Luke: Well, it’s funny you Emrys. About four years ago, I undertook his training in trans auricular vagus nerve stimulation. So, that’s really where I started to learn about the vagus nerve. And obviously, Emrys is one of the forerunners in vagal stimulation. So, a lot of what you’re gonna hear today might be replicating some of those older podcasts that Emrys’ been on, but I think it’s always good to do a bit of a refresher. And obviously, with Simon’s talk, he would’ve talked about more of the psychological components about polyvagal theory, which was really built, you know, coming from the ’90s of Stephen Porges’ work. And I think working in an integrative clinic alongside people like Simon and some of the other psychologists, when we bring in the physiology component of that through the vagal stimulation, we kind of see the two marrying up.

So, I guess, polyvagal theory really talks about three primary states of being, which is ventral vagal or social connection, interaction, grounded, calm, curious, safe. And then, obviously, along comes our fight or flight response when, you know, the bills come in, or the news comes on, or, you know, whatever that may be for each person. And that’s kind of obviously, a sympathetic nervous system response that kind of triggers that. And I guess, the theory kind of went into the next stage of that, which is called a dorsal vagal crash, or when, you know, you’re threatened with a life-threatening situation, or something like a car accident, or an extreme trauma, the body just kinda shuts down into this lower state of being. And it’s more of a survival mechanism to kind of keep the body safe in a certain way.

And what I’ve found clinically is a lot of people that are coming to our clinic are coming with a multitude of chronic issues, and they’ve been in that dorsal vagal state for a long, long time. So, one of the great things we can do through the psychological component is educate people on those three states and help them kind of understand where they’re at in those three stages. And then when it comes to the therapeutics, actually offer them, you know, a way out of those dorsal states, and, I guess, higher activation states.

Andrew: Right. When you are mentioning the dorsal vagal crash, is this what we are seeing in… I’m not talking about causality, but effect, if you’d like. Is this what we are seeing with chronic situations like chronic fatigue syndrome, long COVID, that sort of thing?

Luke: Yeah, there’re some recent studies that they’re only pilot studies that have come out looking at long COVID and the association with the vagus nerve. And from what I’ve seen, they’re actually seeing physiological changes in the nerve. There’s been a theory for a long time, viral exposure can actually affect the nerve, and they’re actually quantifying that with radio imagery and seeing a thickening of the nerve, which is actually really indicative of inflammation of the nerve. And a lot of the symptomology that long COVID patients present with marry up pretty concisely with the type of symptoms we see in vagal dysfunction. So, the cardiovascular events, digestive complaints, vocalization changes, tinnitus, they’re all the classic ones that we kind of see. So, I guess it’s probably too early to say how much is involved, but definitely, the pilot studies are showing that.

Andrew: Wow, that’s really interesting. And that’s sort of… I know we are going off onto a tangent here with things like long COVID, but that’s really interesting with regards to therapeutic options. Like, it sort of really steers away from this…I’ve always thought it was erroneous, this immune “stimulation,” which I don’t necessarily believe this happens, but anyway. But the immune stimulation model, and sort of draws more into the hyper-inflammatory sort of model that’s going on.

Luke: Yeah, so, I mean, some of the clinical tests we do with patients coming in with long COVID symptomology, things like cytokine panels where we can actually see these interleukins, now particularly interleukin 6 and interleukin 8 elevated, and we know interleukin 8 is definitely involved in with the pro-inflammatory long-term sort of response, and it takes a while to kind of down-regulate that. So, knowing that, we can actually use the non-invasive techniques like trans auricular vagus nerve stimulation alongside other therapeutics to actually help down-regulate that. And we’ve got some pretty nifty tools that we use as naturopaths and herbalists and nutritionists to support that, which is good. So, you’re twiddling your thumbs there going, “Come on, reveal, reveal.”

Andrew: So, just finishing off on the physiology and the anatomy of the vagus nerve, it’s both an afferent and an efferent nerve, so it can both be sensory and somatic.

Luke: Absolutely. I mean…

Andrew: Is this at same points or is it at different points? Like, for instance, there’s supposed to be two origins, not one origin of it, is that right?

Luke: Yeah, there’s two branches of the vagus nerve. So, there’s what’s called the ventral and the dorsal. Eighty percent of the nerve fibres are afferent, so really, it’s a sensory nerve. It’s kind of like what our eyes, ears, taste receptors, but it’s internal. So, it’s kind of going through all the organ systems, sensing what’s going on and sending the information back to the brain for the brain to recalibrate. And 20% of the nerves are afferent, so they do send signals back out to different organs, particularly the heart, lungs, and part of the digestive tract. It doesn’t go all the way through, like, the dorsal branch, but, yeah, it does both. And just like anything, like the nerve’s still a tissue, and I guess what I think about is those old physiomedicalist that said, you know, “The issue is in the tissue. Look to the tissue for the areas to kind of treat.” And that’s where my approach as a herbalist may be a little bit different to some naturopaths and herbalists. Obviously, we kind of focus on the biochemistry so much, but, definitely, the energetics behind some of these herbs can really play into therapeutics when we’re treating people for vagal dysfunction as well.

Andrew: Okay. And so, when you’re talking about 80% efferent, 20% afferent, is there a way therefore to assess using efferent or afferent symptoms the state of the vagus nerve?

Luke: Yeah, so I guess, a lot of the lower digestive symptoms are going to be more of that afferent nerve fibres. That’s what I kind of look for. They do cross over pretty nicely. It’s not really the area that I’m kind of looking at. We’re really looking at how to regulate the nerve as a whole because we want both of those systems working effectively. And generally, when it comes to clinical assessment, we’re looking for things like uvular elevation, so the little dangly part of the back of the mouth that’s meant to pull up. Talking about that earlier. Things like the symptomology, tachycardia, tinnitus, vocalization changes, issues with swallowing, those sorts of things, and classic vagal symptomology.

And then even things like cervical extension, so, can they actually put their head all the way back? You know, history-taking, like have you ever had a car accident? Were you a gymnast as a teenager? Have you ever had a upper cervical event? We know that vagus nerve innervates cervical spine once. So, a lot of the time if I’m seeing that uvular swinging to one side or stuck to one side, I’ll go send the patient off for a chiropractic assessment or an x-ray to kind of see if there is anything in that area that needs to be addressed.

Andrew: That’s really interesting about the uvula sort of de-innervation, isn’t it? No. Would that be de-innervation if it’s…

Luke: Yeah, I mean, I guess, talking about the two sides and the branches of the vagus nerve, if you’re seeing the uvular swinging to one side, it’s really indicative that one branch of the vagus nerve isn’t functioning as well. And what we tend to do is ensure that there isn’t any cervical compression on the nerve, because if there is, vagus stimulation isn’t gonna do what we hope it will do. You really need to address the structural component of that. And that’s where, you know, people like Emrys are really great because they do the bodywork as well as the vagal stimulation, but we’ve got some really good chiropractors and osteopaths around that I send in for assessment, and they generally pick it up and treat that before we start any therapies.

Andrew: Gotcha. So, what other clinical assessments do you go through to determine parasympathetic sympathetic nervous stimulation or dominance?

Luke: Yeah, I guess, you know, case history is a big one. You know, as naturopaths, we really need to understand what the person’s coming in with and symptoms they’re presenting with. I take a pretty thorough case intake. We know that the ventral aspect of the vagus nerve is myelinated. So, knowing things about their birth history, we know that infants that were breastfed tend to have better myelination than infants who weren’t. We know that there can be traumas at birth. We know that, you know, people with previous car accidents and whiplash and those sorts of things that create upper cervical instability that can be trigger events later in life that kind of put the nerve out of whack. Yeah, there’s a whole bunch of things, even to the point where we look at people’s work history.

There’s some studies out there showing copper factory workers that have had high lead exposure have actually affected the vagus nerve and reduced heart rate variability. So, toxic metal exposure is one of the big ones that kind of keeps coming up when we look at people’s vagal dysfunction. So, anything that’s pro-inflammatory that can affect the nerve tissue is going to potentiate or aggravate the vagus nerve in some way, and it’s just about how long along the path is the fallout. And it’s usually, you know, that’s why they’re coming to see us. They’ve kind of done the lap around trying to figure all this out, and they come to us, and we kind of go through that history, and, you know, piece it all together for them.

Andrew: It’s really interesting, though, that it seems to be this late-stage thing, whereas really it should be looked at quite early on in the piece. So, we really need practitioners to become cognizant about vagal nerve theory or polyvagal theory so that they can introduce it as an early-stage therapy rather than late.

Luke: Yeah, I mean, most of the patients that are coming through my clinic are in those later stages, but you’re right because there’s obviously things that we can do early on to help strengthen and support the whole body, but particularly, the nerves. And, you know, nutrition and dietetics is a big part of that, particularly when we go into things like DNA analysis. Like, if we have a, you know, 3 or 4-year-old child coming in with neuroinflammatory issues, often we’ll do a DNA panel. And we’re looking for those, not only those markers that show the body’s susceptibilities to putting out inflammatory issues, but also things like your FGFR2 gene or your TCN2 receptor that allow, you know, the utilization of vitamin B12. So, if you have some of those genetic susceptibilities and the diet’s not on point, then you’re gonna have a tough time getting the nutrients in to support the nerve and the myelin sheath and helping that person’s nervous system function optimally. So, again, there’s no quick answer on this. We kinda gotta look at a few different areas and piece it all together and give the most appropriate treatment advice based on our investigations.

Andrew: Gotcha. And so, you know, when we’re talking about therapy, we’re talking about the periocular nerve stimulation. Can you take us through that from go to woe because, I mean, this is the whole sort of thing about how we intercede in this? How do you do it? Where’s the correct spot to place it? I know that we can’t really take our listeners through this, it’s something that they have to experience, but we’ll talk about how we can learn more later.

Luke: Absolutely.

Andrew: So, take us through, yeah, the vagal nerve therapy.

Luke: Well, I guess, we need to first talk about the anatomy of the vagus nerve coming off the brainstem. There’s actually, as it sort of leaves the skull, there’s two points. There’s your superior ganglion and inferior ganglion, and obviously, the superior meaning on top. That’s the one where the auricular branch goes to the outside of the ear. So we know we can access the nerve from the ear based on knowing the anatomy of the nerve. And there’s a few particular points on the ear, in particular the cymba conchae, which is a really tricky spot to get depending on someone’s…the way their ear is shaped. And the cavity of conchae, which are the two primary stimulation sites where a lot of the studies are focused. I’ve actually found clinically that the tragus is actually a really good point for people. Particularly, the vagus nerve stimulation doesn’t have a huge amount of side effects, but the clips that we use can be a bit pinchy. So, if you’ve got a sensitive patient that just isn’t tolerating the clips, then the tragus is a really good point where you can still get some stimulation from.

So, when we do a therapy of the vagus nerve, we’re really looking to place the clips on these particular areas. And my training with Emrys, we use the NeuroTrac TENS machines, which I know that there are other stimulators out there, but they’re the ones that I tend to use and find that I get the best therapeutic results for. And really, vagal nerve stimulation is like exercise for the nerve. So it’s like going to the gym for the nerve twice a week, whereas your at-home exercises are more, you know, your gentle yogas and your stretching at home, and it’s great exercise, but it might not get you fit for the triathlon that you need to run.

So, we do know we can access the nerve from there. And, you know, the nerve is actually in some reports to be about 11 meters long. You know, the word vagus in Latin means wandering, so it’s such an interesting nerve. There’s really no other nerve like it in the body. I guess, it innervates all of our throat muscles for swallowing. It innervates our heart. And that’s really where we can see the changes is through monitoring people’s heart rate variability, which is the gold standard for looking at vagal function. So, that’s something that I do prior to post-treatment monitoring that ongoing with the treatments that we offer as well.

Andrew: Can you take us through heart rate variability, how you measure it?

Luke: Sure. So, if you’re a TCM practitioner and you’re very, very good with your pulse diagnosis, you might be able to do it through pulse, which is something that I’m definitely nowhere near doing. But one of the things we use is just a little… Actually, I might have it around here somewhere. You just get some software and you put a little clip on the end of the finger. And what heart rate variability is measuring is the space between the heartbeats, the timing between the heartbeats. And what we do know is people with a higher heart rate variability of 70-plus tend to be healthier, live longer, have less disease. People that tend to have a lower heart rate variability, let’s say, below 40 or 50, tend to be more susceptible to chronic issues or present with more chronic issues.

So, knowing that, and knowing that vagal nerve stimulation actually increases heart rate variability, we’ve got a really good biomarker to kind of see how people are responding to treatment. And that’s the device that I use, but people, you know, the Oura Rings are really popular now. People wear a lot of those. Apple Smartwatches are another way people can monitor their heart rate variability. I think the technology’s there for them now. And you can get other devices like through the HeartMath Institute that has the clips on the ears is another way you can do it, that way as well.

Andrew: Can I just ask, from a safety perspective, when we’re talking about heart rate variability, can you just take us through a little bit of differential diagnosis? When does it become an issue? Like, are you looking at, for instance, atrial fib, or supraventricular tachycardia, something like that? I mean, SVT is gonna be just fast, plain fast. But atrial fib, you know, you’ve got a variability, if you like, there, because you’ve got ectopic beats going on. When is it healthy? When is it…

Luke: Yeah. So, I mean, Emrys talks…

Andrew: Sorry.

Luke: Yeah, no, that’s okay. Emrys talks a bit about that in atrial fib. I mean, we do have protocols for atrial fibrillation. I guess, anything… The three sort of things that we look for to sort of say, “Look, we need to obviously investigate this further,” would be if somebody has a pacemaker, they would need clearance from the cardiologist to do any type of vagal stimulation. If someone has an active form of cancer, they would need clearance from their oncologist for any type of vagal stimulation. And the other one is a acute viral infection. They’re really the three things that we look for where we would say, “Look, now, you need to obviously get these cleared, or you need to wait for the virus to pass.” We have seen some success in AF. I think if you listen to some of those podcasts Emrys did with you back in 2008, 2009, he talked a little bit about this. So, it is something that we can tend to use, but I just don’t see a lot of that in my clinic. Most of the people that are coming to my clinic are presenting with more neuroinflammatory issues or digestive complaints. They’re really probably 95% of the people that are coming through for vagal stimulation.

Andrew: Right. What about psychological issues, anxiety, depression, we’ve spoken about chronic fatigue and that sort of depressive component there, but post-traumatic stress disorder?

Luke: Yeah, you’ve probably listed three that have pretty good meta-analysis on that. You know, we know that with anxiety, the meta-analysis shows that there is definitely a decreased heart rate variability in anxiety across the board. So, if we know that people have a decreased HRV, we know one of the therapeutic actions to pull them out or increase that is getting the vagus nerve back online.

There has been some pilot studies on PTSD which have shown around about 30% reduction in the symptomology of PTSD from people that have done trans auricular vagus nerve stimulation as compared to sham stimulation. So, there’s definitely some evidence out there to show that those sorts of conditions are improved with vagal stimulation, which is quite exciting. And, you know, the papers just go on and on. If you get onto PubMed and start looking at this stuff, it just, you know, you could spend your life just burrowing through the data. So, my time, I don’t have the luxury of time for a lot of that, so I kind of look a little bit towards others that are in the field that are kind of bearing through that data for me and cherry-picking what is useful for me, that’s for sure.

Andrew: Right. And I also remember Emrys talking about things like gargling, like a really deep gargle, which I tried for the life of me, and I just choked. And I tried it in the shower eventually because I was just spurting water everywhere. And the other one was singing. So, you know, just thinking about therapy for singing… sorry, therapy for anxiety, for singing, or therapy for, let’s say, AF with singing, things like that, do we have any evidence that singing and that is useful, or is it really back to the you know that you have to stimulate the nerve?

Luke: Well, I guess I use singing a lot with my patients. And the ones who won’t sing, I’ll get them to gargle, but it comes back to, you know, old Greek medicine. They would say, “Exercise for the body, education for the mind, and music and singing for the soul.” And I think singing and music is such a big part of medicine that we forget. If you look at every culture around the world, every system of medicine, there’s always some aspect of chanting or singing that’s part of it. And one of the things that is highlighted out there in some of the yoga journals and the literature is heart rate variability improving with chanting Om. So, if you actually chant Om as opposed to other sounds, it has shown to actually increase heart rate variability, and they associate that with the vagus tone. So, again, you know, we kind of need to look back in history for some of these beautiful modalities and simple things that we can do on a day-to-day basis to help support the nerve.

And, I guess, I kind of equate the difference between doing the singing, the gargling, the chanting, those sorts of things, and trans auricular vagus nerve stimulation. I’m very lucky to live in the beautiful Byron Bay, and a lot of people do the lighthouse walk, which is lovely to do, but, again, it might not get you trained for the triathlon. Whereas, when you come in for a clinical session of vagus nerve stimulation, it’s really like going to your F45 class or your PT, and you get put through your paces for half an hour. And it’s just a faster way to get better clinical results. And often when people are stable, then I’ll get them to continue on with the at-home exercises. Obviously, not everyone may have the luxury of a clinician in their area to get in and do a clinical vagal stimulation. So, definitely, the at-home exercises are well worth it. And I always say to people, you know, you brush your teeth morning and night, it’s a great time just to do some gargling and work on that. And people do notice a difference, particularly with the singing. When people can get 20 minutes of singing three times a week, they feel better. They feel better and nearly immediately, which is something to say.

Andrew: When I sing, I feel better, but my neighbours feel demonstrably worse.

Luke: Well, I do say to my patients. It doesn’t matter if you’re any good or not, just get it in.

Andrew: Yeah, get in the car. I will always remember this thing. Let me tag it into what you said. You said that almost every form of medicine have some form of music or chanting through it. And I will always remember the innate pentatonic scale that Bobby McFerrin demonstrated it, I think it was a science fair. And he just got the audience to… He initiated the jump, the first jump or the first two jumps. From then on, the audience did it automatically. So, music is within us, it’s hardwired. It’s quite amazing. What I’d love to do is I’d love to get an audience of supposedly tone-deaf people and see what their reaction would be. That would be hilarious.

Luke: You could be onto something there. That might be a Ph.D. for down the track, you never know.

Andrew: Ph.D. of tone-deaf people. Now, obviously, if you are going to be doing a workout for your nerves, we’re gonna be using nutrients, we’re gonna be using energy, joules, kilojoules. So, how do you support the body’s energetics through this? Do we talk about, you know, putting your neighbours on really highly nutritious soups throughout this phase where they’re coming to see you and, you know, sort of really getting put through their paces? Do you use nutraceuticals? What about herbs?

Luke: Yeah. I think it’s really dependent on the patient’s, obviously, symptomology in their presenting case. Anything that we can do… The way that I practice is I really look at the person holistically. As much as we zoom in with the genetics and we go down the organic acids path and the gut tests and those sorts of things, sometimes we also need to zoom out and look at who we’ve got in front of us, both psychologically and even coming back to some of the pillars of those modalities like Ayurvedic medicine, Chinese medicine, Unani medicine, the old eclectic herbalists, really looking at constitutional patterns. I did a talk earlier in the year. I was thinking about that with the different aspects of Stephen Porges’ polyvagal theory of the dorsal vagal, the ventral vagal, and the sympathetic nervous response.

Well, it really fits into some of these other modalities like Ayurvedic medicine’s kapha, pitta, vata dosha systems and the Chinese medicine’s three treasures of Xing Qi aspects. And even looking at the modes of astrology of cardinal fixed immutable, they’re all talking about different states. So, if we think of the kapha dosha in Ayurveda, it’s earth and water, it’s heavy, it’s fixed, it’s sturdy. And kapha in excess could be looked at as dorsal vagal because it’s kind of a shutdown aspect. Whereas the pitta dosha, which is the fiery energetic, athletic, let’s go type dosha, in excess could be that fight, flight response. And there is actually a paper in PubMed somebody looking at the vata dosha correlating with ventral vagal, or the vagus nerve because the vata dosha in Ayurvedic medicine really talks about bowel function, respiratory aspects, the vocal aspects, all of the pathways that the vagus nerve takes, the vata dosha actually crops up time and time again.

So, there is some research being done into that, looking back at some Ayurvedic texts and how they explain those doshas, and in particular, the vata dosha being associated with the vagus nerve. So, that’s always at the forefront of my mind when somebody sits in front of me, is looking at their constitution first because we tend to see that in clinical assessment as well. If we’re gonna feel somebody’s arm, for instance, and feel the heat, you know, are they a really hot constitution? Are they really fiery? Are they really sharp when they talk to us? Are they in that activated state? Well, that could be a clue as a clinician to kind of see, “Well, they’re clearly sympathetic dominant at the moment.” Or if you get somebody who comes in and they’re very slow and they avoid eye contact and very cold constitution, that’s more indicative of that dorsal vagal crash.

So, we might use different terminology through all the different modalities, whether it’s the eclectic modalities or the biomedical science, but we’re really kind of looking at similar patterns. And I guess, that’s what I look for. Even with DNA analysis, sometimes we’re looking, is the gene fast? Is the gene slow? Is the gene flexible? So, that’s, you know, the three modes again, like is it a cardinal? Is it really quick? Is it mutable? Is it flexible, or is it fixed and stuck? And they’re very similar concepts through each of the different systems of medicine.

Andrew: This is something that interests me greatly, and I’m guilty of it myself being orthodox in training. I mean, heck, I used to pooh-pooh nutritional medicine and herbal medicine just outright. How arrogant of me. But I think it’s so interesting how there are some who will just offhandedly dismiss, let’s say, the oriental therapies without looking for the possible connection. I did a couple of podcasts years ago with Paul Keogh about this, how, you know, if you look at this symptomatology, it could very easily, if you look at the symptoms of that Chinese expression, of that energetic condition, that very closely mimics or correlates with this Western paradigm. And isn’t it funny we use those herbs for exactly the same thing? Boo, it just blew my mind when these correlations were exposed.

Luke: Yeah, and I think I’ve been a bit blessed to have a bit of an interesting health journey through my life. And it’s only through experiencing lots of different modalities from both east and west and in lots of places of the world is coming to this understanding that all medicine has its place. It’s just it’s time and place. But when I started to do my studies and, I guess, look at some of these aspects in a little bit more detail, I could see there were so many similarities between the way that symptoms present, the way treatments were given. We’re just talking a little bit of a different language. And when we see the commonality, we see that these modalities have a lot more in common than what we might think. So, yeah, I think like you said, you know, sometimes we get a bit fixed in our mind if we think this way is the right way.

And I’m definitely trying to keep my mind as open as I can because you just never know when the next, you know, great insight’s gonna come and you can kinda see a different therapeutic for a client. And I believe that medicine really does come in all different aspects as well. Like, you know, we’re talking about singing to attune a nerve tissue and downregulate inflammation of the gut. I mean, if you’re having this conversation with a gastroenterologist, they’re probably gonna laugh at you, 90% of them. But the evidence and the studies are out there. And, you know, the best evidence is your patients’ feedback. Are they getting better? And time after time, they get better with these therapies.

Andrew: Well done. Now, I just I have to circle back to the nutraceuticals because, you know, if we’re talking about sympathetic dominance, we’re talking about, you know…I’ve got AMPK on the brain, forgive me. NMDA receptor agonism. Agonism? Stimulation. NMDA stimulation. So, we’ll be churning through nutrients like magnesium. We’ll have an excess at least at the site of the nerve and the synapses of calcium. So, do you tend to use nutrients and indeed herbs to help periauricular stimulation, gargling, singing? Do you ever use nutrients? I know you’re talking about personal medicine and where it fits, I get it, but just commonalities. Do you ever use things like magnesium, say, PEA, say, you know, I mean, a plethora of herbal restorative herbs, nervines, forgive me? What do you tend to use?

Luke: Well, there’s a lot of evidence to show that probiotics like Lactobacillus rhamnosus have a pretty big part to play in supporting vagal tone and supporting GABA expression through the vagus nerve. So, sometimes, again, like coming back to personalized medicine, we would kind of look at those sorts of aspects. We know the PAs, and the quercetins, and those sorts of things for sort of reducing histamine flow on neuroinflammation. We know the vagus nerve attunes histamine response in the duodenum, so we can actually use a combination of therapies for that. Definitely herbals. Most of the adaptogens are really good. I find if people are presenting with more of the tachycardia aspects of vagal dysfunction, herbs like motherwort are beautiful. They’re grounding, they’re downward bearing, they stimulate gastric secretion. Even the name means lion-hearted, so they can bring people out of that freeze state into more of their confidence.

There’s a really interesting herb. Wow, what’s the name? Calamus. I don’t think it’s actually allowed in Australia anymore, calamus. I’m not sure. I have to check that one. But there’s a really strong correlation between calamus and the vagus nerve, particularly ventral vagal. It’s dual-acting, so it’s quite grounding, but it’s also aromatic. So it uplifts you and stimulates at the same time. And native Indians in North America would chew it to help their vocal cords when they would do their singing as well. So, there’s that correlation between using the voice, too. So, it’s a really interesting herb. I don’t use it a lot, but I thought that was an interesting one when I came across it. Most of the herbs I do use, I use more from an energetic perspective, whereas I’ll use nutraceuticals based on the biology, so doing blood pathology or more functional pathology to look at where people are at.

We definitely know anything that’s gonna support myelination is gonna be helpful. So, all of your B vitamins, in particular B12. Choline is really important to make acetylcholine to basically, you know, which the vagus nerve is involved in the screening. We need to…

Andrew: Myelination. Yeah.

Luke: …have enough choline for that. So, there’s your supplement or there’s your food groups, like your broccoli and eggs and those sorts of choline-rich foods that we’ll talk about. So, again, we kind of piece this together through diet, lifestyle, therapeutics in clinic, looking at the testing, looking at their history, looking at their exposures, and come up with a suitable plan, whether that’s herbs, nutrients, whatever that may be for that individual.

Andrew: I love that you’ve covered off on toxic metal exposure because, you know, as an issue for demyelination and potential inflammation of the vagus nerve, it’s a biggie, it’s a hugie. Luke, oh God, I said this is part one of two, but there’s a lot to learn from you. Rather than doing that, where can we learn more? You’ve done a couple of courses with The Health Lodge, haven’t you? A couple of seminars where you were last.

Luke: Yes. So, my primary practices are my wife and I run a clinic called Little Earth Health. We’ll actually have quite a bit of education coming up next year on that website, littleearthhealth.com.au. I also work as an integrative clinician with a lot of functional doctors through The Health Lodge in Byron Bay. And next year or probably this year, by the time the podcast comes out, we’ll be up and running with our vagus nerve clinic. So, people will be able to have an assessment either online or come into Byron Bay and have their assessment, and then we can come up with suitable protocols or even see if they fit vagal dysfunction. You know, some of those symptoms that we kind of talked about earlier are just some of the clinical indicators, but there’s a whole list of symptoms that people can present with and disease states that have shown to be effective outcomes with vagal stimulation. So, to learn more, there are a couple of talks on The Health Lodge website education portal, and there’ll be a few on littleearthhealth.com.au as well. So, people can find a little bit more about me and a little bit more about the vagus nerve on those sites.

Andrew: Luke, amazing stuff. New Emrys. You’ve done so much, but I can tell that you’re kind of like Emrys. You wanna drill down, you wanna find out exactly why, how. You know, where does this work, where it doesn’t, what really is working? I love your mind. I can see this whole plethora of research floating around that you can just pick from and access and say, “Okay, this is where it’s appropriate for that, and this is where it’s appropriate for this.” I love your mind. I love what I’m seeing. Luke, thank you so much for taking us through part two of polyvagal theory today. You’re a wonder. You’re good.

Luke: I really appreciate it. Thanks for having me, Andrew.

Andrew: It’s our pleasure. And thank you, obviously, for joining us. You can catch up on today’s podcast show notes, and there will be many, and, of course, all the other podcasts on the Designs for Health website. I’m Andrew Whitfield-Cook, and this is “Wellness by Designs.”