#824: Dr. Kevin Tracey — Stimulating The Vagus Nerve to Tame Irritation, Alleviate Despair, Deal with Autoimmune Problems (e.g., Rheumatoid Arthritis), and A lot Extra (#824)

Kevin J. Tracey, MD (@KevinJTraceyMD), is president and CEO of the Feinstein Institutes for Medical Analysis at Northwell Well being, a pioneer of vagus nerve analysis and creator of the latest ebook, The Nice Nerve: The New Science of the Vagus Nerve and Methods to Harness Its Therapeutic Reflexes. 

His contributions embrace figuring out the therapeutic motion of monoclonal anti-TNF antibodies and discovering the particular reflex management of immunity by the nervous system, referred to as the “inflammatory reflex.” These discoveries launched the brand new scientific area referred to as bioelectronic drugs, which investigates the therapeutic purposes of vagus nerve stimulation to remedy illness.

Dr. Tracey, a neurosurgeon, pursued research of irritation after the mysterious dying, from sepsis, of a toddler who was in his care. His lab has since revealed molecular mechanisms of irritation and recognized using vagus nerve stimulation to deal with it. An inventor on greater than 120 US patents and the creator of greater than 450 scientific publications, he’s among the many most extremely cited scientists on the planet. He co-founded the International Sepsis Alliance, is the creator of Deadly Sequence, and is a nationwide and worldwide lecturer.

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Wish to hear one other episode about the way forward for electroceuticals and mind stimulation? Take heed to my dialog with Stanford’s Dr. Nolan Williams, by which we mentioned 70%–90% remission charges for treatment-resistant melancholy, mind stimulation for sports activities efficiency, accelerated TMS protocols, de-risking ibogaine for TBI/PTSD, the way forward for “electroceuticals,” and rather more.

SELECTED LINKS FROM THE EPISODE

SELECTED LINKS FROM THE EPISODE

• Join with Dr. Kevin Tracey:

The Feinstein Institutes of Northwell Well being | SetPoint Medical | LinkedIn

Publications & Media

Medical Circumstances

• Rheumatoid Arthritis: An autoimmune illness that causes irritation within the joints.
• Crohn’s Illness: A kind of inflammatory bowel illness that impacts the digestive tract.
• PTSD (Publish-Traumatic Stress Dysfunction): A psychological well being situation triggered by experiencing or witnessing a traumatic occasion.
• Continual Fatigue Syndrome: A protracted-term sickness characterised by excessive fatigue that doesn’t enhance with relaxation and will worsen with bodily or psychological exercise.
• Despair: A temper dysfunction that causes persistent emotions of unhappiness, hopelessness, and lack of curiosity in actions.
• Lyme Illness: An infectious illness brought on by micro organism transmitted by means of the chunk of contaminated ticks.
• Neurodegenerative Illness: A variety of circumstances that primarily have an effect on the neurons within the human mind, resulting in progressive deterioration of operate.
• Anaphylaxis: A extreme, probably life-threatening allergic response that may happen quickly after publicity to an allergen.
• Bronchial asthma: A respiratory situation by which airways grow to be infected, slim, and produce extra mucus, making respiration tough.
• Sepsis: A life-threatening situation that arises when the physique’s response to an infection causes widespread irritation and organ dysfunction.
• Psoriatic Arthritis: A type of inflammatory arthritis that impacts some individuals who have the pores and skin situation psoriasis.
• Autoimmune Circumstances: Problems by which the immune system mistakenly assaults the physique’s personal wholesome tissues and organs.
• COVID-19: A contagious respiratory sickness brought on by the SARS-CoV-2 virus that may vary from gentle to extreme signs.
• Alzheimer’s Illness: A progressive neurodegenerative illness that destroys reminiscence and different essential psychological capabilities.
• Parkinson’s Illness: A progressive dysfunction of the central nervous system that impacts motion, usually inflicting tremors, stiffness, and problem with stability.
• Metabolic Syndrome: A cluster of circumstances together with hypertension, excessive blood sugar, extra belly fats, and irregular levels of cholesterol that improve the danger of coronary heart illness, stroke, and diabetes.
• Diabetes: A power illness that happens when the physique can not correctly produce or use insulin, resulting in elevated blood sugar ranges.
• Most cancers: A gaggle of illnesses characterised by the uncontrolled progress and unfold of irregular cells within the physique.
• Malaria: A life-threatening illness brought on by parasites transmitted by means of the bites of contaminated feminine Anopheles mosquitoes.
• Tuberculosis: A severe infectious bacterial illness that primarily impacts the lungs however can unfold to different elements of the physique.
• Peptic Ulcer Illness: A situation characterised by painful sores or ulcers that develop within the lining of the abdomen or the primary a part of the small gut.
• Epilepsy: A neurological dysfunction by which mind exercise turns into irregular, inflicting seizures, uncommon habits, sensations, and generally lack of consciousness.
• Cluster Complications: A sequence of extraordinarily painful complications that happen in cyclical patterns or clusters, usually on the similar time every day for weeks or months.
• Migraines: Intense complications that trigger extreme throbbing or pulsing ache, usually on one aspect of the pinnacle, usually accompanied by nausea and sensitivity to gentle and sound.
• Sciatica: Ache that radiates alongside the sciatic nerve pathway from the decrease again by means of the hips and down one or each legs.

Remedies & Therapies

• Vagus Nerve Stimulation (VNS): A medical remedy that includes delivering electrical impulses to the vagus nerve.
• Audio Chakra Cleanse Soundtracks: A kind of different remedy talked about for example of “nonsense.”
• Biologics: Drugs constructed from residing organisms or their parts.
• Ketogenic Weight loss program: A really low-carb, high-fat weight loss program.
• Exogenous Ketones: Ketones which might be ingested by means of a dietary complement.
• GLP-1 Agonists (e.g., Ozempic, Mounjaro): A category of medicines used to deal with sort 2 diabetes and weight problems.
• Microbiome Transplants: The switch of fecal matter from a wholesome donor to a recipient to revive a wholesome intestine microbiome.
• TMS (Transcranial Magnetic Stimulation): A noninvasive process that makes use of magnetic fields to stimulate nerve cells within the mind to enhance signs of melancholy.
• Targeted Ultrasound: A non-invasive therapeutic expertise that makes use of targeted sound waves to focus on and deal with quite a lot of medical circumstances.
• Psychedelics (e.g., LSD, 2C-B, Ayahuasca): A category of hallucinogenic medicine whose main impact is to set off non-ordinary states of consciousness.
• TENS (Transcutaneous Electrical Nerve Stimulation) items: A non-invasive technique of ache aid that makes use of a light electrical present.
• Auricular Remedy: A type of different drugs based mostly on the concept that the ear is a microsystem which displays your complete physique.
• Famotidine (Pepcid): An over-the-counter antacid that Dr. Tracey describes as a pharmacological vagus nerve stimulator.
• Antibiotics: Drugs that battle bacterial infections.
• SSRIs (Selective Serotonin Reuptake Inhibitors): A category of medicine which might be usually used as antidepressants within the remedy of main depressive dysfunction, nervousness issues, and different psychological circumstances.
• Ibuprofen: A nonsteroidal anti-inflammatory drug (NSAID).
• Monoclonal Antibodies: Laboratory-made proteins that mimic the immune system’s capacity to battle off dangerous pathogens similar to viruses.
• Optogenetics: A organic method that includes using gentle to regulate cells in residing tissue, usually neurons, which have been genetically modified to specific light-sensitive ion channels.

Key Ideas & Theories

• Polyvagal Idea: A concept that hyperlinks the evolution of the autonomic nervous system to social habits and emphasizes the significance of physiological state within the expression of behavioral issues and psychiatric issues.
• Coronary heart Fee Variability (HRV): The variation within the time interval between consecutive heartbeats.
• Sympathetic Overdrive: A situation the place the sympathetic nervous system is overactive.
• Inflammatory Reflex: A physiological reflex that controls the inflammatory response.
• Bioelectronic Medication: A area of drugs that makes use of digital units to deal with illnesses and accidents.
• Blood-Mind Barrier: A extremely selective semipermeable border of endothelial cells that stops solutes within the circulating blood from non-selectively crossing into the extracellular fluid of the central nervous system the place neurons reside.
• Cytokines (e.g., TNF, IL-1, IL-6): A broad and unfastened class of small proteins which might be essential in cell signaling.
• Cytokine Storm: A extreme immune response by which the physique releases too many cytokines into the blood too rapidly.
• Inflammaging: Continual, low-grade irritation that develops with superior age.
• Neuroinflammation: Irritation of the nervous tissue.
• Neuroplasticity: The power of the mind to type and reorganize synaptic connections, particularly in response to studying or expertise or following harm.
• Interoception: The sense of the interior state of the physique.
• Engram: A bodily hint of reminiscence within the mind.
• M1 and M2 Macrophages: Two several types of white blood cells with totally different capabilities within the inflammatory response.

Folks

• Kelly Owens: A affected person of Dr. Tracey’s who suffered from Crohn’s illness and rheumatoid arthritis and was efficiently handled with a vagus nerve stimulation system.
• Murthy Simhambhatla: The CEO of SetPoint Medical, a bioelectronic drugs firm creating vagus nerve stimulation therapies.
• Dave Chernoff: The Chief Medical Officer of SetPoint Medical, overseeing scientific growth of bioelectronic therapies.
• Nolan Williams: A psychiatry professor and director of the Stanford Mind Stimulation Lab who pioneered Stanford Accelerated Clever Neuromodulation Remedy (SAINT), an FDA-approved remedy for treatment-resistant melancholy utilizing accelerated TMS.
• Nora Volkow: Director of the Nationwide Institute on Drug Abuse (NIDA) who pioneered using mind imaging to analyze dependancy as a mind dysfunction and is researching targeted ultrasound therapies for dependancy remedy.
• Steve Liberles: A professor of cell biology at Harvard Medical College and Howard Hughes Medical Institute investigator who research the molecular neuroscience of vagus nerve sensory methods and recognized particular vagal neuron subtypes that management respiration and digestion in mice.
• Ok. Frank Austen: A number one professional on bronchial asthma analysis and respiratory drugs.
• Barry Jacobs: A researcher at Princeton College who studied the consequences of LSD on cats and contributed to early psychedelic analysis.
• Andrew Weil: A doctor and creator with a background in ethnobotany who has written about his experiences with psychedelics together with LSD and integrative drugs approaches.
• Ulf Andersson: A retired professor of pediatric rheumatology on the Karolinska Institute and buddy of Dr. Tracey’s who used a TENS unit to deal with his personal inflammation-related melancholy.
• Paul Nogier: A French doctor who created the primary auricular acupuncture maps in 1957, pioneering trendy ear acupuncture strategies.
• Kenneth M. Ford: Founder and CEO Emeritus of the Florida Institute for Human and Machine Cognition (IHMC), and co-host of the STEM-Speak podcast.
• Geoff Ling: Retired colonel who based the biology expertise workplace at DARPA.
• Richard Feynman: Nobel Prize-winning American theoretical physicist recognized for his work in quantum mechanics, quantum electrodynamics, and superfluidity.
• Charles Sherrington: One of many founders of recent neuroscience, recognized for his groundbreaking work on neural reflexes and The Integrative Motion of the Nervous System, for which he received the Nobel Prize in Physiology or Medication in 1932.
• Santiago Ramón y Cajal: The opposite founding father of recent neuroscience, recognized for his pioneering research of the construction of the nervous system and the neuron doctrine, Nobel Prize winner in Physiology or Medication in 1906.
• Asya Rolls: A professor who found that irritation within the colon can type a neural community connection to the mind, advancing our understanding of the gut-brain axis.
• Sangeeta Chavan: A colleague of Dr. Tracey’s on the Feinstein Institute for Medical Analysis, contributing to bioelectronic drugs analysis.
• Stavros Zanos: A colleague of Dr. Tracey’s on the Feinstein Institute for Medical Analysis, specializing in neural engineering and bioelectronics.
• Okito Hashimoto: A colleague of Dr. Tracey’s on the Feinstein Institute for Medical Analysis, working within the area of bioelectronic drugs.
• Eric Chang: A colleague of Dr. Tracey’s on the Feinstein Institute for Medical Analysis, contributing to neuroscience and bioelectronics analysis.
• Martine Rothblatt: A buddy of Dr. Tracey’s and CEO of United Therapeutics, she is a famend polymath who based SiriusXM satellite tv for pc radio earlier than getting into biotechnology to develop therapies for her daughter’s pulmonary hypertension, changing into the highest-paid feminine CEO in America.
• Lorimer Moseley: Co-author with David Butler of the ebook Clarify Ache and a number one researcher in ache neuroscience and scientific neurosciences on the College of South Australia.
• William Bushell: A scientist who works with the Dalai Lama on research involving meditation, consciousness, and human potential.
• Elizabeth Blackburn: A scientist who received each the Lasker Prize and the Nobel Prize in Physiology or Medication in 2009 for her work on telomeres and telomerase.
• Bob Thurman: Uma Thurman’s father and a professor of Tibetan research at Columbia College, recognized for his scholarship on Buddhist philosophy.
• The Dalai Lama: The religious chief of Tibet and international advocate for compassion, peace, and interfaith dialogue.
• Invoice Murray: Formidably humorous man and serial-striking bowler.
• Kevin Rose: In all probability not the Kevin you’re searching for, however Kevin, by every other title, would odor as candy.

Establishments & Firms

• SetPoint Medical: A commercial-stage medical expertise firm that developed the primary FDA-approved neuroimmune modulation system to deal with rheumatoid arthritis utilizing vagus nerve stimulation.
• Feinstein Institutes for Medical Analysis: The analysis arm of Northwell Well being and residential to 50 analysis labs, 3,000 scientific analysis research, and 5,000 researchers the place Dr. Tracey and his colleagues work.
• Mayo Clinic: A world-renowned nonprofit American medical group devoted to built-in healthcare, schooling, and analysis.
• Stanford College: A prestigious non-public analysis college in California recognized for its groundbreaking analysis, together with work on accelerated TMS and different medical improvements.
• Facilities for Illness Management and Prevention (CDC): The nationwide public well being company of the USA, liable for defending public well being and security by means of illness prevention and well being promotion.
• Karolinska Institute: A prestigious medical analysis institute and college in Sweden, house to the Nobel Committee for Physiology or Medication.
• Protection Superior Analysis Tasks Company (DARPA): A analysis and growth company of the USA Division of Protection liable for creating rising applied sciences for army use.
• Protection Language Institute: A United States Division of Protection academic and analysis establishment that gives language coaching to army personnel and federal staff.
• United Therapeutics: A biotechnology firm targeted on creating progressive merchandise to deal with the medical wants of sufferers with power and life-threatening circumstances, together with pulmonary arterial hypertension and organ transplantation applied sciences.
• World Well being Group (WHO): A specialised company of the United Nations liable for worldwide public well being, setting international well being requirements, and coordinating worldwide well being responses.
• Columbia College: A prestigious non-public Ivy League analysis college in New York Metropolis, famend for its contributions to drugs, science, and different fields of examine.
• Pendulum: A science-backed biotechnology firm based by medical doctors and scientists that produces next-generation probiotics, together with the one commercially accessible dwell Akkermansia complement.
• WHOOP: 24/7 monitoring throughout sleep, pressure, stress, and coronary heart well being.
• Oura Ring: A wise ring that screens over 20 biometrics that instantly affect how you’re feeling.
• Fitbit: Wearables designed to “hold you near your targets, enhance your motivation, and present your progress all through your well being and health journey.”

Related Analysis & Assets

SHOW NOTES

• [00:00:00] Begin.
• [00:06:34] Components assuaging my skepticism about vagus nerve stimulation.
• [00:11:12] SetPoint Medical receives FDA approval for vagus nerve stimulation system to deal with rheumatoid arthritis.
• [00:13:24] How Crohn’s illness sufferer Kelly Owens went from a wheelchair to operating up stairs in Amsterdam.
• [00:20:36] Placebo impact issues and the circumstances driving my curiosity in bioelectric drugs.
• [00:25:31] Vagus nerve anatomy 101.
• [00:32:53] Cytokines and irritation: What occurs when the vagus nerve is stimulated.
• [00:33:45] Discovery story: Unintended discovering of brain-body irritation connection.
• [00:35:39] Bioelectronic drugs method vs. pharmaceutical method.
• [00:38:18] Mice don’t wheeze.
• [00:40:13] Despair and irritation connection: SSRIs may match by means of anti-inflammatory results.
• [00:42:46] My private expertise with vagus nerve stimulation and temper stability.
• [00:44:22] The professionals and cons of irritation, and the way controlling it might result in even longer lifespans.
• [00:50:56] Weighing the protection of VNS vs. biologics in cytokine suppression.
• [00:56:27] Chilly publicity, meditation, and respiration practices affecting the vagus nerve.
• [00:59:01] A population-level improve in power inflammatory illnesses: Nature vs. nurture.
• [01:00:48] H. pylori: For when you’ll be able to’t blame stress, God, or the affected person for that nagging ulcer.
• [01:03:13] Stress, cortisol, and irritation connections.
• [01:05:42] SetPoint system vs. non-invasive options for various affected person populations.
• [01:11:09] Auricular remedy’s curious French origins.
• [01:13:28] There’s one thing fishy about this vestigial vagus nerve pathway.
• [01:16:03] Overlapping activation patterns from mind imaging research of ear stimulation.
• [01:19:01] DARPA assist and Geoff Ling’s “What if it’s sure?” perspective.
• [01:21:58] Neurocognition and vagus nerve inputs.
• [01:27:20] How Ulf Andersson turned his melancholy round with a TENS unit.
• [01:31:55] Coronary heart price variability complexity and measurement challenges.
• [01:33:05] A respiration train for instantly controlling coronary heart price.
• [01:35:30] Utilizing a typical antacid as a pharmacological vagus nerve stimulator throughout COVID.
• [01:36:23] A name for extra inflammation-based melancholy analysis and affected person stratification.
• [01:39:52] SSRIs and anti inflammatory mechanisms in melancholy remedy.
• [01:42:20] Interoception: The physique’s inflammatory indicators reaching the mind by way of vagus nerve.
• [01:43:22] Ulf’s printed protocol for TENS unit ear stimulation.
• [01:44:37] VNS, acupuncture, fertility, and Martine Rothblatt.
• [01:47:16] Continual low again ache and an inflammatory overreaction analogy.
• [01:48:35] Implications of Asya Rolls’ engram analysis and irritation recollections within the mind.
• [02:02:35] Cervical TENS vs. true VNS.
• [02:07:12] Charles Sherrington’s reflex concept and nervous system integration.
• [02:12:15] Blue vitality meditation and vagus nerve pathways with the Dalai Lama.
• [02:16:47] Parting ideas: Critical medical circumstances vs. self-help approaches.

MORE DR. KEVIN TRACEY QUOTES FROM THE INTERVIEW

“60 million individuals die on the planet Earth yearly. And 40 million of them die from coronary heart illness, stroke, neurodegeneration, Alzheimer’s, Parkinson’s, metabolic syndrome, diabetes, and most cancers. So two thirds of the those who die yearly on the planet Earth die of these circumstances. And that’s in line with the WHO. These circumstances all have one factor in widespread — they’re both brought on by irritation or made worse by irritation.”

— Dr. Kevin Tracey

“It was simply introduced that the corporate SetPoint Medical, which can now be advertising and marketing a tool to stimulate the vagus nerve to deal with rheumatoid arthritis, has acquired FDA approval. So there’ll be a product launch underway for the whole lot we’re about to speak about within the context of utilizing a medical system that prompts an evolutionarily conserved and historic reflex by means of which the mind can suppress irritation when it’s operating uncontrolled.”

— Dr. Kevin Tracey

“We’ve found that indicators journey from the mind by means of the vagus nerve. … These indicators touring within the vagus nerve are just like the brakes in your automobile. And once you faucet these brakes to gradual your automobile barreling down the hill, this system prompts what we name the inflammatory reflex.”

— Dr. Kevin Tracey

“If we are able to discover such nerves, then we are able to construct units to regulate the nerves, and the units grow to be the remedy. The bioelectronic drugs story works so long as you already know the molecular mechanism, and that’s the place individuals should be actually cautious with vagus nerve stimulation.”

— Dr. Kevin Tracey

“Virtually everyone till 100 years in the past, 150 years in the past, virtually everyone died by the point they have been 30. And what occurred within the final 150 years may be summarized in a quite simple sentence. The human race within the final 150 years eliminated an infection because the main reason behind dying. … I feel one thing comparable will occur perhaps within the subsequent 20 years if we are able to actually perceive the right way to modify irritation.”

— Dr. Kevin Tracey

“My adage for this factor is, once you don’t perceive a illness, consider epilepsy. You begin off, you blame God. In order that they did exorcisms, and that doesn’t work. So if it’s not God’s fault, the subsequent factor you do is you blame the affected person. And once you notice it’s not the affected person’s fault, in as we speak’s period, oftentimes we discover out it’s really brought on, there’s some infectious reason behind this factor. And so autoimmune illness might have an infectious trigger, it might have an environmental trigger. Folks discuss genetic causes. You inherit some degree of danger for autoimmune illnesses, however in only a few of those circumstances do you really inherit the situation.”

— Dr. Kevin Tracey