CHARGING YOUR AUTONOMIC BATTERY

Jan D. Huizinga and Jihong Chen

https://www.friesenpress.com/blog/2022/8/9/8-steps-to-prep-your-manuscript-for-
professional-editing

Table of Contents
Introduction to the book........................................................................................................................................3

PART 1 THE CONCEPT......................................................................................................................................4

Terms and abbreviations.......................................................................................................................................4

The autonomic nervous system.............................................................................................................................4

Autonomic tone and autonomic reactivity........................................................................................................5

The autonomic battery, the concept.....................................................................................................................5

Where is the autonomic battery in the body........................................................................................................6

The good, the bad and the ugly of sympathetic activity.....................................................................................7

What is draining your battery?............................................................................................................................8

Chronic stress.....................................................................................................................................................9
A sedentary lifestyle............................................................................................................................................9
Superficial breathing...........................................................................................................................................9
Patient #1........................................................................................................................................................9

Charging your battery.........................................................................................................................................10

By sleeping well................................................................................................................................................10
By physical activity...........................................................................................................................................10
By breathing well..............................................................................................................................................10
By doing relaxation..........................................................................................................................................11
By taking enteric-coated peppermint oil..........................................................................................................11
By intermittant fasting.....................................................................................................................................11
Respiratory therapy...........................................................................................................................................12
HRV biofeedback...............................................................................................................................................12

How did the autonomic battery develop in the human body?.........................................................................12

Other conditions that are related to sympathetic over-excitation...................................................................13

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Idiopathic intracranial hypertension..................................................................................................................13

PART II THE DIFFERENT ORGANS AFFECTED BY THE ANS..............................................................14

PART III MEASURING IT................................................................................................................................14

Can we measure the health of our autonomic battery?....................................................................................14

Can we measure the strength of the drainforce?............................................................................................15

What is heart rate variability..............................................................................................................................15

The parameters of HRV......................................................................................................................................16

What is breathing frequency power...................................................................................................................16

You have been diagnosed with autonomic imbalance, what to do now..........................................................16

PART II: THE SCIENTIFIC EVIDENCE........................................................................................................16

Detailed outlines and evidence for treatment of autonomic dysfunction........................................................16

Deep breathing.................................................................................................................................................17
Peppermint........................................................................................................................................................17
Meditation.........................................................................................................................................................18
Exercise............................................................................................................................................................18
Intermittent fasting...........................................................................................................................................18

Detailed discussion on heart rate variability parameters.................................................................................21

References.............................................................................................................................................................22

Further reading....................................................................................................................................................22

Introduction to the book

The idea for the book came from working with Dr. Jihong Chen to help her patients get the
right diagnosis and for us to understand the pathophysiology. We became convinced that the
best way to approach this was through the concept of autonomic dysfunction. It took us years
to fully appreciate all aspects of this concept ourselves, and we are still learning. Then, we
spent years explaining the concepts to students and patients. Many patients told us that our
explanations were the first time they understood what was happening in their bodies. Many
students had difficulty understanding, which led us to realize that we needed a vehicle to
explain. Having discovered that vehicle cemented the idea to write a book.

2
 Jihong's patients suffer chronically from gastrointestinal problems, constipation,
incontinence, nausea, vomiting, bloating, and pain after eating... However, the book is not
intended to focus only on these patients. I have not yet decided if I should focus on the
problems these patients have or make it more general.
The audience will be anyone who has a chronic disease, anyone who cares for someone with
a chronic disease, and anyone who wants to prevent getting a chronic disease. It is also for
physicians to explain concepts to their patients.

https://www.chenhuizingalab.com/

PART 1 THE CONCEPT

Terms and abbreviations

The autonomic nervous system

Your autonomic nervous system is a constellation of nerves throughout the body that makes
everything possible that happens automatically, such as breathing, having a normal heart rate,
and digestion. Because your autonomic nervous system is important for almost all body
functions, you have to take care of it, because when it starts to malfunction, your quality of
life goes down and you might get into serious trouble.. The autonomic nervous system
contains three types of nerves, sensory nerves, parasympathetic nerves and sympathetic
nerves.
The sensory nerves monitor the state of every organ function, they tell the brain what
is needed. The sensory nerves notice that you start running, which makes the sympathetic
nervous system become active. The sensory nerves notice that you start to fill your stomach,
and consequently, the parasympathetic nerves start to activate the stomach muscles to mix
and grind your food. The sensory nerves notice that your oxygen levels xxx. Whatever the
sensory nerves notice, the sympathetic or parasympathetic nerves become active, and they do
whatever is needed to fulfill the task and when the task is done, to bring the body back to its
resting state.
Parasympathetic nerves generated contractions in the stomach to digest food, they
evoke contractions in the large intestine to move stool into the rectum, they facilitate
defecation and urination, etc. Some of these nerves are well known; the parasympathetic
nerves that regulate sensation and actions within the stomach are bundled together in a single
nerve called the vagus.
The sympathetic nervous system maintains blood pressure, contracts the sphincters in
the gastrointestinal tract .... it keeps your skeletal muscles in good shape when you are busy
putting 4x4’s up to construct a wall in a house.
The parasympathetic and sympathetic systems work in harmony; when the intestine
needs more time to digest, the sympathetic nervous system relaxes the musculature, to
prevent fast movement of content through the gut. When we work in the garden, we need an
active sympathetic nervous system that increases heart rate and respiration and inhibits
digestion, so that energy is fully utilized to do the gardening.

3
Autonomic nervous system and homeostasis

In a healthy person, the SNS and PNS work in harmony to provide a healthy state of being,
we also called this homeostasis. Homeostasis does not mean that all systems are in a fixed,
stable condition. It means that when change occurs, such as running, eating, doing an exam,
or snow shoveling, the body acts and when the act is done, it goes back to a normal resting
state and builds up reserves, such that when we need to do stuff again, we are ready.

Autonomic tone and autonomic reactivity

The autonomic nervous system is always active, always monitoring and always
adjusting body functioning to keep all homeostatic mechanisms in optimal condition. The
condition of the autonomic nervous system when in a total relaxation condition is defined
here as the autonomic tone. The major function of the autonomic nervous system is to react to
a changing status of an organ for whatever reason and to bring it bac to its most optimal
resting state. Hence measuring autonomic reactivity is an essential part of understanding
autonomic functioning.

The autonomic battery, the concept

The parasympathetic nervous system gives you a normal heart rate, it orchestrates normal
digestive function, it gives you normal breathing. These are all functions that are critical to be
taken care of throughout the day and night. Hence, there has to be a store of energy that
makes this all possible. And since we are not wired to an outside energy source, there has to
be a battery within the body. For the autonomic nervous system to work well, you must have
a fully charged autonomic battery, just like your car only works well with a good battery. The
fully charged autonomic battery is full of parasympathetic juice. Parasympathetic juice gives
you normal blood pressure, makes the stomach work to digest your food, makes your large
intestine work to have normal bowel movements, it makes you breath normally under diverse
condtions, and makes you have a good night's sleep. But batteries can drain. The same goes
for our autonomic battery. It is connected by wires (nerves) to all body organs. Take your
stomach. When you take in a meal, nutrients in your meal, and the stretching of the stomach
to accommodate the meal, activate the battery to start the digestion process. It starts stomach
contractions and secretion of acid and enzymes to digest food particles, making nutrients
ready to be absorbed in the bloodstream.

A drained battery gives you hypertension, constipation, pain after eating, not sleeping well.
So, what drains your autonomic battery? It is drained by sympathetic activity, just as your
car battery drains when you leave the car lights on. Nothing wrong with the car lights, they
are essential for driving in the dark. Just don’t leave them on when you park the car in the
garage. Nothing wrong with your sympathetic activity during running and extensive mental
work, just don’t let it be used by things that chronically deplete your battery.

Where is the autonomic battery in the body.

The battery is the vast network of parasympathetic nerves in the body. The vagus is part of it.
The vagus has back and forth communication with xxx. Google “vagus images,” and you see

4
the entire body depicted in its various components. Another major system is the sacral
parasympathetic nerves originating in the sacral parasympathetic ganglia (?) that innervates
and gets information from the lower gut, the urinary tract and the sexual organs.

The parasympathetic nervous system is always charged in a healthy body, actively doing
many things in the background, and ready to do important things when it gets a stimulus. The
battery is connected to the heart and to all body organs. Its connection to the heart shows us
that it is always active. Our heart rate is determined by about 500 pacemaker cells located in
the heart's sinus-node musculature. The pacemaker cells drive the heart rate without the need
for nerves. The battery is connected to these pacemaker cells of the heart and charging them
throughout the day and night. The pacemaker cells make the heartbeat at about 120 beats per
minute in a young adult, but the battery slows the heart to about 60-70 beats per minute. So,
if you feel your pulse at 60 beats per minute, you can feel the battery at work.

Breathing, the workings of the lungs, is under constant surveillance and adjustment executed
by the parasympathetic nervous system, the vagus. It monitors the composition of air so that
the lungs can optimally extract oxygen and can prevent particles like dust from interfering
(Mazzone & Undem, 2016). Coughing is an autonomic reflex triggered by the vagus to
remove particles from the lungs. We will breathe faster if oxygen levels are low in the air, as
when we are high up in the mountains. So, to keep breathing optimally under a wide variety
of circumstances, we need the parasympathetic nervous system. We need the battery juiced
up.

The sensory nerves within the vagus nerve

The battery in your car is connected by wires to the light bulbs, the heater, the turn signals,
the sunroof and so on.

A fully charged battery means that the parasympathetic nervous system is in a state of high
activity. This will be reflected in the activity of the mitochondria in the cell bodies and motor
ends to generate healthy ATP levels. It will be reflected in abundant sodium ion channels to
allow nerve action potentials to be generated which are the means of communication between
nerves and their targets. It will be reflected in a healthy state of ongoing activity of the
endoplasmic reticulum to communicate and synthesize proteins in communication with the
cell's DNA.

Let us look at the example of the skeletal muscle in your legs. There is ongoing activity in
skeletal muscle just like in nerves. All these processes within the skeletal muscle are kept
active by movement. By using the skeletal muscle. If we do not use them, for example by
being forced to lie in bed for a month due to being in a coma or after a very serious surgery,
our skeletal muscle becomes weak, even atrophies and it will take time and effort to get them
back to normal again.

The good, the bad and the ugly of sympathetic activity.

Sympathetic activity is essential for our normal functioning. When you walk or run, the
sympathetic nerves become very active. These nerves release the chemical noradrenaline onto

5
skeletal muscle fibers where they act on a receptor. This allows calcium to go into the muscle
fibres to cause contraction. Noradrenaline also increases blood flow to the muscle and
promotes the breakdown of glycogen into glucose to provide energy for contraction.

The sympathetic nervous system allows one to compete at the chess olympics. The
excitement and anticipation promotes blood flow into the brain. It increases alertness and
promotes mental clarity and performance. There is a cluster of nerve cells in the brainstem i
that is regulating alertness. Sympathetic nerves go into this cluster, release noradrenaline and
activate the cluster when we try to concentrate on a mental task. Noradrenaline is said to
promote the good stress, sometimes called “eustress” (Bienertova-Vasku et al., 2020). But
there may be nothing fundamentally different between good stress and bad stress; the best
way to clarify these concepts is to understand the different roles of the sympathetic nervous
system in body actions and body maintenance as we do in this book.

When you are an Inuit hunter, and you unexpectedly encounter a polar bear, all your senses
go into high alert mode. It is an autonomic reaction, activating your sympathetic nervous
system upon seeing the polar bear. In high alert mode, your body prepares you for the things
you need to do by energizing xxx

Sympathetic activity becomes counterproductive when it sneaks up on you in a chronic

manner, when it builds up slowly, and it won’t go away. Short-term sympathetic activity, like
walking, is like driving; yes, it uses a lot of battery power, but it charges the battery at the
same time. The sneaky stuff, like leaving your lights on when the car is not driving, that
drains the battery. Chess playing may not charge your battery, so you are better off walking a
few blocks between chess matches and getting a good night’s sleep. This is not just for
relaxation, you truly need to bring your parasympathetic nervous system back to normal.

What is draining your battery?

In the first years after I immigrated to Canada, I used to drive old cars because that is what I
could afford. I was constantly aware of the possibility that my battery would die, again. Then
I had to call a friend or the CAA to kick-start my car, and I had to drive the car for 20
minutes to charge the battery. For us to avoid a drained battery, we have to charge it. If you
do not charge it, it will drain empty. In your body, lights are always on, the parasympathetic
nervous system is active all the time. If you sit in your car, have the CD player on, and heat
up the car to keep warm but don’t drive, your battery will soon be dead, and you will have to
call somewhat to get the thing started again. If you do all the things that slowly drain your
autonomic battery but do not charge it, things will go wrong. There is no other way.

You might say: why do I have to think about this? Why does the charging not happen
automatically? Here we have to go back again to the millions of years the autonomic nervous
system developed. When we needed to hunt and gather to find food, when we needed to be
constantly aware of dangers, the charging did happen automatically. Because we were
physically active all day. But when we adopt a lifestyle that does not allow the charging, then
we have to think about it to stay healthy. Here are some of the phenomena that drain your
battery.

Chronic stress. We all know that stress can be good. If you have to prepare for something
important, stress will keep you focussed, it will tell you not to go out with friends but to

6
prepare! But if you constantly worry about bad things that might never happen, you tell your
body that it should keep itself in an alert state; and how does the body do that? It activates the
sympathetic nervous system, but it does not charge your battery at the same time, so slowly
but surely the battery drains. We can measure this as a high Stress Index, as we saw in patient
XXX and as we will discuss in the section XXX..

A sedentary lifestyle. A sedentary lifestyle is sitting on your bum for hours on end. We
already said that you have to charge your battery. Walking and exercising (or working in the
garden or renovating your house, or doing the dishes, or cleaning up your grandmothers
room) are the best ways. So naturally, if you sit on your bum the whole day, it is like not
driving your car but using its radio to keep you entertained. It won’t work, the battery will
soon be dead. Why is walking so important. This is simple. The battery system in your body
was developed over millions of years. During all those years, man and women had no choice
but to walk. They walked to find food and shelter. There was no other way. So over those
millions of years, walking charged the battery. That is how the body system developed and it
worked well. And that is how it still works. So, we can say, I do not feel like walking. Well,
you cannot change how your body works, so you will have to live with the consequences. Of
course, if you cannot walk, if you are confined to a wheelchair, you have to figure out
different ways to charge your battery. You have to exercise with your upper body. That
works too.

Superficial breathing

Patient #1 (real data!) MiBu

This patient had an almost empty battery. He was overweight and had high blood pressure
and constipation.
His BFp was 93. His drainforce was 998. For a person his age a normal BFp is xxx and a
normal drainforce is xxxx. Hence a pretty serious battery problem! But when he started
deep breathing, his BFp soared to 560. When he returned to his normal breathing, it stayed
high at 605. Ten minutes later it was still 612. This shows that in his case, deep breathing
activated his parasympathetic system, and it charged his battery. Otherwise, his battery
charge level and his BFp would have gone down right after he stopped deep breathing. And
his draining force? It dropped from 998 to 219 after 10 min. So, this patient has a serious
problem, but he also has a way out. How long does the effect of slow breathing last? Many
studies have addressed that question, and you can read about this in section xxxx.

Charging your battery

How does a healthy person charge their autonomic battery? That happens automatically:

By sleeping well. When you have a healthy sleep, you go through sleep periods. One of
those periods is called non-REM sleep. Every night, the non-REM sleep lowers your
sympathetic tone and activates your parasympathetic activity (Busek et al., 2005). Activating
your parasympathetic nerves charges your battery; it will be ready for a full day's work. If

7
you do not sleep well for days, you will end up with a high sympathetic tone1 , which is a
sign of a drained battery.

By physical activity. Physical activity, walking, yoga, and stretching first activate your
sympathetic nervous system, which is needed to do the work, but after this physical activity, a
recovery period starts that actively stimulates the parasympathetic nervous system, which is
an automatic process that allows the body to repair tissue damage, restore energy. Physical
activity also causes a release of endorphins which reduces stress and increases tolerance to
pain and promotes a feeling of well being (Daniela et al., 2022). Endorphins indirectly
stimulate the parasympathetic nerves.
Exercise reduces the stress hormones cortisol and adrenaline, causing parasympathetic
activity to dominate over sympathetic activity in the aftermath of exercise. Exercise promotes
a healthy sleep and sleep charges your battery as we saw earlier.

When we talk about exercise, it is a shorthand for physical activity, but it does not mean that
you have to get a membership to a fitness club. Nothing wrong with a fittness club if that is
what you like, but there are so many ways to get physical activity. If you work in a building
with the cafeteria three floors down or 2 floors up, take the stairs. If a bathroom is close by
but there is another one 5 min walking, take that one. Take your lunch break outside and
walk. Take a membership to a nature conservation area or a botanical garden, or make a park
nearby your charging station by walking there frequently, enjoying the changing of the
seasons. You just have to take time to charge your battery. The only real decision you have to
make it to take time out for charging your battery. The possibilities to do so are endless.
Wash the dishes by hand, take on photography and get out and tell amazing stories with your
camera. Walking your dog may be a chore, but think again, you are charging your battery,
maybe you will enjoy it from now on, knowing this. Yes, you can change your mindset about
these things. Taking up a hobby that charges your battery is a win-win situation. Once you
realize the amazing benefits of a fully charged battery, taking the stairs brings a smile to your
face.

By breathing well. When you breathe, you activate your parasympathetic system; you
charge your battery. The best way to breathe is slow and deep, and by using your belly, not
your chest, so by doing belly breathing. Every time you breathe out, you activate your
parasympathetic nervous system. Every breathing-out period charges your autonomic battery.
This is why in some breathing relaxation techniques one is advised to inhale for 4 seconds
and exhale for 6 seconds, optimizing the breathing out. We measured this, deep breathing
immediately activates your parasympathetic nervous system [REF], and this activation does
not stop immediately after you start normal breathing again. That is the very definition of
charging!

Breathing is controlled by nerves, including pacemaker nerves in the respiratory control

centres. Both sympathetic and parasympathetic innervation of the respiratory control center
influence breathing in response to stress, exercise, etc. In addition, breathing is controlled via
chemoreceptors that monitor oxygen and carbon dioxide in the blood, which is mediated by
the autonomic nervous system.

Inspiration is largely controlled by the diaphragm which is controlled by the phrenic nerves
originating in the cervical part of the spinal cord (dorsal horn).

1
Chapter 50 of Primer of the Auton.. 2024

8
When we do not get enough oxygen in our blood, chemoreceptors in the carotid body are
activated; this causes an increase in sympathetic activity that causes hyperventilation and
constriction of blood vessels. In some conditions, these patients experience a marked
overexcitation of the sympathetic nervous system. This is counterbalanced by deep breathing
exercises and the benefit is long-lasting {Kara et al., 2003, #41993}{Bernardi et al., 2001,
#152648}{Bernardi et al., 2001, #152648}{Zoccal et al., 2014, #7447}{Spicuzza et al., 2000,
#102995}.

By doing relaxation
Studies have shown that monks in mediation xxxxxx
By taking enteric-coated peppermint oil

Peppermint oil comes in “enteric-coated” gels that should be taken 3 times a day, about 1
hour before meals. How many gels depends on their peppermint oil content. If a gel contains
about 200 mg peppermint oil, one is taken; if it contains about 100 mg, two are taken 3 times
a day. It will start to work within a few hours but it could take up to 2 weeks to take full
effect. Enteric-coated means that the good stuff will not be broken down in the acidic
environment of the stomach, so that it can be absorbed in the intestine.

Some physicians will recommend peppermint oil for “indigestion” and it is even endorsed by
a gastroenterology physician organization2.
By intermittant fasting

We know that obesity gives us many health problems and most often it is related to not eating
healthy food or eating too much. So how to slow down the craving for more food. Many have
found that intermittent fasting is a method that they can maintain over a long period of time.
It is not related to a specific diet, although healthy eating is a prerequisite for health, of
course. But there is no need to hold onto any specific diet. Fasting has many benefits .. In one
experiment 41 subject fasted for 16 hours, just a single session, and their heart rate went
down and the parasympathetic parameter RMSSD went up significantly (Schwerdtfeger &
Rominger, 2024). A very common regimen is to not eat anything after 8 o’clock in the
evening and only start eating at noon. So you have an 8 hour window to eat, a lunch and a
dinner. As long as you do not binge during lunch or dinner, and eat healthy, you will loose
weight. But there are more benefits. Having almost always food in your system forces the
body to deal with it so that it cannot use that energy for body maintenance such as tissue
repair. Many studies have provided evidence that intermittent fasting exerts
neuroprotective effects by enhancing autophagy (cellular cleanup) removing dead
cells and repairing damaged cells and reducing oxidative stress and inflammation in
the brain. Note that “intermittent fasting” was the norm for us over millions of years
when we lived a nomadic lifestyle, and food was not readily available 24 hours per
day.
2
The CAG

9
 Your autonomic
nervous system

controls almost
all body
functionsall body
functions

Respiratory therapy

Respiratory therapy for the treatment of anxiety: meta-analytic review and regression(Leyro
et al., 2021)

Buddhist practice

Thich Nhat Hanh speaks about mindfulness energy. By practicing meditation or mindfulness
one generates energy that can we used to face life’s challenges. The energy that mindfulness
generates gives you energy to concentrate. And concentration gives you insight. He points
out that this meditation does not need to involve sitting on a cushion for hours. Mindfulness
can be practiced by doing every activities like drinking tea or walking in a mindful way.
[peace is every breath]
https://plumvillage.org/library/clips/what-is-mindfulness#hypertranscript=192,230

10
HRV biofeedback

Protocol for HRV biofeedback (Lehrer et al., 2013)

How did the autonomic battery develop in the human body?

The battery system in your body was developed over millions of years. This happened during
the time when humans were hunter gatherers. It was already there prior to this period but it is
safe to say that it developed into its present state during that period. During all those years,
man and women had no choice but to walk. They walked to find food and shelter
So, why does our battery not adapt to a life of cell phone watching and chips eating? It may
adapt, but is may take millions of years, so don’t wait for it.

It is designed for that purpose millions of years ago. Any threat to life would and will activate
the sympathetic nervous system. When we were hunter-gatherers, the threats were real life-
threatening, activating the central autonomic network. In the 21st century the threats are
almost all not life-threatening but nevertheless are activating the central autonomic network,
sometimes chronically, to generate a state of gastrointestinal motor inhibition. The central
autonomic network is not only activated by real threats but also by perceived threats. This
was important in our hunter-gatherer days because anticipation of threats would have been
essential if reacting to a real threat would be too late. Now we have to teach our brain about
the differences between perceived and real threats. For example, for millions of years our
food intake was intermittent and the periods of “fasting” provided essential homeostatic
activities. Now even the slightest feeling of “hunger” will provoke us to eat, all day long. Not
only does this lead to obesity, it also robs the body of the health benefits of restricted calorie
intake (Colman et al., 2009; Mattison et al., 2012). Restricted calorie intake was the norm for
thousands .network and the urge to be healthy comes from the cortex and, unfortunately, the
central autonomic network commands are stronger in most people. The only way to prevent
this cycle is to realize that the urge to eat is an autonomic reaction to a threat that is not real.
We have to teach our brain that a feeling of “hunger” should be rewarded by an impulse to
work on our health, to evoke the feeling that long term goals are more satisfying than short
term goals.

Other conditions that are related to sympathetic over-excitation.

Idiopathic intracranial hypertension

fibromyalgia and chronic fatigue syndrome/ These are frequently associated with sympathetic
overactivity symptoms and obesity (Hulens et al., 2018).

Fibromyalgia has been shown by many different techniques to be associated with sympathetic
overexcitation according to a review of case-control studies (Martínez-Martínez et al., 2014).
(Rizzi et al., 2017). Persons with fibromyalgia may limit physical activity as a mechanism to
reduce pain and fatigue. Poor sleep increases the perception of pain, but poor sleep is also a

11
consequence of pain. Chronic stress may lead to emotional eating or reduced motivation to
live a healthy lifestyle.

PART II THE DIFFERENT ORGANS AFFECTED BY THE

ANS

The heart

The respiration

The gut

PART III MEASURING IT

Can we measure the health of our autonomic battery?

The health of your autonomic battery can be measured through determining your heart rate
variability. Just like your car battery can be tested by a voltmeter, your autonomic battery can
be tested by studying how the beating of your heart fluctuates every minute, all the time.

How your heart rate behaves when you are lying flat on your back can tell us the health of
your battery. We measure the BFp or the “breathing frequency power”. With that, we can tell
if your battery is 100% full, 50% full or almost empty. BFp is a measure of the battery charge
level.

Sometimes, your heart rate can tell you the state of your battery. If you seriously exercise or
are a meditating monk and have a heart rate of 50 bpm, you probably have a healthy battery.
If you are a 70-year-old with a heart rate of 100 bpm at rest, your battery may not be a such a
good shape. A heart rate of 100 bpm at rest suggests that your sympathetic nervous system is
too active; it appears to be chronically active. If you do not have serious cardiac issues, you
must check your lifestyle, and you have to charge your battery, which is depleted by ongoing
sympathetic activity [see patient XX]

12
If our body is under stress because we experience serious life challenges, our battery slowly
drains. Let us say a child that gets sick. We worry, we take care of the child, but the worrying
does not stop. We forget everything else. Our battery will drain, we get sick and cannot help
anyone else. So, no matter what challenge you face, make sure you take care of yourself, of
your battery, so that you can help anyone who needs it. That is not selfish, it is necessary.
Can we measure the strength of the drainforce?

Can we measure the strength of the draining? Can we measure how strong the forces are that
drain our battery? Can we measure the drainforce? Yes. We also measure this through heart
rate variability. The drainforce we measure is called the Stress Index or sometimes we call it
the Baevsky index, named after the scientist who came up with it. He used it to measure the
health of the Apollo astronauts stationed in the Space XX. When heart rate variability goes
down, the SI goes up. SI is somewhat similar to SDNN but it is much more sensitive. In some
studies, where sympathetic activity goes up as determined by receptor antagonists, the SI
goes up. Whenever there is a marked change in sympathetic activity there will be a marked
change in SI. Therefore, Beavsky also called it a sympathetic index. Not every change in SI is
a reflection of the drainforce, so every change has to be related to the circumstances. When
we start walking, the SI goes up, reflecting an increase in sympathetic activity but that is the
good, short-term activation. But sometimes the increase is way to high. We measure this
potential over-excitation by measuring SI in response to going from lying down to standing.
Sometimes the increase is very high, and this often goes hand in hand with hypertension-
upon-standing3.

High activity of the sympathetic nervous system can also be seen in the blood. When
sympathetic nerves are active, they release noradrenaline. Most of the noradrenaline stays
close to the nerves and act on nearby tissue cells. But some leaks in the bloodstream and can
be detected. Usually a “catecholamine” test is done which measures adrenaline, noradrenaline
and dopamine. The noradrenaline will give you an indication of activity of the sympathetic
nerveous system. More... When to measure...
(Ermis et al., 2004)

What is heart rate variability

Heart rate variability is the phenomenon that the heart rate goes up and down a little bit all
the time. Hence, your heart does not beat like a metronome; this variability is essential, and
having no variability ushers imminent death. A healthy heart that beats at 65 bpm, has an
interbeat interval of 0.92 seconds. If we look at each interval over time, we will see
something like 0.92 – 0.94 – 0.89 – 0.91 etc. This variability is what we refer to as heart rate
variability. Why does that happen? Was it only up to one's heart muscles, in a 30-year-old
female, it would beat at about 110 beats per minute, but the ongoing activity of the
parasympathetic nervous system slows it down to about 60-70 beats per minute? When we
exercise, the sympathetic xxx. We know this because we can block the action of
parasympathetic nerves4, and when we do that, our heart rate goes up dramatically. This
neural activity does not occur at a constant rate and hence the variability.

3
See section xxxxx
4
Explain here receptor antagonists

13
The parameters of HRV
We have several parameters of HRV that help us understand sympathetic and
parasympathetic tone and reactivities. All of these parameters are taken from the
measurement of the times between each pair of heart beats monitored over a certain period,
preferably 1 min or longer. It is important to know that because they come from the same
source all these parameters are not independent5. But they are not related in a fixed manner.
In some cases, the sympathetic activity goes up with little effect on the parasympathetic
nervous system and so on. When we talk about specific parameteres being parasympathetic,
that means that under many conditions, when the parameter changes, it is due to
parasympathetic acitivty as proven by blocking cholinergic receptors.

What is breathing frequency power

As we have seen earlier, the autonomic nervous system is affecting almost all organs and it
does so in an integrated manner. Control systems of heart, lung and gut overlap so that if the
need to increase heart rate occurs, digestion will slow down so as to not have two systems
acting counter productive. This is why we can look at heart rate or respiration to get
information about the general state of the autonomic nervous system. The major contributor
to heart rate variability is the ongoing activity of the parasympathetic nervous system, the
vagal branch that xxx, to the sinus node of the heart, its pacemaker system. Another major
contribution is breathing.

You have been diagnosed with autonomic imbalance, what to do

now

PART II: THE SCIENTIFIC EVIDENCE

Detailed outlines and evidence for treatment of autonomic

dysfunction.

Deep breathing
xx
Peppermint

Source: Natural factors: One gel contains 200 mg peppermint oil = 100 mg menthol
(combined with Oregano oil). 1 gel 3x/day. Cost: $0.96/day

5
Explain more how a change in SI can be dominated by a change in RSA

14
Source: IBguard: One gel contains 90 mg peppermint oil = 40.5 mg menthol., 2 gel 3x day.
Cost: $3.42/day
Source: NOW: One gel contains 181 mg peppermint oil, 1 gel 3x/day. Cost: $0.60/day

They found that 200 mg peppermint oil caused a marked increase in RMSSD starting
at 25 min after ingestion and lasting about 1 hour (figure xx) and a decrease in HR
of 4 bpm (Kazadi et al., 2018).

 Common side effects include heartburn and indigestion.

Pep oil 7.35 9.39 10.00 10.18 10.34 10.56 11.26 1.43 4.24
HR 66 61 59 59 61 58 57 67 70
HFp 128 121 158 227 177 205 173 60 62
SI 12.4 15.x 13.9 10.7 11.5 14.1 8.8 16.7 12.7
RMSS 22 22 20 29 28 28 29 17 19
D
SDNN

Pep oil
HR
HFp
SI
RMSS
D
SDNN

Menthol acts on the TRPM8 channel which is a channel that senses cold.

The principal ingredient of peppermint oil is menthol. A review of clinical trials by

authoritative gastroenterologists concluded that peppermint oil reduced the symptoms of IBS,
including abdominal pain (Ford et al., 2008). One of the studies showed that after taking
pepermint oil for one month, 83% of the subjects experienced a reduction in bloating
compared to 29% using a placebo [13] (Ford et al., 2008).

15
Some suggest that there are no contraindications to taking peppermint oil (Chang et al.,
2006). Others point out that in vitro studies suggest that peppermint oil may inhibit
cytochrome P450 isoenzyme CYP3A4 and that, therefore, peppermint oil should not be taken
together with certain anti-depressant medication because it might increase their effectiveness.
The recommended dose is 3 times daily about 200 mg peppermint oil, and it is recommended
by some not to take more, since xxx

Reduces blood pressure A TRP Channel that Senses Cold Stimuli and Menthol and
vasorelaxation Sun Hypertension 2014, activation of cold-sensing.... (Jesus et al., 2023)
Menthol also lowers blood pressure and antagonizes vasoconstriction through TRPM8 activation.[11]
Sun J, Yang T, Wang P, Ma S, Zhu Z, Pu Y, Li L, Zhao Y, Xiong S, Liu D, Zhu Z (June 2014). "Activation of cold-
sensing transient receptor potential melastatin subtype 8 antagonizes vasoconstriction and hypertension through
attenuating RhoA/Rho kinase pathway". Hypertension. 63 (6): 1354–
63. doi:10.1161/HYPERTENSIONAHA.113.02573. PMID 24637663. S2CID 11029018.

Meditation
xx
Exercise

Xxx

Intermittent fasting

Eating will fill our body with carbohydrates, and we will generate energy by making glucose
out of the carbohydrates. When we fast, and the easy source of carbohydrates is disappearing
and glucose levels become low, we get our energy from stored fat, which we change into free
fatty acids, and these are converted into ketones. Ketones are an energy source, they go into
the blood stream and can go anywhere including the brain, heart and muscle. A win-win
situation, we take away stored fat that may cause weight gain and we provide the body with
an energy source. When we eat a lot, the glucose we cannot use is transformed into xxx.
Ketones are beneficial for other processes in the body as well. Ketones have anti-
inflammatory effects. Ketones also improve insulin sensitivity so that it helps maintain health
in patietns with type 2 diabetes. In humans, the fed-state blood levels of ketone
bodies are at or below the limit of detection and reach levels of 0.2–0.5 mM
within 8–12 hours after the onset of fasting, but reach levels between 1 and
2 mM by 48 hours36,37. (Longo et al., 2021)

Fasting and refeeding regimens are powerful promoters of stem-cell self-renewal

mechanisms and activators of tissue regeneration, in part through inhibition and reactivation
of the IGF-1, PKA and mTOR pathways19–21,103 (Fig. 3). The PF and FMD regimens
can promote a rejuvenation process in tissues, organs and cells through the activation
of cell death and autophagy followed by the activation of stem or progenitor cells 19–21
.
For many organs to stay healthy, cells have to die and be replenished, tissue regeneration has to occur . This
process in stimulated by fasting. One could say that without fasting, proper tissue re-genearation is inhitied

16
which could lead to premature illness and death. And of course, intermittent fasting has been associated with a
longer life span. Animal studies have shown that the benefit of fasting is dependent on the quality of food taken
in the feeding period. So intermittent fasting should be accompanied by a healthy diet

What if we feel hungry? Is that not a sign that we should eat. Is feeling hungry not a warning
sign that our body needs food? We have to distinguish between real physical hunger and
craving, just feeling like you want to eat something. If you skip breakfast and you feel
“hungry” at 11 AM, it is not a sign that your body needs food. Fasting for 24 hours has no
harmful effects for a healthy body. When you have diabetes or a metabolic disorder, of
course, you have to be very careful. When you are healthy and do intermittent fasting, after a
while, you do not feel hungry during those 16 hours. In fact, studies have shown that
intermittent fasting produces xx that may reduce your feelings of “hunger”. For many, when
the 16 hours have past, they do not feel the need to eat extra; a normal meal will do just fine!

IF and PF or FMD activate ancient programs that promote entry into alternative metabolic
modes focused on conserving energy and on protecting the organism while enduring
extended periods of food deprivation to optimize survival and reproduction once food
becomes available. (Longo et al., 2021)

“Intermittent fasting” has been the norm for millions of years. When food was available one
ate, but not too much since we did not know when the next supply would be available. So it is
logical that the body would create ways to make this regimen optimal for survival. So what
happens when we start, even a limited, fast?

During fasting, glucose levels become low, and the body starts restricting glucose for
essential functions such as critical parts of the brain and red blood cells. For other energy
needs, the body starts to use ketones. Ketones are then also used for general brain functions.
Ketones easily generate ATP, the primary source of metabolic energy. Ketones also have
anti-inflammatory effects, helping to maintain health. Fasting changes making energy from
carbohydrates to making energy from utilization of stored fat in the form of lipids from
adipose tissue. Into free fatty acids which are then metabolized in the liver into ketones.

During fasting, distinct processes occur in the body. Heart rate and blood pressure decrease,
and heart rate variability increases . Markers of oxidative stress are reduced. Within the
brain, we see enhanced autophagy (xx), cognition, reduced inflammation, and neurogenesis
(Mattson et al., 2017). Brain-derived neurotrophic growthfactor (BDNF) is produced by
neurons and released from them in a synaptic activity-dependent manner (Matsuda et al.
2009). Vigorous exercise and intermittent fasting stimulate BDNF production in many
different brain regions including those involved in sensory–motor function and cognitive
processing (Lee et al. 2002; Duan et al. 2004; Gomez-Pinilla 2008; Marais et al. 2009;
Marlatt et al. 2012). Our findings suggest that BDNF acts in the brainstem to enhance
parasympathetic activity and reduce resting heart rate. Because exercise and intermittent
fasting also reduce resting heart rate by a mechanism involving enhanced vagal
parasympathetic tone (Shi et al. 1995; Wan et al. 2003; Mager et al. 2006), it will be of
considerable interest to determine whether BDNF mediates the effects exercise and
intermittent fasting on autonomic regulation of heart rate. (Wan et al., 2014) Wan et al
showed that intermittatn fasting reduces heart rate and blood pressure in rats and increases
their lifespan (Wan et al., 2003). Acute fasting modulates autonomic nervous system function
and ambulatory cardiac Interoception (Schwerdtfeger & Rominger, 2024)

17
These intermittent or periodic dietary interventions can promote cell protection and repair as
well as the clearance of damaged cells and intracellular components, in part through the
modulation of conserved stress-response or nutrient-sensing pathways. Whereas the dietary-
restriction field has mostly focused on the benefits of continuous caloric or macronutrient
restriction, here we focus both on the importance of much shorter restriction periods and the
refeeding and post-refeeding phases, which is accompanied by a regenerative process that

[13]. (Gudden et al., 2021). An intermoittent diet may slow down the progressioin of
multiple sclerosis (Gudden et al., 2021) (Johnson et al.2007; Wan et al.2010) (Fig. 1).
(Fond et al.2013).multiple sclerosis (Choi et al.2016)

When a seed is carried by a bird to a very different part of the world, it catches on in this
different landscape. If it Survives, its evolutionary path is going to be influenced by this
different environment, such that 100.000 years later, the plant looks different from the ones
that grew up in its native environment. In evolutionary terms, we changed our lifestyle
overnight when we discovered agriculture and stopped being nomads. In the beginning the
farming was hard work and we survived. But very few of us do farming today, we let others
do it so that we can sit behind a computer all day. , so we cannot expect that our body is
handling that very well, and indeed it doesn’t. It does not mean that we have to go back
living in caves, or that we have to become nomads. We now know what factors in our
modern lifestyle are detrimental. So that we also know what to change. The most important
factors are physical activity, healthy food but not too much, and intermittent fasting.

Why is a correct lifestyle so important to maintain a healthy battery? Because all our body
systems and our batteries developed around a certain lifestyle for millions of years, body
functions and lifestyle and environment developed together, that is how evolution works.
When you put your body into a very different environment without the necessary tools to
manage it, your body will experience problems. We can easily imagine that we cannot
survive in the desert or Antarctica without extraordinary measures. But we also have to
understand that our body cannot maintain health if we live in a favourable climate but we
subject our body to a lifestyle that goes counter to what our body is designed for.

Our autonomic nervous system’s origin can be found in early vertibrates such as the jawless
fish, 550 million years ago. Apes have been around for 25 million years. Our species the
hominins, emerged aournd 7 million years ago. Homo Erectus came around 1.8 million years
ago as hunter gatherers. Homo Sapiens started around 200.000 years ago, and our current
lifestyle started with the development of agriculture, and that has been around for a mere
12.000 years. 12.000 years is not enough time by a longshot for evolutionary forces to adapt
our body to a dramatically different lifestyle.

Calming the Nervous Heart: Autonomic Therapies in Heart Failure

Peter Hanna
,
Kalyanam Shivkumar
,
Jeffrey L Ardell

18
Detailed discussion on heart rate variability parameters

References
xxxxx

Further reading
xxxxx

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Nor Bad, but Rather the Same. Bioessays 42, e1900238.
Busek P, Vanková J, Opavský J, Salinger J & Nevsímalová S (2005). Spectral analysis of the
heart rate variability in sleep. Physiol Res 54, 369–376.
Chang HY, Kelly EC & Lembo AJ (2006). Current gut-directed therapies for irritable bowel
syndrome. Curr Treat Options Gastroenterol 9, 314–323.
Colman RJ, Anderson RM, Johnson SC, Kastman EK, Kosmatka KJ, Beasley TM, Allison
DB, Cruzen C, Simmons HA & Kemnitz JW (2009). Caloric restriction delays disease
onset and mortality in rhesus monkeys. Science 325, 201–204.
Daniela M, Catalina L, Ilie O, Paula M, Daniel-Andrei I & Ioana B (2022). Effects of
Exercise Training on the Autonomic Nervous System with a Focus on Anti-
Inflammatory and Antioxidants Effects. Antioxidants (Basel) 11, 350.
Ermis C, Samniah N, Sakaguchi S, Lurie KG, Pham S, Lu F & Benditt DG (2004).
Comparison of catecholamine response during tilt-table-induced vasovagal syncope in
patients <35 to those >65 years of age. Am J Cardiol 93, 225–227.
Ford AC, Talley NJ, Spiegel BM, Foxx-Orenstein AE, Schiller L, Quigley EM & Moayyedi
P (2008). Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable
bowel syndrome: systematic review and meta-analysis. BMJ 337, a2313.
Gudden J, Vasquez AA & Bloemendaal M (2021). The effects of intermittent fasting on brain
and cognitive function. Nutrients
Hulens M, Rasschaert R, Vansant G, Stalmans I, Bruyninckx F & Dankaerts W (2018). The
link between idiopathic intracranial hypertension, fibromyalgia, and chronic fatigue
syndrome: exploration of a shared pathophysiology. J Pain Res 11, 3129–3140.
Jesus RLC, Araujo FA, Alves QL, Dourado KC & Silva DF (2023). Targeting temperature-
sensitive transient receptor potential channels in hypertension: far beyond the
perception of hot and cold. J Hypertens 41, 1351–1370.
Kazadi LC, Fletcher J & Barrow PA (2018). Gastric cooling and menthol cause an increase in
cardiac parasympathetic efferent activity in healthy adult human volunteers. Exp
Physiol 103, 1302–1308.
Lehrer P, Vaschillo B, Zucker T & Graves… J (2013). Protocol for heart rate variability
biofeedback training. …
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longevity and disease. Nat Aging 1, 47–59.
Martínez-Martínez LA, Mora T, Vargas A, Fuentes-Iniestra M & Martínez-Lavín M (2014).
Sympathetic nervous system dysfunction in fibromyalgia, chronic fatigue syndrome,

19
 irritable bowel syndrome, and interstitial cystitis: a review of case-control studies. J
Clin Rheumatol 20, 146–150.
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74–80.
Schwerdtfeger AR & Rominger C (2024). Acute Fasting Modulates Autonomic Nervous
System Function and Ambulatory Cardiac Interoception. Biological Psychology
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cardiovascular and neuroendocrine responses to stress in rats. J Nutr 133, 1921–1929.
Wan R, Weigand LA & Bateman… R (2014). Evidence that BDNF regulates heart rate by a
mechanism involving increased brainstem parasympathetic neuron excitability. Journal
of …

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i
RAS