Jodi: Hi, I am Jodi Cohen, your host, and I’m so excited to be joined by my friend Dr. Stephanie Canestraro, a fellow vagus nerve expert. Dr. Stephanie is a chiropractor and soft tissue specialist, also certified and functional medicine who works mostly with elite athletes to support performance optimization.
Stephanie: Thanks so much for having me. I’m so excited to be here.
Jodi: Can you share a little bit more about your story and how you became the vagus nerve expert that you are today?
Stephanie: It was through my own health struggles that I ended up being so interested in the vagus nerve and the gut-brain connection because I had such a destroyed gut. It’s embarrassing, but I share my story and that’s how I started sharing it with athletes. And they started being more vulnerable, but it was almost to the point of bowel incontinence. You can imagine how embarrassing that could be. It led to this spiral of anxiety and a lot of sickness that turned into systemic sickness, not just my gut, where all these self-infections came up.
I eventually learned it was Lyme and all these co-infections that had hijacked my vagus nerve. So everyone can have a little bit of anxiety based on what’s going on with their life, situational anxiety. But this was like rumination to the max. This was panic. This was sitting there being fine spiraled into what people would call a panic attack. But I now call it a toxicity attack and I think it’s toxins reaching the vagus nerve. And I’ve actually tested that on myself and then on my other clients, patients, and friends, and I am just convinced a lot of these so-called panic attacks when something isn’t inciting, the panic is actually a toxicity attack.
These toxins reach the vagus nerve and it’s your body going into this fight or flight response because it feels like it’s being attacked. It’s a war inside you and the world has been getting more toxic. I’m working with elite athletes that are having these full-blown immune system dysregulation like cardiovascular events and gut issues. All of these things that I was not seeing previous to the past three years. It’s become even more important – the vagus nerve and a lot of post-Covid or post-Covid vaccine things that I’ve been seeing.
They’re getting told you have vagal nerve dysfunction, but no one knows how to sort out what that even means. And so vagus nerve starts trending and our clinic’s called the Vagus Clinic and then all of a sudden we’re getting all these hits of people that are just told they have POTS and it’s from vagal nerve dysfunction, but no one knows how to dig deeper and resolve it.
That’s how I got really interested in the vagus nerve and specifically with athletes for concussions. Because I was doing functional medicine tests on them, I ended up doing a test on one player and he was perfectly healthy. Nothing came up in his gut test. And then he got a hit to the head and he was so sick and his gut turned and he had diarrhea and he had liver pain and all this stuff after a hit to the head, and we tested his gut, his leaky gut markers, his leaky brain markers, and it was just like insane. This hit to the head triggered this whole spiral of digestive system effects of different stealth infections. His immune system was dysregulated, so that really was an Aha! moment for me even more than already being interested in that kind of gut-brain connection.
Jodi: So many of the things you said resonated.
After my son died, I was having crazy anxiety attacks and I would notice every time I would regularly activate my vagus nerve. That seems to help. I didn’t connect the toxicity. Just to start, for anyone who’s listening, who’s not completely aware of the vagus nerve and what it does, could you explain that?
Stephanie: Our vagus nerve is our 10th cranial nerve. So we have 12 nerves that come off, either our brain stem or our brain. And the vagus nerve is cranial nerve 10. The vagus nerve means “the wandering nerve” because it’s the longest of the cranial nerves. It travels all the way down to your digestive system. It’s in charge of your parasympathetic nervous system. Other than a little bit of input from cranial nerve three, cranial nerve nine, and cranial nerves 11 and 12, it is the main parasympathetic nerve. And then we’ve got two or three nerves in our sacrum that take care of what the vagus nerve does, not innervate as far as parasympathetic.
So what are parasympathetic? It’s easiest to explain parasympathetic as the rest and digest side of our nervous system, which a lot of people are becoming aware of. And the sympathetic, which is the opposite. That’s our fight or flight. And just like anything else, we are supposed to be in balance, we need our sympathetic nervous system. It has a role. We need our parasympathetic, but we’re the only mammals that, through our thoughts alone, can put ourselves into fight or flight – the sympathetic nervous system. Any other animal, they get chased by a bear. They get away within moments, they’re back into their rest and digest. They’re grazing. They’re not thinking back about, “oh, I almost got chased,” or they don’t replay it in their mind. We’re the only ones that are living almost our whole lives in the sympathetic state.
Even news is always bad, like watching a show, even the music they play on these horror movies or these thrillers… I can’t watch them.
Jodi: It’s terrifying.
Stephanie: It’s stimulating your vagus nerve. The music that they use – because sounds can affect either your vagus nerve or your sympathetic – even the TV we watch is throwing us into the sympathetic state, or the fight or flight kind of response, where we’re on high alert and all of our blood flow leaves our digestive system and it’s going to our legs cuz we wanna get away so we’re not digesting well anymore. Blood flow’s not going to like it. It is not going to our organs. It’s going to all of the things to get away. No wonder we’re not doing great, you know?
Jodi: I love what you were talking about vagus nerve toxicity and toxins because I think most people think it’s either physical (the lion chasing you) or emotional (you’re worried about something). People don’t realize the toxicity, and toxic load… Can you talk about that a bit?
Stephanie: There’s the physical toxic load. Meaning your vagus nerve exits if you follow down your neck, it goes kind of behind your bone right here, behind your clavicle. Your sternum. That’s also where all of our lymph clears. All of the waste that your body is clearing, it has to come through your collarbone. So even pressure builds when lymph isn’t clearing properly or your body has too many toxins and all those toxins can build, in my opinion, it’s causing a lot of thyroid problems for people. And a lot of the vagus nerve, it’s all in that vicinity.
You can even see when someone’s lymph is really jammed. Their voice changes it gets hoarse, like that’s the vagus nerve being compressed. There can be physical stress on it, lymph building up, and then the toxins, but then it can actually be infected with certain viruses or bacteria like Lyme, with the viruses like HHV-6 and HHV-7. There was just a huge study that came out on those herpes viruses. There’s the toxins from your actual gut that can hitch a ride up the vagus nerve because the gut is becoming leaky and we have all these toxins in it, and there’s even lots of studies on certain gut infections that can put people into a panic. Campylobacter is one of them. So that toxic load in your body – it’s literally like a war is going on in your body. So even if you’re not having mental stressors or watching the actual stress going on in your body, because your body is not in a rested state.
It’s fighting at a cellular level to kill off these toxins, to lower the toxic load. That’s why when people are having panic attacks, I tell them to not grab an anti-anxiety but to grab a binder and see if a binder lowers their anxiety within 20 minutes because it often does. Or when people wake up in the night anxious… I had one patient who was reaching for passion flower, and those are great, but I’m like, try a binder, and she was able to go straight back to sleep because we start detoxing in the middle of the night as well.
In those hours when our glymphatic system’s turned on, where our brain’s trying to drain, but we have this clogging, people can wake up with anxiety. So you gotta show people when you take a binder, you’re temporarily lowering your toxic load. Do you feel better? Is it an anxiety problem or is it a toxic load problem? That’s how I started to explain it to people.
Jodi: We will continue to unpack that one. I am really curious, as someone who works with elite athletes, how do you see the vagus nerve impacting their performance? You mentioned concussions. I’m curious about what else it regulates where blood flow is allocated. How are you working with professional athletes to enhance vagus nerve function and performance?
Stephanie: Going back to the toxic load thing, we lower their toxic load first of all. We’re doing manual treatment to help clear those areas, even like people’s arms over their liver, all of these detox organs, right? Getting stuff flushing out of the body. They don’t need help sweating. Most of them sweat a lot.
Jodi: But are you doing facia or lymph? Tell me what you’re doing with the manual therapy.
Stephanie: We call it specialized soft tissue, but it includes lymphatics, fascia, acupuncture, and manipulation at times. But we’re just trying to fix fluid mechanics throughout the body. Even in your fascia, when your fascia has to be detoxed, right? Like it needs to be cleaned out. After that, you work on someone’s fascia, we’re making sure the lymph is getting where it should be so it can get outta the body. So through the lymphatic ducts, we see athletes and they’re like, oh, they only ever treat my hips when I see people. Like we’re doing the head, face, neck, arms, a lot of like needling the points that help turn on the parasympathetic nervous system, like the homeostatic regulatory points, like points in your ear. Points in your face, points in your sternum, like over the emotional heart, all of that, and just like flushing out the system. But we’ve seen guys with their HRV…
Which is one of the ways to measure the heart rate variability for the vagus nerve because the vagus nerve innervates the heart and heart rate I variability the higher it is. And I haven’t seen it be too high. I’ve only seen people have benefits when it’s high. So one guy was like close to 200, which is high, most people are functioning in like 30 to 70. And one guy, he went up from 80 to 130. He goes, Steph, I feel like I could literally do anything right now – he’s having a record year.
He’s one of the older players on his team, and he is doing the best ever. We lowered his overall pathogenic load. We treated his face, neck, opened up this area, his hips, and everything as well. We have to clear all the lymph, but these guys are just used to only getting their hips treated because they’re skating. And everyone zones in there. So that’s the biggest thing. It’s like fluid mechanics, getting everything moving better. Everything needs to be moving properly through your whole body. Not like your arms don’t matter if they don’t move just because you’re playing hockey and not using your arms as much or so just kind of stressing that for people.
But that’s the same for regular patients as well. We’re seeing these patterns where their whole right side is getting jammed and it’s all associated with a stagnant liver, like fatty liver, enlarged liver, which we’re seeing even in these players. And you get that flushing and their liver markers. I’ve never seen so many high liver markers in these healthy, young players. So their shoulder mechanics, it’s almost getting gelled, so releasing like the right side of the neck, the back of the arm, and the quadrangular space is a big flush point. All in the pecs here, the inner arm, and making sure it all clears out and their livers are getting better. It’s helping the entire body.
I said, their vagal nerve numbers after those treatments go through the roof, like their sleep is better, everything. So hugely beneficial in general.
Jodi: You’ve said so many things that I wanna unpack cuz they’re brilliant. First of all, lymph drains primarily 75% on the left side, but then the right side is where the liver and the gallbladder are. More women seem to have breast cancer in the right breast because if the armpit is congested, then the lymph can drain and all the toxins sit in the breasts.
Stephanie: Think about if only things are trickling, like 25% going through your arm, sometimes I find it’s getting more jam. More people are right-hand dominant. So that side’s getting more use and more jam. That’s just what I’ve been seeing and when I look at how they explain lymph drainage and it’s mostly like the right arm and the head that’s going into the right thoracic duct, I kind of think they’re wrong. And it’s the liver too that’s draining into there. And the gallbladder.
Jodi: I’ve noticed that every time I get lymph work done, I’m super nauseous and I’m like, oh look, my gallbladder’s congested. I take a ton of binders. I do everything I can think of to support the gallbladder, but I think you’re right. I’m curious, why do you think the liver has suddenly become a thing? Is it because of Covid and the aftermath, or…?
Stephanie: In 2020, another thing that was something new to the population in general was a whole new radio frequency. And I’ve been studying a lot about like 5G, EMF, and what it does to your cells. And it causes a lot of DNA oxidation. It causes dysfunction of our voltage-gated calcium channels.
Calcium is the most regulated mineral in our body. It won’t go off. Even when you look at blood work and you look at the ranges that they consider normal, it’s always so wide for calcium. In Canada, it’s like a 2.25 to 2.65. It’s 9 to 10 or something in the US. I can’t remember the conversions, but when calcium is dysregulated, which is happening, cuz what happens is the electricity hits the cell and activates the voltage-gated calcium channel. We get an influx of too much calcium, it damages the cell membrane and begins to leak calcium out of the cell. The body has to deal with the excess calcium. Things start to calcify.
What else happens? Our body increases the amount of LZL cholesterol to bind to it. We get increased albumin to bind to the calcium. We increase our kidney function in order to flush more. What also happens with that is it stresses your liver. Part of it is the sluggishness. I’m always going back to fluid mechanics. People are less fluid. Everyone needs systemic enzymes. Everyone needs a chunk of Piedra, which is a stone breaker. Everything is turning to gel. I think is a big thing that’s being overlooked even for causes of cardiovascular. Because if you think of calcium channel blockers, that’s what people do when they’re trying to control heart rate after heart attacks, all of that, people are on calcium channel blockers. Now our calcium channels are through the roof being overactivated, which has a huge downfall in all of our mineral regulation as well.
I’m seeing lots of dysfunction and electrolytes and stuff I’ve never seen before. And these athletes get their blood done twice a year. So I see it twice a year on a regular basis. It’s easy for me to go back and look and have never seen these trends before. I think that that’s part of it. When the liver gets stressed, liver enzymes go higher. We get bile backflow. We get all of this stuff that can lead to these even vagal nerve kind of changes.
Jodi: It’s so interesting cuz the vagus nerve, it’s gut, brain, brain, gut.
And so if the liver is dysfunctional, it’s throwing off the vagus nerve. There are so many more things that can kind of challenge the vagus nerve. But one way I think to fix that is to fix the vagus nerve.
Stephanie: There’s input both ways. There are studies with the vagal nerve stem where they actually, they used to have to implant it on the actual vagus nerve and you could use like a button to electrically stem your vagus nerve. And they were reversing autoimmune diseases, pretty advanced autoimmune, like taking people’s pain away, stopping seizures immediately. Like that with this vagal nerve stem. And so we know that the input from there, you can do it both ways.
If you can activate the vagus nerve, then you can give the body the help it needs to regulate all the stressors that are coming at us. If you go at it both ways, where you’re lowering the toxic load, like we were talking about with binders, or you’re supporting the liver or you’re lowering infections or parasitic load or helping balance the immune system. You give it help from an external-internal, and then you can do it also through manual stimulation, your essential oils, which I do use on players. There’s a lot of research showing that before performance, the more you activate the vagus nerve, the better your performance is. And like that’s been shown time and time again.
And it’s like they’re switching into sympathetic to go onto the ice. But the more you’re in the opposite going on there, the better people perform.
That’s been shown time and time again. And so we use some oils before the game to be more into the parasympathetic and activate the vagus nerve, and then during the game ones that are more stimulating.
And then after the game, unwinding again with the ones that activate the vagus nerve. So any ways that you can stimulate sounds? Like I said, when you’re watching thrillers and they have music that stresses you out. The opposite is true too. There are lots of sounds that are very healing to the vagus nerve. 528 Hertz, it’s easy enough to go on YouTube and listen to that. Binaural beats. There are all types of different frequencies that you can search. Humming yourself too.
Jodi: Friends of mine went on a hike with me and it was a lot of switchbacks over a river where you either walk on rocks or logs and I have good balance. They don’t, but I’m like, here’s what I do. I think of my favorite song and I hum it when I’m walking there’s something about humming it that puts me in flow and it’s easier to not slip.
Stephanie: Think about you’re fumbling around when you’re in a stressed-out situation. When can you find your words easier? When you’re in the vagus, when you’re in the parasympathetic state, not when you’re in a fight or flight. Like nothing works as smoothly.
Jodi: But I love the other thing that you brought up, fluid movement, like, can you talk a little bit about how when the lymph is stagnant, it impacts the vagus nerve? You kind of mentioned that it backs up a little bit into the neck. Is there more that you’ve observed or that you’ve read about?
Stephanie: It’s just the toxic load. You have to drain sinuses, I’m sounding stuffed up right now. I never feel as good when I’m stuffed up because you need to drain everything around the brain or else it affects the whole body.
Some stop points are tonsils sometimes for people. That’s why a lot of people get their tonsils injected and I’ve been introducing some of the players to that because better airway, better vagus nerve function, better nasal breathing, better vagus nerve function. Just opening these ducts and getting the toxins away from the vagus nerve is just priceless for your health. I have a little toothpick technique. I’m an acupuncturist by trade. I took it after chiropractic college and there’s points like in the ear that are innervated. But the skin is actually innervated inside of your ear.
A toothpick has a small surface area, right? Similar to getting acupuncture. It’s like pseudo-acupuncture. And you know, I’ve had to use it in times where I was panicking and it would calm me down. So there’s a point in her ear. So you go into the ear right here and you tap in here. And then the tragus of the ear too if you tap right here. There’s other points that are regulatory in the ear. So really just finding whatever calms you down scalp points. So taking this and finding tender points in your scalp and then focusing on those areas and tapping a little bit. You’ll notice it calms you down, tracking the vagus nerve downwards, and even like, I’ve had it where I have visual lymph stagnation because I got really sick actually after Covid and I have a history of all the stealth infections and stuff, and I got the lymphedema where my breast was enlarged, like a DD compared to like my other side.
And so I was tapping all along the collarbone and I started to get heart palps as it started to like clear out the toxins, as they came out of this stagnation all around my breast and I could actually see the physical blockage going up my neck and as I massaged it and used like the toothpick along it and the toothpick along my sternum, like I literally felt it starting to dissipate.
Neural therapy is something that’s activating for the vagus nerve. You’ve heard of neural therapy, right? It’s injections of propane. The tapping wasn’t enough. I had my colleague, he injected me all along here and then, I’m not kidding, one heart palpitation after another, and then a little bit of breast massage and massaging all these outlets like over your peck right here. At the top of your shoulder, the muscle here, your trap, is innervated by a muscle that shares a tendon or a sheath with the vagus nerve. Often when people are in a sympathetic state, they have like tight shoulders. When you can start to loosen that, you can affect the vagus nerve as well. And then it all cleared out.
And so that actual physical stagnation that you could see took away anxiety, I could breathe. It was putting pressure on my lungs, it was putting pressure on my heart. So there’s this actual physical blockage that is not always so obvious as it was with me. And practitioners who treat the fascia and who treat the soft tissue, they can feel when it’s backed up like that. Start to teach people how it’s supposed to feel under your collarbone, it shouldn’t feel matted. It should slide and glide. At this exact moment, my right side slides and glides better than my left. But I was focusing more on this side cuz that side was stuck.
A lot of these videos that I see on Instagram and stuff, it’s always very light touch for the lymph. But if you see me, I’m like pushing and I’m pumping because there’s deep lymph too. It’s not enough right now when people are really congested to just do this feather-light touch, it’ll get the superficial lymph, but it’s not gonna get those deeper lymphatic ducts. And then you can massage and then you can bring your arms up and shake your arms, you know?
Jodi: If you’re rubbing under her armpit and it’s tender, keep working on it.
Stephanie: Those are some things that I get people to work on themselves. But as I said, it’s way more obvious with some people than others. But if you really start to practice, you’ll start to feel the difference. And whenever you’re working on lymph, to clear it, you’ve gotta start with the duct first. Open up here. Because again, you don’t want it to block. You start to move it up, but then it has nowhere to go, and then you’re just gonna give yourself symptoms because you’re correct.
Jodi: When I used to comb my daughter’s hair, I started at the bottom to work the tangles out. It’s kinda the same thing you’re stating. I have one final question for you. You mentioned that some of your players like to use oils to enhance performance before their games. I’m just curious which ones are some of their favorites?
Stephanie: I actually have sent them your links and they love it, but citrus, which the parasympathetic. And then other things like bergamot, sometimes lavenders, there’s a few that help turn on the vagus nerve and like get into that rested state.
Jodi: Is there anything that we didn’t talk about that you wanted to share?
Stephanie: I wanted to say a few little vagal nerve activation tips. I showed the one with the toothpick, but the one with your eyes cuz I mentioned there is cranial nerve three, that’s the ocular motor. There’s an ocular motor reflex. There’s a reflex between your eyes and your heart that tells your body you’re feeling safe and one of them is slight pressure on your eyeballs. Sometimes I get people to put their elbows down and lean the weight of their head.
And then you do extended box breathing. So instead of breathing in for six, hold for six, breathe out for six – you’re breathing in for six seconds. You hold it for six seconds, and you’re breathing out for eight to 10 seconds while making a humming sound. So like six seconds in, holding for six seconds, breathing out while humming, while having slight pressure on your eyes can be really calming if you’re in a state of fight or flight that you kind of can’t get out of.
I get people to do this at night when they can’t sleep cuz your eyes can be closed, but while they’re closed, you’re just gazing as far to one side, come back to the center and gaze as far as you can to the other side, and you hold for like 15 to 30 seconds if you can. You don’t wanna strain your eyes too much, but you should feel relaxation. Exhales sounds, smiling when you don’t feel like smiling, it changes the input onto your vagus nerve. Find little things that you can do to turn it on more, because most of the time we’re in like stressed state and our face is the same, so just move your face and massage it, puff your cheeks, stick out your tongue. All of those help your vagus nerve.
Jodi: How can people find you?
Stephanie: Instagram we have the Vagus Clinic, my personal one, which is Dr.SCanestraro – we post mostly on there. We have our blog and our store and all of our information on www.vagusclinic.com or healyourgutfirst.com, which takes you to the same page. We’re working on creating a lot of content and trying to get all of the stuff that we’re talking about on here into little digestible bits of information.
Jodi: Thank you so much for sharing your knowledge!
