Patrizia Coffaro
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VAGUS NERVE: STRATEGIES TO IMPROVE IT
The vagus nerve is one of the key elements of our autonomic nervous system. It is the longest of these nerves and extends from the brainstem, through the neck, to the thorax and abdomen. Although it is commonly referred to as the singular, there are actually two vagus nerves, one on the left and one on the right. The term “vagus” comes from the Latin and means “wandering,” a name that well describes its path through the body.
This nerve is involved in an impressive number of physiological functions, connecting the brain to the intestines, carrying sensory and motor signals, and is responsible for the innervation of fundamental structures such as the heart, lungs, esophagus, stomach, intestines, and major blood vessels. It regulates heart rate, digestion, blood pressure, sweating, and even the voice.
By coordinating the muscles of the larynx and pharynx, it enables phonation and swallowing. It also helps our body maintain a state of balance between arousal and relaxation.
The vagus nerve represents the main channel of the parasympathetic branch of the autonomic nervous system—the part of the system that allows us to relax, digest, slow our heartbeat, and recover from stress. Its function is to modulate blood pressure, sweating, the gag reflex, and bowel function through coordinated involuntary contractions.
However, overactivation can be problematic and manifest as dysautonomia, as in postural orthostatic tachycardia syndrome (POTS). If stimulated suddenly, it can trigger a vasovagal reflex that causes a sudden drop in blood pressure and heart rate, leading to feelings of faintness, nausea, pain, or stress reactions. On the other hand, controlled stimulation can help stop persistent tachycardia or hiccups.
For all these reasons, the vagus nerve has long been studied by physicians, neuroscientists, and therapists. Vagal stimulation techniques, such as electronic neurostimulation, are already used clinically for epilepsy and depression, and also show promising results in the treatment of chronic inflammation, tinnitus, migraines, fibromyalgia, and others.
According to some theories, our autonomic nervous system is not limited to two states: activation or relaxation, but also has a third mode: the social interaction system.
Imagine a gazelle grazing peacefully in the savannah. Suddenly, it detects the presence of a predator. It goes on alert (sympathetic activation). When captured, it enters a frozen state (dorsal vagal dominance).
If it manages to escape, it reactivates the sympathetic system to flee.
These three states—connection, fight/flight, and disconnection—are what the polyvagal model describes for understanding our reactions to stress, danger, and emotions.
When we feel safe, we can communicate with others, express emotions, sleep well, digest properly, and experience curiosity, empathy, and presence. But if the system goes into alarm (fight or flight) or shuts down, anxiety, insomnia, rapid heart rate, digestive difficulties, fatigue, disconnection, and inflammation occur.
The “fight or flight” response is a useful physiological response in emergency situations.
But when it becomes chronic, as in those who have suffered abuse, accidents, or repeated trauma, the body remains trapped in that state. However, some live in a constant state of isolation, feeling dissociated, apathetic, empty, and unable to experience pleasure or connection. This condition is a sign of low vagal tone.
The problem arises when these responses, once thought to be temporary, become persistent.
This is when anxiety, depression, digestive disorders, sleep disturbances, immunosuppression, and systemic inflammation appear.
The most common causes include:
– Trauma in childhood or adulthood;
– Chronic stress and insomnia;
– Chronic infections (e.g., Epstein-Barr virus, Lyme virus, herpes virus);
– Glycemic imbalances;
– Environmental poisonings (heavy metals, mold, pesticides);
– Breathing problems and hyperventilation;
– Head or neck injuries.
Most common symptoms:
– Anxiety and depression;
– Chronic fatigue;
– Emotional dysregulation;
– Abnormal blood pressure or heart rhythm;
– Digestive difficulties;
– Recurring inflammation;
– Feeling detached or not present;
– Voice, swallowing, or nausea problems.
There are some simple tests that may suggest an alteration in vagal tone:
1. Heart rate variability (HRV): a low HRV indicates low nervous system resilience;
2. Orthostatic blood pressure test: A drop in blood pressure when moving from a lying to a standing position may indicate a neurovegetative imbalance;
3. Pupillary testing: if the pupil cannot remain constricted in light for at least 20 seconds, vagal tone may be weak;
These are strategies to improve vagal tone:
1. Diaphragmatic and conscious breathing: slows the heart rate and activates the parasympathetic system;
2. Meditation and prayer: calms the mind and nurtures a sense of inner security;
3. Chanting and gargling: stimulates the throat muscles and the vagus nerve;
4. Cold baths or alternating showers: activate the parasympathetic system;
5. Safe and nurturing social contacts: essential for the social interaction system;
6. Anti-inflammatory diet: prioritize vegetables, healthy fats, and wild and fermented fish;
7. Intermittent fasting: improves neuroplasticity and reduces inflammation;
8. Daily movement: from stretching to sports, essential for vagal health;
9. Somatic techniques (dance, yoga, etc.): release tension and body trauma;
10. Magnesium and zinc: promote nervous system health;
11. Adaptogens (e.g., Rhodiola, Magnolia): regulate cortisol;
12. Relaxation technologies (e.g., BrainTap): stimulate the return to calm states. Techniques such as osteopathy, craniosacral therapy, acupuncture, chiropractic, and massage therapy can support the autonomic nervous system, releasing physical and neuroemotional tension.
Hyperbaric oxygen therapy is also showing promise for improving brain and vagal function.
The vagus nerve is critical to our overall health: it regulates the heart, breathing, digestion, emotions, sleep, and immune system. Caring for it means helping the body overcome a state of chronic emergency and return to living with serenity, vitality, and connection.
If you experience many of the symptoms described, begin applying even just one of the suggested strategies; little by little, your system can return to a state of safety and well-being.
XO – Patrizia Coffaro
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