Is your brain causing your leaky gut? One of the ways brain dysfunction can contribute to leaky gut is through poor vagus nerve activity. The vagus nerve is a large nerve that sends communication back and forth between the organs and the brain. When the brain is in poor health it can inhibit vagal nerve activity, thus robbing the digestive tract of optimal function.
We have a few ways to spot poor vagal nerve function in an exam. For instance, since the vagus is responsible for bowel motility, a practitioner should be able to hear rumbling in the abdomen with a stethoscope. When the gut-brain axis is impaired, it is common to hear very little rumbling.
The vagus nerve is responsible for raising the uvula, the tissue in the back of your throat that looks like a punching bag. When you visit your doctor and say “ahh” he or she is looking for it to rise. When the vagus is not working well, the uvula does not rise much.
The gag reflex is also not very responsive. When exam findings show these functions are poor in a person with chronic digestive problems and a poor brain function, it indicates a strong possibility the gut-brain axis is not working well.
It is not uncommon for doctors to ignore the gut-brain axis in patients with chronic gut complaints. Interventions such as enzymes, probiotics, and other digestive aids may improve digestive health, but the clinical focus should also support brain health to improve the gut-brain axis.
Improving your vagus nerve
Like muscles, neurons need constant stimulation to be healthy. If you break your arm and wear a cast, the muscles shrink within a few weeks from reduced activity. Neurons are no different. Without activation they lose function. Remember, 90 percent of the brain’s output goes through the brainstem. If a poorly functioning brain does not stimulate the vagus nerve, the result is reduced activation of the gastrointestinal tract.
In functional medicine brain care, practitioners rehabilitate the vagus nerve through exercises that make it stronger. Brain pathways can be strengthened just like muscles.
For example, a person with weak biceps can make them stronger doing bicep curls, which develops proteins in the muscles to build strength. Functional neurology brain rehabilitation is no different. As you stimulate weak neurons they develop more proteins to become stronger. This is called the development of positive plasticity and can be done with any part of the brain. If you have a poorly functioning gut-brain axis and vagus nerve, neurological exercises can increase the plasticity and function of the vagus pathway.
Vagal exercises are easy to perform at home. I commonly prescribe the exercises below to my patients who have poor vagal tone and gut-brain axis failure.
Gargle
The first exercise is to gargle with water several times a day. The vagus nerve activates the muscles in the back of the throat that allow you to gargle. Gargling contracts these muscles, which activates the vagus nerve and stimulates the gastrointestinal tract.
Drink several large glasses of water per day and gargle each sip until you finish the glass of water. You should gargle long enough and deep enough to make it a bit challenging. A two-second light gargle may be equivalent to using a 2-pound dumbbell to strengthen your arm versus a 10-pound dumbbell. It will not work unless it is more challenging. Do this exercise for several weeks to help strengthen the vagal pathways.
Sing loudly
I also encourage my patients to sing as loudly as they can when they are in their car or at home. This works the muscles in the back of the throat to activate the vagus. This exercise may become a nuisance for family members, but I still recommend it.
Gag
I also have patients purchase a box of tongue blades so they can stimulate their gag reflex throughout the day. Do not jab the back of your throat with the tongue blade and hurt yourself, just lay the tongue blade on the back of your tongue and push down to activate a gag reflex.
Gag reflexes are like doing push-ups for the vagus while gargling and singing loudly are like doing sprints. It will take some time using these exercises to strengthen vagal tone and the gut-brain axis. You need to perform them for several weeks to produce change, just as you would with weight training. You cannot go to the gym for just a few days and expect your muscles to grow. Nor can you perform these exercises for a couple of days and expect to see profound change, although it does produce change very quickly for some.
Coffee enemas
In patients with brain degeneration who are having significant difficulty with regular bowel movements, I encourage them to perform daily coffee enemas. Distending the intestines with an enema activates the vagus. The caffeine in the coffee stimulates intestinal motility by acting on cholinergic receptors. This allows the patient to relieve bowel contents, which is very important for overall health.
Many people notice bowel function improves over time and they can begin weaning off the enemas. This is because the enemas help develop positive plastic change in their vagal system pathways. Unfortunately, some people have such rapid brain degeneration that it outpaces the ability to gain positive changes. In this case the coffee enema is used to prevent impacted bowels.
A coffee enema is very easy to do. For detailed instructions, see my article “How and why to do a coffee enema.”
The coffee will stimulate the cholinergic receptors in your intestines and activate motility as well as stimulate your vagal system to develop plasticity. The cholinergic stimulation from coffee will also cause your gallbladder to contract, helping release liver metabolism end-products into your bowel for elimination.
If you do not have significant constipation, leaky gut, or other GI issues, but your gut-brain axis is compromised, it is still a good idea to build vagal tone (along with gargling, singing loudly, or performing gag reflexes on yourself). Loss of vagal tone is almost always secondary to poor brain function. Strategies to improve overall brain function are absolutely critical when working on gut function.
Is there any concern that too many coffee enemas causes dysbiosis in the colon? If so, what can you do get the benefits of the enema and maintain good gut flora?
Also, how quickly would you start to see results from the gargling and gagging exercises for the vagus nerve?
Hi Jackie,
Some patients start to see a response to the vagus nerve exercises within days, such as better gut motility, reduction in bloating, improved mental clarity. For some it takes longer. Dr. Kharrazian encourages patients to keep up with it regardless.
Hi Jackie,
I have seen this question go around support groups, but I have not heard practitioners state concern over it. I suppose the answer might depend on how you qualify “too many”. I do remember hearing Dr. Kharrazian address this in a lecture and the gist was “not a concern” but I’m sorry I do not remember which lecture. I’m not sure there’s a simple or single answer to your question because there are so many factors that could play in.
Interestingly, some research has shown that even after the prep for a colonoscopy (it’s quite harsh on the intestines) patients naturally rebuilt their bacterial populations within a matter of weeks (https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0062815). Daily coffee enemas have been used for decades in cancer treatment (look up Gerson protocol). Many of Dr. Kharrazian’s brain patients use them regularly and we haven’t heard complaints of detriment to gut microbiota.
If you haven’t read it yet, check out Dr. Kharrazian’s article on coffee enemas:
https://drknews.com/coffee-enema/
In your shoes I’d do the amount of enemas that seem to benefit my vagal nerve function, and continue all the things I’d otherwise do to support my gut microbiome: fiber-heavy diet, no processed foods, 7-9 servings of produce (mainly low-carb veggies) per day, hydration, botanical support for gut lining integrity, managing systemic inflammation, prioritize sleep, etc.
For articles on supporting gut health and flora, see these articles on his blog:
https://drknews.com/functional-medicine-articles/?term=69&orderby=date&order=DESC
You might also check out his new 3D Immune Tolerance course: https://drknews.com/3d-immune-tolerance/
The course works on supporting the gut microbiome and immune function.
Hi, I tried the gag reflex and discovered I lost it completely, and I know I do it right because I know I had it a few months ago. What does it mean?
Hi Avi,
If you have no response to the gag reflex, you may have very underactive vagus function. I’ve been told in this case to just keep doing all 4 of the vagus exercises and see how it changes. It may be you will start to notice some reaction over a few weeks.
I’ve had Lyme and co-infections (misdiagnosed for 4 years) since 1998, very disabled still, found out about mold and am not completely out of it in spite of many exhausting moves. In 2011 my vagus nerve began going berserk: as soon as I would take a sip of water or begin to eat I would feel an intense agitation and almost breathlessness and an impulse to keep eating more and more. Sometimes I will chew some gum to satisfy the urge instead of unconsciously biting my lips raw, it is a feeling of franticness which is not at all my nature, and it takes a long time after eating or drinking anything for it to calm down. I do not have a gag reflex. I do gargle, stimulate the vagus often during the day but the effects last only a minute if that much. I did receive magnet therapy for a short while about 5 years ago but my heart was at that time skipping a lot of beats (also got a dx of Bartonella for the first time around then) and I had to have an ablation then a pacemaker so no more magnets. Doctors do not know what to do with me other than encourage more of the singing or specific head and eye movements etc but I am exhausted from so many years of this. I still test positive for Babesiosis but have not been able to tolerate the meds for it and years and years of herbs have not cleared up the infections. Neurologists can not find any reason for this happening. Can you help?
Hi Susan,
Sorry to hear you are suffering from all of this. Dr. Kharrazian isn’t taking on any new patients at this time, however he has a practitioner-finder page on the Kharrazian Institute website where you might seek someone who has trained with him: https://kharrazianinstitute.com/ki-practitioner-locator/.
In your shoes, I’d seek out the ones who list functional neurology as a focus or specialty. FN is a bit different than conventional neurology, and many of the practitioners have added ways to dial in on the causes for symptoms. Perhaps one who is experienced in both FN and functional medicine can make the connections your past neurologists have not been able to make.
Please look into a program called DNRS (dynamic neural retraining system?) from Annie Hopper. Her program has helped people with complex and ongoing issues like yours. A family member of mine has been using this program with excellent results. Good luck!
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I am trying to take your brian course and food intolerance courses and it is now allowing me to proceed to payment. Please advise.
Many thanks
Hi please email through the contact page so this gets to the person who can help you.
In addition to the Vagus nerve exercises , what are Dr. K’s suggestions for improving brain dysfunction?
Doreen
Please refer to his brain book and brain course as that is an involved topic.
Hello. I have the opposite effect. Singing, gargling, yawning, talking at times, having food in my mouth for too long, working out and stress causes me to gag or have a strong urge to.
Are there any side effects to repetitive exercises like gag/gargle if used regularly?
Like sore throat, chest, stomach from the path the nerve runs on
Do vagus nerve stimulator devices work in conjunction with or in place of the four exercises you describe? Any units that you like in particular?