Although five minutes of VNS per day seems insignificant, it has the potential to lower systemic inflammation for 24-36 hours.  The need to increase tVNS to more than five minutes per day rarely occurs in children under twenty.  If there is no significant improvement within this age group, the cause of no neurological improvement is likely due to a relapse of intestinal bacteria overgrowth rather than the tVNS not being effective.  This scenario would need to be addressed with another round of rifaximin, initiating cyclic or continuous rifaximin, or if the patient is on inulin, I consider it to be inulin failure, and I replace inulin with rifaximin.  Again, I always look for an external factor such as an intensely stressful situation, supplements, homeopathic remedies, or a probiotic that might be preventing or masking recovery.nnNOTE: There is an exception to the five minutes of tVNS per day rule in children under twenty-five. Parents will often notice that after just five minutes of tVNS, their child may experience a prolonged calming effect that can last for a few hours.  In these cases, I suggest the tVNS be used at least once daily to control inflammation and an additional two to three five-minute increments as needed to control anxiety. 

It is improbable that anyone is deficient in every mineral and vitamin, so I prefer that people have lab-certified blood work done to determine any deficiencies and supplement only what is needed. Additionally, I prefer vitamins to come from food sources instead of some abstract pill that may not contain what is advertised on the label.

I recommend that my patients get their vitamins and minerals from food. Most of the mild deficiencies found in lab work are generally due to malabsorption, and the inulin or rifaximin both result in repair of the intestinal tract and normalization of absorption. Exceptions would be supplementation for significant B12, iron deficiencies, or kids with folate-receptor antibody issues.

No.