Dr. Navaz Habib, aka “The Vagus Nerve Doc,” is a best-selling author of 2 books – “Activate Your Vagus Nerve” and “Upgrade Your Vagus Nerve” and host of The Health Upgrade Podcast. After using functional medicine to overcome his own health challenges, Dr. Habib built Health Upgraded, an online health program implementing his VAGUS protocol, to guide parents and professionals to enhance their health by unlocking the healing power of the Vagus nerve to reduce the effects of stress and inflammation.
Dr Ritamarie
What if the most powerful healing tool you had in your body was not a lab test or a diet change, but a hidden switch that's hidden deep inside the brain that if that is off, nothing's going to happen. No healing, no matter what supplements, no matter what food, no matter what activity, exercise, whatever, you've got to start with that.
The vagus nerve is the body's built-in pathway. It's a healing pathway. It calms inflammation. It increases your vitality. It does all of these things, and we need to learn how to manage it. And it is manageable. That's the good news. It takes a little effort, but before you as a practitioner go out there and start prescribing the latest and the greatest supplement for your clients, you've got to balance the switch.
That's why I'm super excited to have here today, Dr. Navaz Habib, the vagus nerve doc he's known as. And we're going to uncover how activating the vagus nerve can transform your health and your practice. Welcome today. I'm so excited to have you here.
Navaz Habib, DC (01:32)
I'm honored to be here with you, Dr. Ritamarie.
Dr Ritamarie (01:36)
Thank you, thank you for taking the time. I know you're busy, and I know you have a lot of speaking engagements, and you're in demand, because this is a hot topic.
Years ago, I don't know about you, I've been around a long, long time. And when I first started in practice, if I said the word “vagus nerve,” people go, what's that? Right? Now everybody knows what the vagus nerve is. It's all over the place. Kind of like SIBO, the vagus nerve, things that we used to just see or talk to our colleagues about. Now everybody's talking about it. As a practitioner, you need to know, right? You need to know what this is, and you need to have that magic activating switch.
Navaz Habib, DC (02:11)
100%. You couldn't have said it better.
Dr Ritamarie (02:14)
Well, thank you for that.
Let's just jump in. I mean, I think it's overlooked. I think it's talked about more, but it's overlooked in the sense of actually when you have a client in front of you or when you're starting your healing journey, stopping, slowing down, and really looking at how can I activate my healing. Let's talk about parasympathetic versus sympathetic balance and how that relates to healing.
Navaz Habib, DC (02:37)
I love that. And I always kind of bring this up when I'm speaking to practitioners, and I appreciate that the majority of listeners here, and people that are watching, are going to be on the practitioner side or on the healer side of things.
I just want to bring something that you said when we get into a room, when we sit down with the client, when we get on a call with somebody, our energy transports them into a state that they need to then ideally take on. And so if our energy is flustered and is running around as stressed out and is not in a focused calm mode, then we're pushing that energy on to our client. And so we need to be really, really careful about that.
And I realize I've gotten a little preachy off the bat, but it's very important as a practitioner to enter this doctor patient, this healer and client relationship with being in this particular mode. And so why does this mode matter?
Why is the vagus nerve so unique when it comes to this particular mode? Well, it literally is as simple as sympathetic parasympathetic.
Sympathetic is the fight and flight side of things, right? We know that that's the go-go, let's push, push, we're under stress, things are going on, whether positive or negative, they're pushing us into a sympathetic state.
And this is a necessary state. Sympathetic is absolutely necessary. Without it, it's like having a car with no accelerator, right? The car won't go anywhere. You need to have an accelerator to make the car go. Without an accelerator, without a functioning engine, it's a hunk of junk sitting in the garage. Versus if we don't have the other side of this, and that's the parasympathetic side of things, which in this analogy is the brakes.
This is the rest-digest, and I've added recover mode, because we need to be in this state in order to rest, to calm down, to digest, which doesn't all disease begin in the gut? Don't we need to maybe send the signals to the gut to turn on through rest, digest, and recover state. And we add recover, because we now realize very importantly that the vagus nerve, and this autonomic nervous system of sympathetic parasympathetic, is actually speaking to the immune system.
And it's the immune cells that are getting pushed in one of these directions, whether they're going into fight or flight, or they're going to rest, digest, and recover. The immune cells are the ones that we're actually speaking to. That's going to dictate inflammation, that's going to dictate a lot, just on the basics, sympathetic, accelerator, parasympathetic, breaks.
If you're going into a room with a client, or you're sitting down with them, you're pushing on your accelerator, they're going to take on that energy. So you need to go in and take a breath.
Something that I like to do when I start a call with a client, I do everything online, I will sit down with my client, and we'll say, okay, let's take three breaths, three breaths, one hand on our chest, one hand on our belly, breathing through our nose, breathing into our belly. I'll teach all of that. Three breaths of basic nasal diaphragmatic longer, longer exhales. And we'll get into why I do that. It is such a powerful tool, not only only in helping them shift into that state where they can take in the teachings and the work that we're going to do, but for me to take on that state, so that I enter, sit down, and my focus, engagement is purely with them. So that's, I think, a really powerful tool for practitioners to take on.
Dr Ritamarie (06:08)
Beautiful. I love that. And thank you for sharing that process that you do at the start of it. Because so many times we're going from one thing to the next, and we just hop on and jump right into it. And to take that time, and the three breaths, and the hold, and it's so focused.
I want to go back to something you said about the immune system. Let's share a little bit more about the immune system connection. Because that's been a big “talk of the town” for the last five years.
Navaz Habib, DC (06:34)
It should be the talk of the town forever. It's the immune system that has been more misunderstood than anything else, right? We've always kind of placed the immune system as being our protection system. It's the survival mode system. When there's a threat to our survival, the immune system turns on. Bacteria, toxins, something's entering the body. The immune system needs to turn on. That assumption, sadly, is that the immune system is off when we don't have something that we're fighting against. And that is a very unsafe assumption to make.
The immune system builds us. It's the first cell to differentiate. When we are in the womb, when we are conceived, and we are this nice bundle of cells, the first stem cells differentiate our tissue resident macrophages. These are the innate immune cells. They happen to differentiate around, I believe, it's around day eight.
And they start to go out to areas where they then create the somites, and the somites form around those differentiated tissue resident macrophages. Those macrophages then dictate the growth of each of the organs, each of the organs within those areas, within those somites, growing an organ. And those tissue resident macrophages remain in those organs for the rest of your life. So in the brain, they're microglial cells, in your liver, Kupffer cells, in your lungs, they are your alveolar macrophages, in the gut, they are the intestinal macrophages at every different layer, right?
This is essentially where the immune system is functioning. Now, how do we make sure that the information getting from the immune system to the brain is functioning well, and we're getting that information effectively through? Well, that's the role of the vagus nerve.
80% of the information on the vagus nerve is coming from these immune cells up to the brain to the nucleus tractus solitarius that specific spot within the brainstem in the medulla, and 80% of the on vagus is coming up. We've always made this assumption, vagus nerve, parasympathetic, rest, digest, recover information, brain to body. It's not just that, it's body to brain. Vast, vast majority, four out of five lanes on that highway are up to the brain.
Otherwise, we don't know what's going on. And if the brain is the CEO of the body, the vagus nerve is getting the information up. It's those important meetings that the CEO is getting information from the CMO, the sales staff, the HR team, all of the organs are sending their information up via these immune cells that are constantly there checking what's going on, ensuring that these organs are working well. And that information comes up via the vagus nerve to the brain.
Only 15% of the vagus nerve's information is brain to body parasympathetic information. That's going down to the immune system to say, hey, you're in an inflamed state, but I don't think you need to be in such an inflamed state. Let's calm that down. And the vagus nerve sends that signal when necessary, when appropriate. But if it needs to be on, then it sends a signal via the sympathetics through the brain to say, yeah, get inflamed, go for it. You're under stress, let's do it.
Your nervous system dictates whether you're going to go into sympathetic, or parasympathetic and send those signals effectively. But if it doesn't get the information effectively, if the information that's coming from the organs to the brain is not effectively getting there, your brain can't make a good decision. The immune, neuroimmune connection is what this autonomic nervous system truly is managing. the entire thing.
Dr Ritamarie (10:15)
Wow, that's a lot to take in. And where's the other 5%? You said 80% up and 15% down. And I caught that, because I'm a mathematician.
Navaz Habib, DC (10:27)
I always ask for the math people, there's 5% missing. So 4% is actually motor information to the muscles, muscles of the throat and the vocal cords, the pharyngeal the laryngeal muscles. So you're opening and maintaining a good patent airway, and you're tensioning and lengthening the vocal cord. You can go really, really low or really, really high with your voice by enabling the tensioning and lengthening of the vocal cord muscles via the laryngeal branches. That's 4%.
1% is auricular. The sensory from the auricular branches of the vagus nerve. So auricular acupuncture was found to be really beneficial for vagus nerve health for inflammatory control, because it was stimulating the auricular branch of the vagus nerve, getting activation to the nucleus tractus solitarius. But remember it's a very small percent, which is why auricular therapies tend to take a bit longer to have a really positive effect. That said, it's a great tool.
Dr Ritamarie (11:22)
It's a great tool. And when you first said auricular thought, I'm thinking hearing so that you're alerted to the dangers.
Navaz Habib, DC (11:27)
No, it's the skin of the ear only. It's only sensory on the skin of the ear. We have our other cranial nerves that are pulling auditory information, but it's our perception of that noise that's going to push us either sympathetic or parasympathetic. So that's a secondary piece, but it's the auditory, the auricular branch of vagus nerve is not involved in hearing. It's literally just the skin of the ear.
Dr Ritamarie (11:55)
Not involved in hearing. Okay, interesting. Okay, so that's good to know. And there was one other thing. So if you could go back and just make sure that everybody that's listening really has a sense of all the things that the vagus nerve does, which organs and, know, so what is that? Because a lot of people hear it, and, going back 20, 30 years from when they were in school, they were trying to remember what exactly it does.
Navaz Habib, DC (12:14)
I love the name vagus nerve, because it's literally from the root word vague. Because anatomically speaking, it's going virtually everywhere. It's the 10th cranial nerve, but it's the only cranial nerve that leaves the cranial cavity. And it has direct physical connection to virtually every visceral organ in our body.
We have direct connection to, as I mentioned earlier, laryngeal, pharyngeal muscles, the auricular branch goes to the skin of the ear that goes down, and it connects to the trachea and the esophagus. It has branches, significant and very important branches, to the heart, to the lungs. So it's constantly managing. It's lowering the heart rate. It's involved in breath management and ensuring that the lungs are functioning optimally. And breath is a massive piece to turning on vagus nerve health. We'll talk about that in a minute.
It continues down along the esophagus. As it goes through the diaphragm, it does not innervate the diaphragm. That's one very important piece. The diaphragm has the phrenic nerve. So phrenic nerve goes to the diaphragm, but vagus goes through the diaphragm alongside the esophagus. It then goes to the stomach, stomach to the small intestine, the large intestine, a good chunk of it, not the entire large intestine, the pancreas, the gallbladder, the liver, indirectly to the spleen, direct to the kidneys, and direct to virtually every other organ, again, that I likely forgot to mention at some point.
Every organ in the body, except for the spleen, has a direct physical connection via the vagus nerve. The spleen has a very important connection, but it's an indirect connection. It goes through a different branch which we'll talk about. It's essentially managing the regulated optimal function of every single organ in the body.
It regulates towards the rest, digest, recover state. So when we experience feeling, here's the key word here, “safe”, then we send a signal of parasympathetic activation via vagus nerve. Those 15% send their signal down, and they say, we are calm, we are safe. Go ahead. Let's go and digest food. Let's enter that calm state. Let's slow the breath rate, let's slow the heart rate, let's get things working. so we can absorb and consume right now, because we are not in a threat management state.
If we're under threat, all of those functions either slow or shut down, and we go into a state where we are fighting or running away from a threat to our survival, and all the energy needs to go there. So that's really where vagus nerve connection is and what it's doing.
Dr Ritamarie (14:54)
And that's important to really realize when you think about all of the things, because when we're under stress, we talk about this with clients and patients all the time, right? When you're stressed, it affects your whole body. How does it affect your blood sugar? Well, it affects the pancreas. How does it affect the cortisol and adrenals, all these other things, but it's affecting these things, these organs and saying, it's not safe. Let's get activated to run away from the tiger.
Navaz Habib, DC (15:22)
On that point as well, a really important note is if 80% of the signals are coming up to the brain, where are they coming from? Well, here's a big one, the microbiome. And what signals are making their way up? Well, what's really popular right now, GLP-1, GIP, and satiety hormones. Which nerve is that signaled up to the brain through? How does the brain know that we have enough GLP-1 or satiety being signaled up? It's the vagus nerve.
Can you imagine if a dysfunctional vagus nerve is currently present in a person, is there going to potentially be a lack of signal signaling of these incretin satiety based hormones? The answer is absolutely yes.
Dr Ritamarie (16:00)
Absolutely. Physical basis for emotional eating and binge eating, right? There's a physical basis, right? It's not your lack of willpower. It's physically, physiologically, biochemically, you're being inhibited. Yeah.
Navaz Habib, DC (16:16)
100%. You're exactly right. Nervous system regulation and managing those emotions via this physical structure of vagus nerve activation. or vagus nerve function. is how we are able to manage these things. So willpower comes into it, but it plays a massive role on your nervous system regulation. And that's really the key to all of this.
Dr Ritamarie (16:35)
Yes, so interesting, because when you think about the popularity and the success of the GLPs and reducing appetite and all that, it's nice to understand the mechanism. And then, how else can we do that without having to shoot up a $2,000 a month drug to get that? How do we do that?
Can breath work help, and just taking that avenue, because you mentioned it, the GLPs and the appetite regulation as well. Let's talk about breath.
Navaz Habib, DC (17:07)
Breath, 100%, is the single strongest lever in shifting between sympathetic and parasympathetic without a doubt, without fail. And this is not even mildly debatable. Without fail, your breath mechanisms, your breath mechanics, your breath rate, your breath form are all pieces to the regulation and the determination of which state you're going to enter.
How you're breathing is going to tell us whether you're going to push towards fight or flight or towards rest and digestion recovery. The way this works, really simply, we can start with how is it validated? And we validate this particular idea through HRV, heart rate variability.
HRV is the marker that tells us whether our bodies are entering more of a sympathetic state or parasympathetic state. It's an overarching number that tells us the number of milliseconds between beats of the heart averaged over a period of time, how variable is that?
We actually want more variability. We don't want our heart beating like a metronome. If we do have a heart beating like a metronome, it means that the signals coming to the heart are not coming both sympathetic and parasympathetic. They're primarily sympathetic during that time. A low HRV is telling our bodies that we're mostly in a sympathetic state. A higher HRV is telling us that our bodies are more in a parasympathetic state.
Now, HRV is very dynamic. If you're driving straight on a road, and you've got green lights, it’s guaranteed your HRV is higher. The moment a red light pops up, or the moment you have to make a bit of a sharper turn, your HRV is going to go down. This has been proven with F1 race car drivers that their HRV is sky high on a straightaway. And once they hit a bend, they're their HRV drops immediately. And so it can happen very, very quickly.
HRV is a very dynamic number, and it's a very important one to note. So that's telling us, are we pushing more in sympathetic or parasympathetic state? Our breath is the biggest tool to dictate that or to shift that.
Breathing patterns come down to three different things. Are you breathing through your nose or your mouth? Are you breathing with your diaphragm or accessory breathing muscles? And are you breathing more inhale or exhale? We'll talk about these three things.
Number one, we only have nose hairs in our nose. We only have teeth in our mouth. The nose is the breathing tube. The mouth is the eating tube. We have a backup if we need it, but ideally, we're breathing through our nose. Nasal breath is key to this. Number one, your breath should be nasal. No question about it.
Number two, the primary breathing muscle is the diaphragm. It is not your trapezius. It is not your rhomboids. It is not the intercostal muscles between each of your ribs. That's what we're using, because so many of us are breathing incorrectly. We're not using our diaphragms effectively. This is a learned trait.
Watch babies when they're breathing. Brand new newborn between freshly born and nine to 12 months. Take a look at when they're sleeping, when they're breathing, what's happening. It's their belly slowly rising and falling.
And that's telling us, signaling to us, that we have a diaphragmatic breath happening. The diaphragm is moving up and down. As we breathe in, the diaphragm moving down is going to create a vacuum in the lungs, pulling and drawing air in. And that pulls, ideally, a good ton of oxygen in and ideally through the nose, so you can filter it, humidify it, and warm it, so that the air that gets in the lungs is nice and clean and ready to be absorbed easily into your bloodstream. As opposed to oral where there's no filtration, there's no warming, and there's no humidification.
Nasal, diaphragmatic, we're pulling that in. Guess what's also happening when you're using your diaphragm. We've always thought of the diaphragm as simply being attached to or supporting the lungs and creating this vacuum above. Well, the diaphragm is intimately connected to every organ below it in the abdomen The diaphragm separates the thorax from the abdomen. It's also intimately connected to the stomach and pancreas and the liver and the kidneys and the intestines.
Can you imagine if we have diaphragmatic breath going up and down, what that's doing? A really awesome video of this that I'd love to share with you. I'll send it to you at some point. That video shows that we almost have what's called a massaging effect in the organs below.
If we breathe with our accessory breathing muscles, and how many of our patients have sore traps and neck muscles and back muscles and are constantly in these terrible postures, but then add to it that they're not breathing with their primary breathing muscle of their diaphragm, what are we then doing? We're causing these people to enter a sympathetic breath state when we're breathing with accessory breathing muscles.
We have to make sure that our breath is primarily diaphragmatic. Okay? When the diaphragm goes up and down, it creates that massaging effect in the organs below. It's actually stimulating that 80% of the vagus nerve signals up to the brain. We're getting these signals through our breath patterns that are telling the brain, “Yes, we are calm. We are in a parasympathetic state. We are safe.” That's exactly right. nasal, diaphragmatic.
The third one is longer exhales. This is directly tied to HRV. When we inhale very mildly, we're pushing the accelerator. We're going to a sympathetic state. Very mildly, but enough of us. This is proven by if there's a loud sound, or a big bang of light, or something flashes to scare you. What's your first reaction?
There's an immediate shift towards sympathetic. You inhale immediately. You are going to get ready to react to whatever that threatening situation is. Even if it's a mild thing, there's a very small shift towards inhaling and ready to do something about the threat. That's your inhale.
As soon as you realize it wasn't a big deal, it was just a toy that fell off the shelf or not a big deal. You go, and there's a sigh and exhale of relief, and we enter a parasympathetic state. When we exhale, we're going into pushing the breaks. We're turning on the vagus nerve, and we're entering a parasympathetic state.
Inhales, sympathetic. Exhale, parasympathetic. This is what creates variability in, are we shifting towards sympathetic? Are we shifting towards parasympathetic? And that's what dictates HRV. Time-wise, what you can do, you can hack this by spending a little less time on the inhale and a little more time on the exhale and slowing your whole breath rate down. That is one of the biggest, most simple, almost too simple for people to experience. What do you mean I can change my entire life by how I breathe? The answer is you absolutely can. You can shift your entire nervous system in three breaths, nasal, diaphragmatic, longer exhales.
There's patterns we can use here. For most people to start off, a box breath is a great place to start. Four seconds in through the nose, four second hold, four seconds out through the nose, four second hold. Okay, so a nice, simple box, four second even breath. Because most people are actually doing a two seconds in, one second out type of rate. Or two and half in, one and a half out. Our rate is already off. If we were to go full shift to longer exhale than inhale, for some people it can be very challenging. Meet them where they're at. I think this is a really important place to start.
Then we go into a longer exhale time period, three seconds in, six seconds out. Right? Three seconds in, double the time on the way out. Three, six pattern. And then we can level up to the Navy Seal level. And this is a tool that Navy Seals use to help them fall asleep very quickly. The four, seven, eight breath pattern.
Four seconds of inhale, seven second hold, eight second exhale. Remembering throughout that nasal and diaphragmatic tie those longer exhales. Four, four, four, four box breath or three, six, and then level up four, seven, eight.
Dr Ritamarie (25:40)
Seven, eight, awesome. Now here's the thing, right? When you pay attention to your breath, you do that. How long does it take? How much practice does it take to actually start doing that? Or do we ever get to the point where we could just do it without thinking?
Navaz Habib, DC (25:54)
We'll always be better at it when we're paying attention to it. There's no question about it. We're never going to have a resonance breath rate of five passively, right? When we're not conscious or thinking about it, we're not going to have a breath rate of five breaths per minute. But when we train that and practice that over time, our breath rate on average is going to go from 12, 13, 14, 15 down to 10, 12, 11, 13, right? Somewhere in that range.
We're going to teach greater efficiency of our breathing patterns. This is a great tool to test where you're at on your breath patterns, on your breathing capacity, your carbon dioxide tolerance, your CO2 tolerance. If anybody has ever read the wonderful books, The Oxygen Advantage by Patrick McKeon, He’s not a doctor, but he should be with how brilliant this stuff is.
The BOLT score, BOLT, body oxygen level test. Really simple test to do. It literally costs zero dollars and takes one minute. What you do is you breathe in normally, you breathe out completely, and you measure from when you are completely empty until the first sign that you need to inhale.
The first sign that you feel like you need a breath. Okay? That first sign, the number of seconds that it takes between the emptying of your lungs with normal breathing pattern. You're not practicing like a three breath pattern before, just your normal breath pattern. How many seconds from the empty till the first urge to breathe? Okay? Under 10 seconds, big problem. Like you have very, very low CO2 tolerance.
Between 10 and 20 seconds, meh, not great, could be better. 20 to 30, it's pretty good. But if you can get over 30 seconds, if you can get between 30 and 40 seconds, that tells us that your body oxygen level breath score is very high. That you have incredible CO2 tolerance, and your body is very, very good at managing your breath and being able to go towards a calm breath pattern, automatically.
This is a great way to validate. I'm going to tell you fun stuff today. This is a great way to validate if the breath patterns, the breath work, the tools that you're using to train your breathing, are working. This BOLT work can be done on a weekly basis where you're tracking one week after the other and you're saying oh, I'm at 18, 21. Oh, I'm at 23, and you're moving up and up, moving up, and so this is a very simple tool to add into your client toolboxes box.
This is a tool that I use in every program that I do without fail. BOLT score is a great starting point and a great validation tool that costs zero dollars. It's not a functional lab test. I love functional lab tests, but we don't have 500 bucks to spend on every test like 10 times a year, right? BOLT score on a weekly basis is a phenomenal validation tool.
Dr Ritamarie (29:04)
Great, weekly basis. How quickly do you see a change if people are, they're needing to be practicing breath in between?
Navaz Habib, DC (29:09)
If they're doing it, within two or three weeks, you can see a huge change.
Dr Ritamarie (29:13)
Okay. And then the practicing that they're doing in between. Yes. What is it?
Navaz Habib, DC (29:18)
The practicing can be anything from the toolbox of breathing, box breathing, from very, good attention focused box breathing or a three, six or four, seven, eight pattern breathing. Okay. There are lots of breath work tools out there. Kind of pick and choose what you feel comfortable with as a practitioner or as a client.
What do your clients resonate with? Do we want more meditation? Do we want more guided work? Do we want to just go into nature and sit and do your breath work for 20 minutes? Or do you want an app that supports the guided meditation practice or the breath work practice? Breath work, teaching your body to breathe more effectively. That's a great tool. And even Patrick McKeon, Oxygen Advantage app has a great journey that you can go on as well. The Oxygen Advantage app is quite good as well.
Okay, so they have some guided work, and they have some checklists. They have five practices per day as a recommendation to really boost your BOLT score over a short period of time.
Dr Ritamarie (30:23)
I was going to ask you, because as practitioners, people are busy, and you're giving them all kinds of things to do. But going back to what we said at the beginning, they're saying, well, I'm having to do this, and I have to do that. And I just don't have time for it. We help them to prioritize. This is the starting point and all the other things are going to be useless if you don't.
Navaz Habib, DC (30:45)
This is the most important point of our conversation today, right? You can throw as many supplements, medications, tools, devices at your patient as possible. We cannot heal. The body cannot heal when it's stuck in a sympathetic state, period. Healing only happens when we enter a parasympathetic rest, digest, recover state.
Healing needs parasympathetic signals going down to those immune cells to tell them, yes, you are safe. It's time to rebuild. Because when they're in fight mode, those immune cells, they're breaking things down. They're fighting, and they're not in build and recovery and healing mode. But when we start signaling with the vagus nerve, and the way this works, there's a real mechanism that's here.
Vagus nerve sends acetylcholine through the body. Acetylcholine is primary, it's in fact the only neurotransmitter utilized by the vagus nerve. It's also, as we know, going to the muscles, right? Acetylcholine attaches to a very important receptor on immune cells. Every immune cell has it, but it's primarily found in these tissue resident macrophages. It's the alpha-7 nicotinic acetylcholine receptor. When acetylcholine binds to that, what it's going to do is it's going to turn on the JAK2-STAT3 pathway or the NF-kB pathway or both.
It actually is also going to go directly to the mitochondria. There is a direct mitochondrial receptor for the alpha-7 nicotinic acetylcholine receptor. It's actually going to have three different mechanisms that it activates. NF-KB and the JAK2-ST3 pathway are going to shut down inflammatory cytokine activation. The cells are not going to produce inflammatory cytokines. That's the IL-1, IL-6, right? That's going to go towards the anti-inflammatory cytokines, the IL-4, IL-10.
Right? And TNF alpha being on the inflammatory side of the site as well. It's going to down-regulate inflammatory activation. And it's going to also go on the mitochondrial side, decreasing mitochondrial DNA release. What it does is it stops the cell death that is going to occur when the cells are under hyper amounts of stress, when the mitochondria are not functioning well. And so they'll work to repair that, because the immune cells are going to work to get rid of the junk, but clean up and support the healing processes within the cells that are present in those organs.
That's how the acetylcholine vagus nerve-gut nerve link is going to shift those immune cells into a state where they can build, build and heal and repair. And that needs to happen.
The nervous system regulates the immune system, whether to go into firefighter state or construction worker rebuild or build or maintenance state. And we cannot heal with firefighters here all the time. They're necessary, but once the fire is out, we don't need them anymore. We need to then call the construction crews. We need to shift these cells over. And it's acetylcholine, vagus nerve activation, and vagus nerve stimulation that create that shift to go from sympathetic to parasympathetic, from firefighter to construction worker.
Dr Ritamarie (33:56)
Wow. Great information and from a practical standpoint in coaching our clients to the optimal. What's the bare minimum amount of practice that they should be doing with breath and what's the ideal?
Navaz Habib, DC (34:12)
The bare minimum is twice a day. I like to make it as simple as possible for my patients. I'll have them bookend their day with some sort of practice. So when you wake up in the morning, I want a minimum of five minutes. So going a minimum five minute practice, it can be in the sunlight, doing breath work at your window or right outside your door where possible.
Getting that sunlight in and doing a five minute check in breath work, meditation practice, kind of priming yourself for the day and saying that I'm safe. I'm in healing mode. And then ending the day with a very similar practice. Obviously, the sunlight should not be there at night when you're going to bed, but we want to do that in a calming state. Just have a candle on, no cell phones. Let's get away from the technology for five minutes and let's do a five minute breath work practice to calm ourselves at night. That's the bare minimum.
If we can, where possible, I'd love to do three to five breath practices per day. The bookends being two of them and then the three around meal times, because we want to enter rest, digest, recover state, and it's very easy to habit stack on top of your meals. Breakfast time, let me do three minutes of breathing practice. Now calm myself, get into rest, digest mode, so I can actually digest the food that I'm about to eat before lunch. Same thing before dinner. Same thing.
Okay, so many practices through the day and then bigger bookends would be my optimal scenario.
Dr Ritamarie (35:45)
Awesome. And so this sounds like what I teach people. I teach people to do heart math, quick coherence, and I teach them to do it in bed beginning and end of the day and before each meal. But three minutes is a little bit more, so I'm going to start to incorporate that to ask them to just feel like, OK, just take a minute to just breathe before you eat. It's going to make your food digest better.
Navaz Habib, DC (36:03)
Exactly. If you can go to three, then there's almost a minute of getting into calm, a minute of being in calm, and then a minute of maintaining that long term.
Dr Ritamarie (36:11)
Okay, cool, that's good to know. Tell me what your thoughts are. You said you love Heart Math. Tell me what your thoughts are and what you've seen in terms of its ability to activate vagus nerve and control HRV.
Navaz Habib, DC (36:23)
It's such a powerful tool. Heart Math is real time feedback, which for people data feedback, real time understanding of being in a coherent state is so powerful and completely overlooked. This coherence state is when your breath rate, your heart rate, and your HRV align together. And that's essentially HRV training through bio feedback. You're teaching your body with the direct sign of what's happening at this time, what this style of breath is teaching your body to do.
By regulating your breath and having it affect your heart rate, you're then having this feedback mechanism saying this breath is calming you, it's increasing your HRV, you're entering this flow state. You're able to push this sympathetic when necessary, and you're able to push this parasympathetic when necessary, and you're able to do it on demand.
That is the ultimate capability. The ultimate tool is being able to shift your state on demand, at will, without having external influences push you in either direction. You, then, are empowered and capable of handling your nervous system state, your immune system state, simply by how you regulate through your breath.
Dr Ritamarie (37:44)
Beautiful, beautiful. And do you think that the little ear thing, do you use that much? You love it? I haven't been able to get myself into using it on a regular basis. I just kind of stop myself and do it, but you think it gives better results?
Navaz Habib, DC (38:00)
Yes. I think where necessary. Right. Remember it's very much a meet people where they're at type of thing. If somebody is very data driven, they really want to see that they're gamifying their health. Then that's where a tool like Heart Math, where you actually use the Inner Balance Coherence Plus device is a phenomenal way to add it in. But if they're not a gamified, data driven person, wearing eight wearables and all the things, then they're not necessarily the one you need to worry about for getting the device. It's just more, can you do the practice? How do you feel organically? Are we objectively able to get data points off of your subjective thought processes?
Dr Ritamarie (38:41)
But either way you do it. I have a funny story about that I'll tell it real quick. When the first device came out, it was not on the phone. We didn't have these kind of phones. It was a separate little device, and I was sitting on a plane next to my six or eight year old son.
What is that mommy, so I told him, and I just handed it to him and good, he's occupied. I'm going to read a book. And he says mommy, mommy. I figured it out. Okay, what'd you figure out? Watch this. So he crunches up his face. He gets all of it to turn red. He goes, watch, I can make it turn green now. And he just does this breathing and meditation, and it turns green. So he figured it out like that.
Navaz Habib, DC (39:20)
I love it. I love it. That's one of its real benefits is just how intuitive it is that a kid can figure it out and realize that they shift how it looks on the screen just simply by how they're breathing their patterns.
Dr Ritamarie (39:36)
By how they're breathing. This has been great. I could probably talk to you for two or three more hours, but we're going to wrap it up. What did we not talk about today that we should have talked about?
Navaz Habib, DC (39:49)
A couple of things, vagus nerve stimulation, I think from a practitioner standpoint, it is something that is really coming into a great place when it comes to being able to enable that shift. It's that there's cervical devices. I've got my Truvaga over here, which is a great little cervical device. I've got the Zen Bud, auricular ultrasound device sitting beside me here. You can imagine I get sent a few of these devices.
I've tried them, and I really do like them. It depends very much on where your patient stands. Do they need something to help enable that shift to parasympathetic? Do they need a prompt with an electrical stimulation tool that can help to create that shift, or an ultrasound based tool? These are phenomenal tools that I think are out there.
Do your research, figure out what works best. There are some pretty significant, terrible rip off rip offs. There are great biofeedback tools like Sensei and Apollo Neuro. They're great, great tools that help people to enable this state just simply by reminding them.
Finding the right tool for each individual, for your clients, having the tools in your toolbox to enable that. But I think vagus nerve stimulation is a place that is really growing and has a lot of very positive potential.
Dr Ritamarie (41:04)
Great, you can do it with breathing, but we're a little bit far gone in our world these days that we need some extra help sometimes, right?
And the last thing I wanted to ask you about, and you said there were a couple of things, I'll get back to that, but it was HRV. I wear my Oura ring, and I love it. And my HRV is variable, right? On some days I'll go a whole week where it's not getting out of the 20s and other days it's in the 40s to 70s.
But what I notice, and I know it's all related to life, right? But what I notice is that when I look at the graph, say it says it's 46, but there's the high end is 118. What causes those peaks of variability during sleep?
Navaz Habib, DC (41:51)
Those are the moments where your vagus nerve is turning on the most when your HRV is the highest. What's really important to note, and then we didn't get into the sleep side of things, but when we sleep, the vagus nerve is most active, because it's helping to repair the damage, or send signals to the immune cells to repair the damage that's been done throughout the day.
You can imagine then if poor sleep is being had, that we're not then giving a real opportunity for the vagus nerve to turn on. And really important for the glymphatic system to turn on, which is vaguely activated or mediated as well. The glymphatic system is how we get the toxins out of the brain. That's key.
If we're not getting that sleep to turn on, then what's happening is we're not getting the biggest nerve activation. What you're seeing, even though the average number that comes out on the HRV is maybe not where you want to see it. You're seeing peaks where you are entering that state. You actually want a high degree of variability.
What we want is to see those peaks and valleys, because that's telling us that there's more sympathetic than more parasympathetic. And we're doing this a lot, and we're having these higher peaks and lower valleys. That's a really good sign. The average is the average, but I'm not so worried about the average, because I told you earlier, HRV is very dynamic. We want to be able to enter and shift state. If you want to see it in real time with the device like Oura Ring, because of how popular it is, there it is. I've got seven years of data on mine.
We can do what's called an unguided session on your Oura ring, where you can actually pull your HRV data in just a three minute meditation or breath work. This is a great way to check how your breath is affecting your HRV acutely in that moment, where you do a three minute unguided session, where it's actually drawing that during the day, not during the night. It's a great way to do that, to hack that.
One of the most hidden and very important tools that the Oura has is that unguided session button. And I know a lot of people have that kind of tool here. I'm going to pull mine up. This is my Oura Ring app that's pulling up here. And if you just click on the plus button on the bottom, you'll see the second one up is the unguided session. You click that, and you do a minimum of three minutes on that. You'll be able to pull your heart rate HRV data from that. Okay.
If you do over five minutes, you'll also get skin temperature trends, and you can do this as an open-ended session. A minimum of three minutes to get HRV.
Dr Ritamarie (44:19)
This is great. And is this something you can do like, hey, I'm going to do my breathwork. I'm going to focus on my vagus nerve. I'm going to do an unguided session a few times a day. And for those of us who do better with apps than we do on our own, this is a good way to do it, right?
Navaz Habib, DC (44:34)
100%. Yes. Expect that your daytime HRV levels will be lower than your nighttime HRV levels generally, because melatonin, when it is activated, it's revolving around the brain and body and going through the bloodstream, what melatonin does is it shuts off the sympathetic nervous system, essentially giving the vagus nerve an opportunity to turn on the parasympathetics more readily without any hindrances.
When we're awake, the sympathetic nervous system is on. We don't have that melatonin level as we would at night. Your HRV in general will be lowered during the day than it is at night. But to test where you're at, you would make sure you're not in the single digits or the low teens, right? You want to be in a slightly higher level than when you're engaged in a sympathetic state.
Dr Ritamarie (45:24)
So last question, I know I keep asking you more questions, last questions. So for people who want to, and we want to teach our clients, how to get their HRV up, because people come to me all the time. I talked to one of our clients last week and she said, I've been doing this for years, and I can't get to 20, I'm happy that day. I want to get it higher. What do I do?
Navaz Habib, DC (45:45)
Yes, that's a great question. And the answer is just try to be better than yesterday. We're not trying to affect a change where you go to like Olympic athlete level, right? Where you're in the hundred all the time. It's just not truly possible.
We're aging every day. We're getting a little bit older. Our body is breaking down just ever so slightly every single day. If you can even maintain your HRV level, that's a real positive sign. If you can just try to be slightly better than yesterday, and work on your habits, and your trends to work on getting slightly better every day. And over time, increasing your average one, two, three, four, five points at a time, slowly.
Slow progress is way better than perfection here. I think that is so important for people to understand. Your HRV is not a good dictating factor of your health. It is just telling you where your autonomic state is, and your balance is. And if we're just dictating our entire health off of a single average number after seven or eight hours of sleep, we're doing ourselves a disservice.
Are you having those peaks and valleys effectively? Are you capable of on demand entering that parasympathetic or sympathetic state to enter flow state when necessary, to exit flow state and enter healing state when necessary, to get out of undesirable fight or flight date, right?
What is happening on those sides of things? Don't put all your chips and all the marbles on HRV. It's not the end of the world, if your HRV is not great, you can get better even though it's not getting better.
Dr Ritamarie (47:22)
Okay, but what are those actions they should be taking on a daily basis? Is it the box breathing?
Navaz Habib, DC (47:25)
The sleep thing is key. Sleep, box breathing, cutting out alcohol. Alcohol is one of the biggest droppers of HRV. Whole food diet, intermittent fasting, long term fasts are a phenomenal way to boost up your HRV. I do 72 hours every month. There's a lot of great little tools, little hacks. Generally everything that we teach as holistic, integrative, functional medicine style practitioners. If you do them regularly, and you create positive habits out of those things, you will start to see some changes in your journey.
Dr Ritamarie (47:59)
Awesome. And do you see coffee as having much of an impact, because everybody's addicted to it.
Navaz Habib, DC (48:03)
I see a 3 pm grande having big negative problems. Yes, absolutely. A single coffee in the morning, go for it. I had mine, right? I've got my coffee mug here, that's empty. I had my coffee this morning, but I had my one coffee this morning. Maybe to cut it out, allow your body to enter that healing state, and allow it to enter that cortisol drop-off state.
Make sure that your blood sugar isn't an issue, right? Blood sugar is a massive stressor, and your pancreas is constantly working hard if your blood sugar is off. There's a lot of different factors here that need to go into optimizing. Where possible, pull a few of them and start doing those consistently.
Dr Ritamarie (48:47)
Awesome. Thank you. Thank you. Thank you. Is there anything else that I didn't ask you that I should have?
Navaz Habib, DC (48:52)
I'm sure there is but it'll take us another two or three hours. I think this was great.
Dr Ritamarie (48:57)
If you're open to it, I want to have you back in to talk about sleep and all, that would be awesome. Because it's a problem for so many folks, right?
Well, thank you so much. You know, this vagus nerve is so important in so many things, and you're an expert in it. I read your book. I listened, I don't read books anymore. I listened. I listened to your book a few years ago, right? You have multiple books. Tell us about the multiple books, and where we should start, where they should start.
Navaz Habib, DC (49:27)
I have two. The first one is Activate Your Vagus Nerve. I think that's the one that everybody is more aware of. It's done, numbers wise, relatively, significantly better than the other. That said, it's a great beginner point. Activate Your Vagus Nerve is kind of simple for people to understand but still has a bit of the science in it. The practitioners get it and those who are really interested in the science can get it.
And then the practical tools and tips.
Then after about five years of practicing and focusing on vagus nerve activation, there were a few things that I learned. I decided to write my second one. It is Upgrade Your Vagus Nerve. This is number two. I got to talk a little bit more and more about vagus nerve stimulation. I got to talk about temperature therapy. So cold and hot. I got to talk about BOLT scoring and stuff like that. All of those pieces are in there plus a whole lot of other stuff.
And for this one, on the audio side things, I got to record the second video. It's my wonderful calming voice for the second one.
Dr Ritamarie (50:23)
Nice. I love that. I love that. I'll get it. I'll download it later. Those of you who are listening, I really encourage you to go do a deep dive on this, because it is the key. You may have people that you've been working with for months, and you're doing all the right things. They're doing all the right things, but they're still not getting there. It's really looking at this vagus nerve. And I recommend you don't wait till that, you do that right at the beginning. Check out the books. I think the books are great. You also have a podcast.
Navaz Habib, DC (50:53)
I do. We've got the Health Upgrade podcast where myself and my cohost JP, who actually invented the Truvaga. We actually get to dig into tons of different topics all around health. We have some wonderful guests on there. It’s just a nice way to have great conversations.
If you're interested in the science, really digging into the science and the clinical side of things, that's where we definitely have it. JP has got a very engineering brain, the Health Upgrade podcast.
Dr Ritamarie (51:19)
Check it out. It's the Health Upgrade. Awesome. Awesome.
Well, all of these things are in the show notes and in the description down below. Make sure you check all those out. And I just so appreciate you being here. And I encourage all of you listening to deep dive to get into this and really use this as a tool, as a first tool in your toolbox.
It doesn't mean that supplements and food and exercise aren't equally important, but if you don't start with getting the nervous system in the right place, none of those things are going to work.
So for those of you who are here and those of you are regular, you know that I always talk about how we're the future of healthcare. You know we're moving away from the symptom suppression. It's outdated. It's not working, and people are getting wise, and they don't want that. They want us who are really digging in to finding root causes and look around you in this world.
Sympathetic overdrive is, I think, the top cause of all the health problems that we're having. It's not like we need another drug, another supplement, another vaccine or anything like that. All this stuff about the immune system and the vagus nerve is fascinating and the public needs to know it. Share it, share it, share it. Until next time, shine on.
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