Electro-Acupuncture for Vagal Nerve Stimulation
Electro-acupuncture stimulates the vagus nerve and improves vagal tone
How many would you get if I asked you to name the twelve cranial nerves? Some? One? None? All of them (you smart thing!)?
With some prompting, I reckon most people could get one or two, maybe three. One of these would certainly be the infamous vagus nerve (cranial nerve ten). The vagus nerve has gained popularity recently, heralded as the key to solving a host of health problems.
There is some hype in the wellness community around the wonders of the vagus nerve, and a quick search will yield hundreds of influencers encouraging you to breathe a certain way, hum, sing, laugh, dance or icebath your way to improved vagal tone.
Do I think there is a problem with this? Maybe, but not necessarily, and if it makes you feel better and empowered to engage with your health - great!
Do I want to add to the maelstrom of internet information which is in and of itself, kind of stress-inducing? No.
What I would like to do though, is offer accessible, evidence-based information about the vagus nerve, and introduce you to the benefits of using electro-acupuncture to improve vagal tone.
Improved vagal tone can result in better regulation of:
heart rate and blood pressure
muscle movements of the throat for breathing and swallowing
peristalsis of the stomach and intestines (for digestive ease)
secretion of digestive enzymes from the pancreas
insulin secretion and glucose levels in the liver
sympathetic activity to counteract anxiety and stress responses
suppressing chronic inflammation
pain conditions (including chronic pain)
What is the vagus nerve?
Let’s jump into some very basic anatomy & physiology, don’t worry, things won’t get too complicated.
The autonomic nervous system regulates involuntary bodily functions, with two main branches: the sympathetic, responsible for the "fight or flight" arousal response, and the parasympathetic, governing the "rest and digest" relaxed state. The vagus nerve is the main component of the parasympathetic system and plays a vital role in modulating heart rate, digestion, mood, immune response and other internal processes.
The vagus nerve (although we usually refer to it as singular) is a pair of two nerves, emerging from the left and right sides of the brain stem. It is the longest nerve in the body and reaches most vital organs - heart, lungs, spleen, stomach, pancreas, liver, small intestine, large intestine, and kidneys.
It is named for its prolific nature through the body, vagus is Latin for “wandering”.
For all its buzz, the vagus nerve is a relay mechanism (all nerves are really). It provides the brain with information from the internal organs, the brain processes that information, then sends back instructions through the vagus nerve to influence how our organs function.
The vagus nerve is the interface of the gut-brain axis
So, we just learnt that the vagus nerve is the main component of the parasympathetic nervous system, and it carries information from the organs to the brain and vice versa.
Part of this two-way communication between the brain and organ systems includes the gastrointestinal tract; the so-called “gut-brain axis,” which includes the vagus nerve (and other systems).
A lower vagal tone (more on this below) has been found in patients with gastrointestinal disorders like irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) (Bonaz et al. (2018).
Several neurotransmitters implicated in mood are created in the gut, including glutamate, GABA, serotonin, and dopamine (Chen et al., 2021). Dysbiosis of the gut has been linked to several mental illnesses including anxiety and depression (Clapp et al., 2017).
The vagus nerve and gut microbiota (gut-brain-axis) are also implicated in regulating the immune system, inflammation, appetite, and peristalsis or gastric motility (the movement of the stool through the system - think constipation / loose stools).
If gut issues and dysbiosis are coming from dysregulation in the nervous system, then I’m afraid probiotics alone won’t help.
What is vagal tone?
Vagal tone manifests as our capacity to regulate stress. It refers to the activity level of the vagus nerve, influencing the balance between the sympathetic and parasympathetic branches of the autonomic nervous system. Higher vagal tone is associated with better regulation of bodily functions, including heart rate, digestion, and stress response.
As you might imagine, high (and prolonged) stress causes a loss of vagal tone.
Why does vagal tone matter?
It is not just about balancing the two branches of the nervous system. This is an oversimplification. And it is not about thinking of the sympathetic nervous system as the bad guy - it is not.
It is about bolstering the capacity for responsiveness. So that in any given moment, the nervous system can respond appropriately to a situation with either a stress (sympathetic) response or a rest (parasympathetic) response.
Improving vagal tone is about ensuring that the nervous system can respond appropriately from moment to moment. So that once a stressful event has passed, you can quickly switch back to a calm, restful, peaceful state. Things go awry with our health when we are ‘stuck’ in a sympathetic state for too long.
A loss of vagal tone (meaning a preponderance of sympathetic arousal) can result in:
• elevated heart rate
• increased BP
• diminished swallowing and gag reflex
• slowed peristalsis of the stomach and intestines (constipation)
• loss of pancreatic secretion of digestive enzymes (food sensitivities, difficulty digesting)
• decreased insulin and glucose regulation (poor blood sugar regulation)
• increased sympathetic activity fueling anxiety
• increased inflammation (via something called the “cholinergic anti-inflammatory pathway”)
So how does electro-acupuncture stimulate the vagus nerve?
There are already numerous conventional approaches to vagal stimulation. In Australia, the TGA has approved the use of vagal nerve stimulators in some cases of depression, epilepsy and migraines. These devices are often surgically implanted. They can also be transcutaneous (over the skin) or percutaneous (through the skin).
Acupuncture falls into the category of a percutaneous approach, as the acupuncture pins (needles) are inserted through the superficial layers of the skin.
What are the benefits of using electro-acupuncture to improve vagal tone?
Using electro-acupuncture via the ear for vagal nerve stimulation has been shown to help regulate the following conditions (Butt et al 2020):
stress
anxiety
depression
high blood pressure
gut dysfunction
migraines
pain
opiate withdrawal
What is the benefit of modulating vagal tone with electro-acupuncture, over using pharmaceuticals which force the nervous system to act in a certain way all the time?
Modulating vagal tone allows for a more nuanced and adaptive regulation of the autonomic nervous system, promoting overall physiological balance and resilience. Unlike pharmaceuticals that enforce a constant state (often associated with side effects), vagal nerve stimulation to increase vagal tone supports the body's natural ability to adjust its responses to stimuli.
Remember, we do not want a constant state of parasympathetic activation, just like we want to move away from sympathetic dominance. We want responsiveness — an appropriate response to the unfolding of life, moment to moment.
That said, there is absolutely a place for conventional interventions like medication, and I always work collaboratively with your primary care team and respect your healthcare needs and choices.
Acupuncture can greatly support your health in partnership with conventional medicine.
What does vagal nerve stimulation with acupuncture treatment look like?
To begin, we do a comprehensive intake assessment together - this includes a questionnaire to complete before your appointment, and a bunch of questions to help me ascertain your Chinese medicine patterns, and test whether vagal stimulation might be beneficial.
Once we are clear on the treatment plan, to stimulate the vagus nerve, two small acupuncture pins are inserted into the ear, and/or into the lower leg, and a small comfortable electrofrequency is applied. Other acupuncture points are also used elsewhere on the body to support the treatment and your specific symptoms. You rest like this for 25-30 minutes and the points are removed. You should feel quite well during and immediately after the treatment, with people usually reporting a sense of calm and ease, and immediate changes to pain levels.
You will require a series of treatments over some time to address your needs, and this treatment plan will be shared with you during your initial appointment.
Can it help everyone?
In short, likely not. Firstly, improving vagal tone will only affect your symptoms if lower vagal tone is contributing to the problems. There are ways to test this to some extent in the acupuncture clinic, which are carried out during your initial intake interview.
There are also variations in anatomy from person to person, meaning that the nerve might not be present at the surface of the ear in everyone, BUT, we can also influence the vagus nerve via the peroneal nerve in the lower leg, and I have seen this work well in clinic for some conditions.
For an acupuncturist in Brisbane North with training in Vagal Nerve Stimulation to harmonise the nervous system, book online today.
I offer free 15-minute discovery consultations via phone, or from Albion, North Brisbane.
REFERENCES
1. Bonaz, B., et al. (2018). "The Vagus Nerve at the Interface of the Microbiota-Gut-Brain Axis." Front Neurosci 12: 49.
2. Clapp, M., Aurora, N., Herrera, L., Bhatia, M., Wilen, E., & Wakefield, S. (2017). Gut microbiota's effect on mental health: The gut-brain axis. Clinics and practice, 7(4), 987. https://doi.org/10.4081/cp.2017.987
3. Chen, Y., Xu, J., & Chen, Y. (2021). Regulation of Neurotransmitters by the Gut Microbiota and Effects on Cognition in Neurological Disorders. Nutrients, 13(6), 2099. https://doi.org/10.3390/nu13062099
4. Butt, M. F., et al. (2020). "The anatomical basis for transcutaneous auricular vagus nerve stimulation." J Anat 236(4): 588-611.