhale versus exhale is actually determining how much we're pushing on the accelerator and the brakes and forth. And what we want to do is spend more time pushing on the brakes Okay. But most of us, what happens when you hear a loud bang or a big thing that's occurring around you the immediate stress based response as it should be is Breathe in, tighten up Protect yourself fight or flight right away. until you identify that it's not a threat to you you are going to be in this stressed out mode On the macro level, every inhale is a little bit of a sympathetic push every exhale because as soon as you realize that loud sound isn't a big deal. It's not a threat to you. Everything's okay There's a bit of a sigh of relief and you go H. And that exhale is bringing us back into parasympathetic mode This balance point is what needs to be identified. So how much time are you spending on inhale versus exhale Longer exhales are the goal. Your breath needs to be three things. nasal, diaphragmatic, longer exhales, And if you have a physical stressor, physical strain that's occurred due to a physical trauma, like a whiplash injury, if slip and fall, or You just have this pain issue that's occurring or neck pain checked out, get that assessed by a practitioner who understands that breathing mechanics are primary to enabling that healing opportunity in the body. It's so important. It's interesting. when I interviewed James Nestor in his book, Breath, which I recommend all the time, I remember him talking about Once you've seen an obligate mouth breather, you will never forget it. So me being someone that, you know, I'm the person in an airport or wherever I have my sunglasses on, I'm just people watching, not disrespectfully, just observing And I think for listeners, it's understanding that There are so many of us that our primary way that we inhale is through our mouth and not through our nose. That's number one I think that all these airway issues that we're seeing with our modern day lifestyles, you, I think about, you know work that's been done. you know, I'm thinking about Weston A. Price in particular, who was a dentist, but went out to Iigenous cultures and was talking about how very few of them had very few of them had cavities and none of them had crowded teeth and how we've gotten to a situation where Our modern day lifestyle is the ultra processed foods. We're not masticating enough. We're not, you know, chewing enough how that impacts airway issues, how that's impacting, you know why so many people need braces to straighten their teeth, and how we have it has really become a commonplace for people to be obligate mouth breaters. So for listeners, I'm telling you, when you go into your community, once you've seen it, you can't unsee it. And I don't say this to be, you know, it's just me being nerdy. I'm just kind of observing things observing patterns. But to your point, if you're breathing through your mouth and not through your nose, you're already dregulating this process. And that's something you can train yourself to do. It's not per say, yes, some people need their septomums repaired, some people have you know nasal polyps. There can be many some people have obstructive sleep apnea. There's a lot of different reasons why this can happen. But for many of us, we've just gotten trained to breathing through our mouths as opposed to breathing through our noses. Have you found that to be pretty common, you know, when you're working with your clients too? Like peopleeople are just completely unaware the fact that they're breathing improperly Not by any real fault of their own, people are just unconscious, right? We've just always breathhe. As long as you're alive, you're breathing. And we've almost just taken it for granted that the breath that we have is the breath that it's supposed to be, but we haven't actively chosen How to breathe. And when you start to realize that you can shift your physiology in three breaths literally just to shift towards a nervous system that's more regulated, calmer, you're not going into fight or flight. It almost becomes an obligation on you to be aware of your breath as often as possible And that shift is so powerful. That shift is enormous for so many people. And because it's so simple, it's so easy to overlook, I really think the breath is where all of this begins. It really is the beginner point For me, it was I loved James' book Breath, by the way, it was a wonderful, wonderful overview But the one that really stuck out to me was the Oxygen addvantage by Patrick McKean That was ultimate book on understanding how airflow effectively creates your autonomic state which then creates everything else. It helps to determine the shifts in your physiology That was a really great book. I'll have to check that book out. Now let's talk about HRV. know bothoth of us, you know I'm wearing my aura, you're wearing your aura. I think a lot of women measure their HRV without actually understanding what it's telling them So let's talk about what HRV is actually measuring and how this can be a reflection about the very important vagus nerve The HRV is a little bit misunderstood and I think There's a little bit of a disservice being done. I've had my aura for seven and a half years. Like I've got data beyond what anybody should have and The let's get into what it is first. So Heart rate is very simply, how many times is your heart beating in a sixty second period? Beats per minute Heart rate variability is measuring the number of milliseconds between beats of the heart. averaged over a period of time. So the variance in the number of milliseconds. So if you have two beats that are one hundred milliseconds apart and then one hundred and thirty and then one hundred and then one hundred and thirty and it's shifting, your heart rate variability is thirty milliseconds. Okay Just for simple numbers there the higher your heart rate variability the more you are in a parasympathetic state. So higher HRV is linked to vagus nerve being turned on Lower HRV is linked to sympathetics being turned on. our heart is or our foot is on the gas pedal. We're in the sympathetic state during that time Now the mild disservice that I would say is happening is We're measuring HRV overnight, which is the time you should be measuring it But we're looking only at the average number through the night And we should be seeing a certain pattern of this because How many times the HRV goes high and how high it goes during the night is actually a better sign of your capability of shifting between sympathetic and parasympathetic state. This is significant. So when I see this in my app on the morning, that's actually indicative of a healthier variability Okay. That's exactly it. We shouldn't necessarily just put our full data and put all our trust in the number that says HRV twenty five Right? That is not the number The number is the number, but that number doesn't mean as much as how many times we're spiking through the night how high the spikes go and how low the spikes go. And what that is, we want to have a high ability to go between. What we want ultimately, the goal here is flexibility, autonomic flexibility, the ability to shift into sympathetic as desired and then to shift out of sympathetic into parasympathetic as desired on demand the ability to shift between these two That's the goal what we're really trying to have is, and here's a really simple analogy. If anybody's got a dog or We've all seen dogs running around. You can see how As soon as a doorbell rings, they lose their mind. They go to the door. they're barking like crazy. The world is going nuts As soon as that person is gone from the door or whatever that threat was They're back on the ground, just chilling So they went heavy sympathetic mode and then back into parasympathetic. And for many of us, we stay in a sustained sympathetic state even after the stress is gone because we're either reliving it in our minds or trying to put meaning towards And we're staying in a sustained sympathetic state and we're not able to shift to parasympathetic as easily What we've lost is autonomic flexibility, the on demand ability to shift And so this is what we need to retrain. This is what breathwork helps to retrain This is what getting into a cold plunge helps to retrain, not that I'm condoning or recommending it for everybody concept of this is you get into a stressed state because you get into a cold shower or into a cold plunge or into a sauna or some performative specific stressful scenario And then you teach your body how to not be stressed while in an environment that is stressful That is how we train autonomic flexibility. And what we get when we do this, when we train good autonomic flexibility Over time, we increase our average HRV We increased the average number. and what that then shows us is that we're increasing vagal tone. That's the goal. We want to increase vagal tone over time through these practices of experiencing a stressor, but being able to bounce back from it very quickly. and training your ability to do so because we cannot eliminate stressors from our experience Life is full of stress sores But whether you become stressed about it or not is actually the deciding factor. We have the ability to perceive it. determine whether it's actually a stressor and change our mind about it or live as objectively and calmly through that stressor as we can bounce back from it as quickly as possible We need to be able to experience a stressor and recover from it. And the recovery process is where the vagus nerve comes in. The vagus nerve, when it is effective and can turn on, decreases the cumulative buildup of stressors over time And this is how we reduce allistatic load or the shift towards the breakdown or the filling of that bucket over time. becausecause what we're doing on the bucket is we're poking holes at the bottom of the bucket, allowing the water, the fluid to come out of the bucket. As we empty the bucket The stressors can come in, but the likelihood of it overflowing is not as high And what that does is when we have good the coping mechanisms We're emptying that bucket at a greater rate than we're filling it I think this is significant. I think about I have one dog. he's only two, but he's very easily triggered sometimes and we're working through we have a dog behavior list, we have a trainer, We've got all the things. and What I noticice he does after he has an episode where he goes berserk, whether it's the person delivering mail or it's sometimes the three legged dog down the street, which makes no sense to me because that dog's ten pounds and he's almost eighty is that he will shake his body He will do a whole body shake. And when I was mentioning this to the vet, the vet said, Ohh, well, you understand what he's doing. gettingting himself out of this sympathetic state. his body hass been flooded with adrenaline And that's how he gets himself back to a state of like relaxation. And so if you watch animals Sometimes they're doing exactly what we need to be doing, but we've gotten so consistent with these patterns of I get revved up because I'm stressed and I don't know how to decompress or distress myself. So this is my little segue into breathwork and sound and other things that we can do proactively to help ourselves. Like I know before I get on a stage, I do breathwork exercises and I've always done that but it's my way of regulating my vagus nerve and also slowing my heart rate and it also slows my Because when we're nervous, we speak quickly and there's nothing worse than a public speaker speaks quickly. So I share this just to kind of give listeners some perspective that this happens even to know trained professionals. But let's talk about strategies to evoke the vagus nerve to improve vagal tone This is it begins with the breath. No question about it. breath is the key point. It's the entry point. It's how we regulate our autonomic nervous system and determine if we're pushing the accelerator or the brakes. Now Like I mentioned, going through specific stressors on purpose. going through what's called hormesis or hormetic stressors. That's what these are purposeful experiences of stress that allow you to train the ability to come out of that stress state And that's ideal But for a lot of people that are in a chronic illness state, hormetic stressors are not the starting point. We need to start veryer, very simple. We need to work first w the ground because what we've got going on and this was an analogy from a friend of mine Asho Gupta who said that These practices, the way you're breathing, how quickly you go into your sympathetic state and stay there is a frozen response. you're kind of frozen into this the rivers are carved out. And so you need to thaw the ground to try to create a new river And the way to do this is by ively learning how to regulate the breath and to affect the vagus nerve specifically So I mentioned a couple of the branches of the vagus nerve, the pharyngeal and the laryangegeal branches. Th are the first ones that we'll talk about. These are the motor components. about four percent of the vagus nerve signals to the pharynx and the larynx. This helps to maintain a patent airway. so the pharyngeal muscles maintain the opening of the back of the throat and the laryngeal muscles go over to the vocal cords and they either tension or relax to give us the ability to go really, really low or really, really high with our voice so that we can have pitch and tone. So clinical side note for anybody who's interested A very monotonous voice is a likely sign of vagus nerve dysfunction Don't just listen to what the patient is saying. Listen to how it's coming out. Yes Big one.'s Clinical Parl So Cing chanting Gargling, singing phenomenal ways to activate those specific branches of the vagus nerve Absolutely phenomen What they do is they turn on that motor component. They get those laryngeal muscles working. So sing in your car, sing in the shower Belt it out, like go for it. It's actually really good for you Laughter, social connection All the things you do when you feel safe do them. Because ultimately what we need to create in our body is a sense of safety. Safety is the driver that turns on the vagus nerve. This is bringing the polyvagl theory. by Stepven Porgis into practical applications becausecause we need to get out of danger mode and into safety mode Safety drives it. So in the daily stressors, sing breathe Be calm In the biochemical stressors, get rid of the toxic foods and focus on whole foods as much as you possibly can minimize the chemical cleaning products around you, minimize the load that drives that danger response in the physical stress mode stop staring at a screen for hours and hours at a time. Take breaks. I have a great friend Bryce Applebum who has this rule, the twenty, twenty, twenty rule. Every twenty minutes Look at something twenty feet ahead of you for twenty seconds Right? You got to get the visual field from being this narrow focus worried state, because this is stress mode into wide aperture, open up, get some fresh air, change your perspective every so often, physical environment matters And then on the psychological side of things, working through some of these past traumas, working through and understanding why you felt the way you did in certain experiences. And ideally you do this with a trained professional, somebody who guide you through that process because it's very easy to evoke negative emotion if you're working through these things on your own. highly recommend working with somebody when you're getting to the root of those psychological issues. But what we're ultimately trying to do is create a sense of safety in the body When you feel safe, you turn on your vagus nerve, your vagus nerve turns on, you're able to do these things. So I was walking through the Lego store with one of my daughters a couple years ago and there was a guy walking around. He had literally like six big boxes of LegOos Dead star and All of these different things. And I looked at them, I was like, that looks awesome And he said to me and I didn't even consciously take it in until afterwards. he said, Lego calms my mind. Yeah It's about creative pursuits You're only going to go into these creative pursuits when you feel safe It creates a sense of calm. You can imagine while you're doing these things, your breath pattern is very calm This is why a couple of years ago, adult coloring books were like the coolest thing because they were calming creative pursuits, get into something along those lines I broke down the science on these in both of my books actually so. Divate your vagus nerve, which is nine years old now and then upgrade your vagus nerve, which came out a couple of years ago And both of these break down the science of different ways to get your breath pattern shifted and to turn on that sense of safety safety in every sense, not just the psychological day to day safety sense, but in the physical and biochemical environment as well saafety drives the vagus nerve. So what we need to do is really focus on those practices as self care routines building out the habits on a day to day basis that enable this. So I've created a bit of an acronym on how I get all of this together. And of course, the acronym is around the word, Vegas So VAG US, validate, first identify what's going on, what's causing these issues, didentify what's happening from functional lab testing, right, getting your oring data or wearable yourre choosing, get to know what's really happening. Don't apply any meaning to it yet tellell yourself a story about whatever here and there, just get the data first. actctivate. We need to then A stands for activate, which is getting your vagus nerve turned on through the breath through these calming practices, humming chanting, gargling singing, Cold plunge if you're ready, Suna temperature therapies, right? Th that help you get your breath pattern optimized, creative pursuits, etcetera. G stands for gut brain immune optimization. Get the gut in line. I love that you wrote your book exactly aligned with what I talk about yourour gut sorted The gut is where the vast majority of biochemical stress enters the body So make sure that that is working well as much as you possibly can and that comes primarily through food Brain, most people won't realize this, but it comes from movement, getting your body moving turns your brain back on. Getting these decreased sources of inflammatory stressors is necessary here. So gut brain and then regulating the immune system is the G You stands for unburdened St to identify all the sources of stress that are filling the bucket start to really parse it out and say, oh my goodness, I've been doing this for years and I didn't realize this was actually hurting me Are there any unhealthy coping mechanisms that I thought were emptying my bucket because I feel calm or comfortable, but they're actually just a hose going back into the top of the bucket, refilling the bucket These are things like, you know, going to a drink every night because that's a calming effect. or you know, binging in front of the fridge or sitting in front of the TV for hours on end because that's how you feel calmer or comforted Those are unhealthy coping mechanisms. We really need to minimize those because those are actively creating think you're putting effort into something that's helpful, and in fact, it's actually more hurtful because it's refilling that bucket. So unburdened is huge and that's the real work of making the change occur. And S is sustained. How do we create new habits such that we don't go into those old patterns through positive science backed habit change formats The Vegas prrotocol is what I call it. That's how I've been working with my clients for the last probablyrob eight years now. Such invaluable information. I just have a couple quick questions. What's one single intervention that produces the fastest, measurable HRV improvement in people who are already fit and healthy which is a lot of people who listen to this podcast The number one fastest HRV shift will come from a reduction in inflammatory sources because if you're fit and healthy, pretty active. lowering the inflammatory burden inside the body is huge. I think Omega three' s and SPMs actually are some of the highest shifts in HRV that you can possibly get. So using specialized pro resolving mediators, that's a next level hack, but those are derived from Omega three' great option for a lot of people For the person who's exhausted and overwhelmed and not doing any of this yet, what is the one place to start that requires no money or equipment literally Three minutes of breathing practice before bed. if you can set up and for me, this is most foundational thing you can do is set yourself up for great sleep because when you sleep well, your vagus nerve turns on because guess when your vagus nerve is on most actively, is during recovery time, when is recovery time when you sleep your sleep, Guard your sleep with your life And so for me, I'm a big fan of adding a five to ten minute before bed routine of some form. simply has you focusing on breath notot being on your screens, just being present, being calm, checking in on your body costs absolutely nothing and it sets you up for a wonderful night of sleep. If you do that consistently because consistency carves canyons do that consistently You're going to realize that everything starts to get regulated at a much better rate, that your emotionality is down and you're not getting hyperactivated. into a sympathetic state because of little things that were affecting you. You become far more capable of regulating and getting into that autonomically flexible state. But it's as simple as three to five minutes of breathing practice before you go to bed every night. That's it And last but not least, what are you most excited about in Vagus nerve research right now? There's a couple things. Veagueas nerve stimulation is something we didn't talk about. I'm sure we could do a whole anotherother hour on that. I was gonna say, I need to bring you back so we can do a second discussion There are invasive forms that have phenomenal research. FDA clearance just came through for the RA device, which is really, really powerful. It's neuromodulation through autonomic regulation. That's great, but we also have non invasive devices that are out there that I'm a big fan of things like trrue Vega things like Yojo, Palssetto, there's a lot of these devices out there I would really lookook at the research, see who's doing the work that you feel comfortable with. Obviously, price points going to matter here. Do your best to find the data points that are resonating and don't just go to the marketing companies the ones that are selling to you the best But Vagus nerve stimulators are ph nomenal and they're a really, really big accelerator into that parasympathetic state, but they can't be relied on on their own. It's got to be paired with breathing practices, paired with and routine of the day. And for me, that is It's never a standalone. It's got to be done in combination with other practices to really get the bang for your buck Well, such a great discussion, Dr. Habib. Please let listeners know how to connect with you outside of the podcast, how to get access to your books or learn more about your work to Instagram Dr. Nvaz Hhabib, very easy to find me there. You can just look up Veagus nerve Doc. That's an easy one. and a couple books activate your Vagus nerve, upgrade your Vagus nerve. If you're interested in learning more about the Veagus protocol, being part of the online community, go to health uppgraded. com And you can learn more about the community and you can join and get access to our weekly calls and all the fun things we do Thanks so much for your time Thank you If you love this podcast episode, please leave a rating in review, subscribe and tell a friend