Vagus Nerve Hydrodissection in Gilbert, AZ
Dr. Drew Timmermans, ND, RMSK and Dr. Jack Meister, ND at Regenerative Performance in Gilbert, Arizona perform ultrasound-guided vagus nerve hydrodissection to treat the structural cause of autonomic symptoms, not just the symptom in front of you. When the vagus nerve is restricted by the tissue around it, the effects can show up everywhere: brain fog, digestive symptoms, chronic fatigue, and a racing heart with normal cardiac testing.
You Have Been Searching for Answers
You have been to multiple doctors. Your labs come back normal, your imaging comes back normal, and your symptoms span different body systems in a way that no single specialist has been able to connect. If you feel like your whole system is "off" no matter what you do, you are not imagining it and you are not weak. The pattern below is common among our patients.
Why Nothing Has Worked Yet
Each symptom usually gets its own specialist, its own medication, and its own explanation. But when a dysfunctional vagus nerve is part of the shared source, treating each symptom individually will not resolve the underlying pattern.
You may have been told your symptoms are stress-related. Managing stress has probably helped some, but it has not resolved the physical dysfunction.
Treat each symptom individually (antacids, stimulants, anxiolytics).
When the vagus nerve is restricted, stress management alone cannot fully make up for impaired nerve signaling.
Evaluate for a structural cause of autonomic dysfunction and treat it directly.
Standard bloodwork does not assess vagus nerve function. Patients with meaningful vagal impairment can have completely normal labs, imaging, and organ-function tests.
Run more labs, see another specialist, cycle through elimination diets.
The dysfunction may be happening at the level of nerve signaling, not the organ itself.
Hands-on exam plus diagnostic ultrasound assessing the vagus nerve and surrounding structures directly.
Patients with vagal dysfunction often accumulate prescriptions from gastroenterology, cardiology, neurology, and psychiatry. Each provider treats their piece well.
Separate providers treating isolated symptoms.
What is often missing is someone evaluating the nerve that connects all of it.
Evaluate the vagus nerve as a possible shared link between systemic symptoms, then treat the restriction itself.
All patients begin with a 2-hour new patient evaluation, whether vagus nerve hydrodissection ends up being the right fit or not. The evaluation exists to figure out if your symptoms are connected, not to sell you a procedure. Our physicians start with a detailed history and a hands-on physical exam, and use diagnostic ultrasound to assess the vagus nerve within the carotid sheath when it is warranted. You leave with a clear explanation of what is happening, which structures may be involved, and a treatment plan suited to your case. If we do not think vagus nerve hydrodissection is appropriate for you, we will tell you and outline other options.
The vagus nerve runs from the brainstem through the neck to the heart, stomach, and intestines, the anatomical basis of the gut-brain axis and why calming the vagus can influence far more than the neck.
Because the vagus nerve regulates parasympathetic function throughout the body, patients who respond to treatment often describe improvement across more than one symptom category at once, not just one isolated complaint.
When the vagus nerve stays dysfunctional for months or years, the body compensates with a higher baseline sympathetic tone, altered gut motility, and ongoing inflammatory signaling. These compensatory patterns tend to become harder to unwind over time. Patients who address vagal dysfunction earlier in that timeline tend to respond more completely.
Vagus nerve hydrodissection for autonomic regulation is an emerging procedure, and published research specific to this technique is limited. The outcome descriptions above reflect clinical observation, not controlled trials of this specific procedure. Individual results may vary based on the cause and duration of the dysfunction.
If your symptoms span multiple systems and conventional testing has not found the cause, a comprehensive evaluation is where this starts. Two hours, a hands-on exam, ultrasound when indicated, and a clear explanation of what is actually happening.
More than 150 vagus nerve hydrodissections since 2021. Ultrasound-guided, performed by Dr. Timmermans or Dr. Meister.
Vagus nerve hydrodissection is an emerging, ultrasound-guided procedure that aims to gently free and bathe the vagus nerve in a fluid solution in the neck. In our clinic, that solution is usually a regenerative biologic, such as platelet lysate or protein concentrate (AKA alpha-2-macroglobulin, A2M), and in select cases, 5% dextrose (D5W). The nerve runs through the carotid sheath in your lower neck, alongside the carotid artery and internal jugular vein. Its signaling can be disrupted in more than one way: fascial thickening, fascial adhesions, or cervical instability, any of which can restrict the nerve and reduce its ability to carry signals between your brain and the rest of your body.
Dr. Timmermans or Dr. Meister uses real-time ultrasound to visualize the vagus nerve within the carotid sheath, then injects the solution around the nerve under direct visualization. The goal is two-fold: to gently separate the nerve from the surrounding tissue, releasing mechanical restriction so it can move and signal more freely, and to bathe the nerve in a nutritive, regenerative solution.
Ultrasound-guided vagus nerve hydrodissection: fluid is placed in the tissue plane around the vagus nerve inside the carotid sheath, gently separating it from the internal jugular vein and common carotid artery. The needle is intended to remain in the perineural plane, outside the nerve.
This is distinct from general nerve hydrodissection for a peripheral entrapment like carpal tunnel syndrome. Peripheral hydrodissection targets localized pain from a compressed nerve in an arm or leg. Vagus nerve hydrodissection targets your autonomic nervous system instead, the systemic symptoms that show up when your primary parasympathetic nerve cannot signal properly.
Vagus nerve hydrodissection for autonomic regulation is an emerging procedure, and published research is limited. When 5% dextrose is used, it is FDA-approved for other uses and administered off-label for hydrodissection. The evidence base is earliest-stage for POTS, long-COVID, dysautonomia, IBS, and chronic inflammatory conditions in particular.
Could This Be Your Vagus Nerve?
No single symptom on this list means your vagus nerve is involved. The pattern across systems matters more than any one item. Patients with a vagal restriction typically describe several of these together:
This checklist is for awareness, not self-diagnosis. Many of these symptoms overlap with other conditions. A comprehensive evaluation is the only way to find out whether your vagus nerve is actually part of the picture.
Vagus nerve hydrodissection may be appropriate when autonomic dysfunction and systemic symptoms are linked to vagal restriction. Because the vagus nerve reaches organs from the brainstem down to the colon, impaired signaling can show up across many body systems.
Honest Expectations
We would rather be upfront about this than have you invest time and money in the wrong direction.
| Feature | Conventional Approach | Regenerative Performance |
|---|---|---|
| Diagnostic process | Standard labs and imaging; each symptom treated on its own | History, hands-on exam, and diagnostic ultrasound assessing the vagus nerve and surrounding structures directly, when warranted |
| Root cause identification | Often no structural diagnosis; symptoms attributed to stress | Vagus nerve assessed under ultrasound for size, shape, and location, which can indicate dysfunction |
| Treatment target | Individual symptoms, separate medications for each | The vagus nerve dysfunction itself, as a possible shared cause |
| Follow-up | Symptom monitoring only | Outcome tracking, reassessment, and coordination with your other providers |
What to Expect
Most patients with autonomic dysfunction have never had their vagus nerve specifically evaluated. Here is what happens once treatment is underway.
Our physicians perform a hands-on physical exam and, when warranted, diagnostic ultrasound to assess the vagus nerve within the carotid sheath and confirm that vagal restriction is likely contributing to your symptoms. No procedure happens without this diagnostic foundation.
The hydrodissection itself takes approximately 15 to 30 minutes. Under real-time ultrasound guidance, the solution, usually a regenerative biologic (platelet lysate or A2M) and in select cases 5% dextrose (D5W), is injected around the vagus nerve to free it from surrounding tissue and bathe it in a nutritive solution. Most patients describe mild pressure, not sharp pain. Plan to rest for the remainder of the procedure day.
Some patients notice changes within the first few days: calmer digestion, a steadier nervous system, or clearer thinking. Mild soreness at the injection site typically resolves within a few days. Avoid strenuous activity during this window.
Patients who respond may notice progressive improvement in autonomic symptoms as the nerve adapts to restored mobility. Heart rate variability may improve, digestive function may normalize, and the fight-or-flight baseline may shift. Some fluctuation is normal as the nervous system recalibrates.
Improvements in sleep quality, stress resilience, energy, and cognitive function may continue developing. Follow-up evaluation lets our physicians assess your response and determine whether an additional treatment is warranted.
Single-Side Release
Targets the vagus nerve on one side of the neck within the carotid sheath. This approach may be appropriate when symptoms or ultrasound findings suggest the dysfunction is mostly one-sided.
Best for: Patients with asymmetric findings on evaluation, or as a more conservative starting point.
Both-Side Release
Targets the vagus nerve on both sides of the neck. The left and right vagus nerves innervate somewhat different organ systems, so a bilateral approach may be indicated when symptoms are diffuse or both sides are involved in the dysfunction.
Best for: Patients with widespread autonomic symptoms, bilateral findings on exam, or incomplete response to a unilateral treatment.
We do not sell treatment packages. Every patient is evaluated individually, and each next step is decided one treatment at a time. We perform one treatment, assess how you respond, and only then determine whether another is needed. If one session gets you the improvement you need, that is the right outcome.
I have never had a physician spend 3 full hours with me, carefully examining, listening, and truly working to understand my concerns. For more than 20 years, I've struggled with an unusual nerve entrapment in my arms and was often dismissed by other providers, leaving me feeling as though my condition wasn't being taken seriously.
Verified Google review
I've spent the last 5 years seeing many doctors across the US and Canada... after working with Dr. Timmermans, I feel the best I've felt in 15 years.
Verified Google review
Been to a lot of doctor offices over my time with my healing journey. And Dr. Timmermans and his staff are top notch, easily most comfortable and capable practice i have been to.
Verified Google review
Vagus nerve hydrodissection is an ultrasound-guided procedure where fluid, usually a regenerative biologic such as platelet lysate or protein concentrate (A2M) and in select cases 5% dextrose (D5W), is injected around the vagus nerve to free it from surrounding tissue and bathe it in a nutritive solution. The vagus nerve controls parasympathetic function (rest, digest, recover), and restrictions in the neck can contribute to widespread autonomic dysfunction. The procedure aims to release those restrictions so the nerve can signal more normally.
Vagus nerve hydrodissection differs from general nerve hydrodissection in what it targets: general (peripheral) nerve hydrodissection treats entrapments that cause localized pain, like carpal tunnel or cubital tunnel syndrome, while vagus nerve hydrodissection targets the autonomic nervous system. Instead of a pinched nerve causing hand pain, it addresses a dysfunctional nerve that may affect digestion, heart rate, brain function, and stress regulation throughout the body.
Vagus nerve hydrodissection tends to help patients who describe a cluster of systemic symptoms together: brain fog, chronic fatigue, digestive dysfunction, a persistent “on edge” feeling, impaired stress tolerance, and disrupted sleep. The pattern that matters is multiple symptoms across different body systems that have not responded to conventional treatment. A comprehensive evaluation, not self-assessment, determines whether vagal dysfunction is actually contributing, and a formal workup is always the starting point.
Vagus nerve hydrodissection is generally safe. It typically uses a regenerative biologic such as platelet lysate or protein concentrate (A2M), and in select cases 5% dextrose (D5W). It is performed under continuous ultrasound guidance so the nerve, surrounding vessels, and needle position can be visualized in real time throughout. As with any injection procedure near major neck structures, the risk of a serious adverse reaction is very low, though not zero. Potential risks include bruising or bleeding, infection, temporary changes in voice or swallowing, and nerve irritation.
Vagus nerve hydrodissection itself takes approximately 15 to 30 minutes. It is a same-day, in-office procedure, and most patients plan to rest for the remainder of that day before returning to normal activity.
The vagus nerve hydrodissection evaluation is a comprehensive 2-hour new patient visit with a detailed history, a hands-on physical exam, and diagnostic ultrasound of the vagus nerve when warranted. It always comes first, because an accurate diagnosis is the single most important factor in whether treatment actually helps.
Most patients who respond to vagus nerve hydrodissection notice initial changes within the first few days to two weeks, often in digestion, nervous system calming, or mental clarity, with progressive improvement over the following 2 to 6 weeks as the nerve adapts. Additional improvement may continue over 6 to 12 weeks. How quickly you respond depends on how long the dysfunction has been present and how many compensatory patterns have developed around it.
The number of vagus nerve hydrodissection treatments is individualized, not fixed in advance. We perform one treatment, assess how you respond, and only then decide whether another is warranted, based on the severity and duration of the dysfunction and whether it is one-sided or bilateral. We take it one treatment at a time and do not sell pre-paid treatment packages.
Vagus nerve hydrodissection is a cash-pay procedure, and cost depends on the complexity of your case, including whether unilateral or bilateral treatment is indicated. A phone call or discovery call can give you a general fee range; your specific quote comes after your diagnosis is finalized at the 2-hour evaluation, since the diagnosis determines what is actually being treated. HSA and FSA funds can typically be used toward services, and financing is available through Advance Care Card.
Vagus nerve hydrodissection differs from a stellate ganglion block in which branch of the nervous system it addresses. A stellate ganglion block primarily targets the sympathetic ("fight-or-flight") side of the nervous system using a local anesthetic. Vagus nerve hydrodissection targets the vagus, or "rest-and-digest," pathway using a regenerative biologic or, in select cases, 5% dextrose (D5W). Depending on your evaluation, one, the other, both, or neither may be appropriate; our physicians will explain the reasoning behind whichever path they recommend for you.
Vagus nerve hydrodissection does not require stopping prescribed medications on your own. If a change is needed for safety around the time of the procedure, for example with blood thinners, our physicians will coordinate with your prescribing clinicians. Vagus nerve hydrodissection is intended to complement your existing medical and mental health care, not replace it.
If the vagus nerve is dysfunctional, the systems it regulates pay the price, often quietly, for years. Dr. Timmermans and Dr. Meister at Regenerative Performance in Gilbert, Arizona focus on finding the structural causes of autonomic dysfunction, not just managing the symptoms it produces. Whether you are local or traveling from out of state, a comprehensive evaluation is the first real step toward an answer.
More than 150 vagus nerve hydrodissections since 2021, with zero severe treatment-related adverse events across our practice-wide orthobiologic cases.
726 N Greenfield Rd, STE 101, Gilbert, AZ 85234
Note on regulatory status and off-label use: Vagus nerve hydrodissection for autonomic dysfunction is an emerging procedure, and published research specific to this technique is limited; the outcomes described on this page reflect clinical observation, not controlled trials of this specific procedure. When 5% dextrose (D5W) is used as the injectate, it is FDA-approved for other uses and administered off-label for hydrodissection; off-label use is legal, common in medicine, and applied here based on clinical evidence and physician judgment. Platelet lysate and protein concentrate (A2M) are autologous biologics prepared from your own blood at the time of treatment and are not FDA-approved drug products. Any procedure near the carotid artery, the internal jugular vein, and the major nerves of the neck carries risk; continuous ultrasound guidance, careful technique, and close monitoring reduce that risk but cannot eliminate it, and the risk of a serious adverse reaction is very low. Every procedure is performed by a licensed physician after a comprehensive evaluation and is supervised by Dr. Drew Timmermans, ND, RMSK. Individual results may vary based on the cause and duration of the dysfunction and adherence to the broader treatment plan.