Heart attacks, CFS, herpes virus infection and the vagus nerve

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I came across upon some very interesting research regarding the vagus nerve and chronic viral infections. This happened almost the exact same day someone very close to me had a heart attack shortly after a herpes virus infection. He is now out of danger and well into recovery, but his words stayed with me: “I think the herpes virus got a hold of my vagus nerve and that is why I had a heart attack”. I thought to myself, it is entirely possible!

The Vagus Nerve: Our Smart Wanderer

The vagus nerve is the heart of the parasympathetic nervous system, the anti-stress system. The vagus nerve is your calming and relaxing nerve which goes from your brain and down to your abdomen, dividing itself into multiple branches that reach your throat, your heart, and all your viscera.

vagus nerve

Med Hypotheses. 2013 Jun 18. Chronic fatigue syndrome from vagus nerve infection: A psychoneuroimmunological hypothesis. Vanelzakker MB.

Acetylcholine is a neurotransmitter responsible for learning and memory. It is also calming and relaxing, and is the neurotransmitter your vagus nerve uses to send messages of peace and relaxation throughout your body. It is also a major factor regulating the immune system. Acetylcholine is a major brake on inflammation in the body and as it happens, inflammation is linked to every known disease. For instance, brain inflammation is linked to every known mood, behavior, attention, memory, or degenerative disease.

Stimulating your vagus nerve sends acetylcholine throughout your body – not only relaxing you – but also turning down the fires of inflammation. So activating the vagus nerve on a daily basis is critical to keep your brain and body healthy. By activating your vagus nerve you can reverse or stop all the negative effects of stress.

Éiriú Eolas – Stimulating the Vagus Nerve

Inflammatory molecules such as cytokines are necessary to protect us against pathogens and promote tissue repair, but excessive cytokine production can lead to systemic inflammation, organ failure and even death.

As a blessing from above, local and systemic inflammation is calmed down by the brain through what is called the cholinergic anti-inflammatory pathway which is a mechanism consisting of the vagus nerve and its neurotransmitter acetylcholine.

When there is inflammation, the vagus  nerve is working suboptimally.  Stimulation of the vagus nerve is already being used in epilepsy and depression, but now this anti-inflammatory pathway has extended its potential benefits to autoimmune diseases and beyond!

Lets look closer to this nerve and what else has in store for us.

20% of the fibers of the vagus nerve controls the organs of maintenance (heart, digestion, breathing). The rest 80% of the vagus nerve fibers sends information from your gut and other viscera to your brain, and the signals generated have the potential to affect the entire organism in order to achieve an homeostatic balance. This is why the vagus nerve is also known as the great wandering protector (vagus: vagare, to wander), for its protective role in our bodies.

The vagus nerve enhances neurogenesis (the creating of brain tissue) by increasing brain-derived neurotrophic factor (BDNF) output, which is like a super fertilizer for your brain cells. It helps repair brain tissue, but also helps with regeneration throughout your body. BDNF plays an important role in neuronal plasticity which is essential for learning, thinking and higher levels of brain function.

Stem cells are related to the vagus nerve as well. Activating your vagus nerve can stimulate stem cells to produce new cells and repair and build your own organs. Stem cells are mother cells, progenitor cells which have the potential to form different specialized cells in the body.

This is why the Éiriú Eolas breathing and meditation program has an amazing stress-control, healing, detoxing and rejuvenation effect in our bodies. It is based on stimulating the vagus nerve and its healing potential on all the body. For more information see Mass nervous breakdown: Millions of Americans on the brink as stress pandemic ravages society and also eebreathe.com.

    I’ve been doing Éiriú Eolas for over 6 months now and I’ve had some great results! Leading a “modern” lifestyle rapidly left me totally stressed… a busy work environment with long hours and short deadlines, three teenage children and generally trying to get ahead in life. I was overweight and not able to sleep for more than 4 hours at a go. After practicing EE for a short period of time, I found I was more relaxed and calm. It was much easier for me to put life in perspective so to speak. My sleep is now much better and I now am able to sleep for 6-7 hours without waking up. Recently while talking with a group of new friends, I asked them to guess my age. I was surprised when the nearest guess put me 5 years younger. I figure that must be rejuvenation!! By far the best benefit from Éiriú Eolas has been the ability to put my life in perspective. I feel I’m now back on track and better equipped to figure out what’s really important in life. I’d like to thank all those who developed and are helping to share this amazing program. – Kinyash, Kenya

Herpes virus infection of the vagus nerve?

So it was with interest that I read the following research “Chronic fatigue syndrome from vagus nerve infection: A psychoneuroimmunological hypothesis.” As this article states:

For years, CFS researchers have been looking in plasma and blood cells for a pathogenic agent that causes the myriad of symptoms experienced by patients with the condition. However, according to VanElzakker, they may have been looking in the wrong place (plasma) and need to search instead in the tissues of the peripheral and central nervous system. During infection, the sensory vagus nerve sends a signal to the brain to initiate “sickness behavior,” an involuntary response characterized by fatigue, fever, myalgia, depression, and other symptoms that are often observed in patients with CFS. However, VanElzakker proposes that when sensory vagal ganglia or paraganglia are themselves infected with any virus or bacteria, these symptoms would be exaggerated. He notes that many of the symptoms of sickness behavior (such as fatigue, sleep changes, myalgia, cognitive impairment, depression and zinc depletion) are also mediated by proinflammatory cytokines and observed in CFS.

It seems to me that this is another explanation why Éiriú Eolas practitioners report significant improvements for many problems that at first may seem disconnected.

The research is unique in that rather than blaming one specific virus or pathogen as a single causative agent of disease, it focuses instead on the location of an infection: the vagus nerve.

The Vagus Nerve Infection Hypothesis (VNIH) of CFS is as follows: While the sensory vagus nerve normally signals the body to rest when it senses a peripheral infection, that fatigue signal is pathologically exaggerated when an infection is located on the vagus nerve itself. More specifically: Immune cells, including neuroimmune cells called glial cells, sense infection and launch the same basic neuroexcitatory response
regardless of infection type. When the glial cells that envelop the sensitive vagus nerve are activated by any viral or bacterial infection, their neuroexcitatory secretions escalate afferent vagus nerve signaling, which is misinterpreted by the brain as evidence of a severe peripheral infection. The brain then initiates sickness behavior, which includes fatigue and many other CFS symptoms (see Key Terms Table). Because of the way that glial cell activation may persist in a pathological positive feedback loop (as it does in neuropathic pain conditions), these CFS symptoms can persist for many years.[…]

The study of phenomena – such as sickness behavior – that sit at the intersection of behavior, brain biology, and immunology, is a relatively new field of study known as psychoneuroimmunology […]  To understand the VNIH, one must understand each part of the connection among behavior (‘‘psycho-’’), the nervous system (‘‘-neuro-’’) and the innate immune system (‘‘-immunology’’).

The VNIH offers CFS researchers and patients a specific mechanism for explaining symptoms, and it offers testable hypotheses and treatment strategies. According to this hypothesis, the major symptoms experienced by CFS patients represent pathologically exaggerated sickness behavior caused by infection-activated glial signaling somewhere along the afferent vagus nerve system. Several researchers have advanced theories that align with the VNIH of CFS. Many groups have pointed out that CFS symptoms are consistent with viral infection and ongoing immune activation. More specifically, Shapiro theorized that CFS could be caused by the common neurotropic herpes virus varicella-zoster infecting the peripheral nervous system [139]. Maes has pointed out the overlap between inflammation, depression, and CFS [140]. The vagus nerve hypothesis provides an exact mechanism to these hypotheses, as well as an explanation for many of the inconsistencies in the literature.[Med Hypotheses. 2013 Jun 18. Chronic fatigue syndrome from vagus nerve infection: A psychoneuroimmunological hypothesis. Vanelzakker MB.]

This herpes virus varicella-zoster is a very problematic virus that contributes to mitochondrial dysfunction even in its latent infection phase. As I explained in On Viral “Junk” DNA, a DNA Enhancing Ketogenic Diet, and Cometary Kicks , most, if not all of your “junk” DNA has viral-like properties and if a pathogenic virus takes hold of our DNA or RNA, it could lead to disease or cancer.

Herpes simplex virus is a widespread human pathogen and it goes right after our mitochondrial DNA. Herpes simplex virus establishes its latency in sensory neurons, a type of cell that is highly sensitive to the pathological effects of mitochondrial DNA damage.  A latent viral infection might be driving the brain cell loss in neurodegenerative diseases such as Alzheimer’s disease.

Members of the herpes virus family, including cytomegalovirus and Epstein-Barr virus which most people have as a latent infection, can go after our mitochondrial DNA, causing neurodegenerative diseases by mitochondrial dysfunction. But a ketogenic diet – a diet based on animal fats – is the one thing that would help stabilize mDNA since mitochondria runs the best on fat fuel. As it happens, Alzheimer’s disease is the one condition where a ketogenic diet has a profound positive effect.

The role of mitochondrial dysfunction in our “modern” age maladies is a staggering one. Our mitochondrial energetic sources are essential if we are to heal from chronic ailments. It is our mitochondria the one that lies at the interface between the fuel from foods that come from our environment and our bodies’ energy demands. And it is a metabolism based on fat fuel, a ketone metabolism, the one which signals epigenetic changes that maximizes energetic output within our mitochondria and help us heal.

So with all of this in mind, it was not surprising to hear speculations such as, “what if the herpes zoster infection had a role in my heart attack via an infection of the vagus nerve?”. I thought that was pretty smart. If the vagus nerve is unable to calm down inflammation due to malfunction and/or infection within its sensory pathways, we are set up for trouble.

The more reason to welcome the idea of practicing Éiriú Eolas to balance up and heal the vagus nerve on a daily basis and so much needed dietary changes! Hopefully my old friend will introduce them soon enough as tools for his recovery.

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  1. Roy  August 19, 2016

    I believe its reasonably well known that sunlight can bring on a session of cold sores (herpes simplex). Why is this?
    Part of the answer might be a Vitamin D connection- I and others suffer cold sores start up every time I go back to taking Vitamin D. So is it possible that taking Vit D could awaken a sleeping H infection in the Vagal nerve?? and produce illness ?? (ive stopped taking Vit D on account of this possibly causing or being associated with my afib). Does any of this vitd/ vagal nerve/cfs/illness fit in with the modelling done by Trevor Marshall Phd

    • Gabriela Segura, MD  August 21, 2016

      It could be, Roy. I think the key is in fighting the stealth infections holistically. That might change how things work at the vitamin D receptor site.

      It reminds me a story a correspondent shared about the Gulf Oil Spill aftermath. People who never had vitamin D deficiency prior the Gulf Oil Spill, started having all sorts of problems including vitamin D deficiency. Other than stealth infections, I think the toxicity just broke their systems.

      • Cindy White  January 16, 2017

        I am 52 and have had the herpes simplex virus since I was 21, one diciscion I made changed my live forever! I started having seizures at age 40, and was diagnosed with autoimmune arthritis at age 27. I now know that becasue of the seizures I have a nervous system problem, and don’t really know much about all this stuff, but after reading this article it all started making sense of all the problems that I face, and all my symptoms! My question is could I have the issues that this article is talking about, and could it all come from this virus, and also is there something I can do to strengthen my nervous system ,and possible reverse ALL the health issues I have?? I take vit D and I have noticed that when I take it I seem to feel worse! What does it do to people with autoimmune diseases, and why?? I want to try the ketogentic diet and see if it helps with my nervous system problems! In just 1 year my nervous system just seem to be shot, and I have been told I have RSD! The one thing that I haven’t mentioned is I have two aunts ( Maternal) that have and had epilepsy. One of them died and my mom has a form of it, but not epilepsy. So there are questions unknown to me what really could be causing these nervous system problems!

      • Gabriela Segura, MD  January 16, 2017

        Trying the ketogenic diet is good. You don’t have to be very strict either. The important thing is to remove all grains and dairy, at least for a period of time. Gluten is a number one cause of epilepsy and it often triggers autoimmune diseases. Some of the components in gluten, a type of lectin, has a very similar structure to a virus. So your body stands a better chance of healing if you remove it. I would give the paleo diet a try because it restricts carbs and it eliminates all gluten grains and dairy. Or at least it should. Hope this helps.

  2. PeterH  October 9, 2016

    I’m 62 and eat healthy and have always enjoyed physical exercise activities or the gym. After 9-months of mono last year, and continued CFS, now at the 14th month mark, the CFS has subsided some, there’s way fewer 3-hour naps mid-morning, but I’ve had some very strange symptoms along the way, beyond multiple colds and (5) ENT infections. My PCP, substitute doctors, and Cardiologist have found nothing recently except “a cold”, or, “a virus” which usually passes. My Osteopath advised rest and sleep. But in between, I’ve had exertion intolerance (instead of energy build up and reward), running nose symptoms, regular swollen glands that come and go, foggy head, flu-like symptoms – so I was drawn to this explanation of vagal nerve virus – especially after going through Mobitz-II back in 2010, and a pacemaker solution. In 2010, my heart rate was slowing, the lower chamber missing the beat. Without the pacemaker setting my heart rate at 60 or above, my resting heart rate would be 50bpm, per my last pacer checkup. So I tried the AI Paleo for 30 days – which I think let my spleen finally rest a bit – lost about 10 lbs, I’m now 157lb at 5’9″ – weight has never been a problem – I used to play soccer in my 40’s.
    I’ve had my liver scanned, recent EKG and Echo(sonogram), all appears healthy.
    Now, after eating home made chicken soup every morning, along with dark fruits and vegetables and hibiscus teas, lots of water, I’m back on hot oatmeal, but no heavy wheats or sugars – I like eggs but not a lot of dairy at all – I drink coconut milk and take apple cider vinegar and coconut oil regularly.
    I’m ready to try Tai Chi and breathing, or anything to get my energy back!
    Thanks for any thoughts you may have,

    • Gabriela Segura, MD  October 10, 2016

      Hello Pete,

      It is best to address the CFS with several measures, other than the diet. I would consider doing saunas, taking supplements with at least vitamin C, magnesium, NAC, and other mitochondrial supporters. Also, doing coffee enemas and a probiotic enema once in awhile will be helpful. Taking lugol, a drop or two every two days will help you too. I have a dedicated post on the front page about the iodine research. All these steps are very helpful and then there is some more, but that is good for starters.

      • Liz  October 11, 2016

        Dr. Segura,
        When I read your comment about mitochondrial supporters, a red flag went up and I wanted to know your thoughts about the effect of Fluoroquinolones on mitochondria. I read a blog a few weeks ago about a Dr. who was ‘ floxed’ and had lyme as well and he/she also mentioned how their thyroid was affected. I’m so confused. I could have written that blog myself as our symptoms are practically identical. I know I have Lyme and I had Babesiosis but I’m very concerned about the damage that may have been caused by the antibiotic that I took in ’03. It was Tequin btw. My titers also indicated Sjorgren’s syndrome but I was told that can show as positive when the immune system is compromised – doesn’t necessarily mean I have that. ???? I don’t understand all this.
        Anyway, just thought I would share a link to the Dr’s blog and ask you about mitochondrial damage/diseases. http://fluoroquinolonethyroid.com/book_page/is-it-lymes-disease-sjogrens-syndrome-mitochondrial-disease-chronic-fatigue-syndrome-fibromyalgia-fluoroquinolone-toxicity-syndrome-or-the-commonalities-of-post-viral-po/

      • Gabriela Segura, MD  October 11, 2016

        Although fluoroquinolones have adverse side effects, I think it is fair to consider other factors for mitochondrial dysfunction first. Mitochondrial dysfunction can be found in practically all diseases. In the case of CFS, it is fair to say that many have found relief using antibiotics including cipro for certain protocols that calls for it, i.e. Gulf War Syndrome and its CFS. Mitochondrial dysfunction can be found in autoimmune diseases, stealth infections, toxicity problems, etc. One could argue what came first, the mitochondrial dysfunction due to the disease itself, or the adverse effect due to fluoroquinolones?

        In my experience, there are certain ethnicities that tolerate fluoroquinolones better. For instance, I’ve seen hundreds of Mediterranean people taking it without adverse effects. On the contrary, its clinical application is very useful and positive when responsibly prescribed. Caucasian people do seem to have more adverse reactions to it though.

        I would definitely choose any other antibiotic if I would have to do it: doxy, amoxicillin, azithromycin. And of course, replacing gut flora is always mandatory and that is best done with a probiotic enema.

        Even if you are certain of having being affected by fluoroquinolones, you can always follow the same mitochondrial healing approach: saunas, diet, supplements, resistance training exercise and so forth.

  3. Liz  October 11, 2016

    Yes, it’s such a mystery…which came first, the chicken or the egg? It’s interesting that you mention how some ethnicities tolerate fluoroquinolones better than others and you’re the only person who has ever addressed this that I know of. I agree with you and I asked my doctor about this because both my brother and I were affected by those antibiotics and we are of European and middle eastern Jewish heritage. The Tequin almost killed me and I’m not exaggerating and my brother has permanent and very painful damage to his joints/connective tissue. I was in intensive care for several days because of drug- induced coma, vasculitis, severe neurological damage (eyes, ears, hands) that has never resolved or healed. I also had a tendon rupture in my groin which caused pelvic prolapse in 2012. I was just sitting down talking on the phone and it ruptured. I also got Shingles in 2010 that was horrible and now with the Lyme, the affected nerves on that side of my face get attacked by the spirochetes and I get trigeminal neuralgia. I’ve been able to control it with daily Acyclovir…interesting, isn’t it? I’ve been under treatment for Borellia, Babesiosis and Bartonella since May and I’m using a combination of two antibiotics and several herbs including Quinine which seem to help significantly though I sometimes relapse. I’ve also noticed difficulty swallowing at times which I relate to the Vagus nerve being affected but not sure. I do take probiotics regularly but it seems so counter-intuitive since I’m always taking antibiotics that kill the probiotics! Your thoughts? How should one take both at the same time?
    I wanted to ask you how mitochondrial diseases are diagnosed. Is it just a clinical diagnosis or is there a test? My Lyme doctor suggested genetic testing in general but I’m not sure what that would reveal or how genetic testing works. Is there a comprehensive genetic test or does a doctor test for a certain disease???

    • Gabriela Segura, MD  October 11, 2016

      I would take probiotics orally every day before going to bed, about a couple of hours after you took your last antibiotic. Then, I would do probiotic enemas every week or two, specially if you are gone through a specific cycle of antibiotics. Then, twice per week, I would do a coffee enema:


      That would raise your glutathione levels. As for tests, you can go with whatever your doctor suggests. I think it is pretty much safe to assume that you have some degree of mitochondrial dysfunction, but the current antibiotic protocol and complementary therapies will help to heal it.

      • Liz  October 13, 2016

        Thanks for the info about the probiotics. I’m taking an expensive capsule probiotic and I’m also drinking Kefir and Kefir water that I make myself. I”ve read that probiotics are the safest antibiotics but I don’t know if I can just rely on them to treat the Borellia, etc..
        I saw my Lyme doctor the other day and I’m convinced that I am now suffering from MFS or ‘ Medical Fatigue Syndrome”…hahaha though I’m being half-serious. Dr. Segura, until a few months ago, I never took medications, rarely if ever visited a doctor and now my kitchen looks like a pharmacy. Sorry to whine, I’m feeling overwhelmed and sick of all this. I must confess that although I purchased the antibiotics that my doctor prescribed, I am too terrified to take them. She has me on 2 new: Cefdinir and metronidazole plus the Doxy. I’m not familiar with the first two and terrified of an adverse reaction like I had with the Tequin. There’s got to be a better way, a safer way???? I am also using herbs but I can’t use the herbal tinctures because they contain alcohol which I msut avoid with the Metron. She also recommended using a product called NutriNerve which is herbal and I don’t think it contains alcohol but I haven’t received it yet..
        Thanks for your thoughtful responses. Liz

  4. Eddie  October 17, 2016

    Hi Doctor. Im a 35 year old male who suffered a mild heart attack on the night of 11th October. I’m a known diabetic and now hypertensive with very poor control. I’ve been admitted in an hospital since my MI and am due for an Angiography tomorrow morning after the doctors have managed to bring my sugar and BP levels under control. This morning, I suddenly noticed a small lesion on the right side of my hip (in the public area) and it seems like one of herpes ( first occurance). I’m not sure if this will have any effect on the procedure of Angiography, and if I should report the same to my cardiologist. Please advice as I’m feeling both embarrassed and stressed at the same time.

    • Gabriela Segura, MD  October 17, 2016

      I would report it to the doctors, although at this point probably the angiography will be prioritized. You are under a lot of stress, so it is not surprising that it occurred. Once you are out of the hospital, know that there are many things you can do to change your lifestyle and diet that will help you enormously at long term.

  5. rew  October 30, 2016

    Thanks for site Dr and your thoughtful comments. I notice with interest your concepts regarding the connection between heart ailments and the vagus nerve via its infection with viral etc components and Vanelzakker.
    Im sure you would also be acquainted with the Roemheld Syndrome “where maladies in the gastrointestinal tract or abdomen trigger/cause cardiac symptoms” Sanjay Gupta -York Cardiology also mentions this in his YouTube presentation.
    The exact mechanism or pathway by which these maladies can cause cardiac symptoms has eluded me. The vagus nerve is a contender one would think but my search has not revealed how burping or a faulty MMC may drive the vagus nerve into the activity that Vanelzakker suggests. From personal experience of these maladies it seems rthe immune system is invoilved- but is it necessarily through the vagus? If so how and why?
    Others have suggested, functionally, that stomach maladies lead to hyperventilation, lowered CO2, and subsequent chronic arterial constrictions (normalbreathing.com for example) and so heart conditions. Still others suggest that intestinal gasses, bloating, or may constrict arteries in the area causing a feed back mechanism to affect normal cardiac rhythm.
    In my own case I tend to think that because the immune system seems to get involved, the vagus nerve may be implicated in this.
    Your thoughts on any of this greatly appreciated

    • Gabriela Segura, MD  October 30, 2016

      Hello Rew,

      I think you will find the “Polyvagal Theory” by Stephen Porges very interesting. It is known that the vagal system connects the gut with the brain, but it is really all connected. There is an important anti-inflammatory pathway which gets activated when the vagus nerve is stimulated. 90% of the fibers of the vagus nerve are afferent, they send info from the environment to the brain. This same system also involves the heart and our pro-social and anti-inflammatory behavior and health. If you study the anatomy of the vagus nerve, you’ll see the interconnections between our heart and lungs, viscera and the vagus nerve and the brain. I know of people who get viral infections and shortly have a heart attack within a few days. The important thing is to remember that we can consciously activate the good parts of the vagus nerve. This is what the eebreathe.com program teaches. The details of the anatomy and physiology of our vagus nerve and body is pretty fascinating. You can read about it in Stephen Porges’s book.

  6. Christy  November 21, 2016

    Hi Dr. Segura,

    This is a very interesting article. One that I can relate to. I contracted herpes last July…I think. I didn’t notice any unusual sores or OB. However, immediately had gut issues. My stools have not been normal since. I am marries and cheated in July(2015) but didn’t tell my husband until December. Prior to telling him, I noticed our breathing was oppressive. My stress was through the roof since July just holding this secret from him. I had been tested for all STD’s except Herpes. My GYN said she didn’t test me because I didn’t have a lesion. I know the oppressive breathing did not start until late November. Once I told him both of our stress levels were up. Still no OB. In April(2016) he got a bad dizzy spell that didn’t let up. In July (2016) he was diagnosed with Meniere’s Disease. I must add that he yawned alot. Always tired, he has gotten a little better. Both of our stools are not right which I know leads to diseases. After is Meniere’s diagnosis I decided to have a blood test done for herpes. It was positive. Oil of oregano seems to help our stools but cannot be used long term. I had him get stool tests done and his bacteria is all over the place. I’ve read about SIBO but it says that if you don’t fix the root of the cause then it will keep coming back. I have so much guilt that I can’t live with myself. But since July I have not stopped reading and have learned so much about the human body. In August I ordered some Diatomaceous Earth and that helped a little but brought on plenty of OB. I know it has something to do with the vagus nerve as to why our gut and breathing are not normal. I am so scared for our future and what other diseases this will bring on. I am so sad! Crying all the time. Are we broken forever? Can you give me any advice or tips to help? I’ve seen so many doctors and haven’t gotten anywhere.

  7. Flgrl75  December 11, 2016

    I’m suffering with PVC’s, PAC’s and Vtac episodes. Very scary stuff. I’ve had every heart test possible and it’s a strong healthy heart.
    After TUNZ of my own research I finally figured out it’s my Vagus nerve. I have IBS-C and whenever I’m constipated (which is almost daily) or have gas, my heart goes crazy.
    Problem is I can’t figure out how to keep my tummy happy. I’m searching for a Dr that specializes in the Vagus and tummy.
    I’m to the point that I need to take laxatives or enemas in order to have a small movement however I’m scared it’ll set the Vagus nerve off.
    I’m thrilled I put two n two together, BUT I still can’t make this stop.

    • Gabriela Segura, MD  December 11, 2016

      I would focus on healing the gut through dietary changes and supplementation. For a healthy diet, you can read “Primal Body, Primal Mind”. There is a chapter there on supplements for gut healing. I would also consider probiotic and coffee enemas, as it helps to heal your gut and with detoxification. People who have heart arrhytmmias with coffee, don’t get them through coffee enemas because in the later case the coffee circulates through the enterohepatic circulation, not the systemic circulation.

      I would also research on fecal transplantation to see if this could help your health.

      Also, do eebreathe.com. The program is available online. It helps balance the vagus nerve via activation of the smart vagus, the healthy system of the vagus nerve.

    • damon  December 11, 2016

      I have the exact same thing. I also was diagnosed with a small hiatal hernia and wonder if that’s affecting things too. These flutters / Palps are soooooooo annoying and give me anxiety to the point I don’t want to do anything. Sitting in a car makes them worse.

      Wish there was someone I could pay to help, all the doctors do is give me PPI s and say it’s acid reflux.

      I’m convinced it’s my stomach irritation and vagas nerve causing everything!

  8. Kingston  December 27, 2016

    Dear Dr.,
    I am a holistic bodyworker with 23 years and 30,000+ bodies palpated. I can feel when the vagal, phrenic, facial, trigeminal, or any major nerve complex (be it CN or elsewhwere) is infected. There are also different variations within the viral loads (yes,they actually have different surface structure). I have no connection to the modern medical paradigm. Where is there research happening? Who is on the front lines? I read Medical Medium, and he is on point (however he also sits outside the medical community). Please respond. A dopo……

  9. Kate Gurt  March 6, 2017

    After infection with lyme, my daughter has proplems with difficulty swallowing and symptomatic sinus bradycardia into the 40s heart rate. Can you recommend treatment? Kate G

    • Gabriela Segura, MD  March 6, 2017

      Have you read “Why Can’t I get Better” by Richard Horowitz?

      • Kate Gurt  March 6, 2017

        Thank you for your response. I am aware of chronic Lyme. My daughter is finally feeling better except for this residual symptom. Unknown if it is damage, inflammation, or still some residual active lyme. I read your article on the vagus nerve and didn”t know if you could recommend anything specific to this symptom in terms of healing the vagus nerve. Thank you. Kate Gurt

      • Gabriela Segura, MD  March 6, 2017

        Treating the root of the problem should ameliorate the symptoms. Hope your daughter recovers.

    • Liz  March 6, 2017

      I also recommend Horowitz’s book. ( hello again Dr. Segura)
      I am still being treated for Lyme and coinfections ( 10 months now). I also had the same symptoms as your daughter and every so often, I still have varying heart rates and blood pressure in the extremes and I have trouble swallowing. Sometimes it is so uncomfortable that I have to get up during a meal and walk around to take advantage of gravity. I don’t know if your daughter has taken an SSRI antidepressant but they can produce the swallowing problems in some patients- creating a lump in the throat effect. In my case, it was nerve damage from the Lyme. I had rather moderate to severe neuro-lyme symptoms. Although I’m steadily improving, my breathing patterns get interrupted every so often as well ( like I have to suddenly gasp for air or I’m having a chest spasm and must strain to take a breath or talk). My Lyme doctor recommended a supplement called NutriNerve ( expensive) that I take twice a day and I’ve had steady improvement since I’ve been taking it. She also told me to take Curcurmin for inflammation and heavy doses of Vitamin C and B Complex. I’m also taking the daily supplement that Vital Choice makes that contains curcurmin. The reason I choose Vital Choice is because they test for radiation and heavy metals- none of which I can tolerate. I also avoid all types of sugar and caffeine except for an occasional ginger ale to relieve nausea. For support from other Lyme patients, I suggest visiting a blog called TiredOfLyme.

      • Kate Gurt  March 6, 2017

        Thank you so much for sharing. We are unable to find a naturopath in our area and most mds will not even acknowledge lyme exista in Alabama. Would it be possible to share your naturopath’s name or lnk?kate

    • Liz  March 7, 2017

      My MD is an Internist who specializes in Lyme and coinfections. Although she works with Dr. Shor in northern VA ( too expensive for me) she also works at a community clinic about an hour from me on a sliding scale. I got lucky- REAL lucky. Anyway, she’s not an ND or Naturopath. I’m in eastern VA which is only slightly better than Alabama in terms of getting proper medical care. http://sabrabellovin.com Have you tried finding a Lyme support group in your state? As you know, you must be proactive about contacting people and getting the help you need because most physicians are ignorant about these diseases or they simply don’t want the burden of treating Lyme patients and risking their license. The most reliable and effective advice I’ve gotten ( aside from my doctor’s antibiotics and supplements) is from the blogger at TiredOfLyme regarding diet, supplements and some treatments.


      I wouldn’t see a Naturopath unless they are a board cert. NMD, not just an ND and I would ask them how familiar they are with Neurological Lyme. It’s possible that your daughter still harbors other forms of the Borellia (biofilm) or that she has other viruses, bacteria and parasites. Probiotics are necessary for healing the gut biome as well ( which affects neurological symptoms since serotonin is in the gut ) and I’m using Florastor ( most effective against C.difficile) and L.salivarious and others. Detoxing is also important. I use Alkaseltzer GOLD and lemon (Horowitz) and charcoal capsules and high doses of Vit C- Ester C.

  10. Sarah  March 20, 2017

    Thanks for an interesting article. I came across it looking for a link between cold sores and vagus nerve issues.
    After many years of probs, coeliac, multiple allergies, food intolerances & fatigue, I was found to have a B12 deficiency. At the time I collapsed frequently, had nominal aphasia, foot drop, fibro pains, bowel and bladder urgency, pins & needles in hands & arms – but if a state really! After 18 months of intensive self administered hydroxocobalamin injections (GP gave me fortnightly injections, I topped up every other day) lots of symptoms went but I was left with fatigue and collapses, about 3 or 4 a week, more if I over-exerted like worked a full day or had a half hour run.
    In Jan I was diagnosed with Autonomic Dysfunction and Tachycardia from an over sensitivity to adrenaline (shock causes collapses). My specialist didn’t put me on beta blockers so that I could continue my sport, I am on an SSRI instead.
    I had frequent monthly bouts of cold sores up for about 3 years prior to the SSRI but it’s just occurred to me that I haven’t had any since starting the SSRI. The meds have also somewhat controlled my collapses – I react less often and less intensely when I do. I’m also on a keto diet, no caffeine, no sugars or fruit, no gluten, no dairy.
    Not sure I understand how the SSRI has controlled the herpes simplex and if this is all connected to adrenaline sensitivity and vagus nerve issues.
    (My collapses start with yawning and my eyes stream, my bowels and bladder need to empty, I cold sweat, lose temperature regulation, I can’t speak or sometimes lift my arms and I want to sleep wherever I am). I’m certain this is vagus/ parasympathetic issues.

  11. Syrena  June 5, 2017

    This is a great article! Thank you! 10 years ago, I was diagnosed with “multiple chemical sensitivities”, but I knew that that wasn’t the whole story. I was also abnormally fatigued, everyday, and struggle with all sorts of sensitivities. I had had many episodes of strep throat as a kid, and spent A LOT of time on antibiotics in my life. I had a rough childhood and certainly PTSD. I came online to do research on the vagus nerve and found this article along the way.

    Interestingly, I have been recently diagnosed with “POTS”, and will be going to a new cardiologist, this week. My last two EKG’s showed an “infarction of unknown age”, and I haven’t yet found a cardiologist that I feel comfortable with to follow up. My nervous system is so easily triggered, that I get motion sick, even from driving my own car. I get sick from being in the presence of cell phones and wifi, too. It feels quite disabling when the symptoms come on from these things. It makes much more sense to me about the hyperactive glial cells and the underactive vagus nerve! Now, what to do about it?

    I already do some yoga, a lot of meditation, and a bit of neural linguistic programming. I cannot tolerate ANY drugs, not even homeopathic. It is difficult for me to even eat, sometimes, because if I’m overstimulated, I can react strongly to foods. Every activity in my life has to be done cautiously. It really sucks!

    I’m pretty sure that you can add POTS and Multiple Chemical Sensitivities to the list of people who suffer from glial cell/vagus nerve issues. :)


  12. Mary  July 28, 2017

    What about heavy metal toxicity due to a broken Essure implant? Would that effect my vagus nerve?

  13. Lei  August 11, 2017

    Thank you for your research and article. I am a health care practitioner, as well as individual who has lived with HSV and “a-typical” CFS/Fibromyalgia for 35+ years. I utilize natural herbals and non processed foods in my daily life, work out 5-6 x/week (since age 15, now 52) though take a generic acyclovir daily to facilitate symptom management. I am in Doctorate school now, and continue with a holistic mindset and clinical practice. I have multiple food intolerances, with constant awareness and avoidance of intake of food or supplements with arginine ratio greater than lysine. Often, I am able to manage the HSV migraines via postural and positional changes offloading nerve compression in the C and L spine. Unfortunately, I was not as successful with my GI and have had all of my lower intestines removed, now with an irreversible ileostomy. Long story short, to this day, believe I was misdiagnosed with what was most likely a secondary symptom of the HSV. Another Oprah show. My apologies, I digress. I have been under great amounts of prolonged stress recently, and subsequently experienced tremendous brain fog, fatigue,, migraines, and loss of appetite over the weekend, while embarking on a CEU. I recognized the viral symptoms and increased my antiviral dose, as I typically take the minimum. The fatigue had gotten a bit better a day after, then, huge stress amounts were reencountered. Last night experienced irregular HR, to the extent that I was unable to sleep. It has continued today, as well as BP changes. I have had irregular tendencies on prior occassions, though typically from hydration issues relating to ostomy/mineral imbalances, typically easily resolved. This did not, and has not yet. So will be seeing a cardiologist tomorrow. I decided to research correlation today, between virus and cardiac symptoms. Low and behold, your article/research/theory/findings were made known by my search. I absolutely will attest to the theory and look forward to further research findings and resolve of this disease that has taken so very much from my life. I feel strongly in community education and believe that the public needs to be aware of the extensive impact this disease potentially can have on their lives. I strongly believe that knowledge and prevention are needed as a community to save many from this challenging path.

    Thank you!

  14. Lei  August 16, 2017

    Dr. Segura,

    Thank you for your response back and insight on photobiomodulation. I actually just experienced this modality about a month ago, post Fraxel treatment and had a very positive response. Will absolutely consider for management of other symptoms.

    Thank you, again!
    Be well!!

  15. Theammit  November 29, 2017

    I’m a 49 year old female that contracted what is assume was HSV-1 when I was in elementary school. Mouth was so full of painful lesions I was unable to eat or drink for over 24 hours. A pathologist my mother worked for prescribed medication that resolved the issue in about another 48 hours. Since then I’ve suffered the occasional fever blister when I’ll or after getting too much sun. They’re truly rare as in less than three times a year. However, I have an old neck injury from a car accident about 17 years ago and I’ve been blaming most of my symptoms on that, but I woke this morning with my only fever blister of the year and I’m experiencing a severe nerve pain under my right clavical. That’s new! I was also battling with heart palpitations all of last week for no apparent reason. Also new. I have been deeply depressed for most of my life and over the last year have been experiencing extreme fatigue, pain and noticeable swelling in my abdomen, an excessive weight gain. It occurred to me this morning that I should check for any correlation between the herpes outbreak this morning and my other symptoms. How would I go about convincing a doctor to try and determine if these things are connected? In the past if I mentioned I found information online I get a general dismissal as if I were trying to be a doctor. All I really want to to know what could be happening to my body.

    • Gabriela Segura, MD  November 29, 2017

      Herpes can be a real problem, specially if the “terrain” (your body) is especially weakened. There are many things you can try to heal, for instance photobiomodulation and an anti-inflammatory diet. You can take nutrient supplements to help strengthen your body. It might be worth seeking an opened minded health care provider who can work with you through several factors that affect your health.

      Another thing that might be useful is autohemotherapy which has had very good results against viral infections. It works as immunotherapy, stimulating macrophages against infections. See for instance:


      Hope you get better.

  16. Adam  February 3, 2018

    Thanks for your articles. I read your blog often a few years back and just now stumbled across it again. I have been curing myself of CFS. I agree wholeheartedly with much of the hypotheses in your writing. I tried all kinds of detoxes, diets, fasting, supplements, etc. What has been the key to my expedited healing(and what I ultimately feel to be the cure)? Reducing sympathetic dominance(aka building parasympathetic and vagal tone) and always doing less than I am able to, rather than attempting to spend my way out of debt by traditional methods such as those failed attempts(*detox reaction often = stress reaction) or just the same, building endurance by pushing myself(which as a former athlete and trainer, is what got me here). Calming herbs in conjunction with deep breathing and an intentionally slowed pace of thinking has been very helpful as well. There is a great video on Youtube by Sally Gray (should you be interested) called: How to Heal the Vagus Nerve to Heal Your Mind & Body. It seems most illnesses are manifestations of stress, even when one does not traditionally “feel stressed”, as stress often feels normal when one does not know calmness. Okay, I’m signing off before I write a novel and am looking forward to reading you Mass Nervous Breakdown article again. I found it true a few years back; and now, a few years forward, I find it blindingly obvious and nearly impossible not to notice. Great work, Doc.

    • Gabriela Segura, MD  February 3, 2018

      That is a great testimonial, Adam! Interesting that you should mention sympathetic dominance. I’m doing neurofeedback right now to reduce “pre-verbal” states of hypervigilance. It has helped me immensely so far. That and the breathing program to stimulate the smart vagus nerve. You can check out the entire Eiriu Eolas program here:


      Thank you for your input!



  17. Franziska Helfenbein  July 15, 2018

    Hello, it is true. I had a herpes zoster infection (Gürtelrose) on / in my left brest 8 month ago. After that, my heart was beating to fast and out of rhythm, I didn’t her deep tones with my left ear anymore, I get dizzy every time I sing and meditate. My doctors neither could help me nor believe me. I thought: My vagus nerve is out of order and go to a Osteopath. He said that I was right and he helped me by giving me several energie massages he had learnd in a Peking hospiteal (chinese medicine). Now, after taking vitamin B 12 and B 6 too, all symptoms are nearly gone. I am so happy.

  18. heather  August 2, 2018

    My boyfriend is HSV-2 positive. I initially thought it was not a big deal until I became aware that HSV-2 can be worse in people who have weak/damaged immune systems. Since it is not known exactly what mechanism is at work in post-treatment/ chronic Lyme it is hard to say if I am in fact immunocompromised or if there is an autoimmune aspect to the disease. All I know is that my body has a heck of a time regenerating energy after minimal exertion and I have to be careful about getting colds because they can last couple months. I’m not a doctor so I can’t say for certain what is going on (though it seems that doctors can’t either) but it seems to be that my immune system is damaged or at least not functioning properly.

    I really freaked out when I found out that herpes can be worse in people with compromised immune systems and shut down the idea of sex at all, which of course caused some issues in our relationship. I realize I overreacted, but after having gone through a nightmare with Lyme (years where I could not get out of bed or shower and pain blindingly painful muscular spasms that would last for days) I was quick to nix anything that could put my health in jeopardy, especially just as I am starting to feel a little better. I’ve done a fair amount of research and now am open to having sex as long as condoms, Vaclovir and pubic hair (I read that having it can help reduce risk of skin to skin transmitted STIs) are all used/there.
    Has anyone had any experience with having HSV-2 on top of Lyme or another chronic/debilitating illness? I really care about my boyfriend and want to be able to be physically intimate but at the same time don’t want it to come at the cost to my health. He has said he doesn’t like using condoms but I feel that it would be too great a risk to not use. Am I overreacting? Is there any guidance from anyone who has been in a similar situation?
    I have stumbled here today, I have also been reading on sites like

  19. Francina Krnach  February 17, 2020

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