“My name is Andrea Parker and I’m an occupational therapist living with ME/CFS. For those who don’t know me, I ran a project evaluating the outcomes of transcutaneous vagus nerve stimulation (tVNS) for people with ME/CFS in 2019 using the Parasym device. I understand that there are some common side-effects that keep cropping up on this Facebook group, which I have some thoughts on. Please note that this is general information rather than medical advice for you personally. Please seek medical advice prior to attempting tVNS, and if you are experiencing any side-effects.

 

Several people are commenting on experiencing anxiety, agitation or becoming more emotional in response to vagus nerve stimulation. I believe this may potentially be explained using the Polyvagal Theory.

 

The Polyvagal Theory explains the way the autonomic nervous system functions. This is the system that we are treating using tVNS. If you don’t know about the theory this next bit won’t make sense. So I’d encourage you to watch my brief 15 minute video which explains this… https://www.youtube.com/watch?v=WGBXKQgg9tU

 

People with ME/CFS and other conditions that have a dysregulated autonomic nervous system (such as PTSD) may be in a more dorsal-vagally dominated state (aka “red zone”). This is a state of shut-down, immobilisation and for some this can feel quite numb emotionally.

 

As we stimulate the vagus nerve, we are endeavouring to bring the ventral vagus (aka “green zone”) back online. We know this system is functioning poorly in ME/CFS. So by stimulating it, we may effectively firing it up. In doing so, this may bring back balance into the autonomic nervous system, moving us into a state of improved overall health (homeostasis).

 

However, we can’t go straight from the red zone to the green zone. According to the Polyvagal Theory, we need to move through the sympathetic mobilisation zone (aka “orange zone”) to get to the green zone because the zones work in order. This looks different for different people. However, it may lead to increases in agitation, anxiety, and a reconnection with emotions that were previously numb. So the healing process can get a bit messy.

 

If you’re feeling a bit “off” with your VNS, this may be a contributing factor. Suggestions I have for this:

– Start on a brief session of 5 minutes, then gradually build up.

– Although a short session might only be tolerable to begin with, based on my own experience and feedback from others, the anxiety-reducing benefits of VNS tend to kick in after 15-20 minutes.

– A setting of 20Hz/200us may potentially be more calming that 30Hz/200us because lower hertz is associated with a calmer brain wave state. This is theoretical though, and we really need more research on effects of different frequency settings. Many people are fine on 30Hz.

– Reach out to supportive friends/family or seek professional support to help manage any emotions that may emerge.

– As stated before, please consult your doctor regarding any side-effects.

 

There could of course be other factors leading to side-effects. For information about potential risks and contraindications please refer to the Parasym manual. https://www.manualslib.com/…/1710627/Parasym-Parasym.html

 

For those who are wondering, the Parasym is just a TENS machine with a tragus clip. Electricity is electricity so provided you have setup your TENS device correctly and it is accurate, you should get the same effect. The risk of course with setting up your own device is that errors can be made in setup. The other risk in DIY setup is that you haven’t had an assessment from Parasym to determine your suitability for this therapy. It is a relatively low-risk therapy. However, I would strongly recommend you consult your doctor and read the Parasym manual prior to undertaking this therapy for yourself as it is not suitable for everyone.”