What Is Vagus Nerve Stimulation and How Can You Practice It? - Dr. Michael Ruscio, DC

Does your gut need a reset?

Yes, I'm Ready

Do you want to start feeling better?

Yes, Where Do I Start?

Do you want to start feeling better?

Yes, Where Do I Start?

What Is Vagus Nerve Stimulation and How Can You Practice It?

Using Vagus Nerve Stimulation for Physical, Mental, and Nervous System Health

Key Takeaways:

  • Vagus nerve stimulation (VNS) is a bioelectronic therapy with two main types: internal vagus nerve stimulation and transcutaneous vagus nerve stimulation (tVNS).
  • Internal VNS involves an internal implant that stimulates the vagus nerve, providing healing effects like reducing seizures and significantly improving mood, while tVNS uses external stimulation via an electrode clip attached to the left ear. 
  • VNS has also been shown to lower stress hormones, improve digestion, and even regulate immune function. 
  • However, an implant is quite invasive, and tVNS has been shown to provide many of the same benefits without surgery or other potential side effects. 
  • You can also practice vagus nerve stimulation without an electrical device simply by practicing deep breathing, using emotional freedom technique (EFT), yoga, and other simple (and free!) practices.

The vagus nerve, also known as the “long wandering nerve,” is the 10th cranial nerve that connects your brain and central nervous system to your heart, lungs, intestines, and most of your other internal organs. You can think of it like a superhighway connecting your brain to the rest of your body, with traffic (signals) running both “top-down” — from the brain to the body — and “bottom-up” — from the body (your gut, heart, and other organs) to the brain. 

Research over the last several years has found that activating and stimulating this nerve has remarkable healing effects from reducing seizures to lowering depression and anxiety to regulating digestive motility. The problem has been figuring out how to stimulate the nerve, and how to do so in a safe and easily repeatable way. 



This is where vagus nerve stimulation comes in, which can be done via an internal implant directly connected to the vagus nerve, or externally through electrical and physical stimulation of certain points where the nerve comes close to the skin. Breathing exercises and even visualization techniques are also known to affect the vagus nerve and parasympathetic nervous system. 

In this article, I want to dive deeper into vagus nerve stimulation, its therapeutic potential, and different ways you can stimulate the vagus nerve to tap into its healing effects. 

What is Vagus Nerve Stimulation?

Vagus Nerve Stimulation

Traditional vagus nerve stimulation (VNS) involves a device implanted in the neck to stimulate the vagus nerve periodically. This invasive version of VNS therapy was created for the treatment of epilepsy and has also been used and studied for treatment-resistant depression, migraines, inflammatory bowel disease, anxiety, Alzheimer’s disease, and other chronic conditions [1]. 

The VNS device works by sending a low-grade electrical impulse to the vagus nerve every so often, consistently stimulating the nerve. Vagus nerve stimulation alters neurotransmitter levels and lowers stress hormones, improving mood, digestion, and even immunity [2, 3, 4]. When the vagus nerve is stimulated, it activates the parasympathetic nervous system (the rest and digest state) and calms the autonomic nervous system (fight or flight). 

Internal vagus nerve stimulation has been a life-saving therapy for severe conditions like drug-resistant epilepsy, but most people would rather avoid an invasive implant if possible. There are also potential side effects like voice alteration, hoarseness, tingling, and even vocal cord or facial paralysis due to overstimulation of the vagus nerve [1]. Fortunately, there is a much safer yet still effective alternative in transauricular vagus nerve stimulation, also known as tVNS. There are also ways to stimulate the vagus nerve without any external electrical input at all, which we will discuss a little later. 

Transauricular Vagus Nerve Stimulation (tVNS)

Transauricular (or transcutaneous) vagus nerve stimulation may have many of the same benefits as internal VNS, without the potential for dangerous side effects that come with an implant. 

As the name suggests, transauricular vagus nerve stimulation involves using an external electrical stimulation device (such as a TENS unit) attached to the tragus of the left ear via an electrode clip, which stimulates the vagus nerve. 

This part of the ear has many vagus nerve endings, so it’s an ideal place to stimulate the nerve. An electrode patch may also be used on the back of the neck instead, but the ear is more common and easy to administer. You may also use a dual lead to stimulate both the ear and the inside of the wrist or the left shoulder.

https://photos.smugmug.com/Infographics-2023-naming-updates/2023-naming-update-infographics/i-j9v4tRX/0/4d8b0aab/L/Vagus%20Nerve%20Points-L.jpg

You don’t have to worry about getting a shock through tVNS. After initially adjusting the electrical current to where you might feel a mild pulse, the idea is that you lower it slightly so that the pulse is nearly imperceptible to you, but it will still be noticeable to your vagus nerve. 

Research, including systematic reviews and human clinical trials, has found that tVNS may [5, 6, 7, 8]

  • Lower heart rate to a healthy and calm level
  • Reduce circulating levels of inflammatory markers
  • Decrease seizure frequency in those with epilepsy by 20–40%
  • Improve GI pain, pelvic pain, and migraines
  • Improve functional dyspepsia (upset stomach with no clear cause)
  • Significantly improve depression and anxiety

These are remarkable therapeutic effects for a treatment that has few to no side effects and does not involve pharmaceutical medication of any kind. Even if tVNS does not completely resolve a target condition, it may still be used as an adjunct therapy for pain reduction, mental health, and improving quality of life. 

The Vagus Nerve and Your Nervous System

Vagus Nerve Stimulation

You might be wondering, “how is it that stimulating the vagus nerve can lower inflammation, reduce pain, improve mood, and regulate digestion?” It all comes back to one central, interconnecting system in the body — your nervous system.

The nervous system has been getting a lot of attention in recent years for its role in chronic, inflammatory, and autoimmune diseases, and rightly so. I’ve seen many patients who have tried multiple therapies, established a healthy diet, improved their gut health, and yet they still can’t seem to completely resolve their symptoms. In these cases, it’s often recalibrating the nervous system that’s the missing piece to restoring total health. 

This is because the state of our nervous system is responsible for how we interact with both our internal and external environment. Are we assuming a threat is lurking around every corner, keeping us on edge and ready to fight or flee at any time? Or maybe we feel like we’re in a state of burnout and have little energy or motivation for life. Or do we generally feel safe to exist in the world and comfortable in our skin? 

Living in the first state (fight or flight) increases stress and overstimulation of the nervous system, making full healing difficult. The second (burnout) means we need to put some more intention toward increasing energy and nervous system responsiveness. And the third is what happens when our nervous system is balanced — able to spur us into action if we need it, but then also able to return to a comfortable baseline. This is the ideal state to create health and well-being. 

When the nervous system is balanced and reacts appropriately to our internal and external environment, deeper healing can take place on a systemic and cellular level. This is what vagus nerve stimulation helps encourage by practicing neuromodulation and re-establishing the mind-body connection. 

How Can You Try tVNS?

Transauricular vagal nerve stimulation is still not a widely advertised therapy (despite the promising scientific research behind it), but there are some doctors and other healthcare practitioners using it with their patients. If you’re interested in tVNS, I recommend bringing it up with your primary healthcare provider or perhaps a supplemental provider you trust, like a chiropractor, and asking their advice on how to start. 

You should not try doing electrical vagus nerve stimulation therapy on your own before consulting a healthcare provider. Since it is an electrical device, there may be contraindications for those with certain heart conditions or other medical devices, and it’s always a good idea to check in with your doctor when beginning a new health regimen. 

Other Ways to Stimulate the Vagus Nerve

Vagus Nerve Stimulation

Besides electrical stimulation, there are other ways to stimulate the vagus nerve that are completely free and can be just as effective. 

Emotional Freedom Technique (EFT)

Emotional Freedom Technique, also known as EFT or tapping, is an acupressure technique that involves tapping on various points on the head and torso while talking through an emotional trigger or simply practicing gratitude in order to reduce mental and physical distress and improve well-being [9, 10]. 

While EFT has not been directly tied to the vagus nerve in scientific research, it has a lot of evidence backing it up in achieving similar results to tVNS, such as reduced anxiety and depression, stabilizing energy levels, relieving stress, and calming the nervous system [10, 11]. It’s highly likely that part of the reason EFT works is that it activates the vagus nerve.  

Deep Breathing Exercises

Taking deep, slow breaths can stimulate the vagus nerve and improve heart rate variability (a measurement of how well the vagus nerve is functioning) [12, 13]. A good rule of thumb to activate the parasympathetic nervous system is to make your exhales longer than your inhales when you practice breathing exercises. 

Singing and humming

Singing and humming create vibrations that can stimulate the vagus nerve through the back of the throat [14]. Bonus: music increases the hormone oxytocin, making us feel content and bonded with those around us. 

Yoga and Meditation

Practicing yoga builds the mind-body connection, improves HRV, and improves stress recovery, all signs of a responsive vagus nerve [15]. Both mindfulness and loving-kindness meditations have also been shown to improve HRV and vagal tone [13, 16]. 

Vagus Nerve Nutrition

While there isn’t really a “vagus nerve diet,” per se, there are some nutrients that can help support your vagus nerve that you can get through a healthy anti-inflammatory diet, and where needed, supplementation. In general, making sure your diet supports a healthy gut will also help support a healthy nervous system. 

Since the primary neurotransmitter of the vagus nerve is acetylcholine, you can focus on increasing choline in your diet. Choline is a nutrient grouped with the B vitamins, though it’s not a vitamin itself. You can find choline abundantly in eggs, red meat, fish, and most animal foods. Plant-based sources include soy and sunflower seeds. 

Omega-3 fats, polyphenols, and electrolytes are other nutrients to keep in mind to support your vagus nerve and nervous system. Making sure you’re well-hydrated is especially important!

Vagus Nerve Stimulation Doesn’t Have to Be Invasive 

While internal VNS has proven effective for treatment-resistant epilepsy and depression, an invasive surgery isn’t necessary to get the benefits of vagus nerve stimulation. If you’re interested in pursuing tVNS as a treatment option, consult your healthcare provider to see if it can benefit you. You can also begin to regulate your vagus nerve with free and easy practices like EFT and breathing exercises. 

For more information on the gut, mind-body connection, and the role of stress on your health, check out my book Healthy Gut, Healthy You and check out my free educational videos on YouTube.

The Ruscio Institute has developed a range of high-quality formulations to help our patients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you.

➕ References
  1. Mandalaneni K, Rayi A. Vagus Nerve Stimulator. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2021. PMID: 32965846.
  2. Breit S, Kupferberg A, Rogler G, Hasler G. Vagus Nerve as Modulator of the Brain-Gut Axis in Psychiatric and Inflammatory Disorders. Front Psychiatry. 2018 Mar 13;9:44. DOI: 10.3389/fpsyt.2018.00044. PMID: 29593576. PMCID: PMC5859128.
  3. Howland RH. Vagus Nerve Stimulation. Curr Behav Neurosci Rep. 2014 Jun;1(2):64–73. DOI: 10.1007/s40473-014-0010-5. PMID: 24834378. PMCID: PMC4017164.
  4. Bonaz B, Bazin T, Pellissier S. The Vagus Nerve at the Interface of the Microbiota-Gut-Brain Axis. Front Neurosci. 2018 Feb 7;12:49. DOI: 10.3389/fnins.2018.00049. PMID: 29467611. PMCID: PMC5808284.
  5. Verma N, Mudge JD, Kasole M, Chen RC, Blanz SL, Trevathan JK, et al. Auricular Vagus Neuromodulation-A Systematic Review on Quality of Evidence and Clinical Effects. Front Neurosci. 2021 Apr 30;15:664740. DOI: 10.3389/fnins.2021.664740. PMID: 33994937. PMCID: PMC8120162.
  6. Lai Y-H, Huang Y-C, Huang L-T, Chen R-M, Chen C. Cervical Noninvasive Vagus Nerve Stimulation for Migraine and Cluster Headache: A Systematic Review and Meta-Analysis. Neuromodulation. 2020 Aug;23(6):721–31. DOI: 10.1111/ner.13122. PMID: 32166843.
  7. Wu C, Liu P, Fu H, Chen W, Cui S, Lu L, et al. Transcutaneous auricular vagus nerve stimulation in treating major depressive disorder: A systematic review and meta-analysis. Medicine (Baltimore). 2018 Dec;97(52):e13845. DOI: 10.1097/MD.0000000000013845. PMID: 30593183. PMCID: PMC6314717.
  8. Zhu Y, Xu F, Lu D, Rong P, Cheng J, Li M, et al. Transcutaneous auricular vagal nerve stimulation improves functional dyspepsia by enhancing vagal efferent activity. Am J Physiol Gastrointest Liver Physiol. 2021 May 1;320(5):G700–11. DOI: 10.1152/ajpgi.00426.2020. PMID: 33624527. PMCID: PMC8887908.
  9. Church D, Stapleton P, Yang A, Gallo F. Is Tapping on Acupuncture Points an Active Ingredient in Emotional Freedom Techniques? A Systematic Review and Meta-analysis of Comparative Studies. J Nerv Ment Dis. 2018 Oct;206(10):783–93. DOI: 10.1097/NMD.0000000000000878. PMID: 30273275.
  10. Sebastian B, Nelms J. The Effectiveness of Emotional Freedom Techniques in the Treatment of Posttraumatic Stress Disorder: A Meta-Analysis. Explore (NY). 2017;13(1):16–25. DOI: 10.1016/j.explore.2016.10.001. PMID: 27889444.
  11. Nelms JA, Castel L. A Systematic Review and Meta-Analysis of Randomized and Nonrandomized Trials of Clinical Emotional Freedom Techniques (EFT) for the Treatment of Depression. Explore (NY). 2016 Aug 18;12(6):416–26. DOI: 10.1016/j.explore.2016.08.001. PMID: 27843054.
  12. Lin IM, Tai LY, Fan SY. Breathing at a rate of 5.5 breaths per minute with equal inhalation-to-exhalation ratio increases heart rate variability. Int J Psychophysiol. 2014 Mar;91(3):206–11. DOI: 10.1016/j.ijpsycho.2013.12.006. PMID: 24380741.
  13. Yuen AWC, Sander JW. Can natural ways to stimulate the vagus nerve improve seizure control? Epilepsy Behav. 2017 Feb;67:105–10. DOI: 10.1016/j.yebeh.2016.10.039. PMID: 28152451.
  14. Vickhoff B, Malmgren H, Aström R, Nyberg G, Ekström S-R, Engwall M, et al. Music structure determines heart rate variability of singers. Front Psychol. 2013 Jul 9;4:334. DOI: 10.3389/fpsyg.2013.00334. PMID: 23847555. PMCID: PMC3705176.
  15. Tyagi A, Cohen M, Reece J, Telles S, Jones L. Heart Rate Variability, Flow, Mood and Mental Stress During Yoga Practices in Yoga Practitioners, Non-yoga Practitioners and People with Metabolic Syndrome. Appl Psychophysiol Biofeedback. 2016 Dec;41(4):381–93. DOI: 10.1007/s10484-016-9340-2. PMID: 27457341.
  16. Bonaz B, Sinniger V, Pellissier S. Therapeutic potential of vagus nerve stimulation for inflammatory bowel diseases. Front Neurosci. 2021 Mar 22;15:650971. DOI: 10.3389/fnins.2021.650971. PMID: 33828455. PMCID: PMC8019822.

Need help or would like to learn more?
View Dr. Ruscio’s, DC additional resources

Get Help

Discussion

I care about answering your questions and sharing my knowledge with you. Leave a comment or connect with me on social media asking any health question you may have and I just might incorporate it into our next listener questions podcast episode just for you!