In this podcast episode, James Maskell interviews Dr. Navaz Habib about the importance of the vagus nerve in healing and overall health.

Dr. Habib explains that the vagus nerve plays a critical role in shifting the body from a sympathetic (fight or flight) state to a parasympathetic (rest and digest) state, which is necessary for healing. He emphasizes the importance of creating a safe and supportive environment for patients to feel connected and reduce stress. Dr. Habib also discusses the role of physical trauma, such as head injuries or spinal misalignments, in affecting vagus nerve function.

He recommends various strategies to improve vagus nerve tone, including diaphragmatic breathing, gargling, humming and physical exercise. Dr. Habib’s new book, Upgrade Your Vagus Nerve, provides further information on these strategies and their impact on overall health.

Listen to the full conversation to learn how:

  • The vagus nerve is the organ of unity, connecting all organs and systems in the body.
  • Chronic diseases are diseases of disconnection, both internally and externally.
  • Breathing exercises, such as slow, nasal and diaphragmatic breathing, can help regulate the breath and shift the body into a parasympathetic state.

  • Gargling, humming and vocalization can stimulate the vagus nerve and activate the parasympathetic system.
  • The vagus nerve is a unifying topic for health professionals and can be beneficial for patients of all ages and conditions.

The Vagus Nerve: The Organ of Unity | Episode 329

Dr. Navaz Habib: I ultimately wanted to figure out, what was the driving force in helping to control that inflammation in the body? And that brought me to the vagus nerve, and I’m more convinced now than I even was when I first started hearing about this topic that the vagus nerve is absolutely critical and creating this state shift from sympathetic fight or flight into that healing state, rest, digest, recover, parasympathetic state is absolutely critical in ensuring that patients can heal.

James Maskell: Welcome to the Evolution of Medicine podcast, the place health professionals come to hear from innovators and agitators leading the charge. We cover the latest clinical breakthroughs and health technology, as well as practical tools to help you transform your practice and the health of your community.

This podcast is brought to you by the Lifestyle Matrix Resource Center, who provide a range of options to help you deliver successful, effective functional and integrative medicine. To find out more and to get started, go to That’s

Hello and welcome to the podcast. This week, we are with Dr. Navaz Habib. He has a new book all about the vagus nerve and about the nervous system and how it regulates our healing. I think this is one of the most interesting podcasts I’ve ever put out. I think it’s hyper relevant. It’s relevant to all practitioners, whatever your modalities are, and it really fits this theme of unity for 2024 because the nervous system and the vagus nerve is a unifying concept that we can bring together for really understanding how healing occurs and how multiple chronic conditions can be healed by turning on the parasympathetic system. Really, really powerful half an hour. If you enjoyed it as much as I do, please share.


James Maskell: So, a warm welcome to the podcast, for the first time, Dr. Navaz Habib. Welcome, doc.

Dr. Navaz Habib: Thank you so much for having me. I’m excited to be here.

James Maskell: Yeah. I’m really excited to have this conversation, and this is a topic I think that is going to be mission critical for every practitioner to really understand. I guess the first thing that I want to say is, having seen you and known you for a number of years now, when I saw the Integrated Health Symposium speaker list come out and saw that you are effectively keynote in that conference, talking about this topic, I just wanted to share that I’ve watched and I’ve witnessed your journey, your evolution, and just really excited to see you stepping up into leadership on this topic, so congratulations.

Dr. Navaz Habib: Thank you. I appreciate that.

James Maskell: So, give us a little bit of the backstory before we get into the vagus nerve. We’re going to be talking about all aspects of it and the relevance for all practitioners. Do you want to just give a little update on how we got here? How did you become fascinated about this topic? What led you to focus your time on this, and why you think this is sort of mission critical time for all practitioners to get up to speed on this topic?

Dr. Navaz Habib: Absolutely. I’ve been in the functional field now for getting close to nine or 10 years, and in that time, I’ve had the opportunity to work with many, many wonderful practitioners and thousands of patients and clients. And what I’ve come to realize is that, healing can’t happen when we’re in a sympathetic state. When we’re in a fight or flight state, our bodies are literally driven to attack any threats and really not give us the opportunity to enter that healing state that’s required, and that’s required for every single patient or client that comes in to see any practitioner who’s practicing a functional or even a conventional practice. What we’re seeing more and more is that, patients, when they’re dealing with anxiety, when they’re dealing with major stressors, when there’s sources of stress that they’re fully unaware of, it’s very difficult for them to enter a state where their bodies are truly able to recreate or rebuild the damage that’s been done, or to fix the damage that’s been done by the disease processes. And those disease processes, ultimately, throughout all of them, are linked to uncontrolled inflammation.

And for me, where I’ve come from and what brought me to this point is, I ultimately wanted to figure out, what was the driving force in helping to control that inflammation in the body? And that brought me to the vagus nerve, and I’m more convinced now than I even was when I first started hearing about this topic that the vagus nerve is absolutely critical and creating this state shift from sympathetic fight or flight into that healing state, rest, digest, recover, parasympathetic state is absolutely critical in ensuring that patients can heal.

James Maskell: So, when a new patient comes to you, what are some of the things that you look to understand, does this patient have the ability or is this patient regularly able to get into parasympathetic and to get into a healing space?

Dr. Navaz Habib: We’re in a really wonderful time, I believe, right now. Patients are more empowered, more enabled to be able to take control of their own health, and I believe that it’s our role to help guide that transition to them being empowered to do so. I love Sachin Patel’s line that the doctor of the future is the patient themselves, and for me, that line is absolutely true. And what I see when patients come in, or when I have my initial assessment with them, is I’m looking for the particular markers of a sympathetic state and how difficult or how easy it is for that client to be able to shift to healing.

So, the things that I’m looking for are, how anxious are they, just in their demeanor and their affect and their mood? Do they tend to be kind of high strung? Are they thinking about lots of different challenges? Are they having trouble getting away from kind of a victim mentality and being able to take on the challenge of being those who are capable of healing? And that’s just kind of on the emotional regulation side of things.

Deep into this, if we were to go down that emotional regulation understanding, what we’re looking at is a concept by Stephen Porges, the polyvagal theory, which looks at the idea of safety being the main driver of, are we able to get out of that frightened threat, trying to eliminate that threat or avoid that threat state, and come into a state where we’re able to actually heal? And we can’t heal when we don’t feel safe. So, I’m constantly kind of prompting or checking for that feeling of, where do you feel safe? What are the things that allow you to feel safe? And is your environment allowing you that opportunity or not?

James Maskell: Yeah, I love that. And part of the reason why, when I read that book and when I jumped into that education, that was part of the reason why I thought it was really critical for group medicine to be a part of the standard of care for functional medicine because I saw that, even if you were able to identify that a patient was feeling unsafe in their environment, it wasn’t necessarily something that you could change as a one-on-one practitioner because they have to go back out into their environment and try and find safety. At least in sort of a community structure where you were delivering community-based care, where you were putting patients who were feeling unsafe together and creating, literally creating, a safe space for them to be vulnerable and build trust with other people going through similar conditions, then you had a structure where safety was possible.

And I just think, I still see that today, which is like, you can identify that this person can’t get into parasympathetic space, but what are you going to do about it? And how are they going to actually do it, right? That’s a big thing. I mean, it’s hard enough to ask someone, “Hey, you’ve got to change your diet.” What does it mean to change your diet? “You got to change your shopping habits. You got to learn how to cook new things.” There’s a lot of factors that go into changing your diet. Well, if I tell you, “Hey, you have a fundamentally unsafe environment and that’s causing you not to be able to heal. Go get them, go fix it,” I mean, what does that even look like?

Dr. Navaz Habib: Yeah, and I completely concur on this topic. And the whole concept of the community cure, which you’ve got behind you there, is to bring people together to enable change to occur in these community groups, and for me, that’s so important. As I went through a lot of the research on vagus nerve and HRV findings and how to improve HRV, a huge component of it was social connectedness. A huge component of it was feeling like you’re not the only one who’s struggling with a particular challenge or needing to go through these changes that are required to make your life better. And when we feel like we’re the only ones, we create loneliness. We create a feeling of threat to our ability to enable ourselves to be a part of a functioning society. And that can be so difficult for patients when they’re trying to create positive change in their lives.

And so, a huge component to the care that I provide is creating a safe group space for members to come together and to support one another, because inevitably, when one or two people lift themselves out of that state and are able to truly begin to heal, they empower the others to be able to do so. And something I’ve found over the last few years since implementing this group program, off of your recommendation, was that it’s not always on the practitioner to have to be able to drive that. It allows for community members that have succeeded to help pick up those around them. So, it’s a huge piece, and HRV markers and vagus nerve support markers have shown very clearly that a social secure system of connectedness is absolutely imperative to allow for that healing process to occur.

James Maskell: So, are you doing the HRV with every patient in your model?

Dr. Navaz Habib: As many as I can. I will absolutely look at wearable devices as a part of each person’s very specific protocol. So, I will ask if they already have some sort of device, if they’ve got a Garmin or a Fitbit or an Apple Watch or whatever, or if they’ve already gone out and gotten an Oura Ring or Whoop Band or whatever it is, it doesn’t matter, I’m not particular about the specific device, but rather that they’re looking at HRV on a daily basis to tell them where they’re at, and that is a wonderful feedback mechanisms to say, yes, I’m in a great state today, or, no, I need a day off and I need to give myself an opportunity to heal. So, yes, absolutely, I’m implementing as much as possible, within financial restraints, for each individual.

James Maskell: Awesome. Well, when we first spoke about this last year, I shared with you that the 2024 theme was going to be on unity, and you argued to me, on the phone, very convincingly, that you thought that the vagus nerve was the organ of unity. And maybe you could just share your thoughts on that and why you think that this topic is relevant for this year.

Dr. Navaz Habib: Absolutely. Unity is this concept of everything working in conjunction with one another, that we’re not separated into various organs, that we can’t look at one system and forget about the others, that everything needs to work in unison together. And when we look at the development of a human, when we look back at the particular cell types, the particular processes that are involved in building a liver or building a gut or building a brain, we see that there are very specific commonalities throughout that process. The commonality being that there is a particular cell type that we’ve been overlooking, I believe, for a long time that’s involved in the building of every single organ and the maintaining of that organ throughout the rest of our lives, and these cells are called tissue resident macrophages. They are a major component of the immune system.

And I think what’s happened, especially over the last five years or so, we’ve had this real shift to believe that the immune system’s role is simply to not allow us to get into that threat state or to protect us from some sort of invading threat to our health. When in reality, the role of the immune system is to maintain optimal function. And these particular cells, these tissue resident macrophages are tasked with that particular job. Every day, they are meant to help support the function of the hepatocytes in the liver, of the neurons in the brain, of all of the epithelial cells across the length of the entire intestinal tract. We have these macrophages that are present there that are sending signals of, yes, we are in a good state, or, no, we’re not in a great state, and we’re able to then call in help where needed, but ideally, revert back to a point where healing and health can be maintained.

And it’s not just this cell type that’s required for this, because that cell type requires signals to come in and tell us what state we are in, because an issue can occur in one particular organ, that gets relayed up to the brain, and the brain then has to relay that info to all of the macrophages throughout the rest of the body. The particular connecting pathway of the line of communication for all of that is the vagus nerve. It is the connecting point that, when it is not working, when it is not functional, we have literal disconnection between one organ and another.

When we have an inflammatory state in one organ, we need to relay that information to another. It’s the exact reason why, if there is an issue in our gut, we have some sort of intestinal hyperpermeability, trying to go back and forth here, and when we have that hyperpermeability occur in the gut, it’s exactly why the blood-brain barrier starts to break down in the brain, because we have this signal telling us that there is an issue down here, that’s what’s causing the brain fog up there.

So, what we need to do is send a signal down to try to control the inflammatory process, to limit the amount of chronic inflammation that occurs. And when we don’t have optimal vagus nerve function, we’re not able to relay that signal over to those macrophages, and they then can go into a state where they’re chronically sending out these inflammatory signals in the form of cytokines. So, this is really what’s necessary to understand, in terms of creating that unity between every single organ in our body.

James Maskell: Yeah, that’s very interesting. It’s interesting because I think, over time, at the functional forum over the years and on the podcast, we’ve heard people say that chronic disease are diseases of disconnection, disconnection from self, disconnection from nature, disconnection from each others, but actually internally, this is a disease of disconnection from the central organizing force in the body, which you could see as the vagus nerve.

Dr. Navaz Habib: Yeah. I would argue, and obviously, I’m biased on this, but I do absolutely believe that when we can’t connect one organ to another, when we can’t connect one feeling to create a signal anywhere else within the body, we create disconnection, and that disconnection leads to lack of control, and thus, a lack of control over inflammation. And the inflammatory processes can become chronic and allow for the breakdown of particular organs or particular systems, leading to particular labels and conditions and diseases that are now being diagnosed left, right and center.

James Maskell: Yeah. Absolutely. Is there a particular pattern of diseases that you feel, if a patient comes in and has been diagnosed with this condition, that this needs to be the top of the tree of investigation for a functional medicine practitioner, or someone who is just trying to do good medicine, and get to the root cause of what’s happening with the patient?

Dr. Navaz Habib: I think we can’t state that it’s purely autoimmune or purely gut-based digestive conditions. I don’t love that particular issue. And for me, the reason for that is, when we look at, I don’t know if you remember that image, I believe Sachin had created this image, but he had the tree. At the top of the tree, he had all these labeled conditions, named off autoimmune conditions, metabolic conditions, chronic inflammatory, mood based disorders. And then the tree obviously had a trunk. The trunk goes into the soil. And then within the soil, we look at all of these different root causes, toxic relationships, nutritional deficiencies, toxic burden, emotional stress, all of these challenges.

For me, that image is very clear that there’s so many root causes and so many types of conditions that can occur. But for me, that trunk was that common pathway, and the trunk was that sign or the pathway between the root cause and the disease. And to me, that trunk was uncontrolled inflammation. And we’re seeing this throughout any type of condition. Autoimmune conditions, high IL-1, high IL-6, high inflammatory cytokine activation. Metabolic activity being dysfunctional, high inflammatory cytokine activation, high inflammation, high CRP present in any fibromyalgia or chronic health condition. These all come down to, the inflammatory process is hyperactive and not being controlled, and the pathway to control that inflammation runs through the vagus nerve sending its signals effectively.

James Maskell: Amazing. Well, I think that’s interesting. I know that the analogy of the tree is something that is central to functional medicine folklore and functional medicine education, and I think it’s a very great analogy because it helps people understand that we are moving away from a model where it’s like one symptom comes from one cause, but it’s really understanding the complexity within. And if the unifying organ that’s modifying and organizing that complexity is the nervous system, then that makes a lot of sense.

I guess, I would just say, before we get into some of the things that patients can do, I guess I’d just love to just understand, from your perspective, one of the things that I loved about functional medicine when I first saw it was that, I felt like it could be a sort of a unifying paradigm for health professionals. Because if you were to build a team, a team-based approach, you need a way for practitioners to communicate. As an example, a chiropractor and an acupuncturist are in the same business. They’re rebuilding function by attending to the body energetic, whether that be the nervous system or the Chinese meridian system.

But really, they don’t talk the same language, and so it’s difficult for even maybe a medical director who has those people on his team to identify when they should be used, but the functional medicine operating system would kick out, okay, well, structure and function is a problem with this person because of the way that it’s being in-taken, and therefore, here’s a opportunity to refer to the chiropractor on the team, or here’s an opportunity to refer out to a chiropractor because we recognize that structure is an important person in this case, and we’d like for this person to focus on this initially because we believe that that’s the priority. There’s the prioritization mechanism.

And yeah, I guess I’d just love to get your thoughts on that as now, running your own clinic, but having that skillset, how critical the role of subluxation management, I guess, is on optimizing nervous system function, and how often you have to go into that set of tools, as opposed to maybe some of the other tools that we’ll talk about shortly on how to create vagal nerve tone or how to bring back sympathetic health.

Dr. Navaz Habib: Yeah, certainly. Structure and function are absolutely intertwined, and I don’t think we can ever discount the fact that if there is some sort of physical injury or some sort of physical dysfunction that is occurring, that it’s going to have a role in creating more of a stressed environment in which that body or that person or that cell is living. And when we look at some of the stressors that can drive dysfunction on the vagus nerve side specifically, and I outline a bunch of these in my new book, which is Upgrade Your Vagus Nerve, brand new one.

So, I outline some of those new physical stressors, and that is, we look at the concept of head injury, slip and fall, whiplash, car accidents, major kind of traumas that can occur in day-to-day life for a lot of people. And we often discount those incidents within the realm of our functional patterns and functional kind of assessment. There’s a very clear sign or a very clear path by which any of those physical traumatic incidents, such as a car accident causing whiplash to the neck will have a very particular impact on the vagus nerve, and that is literally the shearing injury that occurs at the level of the brainstem, when our head literally goes forward and backwards, or sideways when we get hit by a car or when there’s an impact, that the weight of our head will cause a shearing force through the neurons that are running through the brainstem.

And within the brainstem, we’ve got the nucleus tractus solitarius, which is the main nucleus that vagus nerve inputs come into. 80% of the signals on the vagus nerve come up into the brain, and they all come up through, majority of them, come up through the nucleus tractus solitarius. And then in that same region of the brainstem, right below it, we’ve got the dorsal motor nucleus of vagus, which is where we send out signals through the vagus nerve. About 20% of signals go out through that particular nucleus.

And when there’s a shearing force, it actually causes trauma, a physical break or a physical injury, leading to inflammation locally in the site of the brainstem there. These physical traumas can then result in a lack of relaying of information up to the brain, and thus, down to the rest of those cells, the rest of those organs. And so we then are not able to send the acetylcholine signals via the vagus nerve to those macrophages to shut down excessive inflammation. So, physical trauma absolutely plays a massive role.

You mentioned subluxation. I want to quickly touch on the fact that, even slight variations on spinal alignment can play a very stressful role. I know every single person that’s listening or watch this, without fail, has, at some point, had a tweaked neck or a tight shoulder. If we’re an online practitioner, we’re often sitting in these horrible positions for a very long time. These things cause stress within the body, stressful motion, stressful motion patterns. And these stressful motion patterns, where they’re not optimized, will then result in this physical stress coming up into the brain and kind of feeling a little off. And so we’re not feeling great enough to be able to work at an optimal productivity level for the day that we’re trying to.

And so these minor adjustments, minor tweaks, physical activity building of good muscle, maintaining optimal flexibility, standing rather than sitting where possible actually are massive in creating physical supports for our bodies to be able to not go into that sympathetic state readily through a physical pathway. So, I would absolutely recommend to any practitioners that are assessing individuals not to discount any potential physical trauma or physical dysfunction that could lead to that sympathetic state, certainly.

James Maskell: Absolutely, yeah. Well, I think that’s really well said, and I still haven’t yet seen a better system or a more likely system to be able to have a prioritization and organization system for all the data that comes in when a patient has a new workup from a practitioner. And I haven’t seen another system that honors the fact that structure equals function, and that structure is important. And I can’t help but think that chiropractic would never have survived if it didn’t actually have delivered the outcomes because it’s been faced with political and all kinds of issues since its inception of being trying to wiped out, being wiped out many times.

And the fact that it stood the test of time and is proliferated tells me that something healthy is going on there, otherwise people wouldn’t keep coming back. And I think, as you mentioned, there’s some obvious ones and there’s some less obvious ones, and I think it’s critical. I think the vagus nerve may be the thing that opens up a lot more practitioners, the fact that this is important for healing chronic inflammation, and therefore, is connected to a group of diseases that you have to think systemically in order to understand. So, I think that’s really critical.

Well, let’s get into some of the strategies that you talk about in your book, because ultimately, if we’re in the business of getting the body into parasympathetic state and retoning the vagus nerve, tell us, first of all, what is the goal? And secondly, what are some of your favorite tools that any practitioner could employ with their patients to aid in this journey?

Dr. Navaz Habib: The goal, without a doubt, is the concept of resilience, that we want to have a body that is capable of handling stressors and bouncing back to optimal function. We want to get to a point where, something small or something minor occurs, our bodies are able to literally bounce back within a couple of days and not allow for that stressor to push us into a chronic inflammatory state, or pull us into a chronic sympathetic state for that matter. Ultimately, we want resilience, and at the top of that line, we want anti-fragility. We want to be a good strong rubber band, for lack of a better metaphor. We want to be able to bounce back nicely.

And the strategies that we have to utilize are quite simple, honestly. The simplicity is often what allows us or causes us to step back and say, there’s no way it’s this easy. And in reality, it truly, truly is. It comes down to your breath. There is no question, the breath is the main driver of what state our body is currently in. If we have a rib out in our back or we have spinal misalignment that’s occurring, our ability to breathe effectively is decreased. So, we stop taking nice deep breaths.

The depth of the breath, the rate of the breath, and the location of the breath are really the main drivers of telling us, are we in more of a sympathetic state or a parasympathetic state? So, an optimal breathing pattern should be slow, nasal, diaphragmatic. Those are the three things we’re looking for. Slow, meaning that we’re not breathing at 20 breaths per minute. We need to have a slow, calm pattern. You can see this when you watch a child who’s stressed out and their sister stole their toy, which is something I deal with on a daily basis, and the fight ensues and she says, oh, my sister took this. And all of a sudden, the pitch of their voice has increased, the tone by which their speaking is increased. They’re breathing more rapidly. They speed up in their breath, and they’re not breathing diaphragmatically or nasally. So, we have these challenges that start to pick up, and that’s a direct push into a sympathetic state.

So, the tool that I start to utilize, especially, this is a great one with kids, but an easy one for anybody to do, is put a hand on the chest, put a hand on the belly, slow down for a moment, ideally close your eyes, take a deep breath in through the nose, and allow for the belly to fill up as much as possible. And what we’re doing is we’re creating a diaphragmatic amplification. So, the diaphragm is the main muscle driving the breath pattern. It’s creating a vacuum into the lungs, causing air to enter. And most of us, most of the time, are breathing with our chest. We’re breathing with muscles that are meant to be accessory breathing muscles.

So, when we do that assessment where we put our hand on our chest, a hand on the belly, something that we can look for is, are we breathing more with our chest? Do we notice that the hand on the chest is moving much more? If that is true, then often, we’re dealing with tight muscles, upper back, upper traps, rhomboids, all of these muscles. The scalenes in the neck can get very tight because they’re doing the job of breathing, when in reality, it should be the diaphragm that’s doing that more readily. So, the breath, by far, is something that we can work to regulate.

So, with my children, I have them visualize that they have a balloon in their belly, and get them to choose, what’s the color of the balloon? Is there a character on the balloon? Usually, it’s a rainbow balloon with some sort of princess on it, and it goes in their belly and they visualize that, and they’re visualizing the expansion of that balloon with every breath in. And we’re breathing through the nose, and I’ve got my hand on their belly so they can feel that the balloon is expanding in their belly. Simple tool for kids to use, simple tool for adults to use. So, when we feel stressed out, when we feel like we’re dysregulated, oftentimes, it is our breath that is the simplest, easiest, cheapest tool to be able to utilize, to make a shift in.

I recommend this for practitioners when they’re working with a client. When the client comes in, they’re a little anxious, they’re a little stressed out, I want to help create that shift to a parasympathetic state, because like I said earlier, we cannot heal in a sympathetic state. We want to allow that body to get into a parasympathetic state because that’s where rest, digest and recovery occur.

And recovery is where we send the signals to the immune cells, those macrophages, in every organ, saying, we are not in a stressed state. Let’s send a signal to shut down inflammatory cytokine activity. Let’s send a rebuild signal to all of these organs, whether it’s muscle, whether it’s liver, whether it’s gut, send that signal and we can calm everything down. In the brain, it’s the microglia. That’s a whole other topic we can get into, but we want to send that signal of calmness. So, I have, at the beginning of our group calls, when I do a Q&A session with all of my group clients, without doubt, we start with five slow, deep breaths.

The thing we want to do with breath as well, one little way to hack it, is to make the exhale longer than the inhale, because there is this concept that we now know in medicine called the respiratory sinus arrhythmia, which means that our heart rate increases and decreases, based on our breath pattern. So, when we’re inhaling, our breath pattern speeds up, it becomes more rapid, and that is a main driver of pushing towards a sympathetic state. When we exhale, we are going into a slower heart rate state, and that is why we have this arrhythmia, and that’s a main driver of the variability in our heart rate, hence HRV. So, respiratory sinus arrhythmia is key.

So, the way to hack this is a concept like 4-7-8, breathing, four seconds inhale, seven-second hold to slow it down, and eight-second exhale. That’s a huge pattern. That 4-7-8 pattern is absolutely wonderful. It’s dead easy. And I have my clients do a five-breath 4-7-8 pattern, right before we start our sessions. And inevitably, it’s a beautiful, calm, wonderful session where everybody is cognitively processing effectively. Everybody’s present. Nobody’s checking texts or on their phone and sitting there in a sympathetic state where all the dings are going off. We tend to have very calm, very wonderful, nice group sessions because we start every session with a moment of pushing ourselves to parasympathetic.

James Maskell: Beautiful. All right. What about some of the other things? I love breathing. Obviously, that’s critical and seeing that, but what about the environment? I want to hear about gargling and humming. What else have we got?

Dr. Navaz Habib: Absolutely. All of these piggyback off of breath, and so we want to create an environment around us that allows us to get into that breath pattern more easily.

A cluttered desk, a cluttered home, a cluttered space for a lot of people can be a major stressor. So, decluttering, I forget, Marie Kondo, the magic of tidying up, I’m paraphrasing the title of this, but the life-changing magic of tidying up, of cleaning your space is huge. So, spending a bit of time, literally getting rid of junk is a way to de-stress the body to some extent.

One of the… You mentioned gargling and humming. I want to talk a little bit about that. We do have vagus nerve signals, specifically the vagus nerve signals to the laryngeal and pharyngeal muscles of the upper airway. And when the signals go there, they’re the only signals that are sending out motor signals via the vagus nerve, those signals are to maintain the patency and the openness of the airway. So, enabling us to breathe effectively is essentially the job of these motor neurons through the vagus nerve. And they signal to the laryngeal and the pharyngeal muscles.

So, the laryngeal muscles actually affect the pitch and tone of our voice. So, the reason that I can go and send my voice really, really low or really, really high is because I have the ability to have tweaked muscle tone, via vagus nerve signaling. So, humming, chanting, gargling, vocalization of any form is actually a really great way to send that motor signal through the vagus nerve, getting vagus nerve activated, getting that parasympathetic signal activated, literally creating an electrical stimulation within the brainstem and the nucleus tractus solitarius to the dorsal motor nucleus of vagus. We want to get that signal elevated.

So, great ways to do this, gargling. I can get my patients, some of them, to keep a cup by their sink. When they finish brushing in the morning, go and do a gargle for 10 to 20 seconds, three times. Gargle as hard as they can. We want to create as much physical signal as possible. Gargling is actually one of the best because it forces us to maintain a good open airway, because we don’t want to aspirate any of that water, and we’re vocalizing at the same time when we’re making these bubbling funny sounds. So, gargling is one of my favorites, no question. Doing that in the morning, the evening, every time they’re brushing their teeth, it just makes it simple and we’re habit stacking something that they’re already doing with something that they should be doing. So, gargling is a really easy one. And it is a great way to get the day started and calm us down as we’re getting to bed.

James Maskell: What about physical things? How do you move your body to improve that?

Dr. Navaz Habib: Yeah, great question. The concepts behind yoga and Pilates are literally built on, can you maintain your breath while in these physical postures or physical positions that are quite challenging? Joseph Pilates famously said that the vast majority of people are breathing absolutely incorrectly, and once we work to improve their physical patterning and improve their breath pattern, then we can get to a state of real true health.

Yoga is built on this. This is thousands and thousands of years old Ayurvedic tradition that has focused on positions, body positions, physical body positions, but the focus is on your breath while you are in any of these positions, and slowing and controlling and maintaining your breath while doing so.

I’m a huge proponent of muscle being the tissue of longevity. I agree with everything that Dr. Gabrielle Lyon kind of states in her book Forever Strong, and I absolutely love the concept of pushing ourselves, with exercise, with muscle building, with strength training, tools like that, and then being able to actively recover following. So, consciously taking the time to get ourselves back into a parasympathetic state, following signals of sympathetic innervation or parasympathetic activity, which, for most people, to work out is a sympathetic kind of time. Where we need to be able to shift is in having this idea of active recovery, actively being able to pull back to the state where our heart rate is lowered. Our HRV is elevated and our bodies are put into a position to be able to recover from the microtraumas that we just did through the exercise. So, I’m a huge proponent of physical training there for sure.

James Maskell: Beautiful. Anything else that you think practitioners need to know on this topic? I mean, I’m excited to say, what’s the name of your book again?

Dr. Navaz Habib: Yeah, it’s Upgrade Your Vagus Nerve.

James Maskell: Great. And that’s out now?

Dr. Navaz Habib: It’s coming out February 6th. So, by the time we’re up, it should be up. Yeah.

James Maskell: Great. Yeah, that’s awesome. Well, look, anything else that you want to share, some wisdom from the book. I highly recommend it. I think this is a really critical topic for practitioners, and I think that really thinking through, how am I going to…

I’m of the opinion that the standard of care of functional medicine is evolving as we speak, and practitioners are realizing that sitting down, doing an intake, and then coming up with tests and then doing supplements is not the most obvious pathway back to full health. There is a more physical structure that is needed and to get people into their physicality, and that’s why things like group visits, things like supportive therapies like chiropractic, recommending having yoga and having movement therapies as part of an overall clinic design is going to be mission critical to the future of healthcare. And so I’m really glad that you are pioneering that and bringing this topic to us. So, yeah, I’m glad that we had this conversation.

Anything else you want to share with the community before we tap out?

Dr. Navaz Habib: Certainly. I think we’re in a really exciting time because people are becoming aware of the importance of the vagus nerve. And there has been a ton of research done over the last couple of decades with regards to how to stimulate the vagus nerve. And we are in a position, as functional practitioners, to provide devices and accelerated healing care for the vagus nerve. There are tools out there, noninvasive vagus nerve stimulators, that electrically stimulate, either on the neck or on the ear, fibers of the vagus nerve to help rebuild the function of it.

A lot of the patients that are coming in to see us, when they have these chronic immune inflammatory hyperactive challenges that they’re dealing with have dysfunctional vagus nerves. And it’s very difficult to just get them to start doing the breathing and the humming and the chanting. These are foundational exercises, but in those circumstances, it can be very difficult for patients to take on these exercises without seeing real results very quickly. And so these devices can be a real accelerator in helping to push us into a state where we’re capable of improving vagus nerve function much more quickly, much more readily.

And the research on it is absolutely phenomenal. I’ve had cases upon cases that have resolved or significantly improved very rapidly because we instituted the use of electrical stimulation of the vagus nerve, in their care, paired with breathing, humming, chanting, gargling, cold shower, exposure, things like that. So, this is a huge… We’re at the forefront of a real revolution in being able to help shift that state, and then all of the nutritional, supplemental, lifestyle-based strategies that we’re already doing are going to be more effective because the patient is able to move into that parasympathetic state more readily, and be able to actually start to implement those changes with the recovery processes occurring in those macrophages and those immune cells. So, that’s what I’m really excited to share with the world.

James Maskell: Well, doc, thanks so much for being part of this and coming to share. Good luck coming up with the Integrated Health Symposium. I look forward to more engagement throughout the rest of the year and really kicking off this topic in a big way to health professionals. I think that it can be a really unifying topic for health professionals because every patient needs it, and every practitioner should learn how to facilitate it in their patients. And I think that it could be fun and engaging and enjoyable. And it’s good for kids, it’s good for parents, it’s good for adults. It’s good preventatively, and it’s good therapeutically. I’m really glad we had this conversation.

If you enjoyed this, make sure to check out Dr. Habib’s book. We’ll have the details in the show notes. And if you’re going to be at some of the conferences later this year, I look forward to more on this topic. Thanks so much for tuning in. Love to hear your feedback. If you enjoyed this episode, please share it far and wide on social media. Thanks so much for tuning in, and we’ll see you next time.

Thanks for listening to the Evolution of Medicine podcast. Please share this with colleagues who need to hear it. Thanks so much to our sponsors, the Lifestyle Matrix Resource Center. This podcast is really possible because of them. Please visit to find out more about their clinical tools, like the Group Visit Toolkit. That’s Thanks so much for listening, and we’ll see you next time.


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