Clinician's Corner

Vagal Nerve Toning: Clinical Pearls for Pain, Stress, Trauma & Much More (Pt. 1)

Dustin Dillberg, DACM, LAc, PAS

Question: What is vagal nerve toning and how does it fit into my practice?


We can thank the vagus nerve for our two-way gut-brain connection! We know that with digestive insult and microbiome imbalance, our brain is affected; and also that with a brain trauma, such as a concussion, digestive function and the microbiome suffer greatly. However, evidence shows that if there is pre-treatment prior to traumatic brain injury (TBI) with vagus nerve stimulus (VNS), the effects of TBI may greatly lessen throughout the body (especially the gut).

Since we can never predict when accidents may happen, I am excited to explore this wonderful neurological connection and expand on preventative lifestyle habits we can recommend to our patients.

What Is The Vagus Nerve?

The "vagus" nerve is cranial nerve 10, the longest nerve of our autonomic nervous system and the main sympathetic (rest and digest) nerve of our body. Upon leaving the medulla oblongata, it travels through the face and jaw, down the side of the neck along the stomach meridian, and through the thorax, abdomen and digestive tract. Except for the adrenals, it supplies motor sympathetic fibers to all organs from the neck to the transverse colon.

Why Is It So Important?

The vagus nerve is the subconscious sensory communication network between our organs (including the gut-brain connection). The source of your patients' disorders such as IBS, leaky gut, IBD, GERD, and brain fog may be a vagal nerve imbalance. Along with countless other functions, the vagus nerve influences blood glucose levels, digestion, emotional responses, neurotransmitter release, B12 absorption / activation, heart rate variability, and even orgasms. Digestive and metabolic hormones, sex hormones and growth factors require vagus nerve stimulation to work.

What Is Vagal Nerve Tone?

Vagal tone refers to the strength and function of the vagus nerve response. As humans, we have different strengths of this neural response; however, the better this nerve is functioning, the faster we can adapt to stimuli and restore resting homeostasis. Vagal nerve toning is the process of stimulating this nerve for optimal function.

How Can We Identify An Issue With The Vagus Nerve?

There are many ways to test or observe for potential vagal nerve issues. The most common is testing the gag reflex. In addition, you can check swallowing patterns, diaphragmatic breathing, and ability to hum or sing a tune for 30 seconds. Observe the uvula, as it may deviate away from the side of nerve damage.

Potential symptoms of vagal nerve imbalance include the following:

  • Difficulty speaking or loss of voice
  • Voice that is hoarse or wheezy
  • Trouble drinking liquids
  • Loss of the gag reflex
  • Deviated uvula
  • Chronic pain and inflammation
  • Pain in the ear (tinnitus)
  • Unusual heart rate
  • Abnormal blood pressure
  • Decreased production of stomach acid
  • Anxiety / depression
  • Vaso-vagal syncope
  • Gastroparesis
  • Constipation

Potential Causes of Vagus Nerve Imbalance

  • Emotional stress
  • Microbiome imbalance
  • GI distress
  • Hiatal hernia
  • Poor posture
  • Excess alcohol or spicy foods
  • Exhaustion related to overwork / over-training

What Can Vagal Nerve Toning Do For Patients?

  • Elevate performance and potential
  • Protect from negative effects of physical or emotional trauma
  • Speed up recovery
  • Optimize the gut-brain connection
  • Benefit breathing, lung and diaphragm function
  • Calm the mind, help sleep and reduce stress levels

Editor's Note: Ask the expert! Have a question for Dr. Dillberg about this article or another topic? Email him at dustindillberg@gmail.com. Your question may be the subject of a future column. Part 2 of this article discusses in-clinic treatment options, self-care recommendations and research support.

January 2020
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