Having just been through covid myself and noticing some of the effects it has had, and is still having, on my health I couldn’t help observing just how many of my symptoms seem to relate to the vagus nerve (and some other important nerves, such as the trigeminal, but the vagus does seems to be a big player in the kind of symptoms now associated with “long covid”). I happen to be quite familiar with vagus nerve disruption, having experienced it for many years along the path of my chronic health journey (see my much earlier post which covers some of the extremely broad areas of health that might be impacted by a malfunctioning vagus nerve and ways of tackling this). This past couple of weeks dealing with covid and its aftermath have brought it right back into focus for me and here’s what I found.

Curious about whether there was a link with covid, I did some research and very quickly found that an association been covid symptoms and the vagus nerve has been discussed; in particular, there seems to be a suggestion that covid can actively damage the vagus nerve, at least in some individuals. Here’s what I found:

One study, entitled “Vagus nerve inflammation contributes to dysautonomia in COVID-19” discovered “the presence of SARS-CoV-2 RNA in the vagus nerve as well as vagus nerve inflammation and dysfunction are widespread in COVID-19. This is in line with large observational studies reporting dysautonomia as a common symptom of long COVID”.

An article in Forbes magazine entitled New Insights Into Long COVID Point To Damage To The Vagus Nerve, quoting from a study conducted by Llandos et al,  describes the typical symptoms of long covid as brain fog, difficulty breathing and fatigue and goes on to state “Emerging studies now suggest that many of these symptoms may be a consequence of damage to the vagus nerve. As the body’s primary communication superhighway, the vagus nerve extends into every major organ in the body, including the heart, lungs, and gastrointestinal tract. Injury to this nerve, therefore, can disrupt the systems we rely on to breath, digest, and simply function on a daily basis. Here, we will highlight recent insights gained from a team in Spain investigating the impact of COVID-19 infection on the vagus nerve”.

What researchers found was that in 20% of those reporting long covid symptoms, significant thickening (which may result from inflammatory damage) was found throughout parts of the vagus nerve that extend out from the neck and into the chest, which they speculate may be a consequence of direct viral infection as well as indirect damage from such robust activation of the immune system during the infection. Moreover, 40% of those with long covid also had observable flattening of the diaphragm, that all-important muscle at the base of the lungs that controls breathing; often associated with a measurable reduction in lung pressure (a possible cause of shortness of breath and light-headedness). They also found that, surprisingly, the rest of the lung tissue seemed to be fine, which would seem to suggest that respiratory symptoms are not due to lung damage but to this other factor with the diagram and disruption to the vagus nerve, which normally sends signals to the diagram telling it when to contract and expand but which, having gone awry, might not be signalling correctly any more.

Issues with breathing have been a long-standing foe of mine across all the years of chronic fatigue and POTs etc. but only subtly so through the worrying outcome of apparently not getting enough oxygen to my cells (I don’t generally feel breathless though I am a long-term shallow breather). Therefore, now I seem to have them in spade loads, this link back to the vagus nerve is interesting, alarming yet also reassuring if it means that my lungs are not damaged as such, though my nervous system certainly seems to be under attack. For days now, though I only had a very minor cough during the infection itself, my lungs have felt oddly asphyxiated, I feel frequently short of breath, occasionally light headed and generally oxygen starved, symptoms which are some of the worst I’ve had since the infection started (even though they only appeared after I had tested negative again). I find myself longing for the day I find I can take a full lung of air again without it feeling odd or like it is such a big effort.

The lungs aren’t the only organs to be affected by the performance prowess of the vagus nerve. In fact, typical symptoms that might occur if the vagus nerve becomes inflamed or starts misfiring are widespread and may include alterations to heart rate variability, changes in speech, difficulty swallowing and reduced mobility in the gastrointestinal tract, all of which effects were found to be considerable in the group affected by long covid in the study. In my own case, my heart began flipping out with odd arrhythmias and unpleasant palpitations in the very early stages of infection, which was one of the first things that alerted me to the fact something was wrong.

Because the vagus is the body’s longest nerve, running from the brain into the torso, heart, lungs, intestines and various muscles, including those involved in swallowing and breathing (as above) its effects can be far reaching and even bizarre-seeming when the effect seems quite disconnected from anything to do with the virus that apparently triggered these issues. Covid itself felt like a bad flu but why would flu affect digestion or swallowing? It would, of course, if the vagus nerve was affected. Why, for that matter, would it lead to the dysautonomic effects associated with long covid? As this description so elegantly puts it “As the vagus nerve is the primary sensory input and effector for the parasympathetic nervous system, its compromise has many long-ranging detrimental effects on human homeostasis and health. When the autonomic nervous system (ANS) balance becomes sympathetic dominant, a rise in the LF/HF ratio is seen on Heart Rate Variable parameters…affecting the precise balance between sympathetic and parasympathetic function—a condition known as dysautonomia”.

Since contracting covid myself, I have had severe acid reflux for the first concerted time in my life (having been lucky enough to avoid its horrible effects so far beforehand), although I have always had reduced gut motility. This new effect speaks to worsened issues with my digestive system moving food appropriately to the stomach. I have also experienced more gag reflex and choking episodes than my norm (I do experience these from time to time and they usually feel associated with my hypermobility issues), also IBS/bloating has been considerably worse; these are not things you would obviously associate with covid if you hadn’t experienced them for yourself.

I have also experienced terrible deafness and irritated ear canals, an intensely burning throat which comes and goes quite randomly (unlike a classic sore throat), the same crawling numb face sensations I used to experience in the past at times during a flare-up of worst chronic fatigue symptoms and an incessantly stuffy nose (although my nose is not actually blocked with anything), a phenomenon I have now learned is called empty nose syndrome and may relate to misfiring of the trigeminal nerve. I have just read from an expert writing an article on this topic “When you have this trigeminal nerve irritation you can get, for lack of a better word, weird swishing, a “creepy-crawlies” sensation in the face, burning in the throat, burning in the inner ear, problems with sinus and ear drainage, and the problems of Empty Nose Syndrome”.   

I also seem to be experiencing much worsened cervical instability than my usual (this being a usual side effect of my hypermobilty, something which can further aggravate nerves in the neck such as the trigeminal and occipital, though I had got this well under control until now) with severe pain and nerve entrapment sensations in my neck down to my currently frozen shoulder blade and its as though I can no longer support the weight of my own head without pain. I am reading on forums and in studies such as this one that increased inflammation in the cervical spine region can set off a “cascade” of effects that may lead to “cervical spinal instability”.  A study aimed at filling the gap in information about a rare but nonetheless reported effect of covid entitled “Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19” dives into this topic.

So it seems, subluxation is a known cause of vagus nerve damage or compression and may be another angle for looking at this phenomenon of vagus malfunction after covid, or perhaps (the other way around) inflammation of the vagus is what triggers subluxation…either way, there seems to be a link. I would certainly say my vagus symptoms (such as breathing and digestion issues) occurred after I had first noticed I was experiencing nerve issues in the earlier stages of the virus (the very first red flag that I had covid was that I had severe widespread neuropathy issues). Compression of the neck can cause arterial ischemia (inadequate blood flow to the brain) leading to dizziness or lightheadedness or the kind associated with POTs, brain fog, and other weird and unpleasant “brain” symptoms (more on these below). I can only assume that compression or inflammation of the vagus and other nerves may also set off a cascade of other neuropathic anomalies.

Hydration issues seem to be abounding in my case, either because I have the kind of thirst you can’t seem to quench or I’m frequently overriding the need to drink because of brain fog (I zone out so much I forget to take care of even my most basic needs…) or because I am struggling to reach for my water glass due to cervical pain. The vagus nerve is what sends signals from the gut to the brain, signalling the need to drink and mine seems to be either all on or all off at the moment but the generalised state of dehydration that has resulted won’t be helping my situation at all. To try and address this, I have also been making sure to add electrolytes to my water at least twice a day as a boost.

Malfunctioning muscles and other soft tissues are kind-of my thing, having fibromyalgia and underlying hypermobility issues, however these effects seem to be extremely severe at the moment and I have been mostly rigid with the pain of inappropriately contacted muscles for days now. Plenty of magnesium and GABA support can definitely help with this.  Rigidity of the muscles not only affects arms and legs but also digestion and breathing, as tackled above, so doing what you can to relax all of the muscles just enough to function properly is a step in the right direction (though too much supplemental support can go the other way…) As the function of the vagus nerve is to stimulate smooth muscle contraction and glandular secretions in the organs, this kind of issue, where it all seems to have gone awry, can likely be traced back to the same source.

I’ve also been having toothache and extreme tooth sensitivity along every row of teeth so either all my teeth need drilling at once or this is yet another nerve issue (a type of neuropathy) triggered by the virus. The vagus nerve has a branch that connects to the trigeminal nerve so when the vagus nerve is stimulated, it can activate the trigeminal nerve and cause pain in the teeth or jaw. The vagus nerve also plays a role in regulating blood flow to the head and face so, when activated, can cause blood vessels in the head and face to dilate or constrict, leading to changes in flow that can cause pain in the teeth or jaw. A study into covid as a potential cause of toothache determined that “tooth pain can occur due to direct damage caused by the virus on the central nervous system, leading to the feeling of tooth discomfort in a particular non-previously damaged tooth” or “might be caused by the same neurological dysfunction causing the other common symptoms in Covid-19 patients (like olfactory and gustatory dysfunction)”. I am hoping, very much, that this subset of symptoms settles down before too long…

However, the biggest effects have been to do with awful brain fog and a frequent feeling of spaceyness, significantly increased ringing in the ears, aching of the eye muscles and impaired vision, intense vascular headaches and much increased general neuropathy around the body. I close my eyes and am able to drift off into a dreamlike state almost instantly at the moment, such is my lack of mental groundedness at present (the effort it has taken to write this post has been tremendous but the activity has helped me to stay focused and awake for at least the morning part of the day). There is a persistent feeling of oddness to my head as though blood flow is impaired or something else not quite right since the virus passed through and this is my least favourite outcome of all as I feel constantly out of sorts and brain-impaired, as though I have taken some sort of sedative. Worse is a feeling of being generally “off”, as though I am profoundly aware that something is awry but can’t quite put my finger on it. Perhaps this is because, according to this article, “The vagus nerve is our sixth sense and our “gut feeling.” Since the vagus nerve meanders and extends its branches to multiple tissues and organs, its role in health must be immense. It regulates homeostasis by connecting three interwoven systems: the nervous, endocrine, and immune systems…The exchange of information between the nervous, endocrine, and immune systems plays an important role in various physiological, as well as pathological, processes.” The vagus nerve is deeply involved in our moods so when it goes awry, there is no telling how impactful this might be to our overall state of balance or wellbeing.

What is worst, at least for me, is that I oh so vividly remember feeling like this in the very early days of fibromyalgia and chronic fatigue syndrome, during those long amorphous days when I would space out for hours on end, too fatigued to do anything except notice how peculiar I felt, or have such odd sensations in my head when I was out doing parental duties that it was as though I had popped a pill with peculiar side-effects. These effects were an ongoing state of unpleasantness that I struggled to even find the words for when I tried to recruit medical help except that I felt poisoned or tampered with somehow, so I am really not happy to welcome this back.

All of these issues could possibly be traced back to the vagus nerve and/or inflammation of the trigeminal nerve interfering with blood flow or sensory feedback and the passing of crucial messages between different parts of the autonomic system. I can now well appreciate how so many people have been badly affected by long covid and just how detrimental it can be to their lives; I also have no wish to join them so I am quite determined to pool all the resources I have from my many years of living with chronic conditions in order to do my very best to recover quickly, before any of this becomes the next version of “chronic”.

The good news is studies such as those I have linked to show that the vagus nerve might be a worthy therapeutic target for those suffering with long covid (or other post-viral illness, as my original illness was). There are various high-tech approaches and interventions (using versions of electrical stimulation) to be found out there but if none of these approaches are readily available to you then its worth noting that simple daily exercises such as laughing, gargling and singing can help recover the vagus nerve. Bear in mind, in the interests of recovery, that the vagus will lap up positive stimulation…being the kind I often advocate in my posts…but is likely to be adversely impacted by negative stimulation if is already feeling under the weather, so the need to cherry-pick what you are exposed to becomes paramount in the post-covid state and I would say, don’t go back to work or whatever the main source of stress too early for your body to recover from it; you need to somehow make the appropriate time for recovery to occur in its own way or pay the price and that length of time will vary from person to person.

So, I’ve got to ask, am I more susceptible to the vagus nerve taking “the hit” when I pick up something like a virus; are some of us more vulnerable than others (there’s certainly a known link between autism or ADHD and low vagal tone, its why we sometimes struggle to adapt to changes)? I clearly have track record here and so, yes, I’ve languished in these kind of symptoms before, last time lasting for years before I found my way out to a better place…but then I had no experience of it before I was suddenly hit the first time, nor did I feel like I had a choice at the time except to try and push my way through the worse symptoms and hope for the best. This time, I have all those hard-won resources to draw on, am much more familiar with my particular strengths and limitations and I also know far better!

Taking care of basic things like sipping plenty of water throughout the day, maintaining the right body temperature (bearing in mind my thermostat is all over the place, I need to actively intervene with this at the moment, especially to avoid undue muscle contractions if I get cold) and eating the right foods in the most manageable portions for my struggling gut motility will help me get through this phase without too many unwanted side-effects as will stress management and the adoption of the best practices I can muster, such as mindfulness and deep breathing, to support and recalibrate my sympathetic nervous system. I have to consider this to be the flare-up of all flare-ups and thus urgently pool all my resources, right now, to ensure I am taking the best possible care of myself for as long as it takes to come out the other side.

Making extra big effort to avoid aggravating cervical instability by keeping neck, upper back and head warm at all times, using scarves or a support as necessary, vigorously avoiding poor posture or hanging my head over devices and avoiding time spent upright without good support is another angle I intend to take (bearing in mind that, even at times when I feel “alright”, I might still need increased neck protection and support for some time ahead, at least until I am fully on the mend from this nerve-aggravating virus). ADDED NOTE: A few weeks later, I’ve found I need to wear a neck support every day (opted for a softer velcro-nylon support rather than a full-blown collar so that I am more inclined to use it) and only wish I had started doing this straight after covid as ongoing neck issues are really trying hard to mess with my vagus nerve). A big one, I have to keep my neck, shoulder and head area warm at all times including overnight (yes, hat and scarf if likely to get even slightly chilly at 3am as this makes a huge difference to outcomes next day). Sleeping posture is crucial when I’m this vulnerable and pillows have to be just right to prevent compression of nerves. Heavy, or even light, lifting or over exertion are completely out of the question with subluxation risks on the increase and chronic fatigue in the wings, especially as someone prone to these anyway. A bit like the tortoise in the race with the hare, I suspect that taking what seems like the slower route to returning to “normal” right now will save me time in the long run. In other words, its time for a kid-glove lifestyle, at least for a while and in the interests of not dragging the effects of this virus on any longer than I have to!

MUST READ RELATED ARTICLE explaining how interference of vagus nerve due to cranial instability has such far reaching effects

Disclaimer: This blog, it’s content and any material linked to it are presented for autobiographical, general interest and anecdotal purposes only. They are not a substitute for medical advice, diagnosis, treatment, or prescribing. Opinions are my own based on personal experience. Please seek medical advice from a professional if you are experiencing any symptoms that concern you.