Control Your Vagus Nerve to Improve Mood, Alertness & Neuroplasticity
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The vagus nerve, identified as cranial nerve 10, functions as a vast bidirectional superhighway connecting the brain to nearly every organ in the body, from the head down to the lower intestines. Unlike other cranial nerves that primarily serve restricted areas of the face and neck, this "wandering" nerve carries both sensory information up from organs like the heart, lungs, liver, and spleen, as well as motor commands down from the brain. Approximately 85% of its neurons are bipolar cells located in the nodose ganglion; these have one axon extending to an organ and another ascending into the brainstem. This architecture allows the nerve to transmit chemical data regarding acidity or temperature, mechanical signals like heart rate changes, and motor instructions for muscle contraction simultaneously, making it central to regulating bodily states rather than just a simple calming pathway as often popularized in media. Contrary to the common belief that vagal activation is solely about relaxation, Andrew Huberman explains that the nerve plays a critical role in increasing alertness and motivation through specific physiological cascades. When large muscles, such as those in the legs and trunk, are engaged during exercise or movement, they stimulate the adrenal glands to release adrenaline (epinephrine). Although this hormone does not cross the blood-brain barrier directly, it binds to receptors on sensory axons of the vagus nerve, triggering a chain reaction. This process releases glutamate into the nucleus tractus solitarius and subsequently activates neurons in the locus coeruleus that produce norepinephrine, flooding the brain with alertness signals. Consequently, physical activity involving large muscle groups can overcome lethargy and enhance cognitive performance without relying on pharmacological stimulants like caffeine. To harness these mechanisms for mood regulation and health optimization, Huberman outlines several actionable tools supported by neurophysiological evidence. For rapid calming and improved heart rate variability (HRV), he recommends the "physiological sigh," which involves two sharp nasal inhales followed by a long exhale to offload carbon dioxide and mechanically slow the heart via the vagus nerve. Additionally, deliberately extending exhalations throughout the day strengthens the neural pathway connecting the dorsolateral prefrontal cortex to the sinoatrial node of the heart, fostering autonomic regulation that persists even during sleep. To counteract age-related declines in HRV and cognitive function, engaging these pathways through behavior or advanced methods like transcranial magnetic stimulation helps maintain neuroplasticity and robustness against atrophy associated with aging. For those seeking non-pharmacological ways to calm down quickly without relying solely on breathing techniques, Huberman presents two specific mechanical interventions verified by experts in human vagal anatomy. The first involves a neck stretch where one lies flat or sits upright while pushing elbows away from the ears and turning the head up toward each side sequentially; this mechanically activates sensory fibers running deep within the neck muscles that contribute to parasympathetic activation, with effects being more pronounced on the right-hand side of the body. The second method is a specific type of humming where one emphasizes the "H" sound over the "M," creating vibrations at the back of the throat rather than in the mouth or lips. This technique mimics gargling and stimulates vagal branches innervating the larynx, effectively slowing heart rate and inducing deep relaxation by engaging the same deceleration pathways used during a long exhale. Ultimately, Huberman emphasizes that understanding the precise mechanisms behind these tools provides individuals with agency over their nervous system's state, allowing for on-demand shifts between alertness and calm without drugs or devices. The episode concludes by highlighting the vagus nerve as an incredible evolutionary adaptation present in all mammals that facilitates learning, immune function, mood stability, and physical recovery through coordinated signaling between the gut microbiome (specifically serotonin production) and the brain. By integrating practices like high-intensity interval training for alertness, deliberate breathing patterns for HRV improvement, and specific neck stretches or humming for relaxation, listeners can effectively utilize this complex neural network to enhance mental health, performance, and overall biological resilience throughout their lives.
Read the full video transcript
Welcome to the Huberman Lab podcast,
where we discuss science and
science-based tools for everyday life.
I'm Andrew Huberman, and I'm a professor
of neurobiology and ophthalmology at
Stanford School of Medicine. Today, we
are discussing the vagus nerve. The
vagus nerve, or what neuroanatomists
call cranial nerve 10, is an extremely
interesting nerve because when we hear
the word nerve, we often think of a
small, you know, connection between one
thing and another, the wires of the
nerve, which of course we call axons. If
you didn't know that, now you know,
they're called axons. But actually, the
cranial nerve is an extensive pathway.
It's a whole set of connections that
link the brain and body. In fact, in
many respects, it looks kind of like its
own nervous system within the
traditional nervous system of the brain
and the spinal cord, the connections
between spinal cord and muscle. The
vagus nerve is so vast. It spreads out
through so much of the body, and as
you'll learn today, it's connected to so
many interesting different brain areas
and has so many interesting different
functions that it deserves, well, an
entire episode of this podcast. The
other great thing about the vagus nerve
is it is highly actionable, meaning what
you will learn today, if you already
know something about the vagus nerve, is
going to change what you know and
believe about the vagus nerve. What you
hear today will also, if you don't know
or you're not familiar with the vagus
nerve, is going to educate you on the
latest about the vagus nerve. We've
learned a lot about the vagus nerve and
ways to control the vagus nerve in the
last few years. And finally, and perhaps
most importantly, the information that
you're going to learn today includes
actionable tools that will, for
instance, allow you to make yourself
more alert when you want to without the
use of pharmacology. It will allow you
to calm yourself down quickly when you
want to, on demand and quickly, without
the use of pharmacology or devices. And
it will also allow you to alter your
mood for the better and indeed to
improve your ability to learn. The vagus
nerve is that important. It's involved
in that many different things. And the
pathways of the vagus nerve, as I
mentioned, have been charted in more
detail in recent years. And the ways
that we can get into the vagus nerve and
stimulate its actions in specific ways
to achieve those endpoints of improved
mood, deeper relaxation, fast
relaxation, elevated levels of
alertness, and on and on are now very
well understood. So, as you can probably
tell, I'm extremely excited about
today's episode because the vagus nerve
is just one of the most fascinating
aspects to our nervous system. You have
one, I have one. So, let's figure out
how they work and how to put it to work
for the better. Before we begin, I'd
like to emphasize that this podcast is
separate from my teaching and research
roles at Stanford. It is, however, part
of my desire and effort to bring zero
cost to consumer information about
science and science-related tools to the
general public. In keeping with that
theme, today's episode does include
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to get up to $400 off. Okay, let's get
familiar with the vagus nerve. The vagus
nerve is cranial nerve 10. The vagus
nerve is very different than the other
cranial nerves because whereas it does
have connections with areas on the face,
head, and neck and deep to those areas,
too, so throat, etc. It also has
connections, or I should say it receives
and provides connections to areas within
the body. In fact, it has connections
with the head area, the neck area, the
chest area, the abdomen, and even a bit
lower into the lower intestines. So, the
vagus nerve is super extensive in terms
of its outputs and its inputs. And I'll
explain what I mean by outputs and
inputs in just a moment. But, what's
very useful to understand and visualize
in your mind a bit anytime we're talking
about the vagus nerve is we're talking
about a nerve of many, many different
pathways that both receives and provides
information from essentially all areas
of the body down to the base of your
pelvis. And that stands in stark
contrast from the other cranial nerves,
which tend to receive information from
restricted areas of the body, most
typically the head and neck area, and
that tend to provide connections to the
head and neck area. The word vagus
actually translates more or less to
vagabond, which means wandering. So,
early neuroanatomists saw that this
nerve, cranial nerve 10, had connections
to large areas of the body and head and
neck and received inputs from lots of
areas of the body and decided to call it
essentially the vagabond nerve or the
vagus nerve. Now, even though the word
vagabond means essentially wandering,
and the word wandering kind of suggests
random, there is nothing random about
the wiring of the vagus nerve. The vagus
nerve is incredibly precise in terms of
where it receives information from and
where it provides information to. Now, I
want to be very clear what I mean about
information. Okay, if you're a
biologist, you'll probably understand
some of this. If you're not, and I have
to assume most of you are not, it's
still very important that you
understand, and it's very easy to
understand, that your nervous system,
your brain, spinal cord, and of course
your nervous system includes all these
cranial nerves, including the vagus
nerve, are carrying different types of
information along different pathways.
Different neurons or different nerve
cells within the vagus nerve, for
instance,
are receiving or giving different types
of information for different purposes.
For instance,
there is sensory information carried by
neurons, nerve cells in your nervous
system.
Sensory information is the kind of
information that, for instance, converts
light into electrical signals at the
level of your eyes. Then your eyes are
providing information to the brain about
what's out in the visual world. That's
sensory information.
Same could be said for sound waves.
That's sensory information that your
auditory system converts to basically
your understanding of speech, and sound,
and music, et cetera.
Other neurons control motor functions,
literally the movement of your limbs by
controlling contraction of your muscles,
or the movement of your lips, or the
closing
or opening of your airways, for
instance. So,
motor information,
of course, can be seen on the surface of
the body. I'm moving my hands now. I'm
moving my mouth. You don't even need to
see me do that to know that I'm doing
that.
But within our body, we have organs that
also need motor control. For instance,
our gut. Our gut is not just a passive
tube through which food moves. The gut
is contracting and relaxing. It's moving
food through from one end to the other,
okay? We have our pancreas. We have our
liver. We have our spleen. And you might
think, "Oh, well, those are sort of
vegetative organs. They just kind of sit
there. Maybe the cells do stuff, but
they don't move much." But actually,
your spleen even has a contractile
ability. So, it can contract to release
red blood cells or immune cells into
circulation, and and on, and so forth.
Different organs, including your
muscles, but other organs as well, need
instructions as to when they should
move, when they should contract, when
they should relax. So, we have sensory
information that's carried by
essentially one set of neurons in our
nervous system. So, carrying light
information or sound information or as
you'll see in a few minutes, chemical
information about the acidity of the
gut, for instance.
And we have neurons that are considered
motor neurons. They control the
contraction of muscles or the
contraction of these different organs or
the encouragement for different aspects
of the digestive tract to contract or
relax to move food along. Okay? So, we
got sensory neurons and we have motor
neurons. And then there are a lot of
other neurons as well that we call
modulatory neurons. They kind of adjust
the balance between the sensory
information and motor information. We
aren't going to talk so much today about
modulatory neurons, but they are an
important third category of neuron in
the nervous system. Now, why am I
telling you all this stuff about sensory
and motor? Because the vagus nerve is
also unique in that it is both a sensory
pathway and a motor pathway. And this is
something that most discussions about
the vagus nerve, in fact, I would say
99%
of discussions about the vagus nerve
that you see online or when you hear
about, forgive me, in your yoga classes.
By the way, I'm going to touch on how
yoga and ancient yogic practices
actually manage to tease apart some very
important functions of the vagus nerve
without knowing any of the underlying
mechanisms. But it is the case that most
of the time when you hear about the
vagus nerve out there in the general
world or in the media, it's about the
vagus nerve being a calming pathway
that's involved in transmitting
information about the sensory milieu of
the body, so, you know, heart rate, uh
acidity of the gut, um you know, how
comfortable we are in our body to our
brain. And people will say you want to
activate the vagus nerve because you
want to calm down. Well, that is true,
but that is just one small fraction of
the functions of the vagus nerve. Why?
Because the vagus nerve includes both
sensory and motor neurons within it. And
while it is true that a ton of sensory
information is coursing up from the
organs of the body into the brain
through what we call the vagus nerve,
there's also motor information coming
from the brain to the body. So, if we
are going to have an accurate,
meaningful, actionable conversation
about the vagus nerve, it's very
important that you know that the vagus
nerve contains sensory neurons as well
as motor neurons. And I want to be clear
that I'm not just telling you about
sensory versus motor neurons in the
vagus nerve to just overload you with
nomenclature.
Turns out that if you want to access the
calming aspects of vagus nerve
activation
versus the energizing effects of vagus
nerve activation versus the
immune-enhancing effects of vagus nerve
activation versus the ways that you can
improve learning using vagus nerve
activation, you need to know whether or
not you're trying to activate a sensory
pathway or a motor pathway within this
vast set of connections that we call the
vagus nerve. Okay, so I want to just
briefly describe the sensory pathways
within the vagus nerve.
And by the way, if you're a yoga
teacher, if you are a therapist, if you
are a teacher, if you are a human being
on Earth,
this information is going to be very
useful to you because this is the
information that will allow you to
understand why it is that when your body
is in a certain comfortable or
uncomfortable state, it has a particular
effect on your mind and your brain to
feel, well, in general, comfortable or
uncomfortable.
Your vagus nerve includes very
interesting and kind of unusually shaped
neurons. Okay? The neurons of the vagus
nerve are not like the ones that you see
in the typical picture if you were to
look up neuron online. If you were to
look up neuron online, what you would
find is you'd see a picture of what's
called a cell body where the nucleus,
the DNA is. You'd see what are called
dendrites, which typically are the area
where neurons receive input. And then
you'd see the wire-like extension that
we call the axon
out to the area that that neuron
communicates with. And then you might
see a little picture of some little
blobs or what we call vesicles being
released at the end of that axon. That
is not at all what vagal nerve neurons
look like. Some of them do, but the vast
majority, about 85% of the neurons in
the vagus nerve, have a cell body with
that DNA, with the nucleus in it,
sitting in an area kind of near um your
neck and back of your head, sort of what
we call the brainstem. And it's called
the nodosum ganglion. Now, the nodosum
ganglion is a collection of cell bodies
of neurons. So, you could think of it
kind of like a cluster of grapes,
and they do indeed have an axon
extending from them, a wire that goes
out to the body, okay?
That wire looks for all the world like
the axons on any other neurons, and that
little axon can be very short if it
terminates, as we say, in an area of the
neck. It can be slightly longer if it
terminates in the chest area, and even
longer if it goes to what we call our
viscera, our lungs, our pancreas, our
liver,
down to any number of different organs
within our major abdominal body
compartment. Okay, you also see an axon,
a little wire, from a vagal sensory
neuron out to the spleen. Now, what I
just described, a cell body
with an axon extending from it out to
the organs of the body, different organs
of the body tend to be innervated by
different neurons.
Not always, but in general.
But here's what's different about these
vagal neurons. These vagal neurons
have another axon that goes from the
cell body. So, they're what we call a
bipolar neuron. They have another axon
that extends up into the brainstem
and terminates in generally one of three
different what we call brain stem
nuclei, which are just areas of the
brain stem. So, it's very important to
embed in your mind, right? Because in
reality, embedded in your head and neck
or in your brain and neck are these
neurons which are kind of like a cluster
of grapes that have each one is going to
have two branches, one that goes out to
a particular organ of the body and
another branch that goes up into your
brain stem. Now, this visual
understanding, which hopefully is
starting to take place in your mind, is
extremely important to understand how
85% of the vagus nerve works. 85% of the
vagus nerve works by having these
neurons that have axons in, say, the
spleen or around the lungs or that
innervate the heart or that innervate
any number of different organs in your
body,
and they collect sensory information
about what's going on in each and every
one of those organs.
That information goes up the axon.
Remember, there's a cell bodies in the
nodose ganglion, and then it goes
further up past the cell body into the
brain stem. Okay, so when people talk
about the vagus nerve, cranial nerve 10,
as being a sensory pathway, it is mostly
a sensory pathway. It's collecting
information through these axons. Why is
that weird? Well, it's not weird, but
it's different than the way we normally
talk about neurons where the axon is the
output end, right? Where it's dumping
stuff onto the next neuron to make
things happen.
The neurons in the nodose ganglion of
the vagus nerve, I know that's a lot of
language, but these neurons that send an
axon branch out to the organs of the
body are collecting information about
what's happening, what sensory
information is occurring out at those
organs. And that information goes up
those wires, past the cell body, and
into the brain stem, and then that's
communicated to the brain.
So, basically, we can think of 85% of
the vagus nerve, this huge superhighway
from the body to the brain as being
sensory.
And when we talk about sensory, it's
important that you understand that two
types of sensory information are coming
in through these wires, through these
axons, and that are delivered to the
brain. And in response to that sensory
information, as you'll soon learn, your
brain will change its levels of
alertness. Sometimes it gets more alert,
sometimes it gets calmer. Sometimes it
primes you to learn better. Sometimes it
will turn on a fever. I do literally
heat up your entire body based on what
those axons are sensing out in the
periphery.
The periphery, of course, being the
organs and tissues of your body outside
your brain and spinal cord. So, I
realize that's a bit of neuroanatomy for
those of you that aren't familiar with
neuroanatomy, it might seem like an
overwhelming amount of neuroanatomy, but
it's extremely important to have that
idea in your mind of sensory information
flowing up into the brain from your
organs
because
anatomically speaking and functionally
speaking, it runs exactly opposite to
how we typically see neurons when
they're drawn in diagrams for us and how
we talk about neurons as just putting
stuff out at the level of the axon at
the end of those wires. Information's
coming up those wires in the case of the
vagus. Okay, so whereas for the visual
system or the auditory system or for the
smell system or the taste system,
typically we have one type of sensory
information coming in. So, for instance,
in the visual system, light photons of
energy are converted into electrical
signals that the rest of the visual
system unpacks to give you visual
perceptions, to control your circadian
rhythms, or in the case of the auditory
system, you have sound waves which are
transduced by this beautiful mechanism
of your inner ear that then gets
converted into your understanding of
speech or music, etc.
In the case of the vagus nerve,
the sensory information coming from your
organs, from your lungs, from your gut.
And by the way, your gut, when I say
that, I don't just mean your stomach. I
also mean the large and small intestine
and all the stuff above your stomach as
well.
The sensory information that's coming
from the body includes both chemical
information
and mechanical information. Now, the
mechanical information is pretty
straightforward to understand. If your
gut is full of food or air or water and
it's very distended, you can feel that.
The reason you can feel that is because
you have mechanoreceptors
that sense stretch in the lining of the
gut
and send that information by way of
those axons up
to and past the nodos ganglion. There's
some processing of that information in
the nodos ganglion, but then it goes up
and into your brain stem. Okay? Now,
also within the gut, you have chemical
information. There's information about,
for instance, and we'll talk more about
this later, how much serotonin is in the
gut. You may have heard that 90% of the
serotonin in your body is manufactured
in the gut. And indeed, it's
manufactured in your gut. It plays an
important role in gut motility and gut
health.
The serotonin in your gut is distinct
from the serotonin released in your
brain. Later, we'll talk about how the
levels of serotonin in your gut are
conveyed to the brain by way of, you
guessed it, the vagus nerve. And your
brain, in turn, makes different levels
of serotonin to impact your mood. Super
interesting, super important pathway,
has relevance for depression and just
for everyday mood and well-being. We'll
talk about it. It's a highly actionable
pathway. Super cool.
So, you have mechanical information and
you have chemical information coming
from, for instance, your gut up through
these sensory In the technical
nomenclature, it's called afferents.
Afferents is a technical language. Feel
free to ignore this, but for those of
you that want to know, you have
aficionados already know this, that
afferents are the inputs to a structure.
Efferents are the inputs from a
structure. But,
what we've got in the case of the gut is
mechanical and chemical information
being sensed by different neurons with
different receptors that pay attention
to different things. Meaning, those
receptors are activated by either
mechanical stretch or by the presence or
absence of particular chemicals in the
gut,
how acidic the gut is, and that
information goes up, processed a bit in
the nodose ganglion, and then relayed up
to the brain stem. And we'll talk in a
moment about what happens to that
information after it lands in the brain
stem.
Now, chemical and mechanical information
is also being conveyed from other
structures in the body. You can probably
imagine what some of these are, and we
don't have to go through each and every
one, but as one additional example to
the gut, I'll just use for instance the
lungs. When your lungs expand
and contract as you breathe,
that information is relayed up through
and past the nodose ganglion and up into
the brain stem. And as you can imagine,
your lungs, because you're inhaling
oxygen and you're also offloading carbon
dioxide, your lungs are expanding and
contracting, your lungs are also
communicating mechanical and chemical
oxygen carbon dioxide ratio information
up to the brain. Now, if we wanted to,
we could explore and discuss every
single organ of your body that gets axon
input from the vagus nerve and therefore
can carry sensory information up the
vagus.
And again, there's going to be
information about the chemical
environment and the mechanical status of
each of those organs carried up to your
brain stem. We're not going to do that
now for sake of time,
but it's very important that you now
take a step back and you realize, "Hmm,
I understand what sensory information
is. I understand that it's different
than motor information. It's carried by
different neurons in the nervous system.
The vagus nerve has both sensory and
motor neurons. The sensory neurons are
collecting information from all these
bodily organs. And by the way, those
bodily organs don't just stop at the
level of the lungs. It includes the
heart. It includes some stuff that's
happening in the neck. Um some of the
muscles that are controlling the
constriction of the airways. We'll get
into this a little bit more in a few
minutes, but
you now also know that when we talk
about collecting sensory information
from the body and sending it to the
brain
by these vagal pathways, that the types
of sensory information include both
chemical and mechanical information. And
the reason that's important is not just
academic and intellectual, it's not just
to fill the airspace with nomenclature,
it's because if you're going to think
about ways to change the activity of the
vagus system. The ways to, for instance,
calm down or the ways to improve your
immune system function or to improve
your mood in the short and long term,
you need to ask yourself, am I going to
do that through a mechanical change or
am I going to do that by making a change
to the chemical milieu of a given organ
or set of organs? So, to drive the point
I just made home, let's take an example
that we see a lot out there, which is
that if you want to increase the
activity of your vagus nerve, you want
to calm down. Why am I saying calm down?
I neglected to say earlier that, by the
way, every medical student and pre-med
student should know,
which is that cranial nerve 10, the
vagus nerve, is classified as a
parasympathetic nerve. Parasympathetic
refers to one branch of the so-called
autonomic nervous system. The autonomic
nervous system controls your levels of
alertness and your levels of calm. It
has two major branches. One branch is
called the sympathetic nervous system,
has nothing to do with emotional
sympathy. The sympathetic nervous system
is generally responsible for increasing
our levels of alertness. Everything from
being alert like I am now,
all the way up to full-blown panic
attack, which fortunately I'm not right
now.
The parasympathetic nervous system is
often referred to as the rest and digest
system, and indeed it has roles in rest
and digestion, but it controls a lot
more than just that. The parasympathetic
branch of the autonomic nervous system
controls, for instance,
digestion, it controls our ability to
fall asleep at night. If the
parasympathetic nervous system is overly
activated, it can make us sleepy when we
don't want to be sleepy. It can make us
pass out when we don't want to pass out.
It can be responsible for putting people
into a state of coma. So, it's not good
to think about the sympathetic nervous
system simply as fight or flight, how
it's often referred to, because it's
also responsible for generating healthy,
wakeful, non-anxious, non-stressed
levels of alertness, as well as
stressed-out, panic states. And the
parasympathetic nervous system is
responsible for putting us into a calm
and relaxed state or a deep sleep state
or a coma state if it were to be
hyperactivated. The autonomic nervous
system is a seesaw where the levels of
alertness and calm that we experience at
any one moment reflect the relative
balance of sympathetic nervous system
and parasympathetic nervous system
activity. They're serving a push-pull
with one another. Increase the
parasympathetic nervous system activity
a little bit, you get a bit calmer.
Increase the sympathetic nervous system
activity a little bit, you get a bit
more alert. But, they're always both
active. The vagus nerve is classified as
a parasympathetic nerve. However, it's a
bit of a misnomer because, as you'll
soon realize, there are pathways within
the vagus nerve that, were you to
activate these pathways within the vagus
nerve, you would become more alert, not
less alert. This is one of the things
that I'm hoping to dispel through the
course of this episode, which is this
very common myth out there. It's almost
pervasive that when you activate the
vagus nerve, you're going to calm down.
It is simply not true. Okay? There are
instances where that is true. There are
instances where the opposite is true,
depending on which branch of the vagus
nerve you happen to activate or
suppress.
One example, however, where activating a
particular branch of the vagus nerve
does indeed lead to more relaxation is
the branch of the vagus nerve that,
again, is sensory. Okay? So, it's taking
information about mechanical phenomenon,
in this case, pressure
or touch, and it's sending that
information down into the brain stem
areas that are going to interpret that
information.
This branch of the vagus nerve that is
carrying sensory information doesn't
come from the viscera or the neck, it
comes from the head, and it's the branch
of the vagus nerve that essentially goes
behind the ear and in some of the uh
deeper components of the ear. Remember
they tell you you don't put anything
into your ear that's uh you know, uh
smaller than your elbow. Um well, I'm uh
breaking that rule right now and I'm
putting my index finger into my ear and
kind of rubbing in a circular way that
kind of the area right outside um the
hole of the ear. There's a branch of the
vagus nerve there. There's also, as I
mentioned, a branch of the vagus nerve
behind the ear. And were you to rub
behind the ear just gently or, you know,
with a little bit of pressure, indeed
you're going to activate that branch of
the vagus nerve. That branch of the
vagus nerve is carrying sensory
information, so that mechanical pressure
is being conveyed into the brain stem,
and indeed that pathway
satisfies all the criteria of being a
parasympathetic or calming-inducing
pathway. Now, you can find all over the
internet that, you know, rubbing behind
the ears is really going to calm us down
and really bring our level of overall
autonomic arousal way, way down. In
reality, it doesn't bring our overall
level of autonomic arousal way, way
down. It brings our level of autonomic
arousal down a bit, depending on how
active our sympathetic nervous system
happens to be. Why do I tell you this?
Well, I'm not trying to rain on any
parties out there, but the truth is, if
you're super stressed, if you're in a
panic attack, rubbing behind your ears
might help a little bit, but it's not
going to suddenly bring you into a state
of calm. Soon we're going to talk about
things that can bring you into a state
of calm very fast, and I will explain
exactly how they work and why they work
so quickly and why they are so robust. I
don't want to be disparaging of the area
behind the ear or the area within their
ear. Some people really like their ears
rubbed. I certainly like the area behind
my ears rubbed, like I'm doing now or
the areas within my ears gently rubbed.
Who doesn't like that? And indeed it's
calming. But it's one minor branch of
the vagus nerve carrying sensory
information. It's not going to suddenly
shift your autonomic nervous system.
It's not going to suddenly tilt that
seesaw into parasympathetic dominance as
it were. To do that, you need to
leverage some of the other
more robust branches of the vagus nerve.
And I'll teach you how to do that in
just a moment here.
The point is that the vagus nerve does
carry sort of classic parasympathetic
information. If you're asked on an exam,
students, med students, I don't want to
be responsible for you getting this
wrong. I'd love to be responsible for
you getting it right. I teach
neuroanatomy to medical students. If
you're asked, is
cranial nerve 10, the vagus nerve,
parasympathetic or sympathetic? You
should answer parasympathetic. If you're
asked if it's sensory or motor, you
should say it's mixed. It's both. So
it's mixed parasympathetic. However, for
everybody out there, med student or not,
just understand that when you activate
certain branches of the vagus nerve,
you're either going to get an elevation
in alertness, that is an increase in
sympathetic nervous system activity, or
a decrease in alertness, that is an
elevation in parasympathetic activity,
depending on which branch you activate,
and the context matters. So,
if you want to relax, you can rub behind
your ears, you can rub inside your ears.
If you have permission, you can do that
to the person next to you
if they like it.
But
it's not the case that activating any
branch of the vagus nerve is going to
calm us down. That's simply not the
case. And in a moment, I'll tell you
why. I'd like to take a quick break and
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checkout. Okay, so we've talked about
all the sensory information coming in
from behind the ear, from deep in the
ear, from the body,
coursing up past nodose ganglion into
the brainstem.
I told you earlier and it's still true
now that 85% of the vagus nerve pathways
are sensory in nature, carrying chemical
and mechanical information. So, what
about this other 15% of the vagus nerve
that is not carrying sensory information
from the body, from the head into these
brainstem nuclei?
By the way, when I say brainstem nuclei,
I don't mean
nuclei in the context of one neuron.
This can be a little bit confusing, but
when we hear about the nucleus of a
neuron, we mean the area that generally
contains the DNA and we're
distinguishing it from the axon and the
other parts. When we hear about a
nucleus in the brain,
these neuroanatomists should have been
more creative, but when we're hearing
about a nucleus in the brain,
it means a collection of different
neurons. So, a a big group of neurons.
So, when I say brainstem nuclei, I mean
a lot of neurons, thousands of neurons
in little clumps there that we call
nuclei.
So,
the vagus nerve includes different
nuclei, different collections of
neurons.
And these neurons have what we call
efferents, outputs
to, as you might have guessed, the body.
Back to the various organs of the body.
They also have connections to things
within the head and face area, but for
the time being, I'm mostly going to talk
about the motor outputs of the vagus
nerve that come from these brainstem
nuclei. So, these motor outputs
are not themselves paying attention to
mechanical or chemical information. They
are going to control the organs of the
body.
This is extremely important if you want
to be able to understand and leverage
your vagus nerve for health and
well-being, mental health, physical
health, performance, and even for
accelerated learning. I guess that would
fall under performance. Or for recovery
from different diseases. There are
really nice papers starting to emerge
that if you can selectively activate
these motor pathways, you can accelerate
and increase the recovery from stroke.
So, this is of serious significance.
But for those of us that fortunately
don't have strokes, it's still of
serious significance. And in fact, right
now I'm going to tell you about an
actionable tool whereby you can leverage
one of these motor pathways to a very
specific endpoint anytime you want. So,
let's talk about how you can leverage
these motor pathways of the vagus in
order to what's called auto-regulate.
Auto-regulation is not just a fancy word
for calming down. We are going to talk
about calming down, but auto-regulation
is the way in which your vagus nerve
makes sure that that seesaw of
sympathetic nervous system to
parasympathetic nervous system balance
doesn't get tilted too far to the side
of sympathetic nervous system
activation. That your levels of
alertness, your heart rate, your
breathing rate, etc. don't get too high.
And the reason it's called
auto-regulation and not just calming
down is that auto-regulation is
something that's always happening in the
background as you're going about your
daily activities. In fact, it's also
happening while you sleep. In fact, now
we're going to talk about things that
you can do deliberately to indeed calm
down, but to also increase the amount of
auto-regulation that occurs during your
entire day when you're not focusing on
doing these particular protocols, as
well as during sleep, and that will
result in elevated what's called HRV or
heart rate variability. Now, I realize
that's a tall order, but what we're
going to do is we're going to step
through this first by focusing on the
protocol, and then now that you're
familiar with all the business about
sensory and motor and parasympathetic da
da da Now that you have all that science
and nomenclature in mind, it will all
make perfect sense as I describe this
protocol for auto-regulation and
improving HRV and all the protocols that
follow. Okay, so embedded in your brain
and in your vagal nerve pathways
and in your body you have an incredible
neural circuit. This neural circuit is
one that you are born with and it's one
that you will have your entire life.
This is also a pathway that you want to
keep tuned up. That is that you'll want
to make sure is activated on a pretty
frequent basis. Super easy to do as
you'll soon see.
So that the pathway does not
deteriorate.
This is a pathway that originates in an
area of your brain called the
dorsolateral prefrontal cortex. Now, the
dorsolateral cortex
by the way, it's the left dorsolateral
prefrontal cortex in particular sort of
on the left upper part of the front of
your skull. If you were to go deep to
that area, you would be on the left
dorsal top lateral side
prefrontal cortex kind of toward the
front, right behind your forehead. Okay,
dorsolateral prefrontal cortex sits deep
to that area.
The dorsolateral prefrontal cortex has
outputs to a couple of other brain areas
called the cingulate, called the insula.
You don't have to worry about those
names unless you're really interested in
them. Those areas have communication
with one of the brainstem nuclei, one of
those brainstem areas that gets input
from
the sensory pathways from the body, from
the head
of the vagus
and that also contains neurons that have
motor output to particular areas of your
body. And that brain area, and you're
going to love this, is called nucleus
ambiguus. I kid you not, it's called
nucleus ambiguus. Nucleus ambiguus
contains some neurons that project down
to what's called the sinoatrial node of
the heart.
And those neurons are responsible for
deceleration of heart rate.
And it turns out that you can
selectively activate those neurons in no
small part because they receive input,
albeit several synapses away, from the
left dorsal lateral prefrontal cortex.
Because the prefrontal cortex is
involved in deliberate action, in
planning and execution of action. It
doesn't do it alone, it does it through
communication with some other brain
structures, but if you for instance
decide that you're going to activate
this deceleration pathway, you can do
it. The beautiful thing is these neurons
that also control deceleration of heart
rate are active in the background,
they're under autonomic control, but you
can take control of them. When does that
happen? Well, for instance, in sleep, if
your heart rate starts to increase,
these decelerating neurons, which are
neurons of the vagus nerve, they're
motor output neurons, they release
acetylcholine, and they act on the
sinoatrial node, which is a node within
the heart that controls heart rate, to
slow your heart rate down. Okay? This is
the way in which your heart rate never
gets too high. The seesaw that is the
autonomic nervous system
is kind of weighted to the sympathetic
nervous system side. A simple example of
this is if you have to stay awake,
you can probably do it. At some point
you'll fall asleep. But, if you really
want to fall asleep, it's harder to make
yourself fall asleep. The sympathetic
nervous system is one that we can more
easily leverage in order to push through
things, deadlines, stay up to take care
of a sick relative, you know, push push
ourselves to migrate out from a
dangerous place or away from a famine,
another example of a dangerous place, I
guess. The idea here is that the
sympathetic nervous system has kind of a
bias towards activity. And in fact, your
heart rate is driven by the sympathetic
nervous system, and that heart rate
would continue to accelerate unless
there was this deceleration pathway that
every once in a while would pump the
brake on heart rate. And that's what
this vagal pathway from nucleus ambiguus
down to the sinoatrial node is doing.
And by the way, this deceleration of
heart rate that goes from the vagus
motor pathway to the sinoatrial node is
the basis of what's called HRV or heart
rate variability. We hear a lot nowadays
about heart rate variability. For those
of you that have heard of it, and for
those of you that haven't, having a
higher HRV or heart rate variability is
a good thing, right? Normally, if you
hear something like heart rate
variability, sounds like a bad thing.
Turns out it's a great thing. Heart rate
variability is essentially the distance
or the time, rather, between beats of
the heart. So, you might think that it's
great to have a really consistent heart
rate. Boom. Boom.
Or actually, in reality, it's more like
boom boom
boom boom. And I'm missing some of the
uh beats within the waveform, but you
get the idea. But actually, it's well
known to be correlated with a number of
positive health outcomes, including
things related to brain and body and
longevity and performance to have high
heart rate variability. Heart rate
variability is going to lead to a
pattern of heartbeats that is more like
boom boom boom boom
boom
boom boom boom boom boom
boom. Now, you might say, "That's
arrhythmia." Ah, but there are cases of
arrhythmia that are good, and there are
cases of arrhythmia that are bad. Higher
HRV in general is a good thing. You want
it during sleep, and you want it during
wakeful states. In sleep, heart rate
variability comes about because this
vagal pathway from nucleus ambiguus, so
the cell bodies, the the nuclei,
literally the DNA within those nuclei of
those neurons reside in nucleus
ambiguus, and they project to the
sinoatrial node, and every once in a
while they'll just pump the brake on
heart rate and slow heart rate down, and
then they'll come off that brake. Slow
down, come off heart rate. And here's
the really beautiful part, and the way
that you get actionable leverage over
the system.
The control by the vagus nerve of the
sinoatrial node and heart rate
is coordinated with your breathing.
Now, as I tell you this, it'll make
perfect sense, but I just want you to
step back from it a second and realize
that these systems of the body are so
elegantly coordinated. And here's how it
works with respect to heart rate and
breathing. When you inhale air, of
course, your lungs ex- pand. You have a
muscle that sits below your lungs called
the diaphragm. As you inhale air, of
course, that diaphragm moves down. Now,
as your diaphragm moves down and your
lungs expand,
your heart literally has a bit more
space in the thoracic cavity
to expand. Okay, it's not going to swell
massively, but it's going to expand.
Now, as a consequence of that expansion,
the blood that's moving through your
heart is going to move a little bit more
slowly per unit volume. That is sensed
by a particular group of neurons in your
heart,
and that sends a signal to your
sympathetic nervous system to speed your
heart rate up.
Put differently, inhaling speeds your
heart rate up.
Now, the converse is also true. When you
exhale, your lungs deflate, your
diaphragm moves up, and as a
consequence, there's slightly less space
for the heart. So, the heart shrinks a
little bit. Not a ton, but it shrinks a
little bit. And it's enough such that
whatever blood is in the heart
moves through more quickly per unit
volume. That faster movement is sensed
by neurons within the heart, sends a
signal to the brain, and the brain
activates those neurons within nucleus
ambiguous, and very quickly sends a
signal to the sinoatrial node to slow
your heart rate down.
Put differently, exhales slow your heart
rate down, and they do so by way of
vagal control over the sinoatrial node.
This is the deceleration pathway over
heart rate. So, as I mentioned, this is
happening all the time during sleep. You
don't have to be consciously aware for
this to happen. It's a fortunate
consequence of nature that the neurons
within your brainstem that control
breathing and the neurons within your
brainstem that control heart rate and
the other neurons within the heart
itself that control heart rate, the
pacemaker cells, all can function
without you having to think about it.
That's a wonderful thing for obvious
reasons. It's also the case that because
we have this input from the left
dorsolateral prefrontal cortex down
through a couple of other structures
like the cingulate and the insula, and
that converge on nucleus ambiguous, if
you decide to slow your heart rate down,
you can do it. And you do so by doing a
deliberate exhale and or by increasing
the intensity or the duration of your
exhale. So, you can do that right now.
If you want to slow your heart rate
down, that is if you want to increase
parasympathetic nervous system activity
and you want to calm down fast, you can
literally just
Exhales slow your heart rate down, and
exhales tilt that seesaw that is the
autonomic nervous system more toward the
parasympathetic side.
Now, I've talked before on this podcast
and all over social media about the
so-called physiological sigh, a
naturally occurring form of breathing
that occurs in sleep and that we can
deliberately do anytime we want to calm
down fast. And the physiological side
consists of, as many of you know, two
inhales through the nose followed by a
long to lungs empty exhale through the
mouth. Typically, the first inhale is
longer. Again, it's done through the
nose. The second inhale is shorter, kind
of a sharp inhale to make sure you
maximally inflate all the little sacs
within your lungs. And then the exhale
is a long, slow exhale
that dumps all your air.
I'll just demonstrate the physiological
sigh for you for those of you that
haven't seen it.
You again
big inhale through the nose, second
sharp inhale through the nose to make
sure you maximally inflate the lungs,
and then long exhale to lungs empty. It
goes like this.
Okay, lungs are empty.
That is indeed the fastest way to
activate the parasympathetic nervous
system and to tilt that seesaw from
levels of high sympathetic nervous
system activation to lower levels of
sympathetic nervous system activation.
In fact, I immediately feel calmer.
Maybe you can even hear it in my voice.
So, when you do a physiological effect,
you're getting both a chemical signal
into the brain, that is the adjustment
of that carbon dioxide oxygen ratio.
It's mainly due to the offloading of
carbon dioxide.
That lower level of carbon dioxide is
registered by the brain very quickly and
leads to an increase in calm. The
deceleration of heart rate, driven by
the exhale, is also registered by the
brain very quickly, leads to an increase
in calm. When you just emphasize an
exhale, meaning you extend it or you
make it more intense, and you don't do
the two inhales first, that is you don't
do the physiological sigh, well, you get
the mechanical signal, but you don't get
the chemical signal, at least not to the
same degree you do with the
physiological sigh. Put simply, if you
want to calm down fast, ideally, you do
the physiological sigh. However, it
turns out that one of the best ways to
improve your HRV, both in sleep and in
wakeful states, which takes a very
minimum of effort and is rarely if ever
discussed, is simply throughout the day,
I would say 10, 15, maybe even 20 times
per day, anytime it occurs to you to
just deliberately extend your exhale,
that is to pump the brake on your heart
rate through the vagus nerve pathway
that I've been describing, just
just exhale. Slow your heart rate down
and then get about your normal routine.
You can do that essentially anytime you
remember to. This is literally going to
increase your HRV, you now know the
mechanism by which it does that, and get
this, it will also increase your HRV in
sleep at night. And the reason is this
pathway that originates with the left
dorsolateral prefrontal cortex and goes
down to nucleus ambiguus and then to the
sinoatrial node of the heart, because
it's under conscious control,
and because it's subject to what we call
plasticity, to strengthening and to
weakening, that is if you use it
deliberately, it gets strengthened. If
you don't use it deliberately, it gets
weakened.
Well, that's a great thing because it
means that if you just simply remember
to do some extended exhales throughout
the day,
you're going to strengthen this pathway
such that it operates in the background
through auto regulation without you ever
having to think about it. Now, of course
that effect wears off over time if you
don't occasionally remember to just do
some
some longer exhales, but this is a
wonderful protocol in my opinion because
it capitalizes on a inborn circuit,
right? A circuit that you were born with
that is already installed, that you can
use at any point, it doesn't take any
learning, but that if you just ping
every once in a while with some extended
exhales throughout the day, it takes
essentially no time, you get the benefit
of feeling a little bit calmer, slowing
your heart rate down, and your HRV,
which is correlated with a host of
positive health outcomes in the short
and long term, will increase. Two
interesting things everyone should be
aware of is that as we age, of course a
number of things happen, memory gets
slightly to much poorer. All right,
there are ways to offset that.
Heart rate variability gets much worse.
Now, an interesting finding from Nolan
Williams lab at Stanford is that if you
activate dorsolateral prefrontal cortex
using what's called transcranial
magnetic stimulation. This is a
procedure where you take a stimulator
and you non-invasively place it on the
skull outside and just above
dorsolateral prefrontal cortex and you
stimulate through the skull dorsolateral
prefrontal cortex
you observe as you would expect a
deceleration of heart rate and it's
known to be carried through this vagal
pathway to the sinoatrial node.
Even after the stimulation is removed
you find that heart rate variability
increases because this pathway has been
stimulated into neuroplasticity. It's
strengthened. The other way to
strengthen this pathway is to do exactly
what I just described, to deliberately
engage this long exhale mechanism
various times throughout the day. Now,
if you miss a day, is the pathway going
to atrophy? No. If you do it 50 times a
day, is it going to strengthen more than
if you do it one time per day? Yes. Do
we know the exact thresholds of how many
times per day you should be doing these
deliberate exhales in order to keep this
pathway robust? No, unfortunately, we do
not. However, we do know that in human
patients that suffer atrophy of the
dorsolateral prefrontal cortex that's
associated with normal aging or with
accelerated atrophy of dorsolateral
prefrontal cortex or lesions of
dorsolateral prefrontal cortex that tend
to occur in older people who get strokes
or just associated with the normal aging
process, heart rate variability declines
with age. And it is now thought that
heart rate variability declines with
age, of course, in part through lower
levels of physical activity because
there are, of course, certain forms of
physical activity like high-intensity
interval training to keep that heart
rate variability elevated over time
using exercise, but it's also true that
if this pathway degenerates, you see a
decrease in heart rate variability. If
you keep this pathway engaged by
behaviorally, deliberately doing these
long exhales, or if you take the more
robust approach of transcranial magnetic
stimulation, something that most people
unfortunately won't have the opportunity
to do, although maybe in the future
there will be commercial devices that
will allow us to do this,
you can keep heart rate variability
higher as you age, which as I mentioned
before is correlated with a number of
different positive health outcomes. So,
these pathways by which we can happen to
deliberate activation of this vagal
control over the sinoatrial node are not
just incidental. They turn out to be
central to the aging process. They turn
out to be central to countering the
aging process, and you now know you have
some agency and control over them.
So, earlier I was talking about how
despite the fact the vagus nerve is
classified as a parasympathetic nerve,
that it also can be alerting. It can
increase levels of sympathetic nervous
system activity.
And that runs counter to the concept of
parasympathetic, which is always labeled
as rest and digest.
I'm now going to tell you a tool that
you can use when you're feeling less
than energized, less than motivated, and
when you need to exercise and you don't
feel like doing it. And when you want to
leverage exercise as a way to improve
brain function and plasticity.
It all involves the vagus nerve, and it
involves an aspect of the vagus nerve
that very few people are aware of, but
in my opinion is one of the coolest
aspects of the vagus nerve. It's at
least as cool as vagal control over
heart rate variability and auto
regulation. And it goes like this.
There's a beautiful set of findings from
a guy named Peter Strick at the
University of Pittsburgh, who used these
really cool methods for tracing
connections between the brain and body
to ask the question, what areas of the
brain are communicating with our adrenal
glands? Our adrenal glands are two
glands that sit atop your two different
kidneys, so one atop each kidney,
and release, as the name suggests,
adrenaline. Adrenaline is also called
epinephrine. Your adrenal glands also
release cortisol,
but for sake of this discussion, let's
just think about adrenaline released
from your adrenals.
What he found, through a bunch of
experiments done in non-human primates,
and that seemed to correspond very well
to what we observe in humans as well, is
that there are three general groups of
brain areas.
Motor activation areas, so what we call
upper motor neurons. So, these are the
neurons in the brain that control the
lower motor neurons in the spinal cord
that control the muscles of the body,
as well as neurons within our brain that
are involved in cognition and planning,
and areas of the brain that are involved
in emotion,
that can communicate with the adrenals
and cause them to release adrenaline.
Now, that's great, but it sort of points
to a pathway whereby, okay,
you know you should exercise, you tell
yourself you should exercise, you're
emotional about it, and your adrenals
release adrenaline, and you exercise.
Now, that's interesting, but what's
perhaps far more interesting
is that the data from Strick Lab and
other labs as well
shows that when we move the large
muscles of our body,
the adrenals release adrenaline,
epinephrine.
Now, epinephrine has an activating
sympathetic nervous system stimulatory
effect, right? It tends to make the
tissues of the body that are associated
with movement and with so-called fight
or flight, although again, fight or
flight is kind of an extreme example.
It tends to activate the organs of the
body and make them more likely to be
active. It increases the probability
that movement will occur.
Overall body movement. So, when we move
the large muscles of our body, our legs,
and in particular our trunk muscles, we
release adrenaline.
That adrenaline activates the organs of
our body, and further makes it likely
that we're going to move our musculature
more.
But get this, adrenaline epinephrine
doesn't cross the blood-brain barrier.
So how does it increase our level of
alertness in our brain? Right, you don't
want your body to be super active and
your brain to be kind of sleepy. That's
not good. That's not adaptive.
Turns out that when the adrenals release
adrenaline, it binds to receptors on the
vagus nerve itself, those sensory axons
that extend into the body. There are
receptors on those wires, right? Not all
the receptors are at one end or the
other, they're also on those axons.
The adrenaline binds to the receptors on
those axons and the vagus nerve in turn
releases glutamate, an excitatory
neurotransmitter, in a structure in the
brain called the nucleus tractus
solitarius. The neurons in what I'm just
going to call the NTS for simplicity,
in turn, activate neurons in a brain
structure called the locus coeruleus.
The locus coeruleus contains neurons
that release what's called
norepinephrine.
And the neurons of locus coeruleus send
their axons out very extensively across
the brain in kind of a sprinkler
system-like organization such that
when you move the large musculature of
your body, you release adrenaline. That
adrenaline activates the tissues of your
body, makes them more likely to move,
also binds to receptors on the vagus.
The vagus nerve in turn releases
glutamate, an excitatory
neurotransmitter, in the NTS. The NTS
then passes off that excitatory signal,
like a bucket brigade, off to the locus
coeruleus. The locus coeruleus dumps a
bunch of norepinephrine into the brain
and increases your levels of alertness.
What this means is that the vagus nerve
is central to the process of using
physical activity to make your brain
more alert. And we know that activation
of locus coeruleus makes the brain areas
that are involved in motivation and the
propensity to move more
higher in levels of activity. In other
words, if you're not feeling motivated
to exercise or you're not feeling alert
enough.
Movement of the body that includes
especially the legs, the large muscles
of the legs, so quadriceps, hamstrings,
etc., as well as the trunk muscles of
the body,
stimulate this pathway in a kind of
dominoing effect that makes the
likelihood, and believe it or not, the
desire to move
much more likely.
This I've personally found to be an
immensely useful piece of information
because sure, I knew that sometimes I
would go to the gym or I'd head out on a
run and I wasn't feeling motivated,
or I'd sit down to do some work and I'd
feel kind of sleepy despite the fact I'd
slept pretty well the night before and
eaten just fine and the room wasn't too
warm, etc.
I'd feel kind of lethargic and I was
like, "What's going on here?"
And
yes, I had the experience of sometimes,
you know, doing a bit of a warm-up,
maybe some light calisthenics, maybe a
few warm-up sets or jogging for a little
while and then finding that my levels of
alertness increased. But I've also had
just as often the experience of
not feeling that motivation for physical
activity or for cognitive activity come
online, especially if I wasn't extremely
interested in that activity or that
thing that I was supposed to learn. You
know, it's very easy to be excited when
we want to do the activity or we want to
learn the thing that we're supposed to
be learning at a given moment or reading
at a given moment. This pathway is
immensely useful to understand because
it explains why it is that even when
you're not feeling motivated, if you do
some activity that yes, is preceded by a
bit of a warm-up, so maybe I don't know,
you do some light calisthenics or you go
on the treadmill for a few minutes
walking and then maybe a little bit
faster, that it can increase your levels
of alertness and motivation, but
it especially explains how if you put in
some effort that at the moment feels
like a big exertion,
your entire body and brain state shifts
in a way that levels of motivation and
energy to do more physical work or more
cognitive work or both increases
dramatically. And these are not small
effects when they've been measured. In
fact,
for all the talk that's out there in
kind of pop psychology
and in kind of pop neuroscience about
the vagus being a calming pathway,
all the neurophysiologists out there,
and I know there aren't very many, but
I'm friends with a lot of
neurophysiologists,
they'll all tell you that if they're
doing a surgery or they're doing some
sort of brain recording
and the animal or person that they're
doing the brain recording from is
starting to drop into a state of kind of
deep parasympathetic activity, they're
falling asleep or they need to be more
alert, what do they do? They stimulate
the vagus. They stimulate the vagus
nerve in order to wake up the brain. In
fact, stimulating the vagus has been
used to save people's lives when they're
drifting too far down into deeper and
deeper planes of anesthesia. So,
stimulating the vagus wakes up the
brain. And the way to stimulate the
vagus is by way of these receptors on
the vagus nerve itself. And the way to
do that without an electrical
stimulator, right? Cuz we're not talking
about clinical conditions here, in order
to increase levels of motivation,
alertness, and focus for physical
activity or cognitive activity and
learning, etc., or simply to overcome
lethargy and brain fog, is to do some
sort of physical activity that includes
the large musculature of your body.
These could be things like jumping,
these could be things like actual
resistance training, this could be
running.
This information really points to the
idea of of course, after a good warm-up,
doing more sprinting type activity, more
strength type activity, you know, six
repetitions or less where you're getting
close to failure, this sort of thing, to
wake up the brain and body as opposed to
doing long rhythmic activity that's
below the threshold of what would
activate a lot of adrenaline from the
adrenals. So, the idea is to get those
adrenals to release adrenaline into your
system. It won't cross the blood-brain
barrier, but your vagus nerve provides
this beautiful link between the body and
brain to match levels of excitation from
the body to the brain, and you can
leverage that. In In
there's also the well-described effects,
and I've done an entire episode about
this,
of how exercise can improve brain
plasticity and the ability to learn. And
while there are a host of mechanisms
involving long-term changes in things
like brain-derived neurotrophic factor
and increases in lactate, which might
open the door to plasticity, and so on
and so forth, it does seem that one of
the major ways that exercise improves
our brain function and our ability to
learn is simply by increasing our levels
of alertness. And I should say the word
simply placed in there is probably a bit
unfair. There is absolutely nothing
trivial about using exercise as a way to
stimulate a sort of cascade of this
neural circuit from the adrenals up the
vagus and into locus coeruleus in order
to wake up your brain networks that are
involved in motivation, focus, and
learning.
As we'll talk about in a few minutes,
many of us, most of us, perhaps, are
used to using pharmacology like caffeine
or other stimulants in order to try and
wake up levels of alertness in the
brain. And I'm not being disparaging of
that. I am an avid consumer of caffeine
in the form of yerba mate or coffee.
I'll occasionally
take an alpha GPC or an L-tyrosine as
well. You know, I do all those things.
However, in my opinion, it's far more
powerful to be able to leverage, that
is, to activate these levels of
alertness in your brain and body in a
way that doesn't require any
pharmacology if you don't have it
available to you or you're trying to
avoid pharmacology or working out late
at night or you want to focus later at
night
and you don't want to be kept awake by
the caffeine, or even if you consume
caffeine or other stimulants, knowing
the organization of these neural
circuits from the body to the brain and
how they match levels of alertness and
leveraging them is so straightforward,
but most people don't actually get to
the point where they're doing that
high-intensity work or they're doing the
work that involves the large musculature
of their body when they're feeling not
motivated. In fact, they usually do the
opposite thing. Now, sometimes you need
rest days. This is true, right? You need
to rest and recover to make progress.
You don't want to exhaust yourself. You
need to get sleep. You need to take care
of yourself. However, the reason we're
talking about this is it's a beautiful
opportunity to A, explain that the vagus
nerve is not just about calming down.
It's actually actively used to wake up
your brain when your body is active.
When the large musculature of your body
is active. And B, that like with auto
regulation
this stuff is under conscious control.
Yes, if you were to be frightened
immediately, this is the same pathway
that would be reflexively activated by
an intruder or by, you know, a big
explosion or something of that sort,
your body would wake up, release
adrenaline, then that adrenaline would
set up along this cascade and your mind
would be immediately alert as well.
There's some parallel mechanisms too to
make sure that your brain and your body
are alert immediately. But when you
start to understand what these pathways
are and that they are very specific and
very powerful potent inroads into
activating these circuits, it does
indeed give you a tremendous amount of
agency.
Especially for those of you that might
think you're not motivated to exercise
or you're always lethargic or you have
brain fog. There might be other reasons
for that, but for many people, chances
are you're not getting past that
threshold whereby these circuits
involving the vagus can be activated.
And now you know how. So activate them.
I'd like to take a quick break and
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to get early access to Function. I just
got done telling you how you can
increase your levels of alertness by
activating this vagal nerve pathway from
the body to the brain and that
increasing your level of alertness
allows for more opportunity to focus and
to learn. But when we say focus and
learn, what we're really talking about
is neuroplasticity, this incredible
feature of your nervous system to be
able to change in response to experience
in deliberate ways. The plasticity that
you have when you are a child, from the
time you're born until about age 25,
typically can occur even in passive
experience. That is, you're in class, a
teacher's teaching you something, your
brain is changing. Maybe you put a bit
more effort into something, you're
focused,
your brain will change. But as we get
into adulthood, most of our neural maps
in the brain, certainly our sensory maps
in our cortex, our motor maps that allow
us to move in particular ways,
those have been established. You can
still change them, but they've mostly
been established throughout childhood
and into our early 20s. And if we want
to modify those circuits with
neuroplasticity, there are a couple of
key requirements. One, you need to be
alert. You can't get neuroplasticity,
that is, you can't trigger
neuroplasticity unless you're alert. You
also have to be focused. This is
critical and differentiates adult
plasticity in a major way from
plasticity when we're young, where we
can learn by passive exposure. Okay?
When we're young, we can learn by
passive exposure or, even better, by
focused exposure. But when we are
adults, we need alertness and we need
focus. Just passively being exposed to
a,
you know, music or to a motor pattern is
not going to allow us to change our
nervous system. That's been shown over
and over again. Fortunately, what also
has been shown over and over again
is that if we are alert and we're
focused and we are determined,
especially if we undertake what's called
incremental learning, where we go after
small bits of neuroplasticity repeatedly
over time, we can get as much
neuroplasticity as one observes in
childhood, it just takes longer and you
have to do it so-called incrementally.
There's a lot to say about that, but for
sake of today's discussion about the
vagus nerve, I just want to tell you
that there's a particular pathway in the
brain that involves the molecule
acetylcholine.
Acetylcholine is used to contract the
muscles. It's released from motor
neurons in the spinal cord onto muscles
to contract the muscles. It's also used
in the brain and elsewhere in the
nervous system and does a lot of
different things. It's actually involved
in generating the rhythms of the heart.
But acetylcholine released from a
particular nucleus in the brain called
nucleus basalis, the acetylcholine
released from nucleus basalis
is what we call permissive for
plasticity. In other words, if you have
acetylcholine released from nucleus
basalis into the brain, plasticity is
much more likely to occur.
And in fact, acetylcholine released from
nucleus basalis is sort of like a gate
whereby if you release acetylcholine,
the opportunity for neuroplasticity and
learning is available for some period of
time. So, the question therefore
becomes, how do you get acetylcholine
released from nucleus basalis? There are
these incredible experiments that have
been done by Mike Merzenich and
colleagues
showing that if you stimulate nucleus
basalis to release acetylcholine and you
expose an animal or a human to a
particular sensory stimulus, the brain
remaps very fast according to that
experience. Just enormous amounts of
plasticity that you wouldn't observe
otherwise. There are also, fortunately,
experiments showing that if you
pharmacologically increase
acetylcholine, that you can enhance the
opportunity for neuroplasticity. You
still need to do the learning. You still
need to attempt to learn something. You
still have to make it incremental. But,
the amount of plasticity is
significantly increased when there's
acetylcholine released from nucleus
basalis.
So, in the absence of deep brain
stimulation using an electrode, which
most of you fortunately will not
experience because it requires drilling
down through the skull and placing an
electrode in basalis,
and assuming that you're not taking
anything to increase acetylcholine
transmission to learn, although there
are ways to do that. I've talked about
that before and I'll talk about that
again in a future podcast. Some of those
ways include supplementing with things
like alpha GPC, which is a precursor to
acetylcholine.
There are some other precursors to
acetylcholine or things that stimulate
the release of acetylcholine, such as
Huperzine and things like that, that
will open the opportunity for enhanced
plasticity for a few hours. And there is
good old nicotine. I know the word
nicotine brings to mind things like lung
cancer because for many, many years,
many, many people, and still now, smoked
nicotine in the form of cigarettes or
vaping, both of which I think are
absolutely terrible, as is dipping and
snuffing,
because yes, they increase levels of
nicotinic acetylcholine receptor
activation, which is just fancy nerd
speak for acetylcholine transmission in
the brain is enhanced by nicotine, but
those delivery mechanisms also, of
course, can give you cancer in the case
of smoking, dipping, or snuffing, and
vaping, despite what you hear out there,
is absolutely terrible for your health.
I don't care what anybody says, the
evidence is starting to really pile up
that vaping is bad for you. Now,
is oral form nicotine bad for you in the
form of gum or in the form of a pouch,
etc.? I just want to say a couple of
things.
One, it's extremely habit-forming.
Two, it increases blood pressure
and it's a vasoconstrictor. These
drawbacks about nicotine are real and
are critical to consider if you're going
to use nicotine as a focusing agent or a
so-called nootropic. I don't really like
that word, but if you're using nicotine
as a way to enhance cognition and
enhance neuroplasticity, you should know
what the potential drawbacks are. Most
notably, the habit-forming and addicting
properties, which are very robust. Now,
with that said, there are ways to
non-pharmacologically stimulate the
nucleus basalis acetylcholine pathway to
enhance the window for plasticity. And
the way to do that is, you guessed it,
through the vagus nerve. Studies in
healthy humans and humans who have had,
for instance, stroke, as well as animal
studies have shown that if you stimulate
the vagus nerve electrically, you
increase the level of alertness in the
brain, and part of the mechanism by
which you do that is the one I told you
about a few minutes ago,
the adrenals, vagus, locus ceruleus, but
also there's a separate pathway from the
NTS to nucleus basalis that stimulates
the release of acetylcholine from
nucleus basalis and opens up the
opportunity for neuroplasticity.
This, I should mention, is not a small
effect. It is a rapid effect, and it's
one that has allowed stroke patients,
for instance, to improve their motor
capabilities very quickly as compared to
when the vagus nerve is not stimulated
or when acetylcholine transmission is
not enhanced pharmacologically. And
fortunately now, there are studies
starting to accumulate in animal models
and some in humans.
We need more, but there are some showing
that if you enhance alertness by way of
activating the vagus nerve through the
mechanism that I told you before, which
is good old-fashioned high-intensity
exercise, that in the several hours
following that exercise, there is an
enhanced opportunity for
neuroplasticity. Now, that enhanced
opportunity for neuroplasticity comes by
way of two different pathways. You
already heard about the first one, which
is the locus coeruleus release of
norepinephrine. That's going to increase
alertness, which is a prerequisite for
focus,
and it appears to be the case that the
release of acetylcholine from nucleus
basalis, that's also triggered by this
high-intensity exercise, is what allows
for that alertness to be converted into
focus, and those two things together,
alertness and focus, are the triggers
for adult neuroplasticity. If you think
about this, this is really exciting. For
25 years or more, we've known that
plasticity is possible in the adult
human. We knew you needed alertness and
you needed focus. We also, by the way,
know that you need to get great sleep
that night and in subsequent nights in
order to actually allow the plasticity
to occur. Plasticity is a process. It's
not just triggered when you go about
trying to learn something. It actually
takes place in sleep, as well as
sleep-like states like non-sleep deep
rest and meditation, but especially in
deep sleep and rapid eye movement sleep.
This is why you can attempt to learn
something cognitively or behaviorally
over and over and over. You can't get
those scales on the piano right. You
can't get the, you know, the information
dialed in from your class, a language
class, or from engineering, or you're
trying to figure out what this picture
should be in your mind that you're going
to paint, etc.
You work at it. You work at it. You work
at it. You sleep. You sleep. And then
one day you wake up and suddenly you
have the skill. It's because the actual
rewiring of those circuits that we call
neuroplasticity occurs during sleep, but
it's triggered in those moments of
incremental learning and really
struggling. And keep in mind the
struggle to learn something, that
friction is part of the neuroplasticity
process. And it's oh so clear now that
alertness and focus are the
prerequisites for plasticity, that
alertness is coming in large part by way
of the release of norepinephrine from
locus coeruleus, that the focus is being
augmented and perhaps it's even
originating entirely from the release of
acetylcholine in nucleus basalis that
acts as sort of a spotlight on a
particular set of things that are
happening while we're trying to learn.
And then that triggers the plasticity
process which takes place during sleep.
So, that beautiful picture of
self-directed adaptive plasticity in
adulthood
is
allowed to happen because
the vagus nerve, in part, is triggering
NTS to say, "Hey, locus coeruleus,
nucleus basalis, wake up, release
norepinephrine, release acetylcholine.
Now's the time to learn." So, what this
means is if you're struggling to learn,
if you want to continue to have robust
neuroplasticity, if you happen to have
some damage to motor pathways or you're
having trouble with focusing and brain
fog, keep in mind focus itself
is served by a circuit that is subject
to plasticity. You can actually get
better at focusing by working on focus
just the same way you would on any
skill.
And so, if you're struggling with focus,
I highly recommend finding a threshold
of exercise that stimulates brain
alertness,
that triggers these pathways that are
now starting to be clear
that they occur from the literature in
animals and humans.
And yes, you might augment this with
something like caffeine which will
further increase levels of
norepinephrine. You might even use
low-dose nicotine. I'm not necessarily
recommending that, certainly not for
young people, and you do need to be
aware of the habit-forming, aka
addictive, properties of nicotine. You
definitely don't want to consume it in
any form that's going to cause you to
increase your risk of cancer or popcorn
lung from vaping.
You could use pharmacology. You could
use alpha-GPC. You could use huperzine
in combination with exercise. However, I
strongly strongly recommend that anyone
who's interested in lifelong learning
think about organizing your bouts of
learning, especially cognitive learning,
to come in the 2 to 3 hours, maybe even
4 hours, but certainly in the 1 to 2
hours after you do some sort of exercise
that doesn't leave you exhausted, but
leaves you with elevated levels
of energy in your body. So, you don't
want to take this physical exercise that
I'm talking about to exhaustion, because
that's going to leave you depleted.
That's going to cause a, you know,
uptick in parasympathetic activity. Any
of you that have done a hard leg
workout, and then, you know, 2 3 hours
later, you're just like it's very clear,
brain oxygen levels are down,
parasympathetic activity is up. You are
tired because you exhausted all that
energy in exercise. But, if you can use
exercise as a trigger to release
adrenaline and stimulate these pathways
within the brain that arrive via the
signaling from the vagus, you do indeed
open up the opportunity for enhanced
neuroplasticity at any age. And that is
a non-trivial thing. In fact, it's
downright exciting because the search
for adult neuroplasticity tools is one
that's existed probably for thousands of
years and that has been documented for
hundreds of years. And the thing that
makes the nervous system of humans so
special is that it is capable of
changing itself throughout the lifespan.
So, now you know at least one method by
which you can do that, and it of course
involves the vagus.
Okay, so one of the most incredible
things about the vagus nerve that I
myself have really not ever heard talked
about out there
is the way it communicates and
coordinates levels of serotonin in the
gut with levels of serotonin in the
brain. Now, a discussion about serotonin
that's complete would take many many
hours. But, suffice to say that
serotonin is a neuromodulator, much like
dopamine or acetylcholine or
norepinephrine, in that it modulates the
activity of other circuits. It's
critically important for mood. In the
gut, it's critically important for gut
motility, for ease of digestion, and for
gut health. In the brain, we say
serotonin is important for mood. I don't
want to give the impression that high
levels of serotonin good, low levels of
serotonin bad.
Serotonin needs to be at a particular
level, so neither too high nor too low.
As many of you know, one of the major
ways that depression has been treated
over the last decades is through the
administration of something called SSRI,
selective serotonin reuptake inhibitors,
which have the net effect of increasing
levels of serotonin at synapses. SSRIs
are somewhat controversial because in
many people they do alleviate certain
symptoms of depression, but they often
carry side effects because serotonin is
used in multiple circuits throughout the
brain. I don't want to give the
impression that SSRIs are always bad or
always good. It's highly dependent on
the patient and a bunch of other things
that really unfortunately can only be
explored through experimentation. That's
typically what psychiatrists will do.
They'll prescribe an SSRI at a given
dose, see how a patient reacts, maybe
they'll take them off an SSRI entirely,
give them a different type of
antidepressant that works on a different
set of neuromodulators like dopamine and
norepinephrine. So Wellbutrin would be a
non-SSRI antidepressant. And there are a
whole set of issues around SSRIs. For
instance,
they can be very beneficial for people
with full clinical OCD,
obsessive-compulsive disorder. And then
again, other people
suffer terrible side effects from SSRIs.
So, I don't want to suggest that SSRIs
are a solution. I also don't want to
suggest that serotonin is the only
problem with depression or is always a
problem in cases of depression. That
itself is heavily debated. What's
emerging from the data is that elevating
levels of serotonin in the brain can
increase neuroplasticity, which can
allow people who have major depression
to learn new contingencies. You know,
these are people who
at one point are thinking, you know, why
would I ever try and get a new
relationship or job? Like, everything
always turns out terribly. These are
hallmarks of depression, you know, um
lack of excitement about the future. Uh
everything's a negative outcome in their
mind.
Through neuroplasticity, it's clear that
people can form new contingencies. They
can start to imagine life as more
positive and holding more possibility.
And changing levels of serotonin is
known to be, much in the same way
acetylcholine can increase plasticity,
permissive for neuroplasticity. So, that
might be one way by which SSRIs actually
can provide help for certain people for
depression. However, because of the side
effects associated with SSRIs, many
people are leaning away from them. And
yet, having adequate levels of serotonin
is absolutely critical for people
depressed, as well as people who are not
depressed, to feel a sense of
well-being. Just overall sense of
well-being. Being okay with who they are
and where life is at. Being able to lean
into effort and all these things. It's
absolutely critical that we have
adequate levels of serotonin in the
brain. Now, you may have heard, and it
is absolutely true, that 90% of the
serotonin manufactured in your body is
in the gut.
Now, what you don't often hear is that
serotonin stays in the gut. Right? We
hear these days, oh, you know, most of
your serotonin is manufactured in your
gut, which has given millions of people
the false impression that if you get
your gut serotonin right,
somehow it's traveling up to your brain
and performing all the important roles
that serotonin plays in your brain.
That's not how it works at all.
Fortunately, however, there are ways
that you can modify the levels of
serotonin in your gut. And indeed, the
levels of serotonin in your gut
powerfully impact the levels of
serotonin in your brain. And this
occurs, you guessed it, by way of the
vagus. It's a super cool mechanism, and
it's one that you can exert some
positive control over
in in to, for instance, increase your
baseline levels of mood, in order to
increase levels of serotonin if that's
something that you seek. Here's the
pathway and the mechanism, and I'm going
to provide this in kind of top contour
form. In the future, I'll do an entire
episode about serotonin, but here's the
idea.
In your gut, you have cells, including
neurons, but you also have a lot of
other cells, mostly other cells,
frankly. And there's a particular
category of cells called the
enterochromaffin cells. You don't need
to know that name, but if you want,
they're the enterochromaffin cells, and
they manufacture serotonin. They do that
through a beautiful pathway involving an
enzymatic reaction that converts
tryptophan from the food you eat,
tryptophan's an amino acid, gets
converted eventually into serotonin.
There are a bunch of steps in there in
the biochemistry. Gets converted into
serotonin. That serotonin binds to the
ends of neurons, the axons of neurons in
the vagus nerve that innervate your gut,
not just your stomach, but your large
intestine and your small intestine.
Remember, those sensory afferents, those
sensory axons
that extend into the body have receptors
on them, right?
The serotonin in the gut, assuming
you're getting enough tryptophan,
and assuming the milieu of your gut is
correct, we'll talk about what that
means and how you can exert control over
it, get the milieu right,
that serotonin binds to the ends of
those axons in the gut
and stimulates a particular category of
them
that then relays the signal up and
through nodos ganglione, you know,
you're familiar with these names, up
into the brain
to the nucleus tractus solitarius, okay,
that NTS again,
and then the nucleus tractus solitarius
doesn't just communicate with locus
coeruleus and with nucleus basalis, it
also sends a powerful signal to what's
called the dorsal raphe nucleus. The
dorsal raphe nucleus in your brain
is responsible for the release of the
majority of the serotonin in your brain.
So, when you hear that most of the
serotonin in your body is made in your
gut,
that's true. And it stays in your gut.
But, the levels of serotonin are
communicated to the brain by the vagus
and then stimulates the release of
serotonin from the dorsal raphe nucleus.
So, the question therefore becomes,
if we want to increase levels of
serotonin in the brain, or simply to
maintain healthy levels of serotonin in
the brain for somebody who's not
depressed or maybe somebody who's having
low mood, just to keep elevated levels
of mood and proper levels of serotonin
overall because it's involved in lots of
things, not just mood,
we need to make sure that we're getting
adequate production of serotonin in the
gut. And again, adequate production of
serotonin in the gut has a bunch of
other positive effects on the immune
system, on gut motility. In fact, having
adequate levels of serotonin in the gut
is powerfully associated with having a
healthy gut and not having irritable
gut. Irritable bowel syndrome is
something that vexes many people. You
know, it might sound kind of funny to
those of you that don't have it, "Oh,
you have an irritable bowel." People
with IBS, irritable bowel syndrome,
often times suffer tremendously. They
can't go out to dinner, they can't eat
foods that other people
offer them. They'll eat a bunch of foods
for a while and feel fine, then they
feel terrible. It's not just about
having diarrhea. Often, they have a
bunch of other gut issues and it's
correlated with a bunch of other major
problems
over time.
We're going to do an entire episode
about gut health as it relates to IBS.
There are things that you can do to
improve IBS. One of them is to keep your
or
get your gut levels of serotonin right.
How do you do that? Well, one way to do
that is to make sure that the microbiota
of your gut are healthy and that they
are diverse. The best way to do that,
not using any kind of supplementation,
is to make sure that you're ingesting
one to four servings of low-sugar
fermented foods per day. I've talked
about this before on the podcast. This
is based on beautiful data from my
colleague Justin Sonnenburg
and Christopher Gardner at Stanford
showed that the ingestion of one to four
servings of low sugar fermented foods
per day, so these would be things like
kimchi, sauerkraut, again low sugar,
look at the labels. This is the stuff
that would need to be refrigerated. Not
talking about pickles kept on the
non-refrigerated shelf in the
non-refrigerated section of the grocery
store, but rather the brine in the
pickles that don't have a ton of sugar,
so the sour pickles that is that are
kept in the refrigerator, things like
kimchi,
things like kombucha. Keep in mind some
kombucha has alcohol, so keep that in
mind if you're giving this to kids
who shouldn't be ingesting alcohol.
Many adults probably shouldn't be
ingesting alcohol. Kombucha has very
little alcohol, but if you're an
alcoholic and you're completely avoiding
alcohol, you should know that kombucha
contains some alcohol.
Things like kefir,
quality yogurts, low sugar yogurts. You
can look up online what are different
low sugar fermented foods. These things
are going to improve the gut microbiota
that in turn promote the production of
serotonin if and only if, this is
important, if and only if there's also
sufficient levels of tryptophan in your
dietary intake. So you're going to want
to take a look at what you're eating and
just through a simple online search you
can figure out whether or not you're
getting sufficient levels of tryptophan.
Many people are familiar with the idea,
because it's true, that turkey contains
high levels of tryptophan. This is
thought to be responsible for the post
Thanksgiving dinner effect, although
that's probably due to just eating a lot
of food. When the gut is distended,
that distension of the gut is
communicated by mechanosensors
up the vagus nerve sensory neurons and
set in motion the so-called rest and
digest or I guess it would be like
collapse and pass out in the case of
Thanksgiving, collapse and pass out
um
effect of having a lot of food in your
gut. Doesn't matter what the food is,
but you're going to want to make sure
that you're ingesting foods with
sufficient levels of tryptophan. So
dairy products will do that, white
turkey meat will do that. There are
other foods that have tryptophan in
them. I'm not going to bother to list
those off now. You can simply look those
up. So, make sure you're getting enough
tryptophan in your diet. Make sure that
you're getting enough low sugar
fermented foods or if you're not doing
that, and perhaps even if you are, you
might think about supplementing your
diet with probiotic on occasion. Right?
I'm not talking about constantly taking
high doses of probiotics. I actually
don't recommend that. But, for many
people who are suffering low mood,
supplementing with a quality probiotic
can actually improve mood. And the
purported mechanism by which that
happens is the increase in serotonin
that is allowed by improving the gut
microbiota and including foods with
enough tryptophan, which is the
precursor to serotonin. So, what I've
done here is I've created the real
conceptual link,
the anatomical link, and the chemical
link between the production of serotonin
in the gut and serotonin in the brain.
And I wouldn't be talking about this if
there wasn't actually data on this. I'll
include links to a few papers about the
uh and here I'm quoting the title of a
great paper, the interaction of the
vagus nerve and serotonin in the
gut-brain axis.
There's also been at least one clinical
trial study exploring how taking
probiotics, and in this case it was
actually probiotics plus magnesium. It
was magnesium orotate, which which is
just one form of magnesium, as well as
uh
I would say a lowish dose of coenzyme
Q10. Combining those three things in
this paper entitled probiotics and
magnesium orotate, it should have said
probiotics and magnesium orotate and
coenzyme Q10. But, the title is
probiotics and magnesium orotate for the
treatment of major depressive disorder,
a randomized double-blind control trial.
Now, I want to emphasize that the
results of this paper show that in the
short term,
there's an improvement in symptoms of
major depression. That is, symptoms of
major depression were reduced through
the administration of this combination
of
probiotics, magnesium orotate, and
coenzyme Q10.
However, it was a short-lived effect.
Now, it was also a short-lived
treatment, but it was a short-lived
effect that showed up
in the essentially starting about the
4-week mark, and then carried out at 10
and 15 weeks, the effect disappeared.
Now, this is important because what it
suggests is that in the short term, if
you're seeking to improve your mood, or
if you're suffering from major
depression, please seek help for major
depression. This, of course, wouldn't be
the only approach. You don't want to
you know, start being your own
psychiatrist. You know, this treatment
very well could be combined with things
and should be combined probably with
things like exercise, maybe with
pharmacologic treatment, with
antidepressant drugs. It really depends
on the situation. But if you are
somebody who's suffering from major
depression or just mild depression, or
if you're just seeking to maintain
healthy serotonin levels, or improve
your mood slightly,
the consumption of things that are going
to improve your gut microbiome
absolutely is going to support that
process. This has been shown over and
over again because the gut microbiota
create these short-chain fatty acids
that are critically involved in this
biochemical pathway that converts
tryptophan into serotonin.
I'm going to repeat that because it's
very important. The microbiota of the
gut, if they're diverse and you have
enough of them, are going to produce the
short-chain fatty acids that are
critically required for the conversion
of tryptophan, which again is going to
come from your diet, into the serotonin
of your gut, which in turn is going to
be relayed
and it's not the actual serotonin that's
relayed, but the presence of serotonin
at sufficient levels in the gut is
communicated by the vagus nerve up to
the dorsal raphe nucleus. Remember,
there's some stations in between, but
it's communicated up to the dorsal
raphe, and your dorsal raphe then
releases serotonin in the brain. Again,
a beautiful coordination of the body and
the brain. Just as activity levels in
the body and the brain are matched
through the vagus, or from the brain to
the body, depending on the direction of
flow, right? Alertness in the brain,
body becomes alert. Alertness in the
body, brain becomes alert. Serotonin
elevated in the gut,
serotonin elevated in the brain. All of
that happens by way of vagal signaling.
Okay, so the vagus is involved in lots
of lots of things. It's not just for
calming down, it's also for slowing the
heart rate. Which is related to calming
down, but it's critically required for
this thing that we're calling auto
regulation, for increasing HRV.
It's also involved in increasing levels
of alertness.
And you can do that through exercise.
It's also involved in increasing levels
of serotonin in the brain, you just
learned about that. But there is, as
you've probably heard before, also a
role for the vagus nerve in calming
down.
Now, the reason I saved this portion for
last is because there's just so much
information out there about how vagal
activation calms us down.
And I felt it was important that I also
focus on some of the ways that vagus
does other things quite robustly,
including also enhancing learning and
plasticity.
But I would be remiss if I didn't offer
some of the science-backed tools for
calming yourself down by engaging the
vagus. And when I say engaging the
vagus, I mean engaging very specific
pathways within the vagus circuitry. You
now, of course, can appreciate that the
vagus nerve is a super highway,
bidirectional super highway of sensory
and motor connections. Has a ton of
specificity. It's signaling mechanical
and chemical information, it's
controlling the body, and yet there are
specific pathways that will indeed calm
you down if you activate them. These are
the ones that you typically hear about
at the end of yoga classes, that you
hear about often online, and I don't
want to be disparaging of any of that.
In fact, I love love love the book
polyvagal theory by Stephen Porges. I
think it's a beautiful description of
our understanding about the vagus nerve
circa, I don't know, maybe 10, 15 years
ago, which is not disparaging at all. I
think he did an incredible job of
talking about the dorsal motor nucleus
of the vagus, which I'll talk about in a
few moments,
as a pathway for regulation of bodily
state, for calming down, about the role
of parent-child relationships in
infancy, and how the vagus nerve
pathways are present and can be
activated early in life without any
learning or plasticity, and how that's
so critically important to the bond
that's formed between caretaker and
infant. And there's just a beautiful set
of studies and a beautiful set of
clinical data that he describes in that
book, polyvagal theory, as it relates to
things like PTSD, et cetera. So, hats
off, kudos, and much respect and
gratitude to Stephen Porges for writing
polyvagal theory.
Most of what I've talked about up until
now
are things that are either touched on
just briefly or that are not included in
his book on polyvagal theory, mostly
because they relate to data that have
been accumulated in the last 10 or 15
years.
And so, there was no way it could be in
that book. The ways to calm down using
activation of specific vagal pathways
do indeed
start to mimic some of the things that
we hear about in or at the end of yoga
classes, or that we think of in terms of
kind of new agey
types of things. Now, this is coming
from somebody who earlier was talking
about breath work, right? I was talking
about cyclic sighing or cyclic
physiological sighing. You know, in
science we tend to call it respiration
physiology.
Uh we call it cyclic sighing. In
yogic traditions or in breath work
classes, they might call it something
else. For those of you that are familiar
with me, you know that I appreciate all
the lenses into ways to be healthier
mentally, physically, and into
ways to improve our performance. I just
happen to take the biological, typically
the neurobiological, and physiological
perspective on these things because I
like to think, in fact, I know that
understanding mechanism gives us more
agency over these protocols and
practices.
So, what I'm going to describe next is
my view of the specific practices that
yes, absolutely exist in other
territories related to yogic practices,
etc.
that have been
purported to increase levels of
parasympathetic activation by engaging
the vagus. The reason I selected the
things I'm about to tell you is because
I ran them by two colleagues, one who is
a neurologist and psychiatrist
practicing.
The other who is a neurosurgeon
and is very familiar with the vagus.
And what I did is I said, "Listen,
there's all this stuff out there.
You can hear all sorts of interesting
things on YouTube and elsewhere about
ways to calm down by engaging the vagus.
Which of these
and I basically described five. Which of
these typical five practices do you
think actually triggers
activation of the specific nerve fibers
that would trigger a parasympathetic
response?"
And what was interesting is that both of
them said, "Actually, there are three of
them that absolutely trigger activation
of the parasympathetic response, and we
know because we've recorded from those
neural pathways. And so, it's obvious
that they work." So, those are the three
that I'm going to describe.
I want to remind you that if you want to
calm down fast, the physiological sigh
is still going to be your best tool. If
you want to improve HRV, you want to get
better auto regulation, and you want
your HRV to improve in sleep as well,
the deliberate exhales from time to time
spread throughout the day still going to
be great. Still do your high-intensity
interval training and other ways to
increase HRV, but if you want to use the
vagal pathways to calm down, here are
the three best ways that are supported
by the neurophysiology in humans
that I'm going to tell you about. The
first capitalizes on the fact that a
major branch of the vagus
that extends out of the brainstem and
that includes a lot of those sensory
afferents, those axons,
coursing up from the body to the brain
stem,
runs along a portion of the neck that's
deep to the muscle that's going to stick
out if you turn your head to one side.
Now, I'm specifically avoiding the
muscle and vasculature nomenclature
right now because we've already had so
many terms this episode and it's really
not necessary to understand how to use
these practices, but were you to say lie
down or even just sit at a a table
surface like I am now. For those of you
that are listening, I'm just seated in
front of my desk. I'm putting my hands
palms down,
my elbows at the edge of the table,
and what I'm going to do next is I'm
going to push my elbows down and away
from my ears.
Then I'm going to turn my head up and to
the right.
I'm going to talk while I'm doing it,
but you wouldn't want to.
And when one does that, you feel a kind
of stretch both on the outside of the
neck, so that's on the left-hand side,
as well as in particular on the
right-hand side.
Okay?
And it's important to keep your elbows
pushing down and you're looking up into
the right. And then you do it to the
other side, you go up into the left.
Yes, this is looking a lot like yoga,
but this is not yoga. This is
a way of mechanically activating some of
the fibers that course along the
vasculature and the musculature the side
of the neck
that is a major pathway of the vagus.
Now, I had to ask my neurosurgeon and
neurophysiology friends,
"Does this actually activate the vagus
nerve?"
And they said, "Yes, to some degree.
It's mechanically going to activate some
of those
fibers, some of those axons. Is it going
to activate the calming pathways of your
vagus nerve as much as say electrical
stimulation of your vagus nerve? No,
it's not. Electrical stimulation of the
vagus nerve is used for major
depression. It's also used using
different patterns of stimulation
frequency to calm people down. It can be
used for a number of different things
depending on the way the stimulation is
done
and where it's done along the vagus
nerve pathways.
However,
this
basically mechanical activation of this
vagus nerve pathway, it doesn't just
feel good because you're stretching your
neck out. It does indeed activate some
of the sensory and probably some of the
motor fibers as well that course through
the vagus nerve. And keep in mind, this
is interesting, that the majority of the
parasympathetic effect of mechanically
activating those vagal nerve fibers is
going to be on the right-hand side. I
know this is starting to sound a little
bit like yoga classes where they say,
"Hey, you know, breathing through your
left nostril or your right nostril is
going to reflect sympathetic or
parasympathetic activation."
Guess what? When we had Noam Sobel, one
of the world's foremost experts on
olfaction and basically sniffing and
breathing and its effects on the brain
on the podcast, he indeed told us that
the switching back and forth between
right and left nostril dominance is
indeed governed by changes in that
seesaw of the autonomic nervous system.
It switches over, I believe, once about
every 90 minutes. Incredible, right?
Obviously impacted if you have a
deviated septum, etc. So, this stuff
that comes from yogic tradition, while
it might not be mechanistically accurate
and it sometimes includes other things
that are unrelated to the mechanism,
oftentimes it's pretty spot-on. So, if
you want to calm down and you want to do
that by activating your vagus, you
already know a bunch of ways that you
can do that. We talked about it.
The ear thing, the exhale thing, etc.
Physiological sighs.
But, this simple process of looking up
and to the
right
and then up into the left. And the
reason for doing it both sides is you'll
feel a stretch on one side then a
contraction on the the other. Doing that
a few times back and forth, indeed, can
lead to a calmer state following.
How robust that is
is going to depend on a lot of factors.
Frankly, I don't think it's as robust as
the physiological sigh or
exhale-emphasized breathing. I don't
think it's as fast, but nonetheless, it
is supported by the anatomy, it's
supported by the function, and a lot of
people simply like to stretch. So,
I'd be remiss if I didn't include that.
The other way that you can calm down by
way of incorporating vagus nerve
activation, and you can do that
non-invasively, is the following. All
right, this one, again,
verified with people who are expert in
these specific pathways in humans. And
I know it might not sound
neuroscientific, but believe it or not,
this stuff that you hear, no pun
intended, about humming
and activation of the vagus nerve and
calming down by way of humming because
of the way it impacts the vagus nerve,
turns out to be true. However, and get
this, you actually have to hum
correctly. Now, you might think humming
is just
That's not what we're talking about
here.
What we're talking about here is, again,
mechanically, through vibration,
activating the branches of the vagus
that innervate the larynx. And now, keep
in mind, some of the neurons in nucleus
ambiguus that carry neurons that are
officially members of the vagus nerve,
they travel with neurons that are not
officially members of the vagus, but
they travel together from nucleus
ambiguus to a lot of the speech
machinery
in your throat and in your mouth and
with your tongue and your lips, okay?
That's a discussion for an entirely
different podcast. But it turns out, if
you view the hum through the perspective
of that it's an H and an M, right? Hmm,
right?
That if you want to activate this vagal
pathway to calm down, the way to hum
correctly, I know this sounds wild, but
the way to hum correctly is actually to
extend the H part, not the M. I talked
to somebody who's expert in speech
neurophysiology, and it's because the H
part, the
is different than the
part. The is slightly higher frequency,
and actually, if you notice, if you do a
extended H hum and then an M hum after,
you'll notice that it shifts from the
back and deeper parts of your throat,
which is where the vagal activation
comes from, to sort of further up along
your speech pathway toward your mouth
and your lips. So, just give that a try
for a second. Maybe you have to do this
in private, because otherwise it'll be
too embarrassing, but you
is incredibly calming. I did this
earlier, and I was really positively
surprised how how well it worked. It's
basically this.
You're trying to get the vibration to
move from the back of your throat down
your neck into your chest and even into
your belly and diaphragm. So, it goes
like this.
If you want to know what it's like from
a sensation perspective, think about
gargling. I know this is getting crazier
and crazier toward the end of this
podcast, but indeed, if you look online,
gargling has been proposed as a way to
activate the calming aspects, so-called
parasympathetic aspects of the vagus
nerve. And indeed, when you gargle,
you're using the back of your throat.
That's the sensation. It's this
vibration at the back of your throat.
So, when you hum, emphasizing the H part
of the hmm and leaving off the M part,
it's
and you can actually move the vibration
down into your chest. I find it's easier
if I'm lying down. And when you do that,
it's
quite remarkable how fast you calm down.
But, give this a try. I know it might
seem a little silly, but if you want to
try and really deep relax,
this extended humming that you're trying
to move down further and further from,
say, your lips to the back of your
throat to deeper in your throat near
your Adam's apple to your chest region
even into your
abdomen and your diaphragm
you notice that it really really calms
you down. This is also it turns out cuz
I talked to somebody who is a singer.
This is the way that singers often will
start to relax in order to get into some
of the deeper frequency notes that they
need to hit with their voice. As you've
probably observed high notes sort of
bring people up into their head and even
if they're using their diaphragm higher
and higher and higher whereas lower
frequency sounds deeper and deeper and
it's just mechanical activation of the
particular branches of the vagus that
are able to drive this parasympathetic
response. And if you notice the hum is
like all speech
an exhale. It's a long slow exhale. So
this is the third part. There's also a
collateral activation which is just
neuroscience speak for activation of
that deceleration pathway. When you do
this humming at the back of your throat
and down into your chest and into your
belly you're also getting the same
effect that you get with an exhale which
is to slow the heart rate way way
down.
So it turns out the stuff they say at
retreats in yoga classes
is mechanistically supported. At least
some of it is and some of it perhaps
isn't and that doesn't really matter
right now. What we're talking about is
the incredible pathway the incredible
neural circuit that is the vagus nerve.
In fact calling it the vagus nerve you
now realize as I talked about the
beginning of the episode is really not
sufficient to encapsulate the incredible
variety of different pathways the
sensory stuff up from the body the motor
stuff down from the brain the way you
can calm down the way you can
alert yourself the relationship and
pairing of serotonin levels in the gut
through the microbiome and what you eat
and the tryptophan with serotonin levels
in the brain and mood
and neuroplasticity and learning and
to be fair
we didn't even cover everything that the
vagus nerve does. There's this whole
landscape of electrical stimulation of
the vagus nerve, transcranial magnetic
stimulation of the parts of the brain
like the dorsal lateral prefrontal
cortex that allow you to engage more
plasticity and control over auto
regulation.
That stuff all requires devices and a
physician or a laboratory to deliver, so
I focused on the things that you can do
to activate your vagus in the various
ways that's going to serve you best in
terms of mental health, physical health,
and performance. And I like to think
that you also learned a lot about the
vagus nerve biology both structurally
and functionally. I personally find it
to be one of the most incredible aspects
of the nervous system. It exists in all
mammals. It's also in non-mammalian
vertebrates,
but it's definitely in us humans and
it's absolutely active from the time
we're born until the very last breath we
take in hopefully late late age.
And it's just a miraculous pathway.
Nature
created this vagus nerve thing
and you can control it and understanding
the mechanisms by which you can control
it, I do believe, is the best way to go
about it.
So, thank you for joining me on this
mechanistic {slash} practical voyage
through the vagus nerve. I'm enchanted
by the vagus nerve and I like to think
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you once again for joining me for
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and all the incredible things that you
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