What Is Vagal Tone and How to Improve Yours

You’ve likely heard about the vagus nerve. Maybe in the context of gut health, stress, or nervous system balance. Now you’re wondering what vagal tone actually is and whether there’s anything practical you can do to support it.

Vagal tone describes how well the vagus nerve is functioning. Because this nerve helps regulate digestion, heart rate, and the body’s ability to settle into a calm, restorative state, it’s become a point of interest in both research and clinical care.

There’s no shortage of advice on how to improve vagal tone. Some approaches are well-supported. Others are less clear. In this article, we’ll walk through what vagal tone means, how it’s measured, and which strategies are worth your time.

What Is the Vagus Nerve?

The vagus nerve is the 10th, and longest, cranial nerve, starting at the brain stem and “wandering” down into the neck, chest, and abdomen. “Vagus” translates from Latin to “wanderer.” It affects the gastrointestinal system, heart, lungs, tongue, and throat 1. 

The vagus nerve is also the main part of the parasympathetic nervous system (PNS), which is responsible for our body’s “rest and digest” state and regulates automatic body functions such as breathing, heart rate, and digestion 2. 

The PNS works in opposition to the sympathetic nervous system (SNS), and together they make up our autonomic nervous system (ANS). The SNS regulates our “fight or flight” state and is needed to respond to stressful situations and to physical activity 3.

Because the vagus nerve innervates so many parts of the body and is part of the autonomic nervous system, it is involved in almost all body processes. This makes it particularly important when talking about health, because dysfunction of the vagus nerve can contribute to health disorders.

The vagus nerve is connected in one way or another to many different systems in the body. Here’s a quick chart: 

Measuring the functioning of the vagus nerve—vagal tone—is not straightforward, and the concept of improving vagal tone is relatively new in functional and conventional medicine. Let’s take a look at what we do know about improving vagal tone and how you can support your vagus nerve at home.

What Is Vagal Tone?

Vagal tone is essentially a way of describing how well your vagus nerve is working. We don’t measure it directly—instead, we estimate it using something called heart rate variability, or HRV. 

You may also have heard HRV referenced in fitness recovery, as it is an indicator of how well your body recovers from stress and whether it can reach the rest-and-digest state to support recovery. 

Vagal tone’s relationship to the heart is why you may have also heard that cardiac vagal tone is a good indicator of how well our heart and parasympathetic nervous system are working. 

Low vagal tone is associated with:

• Irritable bowel syndrome (IBS) and Crohn’s disease 7 
• Neurological conditions such as epilepsy and Parkinson’s disease 10 11
• Depression, anxiety, and post-traumatic stress disorder (PTSD) 4 6
• Metabolic disorders such as type 2 diabetes 12 13
• Cardiovascular disease, hypertension, and irregular heartbeat (atrial fibrillation) 14

How Is Vagal Tone Measured?  

There’s no direct test that measures how well the vagus nerve is functioning throughout the entire body. Instead, vagal tone is indirectly estimated from heart rate variability (HRV).

HRV looks at the small changes in time between each heartbeat. While that might sound odd at first, a healthy heart is not meant to beat like a metronome. In fact, variability from beat to beat is a good thing. It reflects flexible, responsive input from the vagus nerve to the heart.

So, the more variation you have between heartbeats, the better your vagal tone tends to be. Higher HRV generally signals stronger vagal activity and better nervous system resilience, while lower HRV suggests reduced vagal tone and a system that may be under more stress.

Higher variability generally reflects greater vagal activity at the heart and is commonly used as a proxy for cardiac vagal tone. Importantly, HRV only tells us about vagal signaling to the heart, and not the vagus nerve’s effects on digestion, immunity, or mood.

Additionally, it’s important to remember that there are no baselines for what is considered a low or high vagal tone. Meaning, we can’t say that a high HRV for men ages 30-40 should be X 15. Your HRV baseline is individual, so a high HRV for you could be 42, while a high HRV for someone else is 66.

Because the vagus nerve connects to many body systems, people often assume that improvements in digestion, anxiety, or stress tolerance automatically reflect improved vagal tone. That may be the case, but at this time, research hasn’t confirmed those changes as reliable measures of vagal function.

If you want a practical way to track trends over time, some wearable devices estimate HRV during sleep. Tools like the Oura Ring and the Whoop Band can help establish a personal baseline and show how your HRV changes in response to exercise, stress, sleep, or recovery. These devices aren’t essential, but they can be useful if you like having objective data.

This raises the bigger question: Because low vagal tone is associated with many health conditions, do interventions like vagus nerve stimulation actually improve vagal tone and symptoms in meaningful ways? Let’s take a closer look.

7 Ways to Improve Vagal Tone

There are many ways to support vagal tone, but not all approaches carry the same level of evidence. Below, we’ll walk through strategies that range from foundational lifestyle practices to more targeted interventions, highlighting what research supports and when each approach may be appropriate.

Exercise

There are many smaller studies showing that exercise can improve your vagal tone, and this is probably one of the easiest interventions to do at home 10. There are also numerous health benefits associated with exercise beyond increasing vagal tone. 

High-intensity exercise was shown to improve vagal tone better than moderate-intensity exercise in people with chronic heart failure 16. However, even light exercise, like walking, has been shown to improve HRV 10. 

In general, I find that clients who use an HRV tracker do see improvements in HRV when adding exercise into their lives. It is important to note that more exercise does not necessarily mean better. Over-exercising, with too much high-intensity exercise without enough recovery time, can lower HRV. 

You may see recommendations for specific vagus nerve exercises, but for most people, regular movement and fitness seem to provide similar benefits. We break this down further in our article on vagus nerve exercises.

Breathing and Meditation

The vagus nerve helps control our breathing, and research shows that we can improve vagal tone by practicing certain breathing techniques. 

The easiest form of vagus nerve breathing is to make your exhalation longer than your inhalation. When you breathe out, your heart rate decreases, and you stimulate the vagus nerve. Just as you may notice that when you are anxious, your breathing may become short and fast, indicating sympathetic nervous system activation, slow breathing helps increase parasympathetic activity 10.

In one study, slow breathing, around 5.5 breaths per minute, showed the greatest improvement in HRV and vagal tone, and increased relaxation. In this study, the exhale and inhale were equal, each lasting five seconds in and five seconds out 17. However, many other studies looking at meditative practices and variations in breathing show that most forms of slower breathing improve HRV, decrease stress and anxiety, and even improve chronic pain and gastrointestinal symptoms 8 18 19. 

In addition to breathing techniques, similar ways to stimulate the vagus nerve include singing, chanting, and humming. However, all of these practices slow breathing in some way, which may be why people report improvements in HRV and feelings of calm, as well as decreased stress and anxiety 20. Adding in 10-20 minutes of slow, mindful breathing each day can be a great way to improve your vagal tone. 

Diet and Probiotics

Some dietary interventions may help improve vagal tone. Overall, anything that is good for the gut and brain is good for the vagus nerve, and anything that increases inflammation and decreases gut health will tax the parasympathetic nervous system via the gut-brain axis (the vagus nerve).

A generally anti-inflammatory, nutrient-dense diet, such as a Paleo diet that removes inflammatory foods like grains, dairy, and legumes, may be helpful. 

Some studies also show that supplementation with fish oil significantly increases vagal tone and heart rate variability 21. Further, one study suggests that maintaining adequate sodium levels (which will vary from person to person, as some are more sensitive to sodium than others) increases HRV and blood pressure, while a low-sodium diet decreases HRV 22. 

Probiotics may also be a good way to support the vagus nerve, theoretically through their effects on gut health and the gut-brain axis 23. While we still need more research to show that probiotics can directly improve heart rate variability or vagal tone, there is already a strong body of evidence showing that they can improve gut health. And this matters because what supports the gut and the brain generally supports the vagus nerve as well. In the clinic, we view supporting gut health as one of the most consistent ways to influence vagus nerve signaling. If you want a more structured approach, our vagus nerve reset guide walks through diet, lifestyle, and gut-focused strategies in more detail.

Cold Water

Have you taken the cold water bath plunge? Short cold-water baths, of about two minutes, have become popular in athletic communities for muscle recovery and improving HRV. And, research does back this up, although exactly how cold the water needs to be, how long you need to stay in the water, and how often you need to do it is not yet agreed upon 24. 

Coldwater immersion has been shown to reduce heart rate, improve HRV, and increase parasympathetic nervous system activity after exercise 10 25 26. If you want to test out cold water therapy, start off by taking the last 10-20 seconds of your shower on the coldest water setting you can handle. If you have poor vagal tone, jumping into an ice bath may not be something your body can handle yet, so test the waters with a cold shower first. 

Tapping, Gargling, and Laughing

Vagus nerve tapping, where you lightly tap on the chest while holding your breath to stimulate the vagus nerve, has become increasingly popular. Many people anecdotally report improved mood and decreased stress and anxiety. However, there are no studies published about “vagus nerve tapping.” Again, this does not mean it is not helping people who use it, we just don’t have the research to show it improves vagal tone and increases HRV. 

Vagus nerve tapping should not be confused with EFT (Emotional Freedom Technique), a form of tapping used in psychotherapy alongside cognitive behavior therapy. This form of tapping targets acupressure points in order to help decrease levels of anxiety and improve emotional regulation. However, the points you tap during an EFT routine are different from those that would be associated with the vagus nerve. 

Because the vagus nerve innervates the throat and diaphragm, practices like gargling, gagging, or even laughing are sometimes suggested as ways to stimulate vagal tone. The theory makes anatomical sense, but at this point, there’s little to no good research showing that these techniques meaningfully improve vagal tone.

Vagus Nerve Massage

Vagus nerve massage essentially uses light to moderate pressure in areas of the body near the vagus nerve, such as in the neck/shoulder area near the base of the skull or on the side of the neck near the carotid artery (in carotid sinus massage) to improve vagal tone and slow heart rate 27. 

Both forms of massage have been shown to increase HRV and decrease feelings of stress. Carotid sinus massage (CNS) is used in cardiology emergency settings to slow a rapid heart rate or improve an abnormal heart rhythm by stimulating receptors in the carotid artery to raise vagal tone. CNS does come with risks, especially for people with heart disease. It should not be used in people with diseased carotid arteries, stroke, or tachycardia, and needs to be administered by a qualified professional 28. 

Electrical Vagal Nerve Stimulation

The FDA has approved electrical vagal nerve stimulation (VNS) for epilepsy and treatment-resistant depression, and it is also currently being studied for use in treatment for migraines, obesity, inflammatory bowel disease (IBD), Parkinson’s disease, Alzheimer’s disease, and more 1 29. There are two types of electrical vagal nerve stimulation: invasive and non-invasive. 

Invasive electrical VNS involves surgically implanting a device under the skin of the chest to stimulate the vagus nerve. This is most often used for the treatment of epilepsy and treatment-resistant depression, but it is being studied for use in other conditions. 

In fact, in a study of patients with Crohn’s disease, invasive VNS reduced gut inflammation and IBD symptoms after 4-6 months of use 30. 

Invasive VNS does carry a low level of risk, including infection at the surgical site, cough, difficulty breathing, or vocal cord paralysis 29. Fortunately, non-invasive VNS is also very effective, without these risks. 

There are two forms of non-invasive electrical VNS: taVNS (transcutaneous auricular vagus nerve stimulation) and ctVNS (cervical transcutaneous vagus nerve stimulation). In taVNS, an electrode is placed on the ear to stimulate the vagus nerve, and in ctVNS, the electrode is placed on the neck 31.

Benefits of taVNS and ctVNS include 32 33 34 35: 

• Decreased seizure frequency in patients with epilepsy
• Reduction of inflammatory markers in the body 
• Improvements in gastrointestinal pain, pelvic pain, and migraines 
• Improvements in depression and anxiety scores 
• Less indigestion 
• Improvements in IBD symptoms and gut pain 

Most people do not have access to electrical VNS, which should be performed only under medical supervision, but as you can see above, there are other non-invasive ways to increase vagal tone.

Frequently Asked Questions About Vagal Tone

What Are the Symptoms of Low Vagal Tone?

Low vagal tone is not a diagnosis, but it has been associated with patterns seen in several health conditions. Research has linked lower vagal tone with gastrointestinal disorders such as irritable bowel syndrome (IBS) and Crohn’s disease 7 30, neurological conditions including epilepsy and Parkinson’s disease 10 11, and mental health conditions like depression, anxiety, and PTSD 4. 

It has also been associated with metabolic disorders such as type 2 diabetes 13 and cardiovascular conditions, including high blood pressure and irregular heart rhythms 14.

Because vagal tone reflects nervous system regulation rather than a single disease process, symptoms often overlap across digestive, neurological, metabolic, and emotional systems.

How Do I Restore My Vagal Tone?

Vagal tone isn’t something that can be restored overnight. Research suggests it may improve over time with consistent lifestyle practices that support the parasympathetic nervous system, including regular exercise, slow and controlled breathing, stress management, adequate sleep, and supporting gut health. In certain clinical contexts, medical therapies such as vagus nerve stimulation are also used under professional supervision.

What Causes High Vagal Tone?

Higher vagal tone is generally associated with good cardiovascular fitness, effective stress regulation, and healthy autonomic nervous system balance. Factors such as regular physical activity, good sleep quality, metabolic health, and recovery from stress all appear to contribute.

How Does Vagal Tone Affect Heart Rate?

The vagus nerve plays a key role in slowing the heart rate after physical or emotional stress. Higher vagal tone is associated with greater heart rate variability, meaning the heart can adapt more easily to changing demands. Lower vagal tone is associated with reduced variability and less flexible heart rate regulation.

Supporting Your Vagus Nerve

Improving vagal tone may be a great way to improve your overall health, particularly if you struggle with gut issues, heart disease, or anxiety. The great news is that simple health interventions can improve your vagal tone. You can decide to track this with a device that measures HRV, or keep a list of symptoms, emotional and physical,  to track and see if they improve as you try an intervention.

If you are still struggling and want more help, feel free to reach out to us at the clinic. We are happy to help you start feeling and functioning better.

Dr. Michael Ruscio is a DC, natural health provider, researcher, and clinician. He serves as an Adjunct Professor at the University of Bridgeport and has published numerous papers in scientific journals as well as the book Healthy Gut, Healthy You. He also founded the Ruscio Institute of Functional Health, where he helps patients with a wide range of GI conditions and serves as the Head of Research.