Flares are not only physically tough. They really take a toll on us mentally. The frustration, anger and fear that come with flares do not help them go away any faster. In fact, your thoughts and feelings can directly impact your own inflammatory process. By shifting your mental state and activating your vagal nerve, you actually have some control over your inflammation.
Cholinergic Anti-Inflammatory Pathway
When you are in a flare, pain pushes your body into a sympathetic “fight-or-flight” state. This state triggers the release of pro-inflammatory cytokines, creating a vicious feedback loop. For most people, flares increase feelings of stress and frustration, both of which contribute to sympathetic nervous system activation.
However, the nervous system holds a direct kill-switch for inflammation. It is called the Cholinergic Anti-Inflammatory Pathway and it is mediated by the vagus nerve. This pathway is controlled by the brain and sends signals to the vagus nerve to shut down inflammation. Stimulating the vagus nerve activates the parasympathetic system, which directly signals immune cells to lower their production of inflammatory chemicals.
This pathway is important for two main reasons:
- It helps prevent the immune system from overreacting and helps bring the body back into balance, and
- It has opened up possibilities for alternative therapies to treat chronic inflammatory conditions, including some autoimmune diseases.
Vagus Nerve Stimulation
One of the most interesting tools that has come out of discovery of the Cholinergic Anti-Inflammatory Pathway are vagus nerve stimulation devices. These devices fire electrical pulses down the vagal nerve and block inflammatory proteins like TNF-alpha and IL-1B. There are now two different types of vagal nerve stimulators. Transcutaneous stimulators are available to anyone and can be purchased online. These devices target either the fibers in the ear or neck. Most of these are not used clinically for autoimmune conditions but can be helpful for migraines, depression, anxiety, mood disorders, pain management and chronic stress.
The other type of vagal nerve stimulators are implants. These have recently been approved by the FDA for rheumatoid arthritis (RA) treatment for patients with moderate to severe RA who did not respond to traditional medications. A randomized controlled trial found participants with the implanted device had improvements in swelling and less progression in joint erosions than the control arm. The SetPoint System is slowly becoming available in the U.S. for those who don’t respond to traditional treatments for RA.
Lifestyle Factors to Influence This Pathway
Not all of us can get or want an implantable or transcutaneous device. The good news is, there are several non-invasive practices you can do to stimulate this pathway.
The easiest and most practical option is breathwork. My two favorite breathing techniques are slow, deep breathing and box breathing. Slow, deep breathing is where the exhale is longer than the inhale. Box breathing is equal parts inhaling, holding, exhaling, holding. Both activate the vagus nerve and down-regulate stress.
Another option is vocal vibrations. Chanting, humming and singing loudly actually help stimulate the vagal nerve. So sing in the shower, in the car, or hum along while you do housework or busy work. I also love when yoga instructors incorporate humming, chanting or vocal work into their practices. It’s a great way to hit all of the things: breathing, vocal work and exercise.
Cold exposure, while not fun, can also help activate the vagal nerve. For those of you who don’t love cold showers or cold plunges, you can simply splash cold water on your face to activate the “diving reflex”. This immediately activates your parasympathetic nervous system.
Lastly, meditation and yoga can help bring the cholinergic pathway into action. Both have been clinically shown to lower stress and circulating inflammatory cytokines.
Shifting Your Mental State
It is so easy to feel angry at your body when a flare hits. You might feel betrayed, frustrated, or scared about when it will end. But those anxious thoughts tell your nervous system that you are in danger, which only winds up the pain dial even tighter. Try to change the conversation you’re having with your body when a flare hits. Instead of frustration, offer it reassurance. Lay a hand over your heart and quietly tell yourself: “I am safe. My body is doing the best it can right now. We are working together to get through this.” Shifting away from panic doesn’t mean the pain magically disappears, but it gives your mind a peaceful place to rest while your immune system calms down. Remember, your body is not punishing you, it is trying to survive a storm.
If you need more help with your autoimmune disease and are interested in seeing how nutrition can help, please contact me for more information. Additionally, check out my socials (Instagram, Facebook, YouTube) for more tips on integrating nutrition into your autoimmune journey.
Photo by Ginny Rose Stewart on Unsplash
THE INFORMATION IN THIS POST IS NOT A SUBSTITUTE FOR THE DIAGNOSIS, TREATMENT OR CARE OF DISEASE BY A MEDICAL PROVIDER. THIS IS FOR INFORMATIONAL PURPOSES ONLY. PLEASE CONSULT YOUR QUALIFIED HEALTH PROFESSIONAL FOR ANY CHANGES TO YOUR MEDICAL CARE.
