When they arrive in your office, they
all look the same with minor variations,
rather like identical suburban tract
houses with different floor plans and
exterior colors.
They have body pain that varies
between a 4-5/10 and a 6-8/10. They
don’t sleep. They report being fatigued
and depressed and say that walking
down the soap aisle in the grocery store
or standing next to someone who wears
perfume gives them a headache or
makes them sick for days. They seem to
react to so many foods and are allergic
to everything. Medications might reduce
the pain a little and create side effects
like fatigue and slow thinking, but it’s all
the doctor can do.
It doesn’t matter how many doctors
of what type they have seen, they
get one or more of these diagnoses:
fibromyalgia, chronic fatigue, multiple
chemical sensitivities and recently
they are often told they have mast cell
activation syndrome (MCAS) or small
intestine bacterial overgrowth (SIBO),
gastroparesis, leaky gut, mold toxins,
Epstein-Barr (EBV) or maybe Lyme
(even though the Lyme tests have been
negative or show only 1 band). Or they
are told they really just have depression
even though they are already on an
antidepressant and they are prescribed
an additional antidepressant or a
stronger dose of the one they are already
on. Or, worse yet, they are put on a
“mood stabilizer” that turns out to be an
“atypical antipsychotic” with severe long-
term side effects we won’t have time to
cover in this article.
In general, no one asks them,
“What happened immediately before
the onset?” If the answer is, “Nothing
happened, it just started,” the doctor
usually moves on to the next questions
instead of drilling deeper. If the patient
is lucky, the next question might be,
“When was the last time you felt well?”
And the answer is often, “I’ve always
been sick. I think I’ve been like this since
childhood.” The next question should be
but isn’t usually, “What did you do for
fun in grade school or high school?” That
answer is often, “I played soccer, rode
horses or did gymnastics or theater.”
Replies the doctor, “So up until that year
you were fine. Then what? When exactly
did the symptoms get this bad?” After
that the answers might be relevant. But
few doctors ask the set of questions that
should come next.
My entire practice since 1998 has
been the 10% of patients no one else
could help, and I failed a number of
them myself. But eventually through trial
and error and being sick and recovering
myself through the help of brilliant
colleagues, I learned what I am about to
tell you in this article.
In general, there is either the most
basic medical blood work ordered, which
will turn out normal orthere may be up to
$3,000 to $4,000 worth of exotic complex
blood work ordered, which will show
all sorts of items out of range. But the
exotic blood work doesn’t ever say how
the analysis is done, where and on whom
the normal levels were determined or
published and gives very little guidance
about what to do to correct the abnormal
results. Patients either leave with a
prescription for something that might
not help much or $500-$1,000 worth of
supplements to take three to four times
a day that might help in a few months
after they have been on an incredibly
restrictive diet.
If they look on the internet, they will
be even more frightened and hopeless
but will feel, at least, that there are many
other people who have what they have
so they know now that they are not crazy.
And then they come to you, for one last
chance, that you might be able to help.
If you’re like most practitioners, you
swallow the rising panic and desperation
and apply the latest thing you read or the
technique you’ve learned that helps most
patients and hope it will help this patient.
If you’re the patient, you hope that
this person might be the one with a
solution to this thing that has made your
life miserable for the last two, five, 10, or
20 years. You hope that the little glimmer
of hope you have will turn desperation
into a solution that makes the trip and
the office visit worthwhile as you tell
the story for the tenth time to the tenth
doctor.
And, the truth of the matter that gives
rise to this unified theory, is that these
conditions and these symptoms have one
thing in common that no one thinks of
because they don’t have a way to treat
that one thing. I propose that this thing
they all have in common is the vagus
nerve through its role of suppressing the
immune system, regulating gut motility
and gut pH and therefore gut bacterial
flora, and the connection of the vagus
to the brain and limbic system. Once
you have a way to treat the vagus fairly
quickly and you can see the results and
improvement fairly quickly, then the
connections begin to be obvious and the
patients improve.
It should be said up front that
I developed Frequency Specific
MicrocurrentTM (FSM) in 1996, and FSM is
what I add to treat all of these patients
as an adjunct to what most practitioners
already do. It has to be said that I don’t
know how I would treat any of these
conditions without FSM, so this article
can only tell you the unified theory based
on treatment experience; it won’t teach
you how to use FSM, but it might give you
a reason to look into it. It is hoped that
the theory will be interesting whether
FSM appeals to you or not.
Fibromyalgia (FMS) is a neuro-
endocrine condition characterized
by chronic full body pain in all four
quadrants, chronic non-restorative sleep,
and central pain sensitization lastingmore
than three months. Fibromyalgia patients
have reduced levels of growth hormone
due to reduced levels of growth hormone
releasing hormone (GHRH) in the brain
and loss of stage 4 sleep during which
85% of growth hormone is generated.
Growth hormone in an adult facilitates
transport of amino acids into muscle cells
for repair. Fibromyalgia patients do not
tolerate exercise because they don’t have
enough growth hormone and can’t repair
the normal wear and tear produced by
even minor exercise. They have reduced
levels of branch chain amino acids,
and there are consistent hormone and
neurotransmitter abnormalities across
all fibromyalgia patients no matter what
caused the fibromyalgia.
After treating over 500 fibromyalgia
patients in 23 years, it has become
obvious that there are at least five
different and distinct causes of
fibromyalgia. The literature says that
27% of cases are caused by physical
trauma. Clinical experience puts that
number at closer to 40%. The other
causes are organic chemical exposure,
severe prolonged stress, viral illness,
and there is a genetic type characterized
by genetic defects in the serotonin
pathways that affect pain processing or
genetic defects in other neuroendocrine
pathways. Fibromyalgia may start from
any one or from a combination of these
causes. Regardless of how they start out,
fibromyalgia patients end up looking like
the patient described in the first section
of this article.
Chronic fatigue syndrome (CFS) is
distinct from fibromyalgia although
both diagnoses are sometimes used
as a garbage-can diagnosis by many
of the physicians who treat these
patients. Chronic fatigue is associated
with a positive Epstein-Barr titer and
tender lymph nodes suggesting some
infectious influence. Some researchers
question whether EBV causes CFS or is
opportunistic. There is some support
for the idea that CFS is an advanced
form or variant of fibromyalgia but that
is not well accepted. In CFS, fatigue and
cognitive problems are the overwhelming
complaints, along with non-exudative
pharyngitis, swollen cervical lymph
nodes and low-grade fever. In one study
substance P was not elevated in the
spinal fluid of CFS patients whereas it
is generally elevated in fibromyalgia
patients.
Multiple chemical sensitivities (MCS)
is a controversial diagnosis unless you
are the patient who has it. The medical
community is still trying to decide
whether it is a clinical diagnosis or
not. Many in the medical community
consider MCS symptoms to be a physical
manifestation of psychiatric illness rather
than a primary medical illness. This
attitude prevailed towards fibromyalgia
for many years until there was finally
enough research to demonstrate
consistent physiological abnormalities
among fibromyalgia patients. There are
those in the medical community and
patient advocate groups who agree that
multiple chemical sensitivity is a negative
physical reaction to certain chemicals.
Which patients have which symptoms
may depend on individual genetic
variants in individual liver detoxification
pathways and neurochemical and
metabolic pathways. There is still
debate as to whether multiple chemical
sensitivity can be a diagnostic illness on
its own.
The most common symptoms of
multiple chemical sensitivity may include
headaches, rashes, asthma, muscle and
joint aches, body pain, fatigue, memory
loss, and confusion exacerbated by
exposure to specific organic chemicals,
fragrances or volatile organic chemicals
(VOCs) that outgas off of carpets,
synthetic fibers or paints. Each patient
experiences symptoms differently, which
may be why the medical community
has difficulty deciding that this is one
diagnosis.
A Unified Hypothesis for these three
conditions isn’t meant to suggest that
they are the same thing; this hypothesis
suggests that the vagus nerve plays a
role in the cause and perpetuation of the
symptoms in these conditions.
The vagus nerve starts in the
medulla, part of the brain stem, and it
has dense upwards connections to the
limbic system, the stress centers in the
brain, made up of the amygdala, the
hippocampus, the prefrontal cortex
and the cingulate gyrus. When it leaves
the skull and descends down through
the neck into the trunk, it becomes the
longest and most complex nerve in the
body.
The vagus motor fibers start in
the nucleus ambiguous and control
every muscle that controls speech and
swallowing and even some muscles of
the face. The recurrent laryngeal nerve
opensthe vocal cordsso you can breathe,
and a different branch closes the vocal
cords so you can make sounds. The vagus
nerve is why you can speak. The superior
laryngeal branch of the vagus is why you
can scream or sing high notes. The vagus
supplies the pre-ganglionic neurons for
the heart muscle. It beats your heart. The
vagus moves your digestive system and
vagus secretory fibers are why you have
saliva and mucous in your pharynx and
larynx. The vagus controls the smooth
muscles in your bronchi and esophagus.
The vagusis why you can swallow. The left
side of the vagus slows the left ventricle
(AV node) and it is why you do not have
ventricular tachycardia. The right vagus
slows the atria (sino-atrial, SA node) and
it is why you don’t have atrial fibrillation.
The motor fibers of the vagus follow
the esophagus through the diaphragm
and control the esophageal sphincter
that keeps the contents of the stomach
out of your esophagus. The vagus is why
you don’t have reflux.
When you’re under stress, your
muscles and brain need glucose from
the blood. The vagus has fibers to the
liver that stop the liver from producing
glucose. These vagus fibers need to be
quiet when the stress response from
the sympathetic nerves and the adrenal
glands send signals to the liver to pump
out more glucose so you can run.
The visceral sensory fibers of the
vagus are why you know you have pain
anyplace in your abdomen – the stomach,
the liver, pancreas, spleen, and the gut.
The vagus has stretch receptors in the
stomach that tell you when you should
stop eating. The vagus sensory fibers
are why you feel hunger, satiety and
nausea. The visceral pain information
from your heart, esophagus, and trachea
travel up the vagus and make you cough
and tell you you’re having angina. The
pressure receptors in the aortic arch
and the airways tell your heart to slow
down before something bursts. There
are chemo receptors from the vagus
in the aorta that tell your system that
you need more bicarbonate from the
pancreas. The vagus chemo receptors in
the upper small intestine make you crave
certain foods because you need certain
nutrients. Those chemo receptors could
also be responding to organic chemicals
in the blood that cannot be processed
by your liver because you lack the
enzymes or substrate to take them apart.
There aren’t good references for this
hypothesis, but it’s a reasonable guess.
The recurrent branches of the vagus
follow the posterior meningeal artery
from the upper cervical spine into the
skull. This branch is sensitive to dilation
of the blood vessels in the posterior
portion of the dura. This contributes
to the sensation of headaches that
happen when air pressure drops. Vagal
nerve stimulators are approved for the
treatment of migraine.
The vagus general sensory fibers
carry sensations of touch, pain and
temperature from the ear pharynx and
larynx. The branch of the vagus for the
ear (auricular branch) enters the superior
vagal jugular ganglion and joins up with
the C2-3 nerve root and the mandibular
(lower) branch of cranial nerve V. The
general sensory fibers from the pharynx
and larynx join with the motor fibers.
This gets complicated but stay with
it. It all makes sense and once you see it,
you can’t ever un-see it.
All of the general sensory fibers of
this portion of the vagus synapse within
the spinal nucleus of Cranial Nerve V
at the place where the cervical 3, 4
and 5 nerve roots exit the spine. Why
is this important? In neurology you
learn a memory trick, “C3-4-5 keep the
diaphragm alive.” It’s why you cough
when you put a cotton swab too far into
your ear. It’s why you cough when you
get something in your throat that you
didn’t even know you swallowed. The
sensory fibers of the vagus join up with
the motor fibers of the nerve roots that
relaxation or a slow heart rate; you need
stress hormones and the sympathetic
nerves to dilate the bronchi and speed
up your heart so you can run. You don’t
need to sleep right now because you
might miss your chance to run away if
the threat eases for even a moment. You
need to run away from the “tiger” that is
chasing you.
control your diaphragm and make you
cough before you even know you need
to. It’s automatic.
Basically, the vagus nerve keeps you
alive. It beats and controls your heart,
moves your digestive system, keeps
you from choking, allows you to empty
your bowels and tells you what to eat
and when you’re full, tells you that you
have inflammation in your liver, pancreas
or gut, regulates your blood sugar and
allows you to breathe and speak.
And the vagus controls your immune
system. This is where the vagus becomes
crucial in FMS, CFS, and MCS. The vagus
quiets the immune system by fibers that
go from the celiac ganglion to the spleen
to quiet T-cells and macrophages, and
from the splenic nerve to the spleen to
control antibody responses. Signals from
the (afferent) vagus tell the brain when
there is threat from infection, stress, or
physical trauma. The brain sends signals
down the vagusthat tell the vagusto turn
itself off or down. The (efferent) vagus by
way of the celiac and splenic ganglia are
now NOT turning off the macrophages,
T-cells and antibodies in the spleen.
If there is infection, stress, threat, or
trauma, the vagus needs to be off to help
with survival. The spleen and the immune
system need to increase inflammation to
fight infection and repair trauma.
Take a moment and think about
that. When life is good, the vagus slows
the heart, digests your food, reduces
inflammation, and quiets immune
response. When there is threat, stress,
infection or trauma you don’t need to
digest your food, therefore you don’t
need digestive enzymes or stomach acid
or gut motility. You don’t need bronchial
When the vagus tells the brain that
there is infection, threat, stress, or
trauma, itsendsthose signals up from the
body to the vagal nuclei in the medulla
and that message goes directly up to the
midbrain limbic system stress centers,
the amygdala and the hippocampus,
and others. The amygdala registers and
mediates emotions and feelings. The
hippocampus puts into subconscious,
rarely conscious or sometimes conscious
memory every “tiger” you’ve ever
encountered. Every infection, every
physical trauma, emotional trauma and
every stress or threat is stored in the
hippocampus so that the next time that
threat is encountered, the hippocampus
can remember how to get away from it
faster. Short-term memory is reduced.
There is only the “tiger.” Long-term
memory is specific for every bad thing
that has ever happened because the only
thing you need to remember is how you
got away from the “tiger” the last time.
That’s why patients can only remember
being sick since childhood. The threat
receptors literally fire faster in the
presence of very little objective external
stimulus because the hippocampus
remembers the last time this “tiger” was
a threat.
And it doesn’t matter what the “tiger”
is. The “tiger” response is primitive and
exactly the same whether it is a stressful
job, an abusive spouse, hunger and lack
of nutrients, a broken leg, torn connective
tissue because you have Ehlers Danlos
syndrome and your connective tissue is
constantly stretching past its integrity, or
toxic chemical exposure, a virus, parasite,
worm or dental or mold infection. If there
is infection, stress or trauma, the vagus
goes down or off, the immune system
is unregulated, inflammation increases,
and nothing works right.
Now go back and look at the
symptoms of fibromyalgia, chronic
fatigue, and MCS. The common features,
the unifying factor, once you know all
of the things the vagus does, is vagal
dysfunction. But no one ever seems to
think of it that way because there is no
easy or risk-free way to treat the vagus.
No one is going to install a vagal nerve
stimulator because you have multiple
chemical sensitivities, which they’re not
even sure are real. No one is going to
install a vagal nerve stimulator because
you have a sore throat and swollen lymph
glands from a chronic infection that
they call chronic fatigue syndrome. And
they don’t use vagal nerve stimulators
for fibromyalgia even though 86% of
fibromyalgia patients have irritable bowel
and don’t digest their food well. It’s just
too risky to install them and there are
too many potential side effects, and it is
really just easier to tell the patient to go
on this diet, take these pills, and learn to
live with it.
If you’re lucky and have the right
skills, you can treat the trauma, resolve
the mold, virus, dental or parasite
infection and the patient is not inherently
sensitized from some early childhood
trauma and the hippocampus tells the
vagus that the threat is gone and it is OK
to come back on. The vagus comes back
on and the patient recovers. If you and
your patient are both lucky.
Case Report
The patient was a 49-year-old female
who had fibromyalgia for 18 years
following an auto accident. Her pain had
been between 4/10 and 8/10 for 18 years.
Her symptoms included headaches,
burning midscapular pain, hand, arm,
leg, foot, neck, back and jaw pain. Over
the years she had developed asthma,
allergies, acne and irritable bowel
syndrome and had been diagnosed with
digestive system candida overgrowth.
Fortunately, her body pain responded
to the Frequency Specific Microcurrent
treatment for fibromyalgia associated
with spine trauma. When the pain
decreased so that it was consistently
below a 4/10, her digestion improved,
her immune system quieted down, the
allergies to food and environmental
factors disappeared, the asthma
resolved, her sleep improved and her
fatigue resolved as her adrenal function
and diurnal rhythm returned.
She had twenty treatments between
December 8 and March 15, and she
used a home microcurrent unit as often
as needed to keep her body pain below
a 4/10 at all times. She had physical
therapy to repair the pain generators in
her neck and two sets of facet injections.
She used one combination supplement
for repairing her gut. Her acne and night
vision cleared up when she was given
an oil-based vitamin A supplement.
No genetic testing was done, but it has
been suggested that some patients
can’t convert beta-carotene into the
active form of vitamin A. By February 8,
after eight weeks of treatment, she no
longer met the diagnostic criteria for
fibromyalgia. Her pain was consistently
between a 2/10 and a 4/10 without
medication. She slept well without
medication and her irritable bowel
syndrome resolved. By March 15 she
was discharged from treatment and in
June she moved to Colorado where her
recovery was maintained for at least six
years.
Think about all of the confusing,
multi-system symptoms that were simply
a result of body pain that remained
between a 4/10 and 8/10 for 18 years.
The body pain was eliminated by treating
inflammation in the spinal cord, but the
immune system activation, allergies and
asthma were from the vagus.
Irritable bowel and candida. If your
gut doesn’t move, and your pancreas
continues to secrete bicarbonate, but
your stomach doesn’t secrete as much
acid as usual, your gut contents become
alkaline and candida loves an alkaline
environment. The friendly acid-loving
bacteria don’t thrive, and they aren’t
creating the short chain fatty acids and
other products that repair your gut wall.
The vagus. Again.
Sleep disruption resolved because
the “tiger” was gone. The amygdala and
hippocampus kept the threat response
high because if the pain was a 7/10 there
must be a “tiger.” When the pain was a
2-4/10, the tiger was gone, and sleep was
welcome.
We were lucky because she had no
early childhood trauma to maintain the
sensitization and the vagus came back
on by itself once the pain resolved. In
2000, when she was a patient, the vagal
treatment had not yet been developed.
In 2020, the vagus can be treated with
FSM and treating the vagus can improve
the speed of response; but if the cause
of vagal dysfunction is not corrected, the
limbic system can turn the vagus off faster
than it can be turned back on. Knowing
how the vagus works and how it creates
symptoms in so many body systems helps
make sense of it all and makesthe patient
presentation less overwhelming.
If you look for the cause of the
infection, stress, threat, pain or trauma
and resolve that, and if you’re lucky, the
limbic system will calm down and the
vagus will come back on. If you need
a little extra luck, Frequency Specific
Microcurrent can give you a tool to help
quiet the limbic system directly and turn
the vagus back on.