With the objective of taking a deeper dive into some of the favorite topics of the recent Anxiety Summit: Gut-Brain Axis, today’s blog is about the vagus nerve since Dr. Navaz Habib’s interview, Vagus Nerve Activation to Reduce Anxiety, was voted one of the favorites. I’m focusing on one tool that improves vagus nerve function that we didn’t have time to get into in great detail – and that is how increased sociability helps. It’s all good and well to recommend getting out and hanging out with more people but if you have the social anxiety condition called pyroluria it’s really challenging, hard work and very stressful. Added stress makes pyroluria worse so it becomes a vicious cycle.
Let’s start with the research that supports the connection between the vagus nerve and increased anxiety and mood problems. In the interview with Dr Navaz, we discussed this paper: Vagus Nerve as Modulator of the Brain–Gut Axis in Psychiatric and Inflammatory Disorders which states that “vagus nerve stimulation is a promising add-on treatment for treatment-refractory depression, posttraumatic stress disorder, and inflammatory bowel disease” and how stimulation of vagal fibers that go from the gut to the brain (afferent fibers) influences neurotransmitter production and “play crucial roles in major psychiatric conditions, such as mood and anxiety disorders.” The gut bacteria play a major role too, “partly by affecting the activity of the vagus nerve.”
In our interview we end with very practical ways to activate your vagus nerve
- Deep breathing exercises (mentioned in the above paper, together with yoga and meditation) and cold showers (which makes you breathe harder)
- Gargling and using the gag reflex
- Humming, chanting and singing (I used these approaches for my vagus nerve issue after my terrifying plane ride. GABA also helped with the voice/throat spasms I experienced – more here on that)
- Auricular acupuncture (which is also very effective for addictions)
- And finally, social interaction or increased sociability, which I want to cover today
The research on the vagus nerve and being more social
Let’s look at the research on the vagus nerve or vagal tone and being more social. This paper, Upward spirals of the heart: autonomic flexibility, as indexed by vagal tone, reciprocally and prospectively predicts positive emotions and social connectedness, reports that that vagal tone and connectedness or being more social is a two-way street i.e. it’s reciprocal
- “…increases in connectedness and positive emotions predicted increases in vagal tone” and
- “Adults who possessed higher initial levels of vagal tone increased in connectedness and positive emotions more rapidly than others”
In summary, the more social and happy you are, the healthier your vagus nerve is and a healthier vagus nerve leads to feeling more connected and happy.
This study was done with adults in a community-dwelling setting over 9 weeks: “adults were asked to monitor and report their positive emotions and the degree to which they felt socially connected each day.”
Address pyroluria in those who have social anxiety
Pyroluria, the social anxiety condition, was not part of the study because it’s under-recognized as a factor in anxiety. I’d like to propose that we address pyroluria in those who have social anxiety in order to further improve social connectedness and their vagus nerve function.
Many folks with pyroluria put on a brave face in social settings and even “extrovert” which is extremely stressful. The added stress makes pyroluria worse (zinc and vitamin B6 are dumped in much higher amounts) so it becomes a vicious cycle.
Others, who are not willing to even show up because of their severe social anxiety, are not getting that social interaction and connectedness that is so crucial for improved vagus nerve function and better overall health.
Here is the pyroluria questionnaire and the pyroluria/introvert connection.
Connecting the dots further we have
- research that reports that vagus nerve stimulation has potential in autism treatment and we know pyroluria and social issues are common in autism
- one of the key nutrients for pyroluria, zinc, plays a role in vagus nerve function
- another key nutrient in pyroluria is vitamin B6 and it plays a role in reducing inflammation
- according to the vagus nerve study above, the vagus nerve “plays important roles in the relationship between the gut, the brain, and inflammation”
- both zinc and vitamin B6 are needed for neurotransmitter production, so increasing both GABA and serotonin will further improve mood and reduce anxiety
- and finally, the more social and happy you are, the healthier your vagus nerve is and a healthier vagus nerve leads to feeling more connected and happy
By addressing the social anxiety called pyroluria with a foundation of zinc and vitamin B6, we can increase sociability and thereby improve vagus nerve function.
UPDATE 5/7/2020:
Social isolation during the coronavirus pandemic – other vagus nerve exercises
This blog is very applicable now during the coronavirus pandemic. I’ve made an update because I feel we need to start thinking about the longer-term adverse impacts of social isolation and work on other ways to improve vagus nerve function during isolation or quarantine.
This can include any or all of the ways mentioned above: deep breathing exercises, yoga, meditation, cold showers, gargling/gag reflex, humming/chanting/singing and/or auricular acupuncture.
Do you find you have better vagus nerve function when you are more sociable? What of these vagus nerve exercises have you been doing and found helpful during isolation? Do you have any other favorite approaches like using essential oils or anything else?
Vagus nerve stimulation to treat respiratory symptoms associated with COVID-19
This paper reports benefits in 2 patients with coronavirus – Use of non-invasive vagus nerve stimulation to treat respiratory symptoms associated with COVID-19: A theoretical hypothesis and early clinical experience
- Both patients reported clinically meaningful benefits from nVNS therapy [non-invasive vagus nerve stimulation].
- In Case 1, the patient used nVNS to expedite symptomatic recovery at home after hospital discharge and was able to discontinue use of opioid and cough suppressant medications.
- In Case 2, the patient experienced immediate and consistent relief from symptoms of chest tightness and shortness of breath, as well as an improved ability to clear his lungs.
The authors also share that “vagus nerve stimulation has been demonstrated to block production of cytokines in sepsis and other medical conditions.”
With this virus being novel and with everyone learning we are still appreciative of small case reports like this and hope to see bigger studies done. Until then there is other evidence of the overall importance of the vagus nerve in helping to regulate lung infection and immunity.
The nVNS therapy mentioned in the COVID-19 paper is an external device that delivers “a proprietary signal through the skin to either the right or the left branches of the vagus nerve in the neck.” It’s not something I’ve used personally or had clients use so please share if you’ve had success with this device or a similar device.
Loving social isolation and thriving during coronavirus
On the flip side we also need to consider that there are some individuals who are loving social isolation and thriving emotionally. I share some feedback from folks in my community:
- Elissa: “As an introvert, my mental health has never been better ☺️. Loving isolation life.”
- Drew: “Loving it in many ways. Dreading the hedonism starting up again…”
- Tiffany: “My anxiety levels have decreased and I have decreased my anxiety meds! I think it’s because the demand to produce has decreased. I can actually move at my own speed in this world. I’m fortunate, though. My heart goes out to those people in medical fields. I really miss some things, like time with my dad, but we have made some adjustments, like driveway picnics.”
- Katie: “I was praying for relief from the busyness. Definitely didn’t have this in mind and my heart hurts for those who are impacted. It has been a beautiful time of rest and restoration for my body and soul.”
- Wendy: “My life is usually slow paced and introverted. Now it’s more so and I’m finding the less I do in a day, the better I sleep. I’m actually dreading getting back to “normal” with all the pressures put on us by extroverts. Yes I have sympathy for people suffering mentally by isolation, but for the first time I feel like my type of lifestyle is socially acceptable. I’m tired of life expectations being dictated by the extrovert half of the population.”
I appreciate these folks for sharing their valuable perspectives about thriving in these times. It reinforces how unique we all are.
If you’re struggling with social isolation…
- How are you feeling and what are you most looking forward to doing once social isolation recommendations are relaxed?
- I’m guessing you don’t have pyroluria but please share if you do?
If you are thriving in social isolation…
- Would you consider yourself an introvert /a contented introvert?
- Have you got pyroluria and has addressing it nutritionally in the past allowed you to be more sociable or at least less anxious when you are in crowds?
- How are you feeling during social isolation and what do you love the most right now?
- What are you not looking forward to once social isolation recommendations are relaxed?
- And how do you plan to go back to the old “normal” or don’t you?
Please comment below and let us know where you are with social isolation during this pandemic – struggling or thriving? And what vagus nerve exercises are you using right now? Have you used an external device with success?
Excellent article. The arrow so often points in both directions. Thank you, Trudy.
Dancing, especially partner dancing!
Cathie
Love it!
Thank you Trudy, the links took me where I needed to go. I scored very high on the Pyroluria check list. I believe I had Vagus nerve damage from a car accident in which I had major head trauma and/ or decompression surgery for Arnold Chari Malformation. I didn’t know there was a Vagus nerve until I stumbled on to you. Thank you very much for getting this information out.
Hi Trudy
My 12 years old son suffers from social anxiety. He is extremely smart and gifted and struggling to fit in.
I am giving him sometimes Gaba calm before school and L theanine but doesn’t help a lot.
I was wandering if I could also give him B6 ?
Barbara
I’ve had great results with the complete pyroluria protocol with boys and girls this age – zinc and B6, a copper-free multi and watching high copper in the diet. Many families who are now gluten-free and consuming large amounts of backed goods with nut flours which are high in copper.
Unfortunately my vagus nerve was severed following a perforated duodenal ulcer caused by prescription anti-inflammatories prescribed by a rheumatologist for my ankylosing spondylitis. The surgeon in question was a known alcoholic with questionable judgement.
The AS is just one of a number of inflammatory autoimmune conditions I have, colitis, rheumatoid arthritis, Sjogrens syndrome, and more. Diagnosed as Lupus.
Dietary changes have gone a great way to controlling my disease and I avoid all processed foods, dairy, refined sugars, starches and refined flours. I avoid most beans, corn and GMO foods. I stick to a plant based diet, whole foods and avoid stress. This new info on vagus nerve health discouraging.
Shelley
I am sorry to hear what you went through but it’s wonderful you have found success with dietary changes. You don’t mention anxiety but if social anxiety is an issue I would look into pyroluria.
I’m currently digesting Dr Navazs book after your summit and it’s amazing. I’m loving it.
I scored relatively low on pyroluria test that my NT highlighted early on in my M.E diagnosis. I have been taking Epigenar HPU for the last 18 months and I’ve definately noticed a difference.
I relate with the pyroluria symptoms and I tick every single introvert point. Even though colleagues don’t see me as an introvert.
When I got diagnosed with M.E my cognitive fatigue was the worst symptom, word finding and talking was exhausting and I hibernated for 2 years during recovery. Thankfully my recovery is going really well and I’m able to start back work (very slowly) next month.
Social interactions and networking are a bit of a mental nosebleed for me however it will be interesting to see how this will change now my M.E has improved, pyroluria has been identified and now starting VN exercises. This point has never been discussed in my recovery before your summit.
In addition, yesterday I listened to ‘broken brain’ podcast with Dhru Phuroit with the topic of ‘building meaningful relationships’ and he reinforces this important point of social interactions.
I’m now super excited to get back out into the world after my hibernation ….. thanks again for your amazing work on anxiety/pyroluria and everything else. I love your work
Louise
So glad to hear you’re getting so much of of this information – enjoy getting out into the world!
I keep my vagus nerve strong by following an acupressure protocol I was taught by Kim Dowdell of Vision for Living. I also do Stanley Rosenburg’s exercises and Jim Donovan’s exercises. Fortunately I find social isolation easy as I am not in a town or city. I am using it to reflect and do on-line courses. Very much looking forward to the summit to learn more about the vagus nerve. Thank you for organising it.
I really appreciate your sharing these resources.
Suzanne
Thanks for sharing – I’d love to hear more about the acupressure protocol taught by Kim Dowdell of Vision for Living, Stanley Rosenburg’s exercises and Jim Donovan’s exercises. And how often you do them.
I’m a speaker on the vagus nerve summit and Eva Detko is the host and organizer. I’m also very much looking forward to it!
WOW! I LOVE being able to access not only great General ideas but specific dosing! And the way you assess progress with things like dream recall… This is great material! And yes, if you can post the other speakers talks, that would be wonderful!
Lea
So glad this resonated with you. I’ll post some of the other speaker videos in the coming weeks
I’m wanna try taking some Zinc & B6 cuz of possible Pyroluria. I was hoping to get some advice on this. What brand and how much to take.
Ron
I list the supplements I use here https://www.everywomanover29.com/blog/amino-acids-pyroluria-supplements/ I typically start clients on 30mg zinc and 100mg B6 and we adjust based on zinc challenge test, dream recall and social anxiety/other symptoms on the questionnaire. I also use alk phos as a marker for low zinc.
I also like to use 1300mg evening primrose oil, copper-free multivitamin and sometimes additional magnesium depending on unique needs.
For many folks it’s simple and we see results in a few weeks. For others we have to unwind many issues – I cover trouble-shooting here https://www.everywomanover29.com/blog/pyroluria-protocol-why-arent-i-getting-results-trouble-shooting-checklist/
I also have an entire chapter on pyroluria in my book “The Antianxiety Food Solution” which I have all my clients read too. More here https://www.everywomanover29.com/store/aafsbook.html
Social anxiety hasn’t been challenged during lockdown and I have been able to wean off antidepressants completely. But now I’m dreading “normal life” returning. I live in Ireland, thungs are opening up. Taking GABA, DLPA, Tryptophan, 5htp, B6 & zinc, but still full of dread each day. In my 60s, “hiding” my symptoms since my teens & finding it increasingly harder to socialise, I even fear the phone!
Maggie
Wonderful about the antidepressant. I’m hearing more and more stories like this – doing better in lockdown and getting off meds! I’m encouraging folks to find a new normal that works for them. But also consider that if the dread and fear is still there, work can still be done to find the correct dose of nutrients and biochemical imbalances. This means diet, lifestyle, gut, no caffeine, blood sugar control and more
The Pfeiffer Clinic in Illinois orders tests and treats pyroluria. Why guess if you have it or not? The test is under $100.
Linda
Thanks. Using the pyroluria questionnaire and supplement trials is not guessing. I’m a big fan of testing however the pyroluria testing does often lead to false negatives so I always tell my clients to keep this in mind if they choose to test. If it’s negative and they score high on the questionnaire we do a trial of the supplements anyway.
I’d appreciate you sharing if you have tested yourself? Your results? And how you score on the pyroluria questionnaire?
I don’t mind the social isolation personally, but I worry about the economic implications of having so many people unemployed and so many businesses closed.
Introvert
I hear you about this aspect of unemployment and close businesses.
I’m curious, since you don’t mind the social isolation, do you have pyroluria and has addressing it nutritionally in the past allowed you to be more sociable or at least less anxious when you are in crowds? What do you love the most right now and how do you plan to go back to the old “normal” or don’t you?
I wish I were not so overwhelmed with the sadness of isolation. I’m an extrovert and really get my energy from being near people, it doesn’t need to be interaction with people but that helps. I can feel the energy of people. Does that make sense? I connect with people electronically but it is not helping that much. I meditate daily and have worked with a clinical nutritionist for many years so I feel other things are in control but not this. I wish I had some strategies.
Susan
As Deb mentioned, she’s added back Endorphigen because she noticed bouts of crying. When I hear that and “the sadness of isolation” I immediately think of low endorphins. The amino acid d-phenylalanine (also called Endorphigen) is wonderful for boosting endorphins. More here https://www.everywomanover29.com/blog/dpa-comfort-eatin-weepiness-endorphins/ Here are a few other ways to boost endorphins – self-hug, weighted blanket, hug a tree, exercise, self-massage, giving and acupressure.
I’m an extrovert who needs a lot of reflective time to be my best. This time of social isolation is increasingly more difficult because of the lack of touch. I’ve noticed increased bouts of crying so I just restarted EndorphiGen today and increased the frequency of GABA Calm to 2-3x/day.
Hugh gratitude to you Trudy for all you’ve so generously taught me.
Deb
I’m finding many folks are needing to add back Endorphigen because of lack of touch (both extroverts and introverts) for the endorphin boost. Hope it’s helping! Here are a few other ways to boost endorphins – self-hug, weighted blanket, hug a tree, exercise, self-massage, giving and acupressure.
I have diagnosed pyroluria; my sister has porphyria. I saw this pandemic coming from early reports out of Wuhan and began to prepare. Huge anxiety as I saw its wildfire spread beyond China and people around me seemed not to make the connection that there was little to no chance it wouldn’t be here in short order. Once we closed our doors, two weeks before shelter in place orders were initiated in CA, I began to feel safe and that, except for the Covid suffering out in the world, “I’ve been waiting all my life to be quarantined!” I felt contained, anchored, down-shifted.
Then several among family and friends had terribly serious medical calamities one after another and the rest of us were, of course, unable to lend in person support, which created another round of anxiety that led to a triggering of PTSD (a history of severe trauma), little sleep and panic attacks. Now that those situations have begun to resolve, I’m once again feeling settling.
I miss in-person hanging out with my son, daughter in law, co-grandparents, and our young grandsons. I miss drifting around my local organic market and all the familiar worker faces there. But I this ‘confinement’, the simplicity of being reduced to basics: cooking, cleaning, tending, reading, doing my fiber art and quilting, watching the always lively park across the street where people come to dog walk and exercise and are doing their best to observe social distancing.
This ‘in’ status is so good for pyroluric me…I feel grounded, relieved. I’m just so sorry its causing others so much suffering. Thank you Trudy, for being so knowledgable and helpful to those of us with this condition: for much of my life I was so sick, trying to solve the mystery of terrible tension, hideous neuro sensations, tachycardia, stitch in my side, noise sensitivity, pedal to the metal on the brakes and gas pedal simultaneously…etc, etc: no one had any idea. Once I was diagnosed and zinc and B6 saved my life, literally, conventional medical professionals still pooh-poohed my diagnosis, which led me to find the functional med world. It’s healing to be validated and supported at last.
Ann
Thanks for sharing – so glad you feel validated when discovering pyroluria. I know many here in this community can relate to your feelings now: “contained, anchored, down-shifted” and “grounded, relieved” and at the same time having compassion for the suffering.
Sorry to hear about the serious medical calamities but glad those are now resolved. Good for you for watching and preparing early. I feel that in itself is grounding.
And here’s to some wonderful times with your family soon!
I’m curious – what do you do to support your vagus nerve? And has the pyroluria protocol allowed you to be more sociable in the past or at least less anxious when you were in crowds? How do you plan to go back to the old “normal” or don’t you?
Great article. I always learn something new from you, Trudy. It is remarkable how, with some little changes, whole viewpoint is dramatically changing. Introvert people especially appreciate quiet and lonely places. As a highly sensitive and emphatic person, now I know why always had tendency to isolate myself from crowd. But to long isolation, especially from close people could be contra-productive and even sensitive introverts could struggle with anxiety which comes from pressure of isolation, particularly when it is forbidden to go out for few days. Some things should be shared. And I have to mention that there is a great difference between self-isolation and imposed isolation, when you loose connection not only with other people, but with outer world and nature, what is terrible for all beings.
Vesna
I also see problems with too long, not having a choice and no nature. Hopefully, if we’re fortunate enough, we have access to a garden or plants on a balcony or a walk in the neighborhood or nearby park.
I need help I have sibo think I’m autistic have terrible anxiety. Also have tight sided muscle spasms making my face go into a pulsy which stresses me out even more but no one is helping me get it sorted :.
I’ve had a doctor vagus nerve and autonomic dysfunction ..
Desperate fir help 🙁
Mandy
I would explore low GABA levels with your practitioner – GABA can help with anxiety and muscle spasms.
Apologies for the delay on your comment approval and my response. We had a computer glitch where a large number of comments were hidden from view in a spam folder. It mostly affected new folks who were commenting for the first time but it’s hopefully resolved now.
I came across this study and thought it may help people better understand insomnia and the link to glutamate and GABA.
https://www.hopkinsmedicine.org/news/media/releases/restless_legs_syndrome_insomnia_and_brain_chemistry_a_tangled_mystery_solved
Joan
Thanks for sharing this interesting paper. It’s the first I’ve seen looking at dopamine and RLS
Apologies for the delay on your comment approval and my response. We had a computer glitch where a large number of comments were hidden from view in a spam folder. It mostly affected new folks who were commenting for the first time but it’s hopefully resolved now.
Hi Trudy,.
Great information! I’m likely an introvert who has gratefully learned how to be social. I’ve thrived in the Pandemic, and also have used food as medicine for 40 years. Got rid of major depressions with diet along with a great spiritual path back around age 30 for me. Interesting to find you. May God bless you abundantly!
Heather
Great to hear! I’m curious – how did you learn to be social? And do you have pyroluria?
I’m so glad you added the proviso about introverts…I am most certainly one and social interaction is not where I find my joy or heathfulness, at all, although I tolerate it in bursts as long as my general health is fairly steady at the time. The pandemic only deepened our already introverted lifestyle (my husband and I) and we felt all the happier for the calm that settled over everything where we live…at least for a while. In fact my reading and observations seem to suggest a difference between INFJ and INFP introverts (Myers Briggs scale) and other personality types, for instance, most people entrain together…put them together in a social setting or work place and they pick up each other’s behaviours and mindsets and seem to thrive, entraining to corporate, cultural and societal behaviours with ease…whereas these introvert types (I am INFJ and can concur) do not find ourselves entraining to group behaviours at all but, rather, begin to struggle the more this is the presiding culture. An example given in the book I just read “The INFJ Revolution” by Lauren Sapala gives the example of an INFJ (her) working for a small start-up and thriving on the intimate, creative vibe of a tiny company where you can be your own person but then the company gets bought-out and suddenly expands, becoming more corporate and socially fixated (adopting a teamwork mentality) in the process…the INFJ type does not thrive any longer and can’t wait to get out before they feel suffocated (this happened to me too, in my earlier career).
It seems we introverts are far more likely to get our kicks from being with one person at a time in one-to-one meaningful relationship and as luck would have it I am happily married to an INFP, we compliment each other and dont feel we need, or want, to be part of a crowd (of any size!)…at all. That said, I took on your advice about pyroluria a few months back and added B6 and evening primrose to the zinc I was already taking. I also began using GABAcalm which I now swear by and use every day for a variety of symptoms (I have a lot going on with my health). We recently spent a busy weekend in a city, for the first time since the pandemic, and I was absolutely fine in crowded cafes and streets, none of it bothered me at all for that short spell, and then happily able to get back home to our quiet introverted life once it was over…so perhaps I have become more adaptable, for which I am grateful as it gives me options.
I still choose to spend the rest of my life living quietly with minimal social interaction (a future home in the countryside is calling us…) and I tone my vagus nerve with gentle yoga stretches, Emergy Medicine techniques (similar principles to acupuncture), walking daily in nature and I also notice that when I sing along to my music more when I do my art (I am an artist) it can really help with, well, everything but suspect the vagus toning aspect is a big part of that. I also play a wind instrument from time to time and suspect that helps. My gagging issues, which were worsening at one point, do seem to be better since using GABA daily, now I come to think of it. Nature and hugging give me my endorphine kicks. Attracting a variety of birds to our garden has been a huge factor in this as I get to watch them every day as I work or relax. I think the world is starting to relax its grip on the idea that we all have to be the same or that being in groups or socially engaged is the answer to everything…introverts and solitary folk have always been with us (often providing some of the most creative, innovative and beautiful things and insights) and, from my experience, what feels healthful to us is very different to what makes the other 80 per cent tick. Thanks for all you offer, I have gained a great deal of help and insight from your posts.
Helen
Thanks for sharing all this and so glad to hear the pyroluria protocol has helped you feel better in crowded cafes and streets. I’d love to hear more about how GABA Calm helps you too?
Love the nature, hugging, birds, music, art, yoga and vagus support
Trudy,
I have believed for years I suffer from Pyroluria. Yes to16 questions and I tested borderline a few years ago. My problem is I apparently have trouble absorbing B vitamins, especially B6 and pantothenic acid. Even p5p at more than 50mg creates the opposite effect. It wires me and starts to mess with my sleep which is my biggest challenge when I’m really stressed. I have several friends who share a similar reaction to B vitamins. No one seems to discuss this anywhere. I remain convinced that if I can overcome this mystery it is the key to resolving my Pyroluria. Not sure if this is another clue but aminos generally don’t help me either and valerian similarly wires me. Can you help?
Eliot
Eliot
I’m aware valerian does this to some folks and too much B vitamins can be stimulating. Too much of the amino acids can have the opposite effect too.
Eliot, I have the same issue with B6, even in the P5P form. So despite scoring high on the pyroluria scale, I’ve never been able to take B6 in any more than about 2 mg dose, else I’m wired, tense, and can’t sleep. Same thing with l-theanine. One of these days I want to take the test from TheDNACompany.com to see if there’s something in my genetics that affects the processing of B6, like maybe a COMT gene variation. Good luck in sorting it sort.