Did you know that there’s a nerve in the human body that’s connected to POTS? It’s called the vagus nerve. Maybe you’ve heard of it before. The vagus nerve actually regulates many important functions in the body—so many, that it’ll probably surprise you just how much this not-so-little nerve is responsible for. But how are the vagus nerve and POTS connected? In this blog post, I’ll explain this connection, what the vagus nerve is, and simple ways to activate the vagus nerve.
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What Is The Vagus Nerve?
The vagus nerve is the longest cranial nerve in the body. It regulates the autonomic nervous system, or the functions our bodies perform without us needing to think about it. This includes, for example, heart rate regulation, breathing rate, and digestion. It also manages immune system activity.
The vagus nerve starts at the brainstem, which is near the back of the neck. From there, it runs down the throat, through the chest, and ends in the abdomen. The vagus nerve receives signals from all the major nearby organs, such as the heart, pancreas, and liver, and sends those signals up to the brain. The brain uses this information to create a response. These responses work to keep inflammation low, regulate organ function, and stop disease development.
More specifically, the vagus nerve plays a key role in activating the body’s rest-and-digest state. When the vagus nerve is stimulated, it slows down heart rate, slows and deepens breathing rate, and increases digestion. It transitions the body from a stressful state to a relaxed state. In this relaxed state, the body can recover from whatever stress — be that from work or a life event — we put it under.
That being said, one of the major functions of the vagus nerve is to manage inflammation levels. When the vagus nerve does not work optimally, inflammation can run unchecked in the body. Chronic, high levels of inflammation can lead to many health conditions, including POTS. Now you can begin to see the connection between the vagus nerve and POTS!
What Causes Vagus Nerve Dysfunction?
So, what causes vagus nerve dysfunction? According to Dr. Navaz Habib in his book Activate Your Vagus Nerve, “The first and most common cause of dysfunctional signaling in the vagus nerve is dysfunctional breathing.”
What does dysfunctional breathing look like? Well, to find out, place one hand on your belly and one hand on your chest. Inhale normally. Did you notice if your hand on your belly rose when you inhaled? Or did you feel your chest or shoulders rise? If you felt your belly rise — congratulations, you’re breathing correctly! Correct breathing uses the diaphragm instead of the chest muscles. Breathing incorrectly can lead to less efficient signaling from the vagus nerve.
Poor posture and constantly looking down at computers or phones contribute to poor breathing practices. Both of these daily habits constrict the airway, making diaphragmatic breathing more difficult.
Eating too fast can also cause vagus nerve dysfunction. According to Dr. Habib, “Digestion can only occur in the correct sequence if it is given the right signals from the [vagus nerve] and the proper amount of time for each step to do its part.”
Chewing food is an important step for digestion. It’s when you break down your food into molecules the body can recognize. (Think in terms of carbs, proteins, and fats.) So, eating too fast can interfere with the vagus nerve’s ability to send signals of what you just ate to the brain. Poor signaling can disrupt the next stages of digestion, causing symptoms of vagus nerve dysfunction.
Many signs of vagus nerve dysfunction exist. For example, high blood pressure — a common diagnosis — can be a sign of overactive adrenal glands and unchecked sympathetic tone. This basically means that the body is spending too much time in the fight-or-flight mode. Vagus nerve dysfunction could be a cause, contributing to chronic high blood pressure.
Another sign of vagus nerve dysfunction is lacking the gag reflex. To test this, a doctor may poke a cotton swab into the back of your mouth. If this does not produce the gag reflex, then the vagus nerve may not be working optimally.
Gastroparesis may also indicate damage to the vagus nerve. Other conditions that may point to issues with the vagus nerve include gallstones, vasovagal syncope, autoimmune diseases, and chronic constipation or diarrhea.
How Are The Vagus Nerve and POTS Connected?
The vagus nerve and POTS share an important connection that all POTS patients should know about.
According to Stanley Rosenberg in his book Accessing the Healing Power of the Vagus Nerve, an impaired autonomic nervous system is a primary cause of POTS. He said, ““Many POTS symptoms seem to be caused by an imbalance of the autonomic nervous system’s control over blood flow and blood pressure.”
“The autonomic nervous system regulates the necessary adjustments in vascular tone, heart rate, and blood pressure when we stand up,” Rosenberg continued. “In POTS, the system seems to be out of balance, and blood is not going to the right places.”
This may suggest that regulating the imbalance of the autonomic nervous system might just lessen many POTS symptoms. But how can we do this? Researchers and doctors seem to think that stimulating the vagus nerve could be a key player in getting the job done.
According to a 2018 article in the Seizure European Journal of Epilepsy, an implanted device used to stimulate vagus nerve activity reduced both POTS symptoms and seizures in a female participant. Check-ins at both one month and three months revealed normal results on a head-up tilt test. The participant eventually experienced fewer seizures and no more orthostatic intolerance symptoms.
So, what does this mean for POTS patients?
Researchers are currently conducting more studies and clinical trials to further explore the potential therapeutic effects of vagus nerve stimulation on POTS. This is exciting work that could possibly have a profound effect on the future of POTS treatment. We’ll just have to stay tuned to see what the research says!
But in the meantime, there are easy manual ways to stimulate the vagus nerve that you can try. I will be trying these methods too to see if I notice any differences in my POTS symptoms. For example, right now my worst symptom is getting lightheaded when I stand up. And on occasion fainting. My symptoms have worsened after getting surgery for endometriosis in June. I haven’t been able to exercise like normal, which reminds me just how much exercise has helped my POTS symptoms!
How to Stimulate The Vagus Nerve
Now that you know about the connection between the vagus nerve and POTS, you probably want to know how to activate the vagus nerve. Luckily, there are a few simple ways to stimulate the vagus nerve. All of these ideas are ones you can try right now!
Firstly, since one of the biggest causes of vagus nerve dysfunction is incorrect breathing, the best thing you can do is to start practicing proper breathing. Take a few minutes out of your day and practice breathing deeply through your diaphragm. Remember, you should feel your belly rise when done correctly!
Other easy ways to wake up the vagus nerve are to hum or sing. You can also chew your food slowly and eat in relaxing environments (Don’t eat at your desk!). While potentially unpleasant, cold therapy, like cold showers or baths and splashing cold water on your face, can also increase vagus nerve activity.
For more in-depth information on the vagus nerve, check out Activate Your Vagus Nerve by Dr. Navaz Habib. You can also read Accessing the Healing Power of the Vagus Nerve by Stanley Rosenberg. The first goes into great detail on the physiology of the vagus nerve, as well as more ways to activate the nerve. The second provides insight on the Polyvagal Theory, an interesting theory about the vagus nerve’s healing effects.
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XO,
Laurie
Hello, love this post! I have a complex list of medical diagnoses. To name a few, POTS (ANS Dysfunction), Gastroparesis (Delayed emptying), Gastritis, GERD, Syringomyelia, Hydromyelia, hEDS, Scoliosis, TBI, several vitamin deficiencies (sometimes anemic requiring iron infusions), sleep and mental health issues, I cannot feel my left leg below the knee (I wear an AFO and use forearm crutches. Currently housebound unless helped out of the home), and many other issues. Lots still unknown! My pots causes syncope/near syncope multiple times a day. Sometimes passing out sitting or laying. My head hurts cus I fall and hit my head a lot. I live alone. Have a PCA with very limited amount of time, and sometimes a volunteer from my local hospice. My blood pressure is extremely low all the time, and heart rate extremely high all the time. When I sit up or stand my heart rate goes through the roof, and blood pressure drops sooo low. I live in Alaska, and I don’t feel that I am getting proper treatment for my issues. If anyone knows of any recourses that could me get treatment I cannot tell you how much I would appreciate it! I only have Medicaid for insurance and cannot work. I applied for the vagus nerve implant clinical trial, but never got a response… I am at the point where I can barely get up to use the bathroom or grab a bottle of water. Had a Hysterectomy in April and things weren’t healing correctly. Was bed bound too long. Dr said cardiovascular deconditioning, muscle atrophy, painful fasciculations, esophageal dysphagia, other progression of neuropathies. I tried some of the things that stimulate the Vagus Nerve. It made me pass out. Sorry I know this is a lot of info at once. I just feel at a complete loss and don’t know what else to do or who to turn to…..
I am so sorry you are dealing with so much! I have POTS/dyautonomia. I have a lot of symptoms, but I can still function at least half the day. The things that have helped me the most are some kind of simple exercise. If you can’t walk, I would suggest laying down and doing any exercise you can do laying down that gets the blood flow going. Hydration is huge for me. I drink at least 100 ounces a day. I have to get hydrated before I get moving or I get really sick. A nutraceutical version of B, vitamins, magnesium, potassium, and calcium are huge for me. Also, diet is a big factor. Little to no processed foods and sugars and lots of live food; veggies especially. I hope this helps. I wish I could do more.
It was after a ful hysterectomy that my 25 years of only occasional tachycardia and blood pressure plummet spells (had no POTS dx, yet) became daily, and have been daily for a decade. It was only then that I was dx’d by way of a TTT. I’ve had three major (unrelated to POTS) surgeries, since diagnosis, all of which have triggered a two-month flare, including ER visits, hospitalization, bed bound, and housebound. A PT told me it’s the long periods of anesthesia that are the trigger. Did you already have POTS before the hysterectomy? I just have to believe there must be a connection between hormones and my POTS. I did start HRT the day after the hysterectomy, btw. This connection might also explain why far more females, develop POTS, than males.
Informative article, very interesting. My daughter’s journey with POTS started earlier last year after having her Vagus Nerve Stimulator REMOVED. Her VNS was implanted for treatment of epilepsy. Unfortunately for her, the side effects of the VNS were intolerable. After it was removed, one of her vocal cords was damaged. She underwent therapy for that and finally an injection which finally helped. Then she noticed the heart rate issues/shortness of breath/dizziness. We are amazed at how little information is out there on POTS.
We are currently seeing a heart doctor who is trying to manage the symptoms, hopefully we find help.
You might want to look into mast cell activation, commonly associated with pots especially if you are hypermobile too…