Vagus Nerve Stimulation - Do VNS Devices Work? - Dr Gill
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- Опубліковано 15 тра 2024
- Vagus Nerve Stimulation - Do VNS Devices Work? - Dr Gill
Edit 15/04/24
Nurosym makers have offered a 5% discount to viewers using this link
nurosym.com/discount/DRJAMESG...
Vagus nerve stimulation (VNS) devices have been found to be effective for certain medical conditions. They are primarily used for treatment-resistant epilepsy and depression.
Research suggests that VNS can help reduce the frequency and severity of seizures in some epilepsy patients and improve mood in some individuals with depression
The interaction between the sympathetic and the parasympathetic nervous system is thought to be a key element in the fatigue of long covid, and hence vagus nerve stimulation, whether through box breathing, ro VNS devices may have a benefit
THE PAPERS
Application of Non-invasive Vagal Nerve Stimulation to Stress-Related Psychiatric disorders
pubmed.ncbi.nlm.nih.gov/32916...
Non-invasive Vagus Nerve Stimulation in Healthy Humans Reduces Sympathetic Nerve Activity
www.sciencedirect.com/science...
The Effect of Transcutaneous Auricular Vagus Nerve Stimulation on Cycling Ergometry and Recovery in Healthy Young Individuals
pubmed.ncbi.nlm.nih.gov/37974....
Therapeutic Effect of Implanted and Non-Invasive Vagus Nerve Stimulation on Heroin-Induced Anxiety.
www.sciencedirect.com/science...
#drgill #Vagus #fatigue
You can now consult via video or in person with Dr Gill at Dr Finlay’s Private Practice - www.drfinlays.co.uk/services/...
00:00 - Introduction to Vagus Nerve Stimulation
00:50 - Addressing Patient Desperation and Health Quackery
03:28 - What is the Vagus Nerve?
04:50 - The Autonomic Nervous System
05:05 - The Somatic Nervous System
05:16 - Structure of the Autonomic Nervous System
05:39 - How Vagus Nerve Stimulation Works
05:59 - Vagus Nerve Stimulation for Cardiac Arrhythmia
06:54 - Simulating the Vagus Nerve
08:55 - VNS Techniques for Anxiety and Panic Attacks
09:45 - Long COVID, Fatigue, and Heart Rate Variability (HRV)
11:38 - Vagal Nerve Stimulation for Long COVID
13:01 - Nurosym Device
13:40 - VNS for Refractory Seizures
14:11 - DIY Vagal Nerve Stimulation
14:47 - Independent Research on VNS
18:48 - Personal Testing of the Nurosym Device
26:37 - Conclusion and Personal Take on VNS Devices
30:22 - Final Thoughts
I have a VNS implanted onto my heart, it ended my seizures and changed my life forever. After over 10 years of seizures, i put in a VNS at the age of 18 and and can now finally drive- something that I never thought I would be able to do.
That’s such a positive outcome!
I know a lot of medicine is “take a tablet and hope”, so I REALLY find it great when someone creates a physical device which helps people, is somehow seems more… “real”
I am glad I found this channel
@Dr James Gill i will heed your warnings! Thank You for this Knowledge.
I was about to be like “oh gosh, my heart rate doesn’t have much variability!” It hasn’t for years. Then I remembered I have a chronic inflammatory illness and my body is definitely what you’d call physically stressed. That’ll do it. Maybe I should try vagal stimulation for my fatigue, chronic as it is. I’m curious now. I never considered it for stress or anxiety before, but I knew about the SVT benefit from nursing school.
I use a TENS unit for pain sometimes, especially if I wind up chasing pain and need more help coping, or I can’t take medication for some reason. so electric stimulus for symptom relief isn’t the weirdest idea in some ways. Interesting video! And thanks for sharing your filtering out of the articles while picking them lol. Always a good reminder to check source bias when learning.
Dr. Gill, thank you so much for the very detailed explanations of both vagus nerve stimulation in general and your specific experience. At about 11:59 you seem to say "now there's two easy options you can do at home box breathing or there is also the utilization of a physiological sigh - they're both relatively similar and I'll put simple links in the description where you can find ways to access those techniques"
I see the links to the papers about the vagal nerve stimulation, but I don't seem to be able to find the links to box breathing, physiological sigh, or Valsalva maneuver. There are certainly lots of google results, but since the links not being present seemed like it was probably more an accidental oversight, I thought it might be worth asking.
That’s for that. I’ll get those on.
In direct reply though, most of the articles on how to Box breath etc are very good
I direct patients to this
www.webmd.com/balance/what-is-box-breathing for box breathing
Physiological sigh is here
honehealth.com/edge/health/physiological-sigh-andrew-huberman/
Here is the paper for the science behind the physiological sigh
www.cell.com/cell-reports-medicine/pdf/S2666-3791(22)00474-8.pdf
Valsalva is here
my.clevelandclinic.org/health/treatments/23209-valsalva-maneuver
Hello, my favorite UK doctor ❤️🔥
Morning!
Oh no!! Dr Gill is MY favorite Doctor!
Great info. Have you looked into those lights that help with vitamin D and seasonal depression?
God I love this man and his videos. Hes such a great teacher and communicator.
Thank you doctor for the information. What are your thoughts on using this VNS device for ulcerative colitis?
Thanks Dr. Gill. I am currently experiencing a phase of anxiety as I come out of a period of SAD. This normally lasts 1-3 weeks before I return to a state of good mental health until November/December time normally. I am not on medication for such a relatively short period each year. I'm not a medic, but I'm assuming this anxiety is triggered by fluctuating levels of serotonin in the synapses as production starts to increase again following SAD? It's very similar (though nothing like as severe and frightening) as to when I tried SSRI medication a few years ago - for which the cure was worse than the illness in my case! I'm very grateful for this insight and will practice some of the techniques in an attempt to control the symptoms of anxiety until it passes. I think blowing through an empty syringe (or biro in my case) is the most pragmatic and easy to achieve. Thanks again for what you do.
The doctor we wish that we could have...❤❤❤😊😊😊
Thank you again for the information. Interesting topic. On a side note, I have been getting into cold water 7-12 °C, for about 10 min in the mornings for a while now and I can tell you the positive effects I get from it are quite real. You can just feel it, it temporarily improves my focus and general well-being. I am a bit of a water adorer anyway since my childhood, maybe that has some psychological implications. As I get older I realize it is the obvious and small things that matter, like walking a lot, eating healthy and music.
May I give you some advice. Just get into cold water for 3 minutes at a time. This shocks the system better and can be done more often every other day for maximum benefit.
I have to admit when I first saw the video was posted I imagined that the vns was a device for people with back pain and had no idea you’d be talking about anxiety and long Covid and seizures and such but as someone with anxiety (and ptsd induced anxiety) I found this very interesting and informative!
Hi Dr. Gill! I also do the double wrist Garmin/Whoop duo. I noticed in the main video you have the Whoop sensor on the underside of your wrist as opposed to the top in the Neurosym video insert. Do you notice differences in data acquisition or reliability depending on the location you have the Whoop sensor?
This was Quite Good Information, Keep it Up 👌
👍
Thank you for the video! Do you have any product recommendations for those of us in the US who aren't able to order Neurosym? Thank you!
Hey Dr. Gill, is there already a video of yours about the general anatomical terms of location? Would be very interesting to properly get to know the meanings of distal, proximal, medial and so on. Might be too basic, but you probably know that not all your viewers are medical professionals ;)
Thanks for all your cool videos
There isn’t, but might be a good idea for a series of shorts?
@dr James, do you know of any treatments for long term loss of taste in long Covid?
Very interesting and informative, I am waiting delivery of a Nurosym device to try and help with post ischaemic stroke left arm spasticity. However, I also hope it will help reduce anxiety and improve sleep, a similar device is being used in a UK trial for post stroke patients but to get in the trial there needs to be wrist movement that I lack, so I am doing my own trial! Enjoyed this unbiased and informative presentation. Thanks
Have you gotten it and tried it? I was going to try it for same reason,stroke that affected left side left arm and leg
@@derekterrell3465 hi, I did respond but it seems to have been deleted for some reason?
I saw an advert for a device that looked similar to these, that didn't have any claims of how they worked.
Coming from psychology, I thought the device vibrated on your chest, thus giving the person a physical sensation. Much like some self tapping techniques, I assumed they were aiming for a mindfulness approach by keeping their mind focused on their body, rather than unhelpful thoughts that are the source of anxiety.
I’m not aware of a device like that. But I can see your logic
But the ones discussed here are electrical stimulation
Excellent video! I find your long-form videos very informative, I always learn something. I appreciate your balanced presentation and your endevor to avoid and disclose bias, unlike some other medical influencers out there who are all too happy to recommend all sort of quackery that people will trust in their desperation.
I really HATE quackery. Also dogma. If I’m wrong, I want people to work with me to understand.
I’ve found it very interesting when people do say “you are wrong” and when we work it through find it’s not the case.
I hurriedly highlight I get it wrong all the while, this was an example of it, and what to do better
Hello Dr Gill. I am in the USA and very much want to get this VNS you show in the video, but they dont ship to the USA and ideas on how I can pull it off ? I am tormented by migraines. I am not a Dr but would love to evaluate this device for my migraines.
I didn’t know there was an external device 🤔 I have one implanted for my seizures
UA-cam recommended me your video and I am so thankful, really great stuff Man.
btw
I
was wondering do you need an editor for editing your videos.
Huh, interesting! My mom bought me one of those a few years ago. I tried it once and it seemed to have an effect, but since the advice to use it had come from a naturopath who had also peddled some serious quackery, I attributed it to placebo and shoved it in the back of my closet. Interesting to see there's actual science backing it up- I guess even a stopped naturopathic clock is right twice a day! Might dig it out of the bowels of my closet and give it another go :)
You are completely correct “even the stopped clock is right twice a day!” 😂
I think a high degree of skepticism is ALWAYS warranted when money is changing hands
Not sure if this is something you would cover, but could you possibly talk about the benefits of having mushrooms (cordecyps, lions mane etc) in your diet for cognitive function? Been reading lots of research and studies on this and the possible benefits for children and adults with autism! Would love to hear your thoughts :)
When will this be available in the United States?
Would this (theoretically) then be beneficial even to someone who denied their high level of stress? Hubby gets worked up, but tamps his feelings down…yet, his heart rate according to his phone is around 92-94bpm. What are your thoughts- theoretically?
Just don’t leave that stimulator near your Alexa or you’ll wake up with a taser wrapped in swaddling cloth 😂 But seriously , you have sparked my curiosity as I wonder if the valsalva technique as I, and many others use when freediving is part of the reason why it is so calming (obviously you have to enjoy said activity first)..
Me sitting here with an average hrv of 30 at 22 for the last 2 years
Any idea why?
@@DrJamesGill Not particularly, my GP assumes it has to do with me taking on too much stress over the last couple years, but he said well keep watch of it now that I’ve cut back on stressful activities
I live in Vegas and I have a lot of nerve 😦
is this same treatment as Alpha Stim stimulation ???
You actually don’t have to get a device that expensive. There are cheap tVNS devices available online that do the same thing for anywhere between 20-100€. Or maybe you already have a tens device for your back or neck. Then you only need to get an earclip and set the thing to 100Hz and 150 µs
The only thing I would advise is than any device you intend to use on your cranial nerves (important things!) is CE marked for your own protection
A stress score of 50?! You need to get some Invigaron
May I know the name of the device you have so I can get one, please? Thank you.
Nurosym - there is 5% discount with this link
nurosym.com/discount/DRJAMESG5?redirect=%2Fproducts%2Fnurosym
Discount code DRJAMESG5
Get. A. Wiggle. On.
Glorious.
Hello Dr. Gill, thanks for the detailed video. What do you think about less expensive alternatives to Neurosym, for example using a TENS device with an ear clip?
Also, during a standard ECG, the HRV is not recorded, yes?
Dr. Gill. I love the info, but others that in catch 21 when it comes to a Benzodiazippine to calm them down for panic and generalized anxiety disorder. I'm not a doctor. But I've seen many suffer with these issues. Maybe it is hard to address this from your point of view due to limited restrictions. However, I do feel it is important to not overlook these matters. Thank you for the knowledge Dr. Gill. I just wanted to bring up what I see around me. Heh.
I’m sorry I’m not quite sure about three catch 21 you are referring to?
To put it another way, benzodiazepines, unless in the acute situation are medications doctors should strive to avoid. The side effects and addictive nature far outweigh the way any effect
@@DrJamesGill it is a typo. "Catch 22" I just noticed a lot others around me that are stuck. It's either they are suck with the medication, or have withdrawals. Sadly for them they are stuck in this situation.
@pb879 ah that’s makes more sense. Yes I fully understand that predicament.
The solution unfortunately is not easy, as stopping BZD medications can be hard, even traumatic for some
@@pb879 I've been taking this class of drug for 10 years and periodically when times are less stressful I've been able to stop taking them for a little while. Reading your comment I just realized I stopped taking Lorazepam at the same time I began polyvagal exercises two weeks ago. Polyvagal exercises are all over youtube, you can give them a try without buying a device. I just assumed I was so exhausted I didn't need the benzo, but it was very likely the polyvagal exercises reduced my stress and that's why I could sleep without them. Either way, I've never stopped taking Lorazepam cold turkey without a lot of anxiety, but I did two weeks ago. I didn't actually try to quit, but I just didn't need them after doing these exercises and my rem and deep sleep improved 40-60%. This was just my experience, but it's notable I quit them without trying once I started doing exercises to relax my vagus nerve. It can't hurt to try the ear massages, they're a little goofy, but they have done a lot for me already. Good luck!
Thanks for this video. Doesn't HRV go up by resting though. So if you were to sit still or lie down for the same time you used the device, wouldn't hrv also go up? This is what I have personally found
It go up when resting, assuming that you weren’t stressed that time. In the video, I’d already been sat down for an hour or so doing bits and bobs in order to try and control for that very variable.
This is one of the reasons, my box breathing, can help boost HRV. Because you’re sat down, rested, and crucially, by focusing on your breathing, you’re getting a, degree of vagal nerve stimulation with the challenges of pressure in the chest, but also B, you’re getting a period of rest whereby the focusing on your breathing, means you can’t be stressing about other things at that moment in time
Thank you for the response. I'm about to retry my parasym device having given it a but if a go a fee years ago. I'm 11 years post viral fatigue / me/cfs with pots syndrome. Very much like long covid fatigue patients in presentation. It seems like a promising idea. I'll try for longer this time.
*SO THEN PEOPLE, WHAT'S YOUR OWN DIAGNOSIS, IS HE A DOCTOR OR A SALESMAN.??.*
His advertised device = $599 or a do the very same job TENS Unit = $40..
How does this differ from tACs?
VND is established medical techniques - eg the use in cardiac issues using breathing approaches
I don’t know enough to speak on tACS, but I think it has less of an evidence base.
There is a Nature paper in 2021 highlighting the point the mechanism underlying it isn’t understood
www.nature.com/articles/s41598-021-83449-w
@@DrJamesGill VNS looks to be very similar if not the same. I've been doing tACs for years for the same kind of anxiety relief and relaxation. The electrodes are ear clips but it's a pair of them, one for each ear lobe. I'm curious where the other electrode is for your VNS device? With just one electrode it would not be possible to send electrical signals. Either the unit you hold is an electrode itself or the ear piece has two separated electrodes. I'm curious what waveforms and frequencies the VNS device uses. My tACs unit is 2Hz to 111Hz in a bi-phasic dual polarity waveform.
@@mikewalsh511tACS devices are the GOAT
Is this the same as a TENS device?
Similar but different is the easier answer- it’s like a Philips and a flat head screw driver. Similar things, but slightly different
Tens is looking specifically at pain, VNS is looked at the autonomic nervous system
@@DrJamesGill Thanks, I'm wondering what might better be a better option for tinnitus, this, or a TENS device? As the parasympathetic breathing exercises bring down blood pressure but do nothing for tinnitus then maybe TENS. Or best of all, a new audio cortex if you can advise where I can get one of those?🫤
Hi Dr, would you recommend the nurosym device for Postural orthostatic tachycardia syndrome, an autonomic nervous system disorder. Thank you
I can’t give specific medical advice in this formum. I haven’t seen good evidence that it would be beneficial
"Get Our "Wiggle" On".
I went and found the Nurosim thing and it's bloody 700€...
I guess it's for the rich :/
15 February 2024
*Abstract*
This video explores vagus nerve stimulation (VNS) and its potential applications for anxiety, stress, and long COVID. Dr. James Gil, the presenter, delves into the science behind VNS, discussing the autonomic nervous system and how VNS can influence its balance. He examines research on VNS for various conditions, including its impact on heart rate variability (HRV), a marker of stress and resilience. Dr. Gil also shares his personal experience using a VNS device and its positive effects on his HRV and stress levels. While acknowledging the limitations of current research on VNS for long COVID, he suggests its potential as a complementary therapy, particularly when combined with HRV monitoring.
*Summary*
*Addressing Patient Desperation and Health Quackery (**0:52**)*
* Patients with long COVID often experience desperation and may turn to unproven treatments or supplements.
* Dr. Gil emphasizes the importance of evidence-based medicine and avoiding health quackery.
*What is the Vagus Nerve? (**3:30**)*
* The vagus nerve is the longest cranial nerve and plays a crucial role in the autonomic nervous system.
* It interacts with both the sympathetic ("fight or flight") and parasympathetic ("rest and digest") branches of the autonomic nervous system.
* VNS can be used to dampen the "fight or flight" response and promote relaxation.
*The Autonomic Nervous System (**4:50**)*
* The autonomic nervous system controls involuntary functions, like organ function and automatic bodily processes.
* It consists of the sympathetic and parasympathetic nervous systems, which work in opposition to maintain balance.
*How Vagus Nerve Stimulation Works (**5:42**)*
* Stimulating the vagus nerve releases acetylcholine, a neurotransmitter that calms the sympathetic nervous system.
* This can help regulate heart rate and reduce anxiety.
*Vagus Nerve Stimulation for Cardiac Arrhythmia (**6:03**)*
* VNS can be used to treat dangerous heart rhythms like SVT (supraventricular tachycardia).
* Vagal maneuvers, such as blowing against a syringe or applying a cold towel to the face, can stimulate the vagus nerve and interrupt the abnormal heart rhythm.
*VNS Techniques for Anxiety and Panic Attacks (**8:56**)*
* VNS techniques, like box breathing and the physiological sigh, can help manage anxiety and panic attacks by promoting relaxation.
*Long COVID, Fatigue, and Heart Rate Variability (HRV) (**9:46**)*
* Long COVID patients often experience fatigue and biological stress, leading to decreased HRV.
* VNS may help improve HRV and reduce fatigue in long COVID patients.
*Vagal Nerve Stimulation for Long COVID (**11:39**)*
* Relaxation techniques, including VNS, are being explored as potential therapies for long COVID.
* HRV can be used as a marker to assess the effectiveness of VNS in improving stress levels and resilience.
*Nurosym Device (**13:01**)*
* The video discusses the neurosym device, a non-invasive VNS device that stimulates the vagus nerve through the ear.
* Dr. Gil reviews research on non-invasive VNS and its potential benefits for stress, fatigue, and anxiety.
*Independent Research on VNS (**14:49**)*
* Dr. Gil emphasizes the importance of unbiased research and reviews studies not funded by VNS device manufacturers.
* He highlights studies showing the positive effects of VNS on HRV, sympathetic nerve activity, and fatigue.
*Personal Testing of the Nurosym Device (**18:49**)*
* Dr. Gil shares his personal experience using the neurosym device and its positive impact on his HRV and stress levels.
* He demonstrates the use of the device and its effects on his HRV using a Garmin watch and Whoop band.
*Conclusion and Personal Take on VNS Devices (**26:37**)*
* Dr. Gil concludes that VNS shows promise as a complementary therapy for anxiety, stress, and potentially long COVID.
* He recommends starting with home-based VNS techniques like box breathing and monitoring HRV to assess effectiveness.
* While acknowledging the need for further research, he shares his positive personal experience with the neurosym device.
i used gemini 1.5 pro to summarize the transcript
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please note that he conveniently failed to tell everyone that instead of the very expensive device he was promoting, you can buy a TENS Unit for around £30 that will do the very same job, yeh.. money, money, money.!!.. lol.
Haha, calling out the "studies" funded by companies that benefit from said studies coming out in their favor 😂
When it comes to health care, I always say follow the money. If you don’t like where it leads, that might give you more of an answer than the information they are providing you.
Conflict of interest is sometimes a different thing to bias though.
I work - in addition to my NHS work - one day in private medicine. I have a conflict in that I would like people to come and see me, so I’m talking a little more broadly about health on the channel.
But I don’t feel that biases what I’m saying, as I apply everything I talk about to both my NHS and my private patients 😊
@@DrJamesGill For what matters, as should be the primary goal of all medicine professionals, is the patient getting well - getting paid should be the result of a job well done.
I’m going to disagree, although sound very pedantic in doing so 😊
What matters is the patient getting HELP, which is different to getting better?
I think it was Hunter Adams who said the great quote “treat a disease you win you lose. Treat a patient, no matter the outcome you win”
Also to put it another way you can’t pay doctors based on results, as patients come to harm. We already see certain groups of clinicians declining to provide certain services, as whilst the patient MAY benefit, there is also risk to the patient. As some
doctors OUTCOMES matter, some say “sorry, I won’t take a chance on the treatment [because a negative outcome will affect my numbers]
But as ever this things are massively complex, and ultimately people are looking for help
Sponsored content. Credibility out of the window. Sadly.
I think I’ve tried to be as clear about that risk as possible. Crucially I received no money here, but was allowed to keep the device.
So there is a risk of bias from that, but I think to say that impacts on credibility isn’t correct, especially the way I’ve approached the use cases - directly ignoring everything the company sent and finding the research papers myself
Yeah you don’t know anything. The good Doctor explained it quite well. Don’t like his actually medical opinions, go somewhere else.
We need some placebo measurements. Clip on, device off and paper work.
@@DrJamesGill I greatly appreciate your scientific integrity. Thank you!
Would you consider doing a video on how earphones affect the ear or any part of the head? Because I accidentally fell asleep with my AirPod on and I woke up with my ear and jaw hurting.