Understanding the “Great” Vagus Nerve with Dr. Kevin Tracey [Episode #992]
This Week’s Episode Special Guest: Kevin Tracey
In this episode Dr. Kevin J. Tracy discusses his groundbreaking work on the vagus nerve, its role in inflammation, and it’s connection to autoimmune diseases. He shares personal stories that shaped his career and emphasizes the importance of understanding the vagus nerve for health and wellness. The discussion also covers lifestyle measures, meditation, and the relationship between the vagus nerve and heart health, highlighting the need for further research in these areas. In this conversation, Dr. Kevin Tracey discusses the significance of the vagus nerve in health and wellness, exploring its role in vagal tone, bioelectric medicine, and its implications for autoimmune conditions and depression. He emphasizes the importance of a holistic approach to health, the potential of vagus nerve stimulation as a treatment option, and the reflexive nature of our bodily functions. The discussion also highlights personal experiences and insights that drive the pursuit of medical advancements.
About Kevin Tracey
Kevin Tracey, MD, is a best-selling author, neurosurgeon, scientist, entrepreneur, and leader in the fields of vagus nerve stimulation and inflammation. His new book THE GREAT NERVE (May 13, 2025 Avery) reveals the vagus nerve is the body’s most powerful—yet underutilized—healing pathway, capable of reversing devastating illnesses without drugs. Dr. Tracey and his colleagues in his lab at the Feinstein Institutes discovered the molecular and neural mechanism for the reflexive control of inflammation, now termed the inflammatory reflex. He is a prolific inventor, with more than 120 United States patents. As measured by and reported in the scientific journal PLOS One, Dr. Tracey is one of the most highly cited living scientists in the world. Dr. Tracey was trained in neurosurgery at the New York Hospital-Cornell University Medical Center and was a guest investigator at Rockefeller University before moving to the Feinstein Institutes. There he directs the Laboratory of Biomedical Science and was appointed President and CEO in 2005.
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Guest Resources
Book: THE GREAT NERVE
Website: The Great Nerve: The New Science of the Vagus Nerve and How to Harness Its Healing Reflexes
Episode Chapters
Chapters
00:00 Introduction to Dr. Kevin J. Tracy and His Work
04:05 The Impact of Personal Loss on Purpose
07:10 Understanding the Vagus Nerve and Inflammation
09:58 Exploring Autoimmune Diseases and Vagus Nerve Connection
15:07 Lifestyle Measures for a Healthy Vagus Nerve
19:58 Meditation, Heart Health, and Vagus Nerve Dynamics
26:11 Understanding Vagal Tone and Health Span
28:02 Innovations in Bioelectric Medicine
30:04 Vagus Nerve Stimulation for Autoimmune Conditions
35:02 Exploring the Connection Between Vagus Nerve and Depression
38:57 The Reflex Basis of Health and Well-being
44:05 Practical Applications and Personal Insights
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Transcript:
Solluna By Kimberly Snyder (00:00.972)
Hi everyone. Welcome back to our Monday interview show. I am so excited for our very special guest here with us today. His name is Dr. Kevin J. Tracy, and he’s a neurosurgeon, scientist, entrepreneur, and leader in the fields of vagus nerve stimulation and inflammation. He is one of the most highly cited living scientists in the world, and he has a fascinating new book out, which I read.
cover to cover called The Great Nerve, the new science of the vagus nerve and how to harness its healing reflexes. Dr. Kevin, I will call you Kevin from now on, but just to start off, Dr. Kevin, thank you so much for being here with us today.
Kevin Tracey (00:42.856)
Ha ha ha ha.
Kevin Tracey (00:48.042)
Well, thank you for having me on. I’m really looking forward to chatting all about the great nerve.
Solluna By Kimberly Snyder (00:53.774)
So it’s really fascinating, the subject matter. I think some of us have heard about the Vegas nerve and increasing popularity, whether in the media, social media. There’s so much I want to get into. But first I want to say, Kevin, that, wow, I wasn’t… Sometimes you get into these scientific books and research books and it can be a little bit dry.
But what really surprised me in a positive way about your book was the humanness that you brought to the book. And it was very readable and it was very accessible for a lay person who’s not a scientist to really grasp the information. And right away at the beginning, your book made me cry when you talked about the passing of your mother when you were five. And my youngest is four right now.
I was just thinking how, you know, for a child to lose their mother at such a young age, must have been so just, you your world gets turned upside down. So you go into that story, but also because her condition was related to her brain and that you became a scientist, there was a positive outcome. really, sounded like it really influenced your purpose and the direction of your life.
Kevin Tracey (02:17.994)
It did. You know, the, the idea of, of five year olds, grappling with what reality is and then going through a loss today, modern psychologists and psychiatrists, they look at these events as having long-term trauma to some. And it is a trauma that occurs when you’re five years old and lose your mother. But
You can come out of trauma 60 years later, 63 years later and look back and have an understanding to it. she died of a brain tumor very suddenly. And now here I am, a neurosurgeon trying to invent therapies, trying to invent things to help other people not have to lose their mother or their other. And can you connect the dots and say that?
led to this? Of course not. You can’t. But you can gain an understanding that children, even very young children, are formulating a view of the world that oftentimes I think is much more profound or
Kevin Tracey (03:37.502)
deep, if you will, or intuitive than adults understand. it’s not like it’s easy to study this in the groups of five-year-old children. You’re making assumptions about what they’re thinking and feeling because they don’t have the complete capacity of language and vocabulary that develops over many, many years later. But I’m strongly convinced that what happened to me
Solluna By Kimberly Snyder (03:44.002)
Yes.
Kevin Tracey (04:05.798)
at five influenced the entire course of my life. And I try to tell that story in this book.
Solluna By Kimberly Snyder (04:11.02)
You know, it’s amazing sometimes, you know, people are searching for their why, or they’re looking for, you know, what is my purpose? And it was so clear from the beginning and it, you tell that story upfront. And then there’s other, another story that has a mother made me cry about the 11 month old Janice who got burned. And you’re talking about some of your theories about inflammation and you know, why this child passed away.
And it’s just so clear that your drive, Doctor, is to really understand and to alleviate suffering. And it really comes across in your book and the way you write and your work. And so I just want to really acknowledge that, that, you know, there’s a lot of depth of science, but there’s also so much heart and so much love in the way that you’re writing. And it just really felt and it really touched me when I was reading this book.
Kevin Tracey (05:06.9)
Well, thank you. Your compliment means a great deal, coming especially from you. So thank you sincerely. In my journey as a neurosurgeon scientist for the past 40 years, give or take, I have come across many others who, like me, were touched, if not by a family member, but by a patient, and found in the inability to help that patient,
the drive, the motivation, the meaning, as you say, to pursue a cure. And that story resonates across not only my own experience with friends and colleagues and people I’ve met, but that story resonates across the centuries in the history of medicine. And the idea that one individual suffers and motivates another to find
a cure or to pursue a cure or to pursue an answer. That story recurs over and over again in the history of medicine. And if you think about it, what does it say? It says that one person, one person suffering and another trying to alleviate can change the course of the world. And I think the more that message needs to be internalized more and more by your listeners and listeners everywhere to know that
what they decide to do and how they decide to react makes a difference not only in their own personal lives and their family’s lives, but everyone can change the world for the better. And that’s very inspiring to me.
Solluna By Kimberly Snyder (06:44.396)
Yes, it’s the concept of oneness. know, Dr. Howe, we’re all connected and what happens to us, we can, you know, change our perspective and be motivated to do good, to shift things. And so it was very, very motivational, very inspiring. And then as you continued your work, you came to focus back to the great nerve on the vagus nerve. Can you tell us a little bit about…
just briefly why the Vegas nerve and if people are listening to this and they’re like, I’ve heard of it, but I don’t really exactly know what it is and why it’s important. Of course, there’s a whole book about why it’s important, but just in a nutshell, just to give us a little bit of an intro before we dive deeper.
Kevin Tracey (07:26.91)
Sure. So by way of intro, you made reference to Janice, the little girl that I cared for in the burn unit at the New York hospital. And she died in my arms of overwhelming inflammation. So what is inflammation and what does that have to do with the vagus nerve? Well, inflammation is what happens when the body reacts to either an injury or an infection. And you’ve seen it if you sprain your ankle or your knee, it turns red, it swells, it hurts.
And you’ve seen it if you’ve had an infected pimple or an infected cut on your skin, it turns red and it swells and it’s painful and it gets warm. That’s what inflammation is. And that’s a healthy, good response to injury and infection. It helps heal the wound and clear out the infection. that type of inflammation we need. But the problem is, that inflammation, if it’s not well controlled, if it…
doesn’t stop, if it spreads beyond the cut or beyond the local area of injury that occurs, if it spreads into the bloodstream or into the organs like the lungs and the heart and the kidney, inflammation can kill. And so the question that I confronted after Janice died was why did her body fail to control the inflammation that was occurring and why most people walk around
Solluna By Kimberly Snyder (08:40.215)
Yeah.
Kevin Tracey (08:56.648)
don’t have too much inflammation. And the very surprising answer that my colleagues and I discovered in the mid 1990s is that the brain controls how much inflammation you have in your body. And it does this by sending signals to your immune system, like the brakes on your car, slow down, slow the inflammation and prevent the inflammation from causing
Solluna By Kimberly Snyder (09:11.96)
Hmm.
Kevin Tracey (09:26.43)
damage to your normal organs. And the brake lines in your car run essentially.
to the wheels of your car to stop your car. The brakes on your immune system run from your brain through a nerve called the vagus nerve, which holds the key to stopping inflammation. And that simple sentence, how does the vagus nerve hold the key to stopping inflammation is something that I’ve committed the last 25 or 30 years of my life to studying.
Solluna By Kimberly Snyder (09:44.312)
Hmm.
Solluna By Kimberly Snyder (09:58.892)
It’s really interesting, doctor, because there’s so much autoimmune and there’s so many conditions and we hear a lot about changing your diet or taking medications and you’re talking about this bioelectric therapies and tell us about how this approach is kind of going a little bit further back than some of these other approaches to inflammation.
Kevin Tracey (10:24.564)
So you mentioned earlier, as we were warming up that many of your listeners are women and autoimmune disease is a disease that occurs much more in women than in men for reasons that aren’t well understood. But an autoimmune disease are diseases like lupus or rheumatoid arthritis or inflammatory bowel disease, multiple sclerosis. These diseases are conditions where there’s too much inflammation.
Solluna By Kimberly Snyder (10:37.742)
Mm.
Kevin Tracey (10:54.558)
So the question that we’ve been pursuing for years is if we know that the breaks on inflammation travel in the vagus nerve, if the vagus nerve is carrying signals from the brain to stop too much inflammation, can we use that information to develop therapies for diseases like rheumatoid arthritis? But in order to do that, we had to learn a great deal more. you mentioned…
The vagus nerve has the great nerve and we call it the vagus nerve, but you actually have two of them. You have one on each side, like two thumbs or two kidneys. And you actually have inside of each of these vagus nerves, you actually have a hundred thousand fibers. So it’s fair to say that all of us have about 200,000 vagus nerves. they run from about the level of your ear, deep inside your brain down.
Solluna By Kimberly Snyder (11:29.165)
Mm-hmm.
Solluna By Kimberly Snyder (11:44.61)
Wow.
Kevin Tracey (11:51.88)
your neck on both sides, across your chest and into your abdomen. And what these vagus nerve fibers do is carry information back and forth from your body’s organs to your brain and back. And this information is absolutely crucial to maintaining a balanced homeostasis is called, a balanced output of your organs that keep you in a healthy range. In other words,
The vagus nerve is carrying back and forth from your brain to your body, all of the information necessary to keep you healthy so that you don’t have to think about it.
Solluna By Kimberly Snyder (12:29.914)
Mm-hmm. So what is throwing off the vagus nerve for so many people? Why are these therapies required and is it happening more often in the modern world versus just being able to maintain homeostasis naturally?
Kevin Tracey (12:46.512)
All, sorry, all the answers to that question are not in yet, but there’ve been some dramatic examples that have taught us quite a bit. So for instance, during the COVID pandemic, several studies discovered that the virus itself could infect the vagus nerve, and this was found at autopsy in some victims of COVID. And when…
Solluna By Kimberly Snyder (13:07.81)
Mmm.
Kevin Tracey (13:14.41)
when the investigators looked at the vagus nerve, they found evidence that the virus was in the nerve. And in other patients, there was evidence that inflammation caused presumably either directly by the virus or by the body’s reaction to the virus, that the inflammation had settled in the vagus nerve and damaged it. Now, if you have damage in your vagus nerve, that would be like someone cutting the brake lines on your car.
and the vagus nerve now is no longer going to be able to slow down the inflammation. And if the inflammation keeps accelerating, now what happens, it accumulates in organs and can cause permanent damage, as I said before, to various organs, whether it’s the kidneys or the heart or the lungs or the brain even. So this was a key insight that the vagus nerve can sometimes be damaged in some patients.
Solluna By Kimberly Snyder (14:04.919)
Right.
Kevin Tracey (14:13.128)
Very importantly, we and others have begun to ask the question, is it possible that damage to the vagus nerve, like damage to the brake lines in your car, is actually occurring in autoimmune diseases as well? And there is some evidence that that is occurring. In other words, people at risk, relatives at risk for autoimmune disease,
often have evidence of impaired vagus nerve signaling to the heart called decreased vagal tone. And this can occur before they have any evidence of the disease itself. So the question is, can damage to the vagus nerve actually be one of the reasons that we’re seeing increasing incidence of some of these autoimmune diseases? We don’t know for sure, but it’s definitely possible.
Solluna By Kimberly Snyder (15:07.694)
So is it kind of like the chicken or the egg? Is it the diseases are damaging the vagus nerve or potentially damage to the vagus nerve is one of the reasons that there’s a proliferation of the autoimmune condition?
Kevin Tracey (15:20.168)
Yes or both. Yes or both. Yes, it is an important research question and there’s evidence to support both sides of that equation. Chicken and egg.
Solluna By Kimberly Snyder (15:30.572)
Right. And you know, doctor, in the latter part of your book, I love how you talk about meditation, which is a very big part of our community. You had an experience with the Dalai Lama, and you talk about cold therapy, breath work, we have a mutual friend Wim Hof. You didn’t mention diet as much or you don’t focus on it as much in the book. it based on all the research and what you’ve seen with our lifestyle measures that we can control?
does that have quite a, you know, increases our chances of maintaining a healthy vagal nerve, vagus nerve, you know, barring, of course, if we get COVID or there’s some sort of infection in the vagus nerve, but just on a more general everyday basis, these lifestyle measures can help.
Kevin Tracey (16:17.438)
I think it’s really important to answer this question in the context of some more clear definitions. So back to the basics, we have 200,000 vagus nerve fibers, and each of them has been selected by millions of years of evolution to have a specific job. So a few fibers, maybe a few hundred or maybe one or 2,000 at most, go to the heart and slow your heartbeat.
A few hundred or a few thousand go to your lungs and participate in every breath you take. A few hundred, probably not a few thousand, go to your pancreas and control your insulin. Now, the way the nervous system is organized, each individual nerve fiber controls a specific function. each of those functions can operate independently of all the other nerve fibers.
So for instance, most people, most of us can walk and chew gum at the same time because the nerves that control our walking are different than the nerves that control our chewing. When you apply that basic obvious fact to the vagus nerve, you have to ask a really important question. When someone says to me, I want to do this, that, or the other thing to my vagus nerve, I say, really, which one?
Solluna By Kimberly Snyder (17:42.062)
Mmm.
Kevin Tracey (17:42.184)
Which of the 200,000 fibers do you want to stimulate or inhibit? So for instance, there’s some commonly talked about advice in the billions of web impressions and social media postings about the vagus nerve that chanting or humming stimulates your vagus nerve and that this is good for your overall health. And as I review in detail in the book,
there is a grain of truth to that because a few hundred fibers of the 200,000 go to your voice box. technically, you’re larynx. So technically when you hum or chant, you are stimulating those few fibers of the 200,000. Does that mean you’re also stimulating the fibers that can control your immune system? And does that mean you’re stimulating the fibers like
Solluna By Kimberly Snyder (18:19.118)
Mmm.
Kevin Tracey (18:39.85)
the brakes of your car on your inflammation? Not necessarily. I mean, you can walk and chew gum at the same time because different fibers have different activities. So I tell that story because each of the chapters at the end of the book, in part three of the book, addressing these recommendations and advice given by so many sources on the web.
Each of those has to be considered for scientific validity and reproducibility and truthfulness versus exaggeration of claims beyond what we really understand. So does humming stimulate your vagus nerve? Yes, it stimulates the vagus nerve fibers that go to your larynx. Do we know that humming, because of that is decreasing your inflammation through the vagus nerve? No, we don’t. Do we know that
Stimulating those fibers to your voice box also stimulates vagus nerve fibers that have a role in preventing depression or anxiety. No, we don’t. these are important questions and they can be studied and addressed. And if people like to hum and it makes them feel better, then we should encourage that.
Solluna By Kimberly Snyder (19:58.05)
Well, I love the openness as a scientist doctor where you’re not just shutting something down but saying, hey, you maybe we don’t know more research is needed. You use these two words in the beginning of the book that really stood out to me when you’re describing the great nerve, mysterious and beautiful. When you’re talking about the vagus nerve, there’s mystery around it. There’s a lot of things we don’t know yet. And when you get to that section of the book where you’re talking about meditation, and there are thousands of research papers about
different benefits of meditation for different systems of the body. And I love that you as a scientist are also a meditator.
Kevin Tracey (20:35.218)
Meditation is widely studied across imaging studies, very sophisticated brain mapping using fMRI and PET scan and other brain imaging techniques have studied meditators ranging from monks to extreme, to amateur meditators, to highly trained meditators. And what’s interesting is that meditation does influence brain activity. And what’s interesting is that
Meditation does activate regions of the brain that are implicated in all kinds of mental states. As a scientist, as a researcher, it sort of stops there, however, because depending on the meditative practice and depending on who the meditator is and depending on what other activity there is going on in the meditator’s brain before meditation begins,
you get different answers or explanations as to why meditation could be beneficial to some, but not beneficial to all in terms of reducing anxiety and depression. So for me, I enjoy meditation. I think for me, it’s very interesting to observe myself meditating, if you will, and to watch the state of my mind as I meditate. I find that fascinating.
But I don’t think it’s fair when anyone claims cause and effect explanations of how meditation works. It’s an area of active research and much more needs to be done.
Solluna By Kimberly Snyder (22:18.72)
Yeah, well said. Well said. But it really does add a holistic, you know, I just, love that section of the book. And you talked about meeting the Dalai Lama as well was really cool. One thing I was going to say, when you talked about the relationship with the heart, it’s really interesting to me, Dr. My last book was, we did some, we did a meditation study actually in terms of
heart coherence and just measuring the patterns of HRV instead of just the numbers, getting those nice smooth sine waves. And so could you talk a little bit about how the heart and the vagus nerve are related? You said that some parts can go to the heart, obviously with 200,000 nerves running through it, not all, but there is a relationship.
Kevin Tracey (23:11.25)
Yes, so of those 200,000 fibers, some number of them, several hundred or several thousand go to the heart. And the vagus nerve endings from the brain to the heart stop in two different places. The sinoatrial node, which is the pacemaker and sets the resting heart rate, if you will. And the AV node, which is involved in the conduction of the signals from the atriums of the heart to the ventricles of
And so when the vagus nerve is sending signals to the heart, it tends to slow the heart down. And what does that mean? It means that the time between the first heartbeat, heartbeat one, and the next heartbeat, heartbeat two, is prolonged. Now, when the vagus nerve is firing frequently, you’re going to see…
Solluna By Kimberly Snyder (23:58.861)
Mmm.
Kevin Tracey (24:09.008)
more variability between the time of the individual heartbeats measured in milliseconds. And if you subject those individual heartbeats to statistical analysis, things like Fourier transformations, you come up with what’s called heart rate variability assessments. So the more your vagus nerve is firing, the more variability there will be between the individual times
in the individual heartbeats, the instantaneous heart rates. So that is all fairly well, that’s fairly non-controversial. Where it gets complicated is that there are many, many different statistical algorithms used to map out instantaneous heart rates as a function of time, as a function of
of frequency and in actually in multiple dimensions after being subjected to Fourier transformation. And so there’s no consensus on the analysis of these data. So there are wearables and I won’t name any, but the wearables use different algorithms to assess the different heart rate variability metrics.
Solluna By Kimberly Snyder (25:08.854)
Great.
Solluna By Kimberly Snyder (25:27.063)
Yes.
Solluna By Kimberly Snyder (25:32.088)
Yes, I am mad. That’s great. Mad as I’m tired.
Kevin Tracey (25:37.768)
So now you quickly look online and you see, here’s a graph of heart rate variability by age or by sex or by activity. And you end up with the potential for a great deal of confusion. what I found most interesting perhaps in this is that because the active vagus nerve tends to slow resting heart rate, the slower resting heart rate
Solluna By Kimberly Snyder (25:52.481)
Hmm.
Kevin Tracey (26:07.188)
tends to correlate with longer health span and longer lifespan on a population basis. So it’s a good thing to be aerobically fit with a
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