#824: Dr. Kevin Tracey — Stimulating The Vagus Nerve to Tame Irritation, Alleviate Despair, Deal with Autoimmune Issues (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 writer of the latest e book, The Nice Nerve: The New Science of the Vagus Nerve and How you can Harness Its Therapeutic Reflexes. 

His contributions embrace figuring out the therapeutic motion of monoclonal anti-TNF antibodies and discovering the precise reflex management of immunity by the nervous system, known as the “inflammatory reflex.” These discoveries launched the brand new scientific discipline known as bioelectronic medication, which investigates the therapeutic functions of vagus nerve stimulation to treatment illness.

Dr. Tracey, a neurosurgeon, pursued research of irritation after the mysterious demise, from sepsis, of a toddler who was in his care. His lab has since revealed molecular mechanisms of irritation and recognized the usage of vagus nerve stimulation to deal with it. An inventor on greater than 120 US patents and the writer 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 writer of Deadly Sequence, and is a nationwide and worldwide lecturer.

Please get pleasure from!

Take heed to the episode on Apple Podcasts, Spotify, Overcast, Podcast Addict, Pocket Casts, Castbox, YouTube Music, Amazon Music, Audible, or in your favourite podcast platform. Watch the dialog on YouTube.

This episode is dropped at you by:

Pay attention onApple Podcasts

Pay attention onSpotify

Pay attention onOvercast

This episode is dropped at you by AG1! I get requested on a regular basis, “In case you might use just one complement, what would it not be?” My reply is normally AG1, my all-in-one dietary insurance coverage. I advisable it in The 4-Hour Physique in 2010 and didn’t receives a commission to take action. Proper now, you’ll get a 1-year provide of Vitamin D free together with your first subscription buy—an important nutrient for a powerful immune system and robust bones. Go to DrinkAG1.com/Tim to say this particular supply at present and obtain your 1-year provide of Vitamin D (and 5 free AG1 journey packs) together with your first subscription buy! 

This episode is dropped at you by Eight Sleep. Temperature is without doubt one of the most important causes of poor sleep, and warmth is my private nemesis. However a couple of years in the past, I began utilizing the Pod Cowl, and it has remodeled my sleep. Eight Sleep has launched their latest technology of the Pod: Pod 5 Extremely. It cools, it heats, and now it elevates, robotically. With one of the best temperature efficiency to this point, Pod 5 Extremely ensures you and your companion keep cool within the warmth and comfy heat within the chilly. And now, listeners of The Tim Ferriss Present can get $350 off of the Pod 5 Extremely for a restricted time! Click on right here to say this deal and unlock your full potential by means of optimum sleep.

This episode is dropped at you by Wealthfront! Wealthfront is a monetary providers platform that provides providers that will help you save and make investments your cash. Proper now, you possibly can earn 4.00% APY—that’s the Annual Proportion Yield—with the Wealthfront Brokerage Money Account. That’s almost 10x extra curiosity than in the event you left your cash in a financial savings account on the common financial institution, with financial savings charges at 0.42%, in response to FDIC.gov, as of 05/19/2025. It takes just some minutes to enroll, and you then’ll instantly begin incomes 4.00% APY from program  banks in your uninvested money. And when new purchasers open an account at present, they’ll get an additional $50 bonus with a deposit of $500 or extra. Phrases and Circumstances apply.  Go to Wealthfront.com/Tim to get began.

Money Account provided by Wealthfront Brokerage LLC, member FINRA/SIPC. Wealthfront isn’t a financial institution. The APY on money deposits, as of 04/30/2025, is consultant, topic to alter, and requires no minimal. Funds within the Money Account are swept to program banks, the place they earn a variable APY. Tim receives money compensation from Wealthfront Brokerage for promoting and holds a non-controlling fairness curiosity within the company father or mother of Wealthfront Brokerage. Tim and Wealthfront Brokerage haven’t any different affiliation. Tim displays his personal opinions and Wealthfront doesn’t endorse, sponsor, or promote them. See full disclosures right here.

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: An extended-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 attributable to micro organism transmitted by means of the chunk of contaminated ticks.
• Neurodegenerative Illness: A spread of circumstances that primarily have an effect on the neurons within the human mind, resulting in progressive deterioration of perform.
• Anaphylaxis: A extreme, probably life-threatening allergic response that may happen quickly after publicity to an allergen.
• Bronchial asthma: A respiratory situation wherein airways turn out to be infected, slender, and produce extra mucus, making respiratory troublesome.
• 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: Issues wherein the immune system mistakenly assaults the physique’s personal wholesome tissues and organs.
• COVID-19: A contagious respiratory sickness attributable to the SARS-CoV-2 virus that may vary from delicate to extreme signs.
• Alzheimer’s Illness: A progressive neurodegenerative illness that destroys reminiscence and different vital psychological capabilities.
• Parkinson’s Illness: A progressive dysfunction of the central nervous system that impacts motion, typically inflicting tremors, stiffness, and issue with stability.
• Metabolic Syndrome: A cluster of circumstances together with hypertension, excessive blood sugar, extra stomach fats, and irregular levels of cholesterol that enhance the danger of coronary heart illness, stroke, and diabetes.
• Diabetes: A persistent illness that happens when the physique can not correctly produce or use insulin, resulting in elevated blood sugar ranges.
• Most cancers: A bunch of illnesses characterised by the uncontrolled progress and unfold of irregular cells within the physique.
• Malaria: A life-threatening illness attributable to 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 wherein mind exercise turns into irregular, inflicting seizures, uncommon habits, sensations, and typically lack of consciousness.
• Cluster Complications: A sequence of extraordinarily painful complications that happen in cyclical patterns or clusters, typically 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, typically 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 therapy 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: Medicines constituted of residing organisms or their elements.
• Ketogenic Weight loss plan: 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 kind 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 despair.
• Targeted Ultrasound: A non-invasive therapeutic expertise that makes use of centered 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 medication whose main impact is to set off non-ordinary states of consciousness.
• TENS (Transcutaneous Electrical Nerve Stimulation) items: A non-invasive methodology of ache reduction that makes use of a gentle electrical present.
• Auricular Remedy: A type of different medication primarily based on the concept that the ear is a microsystem which displays all the physique.
• Famotidine (Pepcid): An over-the-counter antacid that Dr. Tracey describes as a pharmacological vagus nerve stimulator.
• Antibiotics: Medicines that battle bacterial infections.
• SSRIs (Selective Serotonin Reuptake Inhibitors): A category of medication which might be usually used as antidepressants within the therapy 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 capability to battle off dangerous pathogens reminiscent of viruses.
• Optogenetics: A organic approach that includes the usage of gentle to regulate cells in residing tissue, usually neurons, which have been genetically modified to specific light-sensitive ion channels.

Key Ideas & Theories

• Polyvagal Concept: 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 Drugs: A discipline of medication that makes use of digital gadgets 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 free class of small proteins which might be vital in cell signaling.
• Cytokine Storm: A extreme immune response wherein 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 kind and reorganize synaptic connections, particularly in response to studying or expertise or following damage.
• Interoception: The sense of the interior state of the physique.
• Engram: A bodily hint of reminiscence within the mind.
• M1 and M2 Macrophages: Two various kinds 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 machine.
• Murthy Simhambhatla: The CEO of SetPoint Medical, a bioelectronic medication firm growing vagus nerve stimulation therapies.
• Dave Chernoff: The Chief Medical Officer of SetPoint Medical, overseeing scientific improvement 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 therapy for treatment-resistant despair utilizing accelerated TMS.
• Nora Volkow: Director of the Nationwide Institute on Drug Abuse (NIDA) who pioneered the usage of mind imaging to research habit as a mind dysfunction and is researching centered ultrasound therapies for habit therapy.
• 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 techniques and recognized particular vagal neuron subtypes that management respiratory and digestion in mice.
• Ok. Frank Austen: A number one knowledgeable on bronchial asthma analysis and respiratory medication.
• 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 writer with a background in ethnobotany who has written about his experiences with psychedelics together with LSD and integrative medication approaches.
• Ulf Andersson: A retired professor of pediatric rheumatology on the Karolinska Institute and pal of Dr. Tracey’s who used a TENS unit to deal with his personal inflammation-related despair.
• Paul Nogier: A French doctor who created the primary auricular acupuncture maps in 1957, pioneering fashionable ear acupuncture methods.
• 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 Drugs 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 Drugs in 1906.
• Asya Rolls: A professor who found that irritation within the colon can kind 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 medication 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 discipline of bioelectronic medication.
• Eric Chang: A colleague of Dr. Tracey’s on the Feinstein Institute for Medical Analysis, contributing to neuroscience and bioelectronics analysis.
• Martine Rothblatt: A pal of Dr. Tracey’s and CEO of United Therapeutics, she is a famend polymath who based SiriusXM satellite tv for pc radio earlier than coming into biotechnology to develop remedies for her daughter’s pulmonary hypertension, changing into the highest-paid feminine CEO in America.
• Lorimer Moseley: Co-author with David Butler of the e book 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 Drugs 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 non secular 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 another title, would scent as candy.

Establishments & Corporations

• SetPoint Medical: A commercial-stage medical expertise firm that developed the primary FDA-approved neuroimmune modulation machine 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, training, 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 US, answerable 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, dwelling to the Nobel Committee for Physiology or Drugs.
• Protection Superior Analysis Tasks Company (DARPA): A analysis and improvement company of the US Division of Protection answerable for growing rising applied sciences for navy use.
• Protection Language Institute: A United States Division of Protection instructional and analysis establishment that gives language coaching to navy personnel and federal staff.
• United Therapeutics: A biotechnology firm centered on creating progressive merchandise to handle the medical wants of sufferers with persistent 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 answerable 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 medication, science, and different fields of research.
• Pendulum: A science-backed biotechnology firm based by docs and scientists that produces next-generation probiotics, together with the one commercially obtainable reside Akkermansia complement.
• WHOOP: 24/7 monitoring throughout sleep, pressure, stress, and coronary heart well being.
• Oura Ring: A sensible ring that displays over 20 biometrics that instantly impression how you are feeling.
• Fitbit: Wearables designed to “maintain you near your objectives, enhance your motivation, and present your progress all through your well being and health journey.”

Related Analysis & Sources

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 machine 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 medication.
• [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: Unintentional discovering of brain-body irritation connection.
• [00:35:39] Bioelectronic medication 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 security of VNS vs. biologics in cytokine suppression.
• [00:56:27] Chilly publicity, meditation, and respiratory practices affecting the vagus nerve.
• [00:59:01] A population-level enhance in persistent inflammatory illnesses: Nature vs. nurture.
• [01:00:48] H. pylori: For when you possibly can’t blame stress, God, or the affected person for that nagging ulcer.
• [01:03:13] Stress, cortisol, and irritation connections.
• [01:05:42] SetPoint machine vs. non-invasive alternate 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 help 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 despair round with a TENS unit.
• [01:31:55] Coronary heart fee variability complexity and measurement challenges.
• [01:33:05] A respiratory train for instantly controlling coronary heart fee.
• [01:35:30] Utilizing a typical antacid as a pharmacological vagus nerve stimulator throughout COVID.
• [01:36:23] A name for extra inflammation-based despair analysis and affected person stratification.
• [01:39:52] SSRIs and anti inflammatory mechanisms in despair therapy.
• [01:42:20] Interoception: The physique’s inflammatory indicators reaching the mind by way of vagus nerve.
• [01:43:22] Ulf’s revealed 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 reminiscences 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 power meditation and vagus nerve pathways with the Dalai Lama.
• [02:16:47] Parting ideas: Severe medical circumstances vs. self-help approaches.

DR. KEVIN TRACEY QUOTES FROM THE INTERVIEW

“60 million folks 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 people who die yearly on the planet Earth die of these circumstances. And that’s in response to the WHO. These circumstances all have one factor in frequent — they’re both attributable to 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 obtained FDA approval. So there’ll be a product launch underway for every thing we’re about to speak about within the context of utilizing a medical machine 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 whenever you faucet these brakes to gradual your automobile barreling down the hill, this machine prompts what we name the inflammatory reflex.”

— Dr. Kevin Tracey

“If we will discover such nerves, then we will construct gadgets to regulate the nerves, and the gadgets turn out to be the remedy. The bioelectronic medication story works so long as the molecular mechanism, and that’s the place folks should be actually cautious with vagus nerve stimulation.”

— Dr. Kevin Tracey

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

— Dr. Kevin Tracey

“My adage for this factor is, whenever you don’t perceive a illness, consider epilepsy. You begin off, you blame God. So 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 whenever you notice it’s not the affected person’s fault, in at present’s period, oftentimes we discover out it’s really induced, there’s some infectious reason for 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

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, wherein we mentioned 70%–90% remission charges for treatment-resistant despair, mind stimulation for sports activities efficiency, accelerated TMS protocols, de-risking ibogaine for TBI/PTSD, the way forward for “electroceuticals,” and far more.