Alyssa Luck

Vagus Nerve Stimulation for IBD

Alyssa Luck · Jan 27, 2022 · Leave a Comment

Summary: Vagus nerve stimulation is an up-and-coming intervention for chronic inflammatory disorders including IBD. Clinically, it involves electrical stimulation of the vagus nerve through implanted or external devices, but natural methods such as yoga, meditation, and specific breathing practices have also been shown to increase vagal tone. Research in both animals and humans indicates that stimulation of the vagus nerve is able to reduce inflammation via various neural and hormonal pathways, with similar targets to popular pharmacological IBD treatments. Clinically, this is an exciting new treatment that is actively being researched; practically, vagus nerve stimulation via natural methods provides a safe way to reduce inflammation and improve health.

This article is part of the IBD Index. Last updated on January 27, 2022.

Vagus nerve stimulation is an ongoing area of research and experimentation for me. If you want to follow along on my personal journey, follow me on Instagram! Eventually, I will update and expand this post as well.

Table of Contents
What is vagus nerve stimulation?
What is the vagus nerve?
What’s the science behind vagus nerve stimulation for IBD?
        Activation of the HPA axis
        Cholinergic anti-inflammatory pathway
        Activation of sympathetic anti-inflammatory pathways
Is there clinical evidence for vagus nerve stimulation in IBD?
Are there any risks to vagus nerve stimulation?
How can I increase vagal tone at home?
        Mind-body disciplines: yoga, tai chi, qigong, meditation
        Left-nostril breathing
        Other possible interventions
Review of the literature
Technical details of clinical vagus nerve stimulation

What is Vagus Nerve Stimulation?

In the clinical research setting, vagus nerve stimulation (VNS) refers to stimulation of the vagus nerve via electrical impulses. This can be done either invasively, via a surgical implant, or noninvasively, via electrodes stuck to the skin in the ear. (For technical details, check out this section at the bottom of this article.)

VNS has been approved by the FDA for the treatment of drug‐resistant epilepsy and depression, and interest is building for its application in the treatment of chronic inflammatory disorders such as rheumatoid arthritis (and of course, IBD). VNS is not yet available as a clinical treatment for IBD, but two small trials have been conducted in patients with Crohn’s Disease (CD), and two more trials are underway.

Outside of clinical research, talk of stimulating the vagus nerve typically refers to at-home practices that naturally stimulate the vagus nerve, including things like deep breathing and meditation. More on these techniques below!

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Quitting Controlled-Arch Braces [AGGA 2.5-year update]

Alyssa Luck · Jan 11, 2022 · Leave a Comment

Hi friends! Today I bring you the news that after 1.5 years in controlled-arch braces (CAB), and over 2.5 years since beginning my AGGA journey, I have decided to quit CAB.

It’s not quite as dramatic as it sounds – I do have to finish up treatment somehow, after all – but this decision did come about in concert with a decline in confidence with the CAB process in general, so I want to share my rationale and current thoughts.

If you’d rather watch/listen to my updates, you can check out the two videos at the bottom of the post. (As a reminder, I do try to post updates to YouTube regularly, and I’m usually a bit delayed posting them to the blog, so subscribe on YouTube if you want to see updates right away.) I also linked all my AGGA update posts/videos to date at the bottom of this post.

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CBCT Results: An Update on Implants [AGGA/CAB Update]

Alyssa Luck · Sep 3, 2021 · 2 Comments

Hey friends! Latest AGGA/CAB video update is up on YouTube, and as promised, below is a snapshot from my CBCT scan.

First, to summarize the video: this was supposed to be the appointment where my dentist showed me my CBCT results, told me that I had plenty of space and bone for implants (as expected), and referred me to the implant dentist for an initial consultation and to get on the books.

INSTEAD, he told me that despite having 7mm gaps in my mouth, I do not have 7mm gaps between the roots below the surface, which means not enough room for implants.

This was a huge bomb drop, since we’d been aligned from the beginning that the plan was to do implants, and he never once had any doubts that that would be possible for me. Up until he looked at the CBCT.

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AGGA/Controlled Arch Braces Progress Update (13 months in braces, 26 months total)

Alyssa Luck · Aug 9, 2021 · Leave a Comment

Monthly video update below!

I did ask my dentist about the concerns I expressed in my last update, and he was very reassuring. I share more details in the video, but he said that the regression I noticed is likely tooth tipping, and that will be corrected (ie my teeth will be tipped outward again) before I get my braces off. He also said my bite will certainly be corrected using rubber bands before getting my braces off. Was still a bit confused about the spacers, but he seemed confident and not concerned, so I’m just going to trust him!

AGGA/Controlled Arch Braces Progress Update (12 months in braces, 25 months total)

Alyssa Luck · Jul 13, 2021 · Leave a Comment

Hi friends! Posted another video update on YouTube (see below).

Cliff notes: Things are still going smoothly, although I do have a couple concerns that I plan to raise with my dentist at my next appointment.

First, I’m worried that I’ve lost some of my forward growth during the braces phase, but I’m hoping it’s just a matter of tooth tipping (which can be corrected) and not true growth loss.

Second, I need to confirm his plans to fix my occlusion. At my last appointment, they put spacers between my bottom molars to “encourage the teeth to erupt until the bite is closed.” But that seems like a strange thing to do when I still have bite pads on the left. Why would you use spacers to prompt teeth to settle into an uneven bite? Wouldn’t it make sense to remove the bite pads, THEN use spacers??

Not a huge deal either way (they can always put in spacers again), but it definitely triggered my paranoia/trust issues. I’ll keep you guys posted!

Akkermansia Muciniphila: Bane or Boon for IBD?

Alyssa Luck · Mar 21, 2021 · Leave a Comment

Summary: Akkermansia muciniphila is a commensal bacteria found in healthy human colons that is widely regarded as a promising next-generation probiotic. Researchers have mainly focused on therapeutic potential for obesity and diabetes, but there’s also substantial interest in the field of IBD, particularly for its beneficial effects on gut barrier function. However, a minority of researchers have suggested that Akkermansia muciniphila could worsen colitis. Despite that, most of the evidence thus far suggests that A. muciniphila could potentially be leveraged as a beneficial therapy for IBD and gut health in general once more research has been done.

This post is part of the IBD Index.

Lactobacillus and Bifidobacteria species may still be the darlings of the probiotic world, but there’s a new kid on the block: Akkermansia muciniphila.

This bacteria was isolated for the first time in 2004 (1) so it’s still relatively new to the game, but you can see from this fun trend analysis (2) that research has exploded, especially in the last couple years.

Source: Hojat et al., Global scientific output trend for *Akkermansia muciniphila* research: a bibliometric and scientometric analysis, 2020

So what is Akkermansia muciniphila, and why the interest all of a sudden?

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Mouse Models of Ulcerative Colitis: What Can They Really Tell Us?

Alyssa Luck · Mar 21, 2021 · Leave a Comment

Summary: Animal models of colitis are invaluable to ulcerative colitis (and more broadly, IBD) research, both in helping to elucidate potential disease mechanisms and in the process of testing and approving new therapies. A huge variety of mouse models of colitis have been developed, but they can be grouped into just a few categories based on the mechanism of disease induction, and a small handful of models are the most widely used by far.

Despite the importance of these models, no animal model yet exists that is an accurate mimic of human ulcerative colitis, and therefore each particular model and its limitations must be taken into account both when deciding which model to use and when drawing conclusions based on the findings.

This article is linked in the IBD Index as a special topic. Last updated on April 20, 2022.

Much of what we know about the etiology of ulcerative colitis (UC) comes from animal research, and we owe all of our current UC therapies to the intensive drug-approval process that begins with preclinical animal studies.

Models of colitis have been developed for many different lab animals from fruit flies (really) to pigs, but since mouse models are by far the most common, we’ll focus on those.

A semantic note: If you read any UC research in mice, you’ll notice that the term “ulcerative colitis” isn’t used to describe what’s happening in the mice; the more general term “colitis” is used instead. That’s because while the mice are exhibiting inflammation of the colon (ie, colitis), it’s not accurate to liken it to human ulcerative colitis. So yes, the title of this article is a bit of a misnomer. More on this below.

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Can Chewing on One Side Cause Facial Asymmetry?

Alyssa Luck · Mar 18, 2021 · 4 Comments

Hi! I recorded a video (below) musing on this topic, and thought I’d give you all a text version as well, both because I’m not very concise on video and so you can see the alien face pics a bit better (ha).

I recently tried one of those “face symmetry” apps where it takes a picture of your face and shows you what it would look like if it were perfectly symmetrical, either using the right or the left side. This really highlights any facial asymmetries you might have, and I found my results super interesting (for a few reasons), so wanted to share!

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AGGA/Controlled Arch Braces Progress Update (9 months in braces, 22 months total)

Alyssa Luck · Mar 16, 2021 · 2 Comments

Just a quick progress update after my last ortho appt. Also – I really struggle with how to name these videos…please excuse the absurdly long title.

Tl;dw (too long didn’t watch…that’s a thing right?): everything is good, premolars are almost all the way forward (left one is, right one still has a tiny gap). Next they’re gonna put me in a new wire, tweak aesthetics/occlusion, then do a CBCT scan to prepare for implants, do implants, then after they settle pull the molars forward.

Controlled arch braces progress + timeline update

Alyssa Luck · Feb 5, 2021 · 2 Comments

Just a quick update here at the 7-month mark of my controlled arch braces! Showed progress with the premolars moving forward, and talked about next steps/timeline updates. Spoiler: I’ll probably have braces until the end of this year. Probably implants by early summer, but then several additional months for them to settle and to tweak my occlusion.