A Little-Known Secret To Fix Your Vagus Nerve, Banish Constipation, Use Nicotine As A Biohack & Much More!

On this episode of the Ben Greenfield.

Fitness Podcast, as sick as I was, I would not wish that on anybody. But it opened the door to get some answers that have been missing. I had to figure out what other reasons could some people need that kind of support. And that was also part of the journey. But I know what it takes to maintain it and stay on top of that. That propensity for some of this abnormal inflammation, the damage it can do, health.

Performance, nutrition, longevity, ancestral living, biohacking, and much more. My name is Ben Greenfield. Welcome to the show. Hey, Today's a pretty interesting podcast all about the vagus nerve constipation, something called orthostatic postural hypertension, something or other. Anyways, my guest on today's show, Dr. Diana Driscoll, gets into it. Hey, so a few months ago I mentioned on a podcast that I had discovered that there was this specific blend of nutrients, couple compounds specifically that I discover could really help to support my vagus nerve function. Because I'm always looking at ways to support that incredibly important nerve that snakes for the body and innervates so many organs. And as a side effect it gave me, I think the way I described it on that podcast was a glorious morning dump that filled the entire toilet bowl on a repeated and predictable basis. Which was of course quite nice because it's a good thing to just get it all done with in the morning and walk away. Maybe double flush in the process. Sorry if that's a TMI for, for everybody but my podcast guest on today's show whose name is Dr. Diana Driscoll. That's D R I S C O L L Driscoll. She is the individual who actually designed that blend and who knows a heck of a lot about the vagus nerve and, and its interplay with our bodies and how to support the vagus nerve and autonomic nervous system function in general. Now, she's an optometrist who went through a pretty interesting health scenario that I'm going to let her fill you in on and share with you. But it did involve something that you may or may not be familiar with called Postural Orthostatic Tachycardia syndrome. Now, it's a mouthful, but it stands for pots P O T S or POTS stands for that Postural Orthostatic Tachycardia syndrome. So it's a disorder of the autonomic nervous system. And Diana's going to fill you in on that too because it's kind of this little known cause of a lot of issues like chronic fatigue and dizziness and poor vagal function and constipation and a lot of issues. So Diana has been digging into this for. For years and using her medical certifications and degree and knowledge to help now literally thousands and thousands and thousands of people, not only with pots, but with a lot of other issues related to the fatigue and the underlying vagal nerve dysfunction that underlies it. She's written multiple books, all of which I will link to in the show notes, but most notably one called the Driscoll Theory. And she also has a very helpful website@potscare.com, p o t s care.com, wonderful blog@prettyill.com like pretty I l l.com and also a range of different vagal nerve compounds that she's developed, which I will also link to in the show notes. So everything that we discussed today, and there's gonna be a lot of notes you're going to be able to find@BenGreenfieldFitness.com pots that's BenGreenfieldFitness.com pots Diana, welcome to the show.

Thank you, Ben. It's so great to be here. What an honor. Appreciate that.

Yeah, I noticed that you're. You're sounding a little hoarse today, and I believe it's due to the recent cigarette smoking habit that you just took up, if I'm not mistaken.

Yeah, no, we'll talk about that. Nicotine, right? No, I. Yeah, you caught me. I did go out last night and we danced and listened to a great band and I swore I wouldn't sing along and so I'd have my voice this morning, but, oh, it was really hard not to. So please bear with me. It doesn't quite sound like it usually does, but we'll. We'll squeak it out.

It is kind of funny that you say that about smoking cigarettes and nicotine, because I know that's kind of part of your story, particularly the nicotine piece. And I have talked on this show before about how I'll occasionally chew nicotine gum because of some of the benefits it can have on nerve function and mitochondria. And so perhaps we can dive into that a little bit, too. But I might be getting ahead of myself. I want to hear a little bit more about your story and how you got into studying all this in the first place.

Yeah. And it was a long, horrible struggle, honestly. But do know what I learned in my struggle ends up helping so many other people because although my situation was so dramatic, it exacerbated exaggerated some symptoms and signs that when you take it down a notch, affect so many people in the general population. And. And that's where I think I can really help. But I went to Costa Rica for a mission trip and got a virus, but all of us got the same virus. It wasn't like, you know, the virus was the cause of an illness, but I couldn't pull out of it. And I ended up with so many weird symptoms. Like, I started out, I just had trouble breathing. It felt like I was breathing through a straw. And even in. I was struggling with that. My heart rate was out of control. If I was vertical, it would just race. My digestion was affected. Sometimes food would just sit in my stomach for hours. And then ultimately I started to develop a tremor. I couldn't handle changes in temperature. As time went on, it morphed and continued to change. I started to lose my memory. I couldn't organize my thoughts. I couldn't even stay awake. And at my worst, I. I was struggling to stay awake even three hours a day. But sometimes I had horrible insomnia and I was awake for days at a time. And as I got sicker, eventually I couldn't handle any sort of stress. And stress at that time was even like answering the phone or making a doctor's appointment. I couldn't order a pizza or something. I was light sensitive, sound sensitive. I stayed in a bedroom with four walls and the shades were drawn and eye covers and earplugs because everything was just too loud, too bright, just too much. And no one could help me. It was horrible. But probably the worst part, Ben, was my kids got sick and they started to develop some similar symptoms. And my son was completely disabled for three years. But no one had any answers, so. So it was not a position I wanted to be in, But I was forced into trying to figure out some of this.

Hmm, interesting. So at that point, you've got all these fatigue issues going on. And I would imagine that most people would begin to look into. I mean, honestly, anybody Google symptoms like that, they come up with chronic fatigue. They come up with, you know, perhaps something that I interviewed, Dr. Sarah Myhill, who you might know about a condition that, off the top of my head, I gotta remember what it's called. It's a different name she gives to chronic fatigue. I believe it's me. Myalgic encephalitis, I think, is the way that she describes it. And I had a whole podcast with her about this. And that's what most people will come up with if they experience the issues like you've had is some form of chronic fatigue, which I think is a catch all term. That's usually when you dig in instead something like mitochondrial dysfunction or Lyme infection or mold or some other type of chronic issue. But I'm curious what, what you found when you started looking into this.

Yes, because my condition didn't begin with fatigue, which was really, really odd. I thought it evolved over time into fatigue. In fact, initially the thoughts by the researchers, and I was in Mayo's even clinical trials for three years, their thoughts were that we needed more exercise and we had to watch our diet. We tended to be deconditioned, but I was very, well, barely athletic at the time and I certainly wasn't deconditioned.

And I told you to get on.

The treadmill, basically, which I did because I love to exercise. I thought, well, that'll be, you know, that'll be great. But it didn't do anything. But it was, it took about two or three years into the condition before the fatigue became so disabling. But it didn't start out that way. Yes, I was disabled by this for a decade. Yeah, it was tough. It was tough.

Okay, so. And this was how long ago?

14 years.

14 years. So that would mean that some, somewhere like three or four years ago, something happened.

Yes. It actually took layers of answers to put all together. And as I started to get answers, I started to release them through, through the blog. As a patient, I put out prettyill.com and then finally came out with the Driscoll theory where I revealed some of the underlying things that we were figuring out. And then it continued. The research continued to move forward. I created genetic disease investigators and we formally started studies to get some answers.

So what exactly did you find? I realize we might be going down some rabbit holes here, but I'm going to keep leading you along because this is something I think is going to be really helpful for our listeners. Matter of fact, I was telling my wife I was just out in the yard planting huckleberries with my boys because I want to see if I can get wild huckleberries to grow on our land. And I came in and I'm dusting my hands and getting my computer ready and I'm like, I might have over scheduled myself today. I've got a lot going on. I got this podcast I need to go record. And she's like, well, you know, why'd you decide to record this podcast on a weekend? I told her, because this is something that I actually think is going to help a lot of people. I Like, I'm going out of my way to do this because when I discovered your work, I realized how helpful this could be to folks. So feel free to digress as deeply as you'd like. But what exactly did you find?

Yeah, well, we found a lot. Everything I found out, I found one layer and I thought, oh, I'm done. This is it. And now the condition tended to continue and evolve. There was another layer. Figured that out. Okay, we're done. Yay. No, no, there was more to it. So it was years and years and years. But the first thing I figured out, and it's in the book, is there is a propensity for abnormal intracranial pressure in this population and it went worldwide and it was really great to see the response from patients and, and then ultimately from doctors. And again, that was great to figure out, but it wasn't the end. We still had to get to bedrock, which for me was the genes, which is a whole nother podcast. But inflammation was playing into a lot of the condition and I think that overlaps greatly with some of your audience because a lot of people are prone to a lot of inflammation. For me it was genetic. But athletes, or certainly masochistic athletes, as you would say, deal with a fair amount of inflammation. People who age and aging is normally inflammatory. Autoimmune conditions are inflammatory. Obesity and high levels of stress are very inflammatory. So those folks also can deal with some of what I dealt with or people with some autonomic dysfunction deal with on a much lower level.

Yeah, I was gonna say, I mean, inflammation typically doesn't cause something as, as drastic as what you've described unless it's, it's, it's like high level chronic inflammation from say like a full blown autoimmune condition or I suppose if you were inducing, you know, mild low level rhabdo from two a day CrossFit workouts for a long period of time or something like that. You'd still experience probably over training syndrome and endocrine dysfunction before you started to experience something like you were going through. So I feel like it would take a lot of inflammation to cause pretty serious issue with long term, 10 year long chronic fatigue.

It absolutely does. And that's not the majority of people. But it was an opportunity, which is interesting when it was so exaggerated in my case and that of my kids, it made it easier to see responsive to treatment. And then for someone, say, dealing with aging or stress or whatever, whose presentation is less exaggerated, it's very easy to say, oh, I'm getting older, I'M going to be more prone to constipation or brain fog or whatever, or I'm under a lot of stress. Stress. I hear that a lot. But we know if some of the underlying problems deal with similar presentations on a much lower level, we can be proactive and we can live so much better lives. We can age much more gracefully, if you will. We don't have to scum to some of those, quote, typical issues that we see in those people. It's often mistaken and blamed on something else. So it was as sick as I was. I would not wish that on anybody. Honestly, I would hate to go through that again. But it opened the door to get some answers that had been missing. And that's hugely helpful.

So the fact that your kids were dealing with this too, I suspect, is why you mentioned that what you found was that some of this stuff can be genetic.

Well, I set up genetic disease investigators because I thought, what are the chances that I could get this and then both of my kids could end up with this without some sort of genetic influence? I thought hopefully we can dig deeper and ultimately come out with the genes responsible. So, one, we get validation for the suffering, and two, we can help people much younger, maybe even prevent them from getting sick. But it was so long and such a difficult process trying to get those answers.

So at this point, basically, you, you were sick and you had a team of researchers that you put around you to help you discover why you were sick. I mean, to me, it's still a little vague what's going on here right.

Now as a patient. And I set up the corporation. I'm an optometrist, of course, My husband is an optometrist. And we had two offices. So I thought we are set up basically to start looking for answers. Me being a patient is helpful. We've got two lab rats, right. Because the kids are affected. And we started by looking in the eyes. No one with this condition had ever really done that before. And I thought, there is no way you could be this sick without some sort of sign. And the eye is such a great window into systemic illness. That's where I started, but that's not where we stopped. Okay. But a lot of the researchers were people I knew. And then. Really interesting. Ben. The Internet has changed research, right? There are physicians and researchers who freelance. And I had doctors really around the globe helping me with research. Microbiologists, geneticists. There's one out of India I continue to work with today. That really helped. So, yeah, it was an amazing process.

Okay, so what happened.

We got answers. We continue to get answers. We're still digging into the genetics today. So, but in, in my recovery and as sick as I was, and my son was especially ill, he, he, he started to waste away. He developed osteoporosis. He was nine years old. And so the kids are doing great. I'm doing great.

You're get, you're getting ahead of yourself though. Like, what, what did you, what did you have? Like, like did you get diagnosed?

Well, you know, that's funny because I think that's one of the issues with this. And even my mother in law said so, so what did you end up being diagnosed with? You know, so I can tell my sister and go, well, that's one of the problems. We don't exactly have labels for many of these genetic setups. And what we're working toward is properly labeling because doctors typically will label a condition and then they will treat according to a label. And if you have a label, such as I did with a pots, POTS is not a disease. It's a symptom. It's a symptom of something else. And you have to figure out that something else and then label those. And it's a process.

So I think, I think we need to backpedal a minute here because I don't really think you've described exactly what POTS is or even what that had to do with what you were experiencing.

Yeah, well, POTS is an autonomic dysfunction. So the autonomic nervous system is a system that of the body you shouldn't have to think about. Right. It controls the automatic processes like breathing or your heart rate, blood pressure, digestion, tear production. All of those are considered to be automatic. And when that system breaks down, you get sick. So there are many reasons for pots, there are many reasons for dysautonomia and, and you have to start at the top and work your way through it. For example, ALS or Parkinson's are conditions or neurological conditions that start to show first with pods, you have to rule out other neurological problems, some autoimmune conditions that affect receptors, et cetera, et cetera. So it's extraordinarily frustrating. I got two big textbooks on autonomic dysfunction when I was sick and went through them and my presentation wasn't in there. I thought, how is this even possible? So there's a lot to reveal and we'll be revealing more in publications as we go. So it's a process and you do have to be careful the way you release information, as I came to find out.

Yeah, that's kind of mysterious, but. But I guess it is a little, you know, in. In the past when I've looked into something like POTS for, you know, specifically, I've had some athletes I've worked with who have been, you know, abnormally dizzy. When they've gotten up from a lying to a standing position, they get this big increase in heart rate and they get lightheadedness. And often it's associated with them having pushed too hard or a little bit of dehydration or low electrolyte status. Sometimes it can be based on endocrine function and the amount of aldosterone and cortisol that they have in their system. But that's, you know, about all I know of pots. And it sounds to me like what you're saying is what you and your children were experiencing in terms of this long term chronic fatigue was a form of pots, right?

Well, we definitely had pots, but again, that was just one symptom. I think the people you're describing are the ones that doctors are the most forbidden, familiar with, where it's fairly transient, be it, you know, dehydration or astronauts get POSs, which is kind of cool when they're out in outer space. And the lack of gravity tends to contribute to that. But that's not what we dealt with. High levels of salt or which is what they tried compression hose or just artificially slowing the heart, did nothing. In fact, if anything, we were just getting worse. So we do have to dig deeper. And one thing that we found after we revealed there was this propensity for abnormal intracranial pressure was that ultimately the vagus nerve appeared not to be working, and we had to figure that out.

Okay, so you. So how did you know your vagus nerve wasn't working? How did that get diagnosed?

Yeah, well, I kind of suspected it because my heart started racing at about the same time my gut wasn't working well. And I think anytime, you know, both systems of the body are affected about the same time, you need to consider. So what do they have in common? And I was considering at the time, compression of the vagus nerve at my neck. We were doing some vascular studies then, and I didn't know if that was right, but that's where I was headed with it. But I got to the point, really, where I couldn't have a bowel movement. And that's probably the one you heard about where it had been 11 days or so, no bowel movement, and I had some vague pain in the lower right hand quadrant of my Abdomen. I didn't know what that was either, but I had tried everything to have a bowel movement and nothing. So I went to my doctor, and she had nothing new to offer. But she said, with that pain, maybe you have a kidney stone. And that doesn't sound right, but okay. And she sent me to a urologist who gave me this dieted drink, that nasty stuff. And he scanned me for a stone, and I didn't have a stone. But I told him what I was considering about the vagus nerve. And I asked him if that pain in that lower right hand quadrant could maybe be the ileocecal valve, the valve between the large and small intestine, and could that be stuck?

And even though very common source, by the way, ileocecal valve dysfunction, you know, people who are taking psyllium husk and magnesium and getting a squatty potty and doing all these things they hear about for constipation, I think many people don't realize the anatomical interplay in terms of ileocecal valve dysfunction contributing to small intestinal bacterial overgrowth. Right. If it's kind of in a stuck open type of condition and then if it's closed, that I've found along with very tight psoas and iliacus muscles, can be an anatomical contributor to poor bowel function and constipation. And I run into this so often in the athletic population, you'd be shocked. Probably 60 to 70% of the active individuals and athletes who I work with, they complain of some form of constipation. And in many cases, they're doing all the right things from a dietary and a supplementation standpoint. And then you dig down and you look into the anatomy. And a lot of it does come down to what it sounds like is the same thing that you discovered in your condition, this ileocecal valve issue. And so what I think would be interesting is if you could elucidate for people kind of how that's linked to vagal nerve function.

Right? Because it's easy to think that, okay, that valve, which controls the stool, of course, leaving the small intestine and going into large intestine, it's super important. I have a whole lot of respect for that valve. And as you said, Ben, if it's stuck open, you get regurgitation of stool back up in this small, small bowel. That's really bad. And you're more prone to sibo, et cetera. And if it gets stuck, as it did in my case, then you can't have normal Bowel movements. So when I hear things like what you just said of people are having these chronic issues, that's exactly the type of population that I look at and go, okay, they don't have pots, they don't have chronic fatigue, what have you, but could they have enough inflammation where that's at the heart of some of the problems with it? And it's certainly possible. But the movement of the stool through the GI tract is what stimulates the that valve to open. It's not directly a vagus nerve issue, but the vagus nerve controls peristalsis or the movement of that stool. So you need to have things moving for that valve to open.

Right. The vagus nerve would be incredibly helpful for what would be called in gastroenterology, gastric motility, which is linked to this other thing called the migrating motor complex. Like the migrating motor complex is how. How the body cleans out your digestive system. You know, it starts off at the top of the small intestine, all the way down to the small muscles within the colon, but that is triggered by signals from the vagus nerve. And so I think what you're getting at here is the vagus nerve is going to trigger activity of the migrating motor complex. Part of that migrating motor complex would involve ileocecal valve function. So if for some reason there's poor vagal nerve function, that could be influencing gastric motility, in part by limiting the ability of the ileocecal valve to function properly. And I know a part of this, too, related to the migrating motor complex is bile production and gallbladder and liver function. And so a lot of this stuff can be multimodal. But I'll see in many cases, people who have constipation or poor motility, they'll have poor bile production and need some amount of liver and gallbladder support. But then there's, of course, that whole ileocecal valve motility, migrating motor complex piece where you have to support that. And that comes down to some of the vagal nerve toning tricks that one can incorporate. And I think that was how I originally found you, was when I was looking into the ileocecal valve, I came across an interview or an article that you wrote. I forget it was, this is a couple months ago and wanted to schedule for the podcast because it looks like you found out a pretty kind of cool method to work on that ileocecal valve. And I believe this might have been where nicotine entered the picture for you. Am I correct?

That is absolutely correct. And again, I kind of got lucky because after I saw the urologist and he had me drink that dye and stuff, I didn't have. Have a kidney stone. But oddly, three days later, I kid you not, Ben, I got a kidney stone. And I called him up and I thought, he's going to think I'm nuts. But I told him, I know, I. You told me I don't have a stone. I get it. I didn't three days ago, but I do now. And he met me at the hospital and removed the stone. And when I woke up, he was standing over me real close. And he said, diana, you're right. It's your ileocecal valve. And I said, said, how did you know? He said, well, that dye I gave you three days ago, it's still in there, but it's all crammed up against the valve. So we knew it was Ilya Siegel.

Val.

Yeah, but he still didn't know what to do about it. So I was at the emergency room. I had prokinetics, nothing. And I was basically put in position where no one I went to could help. So. And even sent me to a surgeon to see. See about opening the valve. And the surgeon said, oh, no. He said, diane, if you think this is vagus nerve related, never have abdominal surgery unless it's life threatening, because we cut right through those nerves and went, oh my. We cause gastroparesis, is what he said. So I appreciated that honesty, but I was left with no answers. So I went home and basically was laying in bed going, what? Now, you know, what do I do? So I thought back in school with what I learned about the vagus nerve in school, and this had been decades ago, I mean, decades. But being a total geek, I remembered studying it and going, well, there's two parts to the vagus nerve. The pre ganglionic part that goes from the brain down the neck into the chest cavity and then down into the abdominal cavity. It's the longest cranial nerve in the body. And then there's a little gap and there's a tiny postganglionic vagus nerve. And I remember the teacher saying, that postganglionic vagus nerve is so small, it's almost a part of the organ itself. And I have no idea why I remembered those words, but I thought, okay, I think I still have that. You know, I've never had surgery. Hopefully, hopefully that little tiny nerve is still there. So I wanted to try to stimulate that postganglionic vagus nerve. And I thought, okay, nerves work when they're of course, they're triggered. And the nerve impulse, if you will, travels down the nerve, and at the end of the nerve, it releases a chemical, a neurotransmitter, and it hops across the synapse and it lands on a receptor and it stimulates an action. So I thought, okay, what is the neurotransmitter that that vagus nerve uses? And I thought, well, that one's easy. The vagus nerve is the only nerve in the body that's called the nicotinic acetylcholinergic nerve. And the reason we call it nicotinic is that the imitator of that neurotransmitter agonist, nicotine. So I called my husband and asked him to swing by the drugstore on the way home and bring me a nicotine patch. And he thought, what the heck are you doing? You know? But he was used to me doing some experiments on my body, so I'll explain it when I get home. But I didn't know if it mattered where I put it, but I put it over the side of the ileocecal valve. Again, I didn't really know what I was doing.

That seems intuitive. Intuitive, though?

Well, it seemed right to me. Yeah. But I kind of pictured that nicotine going through the skin because it's transdermal, of course, and it goes through the tissue. And I pictured it landing on, hopefully, the postganglionic vagus nerve and then maybe stimulating something. And sure enough, about an hour, hour and a half later, things started to move. That valve opened. Normal bowel movement. I was like, what? And I used to used it again, actually, four days in a row.

And that's when you became a chain smoker.

That's right. Well, you know what, though? Nicotine. I couldn't keep using it because nicotine, of course, is not all roses and butterflies because it can activate some inflammatory cells, neutrophils and macrophages. And it looked like my stomach was purple and it was itching and like a fire ants or something. So I knew I couldn't keep using it. But I learned so much from that. I learned that one. All the research and POTS to that day was saying it was an autoimmune condition affecting the receptors. It's like, no receptors work great. It wasn't getting the signal. So either it was a pre ganglionic vagus nerve problem or it was a neurotransmitter problem. And that difference, Ben, is so critical because as it turned out, it wasn't a vagus nerve problem per se. It was a problem with the neurotransmitters and you have to be able to figure out that difference to get as healthy as you can.

I want to talk in a second here about supporting normal acetylcholine through strategies aside from a nicotine patch or a, a, a pack of Marlboros. But what you commented on regarding nicotine, I want to make sure that doesn't fly under the radar for folks. You know, I've, I've of course mentioned before in the podcast how I'll chew a couple pieces of the 4 milligram Lucy brand nicotine gum on many days and levels of dopamine and norepinephrine and serotonin can all increase with nicotine usage, which is one reason why it can be highly addictive and why it could long term lead to some amount of neurotransmitter imbalances if overused at the same time. There are a lot of studies on it for improving attention and memory and focus. It's been looked into in rodent models as a preventative for things like Alzheimer's and Parkinson's. It's somewhat neuroprotective in terms of being able to reduce inflammation in neural tissue. And you're right, at low doses it kind of suppresses inflammation, actually acting through that cholinergic anti inflammatory pathway. But then in higher doses it may increase levels of some pro inflammatory cytokines. And when it comes to the gut, it's again interesting because it is derived from the alkaloid family. In high doses it could aggravate the gut especially same type of people who are nightshade sensitive. Tom Brady probably doesn't use nicotine for example. However, it's able to increase the thickness of the mucus in the colon and can help out a little bit with gut issues in some cases. So it's kind of one of those things where it seems pretty beneficial in low doses with infrequent use and then high frequent doses seem to kind of provide a law of diminishing returns and eventually it becomes more harmful. So in terms of nicotine, you, you probably made a good decision deciding not to use a nicotine patch on your ileocecal valve the rest of your life. But what did you decide to do instead?

Right, and I did want to comment on that. It's such a good point, Ben. In fact, nicotine has been shown to help prevent or treat ulcerative colitis and like you said, it works through that choline or acetylcholine pathway. So I had thought since I couldn't continue to use it, and like I said, I would have had to use it every day, that I thought it'd be great to figure out some way of coming up with, say, an oral mix of supplements. Would that even be possible, where it would do the same thing, trigger that postganglionic vagus nerve, if you will, boost acetylcholine, but not have that negative effect for me, of activating the inflammation, which, and it's probably to some degree, it was more inflammatory in my body because I genetically struggle with inflammation. It was fairly dramatic response. Not, not a good, good response. So I wanted to figure out something else. But I knew we were on to something, so I. I had some goals. First, I needed it to be made from supplements that were already deemed safe by the fda. I knew it was. We couldn't wait around for a new drug to be developed that wasn't even possible. But I also wanted it to work despite any genetic issues with, say, the body's ability to manufacture acetylcholine. When I first was going through that, and since it was genetic disease investigators, I thought, maybe that's it. Maybe that's why we can't make this work. We can't make enough acetylcholine. And that did affect some, some people, but it wasn't the majority. It was about one out of every 50. But I wanted workarounds for that so people didn't have to know their genes. And then I wanted to make sure it stimulated that postganglionic vagus nerve just like nicotine did. And the only way I could confirm that it was stimulated at that time was looking for a bowel movement. So we ran clinical trials, and if the subject had a bowel movement shortly after taking it, we knew it was likely also stimulating the gallbladder, the pancreas, et cetera, as you had said. And then finally, I needed it to cross the blood brain barrier to help cognition. One reason I had gotten so sick and contributed to so much brain fog, I couldn't keep a lot of balls in the air. Mentally. I couldn't even make a to do list, honestly, three things. And I was just too mentally fatigued. I ultimately couldn't stay awake was I didn't have enough acetylcholine release from my brain either. So I sat in my kitchen and tried to use my old organic chemistry knowledge to try to put together enough to cover all of those, and hoping and praying I got it right as I gave it to my son and I took it too. It was really a journey.

I think that's what I heard you talking about in an interview. And I actually, I ordered this supplement that you designed, this stuff called Parasym P A R A S Y M. I'll link to that in the show notes for people over@BenGreenfieldFitness.com pots if you want to check it out and see what the ingredient label and everything looks like. And. And it arrived to my house and, you know, I looked at the label and I might have a few questions for you about the ingredients in it, but that was the supplement that I took and mentioned in that podcast shortly after the fact that I took in the morning when I woke up. And like, you know, right after I took it, you know, I went and did my normal, you know, morning stretch routine, had my cup of coffee, did everything as usual, but my bowel movement was, you know, it felt like. Well, it felt like my ileocecal valve was open. Really, like, that's what it felt like. And I even, because I like to immerse myself in this stuff and try it out, I then the next day didn't take the parasim and instead put a nicotine patch over the ileocecal valve as you had done, and it elicited very similar effects. So obviously, you know, this thing was working on vagal nerve function and gastric motility in the way that you have described. But in terms of how it actually works, I would love for you to get into the ingredients you found that allowed for this cholinergic stimulus and this kind of parasympathetic stimulation of the vagus nerve that resulted in increased gastric motility.

Yeah, and this was, again, it was such a process because like I mentioned first, I thought maybe this, this is a genetic issue. So trying to study genes and we don't know people's genes, you could have a problem with what appears to be the vagus nerve, and it's actually a problem with acetylcholine production because of these genetic setups. So that was one of the first things I studied. So I wanted to have workarounds for that, and that was included in there. But some of the genes I looked at, like there's something called a, a chat gene, and it deals with the enzyme that helps this probably way more geekness than anybody wants to know. But the way we come up with acetylcholine inside the body is the acetyl group comes from something called acetyl CoA and we use a specific enzyme to break off the Acetyl group from acetyl coa to tie it into choline. And some people have a gentleman gene that prevents them from doing that well. So. And we've had a couple patients at POTS Care who had that gene. And boy, you changed their lives because they. They never have normal bowel movements, you know, throughout their lives. So I had to figure out a different enzyme, a different pathway, different place to get an acetyl group from. And I also needed to cover for nutrient malabsorption. If we get. And it's ironic that, that we usually end up with nutrient malabsorption when the vagus nerve is not working well because the pancreas doesn't work well, the gallbladder, stomach acid production, peristalsis, et cetera. How ironic is that? So if we get low in certain vitamins, like B1, for example, we can't make enough acetylcholine. We wanted to cover for that. And then I wanted to also put in something that works against the enzyme that breaks down acetylcholine. Once we produce acetylcholine, you don't want it continually. And that synapse just firing that receptor, you have to. Your body has to break it down normally. But we wanted to pause it to help multiply, if you will, the amount of acetylcholine in the synapse. And we put some of that in there too. At the same time. You don't want. Want to use too much or else the receptors start to shut down. They feel like, oh, we got plenty of acetylcholine. It's more than I need. So the balance was important too. It wasn't even just the ingredients in there, but trying to come up with the right balance to stimulate the nerve and then. But not overstimulate it, if you will. That was important. And when I heard your story about filling the bowl, which just cracked me up, I gotta tell you that. Just crack me up. I thought, that's interesting because this doesn't. It's not a laxative, you know, it's not a stool softener or something. It doesn't make. You have a bowel movement. It allows a normal bowel movement by allowing the vagus nerve to work properly. So it's a hint that something's up. If you have a dramatic response to nicotine, as I did, or to Parasym plus and call it Pearson plus, then there's a reason for that. And I had to figure out what other reasons could some people need that kind of support. And that was also part of the part of the journey.

Okay, got it. So you put together this formulation, this list of ingredients and got it into this encapsulated form. And you know the label, you actually have a proprietary blend, so it's unclear to me the exact milligrams. And I understand that that's. You also have about three years of research and testing and a patent on this thing. So I understand the proprietary angle. But, you know, a few of the primary ingredients are basically Huperzine and acetylcarnitine and a form of choline alpha glycerol, phosphorylcholine. And you know, I've seen other compounds. Probably the one that is most popular is for example, one that I had on hand on its alpha brain, which has a lot of Huperzine in it and is used as a nootropic. That was one that I was familiar with in the past as an acetylcholine Huperzine support. But does your product differ from a lot of these popular nootropics that people might already have in their cupboards? Because I do know many of these things are also used because of their effects on the vagal nerve and on neurotransmitter production for nootropic use. And I'm curious if people could just double up and use the same thing for ileocecal valve function.

Well, I think part of the trick and why it took us so long to pull all this together and doing the clinical trials, et cetera, was the blend was important. And again, we don't want to use too much. Huperzene receptor does shut down and that's not good long term. We did need it to cross the blood brain barrier and that's really important. But it received a patent because the blend was unique and there is no real competition out there. This was a new discovery. Otherwise you don't receive patents. Patent attorneys are tough, they are strong scientists. But I knew my science and was able to they you apply for a patent and then they argue it. And I was able to know that that science is wrong and this is why this is unique. That so it was a long journey and I don't know what people have in their cupboards. But this was a new discovery and it was blended in just the right way to accomplish not just the vagus nerve, but it also and reason we called it parasymp plus because it boosts the parasympathetic nervous system. Plus it crossed the blood brain barrier to assist with acetylcholine. And interestingly, at the end of the trials, it took about four to six weeks, Ben. But we noticed the chronic dry eyes were going away. And this was also unique and we received a second patent just recently for that.

Yeah, I want to ask you about the eyes in a second, but I should note as someone who has used nootropics for some amount of time that nootropics with similar ingredients, particularly Alpha Brain and the products from Qualia or Neurohacker Collective, Qualia Focus and Qualia Mind, while being fantastic, nootropics never really gave me that increase in gastric motility that I experienced when I took the parasym. And interestingly, I did notice a cognitive pick me up too when I took it, and an increase in hrv, likely due to the stimulation of the parasympathetic nervous system. And so there is something going on here that's separate from a nootropic in terms of the link to gastric motility, although the parasym seems to also be acting as a little bit of a nootropic as well. But regarding the eyes, I think one, one thing I wanted to ask you was I know that, you know, you mentioned the eyes, I think you said the eyes of the window to health or something like that. And you, you can see other things in the eyes, particularly regarding the autonomic nervous system. Were you tracking anything like that as well, like pupil size, pupil flickering, anything like that?

No, we weren't at the time. We were so focused on the gut for so long. And like I said, it wasn't until the end, end of the study we realized, oh, look what just happened. The dry eyes went away. But what I found, something that's really sensitive to this is pupil size. And at pause care, when we see patients come in, their pupils are as big as a house. We know one, they feel horrible. But that's usually the first thing to respond is pupils. The only thing that will change pupil size if the light is the same is the autonomic nervous system. So the sympathetic nervous system, that fight or flight system, makes pupils large and the parasympathetic makes them small. When those two are out of balance, the pupil size appears too large. And people get real light sensitive too. We see some people just wearing sunglasses indoors. We did find ever since we had opened POTS care, it's been about four years, years now, that pupils responded very well first very early in the process. But it was actually more repeatable than heart rate variability. Heart rate variability was a little bit finicky. It's very sensitive. Even if you're doing a math problem in your head, you know your heart rate variability can change. Pupils were a little less finicky than that was a little bit more reliable when of. Of watching for response. So yeah, we do look at the eyes and again, I think that's one way I was able to get some answers that had been missed by others is being an eye doctor. And it was unique to consider some of these conditions from that aspect. But for example, the acetylcholine problem, there's something called anticholinergic poison poisoning which you know, we haven't been poisoned. I assume you haven't been poisoned, but we can oftentimes present similarly where we end up with similar symptoms. Constipation, tachycardia, you know, delayed gastric emptying, etc, kind of anxiety. My gallbladder shut down, they wanted me to remove it. The ejection fraction was 8% and I thought this just doesn't make any sense. It sounds you're logical to me. And it was. But yeah, we look in the eyes first and that starts. It doesn't end the process. But it did get some answers that other people had missed.

Okay, got it. Now regarding again, kind of the quantification piece, I think many people who want to go about this in a systematized fashion might be curious if they either have a genetic issue that that would affect acetylcholine production or some other issue in terms of, let's say, lack of the ability to be able to break down acetylcholine properly or anything like that. Is there some kind of test that can tell people if they have some type of acetylcholine problem?

There is no blood test for acetylcholine, which is one of the problems doctors are trained to recognize poor acetylcholine release or anticholinergic poisoning, if you will. By presentation, you have to recognize the symptoms. So if someone shows up in the emergency room with some of these symptoms, they should know, oh, this could be anticholinergic poisoning, but if we haven't been poisoned, honestly, they never think in terms or I found pretty much never think in terms of could this be a problem with acetylcholine. It just wasn't really on the radar. The two genes that I considered, I just wanted to find workarounds for them. So there are genetic tests, which is awesome. Even 23andMe can pick up one or two of them and people can know if they have an issue. But in Parison plus I just put the workaround in at the time. I didn't even know if I could have had a gene with acetylcholine. Ultimately I didn't, but we just worked around around it that way and just tried to put it all in there so people didn't have to break it all down by themselves to figure it out. I wish there was a great blood test for that. That would be really great, but we have to look at the presentation.

Yeah, neurotransmitter testing can be difficult. I mean, just for basic neurotransmitter testing. And I actually have an entire chapter on neurotransmitter and neurotransmitter balance in my book. My book doesn't come out for a few months after this podcast comes out. It's called Boundless over at shameless plug boundless book.com but in that book I discuss Eric Braverman's test for neurotransmitter function, which is like an online quiz you can take for things like acetylcholine dominance, dopamine dominance, different neurotransmitter deficiencies, etc. I've found that one to be somewhat accurate. And in my case with my testing, it did reveal that I do have some issues with acetylcholine balance and me being a hard charging athlete for so long. I'm sure that contributed to the issue and also to some of the parasympathetic dysfunction as well. When you throw in the extremely tight core, tight psoas, and some of the other anatomical issues that can influence ileocecal valve function and gastric motility, along with excess sympathetic nervous system stimulation in a fed state, which will limit bile production and hydrochloric acid production. It's kind of like a perfect storm for gut issues or constipation. And so I suspect that's why this stuff seemed to work so well for me. And so hopefully that will give people a few good resources. Is looking up like Braverman test, for example? I think it's bravermantest.com but I'll hunt it down and put it in the show notes. But. But another thing I wanted to ask you about was how long to take this stuff because basically I, I went through a bottle. I don't have any anymore up in my cupboard. However, it seems to, it seemed to. I realize this might be shooting yourself in the foot, but it seemed to kind of like help me after just, just going through one bottle. So is this something like people take for the rest of their life? I realize that's a tricky question when you're the person who profits from and makes the supplement. But you know, I want to ask it anyways andand I'm just curious what you found as far as, you know, does this thing just jumpstart you or is this something you take for your whole life or does it vary?

Well, it's gonna vary certainly because people have say genetic issues with acetylcholine for example, example they'll always need help. People like me who have genetic issues with inflammation, we're going to always need help. And but I like you, I got to the point where I wasn't fatigued anymore. I thought my bowel movements were good enough, you know, isn't a couple times a week good enough? And as it turns out, it wasn't. I was in the hospital a few years ago and they gave me an antibiotic that activates inflammation and it was just horrifying. Everything just went down a thousand times. But I developed pancreatitis ultimately when I was off of it and I was just hoping and praying that getting back on it would be sufficient to give me some help there. And it started to turn around in two days. The vagus nerve of course is the ant anti inflammatory pathway of the body. And that wasn't my research. That was Kevin Tracy from the Feinstein Institute has figured that out, released that and so for me, who is I'm someone who's set up genetically for lots of inflammation. It's going to be forever and, and that's okay. We can fight back. I've been dealt a genetic hand that is not to able but as long as I have things I can work on, that's totally fine. The cognitive effects of and you mentioned or have been gray it's one reason my husband takes it but absolutely, I think it's, it's an individual reason. Everybody's different for having it work and we have to know what the reason is. One of the reasons that we found that say sometimes just stimulating the vagus nerve, which can be great, right? Like splashing cold water or meditating or chewing, etc. That should stimulate a normal, normal vagus nerve. But there are some situations where it won't work and one is if there's damage to the nerve is if you stimulate it. Kind of think of it like stimulating at the top. It should, the impulse should travel down the nerve but if it's damaged at some point, pulse doesn't make it to the end and the acetylcholine isn't released and the vagus nerve is such a long nerve, it's very prone to damage. So those people will likely need some support. Always. The folks, as I mentioned, with genetic issues in acetylcholine, they'll always need support. But people like me, and I think this is what was new for most people, is that some inflammation, inflammatory cytokines, block the release of acetylcholine. And if that's the case, you can stimulate that nerve or try to stimulate it, and nothing happens. So I had one advantage in kind of getting a clue into that, because as an eye doctor, I knew it was a possibility because of the research in an eye disease called Sjogren's syndrome. It's an inflammatory eye disease. It causes dry eye, and the lacrimal nerve is affected by that inflammation. You can stimulate that lacrimal nerve till the cows come home. Nothing happens. The acetylcholine does not get released. So if. If a nerve is supposed to produce acetylcholine, like the vagus nerve or the lacrimal nerve to produce tears, for example, is affected by certain individual inflammatory cytokines like Interleukin 6 or Interleukin 1 beta, for example, then if you stimulate the nerve, it's unable to release that, the acetylcholine, then we're kind of up a creek. So if. If the inflammation's episodic, say it's, you know, an intense masochistic triathlon. Just saying. Then if that the inflammation go systemic and it tends to last too long, it can work against some of your efforts to be healthy, and you want to naturally try to control that inflammation. The vagus nerve helps with that. So I don't really know. Say, in your case, Ben, was that an instant that your inflammation was just really high for whatever reason? It could be. I know, but it can be tough to figure out. So, yeah, got it.

Got it. So in terms of your case, where are you at right now as far as you and your kids? You guys pretty much pass all this, or are you still digging?

Thank you for asking. First, the kids are doing great, which I wish I had had a crystal ball when we were going through this. I mean, three of us were so sick. My husband was the only one who was well, and we had no answers and no idea what was going to happen, but they're all doing great. And. And my son, interestingly, is in college and is athletic now, and that we so didn't see that in the cards years ago. But as far as the digging we're doing is digging for more of the genes responsible. So people don't have to go through what we did of floundering without a good diagnosis, without a label that we, we need and without some heads up early on that if we don't take care of some things that we could become sick. So we're very good experts at maintaining our health. But I know what it takes to maintain it and stay on top of that propensity for some of this abnormal inflammation, the damage it can do. So it is ongoing as far as maintaining it, but the lifestyle is normal, which is great. So genetic disease is going full steam ahead, though, because there's so many other people we want to help and this isn't the end of it. There's many different reasons for people to have problems with the autonomic nervous system and the related conditions like chronic fatigue syndrome, etc. We want to get more answers for more people. So that's what we're working on now.

Well, it's a fascinating story. I found it incredibly helpful for myself. And I'm really hoping that people who listen in who have similar issues might find some benefit here from both your website, where you have some really good articles and interviews, and also your supplementation program for vagal nerve function and for the issues that we've been discussing, particularly this Parasym plus stuff. What I will do for folks is I'll put a link in the show notes to Parasim. I don't remember Diane. And you can remind me, did we have a discount code that we had available for anybody for the Parasim? And if so, do you recall what it was?

No.

Okay. All right. Should we, should we make one up on the spot? And then you could just, just have your tech team or whatever make sure that it's active.

I think he's already made it up. I just don't know what it is.

Okay, I will. This might be annoying to folks, but what I'll do is I'll hunt down that discount code because I think Diana's right. I think we had one in the past and I don't remember what it was, but I will, I will hunt it down and we'll put the discount code in the show notes for everybody. And then. And that's going to be@BenGreenfieldFitness.com pots BenGreenfieldFitness.com pots and I'll also include links to Diana's website and a whole bunch of other resources that we talked about, like my podcast with Sarah Myhill, another podcast that I did on 32 different ways to support the vagus nerve because Obviously, taking a multimodal approach to this is often very useful. But if you simply are concerned that you might have ileocecal valve issues, I would say one of the best things you could do is take this stuff, support vagal nerve function, do a little bit of psoas and deep tissue work around the valve and around the psoas, and you can be pretty surprised at what can happen without having to take yet another round of psyllium husk at night before you go to bed or something like that. Diana, thank you so much for coming on the show and for sharing all this stuff with us. It's just absolutely fascinating.

Well, thank you, Ben. I really appreciate one opportunity event too. I appreciate people like you who are willing to stick your neck out to get answers for people and sharing what you learn. And I know our efforts here have always been very grassroots because it was just patience trying to help each other. But you are revealing and sharing so much to help people be their very best and be their healthiest. And I know as one, I certainly appreciate the efforts it takes to do that because you have to be smart about it. And you are. In fact, if I didn't know you were a jock, then I would think you were a geek like me.

Definitely a lot of people think I'm a jock and I think I made a mistake painting myself as such. But I, I'm instead a guy who just likes to delve into a variety of different physical and mental activities. And I'm a constant seeker and as a result find myself thrown into many jock esque scenarios. But I am not, I, I am not genetically skilled at just about anything physical. I have to work my ass off for it. Which is probably one of the reasons like, you know, things like physical events attract me because I like things I have to work hard for and things that come easy. You know, for me, for example, something that comes very easy is writing, right? I can just, I can write and edit and it just flows out of me. And you know, my wife will sit in front of a blank page for hours and I don't even, I don't even get it. But then at the same time my wife will go tick off a five minute mile, you know, after being a runner in college. And that, that kind of stuff just comes in naturally to her. So I think everybody has their unique skill set. But yeah, I, I, I would say I probably am more of a, more of a geek than a jock. But regardless, we are, we're probably getting long in the tooth here and we should let people go. But once again, you can get the shownotes over@BenGreenfieldFitness.com pots and also connect with Diana over there. Leave your comments, your questions, your feedback in the show notes and either Diana or I will will hop in and reply. I know she has a money back guarantee on that Parasim plus stuff if you want to try it. I'll get a link to that and hunt down the discount code and get that in the show notes as well. And I think that's it. So thank you so much, Diana.

Thank you, Ben. I appreciate it so much.

All right, folks, I'm Ben Greenfield along with Diana Driscoll signing out from BenGreenfieldFitness.com have an amazing week. Well, thanks for listening to today's show. You can grab all the show notes, the resources, pretty much everything that I mentioned over@BenGreenfieldFitness.com along with plenty of other goodies from me, including the highly helpful Ben Recommends page, which is a list of pretty much everything that I've ever recommended for hormones, sleep digestion, fat loss, performance, and plenty more. Please also know that all the links, all the promo codes that I mentioned during this and every episode help to make this podcast happen and to generate income that enables me to keep bringing you this content every single week. So when you listen in, be sure to use the links in the show notes, use the promo codes that I generate because that helps to float this thing and keep it coming to you each and every week.