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In this episode, you will learn about the vagus nerve and how to support the vagus nerve in regaining health and wellness.

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About My Guest

My guest for this episode is Dr. Eva Detko.  Eva Detko, PhD is a natural health specialist, writer, and podcaster including hosting the recent summit "The Mind, Body, and Vagus Nerve Connection".  Her training in the field of human physiology and nutritional sciences is extensive and includes a doctorate in Physiology, Biochemistry, and Nutrition as well as a Master of Science in Human Nutrition.  She is trained in clinical and medical hypnotherapy and is a Master Practitioner of Neuro-Linguistic Psychology.  Dr. Eva  specializes in working with psycho-energetic and emotional root causes of chronic illness.  As a child, she was weak and vulnerable as the result of her mother's loss of her sister during a pregnancy; leading to physical and emotional struggles which were exacerbated by bullying and abuse.  As a protective mechanism, she tried to control everyone and everything around her and found life unenjoyable.  The trauma and stress she experienced led to a massively dysregulated autonomic nervous system, Myalgic Encephalomyelitis (or Chronic Fatigue Syndrome), Fibromyalgia, and Hashimoto's.  Adopting a comprehensive approach to healing the body's biochemistry, the mind, and the biofield (which she calls the Triage of Health), she has fully recovered her health.  Today, she is grateful for her health and her life and considers it a privilege to be able to be a part of other people's journey to health.

Key Takeaways

  • What is the vagus nerve, and why is it important in health?
  • What factors negatively impact the vagus nerve?
  • What are the two branches of the parasympathetic nervous system?
  • What symptoms and conditions may be associated with vagal nerve issues?
  • How might conditions like SIBO and constipation be associated to the vagus nerve?
  • What role does the vagus nerve play in the function of the heart, blood pressure, and glucose regulation?
  • How does the vagus nerve impact systemic inflammation?
  • Is there a connection between the vagus nerve and MCAS? Autoimmunity? POTS?
  • What is the Vagus Nerve Infection Hypothesis?
  • Do infections and toxins impacting the vagus nerve have the potential to trigger autoimmunity?

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Interview Date

December 29, 2020


Transcript Disclaimer: Transcripts are intended to provide optimized access to information contained in the podcast.  They are not a full replacement for the discussion.  Timestamps are provided to facilitate finding portions of the conversation.  Errors and omissions may be present as the transcript is not created by someone familiar with the topics being discussed.  Please Contact Me with any corrections.       

[00:00:01] Welcome to BetterHealthGuy Blogcasts, empowering your better health. And now, here's Scott, your Better Health Guy.

[00:00:14] The content of this show is for informational purposes only and is not intended to diagnose, treat, or cure any illness or medical condition. Nothing in today's discussion is meant to serve as medical advice or as information to facilitate self-treatment. As always, please discuss any potential health-related decisions with your own personal medical authority.

[00:00:34] Scott: Hello, everyone, and welcome to episode number 135 of the BetterHealthGuy Blogcasts series. Today's guest is Dr. Eva Detko, and the topic of the show is the Vagus Nerve.

Dr. Eva Detko is a natural health specialist, writer, and podcaster including hosting the recent summit “The Mind, Body, and Vagus Nerve Connection”. Her training in the field of Human Physiology and Nutritional Sciences is extensive and includes a Doctorate in Physiology, Biochemistry, and Nutrition, as well as a Master of Science in Human Nutrition. She is trained in Clinical and Medical Hypnotherapy and is a Master Practitioner of Neurolinguistic Psychology.

Dr. Eva specializes in working with psycho-energetic and emotional root causes of chronic illness. As a child she was weak and vulnerable as the result of her mother's loss of her sister during a pregnancy, leading to physical and emotional struggles which were exacerbated by bullying and abuse. As a protective mechanism, she tried to control everyone and everything around her and found life unenjoyable. The trauma and stress she experienced led to a massively dysregulated autonomic nervous system, Myalgic Encephalomyelitis, or Chronic Fatigue Syndrome, Fibromyalgia, and Hashimoto's.  Adopting a comprehensive approach to healing the body's biochemistry, the mind, and the biofield, which she calls the triage of health, she has fully recovered her health today. She is grateful for her health and her life and considers it a privilege to be able to be a part of other people's journey to health. And now, my interview with Dr. Eva Detko.

Today, I'm excited to have Dr. Eva Detko on the show to talk about how we can incorporate a focus on the vagus nerve in our health optimization strategies. And I want to thank you for being here today, Dr. Detko.

[00:02:35] Dr. Eva Detko: Thank you so much for having me, Scott.

[00:02:37] Scott: First, let's start with how you became so passionate about the work that you do today, particularly around the nervous system and its role in healing. Can you talk to us about your personal story and how that led you to the passion that you have today?

[00:02:51] Dr. Eva Detko: Yes, you're quite right that this is something that I am extremely passionate about. As a child, I had quite a lot of trauma. In fact, it started as early as my mother's pregnancy. And consequently, that led to this imbalance within the nervous system that then kind of had a knock-on effect on my physical health. And I had all sorts of issues. I had Chronic Fatigue Syndrome that I was officially diagnosed with. I... looking back even though I didn't have official diagnosis for Fibromyalgia, knowing what I know about fibro now, all those years ago, obviously, we didn't know quite so much, but I definitely had that as well. I had thyroid dysfunction, all sorts of other things going on.

So, really, when I started looking seriously at my healing, particularly at the point when I had chronic fatigue, and I couldn't function, you know, when you get to that point, you really need to say, “Right, okay, what's going on here? Because the doctors are not really helping me,” which I'm sure a lot of people will relate to. It was more of a kind of psychosomatic, “It's all in your head,” sort of situation. Although, there was this one doctor who suggested that chronic stress might have something to do with my situation. So, he was a little bit more insightful, but everybody else was like, “You know, okay, you know, just get on with your life,” which obviously is easier said than done, right?

And so.... and so, I obviously had to really think long and hard how I was going to put myself back on the healing path. And diet is an obvious one that everybody goes to. Isn't that right? You know, I'm sure you will agree, it’s... it’s that one thing that people go, “Okay, perhaps I should change my diet and things will improve,” which of course is important and we need to be looking at that. But from my point of view on where I was, I had already had quite a good diet at that point. So, there wasn't really a lot of tweaking, a lot of things that I will say able to do to really make it impactful enough on my... you know, from the point of view of the situation that I was in, because I was already, you know, mostly gluten free, and all sorts of other things, avoiding too much sugar, and this and that and the other. So, obviously, there's always room for improvement. But I already knew, I think, at that point that I can tweak my diet to the nth degree, but really, there is obviously something else going on.

And so, I started approaching people, because I didn't have, obviously, all the knowledge that I have now. But I started reading and approaching various people who dealt more with the mental side of things. And so, I realized quite quickly that I really needed to deal with my early exposure to stress, my childhood trauma. Because in the end, that was what imbalanced the nervous system to a point where I became a lot more susceptible to infections, to toxins and everything else in between. And then obviously, that affected the physical to a point where I said, you know, I couldn't get out of bed. When I was at my worst with chronic fatigue, I couldn't function at all. It was I was one of those people who would basically try and, you know, get up and do something in the morning, and within a couple of hours, I wasn't really able to carry on with the day.

So... and so, he was he was really either, “I'm going to take control and take charge, figure this out and actually do something about it. Or I've got a really quite a disastrous prospect of spending perhaps the rest of my life in this situation, or worse.” Because obviously, it wasn't necessarily if I... if I didn't take action, it wasn't going to get it... it's not... it wasn't going to get better, but it probably was going to get worse, right? So... so, that wasn't appealing. And I knew I needed to do something. And like I said, for me, the emotional, the psycho-energetic component was the most important. The rebalancing on the nervous... of the nervous system, getting the vagus nerve back online was the key thing that I did. And that was really what brought my health back for me.

So, obviously, under... understandably, I'm going to be quite passionate about that, because I know a lot of people are in the same situation as me, where they have all sorts of weird diagnoses, all sorts of weird labels. In fact, some people don't have labels, but they just feel so awful. And they're not really getting enough support from the Rockefeller side of medicine. And so, I want people to... to think about this, the things that we're going to be discussing today, because that is a missed... missing piece for a lot of people or a lot of people who struggle with chronic health issues of all sorts.

[00:08:06] Scott: Absolutely. Yeah, it's interesting, a lot of overlaps there. I mean, I was diagnosed with Chronic Fatigue Syndrome over 20 years ago, ultimately ended up being more Lyme disease and mold illness. And of course, the mental emotional focus, so... so critical in my own journey. The limbic system work, now learning more about the vagus nerve. And so, it's obvious that you've turned your pain to your passion or your mess to your mission, and really wonderful that you're helping so many other people.

Since we're talking today about the vagus nerve, maybe just at a high level for people that don't even know what the vagus nerve is, what is the vagus nerve, and why is it important when we're talking about chronic complex health conditions?

[00:008:50] Dr. Eva Detko: Yeah, it's a very interesting nerve. We've got 12 pairs of cranial nerves, and this is... this is the 10th cranial nerve. It connects the brainstem (so, right down here, the back) to the body, and in a way that is actually quite remarkable. And in fact, when... I think when it was first discovered, people couldn't quite believe just how much this one nerve connects to. It's the longest nerve of the autonomic nervous system. It's not the longest nerve in the body, it’s the longest nerve of the autonomic nervous system. And it's... it's really... you could say it's the most important of the cranial nerves.

It regulates so many aspects of our physiology, including heart rate, blood pressure, sweating, digestion, even speaking. It has impact on so many things. And the reason why that is, is because this one nerve innervates, most of the internal organs in our chest and abdominal cavity. So, we’re talking anything from heart, lungs, thymus, spleen, and all the digestive organs apart from... well, apart from the lower part of... of the colon. But basically, liver, gallbladder, pancreas, small intestine and 2/3 of the large intestine. So, we've got all that going on. And it doesn't connect to adrenal glands, but other than that, it pretty much connects to all the organs within the chest and abdominal cavity.

So, when you think about all the functions that those organs are responsible for, and then you think innervation, the nervous system is basically what tells the body, you know, what to do, and... and kind of catalyzes a lot of the reactions, and a lot of the physiology happens via nervous impulses, right? So, if you think now, “Well, if that's not working, then a lot of things in the body will not go... will not work.” So, that is why this nerve is so critically important. And we... we need to talk about it more, because it's certainly still... kind of, we're starting to talk about this within the health law and sort of health online community. But it's... it's still not quite enough in terms of the exposure of it.

And also, some people are starting to talk about biohacking and biohacking the nervous and biohacking the vagus nerve. And I actually think that some of the things that we're going to cover here will perhaps... perhaps explain why it’s... it’s not really as simple as doing this one thing, and then, you know, biohacking it, and then all as well. Because if it was that simple, let's face it, if it were that simple, we would all be well, and happy and healthy. And there wouldn't be this explosion of chronic health issues everywhere, right?

[00:11:49] Scott: You have mentioned that Dr. Dietrich Klinghardt suggests that vagal nerve dysfunction plays a role in 95% of chronically ill patients. And it's interesting, because he's been my primary mentor for 15 years. And I haven't really heard him say that before. So, that was really compelling for me to hear him say that it's so high. So, do you think that vagus nerve dysfunction is the chicken or the egg? Meaning, does the dysfunction set the stage for the development of a chronic illness, or is it the result of the chronic illness?

[00:12:23] Dr. Eva Detko: It's both. And I'll explain in a second, but actually, what I believe Dr. Klinghardt actually said, it's not just that 95% of people they see at the clinic have nervous va... vagus nerve dysfunction, he was specifically talking about vagus nerve toxicity, which is one of the things that leads to vagus nerve dysfunction, right? But yes, it's a huge number. And it's to me, from... from what I've seen, and the impact that vagus network has on people's health, obviously, including myself, also, lots of people I've worked with, this isn't particularly surprising. But yeah, we need to take a step back and think, “95%, I mean, wow, you know, that is huge,” right?

So, about this chicken and egg thing. Well, the reason I say it's both is because we need to go back to the starting point of all of this, which ultimately, we can argue and I argue that it... this is the ultimate root cause in terms of physiology, because I'm not even going down the energetic side and biofield at the moment. But in terms of physiology, nervous system dysfunction is that ultimate root cause. People say gut is, but something messes up the gut. The gut isn't just messed up for no reason. There’s something happens before the gut is messed up.

And so, very often, this goes back to pregnancy, not even... this is not even start when we are born. For a lot of people, it starts in the womb. It starts with a stressful pregnancy. And when I'm talking about stressors, I'm of course not just talking about emotional stressors, I'm also going to talk about things like biological agents like pathogens, or in fact, chemical toxins, or, you know, there are loads of different things that can stress the nervous system. From the point of view of that physiological reaction that takes place, it doesn't really matter what that stressor is. For the body, it's a stressor, whether it's a food that your body reacts to, or a chemical toxin or EMF or geopathic stress, or infections or emotional stress, it's all the same in... from... just purely from the point of view of that physiological reaction, and then the biochemical cascade that takes place when we are faced with the stressor and we need to fend it off, right?

And a lot of the time, particularly, obviously, also in the toxic world that we live in today, and the fact that people just live such hectic, stressful lifestyles, what you find is that for a lot of people, it will start with a toxic pregnancy from the point of view of both environmental and emotional. And then look how medicalized birth has become. Just the process of birth, which should be a simple process, it never used to interfere with it so much. And then in the 80s, started throwing every single medical procedure at it possible.

And so, where are we now? You know, a woman will go into a hospital usually. Although home births are getting more and more popular, and this is going to be great. Because it's at that moment where the baby comes into the world in a... in this really, really stressful environment, in this alien environment with all those bright lights and loads of people and noise and beeps, and all of that stuff connected... the mother’s connected to all those machines and craziness like this, that obviously puts mother in the freeze response. By the way, it's a typical freeze response, because she can't run away and she can't fight, right? So, she's just going to be like a deer in the headlights.

Now, obviously, that gets communicated. I think we're clear that the baby's going to pick up on that, right? So, already, in that moment, and some births are extremely traumatic. My birth was extremely traumatic. That was part of my story and how it all kind of went downhill from that. And but basically, what I'm trying to say is it's... that really is where it starts for a lot of people. And then of course, the baby arrives. And from the moment go, from the word go, this baby, when... and it... when... as it arrives, it's completely 100% dependent on everybody around, at least the primary caregivers, right?

And this is really the 0 to 4 in particularly where we have that high level of dependency is where a lot of the attachment and developmental trauma happens. That's when we develop our attachment styles. And this is already... so, people say, “Well, what's that got to do with the nervous system and the vagus nerve?” Well, it's got everything to do with it. Because essentially, as we explained, hopefully, later on, because it's important, those different branches of the nervous system, kind of like work like this, yes? So, you can't have... you can't be in rest and digest and in fight or flight at the same time, or freeze. It's one or the other. It's one of the other.

So, it's... so, if a child has some emotional difficulties, in a sense that maybe... maybe a child is... this child is very sensitive, and the parents are really not recognizing how sensitive the child is. And maybe this is not about parents being psychopaths, by the way, this is just regular parents. This is regular parents, before we even talk about any intentional neglect or anything like that. But this child, who the child can communicate very well, yes? He can't communicate at the beginning. It's completely 100% dependent. There's all these people towering over the child. And... and these are the authority figures.

So, essentially, if a child has an emotional need, and that need is suppressed or is not met, because maybe the parents are just simply too busy, maybe they have their own issues that are unresolved, and for all sorts of other reasons, they... this child will create this internal response of, “There's something wrong with me. Those people are... you know, they don't care that I feel bad or whatever.” This is very kind of like simplified in the head of this little child. But the bottom line is that, by the age of 4 or 5 years old, most children will have this idea already in their mind that they are not okay, that there is something fundamentally wrong with them and download, okay, right?

This obviously is massively impactful in terms of what happens next, because it starts... we just start to develop a core identity. On top of that, we all got the social engineering going on and the things we should or things we shouldn't, and we should be this and we shouldn't be that and all of that kind of nonsense that, you know, goes on, society shaming us in every single possible way. All of that is emotionally toxic. And why is that important? It's important because it basically triggers that fight or flight response, or even in some cases freeze. If... if child suffers neglect in any way, and it's a more... maybe a more sensitive soul, they may actually be in freeze response for a lot of their childhood. If there's abuse, I actually said, you know, that's before, you know, we get to that, but we have to consider that abuse can be present as well. That's going to potentially land this child in the freeze response as well.

And so, I hope that’s starting to become evident already how this really gets shaped very, very early on. And I just want to emphasize that attachment trauma is very prevalent, and we... not... it's we're talking about parents who really, they're so committed to being good parents, and they just want to get it right, and they will still get it wrong, okay? Because this neurology of a small child is just so... it's delicate, it's delicate. We can very easily mess it up as parents, very easily. Because you can't get it right 100% of the time. If you get it right about 30% of the time, it's been observed in research that, if you get it right at least 30% of the time, the child has... has every chance of developing secure attachment. So, great, at least we don't have to get it right... as parents, don't have to get it right 100% of the time.

But this stuff is not taught in schools. And most parents just are clueless about it. Let's face it, right? They want to be the parents, but they actually think that making sure the baby has got, you know, enough food to eat or even eats organically, and then it's clothed and all of that, then that is the most important thing, right? But in actual fact, it's the emotional nurturing, as we now can see from the point of view of physiology, nothing else but physiology. Because if the child gets constantly this internal response of, “This doesn't feel right. This is... you know, this is not good. This makes me feel bad,” then all they're doing is triggering their fight or flight all day long.

And now, if we are in fight or flight all the title or most of the time, as a child can easily be in that situation, then of course, what's going to happen to the rest they digest? It’s like I said, there's like two branches. One of them gets really strong, fires readily. And the other kind of gets left behind. It's like... like I always say it's like going to the gym, you just train one muscle group, what's going to happen? You're going to end up with this imbalance. So, that's how this imbalance actually starts for a lot of people.

And research shows this very clearly, by the way, that early exposure to stress and the sort of childhood trauma, particularly attachment type... type trauma, but there could be other traumas. I mean, there could be somebody dying, or somebody's getting sick, there could be those sorts of things as well. And that actually shapes our nervous system going forward. It's like an imprint from that point on. So, there's an epigenetic imprint on... on the gut and micro... but there’s is definitely an impact on gut and microbiome. And but also what happens is, if you have that exposure to stress that early in your life, you're going to be wired for stress going forward, which then predisposes you to subsequent trauma.

So, it starts.... it could start actually, in a fairly innocent way, mother a bit stressed during pregnancy, you know, birth was a bit, you know, traumatic, maybe there was a C-section or something like that. And then the child, you know, maybe was just left to their own devices a little bit too much. Yeah, it doesn't have to be... this doesn't have to be a psychotic family situation. And obviously, then it just goes... goes... goes on and on and on, because people will then put themselves in situations where they kind of confirm that original hypothesis that they're not good enough and so on and so on. But that is just going in life, and then life happens and there's more trauma. But that nervous system that... that was imbalanced at that point is already primed, almost for trauma. I hope that makes sense.

[00:22:28] Scott: It makes a lot of sense and it resonates a lot with me. I was forceps delivery. My mom was actually restrained during the delivery, knocked out, woke up black and blue. At the same time, my parents were in a difficult situation in their marriage and eventually divorced. And so, I resonate a lot with that, you know, me being a person where the nervous system is already primed for, you know, things that may happen later.

[00:24:53] Dr. Eva Detko: I realized that I kind of didn't circle around to finish answering your previous question because you said Is this chicken or egg? So, I said, this is where it starts. But then of course, what happens as that vagus nerve gets less and less responsive as we train that sympathetic fight or flight to the nth degree. So, it's really strong and powerful and it activates all the time, because of the connection to all of those internal organs and functions, we then have more inflammation. We, you know, detox poorly. We have more gut issues. So... so, this is why I said both. It's kind of the vagus nerve gets messed up. But then because the vagus nerve is messed up, it messes the body function up, and then it kind of goes... I hope that it kind of makes sense what I'm saying that it then goes back and forth and back and forth...

[00:25:45] Scott: Like a vicious circle, yeah.

[00:25:47] Dr. Eva Detko: ... and it almost like line... lines itself up. Exactly.

[00:25:50] Scott: You mentioned the two branches of the autonomic nervous system. So, maybe you can talk to us about what are those two branches? And then how does the vagus nerve fit in with the functioning of the autonomic nervous system from an anatomical perspective?

[00:26:05] Dr. Eva Detko: We’re talking about this vagus nerve, but one thing to realize is that there's actually two. And we've got those two branches. One is what we call the old vagus. That's the dorsal vagus com... complex. And that's really the freeze response that we already mentioned, the shutdown. And then we've got the ventral vagus complex. When we talk about rest, digest, detoxify, and heal response, we're really talking about ventral vagus being active.

So, whenever we now from this point on talk about activating our vagus nerve, we really mean activating the ventral vagus. That's basically the rest, digest, detoxify, and heal. So, this is your parasympathetic nervous system. So, both of those branches of the vagus actually are your parasympathetic nervous system. And then on the other side of the autonomic nervous system, we've got the fight and flight response. That's the sympathetic. This collectively forms the autonomic nervous system. And that is obviously just one part of the nervous system, because we also have our peripheral nervous system. So, obviously, our muscles will do nothing, unless they get a nerve impulse to... unless you get a nerve impulse to the muscle, you will not contract or relax. So, we... obviously, there is that side of the nervous system. And central nervous system is brain and spinal cord. And... and then we've got the somatic, which is the voluntary and involuntary. That's what I was referring to.

So, for instance, let me give an example. So, if you decide to bend your arm, there needs to be an impulse to this muscle to bend your arm, but you do it in a voluntary sort of way. So, you decide and then all of that sort of reaction happens. So, the impulse has happened and loads of reactions within the muscle with calcium and magnesium and various other things. And so, then you bend the arm. So, then you've got... that’s the voluntary side.

The autonomic nervous system, when we're talking about this fight or flight, and we're talking about the parasympathetic, this is all involuntary stuff. And... but obviously, we can affect it, we can affect it. So, that's something that obviously, we want to talk about later on. But in that moment, when it happens, when we hit with that stressor, that response is kind of automatic, instantaneous. And then all the physiology that goes with it, like changing heart rate, changing breathing rate, pupil sort of dilation or, you know, whatever, all of those sorts of things, and that's sort of the body does it without us saying, “Oh, hey, I'm stressed. I'm going to change my breathing right now.” We don't do that. It happens automatically. So, that's your autonomic nervous system is to do with all of those automatic processes. And that includes obviously digestion, detoxification, and, and so on, and so on.

[00:29:02] Scott: So, essentially, then we have what most people think of which is the sympathetic versus the parasympathetic components of the autonomic nervous system. And then I think more recently, based on some of the work from Stephen Porges, that parasympathetic piece, we're breaking down further into the older dorsal vagus response and the... the area that we really want to focus on and want to be in, which is the ventral vagus response. Is that right?

[00:29:29] Dr. Eva Detko: Yes, that's exactly right. And the hier... the hierarchy, just to give an example, is so if you come across a threat, let's just say it's a... it's... it's, I don't know, a big dog coming towards you. And the first thing that is going to happen is your ventral vagus will be in place because, you know, you're walking around, you're nice and relaxed, right? You're in ventral vagus response. You're in rest and digest response. This is also known as a social engagement system. This is also part of the nervous system that enables us to assess whether something is a threat or isn't a threat, right? So, as that animal is coming towards you, you'll be... you'll be straightaway... again, it's automatic. You don't have to necessarily think about it. But you’re already figuring out whether this animal is safe, or whether they're going to pose a threat in any way, right?

Now, if the animal is absolutely fine and you get to stroke it and everything is fine, then fine. You never leave your ventral vagus, and it's great, right? And you had a nice experience with this animal. However, if your nervous system picks up on something not being okay, then your sympathetic response will kick in. And then within the sympathetic, we've got two options. We can fight this dog, or we can run away from this dog, okay? So, here's a choice, you might pick either of those. So, say... let's say that you're going to run away. So, you're starting to run away, and you're running, running, running. And at some point, you realize that actually, there's no way you're going to outrun this dog, it's catching up with you. Oh, dear. So, this is when the shutdown comes in, because if you... if your nervous system decides that you have no chance in hell, and you will most probably be... let's say, you're going to be eaten by this dog, then the shutdown will cause you to not feel quite so much pain while this is happening, right? So, it's literally what it is. That freeze response is the shutdown response.

So, that's basically the hierarchy. That's... that's what tends to happen. So, this is why in chronic illness, we can have somebody who is in sympathetic dominance, and has a lot of this fight or flight going on. But equally, we can have somebody who has... they’re past that, they’re past that and they're essentially are in shutdown. And this is why those people will often say, “Well, you know what? I don't identify with this fight or flight. I don't feel that.” That's because they're not in fight or flight. They’ve past that now. They're in shutdown. And they’re in... you know, they can be that in that for many like people with chronic fatigue, for instance.

[00:32:31] Scott: So, the fight or flight is part of the sympathetic response. The shutdown or freeze response is actually part of the parasympathetic branch in the old dorsal vagus side of things, correct?

[00:32:46] Dr. Eva Detko: Yeah, yeah.

[00:32:47] Scott: Okay. Beautiful. Yeah. And I love that you say... you know, I hear all the time people talking about rest and digest, but I always feel like it's so critical in our modern times to say, “Rest, digest, detoxify, and heal.” And so, I love that you phrased it that way too. Because I don't think people realize that if we're in this sympathetic dominant response, or maybe even the shutdown or freeze response, that we're not able then to detoxify optimally, and we essentially become bio-accumulators of environmental toxins. I think that's such an exciting part of this whole discussion for me is that, if we work on the vagus nerve, we're also optimizing our ability to detoxify.

[00:33:27] Dr. Eva Detko: We’re optimizing everything. We’re optimizing our gut function, our detoxification. That's correct. So, let's just actually stress that again, because it's... it’s critical to recognize no healing will take place in the body if we, in fight or flight, or if we are in freeze. Healing will only ever happen if we in the stress, digest, detoxify, heal, reproduce, because all of those processes are non-essential processes when you’re fighting for survival. This is purely evolution, okay? So, this is no hocus pocus here or anything like that. When you think about it, if you have that actual threat to survival, we're going to talk about perceived versus real in a moment.

But if you have... if you were to have something really threatening your survival, then is it really important that you digest your breakfast properly? Is it really important that you detoxify the chemicals that were in it? Is it really important that, you know, all your reproductive functions...? No, none of this is important. We need to survive. Because if you don't survive, and that animal gets you and it eats you, none of this other stuff matters, right? And this is why physiologically and evolutionarily, that's how it's designed. That's how it's designed.

But of course, it's a very good point to make is that, whether it's a real survival situation, or your nervous system thinks it's a survival situation, the reaction and the cascade of those chemicals, neurotransmitters, hormones, etc., is going to be the same. So, if you think that you opening an email and you get worked up about it, if you think about it, that's not a real survival situation, but to your nervous system, you just send a signal that, “Wow, this is really...” you know, either you get aggressive, or you get fearful because maybe it's an email that, you know, I don't know, threatens your job or something. So... so, you know, threatens you might be in some way, true, but it's not actually a survival situation, necessarily. But even if it's just somebody talking rubbish and annoying you, that is enough to trigger. You've already got your fight or flight, right? The moment you get that angry response or when you get that fearful response, that's it, you've triggered your fight or flight.

And... and I think this is actually a really important thing to... to stress right here right now before we move on, is that if this is an acute situation, meaning, say you go into a job interview, and you have a bit of a, I don’t know, freeze or shut down, because you can't get the words out and you like have this freeze moment, we even say that, yeah, that people freeze on stage or they freeze in the sorts of situations, that would be it, yeah, that... that would be the freeze response.

When you then are done with this interview or meeting or whatever it is that... stressed you out, and then you leave it, and you immediately go, “Hey, forget all about it. Now, I'm good and happy and I'm fine again,” then essentially, that's fine. It's not really that big a deal, because you... the stress response is there for a reason. It is there to help us survive. And if we move through it, right, we move through it, and then we on the other side and we up again in terms of our mood, we’re uplifted, we feel good, then that is not an issue.

What is an issue these days is that people never sometimes get out of it in their day, you know? It... it will be that they'll spend 90, 95% of their day, some people will in fight or flight. And that's not exactly necessarily only because they have a stressful job, but it's because they have poor self-worth. They have a lot of negative self-talk. They have a lot of emotional conflict, all sorts of things going on. Chronic anxieties, chronic fears, all of that sort of stuff, chronic... just being chronically angry, just... just feeling generally pissed off with life, feeling hard done by, victimized, all of that sort of thing, right? That's what I collectively talk about when I talk about emotional toxicity. And you have that kind of background stuff going on, that's going to be triggering your nervous system all the time and not in a good way, right?

So, that's when we have a problem. We have a problem when this becomes chronic, not when it's acute. Because if you can move through a fight flight response, it's really not... not a problem. That's how it's... how we were designed to function. The problem is the chronic situation where you desensitize to a lot of your triggers, you desensitized to a lot of the toxic stuff that goes on in the background all the time. And so, because you're desensitized, because I don't know, it's been there for decades, so you no longer... you know, like that post it note on your fridge that says this is there to remind you of something, but really, it's been there for two years now and you no longer take any notice? Right, it's like that. So, chronic is where the problem is.

[00:38:56] Scott: Yeah, I mean, the acute stress response, I mean, I think... I think we need stress to survive and to live. And... and that acute response is almost a hormetic response, right, where it's healthy in the short term, but it's that chronic response, as you pointed out, that's a challenge.

Very simplistically, I think of the sympathetic nervous system kind of like putting the gas pedal on the car, and the parasympathetic as... as the brakes essentially, kind of slowing things down. And so, we understand now from your explanation that's a little more complex than that. Because if we talk about fight, flight or freeze, that freeze response is actually part of the parasympathetic nervous system. So, that's maybe... maybe a little bit different. But what I'm interested in is when we're thinking about chronic illness, do we need to calm the sympathetic response, tone and strengthen the parasympathetic response? Do we need to do both of those things? Or can we focus on that ventral vagus? And is that enough to move the needle from an autonomic nervous system perspective?

[00:39:57] Dr. Eva Detko: I love your question, Scott. I really... I love your questions because you've... you've really, in a way, you nail it already in the question. And basically, again, it's both, because... and I'll explain this. So, there's a lot of talk about the vagus nerve. Well, I still say not enough, but there is a fair amount more than there was even a few years ago, correct, in the health space, collectively speaking, yeah? But like I said, a lot of people are starting to say, “Oh, look, gargling is good to activate your ventral vagus. So, you know, just do some gargling, and then you biohack your nervous system.” Well, okay, now, I will say it will take you some of the way.

So, I'm not saying it's useless. Obviously, those exercises like gargling, gag reflex, and all of that sort of stuff, which we’ll, you know, come back to later on, do they stimulate the vagus nerve? Yes, they do, they do have that effect. However, I really want to go right back to what I just said a moment ago, if you have unresolved emotional trauma, poor self-worth, limiting beliefs, all this internal head garbage, clutter, emotional conflict, all of that going on, you could be gargling all day long, right? And you're not going to have... you're going to have some impact, I'm not saying you won't. You will. But really, when you're thinking about this whole thing, you need to think about this holistically.

So, if you're still putting garbage in, then it's like... it's like having the garden, you know, full... full of beautiful flowers, and you know, you kind of trying to nurture that and trying to make it grow, you have a seed and try and make it grow into a plant, but you keep dumping rubbish on top of that, it's not going to be great, is it? So, again, you know, that plant may survive and may grow, you're going to have some effects of some enjoyment with it.

But how much more sense does it make to, A, not put the garbage in in the first place. So, turn off your mainstream news, turn off the social media. I mean, just be very, very careful how you engage with that, because you're been programmed, and it's not good programming, every single time you put it on. Those people in the mainstream are masters of programming. They know exactly how to program your subconscious. So, you are stuck in fear response, because it's easier to control people. It's obvious. So, if you don't program your mind, somebody else will do that for you, right? So, we have all of that.

So, just not... not even add to this whole problem by stressing yourself by hearing how many new COVID cases they had in the Philippines or whatever other, you know, essentially, garbage that doesn't really serve you in any way, doesn't really help you in any way. You don't... you can't really do anything about it. So, you know, why overload your nervous system more and more and more?

The same with toxic... toxic people. I know, obviously, there's the whole boundary setting. Sometimes when you have unresolved trauma, that's... it’s easier said than done. But again, if you have people in your environment who just keep adding to your pile of trash inside your head that you already have, that's not going to do anything for your nervous system. So, sometimes we need to take a step back and be a little bit ruthless with that sort of thing, right?

So, then we have stuff that is already there. So, like I said, the limiting beliefs and the unresolved traumas and the rest that is already there, and we need to root it out in order to take that stress off the nervous system. I also mentioned that obviously, this is I'm talking emotional stressors, but we have other stressors. We have chemical toxins in our environment, everywhere we turn. And again, same thing applies. You need to... you need to stop adding that and then remove. So, this is where physical biochemical detox comes in. Because all of that will help to offload this... this massive, you know, strain that we put on the nervous system every single day with toxic water and toxic food and all the rest of it. So, we... you know, we talking toxicity... toxicity collectively. But obviously, like I said, that emotional component is the most elusive. This is where a lot of people just don't have a good understanding of it. So, that's where they get it thought sort of... they tend to struggle with that a little bit and be challenged by it.

And then obviously, we want to do something to train that ventral. So, we want to take the pressure off the sympathetic so we don't stimulate it and stimulate and... and constantly wind it up and wind it up and make it ever stronger. And then we're going to obviously have some strategies that will make the ventral vagus stronger. That is... by far, this is more of a holistic approach. I know that's not what a lot of people want to hear. But quite honestly, just people want to biohack everything these days. And when it comes to the nervous system balance, we need to make a commitment to it, and we need to put some work into it. That's basically where I stand with this.

Like I said, you know, people just want this next trick that's going to sort of get them... I completely get that. And so, in the interim, whilst we, for instance, working on our trauma, so limiting beliefs, we have those fantastic tools that we can use, even including the gargling or humming or cold showers, all of that sort of stuff, essential oils, we can use that to support us through it, to build a little bit more resilience in the ventral vagus, whilst we kind of taking the garbage out, that's absolutely fine to do. But overall, we really need to do both if we want proper nervous system balance. Because if you don't deal, for instance, with your emotional toxicity, you... you... like I said, you can gargle all day long, but you will still stimulate the fight or flight. Does that make sense?

[00:46:13] Scott: Absolutely. Yeah. And it's interesting, and I think you've already covered this or hinted at it, that in some cases, it can be a perception of threat. It doesn't necessarily have to be an actual threat for us to have this same impact to the nervous system and the vagus nerve. So, how often would you speculate that the threat is real versus perceived?

[00:46:38] Dr. Eva Detko: Yeah, well, exactly. I think when you think about how many times you're in the situation where you could actually die versus how many times you're actually feeling stressed, right? So, I think, you know, it... obviously, no, it's a very individual thing. It's a very individual thing. But like I said, I think... I think sometimes 90, 95% of the time for a lot of people will be that that will be they completely just perceived stuff. Whereas, you know, just... let's just think about it. Like, how many times... okay, people can find themselves and things like car accidents, or maybe with an illness or something like that. And yes, you know, in that situation, their life could be at risk. But on a day-to-day basis, I think actually, for a lot of people, it will come close to 100% in terms of when you look at their levels of stress and where this stress is actually coming from, it's not a real threat. But it stimulates the nervous system all the same.

[00:47:43] Scott: So, maybe the area where it is more actual threat is when we get into talking about the infections and the environmental toxins and things like that that are affecting us on a different level. But in the mental emotional realm, a lot of times, it really is more a perception of threat versus an actual threat. And so, I think that's an interesting point.

I want to come back to the fight, flight, and then freeze response. And I'm interested in your thoughts around how often are people in fight or flight on the sympathetic side of the nervous system versus shut down on the older dorsal vagal side of the parasympathetic nervous system? And how do you differentiate those two possibilities?

[00:48:28] Dr. Eva Detko: I think that when we’re talking about an average individual, right, who just goes about their day, and they're basically stressed because they've got kids to look after and money to worry about and then they've got all this other stuff going on in the background, like we said, then they're... they’re probably more in that fight or flight most of the time. The... the shutdown, really you see more with people with chronic, like tough chronic complex, complex chronic issues, like chronic Lyme, like Chronic Fatigue Syndrome, those sorts of things, Fibromyalgia, and another example of that.

And it could be that, at the beginning, people could still be more on the... on the sympathetic. But once somebody has been chronically ill with like very little ability to function normally and they've been like that for years and years and years and then really, we're talking about shutdown, then a lot of the time, it's obvious to people because I think I touched on that at the beginning (didn’t I?) when I said that people actually literally, if you told them that they're in this fight or flight and this kind of high activation, they'll go, “No, I'm really not. I’m not there at all. I'm just like I'm flat... flat out. I'm just... there’s nothing... nothing happening anymore. I just feel like, you know, flatline basically.” And so... so, that would be more of an indication that this... this is more of a freeze state.

People who had traumas, you know, sometimes PTSD, something like that, obviously, will... will come with... with fight... with freeze response as well. So, on that more psychological side, that would be another example. But yeah, a lot of the time, people know themselves, know themselves, whether that they're... they’re kind of... you know, they have this crazy up and down going on, or whether it's just flat down, flat... flatline, or sort of the same all the time. And it's obviously very, very, very, very low energy, because it's a freeze response is... is a hypo metabolic state, which means that there is just everything in place to preserve as much as possible. So, we don't expend any energy (do we?) because we want to preserve.

So, because it's a hypo meta... metabolic state, you'll feel that that's why the chronic fatigue state or diseases associated with a lot of chronic fatigue will be more on that shutdown side because of that. Because it's literally, that's it. We want to expand the least amount of energy that we can get away with here for anything, right? So, that's what the body says.

[00:51:26] Scott: Yeah, that's another interesting connection that you just made for me, which is that that shut down response or the dorsal vagal side of things, that sounds like it overlaps with Bob Naviaux’s Cell Danger Response, right, which is that protective, you know, there is a threat here, actual or perceived. And so, we're going to this hypo metabolic protected state.

Let's talk a little bit about some of the conditions where the vagus nerve plays a significant role. If we look at things like Lyme disease, or mold illness, or autism, or a host of neurological conditions that people are dealing with, do you think that the vagus nerve plays a role in all of those conditions? And can someone have a healthy vagus nerve and still have a complex chronic illness?

[00:52:12] Dr. Eva Detko: No, I don't think so. I don't think so. I mean, if there are any cases, then maybe somebody can name that. But there'll be absolutely fewer and... fewer and far between. Somebody with super-duper ventral vagus nerve function won’t get sick period, they don't get sick. And quite honestly, if I'm... if I'm making this comparison here, people like Wim Hof or Zen masters, or, you know, Qigong masters, they don't get sick, they don't have any of those problems, because their ventral vagus is... is beautiful. It functions really, really well and really, really high. So, it... meaning that it activates readily when you need it to. So, when you sit down to your meal, you don't have to spend ages meditating on your meal to make it kick in, it just kicks in. It’s ready to. It's been so well-trained like, “Yeah, food time now. Slowing everything down.”

So... so now, I don't think you can have super ventral vagus function and have a comp... complex chronic illness. I just don't think so. I just... like it just doesn't make sense to me. And in terms of the illnesses that are associated with it, then you mentioned a few neurological disorders, they are... they’re inflammatory disorders.

So, let's just say that, because obviously the connection to the vagus nerve, the cholinergic anti-inflammatory pathway, if you have an anti-inflammatory disorder of any kind, whatever part of the body is affected and whichever label they put on it, whether it is something like Alzheimer's or whether it is something like, you know, Multiple Sclerosis or whatever, or heart disease, these are all inflammatory. So, whether it's chronic fatigue, Fibromyalgia, depression, Alzheimer's, heart disease, diabetes also obviously, all of those, cancer as well, let's face it, right, obesity, and all of those have an inflammatory component. And so, if we have any... if we're talking about any disease with an inflammatory component, we know that ventral vagus is not working well. Because if it did, we would be able to get on top of that inflammation, even if we're talking environmental toxicity, even if we're talking infections.

What sets the scene is that nervous system imbalance. And that becomes really this primary reason why now we can't detoxify properly, and now that gut is not working. So, we're getting all those issues related to, you know, microbiome, brain... brain-gut connection and all of that. So, but that... but the nervous system, I argue, is what kind of proceeds all of that. So, when we... people are talking about that gut health is the most important thing, it's the... the root cause of everything, it's only partially true. Because yes, gut... the gut is super important. Microbiome is absolutely critical to... you know, in terms of its health and how it connects with the brain and everything else, and immunity, clearly immunity.

But that's only partially true. Because it's actually, in fact, there's been studies on this, right? So, we had this... in animals, not in humans, clearly. But when they cut the vagus nerve, you had the communication from specific bacterial strains like Bifidobacterium longum, and there was another one on rhamnosus, Lactobacillus rhamnosus. When they... so... so, this... the bacteria will actually communicate with the brain via the vagus nerve. And when they severed the vagus nerve, there was... that communication was almost nonexistent, was almost nonexistent, right? So, now, that tells us how important that is.

And if, again, that action of the vagus nerve is a bit (Sound effect), is kind of a little bit floppy and doesn't activate readily, then again, you're not going to have that gut-brain connection. You know, you're not going to have that communication at a decent level. And therefore, yes, then you can talk about, “Okay, the gut is messing this up and messing that up and messing the other one.” But why is it that the gut went wrong in the first place? And it has to be to do with the nervous system balance?

[00:56:47] Scott: Yeah, it's interesting. My next question, I'm almost predicting your answer. And that was going to be, what are some of the symptoms that could be a clue that someone should explore the vagus nerve as a potential contributor to their health challenge? And I'm guessing that the answer is, almost any symptom in the body could be associated to the nervous system and the vagus nerve. Any... any other comments that you might want to share on that?

[00:57:12] Dr. Eva Detko: And it's not... it's not to be vague or generic about it, but we need to go back to right to the beginning when we said, “Hang on a minute, this nerve actually connects to pretty much every organ in the chest and abdominal cavity. And because of that, clearly, it's going to be affecting the function of all of those organs. And those organs obviously have to do with a lot of the symptoms that people are experiencing with all those different conditions,” right? So, in fact, I tell you something, some people go on and on and like for years on end... on end trying to heal leaky gut. And you're not going to be able to heal leaky gut with... no matter what you do, I don't care how organic the diet or how great the supplements that you're taking, if you're vagus, your ventral vagus is not online, it's critical, right?

Now, however, if you correct your vagus nerve function, then every single thing that you do on the diet and supplement front will suddenly take you 10 levels up. Because suddenly... suddenly the body connects with it, suddenly can utilize it better. Because obviously, with the digestion, the vagus affects every single part of the digestive process. So, that includes secretion of digestive juices, motility, but it also affects how well you can absorb nutrients from your gut. It affects all of those things, right?

But in terms of symptoms, there are some specific symptoms as well, which I actually want to... want to mention. Because obviously if you have any inflammatory disorder, you know already something's up with the vagus. And. those are obviously the things that I mentioned collectively, autoimmune disease clearly because of its inflammatory nature... nature. But also, clearly, all the... all the gut-related issues like SIBO, IBD, IBS, all of that. But there are some specific symptoms as well.

And because the vagus nerve actually also affects the muscles right here and obviously the voice box and all the rest of it, we know that if your voice gets a little bit hoarse or like kind of wheezy, sometimes people can project the voice very well. So, for instance, they... it's almost like when they want to shout, you know, if I was to shout, it would carry. And even I'm projecting right now, it kind of really goes out and it goes far, right, because I get really excited about talking about this. And sometimes, you hear that with people who have this problem is that they want to... they really want to project, but the voice kind of dies down and they're not really able to do it. So, that is a classic sign of the something wrong with the vagus nerve.

Also, just talking about the throat area, if people have difficulties drinking fluids or swallowing food, or even with supplements, I don't know whether you you've met people like that. I've met plenty people who say, “Oh, I can't take the supplement. It’s too big, I'm going to choke on. I feel like I'm going to choke on it,” yeah? So, if you've got that at choking reflex, and that can happen easily to you, then that's a vagus nerve issue as well. And which is why obviously, when we're talking about vagus nerve stimulation, the gag reflex is one of those things that will stimulate the vagus nerve.

But anything to do with things like abnormal heart rate or blood pressure, any of those sorts of issues, and... and obviously, we're talking about digestive, so bowel transit time, if that's off, so if it's less than 10 hours or more than 20 hours, then you know that's not... it's not ideal. So, there are obviously some specific symptoms, because somebody may have, for instance, gut issues. They may not have any official label or diagnosis, but they have those gut-type symptoms, or just gener... generic inflammation without having a label necessarily. And that... the same thing applies. It’s still going to be vagus nerve related, because inflammation, chronic inflammation, because obviously we know inflammation has its place.

But chronic inflammation is actually, I would argue, the key number one sign of vagus nerve dysfunction. Because of the vagus involvement in this cholinergic anti-inflammatory pathway, that is basically the pathway that puts... puts a brake on inflammation when the inflammation is no longer needed. So, we have an inflammatory response for a reason. And it's... it’s there because, you know, we're dealing with damaged tissues or we’re dealing with infections and stuff like that. Great, the body has got that response. And that response is not only valid, it saves us, it saves our lives, right?

But it's when the job is done, that needs to be turned off. And a lot of the time, a lot of those chronic disease states like chronic fatigue, for instance, is one of them, that inflammation... that chronic inflammation just... that inflammation is never turned off, and it turns into chronic inflammation. And the very thing that does that, that turns it off is basically the vagus nerve via this anti-inflammatory pathway.

[01:02:29] Scott: I was excited to talk to you about the connection between the vagus nerve and SIBO, which you mentioned, and so small intestinal bacterial overgrowth. It's interesting that a lot of the focus that I see in people that are treating SIBO is, “Kill the bugs. Kill the bugs. Kill the bugs.” And yet, you know, then when they stop their Rifaximin or... or whatever it is, the symptoms come back again. And so, I've always felt that, you know, there is an underlying neurological component of SIBO, and that the vagus nerve plays a really big role if we're really going to improve and resolve that condition.

And then somewhat related, we're talking about detoxification. And so many people are constipated. And so, I think there is also a connection that I'd love for you to talk about between constipation, you mentioned transit time, so constipation and the vagus nerve. And so, the importance of the vagus nerve in both SIBO and constipation, I mean, it seems like that's something that is very much overlooked in a lot of the approaches people take to these complex conditions. And maybe you can just reiterate the importance of the vagus nerve relative to those two things.

[01:03:38] Dr. Eva Detko: Yeah. I did say that the vagus nerve, it affects pretty much every part of the digestive process. So, actually what happens is that digestion starts in the brain via the vagus nerve way before any food goes anywhere near your mouth, okay? So, that's important to remember. So, before it's even... this even enters the body and it's mechanically broken down, the digestive process is already starting. And vagus nerve is involved in that, because the nerve obviously facilitates the brain talking to the body, and then all of those and digestive reactions are set, put in place, waiting for the food to arrive, okay?

So, in a normal digestive, healthy digestive sequence that's going to be happening. And what actually, obviously, you're talking about SIBO. And what's interesting with SIBO, I completely agree, is that kind of paradox, really, because in functional medicine, everybody talking about... is talking about treating root cause, treating root cause, right? But then they're talking about SIBO, and they're just... as you said, they're just going after the bugs. And ultimately, that's not addressing the root cause. And over... I think it's estimated that over 70% of SIBO cases have... have got this vagus nerve component. Because sometimes, you can get SIBO as a kind of like an acute thing, and then it's reasonably easy to deal with.

But I think what you said is exactly right that sometimes people just chase their tail with it, right?
 And they just go round and round in circ... in circles, and they take all of those different treatments, whether it's pharmaceutical or natural, and they just keep going back to square one, pretty much, right? And that's because vagus nerve is actually involved in triggering migrating motor complex. And we know obviously, that has a massive impact on... on SIBO. When that's compromised, then... then you've got that... the body is basically confused in terms of the digestive sequence and when to move food and how to move everybody... everything through the intestines and so on, that becomes disrupted. If that becomes disrupt... disrupted, then you're going to have more of an environment that are kind of more hospitable environment for... for all this bacteria to just sit there and thrive, right?

So... so, it is very much the impulse from the vagus nerve that gets those things moving through... through the whole of the digestive tract. And so, we know that that this migrating motor complex kind of, you know, kicks in 3 to 4 hours after food, and there's like sort of several phases to it and so on. But the bottom line is that that is critical to moving forward along and to then making sure that that the consistency of the stool is right, and that bacteria is in the right place, and so on and so on.

So, vagus nerve is what actually is involved in triggering this migrating motor complex. This is why this is such a big deal with SIBO. And of course, also we need to remember that one of the organs that vagus nerve supplies, innervates is the gallbladder, obviously. So, then if we have this bile issue and the bile is not flowing because this entry, there's this kind of passage is not optimal, and it's all a little bit sluggish, then that is going to have obviously impact on things such as constipation, right? Because they just kind of... everything grinds to a halt, and that... that movement is not timely. And that sequence is disrupting because the digestive sequence, it's quite complicated in the sense that, you know, this happens here, and that kind of, you know, signals to here, and then something else happens. It kind of... it... it is a very clever thing and a very clever sequence. And so, anything out of place in that, anything kind of like bit of puzzle falls out, then the whole thing becomes dysfunctional.

And the vagus nerve is involved in literally, you know, at every... every stage of this process. So, if that doesn't work, the likelihood is that a lot of those stages will be dysfunctional. And this is why people can be chasing their tails for so long, because they're trying to fix this one thing, like maybe they're trying to put a specific bacteria to boost their microbiome in a specific way. But that's just kind of like an isolated, very kind of isolated approach, because that will still not necessarily, you know, fix the real issue. And certainly, if we're just going after dealing with the whatever pathogenic may... may be there, ultimately, we need to remember that people who have strong vagus function don't have issues fighting pathogens and moving them through the digestive tract. So, we need to always go back to that.

[01:09:03] Scott: Yeah. And another connection that I want to make based on what you were just saying that's something that was really interesting for me from your comments. If the vagus nerve is impacting the gallbladder and thus the flow of bile, even when we think about detoxification using binders, for example, we can optimize the potential of those binders to bind on to toxins and excrete them from the body by supporting the vagus nerve, because then we're increasing or improving that bile flow so that the toxins in the bile can then meet up with the binders. If we're taking binders every day, but our vagus nerve isn't working and the bile flow is impaired, they may not be working very well.

[01:09:46] Dr. Eva Detko: Yeah, exactly, exactly. So, again, it's just going that one step back rather than just throwing anything and everything at the body, hoping that something will stick, right?

[01:09:57] Scott: So, we know... we know how important sleep is, how important circadian rhythm is, what's the connection between the vagus nerve and sleep and circadian rhythm optimization?

[01:10:09] Dr. Eva Detko: So, this one goes back a little bit to that chicken and egg we were talking about earlier. Because by vagus activity is supposed to be highs during stage 3 and stage 4 of sleep. But obviously, if somebody is not sleeping well, then that's not going to happen. So, what’s... what’s likely to then happen is that... and you know, there's a lot of insomnia, people are suffering from all sorts of problems with sleep, lots of dysfunctional sleep out there, and actually a lot... a lot to do with emotional toxicity. But basically, what that means is that if you don't have that vagal activation in your sleep when you're supposed to be doing most of your healing and regeneration, that's why... that's why it's there, yeah? And that's why it's activated at that time, because that's where most of our healing is supposed to... and regeneration is supposed to happen.

And so, then what happens is, again, it weakens the vagus because we're not using in the way we're supposed to. And obviously, in our sleep, we're supposed to be using it quite a lot. So, then during the day, it's not going to obviously activate so readily, then you're going to have more of a sympathetic activation, which will then interfere with the sleep again, quite potentially. So... so, see how that can... again, this is one of those things that can just wind itself up to the nth degree. And a lot of people find it really challenging to break... break that cycle. Yeah, because it can just go on and on. Yeah.

[01:11:42] Scott: You've talked about heart-related issues potentially associated to the vagus nerve. You mentioned diabetes. Can you talk to us a little bit about the types of issues people might see from a heart perspective, from a blood pressure perspective, from a blood sugar perspective, if they have less than optimal vagal tone?

[01:12:04] Dr. Eva Detko: This is interesting, because actually, I think heart disease is probably that one area where even conventional Rockefeller doctors will tell people, “If you're going to lower your blood pressure, you need to deal with your stress,” right? So, that's even they've been telling people that for a long, long time. So, in this one aspect there, at least they've got that bit right, but then obviously, they throw medication at it and, you know, hope for the best again.

But basically, so we've got impact on blood pressure, we've got impact on heart rate, we also have impact on heart rate variability. So, heart rate and heart rate variability are definitely not the same things. So, we've got a heart rate, which really is just beats per minute, and we want our heart rate to be low. And most people have a too high. Their resting heart rate is too high. So, we really want it to be, you know, we want to be really kind of good and nail it, then we probably talking about not higher than 70 beats per minute, ideally lower than that between 50 and 70. But we also have something else, another variable, and it's a very important variable, because collectively speaking, heart rate variability actually is the best predictor of mortality. And it's basically what informs us of our potential for how long we're going to live. So... but heart rate variability is different, because it actually measures time between consecutive heartbeats. It measures time in milliseconds between consecutive heartbeats. And what we want is we want a lot of variety within that.

I know it's a bit counterintuitive. And also, often, people will email me when like they get one of my e-books or something and say, “Surely, you made... made a mistake here. Surely, you want that to be low.” Like no, we want heart rate to be low, but we want heart rate variability to be high. In other words, we want our heartbeat to be variable as much as possible, you've got that variability in it. And what that means is that the system is adaptable. When your system... when your heart beats like metronome, it's like even, even, even, even and the spaces between beats are always the same, you have... you have very little adaptability. And then you have more potential for heart attacks and other cardiovascular events, and also other mortality from other causes.

And so, we actually want our heart rate variability to be high. And clearly, this is actually the best measure of vagus function that we have. There are different bands of heart rate variability. And if somebody is interested to look it up more, because there is a lot of complexity there, but if you want to read up more on this, go to HeartMath Institute, and they've got loads of information, lots of papers, and you can look at all the different sort of bands of heart rate variability. But... but basically without overcomplicating it, heart rate variability is the best measure of vagus function that we have.

So, if somebody really wants to measure (some people like measuring), then there are those different devices. I mean heart rate... HeartMath Institute, they have their own apps and various things. But there's also things like Oura Ring, there's these like heart rate monitors that come along with different apps. So, there is a way of measuring this. So, it's not like... it's not a direct... direct measure. But it's... it's the best that we have really. And it's a... it's a very good predictor. So, whenever you see studies, and they talk about, “This improved vagal tone, and this didn't improve vagal tone,” what they actually measured, obviously, they measured all sorts of variables, but the key variable there will be heart rate variability that they measured.

So... so, that would be an indicator, if your heart rate variability is low, I mean, it's obviously depending if you're a man or a woman, it depends on age group as well, so obviously, there's tables and you can sort of place yourself depending on what age you are and what gender you are, you can kind of check where you’re roughly supposed to be with your heart rate variability. And then aim for that with the different strategies that you can utilize to obviously make your vagal tone better or, to have higher... we say, to improve your vagal tone in terms of you want high vagal tone, just like you want high heart rate variability.

So... so that's as far as the heart more or less, but you also mentioned glucose homeostasis, and that's... that's a big one. Because people don't have to be diagnosed with diabetes to have that blood glucose issues, right? We know a lot of people have this pre-diabetic situation where, if they don't change anything, they're probably heading for diabetes. But at this stage in time, at this point in time, they may actually have hypoglycemia or various like kind of those sort of drastic changes, those drastic changes within their blood sugar. So, one moment, they're up and they’re down, and it kind of... they're on a bit of a roller coaster with a blood sugar. You can usually tell if somebody has difficulties with blood sugar regulation if they cannot go without food for a few hours without having symptoms of irritability or dizziness, or you know, those sorts of things when they just feel slightly kind of unwell and deer in the headlights or they feel like they're going to pass out that sort of thing. And then we know that their blood sugar regulation is poor.

And how the vagus nerve comes into it is that vagus nerve, again, pancreas, pancreas is responsible for blood sugar regulation through the... primarily through release of insulin and glucagon. And so, the vagus nerve being connected and innervating the pancreas, that's the connection there, because it... if it functions well, then potentially, there could be other factors also involved. But potentially, at least we've got a good foundation, let's just say foundation for actually having that hormonal regulation to deal with blood glucose. And if that’s good, then we have every chance of being okay with that.

But if the vagus function is not right, then sometimes people can go and say, “Oh, I'm going to change my diet. I'm going to introduce like more protein or this and that and the other just to kind of slow down the... the gastric emptying, so that I haven’t got quite as much impact on my blood sugar.” You can manipulate that with diet to the nth degree. But again, sometimes, and oftentimes, that's not enough. So, you already doing all of those dietary things, trying to measure... you know, manipulate your blood sugar, to make sure it's stable, and you've got that stability. Because that... what you don't want is go up, down, up, down, up, down like this, because then, you know, that's a shortcut to diabetes. So, you want that stability. You want that stability within... within your blood sugar. But again, sometimes with diet alone, you may not be able to achieve that. And that's when you need to be looking at this vagus nerve innervation and the role it plays there.

[01:19:39] Scott: I love the connection that you made between HRV and vagal tone. So, I'm a big fan of the Oura Ring, and that is something that I look at. And so, it's nice sometimes to have, you know, a tool to see if you change this or introduce this, how does that affect your vagal tone, and using HRV as a marker for that. You've talked about many conditions that are inflammation-based. We know in Lyme disease and mold illness, Chronic Inflammatory Response Syndrome, or CIRS, certainly has a chronic inflammatory component. When you start working on improving vagal tone, do you commonly see that people notice less inflammation in their bodies?

[01:20:24] Dr. Eva Detko: So, actually, I love it. Oh, it all flows very well here, because it's exactly what you just said that, yes, some people may want to measure. And then I wanted to just throw something in that, you know, I don't want people to kind of get obsessive and thinking that they have to measure, they have to measure, because ultimately, they will know, and they can go by the way they feel. And one of the things that will be immediately obvious, would be less inflammation. But also, just generally, because we were talking about all these physiological signs and symptoms. So, if you have less inflammation, or suddenly, you feel that your... your heart is not as manic or, you know, because we could have... go from having... from having palpitations to not having palpitations, for instance, right? I mean, you know that something's getting better.

So, there's loads of those different physiological signs. But let's not forget that, when you improve your vagus function, you also feel better in yourself in that you better... you are... you get better at self-regulating, you get better at decision making, you get better at reading other people, because that's the social engagement system. So, now, we may have, for instance, spent half of our lives completely misinterpreting what people around us are saying, or trying to say, or trying to communicate. And suddenly, you find that, “Hey, you know, I think I’m starting to get it,” you know?

So, if you have those sorts of moments, they're... they're really, really amazing because that... that clearly means what you... what you're doing is working. But that has such a massive impact on your social connections and... and your... you know, your life overall, your relationships, that's really important. So, we mustn't just think physiology in terms of how to... how you're going to feel and know. We also have to think that you're going to know because you're going to feel happier. Because obviously, depression is one of the things that is linked to poor vagus function. And in fact, vagus nerve stimulation has been approved, I think, for depression and things like epilepsy and various things like that. But you don't need an implant, you know, you don’t... you don't need an electrical stimulator to get this resolved.

So, you will feel happier. You will feel less... you know, people suffering from chronic anxiety will find that, “Oh, you know, things that used to make me anxious are not making me anxious anymore.” That's really great, right? So... so, there's going to be a lot of signs that you... you will just know in the way that you feel, in the way that people perceive you, in the way you perceive other people that something is different. And it's obviously in change for the best. Yeah.

[01:23:11] Scott: So, less inflammation could potentially be one of those signs. When I think about inflammation in someone with Lyme disease or mold illness, for example, I'm usually thinking that a lot of that inflammation is coming from Mast Cell Activation Syndrome from the mast cells release of histamine, for example. Do we know if there's any connection between improved vagal tone and a lessening of mast cell activation or that hyper reactive immune response? 

[01:23:40] Dr. Eva Detko: Yeah, because, yeah, there is definitely a connection for that same reason that we mentioned earlier. We've got this inflammation and it's a good thing. And it's not in that going rampant and going hyped up and the system not being able to turn that off, that is essentially a problem here, right? So, obviously, muscles are important inflammatory cells. They'll help us find infection, and they're really important. But it’s... it’s that hyperactive response. And it's going to be... again, it's going to be the same thing. It's the cholinergic anti-inflammatory pathway that put a... puts the brakes on that and regulates it. So, if you haven't got that regulation, you're going to have more of an issue with... with something like that. So, it is definitely related. And it's... it’s for the same reasons that we already said.

[01:24:31] Scott: And carrying into the autoimmune side of things, you've also already made the point that the vagus nerve needs to be off to have an autoimmune condition. So, if we have these autoimmune inflammatory conditions, we can be fairly certain that a focus on the vagus nerve and vagal tone would be helpful in those conditions. I want to ask you about a very specific condition and that is POTS.

And so, in the autonomic nervous system realm, we know there are these dysautonomias, POTS being Postural Orthostatic Tachycardia Syndrome, which is not uncommon in the listeners of this podcast. And so, is there a connection between improving vagal tone and improving the condition known as POTS?

[01:25:17] Dr. Eva Detko: Yeah. So, obviously, I'm not necessarily an expert on this condition. And as I understand that there are... there are lots of different triggers, and there are a lot of different ways in terms of how people get to have it in... in that sense, yes? And so, obviously, Diana Driscoll is the one who talks about it quite a lot. But even if people have listened to her, they would have probably heard that she... she talks about the vagus nerve stimulation as a potential helpful tool to... to deal with that. I mean, when we talking about dysautonomia, we’re talking about a situation when fight and flight dominates. So, if we improve the ventral vagus, we can regulate that through... through that improvement.

[01:26:02] Scott: Beautiful.

[01:26:02] Dr. Eva Detko: So, for sure, it's another one of those things that there could be... obviously, there will be other things that you need to do you want to do, but vagus nerve... and basically, not just vagus now, but regulating the nervous system balance. So, again, in this one, taking out the head trash will go a long way to stop unnecessarily stimulate the fight and flight that quite honestly is already a little bit over the top. Yeah.

[01:26:33] Scott: Let's talk about the Vagus Nerve Infection Hypothesis, which was put out as a potential cause of Chronic Fatigue Syndrome. How do we think that infections impact the vagus nerve? And what are some of the key infections that are likely to have an effect on the vagus nerve?

[01:26:52] Dr. Eva Detko: Yeah, this was a theory put forward by... by Dr. Michael VanElzakker. And he basically proposes that nerves kind of love viruses and infections in a way. And you can get those infections in or around the vagus nerve as much as obviously you can have infections of other nerves. But you can definitely have an infection of... of the vagus nerve that can then trigger this immune response, which will produce symptoms like we observe in chronic fatigue and that kind of generalized sickness response. They're like vague symptoms, like we know that that obviously chronic fatigue, that's a feature of that. it is kind of vague stuff, right?

But there could be also things like fever, obviously pain, depression-type symptoms as well present in that. And what he actually said that... is that vagus nerve could potentially get infected by pathogens within the oral cavity via trigeminal nerve, or this could happen through latent infections. And as such, we obviously would be talking about Epstein–Barr for instance, or herpes here. Obviously, Borrelia could also be a culprit here. But as well as that, we could have toxic metals accumulated. Because obviously, nerve tissue is fat tissue, and we know that fat has high affinity for toxins anyway, in general, that's just the basic rule of chemistry, right?

So, what he said, Dr. VanElzakker, was that, once those pathogens are activated, they can move upstream kind of thing inside the nerves and up the nerves into the brain, and they can activate immune cells in the brain. So, that's the glial cells. The glial cells are really there to protect neurons. And so, they kind of regulate your nervous system signaling and the release of inflammatory substances. And that... that... basically, that communication goes back and forth via the vagus nerve, yeah? And so, if those glial cells, again, re activated, then that... that will result in this exaggerated sickness response with those vague symptoms of fatigue and so on. That is basically present in... in a lot of different illnesses, obviously, not only in chronic fatigue, but that's obviously the feature.

[01:29:37] Scott: So, things like Lyme, Epstein-Barr, Herpes Zoster, HHV-6, heavy metals, any of these things can impact the fatty sheath essentially around the nerves. We can also have this neuro inflammation that you're referring to here, talking about the glial cells, that can all have an impact on the vagus nerve. Now, is the case that with infection that it has to be a significant infection? Or can it be a relatively mild or minor infection, but it's more the location of the microbes or the affinity that these microbes have for the vagus nerve itself?

[01:30:18] Dr. Eva Detko: Yeah. So, that was one of the revelations of... of what he proposed. Because exactly right, he said, it doesn't actually have to be a huge infection. It could be something really, really, seemingly small minor, but be because of where it is, so... so, really, is the location of the infection that that will play more of a role here than the... the kind of the volume of it, if you... if you like. And obviously, if it's in and around the vagus nerve, then for those many reasons that we already said, that's going to have such a huge and very wide-ranging knock-on effect on the body because of all the functions that the vagus nerve obviously has, right?

So... so yeah, but it's very much more about the location than it is about the... the kind of volume, if you like, of the... of the load... the number of pathogens, right? So, and then this is why it could be something that it's not necessarily going to come up on any tests. So, you could... could do lab tests to the nth degree and you're not necessarily going to see anything. But you... you still have that problem and nobody knows why, right?

[01:31:33] Scott: So, when we think about these infections, when we think about heavy metals or mycotoxins and so on, that can affect the vagus nerve, is there an aspect of the immune system then attempting to do something about the infection or do something about these toxins, that then it almost becomes an autoimmune type response that that is what's also affecting the vagus nerve?

[01:31:56] Dr. Eva Detko: Yeah, absolutely. Because that's the thing with autoimmune. When you go to your regular Rockefeller trained doctor, they tried to tell you that the body is stupid, right, and this... this body just starts randomly attacking itself, and you've got this autoimmune condition. Obviously, that's not what happens. There is always a reason. There's always a reason. And which is... which is why, by the way, we know that when people start digging deeper, and perhaps go and approach somebody who is trained in functional medicine, or natural medicine and get to the root cause of why this is actually happening, there is always a reason. And if you find that root cause and you remove that root cause, then that autoimmune response goes away. And so, this is exactly why.

So, in this case, what we have here is that the immune system knows this something that, you don't necessarily see it on your standard test, because most of the time, you won't. And yet, you will have that immune response, because the immune system goes, “This does not belong here,” and starts to bash it, perhaps a little bit, you know, in a way overzealous about it, you know, because obviously, those... those pathogens can be quite sort of persistent in the way they operate. A lot of them are very opportunistic. And of course, what we've been talking about is potentially somebody who already is weakened in some way. And so, that immune... that normal immune response almost kind of has lost its sting because of those, you know, maybe environmental toxicity, bad diet, loads of stress, blah, blah, blah, all of those other factors, right?

So, you can get that kind of, “Come on, I'm trying to get this out of here because it doesn't belong here.” And then it kind of escalates a little bit. And because vagus nerve is offline now, because it's not working properly, usually, it is the vagus nerve that would switch off that inflammatory response to make sure that doesn't go over the top. But when that's not working properly, then we don't have that off switch. And so, you end up with that exaggerated inflammatory response that is such a big feature building unity. Yeah.

[01:34:14] Scott: Yeah, I remember moderating a conference in Amsterdam a few years ago, and one of the questions that the audience submitted to the panel was, “Does autoimmunity exist in the absence of infection?” And people like Dietrich Klinghardt and Dr. Ann Corson, Dr. Joe Burrascano, they were all on the panel, and they kind of looked at each other. And I remember one of them took the microphone and just simply said, “No.” So, very much what you're saying here.

This has been an enlightening discussion. I want to thank you, Dr. Eva, for being here for part 1 of our talk. Next in part 2 in Episode 136, don't miss the conclusion of our conversation where we will discuss potential solutions and treatment options. Take care, everyone.

[01:34:58] To learn more about today's guests, visit Dr-Eva.com. That's Dr-Eva.com, Dr-Eva.com.

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