You might of heard of the vagus nerve and vagal tone stimulation, or there again you might not, but it’s not like it’s something new. It was discovered back in 1921, by physiologist Otto Loewi, when “vagustoff” became the first confirmation of a neurotransmitter that stimulates the vagus nerve, slowing the heart rate by the release of a chemical acetylcholine (AcH).

But what’s this got to do with fibromyalgia I hear you ask?

The main point here is that fibromyalgia is very much a stress related disorder shown to have numerous neurotransmitter abnormalities and lately, the vagus nerve has received quite a bit of interest within the science community where more and more medical research is finding that it plays a significant role in various diseases, as well as systems in the body affected by fibromyalgia.

Vagal tone, or the strength of your vagus nerve, has been connected to metabolism, inflammation in the body, immune system regulation, blood sugar and insulin regulation, gut and heart health, swallowing / gag reflex, emotional well-being and sensitivity to stress, all of which I’d say are pretty relevant to overall health, let alone fibromyalgia.

The Vagus Nerve Explained

The vagus nerve, which there are actually two, a left and a right, but are mostly referred to as singular, is a primary component of the parasympathetic nervous system (rest and digest), which is a major consideration when coping with fibromyalgia.

It gets its name from the Latin word “wandering” as it’s the longest nerve in the autonomic nervous system,(, a cranial nerve that runs from the base of the brain, through the neck and branching out through the chest all the way down into the abdomen.

It’s responsible for sending sensory information to the brain, such as sight, sound, taste and smell, as well as controlling certain motor functions throughout the body. Signals that run up and down the vagus nerve let you know when you are hungry or full, telling your tummy muscles to start digesting your food, as well as regulating your heart rate, activates your inflammatory stress response and slows your heart rate.

This incredible nerve has long been thought of as a “remarkable internal sensory system” and no wonder! 

Do you ever get that “gut feeling”?  Well, that’s your vagus nerve communicating within the microbiome-gut-brain axis allowing the microbes in the gut to directly communicate with the brain.

What does vagal tone mean?

Vagal tone is an internal biological process that represents the health of the vagus nerve. Increasing your vagal tone activates the parasympathetic nervous system (rest and digest), meaning it helps you to quickly recover from stress and the effects it has on the body.

This remarkable nerve plays a major role in regulating mood and vagal tone is pivotal to our emotional and mental health.  It’s now known that low vagal tone is associated with major psychiatric conditions including anxiety and depression disorders.  This may be partly down to its relationship with the gut bacteria which is known to affect mood through the activation of the vagus nerve and it’s altogether what is meant by the mind-body connection.

If that’s not enough to convince you, there’s more!  There’s two branches of the vagus nerve, one being a more primitive branch, the Dorsal Vagus Complex which is the activated “freeze” response, like a rabbit in the headlights.  There’s also a newer branch developed in mammals, known as the Ventral Vagus Complex and associated with our social engagement system.

Think of it this way, when we are free of stress and are emotionally healthy, (I’m trying to imagine), physically, our bodies remain in a positive social engagement state, or a happy, content relaxed state.

However, during these uncertain times living with a pandemic, it’s totally understandable that this is not so easy and our primal response is keeping you in a constant state of alert.  This is where the resulting fight-or-flight state is being constantly activated and eventually putting our sympathetic nervous system into overdrive. This has detrimental consequences to the health of the vagus nerve, hence it’s really important to strengthen and keep your vagal tone at its best.

It’s probably no surprise that low vagal tone has been linked to fibromyalgia, chronic fatigue, anxiety disorders, low HRV, chronic stress and depression, headaches and IBS to name a few. 

What also has to be considered is that heart rate variability (HRV) is an indication of the body’s ability to activate the parasympathetic, the rest and digest response and HRV abnormalities have been linked with fibromyalgia.  The higher your HRV, the higher the vagal tone and this correlates with stable mood, better health and cognitive function, which means less brain fog!

Signs of low vagal tone to look out for include:

  • croaky, hoarse voice or loss of voice
  • difficulty swallowing
  • loss of gag reflex
  • abdominal bloating or pain
  • irregular heart rate / palpitations
  • shallow breathing
  • decreased stomach acid and or digestive enzymes
  • persistent diarrhoea or constipation
  • anxiety / depression / sensitivities to stress

Fortunately, there’s so many ways you can stimulate the vagus nerve on your own and it’s really quite simple!

How can I increase my vagal tone?

First of all it’s worth a mention that the vagus nerve runs from the brain stem to the larynx and controls vocal movement.  Anything that involves activating the muscles at the back of the throat, like singing, chanting, gargling or humming, will help to stimulate it and improve your heart rate variability.

Get “OM”-ing:  Taking the wisdom from the ancient Sanskrit, Om (or Aumm) is more than a sound, it’s said that when chanted it produces the vibration of the universe and connecting all life force.  Whatever it is, it’s a great way to massage the vocal cords and stimulate the vagus nerve.   

Deep breathing exercises: There’s so much evidence to support that deep breathing improves the immune system and benefits both mental and physical health helping to build resilience to stress, see related article Fibromyalgia

Meditation and mindfulness:  When you intentionally bring your attention to the present moment it allows the space for you to simply “just be”, relaxing the mind and body and gives your body a chance to heal.  It’s worth persevering with this practice as there are so many researched benefits for pain relief and fibromyalgia.

Yoga, tai chi and qigong:  Practising any of these will involve breath work as well as movement, which will increase vagal tone as well as being beneficial for fibromyalgia.

Laughter:   The say that laughter is the best medicine and who doesn’t feel better after a proper belly laugh!

Fasting:  Research and studies have indicated that fasting acts as a physiological activator of the vagus-mediated pain modulation pathway, whereas a healthy vagal tone will reduce the sensation of pain. (Pain modulation refers to the process by which the body alters a pain signal as its transmitted along the pain pathway).

Cold water therapy:  Cold water swimming is becoming so popular now and those who practice, swear by the benefits and feel-good factor.  Personally, even the thought of plunging my body into cold water makes me dizzy!  On the other hand, a cold compress on the back of the neck or splashing your face in cold water, may work just as well for the vagus nerve.

Probiotics:   This really should be a starting point that keeping your gut healthy with the good bacteria pays dividends for the health of the brain, especially when it comes to reducing anxiety and depression.  It’s all down to the vagus nerve that works as a conduit in communicating signals between the gut bacteria and the brain.  This alone is plenty evidence to be mindfully aware of ensuring your diet includes mainly wholefoods and probiotics, as well as considering a supplement with strains like Lactobacillus rhamnosus and Bifidobacterium, both shown to reduce stress, anxiety and depression.

Omega-3 Fatty Acids:  Really beneficial for overall health, particularly brain, heart and reducing inflammation and have been linked to healthy heart rate variability and vagal tone. Eating fish, nuts and seeds or supplementing with essential fatty acids, bearing in mind that you need to ingest them every day as the body doesn’t make them!

The list goes on to include positive social interaction, practicing gratitude, grounding, connecting with nature and just about anything that helps you to de-stress and feel good, even stroking your pet!

To conclude, remember your vagus nerve is your secret weapon to combat stress and a healthy vagal tone is one way to reduce the symptoms of fibromyalgia.  It helps your body in preparation to adapt to the emotional and physical stress fibromyalgia brings. It helps to improve sleep quality, digestion and increase brain health, heart rate variability and bring balance to the autonomic nervous system.

On the flip side, low HRV and vagal tone may mean you suffer with unwanted and prolonged flare ups which take longer to recover from, as well as increased anxiety, sensitivities to stress and depression. There’s many ways that fibromyalgia could be made worse

Feel free to leave a comment or contact us for further information

Author Jok Saunders, founder of the Fibro Clinic South West    

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