Your Immune System’s Secret Weapon? It Starts with One Nerve with JP Errico

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About Today’s Show

Hi, JP. Welcome to the show. Thank you so much for being here. 

Thank you for having me. 

Before we begin, maybe you can share one of your favorite childhood memories.

Oh, one of my favorite childhood memories. That’s a long time ago. I’m dating myself. I had a very positive childhood, a lot of positive memories. I remember going to the Grand Canyon with my parents. I remember lots of childhood memories of my grandparents on my mother’s side; we’re very close. My mother was an only child. They were around all the time. I had good friends. It’s really difficult to pull out one memory, but I would say just summers by the pool, enjoying the water. I grew up in New Jersey, which is not exactly a warm climate. Fortunately, I’m now in Florida.

No, it’s really hot.

I migrated. But I like it hot.

I like it hot. But I also like the four seasons. I’ve never been satisfied. Let’s talk about what you do in the world. You’re doing remarkable things. How did you get there? How did you develop a fascination with neuroscience, biohacking, and all that? 

It’s a long and winding road. I was always interested in math and science. As a child, I always gravitated towards those classes in school and topics when the opportunity arose. My father was a physician, and my mother had gone to law school. For me, I was always sort of between those two worlds. I didn’t know where I would end up, and I started thinking about blazing my own path as an engineer. 

I ended up going to engineering school. I went to MIT, and I majored in aeronautical engineering, really not for any specific reason. I didn’t pick that because I was necessarily fascinated with that subject. In fact, to be perfectly honest, I asked people what the most difficult major to major in was, and people mentioned that as one of them, and I said, “Well, then I’ll do it.” It wasn’t really for a love of it, other than just math and science. 

When I reached my junior year, I thought, “What am I going to do once I graduate? What kind of graduate school am I going to go to? Am I going to business school? Am I going to go to something else?” I knew I didn’t want to be a doctor at the time. Maybe that was a mistake, I’m not sure, but I went on and I went to law school, because, as I said, my mother had gone to law school, and she indicated that that was a place that was a good jumping point into anything. 

You didn’t have to practice law in a law firm; you could do other things. She sort of knew that I was never going to do that, but it was a good education. And so I went on, after graduating, to work as a patent attorney for a brief period of time because that was sort of a good blend of law and engineering. 

But I was quickly recruited by my uncle, who’s a world renowned spine surgeon, to work with him to develop some new products in the spine field, which was a marriage of my engineering background, my legal work to help patent things, and sort of a new understanding or a new opportunity to learn about medicine. 

That was over 25 years ago, at this point coming up in 30 years, believe it or not. Over the last 30 years, I’ve done everything from taking graduate-level classes to studying all these books behind me on the subject, to doing research, to starting companies in the fields that were interesting to me. Neuromodulation was the area that sort of captivated me. 

I think if I have one memory that sort of drew me into it, I had the opportunity to observe a deep brain stimulation surgery where they used deep brain stimulation technologies to treat a patient who had essential tremor, which is sort of like a Parkinson, like movement disorder. Just magical. The patient literally had to be restrained with screws into his skull, and he was shaking like he had Parkinson’s disease. 

And when they found the right spot to stimulate while he was awake, when they found the right spot, all of his movements stopped, all those shaking Parkinson-like tremors stopped. He could still talk, he could still do everything he would normally do, and it was just that symptom that was gone. I thought to myself, “That’s magical.” 

No drug can have no side effects and have that profound an effect, but this was doing that, and so I just decided that the next thing I got involved in was going to be in the neuromodulation field. That just opened up everything.

What’s neuromodulation? What does that mean?

Neuromodulation means changing how nerves in your body are firing and how they’re working to affect some other change in the body that you’re looking for.

Neuromodulation means changing how nerves in your body are firing and how they’re working in order to affect some other change in the body that you’re looking for. So in the example that’s really profound that we have spent a lot of time studying in vagus nerve stimulation is the fact that if you stimulate the vagus nerve, you can affect the immune system in a way a lot like what you do with drugs like Humera, Enbrel, and Remicade that suppress the immune inflammatory response when it’s pathological. 

But we can do it in such a refined way, so much better than drugs, because drugs are sort of like a hammer. They hit the system in a way that there’s no real control. That’s why there are all the side effects of you can’t take it if you’ve got tuberculosis, or if you’ve got other problems, and there might be cancers that arise. All of those things arise because the drugs are sort of simple—they’re stupid. 

They just come in and they suppress everything that they’re supposed to suppress, independent of whether or not that could harm you. When you modulate the nervous system, the nervous system sort of can calibrate how much your body needs in order to get back into a stable state. That’s one of the really fascinating things that I’ve observed with using vagus nerve stimulation and other forms of neuromodulation is that it resolves the problem you have without causing more problems, even if the problems that two people have are diametrically opposed. 

I’ll give you an example: high blood pressure and low blood pressure. The vagus nerve has the ability to normalize blood pressure in either direction. So, whether you have low blood pressure or high blood pressure, it can help bring your blood pressure back to normal. That’s modulation. As I said to many people, it’s the closest thing to magic I’ve ever seen. It just does what you need it to do.

You mentioned drugs. Many people just believe all drugs, and they believe everybody with a white coat and what they prescribe to them. What’s your take on conventional medicine and how we need to take control over our own health? 

I’ll come at it from a different perspective. There’s a great book, and it’s called The Last Man Who Knew Everything, and it’s about a physician by the name of Thomas Young. Thomas Young was a polymath. He was brilliant in many, many areas. He contributed to a wide range of fields, including metallurgy, history, medicine, and optics. He contributed to twelve different major fields in science. 

He lived 150 years ago, maybe more. In the last 150 years, there’s so much information that’s come out, and we’re now at the pace of learning and creating new knowledge. We’re doubling it every year, if not even sooner, and possibly even faster than that. It’s impossible for anyone to know everything, even within a narrow field of medicine. I’ve dealt with neurologists who don’t know things that I consider to be really important. 

I’ve dealt with immunology and know things that I consider to be really important. I’m sure there are many, many things that they know that I don’t, but what I think is really important for individuals to take agency or ownership of their own medical care, and you have to be, first and foremost, your own advocate. So, if you have something wrong with you, don’t be satisfied with an answer, whether it comes from a medical professional or a professor in medical school; they don’t know everything. 

They don’t know most things, and as a result, you have to seek out your own knowledge and make certain that what they’re prescribing or suggesting to you is something that’s actually going to work for you, because it may not. Remember that medical studies are done over large populations of people who are not all the same.

And mostly male. They don’t even do their research on females. They give the same medicine to a 200-pound man and a 100-pound woman, and they receive the same treatment regardless of their menstrual cycles or anatomical differences.

Neuromodulation resolves the problem you have without causing more problems.

And we now know that you can go in and have your genetic alleles, or genetic code, tested to see whether certain drugs will be effective for you or not, or whether your metabolism will function slightly differently. There are drugs out there that have side effects, but the side effects, if you really dig into it, are only in a group of people who have one specific genetic profile. If you get a genetic profile test, you could know whether or not you could take that drug safely, or whether or not you’re going to experience some significant side effects.

I actually got my genetic profile. I just don’t know where the airport is. 

I’m sure it’s floating around somewhere in Microsoft. 

Yeah, somewhere in the cloud. Let’s talk about the vagus nerve. What is the vagus nerve? How does it affect your immune system?

Ah, okay, that’s a big question. The vagus nerve is the largest of the cranial nerves. There are, I think, twelve or thirteen different nerves that are labeled cranial nerves. The vagus nerve is the tenth cranial nerve. It descends from the brain stem, comes out through two little holes that sit on either side of the base of your skull, and then runs down your carotid arteries. They literally sit in the same tissue sheath that contains the carotid artery and the jugular vein, along with the vagus nerve. 

It kind of tells you how important it is that it’s in with those two important things. Then, it travels down your neck. Each branch, each side, will innervate all sorts of different organs in your chest and abdomen, your heart, your lungs, your spleen (well, actually, not technically, directly to your spleen, but we’ll talk about that), your liver, your pancreas, your digestive system, for sure. It’s what some people refer to as the brain-gut axis. 

If you have something wrong with you, don’t be satisfied with an answer, whether it comes from a medical professional or a professor in medical school; they don’t know everything.

It’s the way your brain is communicating with your organs to make certain that you’re functioning in a healthy way. When I say make certain, I don’t just mean it’s dictating to your body what to do. About 80% of those nerves are actually bringing information back up into your brain stem so that your brain can surveil your body and know what’s happening. With respect to inflammation, back in 2000, a brilliant physician, a neuroscientist and neurosurgeon by the name of Kevin Tracy, identified something truly fascinating. 

He was working on a small protein peptide molecule called CNI-1493, which was later named semapimod. What he found was that if he injected it into animals, he could prevent them from having septic shock-like responses. He was trying to figure out why it had that effect. And so, for reasons that I don’t know, other than the fact that he was a neuroscientist and neurosurgeon and interested, he injected tiny, tiny quantities of this material into the brain, and found that even at those minute levels, he could still have the same effect. 

So that suggested to him that, in fact, what the drug was doing was affecting the nervous system. This led to a long line of research, and literally billions of dollars have been spent studying this, showing that the autonomic nervous system, through the vagus nerve, controls your inflammation state. It controls nerves. It controls cells in your immune system called macrophages. 

It also controls things like platelets, and that control tends to push you back into a state of low inflammation, of health, of homeostasis. It really is incredible. It’s a biohack. I mean, honestly, I call it the greatest biohack of all time, because it not only affects your immune system, but your immune system has such profound effects on everything else that happens in your body, but even beyond that, they have subsequently found that the same pathways that the vagus nerve and vagus nerve stimulation used to control the immune system also has profound effects on mitochondria. 

If you get a genetic profile test, you could know whether or not you could take a drug safely, or whether or not you’re going to experience some significant side effects.

Mitochondria are the power plants, the energy source for every cell in your body. They’re providing the ATP that’s used in all the biochemical reactions in your body. ATPs are sort of like the battery packs that proteins use. Proteins are like the little electronic tools, and ATP is the battery pack that allows those proteins to work.

So, it sounds like you found the fountain of youth.

It’s funny because it’s certainly a very, very, very important part of how life works. 

Yeah, inflammation brings us down, and having our mitochondria work really well, and producing all the ATP, that’s really important.

No question about it. In fact, I think the four most important systems in the body—I’m not going to include the microbiome, because that’s really, really important too—are your immune system, your cellular energy level, your ability to sense nutrients at the cellular level (we call it nutrient sensing), and your autonomic nervous system. All of those systems can be affected if you have some control over what’s happening in your vagus nerve. 

If you control how your nerve is functioning, you control your immune system, you can control your metabolism, and you can control, even at the cellular level, how you are sensing nutrients, whether or not you’re in catabolism or anabolism, whether you’re growing or you’re sort of preserving things. It’s a pretty amazing system that we have. We’ve been gifted this body and brain, which are the most complicated systems in the universe that we are aware of, and no instruction manual.

Nobody gave us an instruction manual; it would be a million pages long. We have to figure it out for ourselves. But the good news is we’re growing in our knowledge of how it works, and with every step we take, it shows itself to be so incredibly beautiful. It’s really interesting, fascinating and beautiful. 

You’re so passionate about it because you can help the world. There is a gap between the story you told about that doctor injecting that substance in the brain of animals, and what you have now come up with as far as non-invasive stimulation.

We have to step back in history. It’s amazing how brilliant people were back in the 1800s and 1700s, and there was a brilliant doctor by the name of John Leonard Corning, and he was based in upstate New York. He’s written multiple seminal works, but one of the things that he thought of was that stimulating the vagus nerve might be the reason why, or an alternative way to treat epilepsy and something called supraventricular tachycardia, which is a rapid heartbeat that actually hurts. 

What he knew was that for hundreds of years, medical practitioners had known that if you take your thumb and you dig the thumb into the neck of a patient who’s having an epileptic seizure that won’t break or is experiencing severe SVTs (supraventricular tachycardia), that if you rub the carotid artery vigorously, you could stop a seizure, or you could stop these SVTs. He knew that. 

The prevailing thought was that the reason it was effective was that it somehow affected the blood flow to the brain. But he was aware of the work by people like Volta and others who had been looking at the effects of electricity on nerves. He was aware of the anatomy. He said, “You know, I think what’s really happening is that when you dig your thumb in and you’re rubbing that area, you’re actually affecting the vagus nerve.” 

And so he devised an instrument that sat outside the body, providing electrical stimulation, with the intention of shocking the nerves. Now, fortunately for me, unfortunately for us today, he didn’t have a very good understanding of electrical engineering, and, frankly, nobody did. He couldn’t make it work. What he did was he started a line of research which extended into the 1920s, 1950s, 1970s, and 80s, where people look to see, “Hey, what is the vagus nerve doing? How is this structure important?” 

About 80% of the nerves bring information back up into your brain stem so that your brain can surveil your body and know what’s happening.

Now, unfortunately, a lot of that work was really theoretical. It was really high-level neuroscience. It never made it into standard medical training. And even to this day, if you go to medical school. In four years of medical school, you’re going to spend about half an hour talking about the vagus nerve, which is, to me, phenomenal, and how terrible that is. 

I think they’re talking about nutrition, or something like that. 

They talk about nutrition. They don’t prescribe exercise. They don’t prescribe dietary things that are needed. What happened was that in the 1980s, a company based in Texas, in the United States, called Cyberonics existed. They decided to make an implanted device, much like a pacemaker, that would stimulate the vagus nerve, because they believed that stimulating the vagus nerve really had been a good idea, a hundred years earlier, from John Leonard Corning and that they were going to develop a vagus nerve stimulator implant for epilepsy. 

It took them several years to get it approved by the FDA, but it works. It works very well. It’s expensive and you have to undergo surgery, but it can prevent you from having to have parts of your brain removed, which is one of the most invasive things that they do to treat epilepsy. So certainly, you would think that before you get a chunk of your brain removed, you’d have an implant put in your neck. 

What happened was that the implant was approved by the FDA and had been in use for about 15 or 20 years. Two people came along, Kevin Tracy, whom we talked about before. He began his work in 2000. I had no idea of the work that he had done. I knew just a little bit about what had been done with Cyberonics, and I was looking for something to do. I had just sold a company, and I wanted to start something new.

Which company did you sell to at that time? 

It was a spine company that we had developed an artificial disk for. We sold it to a large competitor, a large company in the orthopedic space. 

The four most important systems in the body are your immune system, cellular energy levels, nutrient sensing, and autonomic nervous system.

Wow. Later, I want to ask you about your creativity. But, yeah, continue, please.

So, what happened was that I was reading this article. It was a translation of something from the old Soviet Union. It was like from 1968; it’s amazing. There are a lot of really interesting things that people back in history did that we’ve not followed up on. Frankly, the entire field of immuno-oncology really started back in the 1880s with a great work by Dr. Coley, who was the godfather of immuno-oncology. But that’s beside the point. 

What happened was that around 2004-2005, I read an article from the old Soviet Union, from 1968, where they had taken dogs and sensitized them so that they would have an allergic reaction when exposed to egg white. And so they took a group of these dogs that they had sensitized, and they divided them into two groups. One group just got the egg white challenge, had an anaphylactic reaction, and then they all died. 

I love dogs. I hate when they research dogs. But the other group that they did, before they gave them that what would be otherwise lethal challenge, they cut the vagus nerve, and when they did that, all the animals survived. Unfortunately, I couldn’t find any record of them following up on that research. Parallel research was conducted in the United States and England in the early 1970s. But again, Nobody followed up on it. 

It was just sort of there, as, yes, the autonomic nervous system has some influence over the immune system. Well, I had been working with this neuroscientist and neurologist who was doing the deep brain stimulation, and he said something to me. His name is Ali Rezai, and he said something very interesting. He said, “Anytime anybody’s ever cut a nerve, and as a result of cutting the nerve, gained some clinical benefit from it, you may be able to stimulate that nerve and get the same benefit.” 

As I’ve told the story before. I really just stuck that piece of information in the back of my head and didn’t do anything with it until I read this article. When I read the article, I said, “Aha, maybe instead of cutting the vagus nerve, we can stimulate the vagus nerve and we can stop an anaphylactic reaction.” It was early 2006 when we went to Columbia University, and we worked with some research anesthesiologists who had sensitized animals this way, and we duplicated the work. 

We were able to give what would be a lethal anaphylactic reaction to the animal, but save its life by stimulating the vagus nerve. It was really remarkable. It was great, it was sort of one of those moments in science where you just want to be there. You just want to watch and say, “Oh my god, it’s actually worked.” We had a couple of others that were like that, that were really cool. The very first time we ever used vagus nerve stimulation to treat an asthma attack was in our offices. 

We had a guy who worked for us who had asthma, and he was wheezing. I said, “Why don’t you use your inhaler?” He says, “I hate the way it makes me feel.” I said, “Well, we actually have a doctor here, we actually have a physician. Would you like to try it?” He said, “Sure, let’s do it.” We non-invasively stimulated his vagus nerve, and his asthma attack stopped instantly. That was just sort of cool to see. That’s an idea that I remember having, and now I’m watching a person actually recover from an asthma attack because of that. It was fun.

So now you have a device that you’re selling, right? 

We have a company that has developed a non-invasive vagus nerve stimulator. It’s handheld. In fact, I think I have one of the older versions right here. You put a little bit of gel on the electrodes, you place it over your vagus nerve, and you turn it on, and you hold it there, and you turn the amplitude up. There are directions on how to use it. It’s pretty easy. It will deliver a dose of vagus nerve stimulation to you within two minutes. It’s pretty remarkable. 

What it can do is stop an asthma attack. We went through the FDA, a very long and arduous process, but we’ve been through it multiple times now for various different headache conditions, things like cluster headache, migraine and some other very severe but thankfully rare headache conditions. We’ve also done work on PTSD. We’ve done work on stroke. We’ve done work on Parkinson’s disease. We’ve done work on some autoimmune diseases. 

I’m personally doing work right now in animal models to try to prevent autism and schizophrenia. We’ve been invited to submit a proposal to enhance the benefits of sleep when sleep is restricted. So when people can’t get the full seven and a half to nine hours that you need, you start to have cognitive problems over time that can get really bad, especially if the amount of restriction is extreme. 

What we’re trying to show is that with interventions, neuromodulation, interventions that include vagus nerve stimulation, we can enhance the efficiency of sleep so that you don’t have the same level of cognitive problems just because you’ve lost sleep, and emotional problems and and other things, and even metabolic problems. We’re hoping to resolve quite a bit. 

So this device is not only for doctors. Everybody can get it, correct? 

Yeah. There is a prescription version, which is called gammaCore. Then, there is a what we call a wellness version, which is called Truvaga. The United States military is now deploying a version that the company makes for them. I’m actually not part of the company anymore. 

I was on the board of directors for twenty years, but the last two years, I’ve sort of moved into just a consulting role. The company now also sells a product to the military called TAC-STIM. The TAC-STIM device is made to be able to be run over by a car and things like that. It’s used because of the performance and cognitive enhancement that it offers, which is a whole other area to discuss, and it’s fascinating, because I think that what they’re doing is just the tip of the iceberg as to what vagus nerve stimulation can do for children and enhance their cognitive development. 

Is there another way to stimulate the vagus nerve without the device?

We’ve known about stimulating the vagus nerve for thousands of years, through practices such as yoga, deep breathing techniques, stretching, chanting, gargling, and—

Acupuncture. 

Yeah, acupuncture. I’m not an expert in acupuncture, but I suspect that there probably are ways to activate the vagus nerve that way. There’s some interesting research that suggests that if you alter the pH of the stomach, because, remember, the vagus nerve is the brain-gut axis, you can alter the firing rate of the vagus nerve and effectively stimulate it. Here’s the reason why. When you are on an empty stomach, it has a pH of somewhere between 1.5 and 2. It’s very acidic. 

The opposite of the rest-and-digest-and-restore state is stress, the fight-or-flight mode.

In fact, it’s one of the arguments that’s been made why human beings are basically carnivores, and the reason for that is to show that you have to have a very, very low pH in order to be able to digest animal meat. Human beings have an extraordinarily low pH. In fact, I think the only animal out there that has a lower pH than human beings is a vulture. Dogs are at like 3 or 4. But once you eat food, by definition, that food is going to dilute the acid; it’s going to raise the pH in your stomach. 

Now, one of the things that the vagus nerve is doing is sending signals back up to the brain that aren’t reinforcing the rest-and-digest-and-restore mode. So think about it, if you eat, what signals should your stomach be sending to the brain? Rest and digest. So, if you raise the pH of the stomach, the message that comes back up into the brain, because you’ve chemically altered the pH, sends a message back to the brain that it needs to be in the rest-and-digest-and-restore state. 

The opposite of the rest-and-digest-and-restore state is stress, the fight-or-flight mode. What do we experience when we have that anxiety, that stress? The acid in our stomach becomes strong. Our stomach hurts because the acid is so strong; we get reflux and all those things. You can see how the pH of the stomach is tied to that autonomic state. 

So lots of celery juice. 

You know, sodium bicarb, sodium bicarbonate, which is interesting. Tying this back together with the work we did, the approvals for the gammaCore product in the United States are for migraine headaches and other types of headaches. Well, I’ve had conversations with neurologists who say, “You know, the really interesting thing, I’ve prescribed for migraine patients drugs like triptans. I’ve even prescribed them drugs like the CGRP antibodies. 

I’ve prescribed them all sorts of medication. And I found that for some patients, the only thing that will work for them is Alka-Seltzer. I said, “Well, okay, that’s interesting. What’s in Alka-Seltzer?” “Well, Alka-Seltzer is a combination of aspirin and sodium bicarbonate.” So what that’s telling me is that those patients who have Alka-Seltzer helping them, they’re going to benefit really well from vagus nerve stimulation. So, there are other ways to stimulate the vagus nerve. 

Yeah, but it seems like yours is very straight to the point and quicker results, right? Like that guy with the asthma attack, he immediately gets over his asthma attack. It sounds amazing. What type of results did you get in stroke patients, for example, with the home device?

Okay, so off camera, we were talking about stroke. This is an area of considerable research being done right now. This started for us probably eight or ten years ago. A group at Harvard Mass General was interested in studying our device in stroke, and they had an animal model. They take an animal, it’s usually a mouse or a rat, and they expand a balloon, almost like a balloon catheter, inside one of the major blood vessels in the brain, so it’s like a stroke. 

You’re clotting off an area of the brain and making it not get any blood supply. Now, the area of the brain that is basically starved of oxygen is going to die very rapidly within four minutes. What they do is deflate the balloon and remove the catheter, and now blood is flowing again. Now, around that tissue that’s now already dead, is a much larger area of tissue that is very stressed. It’s been damaged. It’s not dead, but it’s under what we refer to as oxidative stress. 

It sends out signals that draw in into that brain tissue, literally out from the blood vessels, through the blood-brain barrier. It is pulling in immune cells. It’s basically sending a signal saying, “I’m hurt. I’m hurt. There must be a problem here.” Those immune cells infiltrate the brain, and the brain’s own immune cells, called microglial cells, become inflamed. In almost a paradoxical response, they actually end up doing far more damage to the brain than the original insult. 

The brain is incredibly flexible; it’s capable of relearning how to do things through a process called neuroplasticity.

In fact, the actual area of the brain that if you look a week later, the area of the brain that’s now dead as a result of that, the combination of the initial, what we call anoxic or basically reduction in oxygen flow from the original stroke-like balloon, and the subsequent damage is it’s two and a half times larger than if there wasn’t that immune response. It’s a significant problem. 

So what the people at Harvard MGH did was they said, “Listen, we think that the effect that you’re going to have with vagus nerve stimulation, or that we’re going to induce, is going to reduce that collateral damage that happens after the initial insult, by a lot.” When they did the studies, they found that that’s, in fact, exactly what happened. We were able to reduce that collateral damage by 60 to 70%. 

That’s amazing. But what happens after that? Let’s say the stroke has been there for two or three weeks, and the damage has been done, and maybe we’ll expand. Does that still have a good effect on it? Is it possible to reverse it?

There’s no way to reverse dead tissue. Tissue that’s actually dead is lost. But the brain is incredibly flexible. The human brain is capable of relearning how to do things through a process called neuroplasticity. 

Yeah, creating new neural pathways to do the same action, right? 

Exactly. When I first learned about this study conducted at MIT, it was years ago, and it drove home the point about how incredibly flexible the brain is. So, what they did was take animals. In this case, they were using ferrets while it was still in development inside the mother. They did intro womb surgery, and they rewired the brain so that the optic nerve of these ferrets was going to connect to the auditory centers, not the visual centers. 

They connected the auditory nerves to the visual centers. I mean, really, truly rewiring the brain. And then these animals were born, and you would think that having all of the optics, all the visual cues, all the visual signals going to the area of your brain that is in charge of hearing, and then reconnecting the hearing nerves into the visual cortex that these animals would be severely damaged, they would be severely handicapped, and what they found was that the animals were entirely normal. 

The brain is fundamentally an immune organ, more than what we think of as all its neurons.

They functioned absolutely fine. They could see exactly the same way other ferrets could see, and they could hear exactly the way other ferrets could hear. It’s just that other areas of the brain were doing the jobs that had been rewired to. That level of neuroplasticity that exists in the brain, that’s the potential. What we need to do is do everything we can to enhance the ability of the brain to be plastic, vagus nerve stimuli does that. 

You can’t do that level of plasticity training if your autonomic nervous system is inflamed or in a fight-or-flight, sympathetically dominated state. You need to be in a rest-and-digest-and-restore state, that is the parasympathetic state, so that the microglial cells—remember those microglial cells, which are the immune cells in the brain, they actually build the brain in utero. They are responsible for all the activity that goes on in the brain to keep it functioning properly, including learning and memory; all of these processes are deeply tied to what the immune cells are doing. 

The brain is really, fundamentally an immune organ, more than what we think of as all its neurons. The nervous system as a whole and the immune system are really two sides of exactly the same coin, because there are neurotransmitter receptors on immune cells, and there are cytokine receptors—cytokines are the chemicals that are released by immune cells that are on neurons. They’re communicating with each other all the time. 

Can vagus nerve stimulation insist in the recovery after a stroke? The answer is yes, there’s work being done on that as well. The reasons are twofold: one, due to neuroplasticity enhancement, and the second is that you want to have those microglial cells perform all the homeostatic tasks they need to do in order to help the brain recover and relearn how to function. Every time you learn, those microglial cells are doing things to help the brain sort of rewire itself and reorganize the network so it can do new things.

Yeah, it makes sense, because after a stroke, the stress doesn’t stop a week or two later, it just continues—rehabilitation, learning how to live again, and family dynamics. It’s a lot. I think everybody in the world can benefit from this. So, if somebody gets the device, how many times a day should they do it? What’s a good daily nervous system stimulation?

For a variety of different reasons, I think that two to three times a day is all you need. It takes two minutes. I tend to tell people to do it twice a day. Keep one by your sink, where you brush your teeth, or by your bedside. Do it before you go to bed. Do it after you wake up in the morning, it’s when you brush your teeth, so you might as well do it. Do it during those two times. Leave it there; it takes two minutes. 

I always say to people, “You know, the dentist will tell you that you’re supposed to brush your teeth for two minutes. Most people don’t do it for two minutes. So, since you’re not going to be doing that, you might as well take the rest of those two minutes and stimulate your vagus nerve.” That’s for most things. Now there are some conditions like asthma or migraine headaches or panic attacks or things like that that occur almost randomly, seizures, for example. 

While those twice a day on a regular schedule, stimulations should reduce the risks of having seizures, reduce the risks of having migraines, reduce the risks of having asthma attacks, and reduce the risks of having panic attacks. When those things do occur, or when you feel one coming on, that’s a good time to use the device. It’s very portable. It fits in your chest pocket. 

It’s very easy to take with you and simple to use. We don’t suggest that people are driving down the road while doing it, but there’s no reason why you couldn’t do that. We want to keep your hands on the wheel.

I think some drivers need to do it while driving. What is one fact, some wisdom that I didn’t ask you about, that has to do with what you share in your book, The Vagus-Immune Connection, that everybody should know?

I’m going to say two things. One is what we touched on before, which is that most of the work that’s been done in vagus nerve stimulation has been done in adults, especially the work that’s been done on the cognitive enhancement side of things, which is the stuff that the military has been doing through the Defense Advanced Research Projects Agency, etc. 

But in my own experience, children who are in a constant neurodevelopmental state from gestation through into their early 20s, there’s a tremendous amount of neurodevelopment that’s happening. What I have seen, observed, and read is that if children between the ages of five to ten or even older, are using this device twice a day, even if they don’t have any medical problems or medical reasons for using it, they’re using it as a wellness product, I believe it optimizes neurodevelopment. 

I’m going to explain why I say that. As I said before, your brain is literally grown, developed, and built by immune cells. When those immune cells get distracted by inflammation, they don’t do their job ideally well. Unfortunately for us, there is no level of inflammation. As you stay below this level of inflammation, everything’s fine. Any amount of inflammation will have some detrimental effect on neurodevelopment. 

It’s probably a very big reason why people who are in stressed environments, who are undernourished, or children who grow up in less than sanitary situations, end up not performing as well in life because their cognitive development was impaired, maybe not to the point of being neurologically measurably impaired in terms of being diagnosed as handicapped. 

But they’ve been handicapped. They’ve been injured. What you want to do is minimize the level to which that inflammation is preventing ideal neurodevelopment.

Is it safe to use the same device on kids? Is the stimulation too much for kids to use less of it?

Unlike drugs, it doesn’t need to be dosed that way. You can use it twice a day. My daughter started using it when she was seven years old. It has had a profound effect on her.

That is so exciting. I really want that device now. Give it to me now.

The hallmarks of aging are the phenomena that accompany aging in all circumstances, including telomere attrition, genomic drift, malfunctioning, autophagy, nutrient sensing, deregulation, dysbiosis, and other related processes.

Who doesn’t want to be smarter? Let’s face it, being smart is helpful. So the other thing I was going to say is, you mentioned also about aging and, you know, sort of finding the fountain of youth. Now, it’s not going to make you live forever.

I know, but as long as you balance it, if your mitochondria perform and your ATP production is amazing, and you have less inflammation in your body, you’re gonna look and feel younger or longer. 

You’ve just touched on two of the twelve hallmarks of aging. The hallmarks of aging are the phenomena that accompany aging in all circumstances, including telomere attrition, drift, malfunctioning, autophagy, nutrient sensing, deregulation, dysbiosis, and all of those things. I have a paper, which I hope will be coming out soon, in which we talk about the fact that every single one of the hallmarks of aging gets worse. They accelerate. They get worse. The damage is more severe if you are in a chronically, sympathetically active state, so if you’re always in a fight-or-flight state. 

Goodness, I’m fighting for flags since I arrived in Israel.

You’re absolutely right. I’m sure that living in Israel is a constant fight-or-flight situation. But if you can get yourself back into that rest-and-digest-and-restore state— 

Yeah, I work on myself all day. I do a lot of meditations and calming my nervous system in different ways, but it sounds amazing just to have that device for two minutes and be like, “Ah, I’m good again. I can tackle today. Woo-hoo.”

Every single one of the hallmarks of aging gets worse when you’re in chronic sympathetic or fight-or-flight mode, and if you can get yourself back into that rest-and-digest-and-restore mode, you actually see all of the hallmarks either reverse, slow down or get better So it is a remarkable tool for at least living as long as possible and living in a healthy health span, as opposed to just lifespan.

JP, you are incredible, a brilliant mind, and it just seems like you’re doing a lot for humanity. So, thank you so much for being here and sharing your wisdom. If people want to reach out, get your book, and get the device, where should they go? 

The book, as you said, is The Vagus-Immune Connection. It’s available on Amazon. It’s now available in paperback, so it’s not too expensive, and it includes many of the topics we discussed, providing a deeper understanding and giving people a solid scientific foundation for these concepts. If you want to reach out to me on Instagram, I’m on @theVNSguy. Everywhere else, it’s JP Errico. It’s jperrico.com if you’d like to visit. I have some interesting content that people can explore. If people want to direct message me, I’m available. I would love to answer questions about this or anything else that people have. I try to be as responsive as I can be.

Amazing. 

The last thing is, I host a podcast, as you do. It’s called The Health Upgrade Podcast. I have a co-host, Dr. Navaz Habib, who’s a great guy. The two of us tackle all sorts of topics, from atherosclerosis to human reproduction to headaches and mental health conditions. So it would be wonderful if people want to tune in to listen to it.

JP, thank you so much, and thank you, listeners. Take care of yourself. Take care of your brain, relax, stimulate your vagus nerve and have a stellar life. This is Orion till next time.