Introduction: The “everything’s normal” nightmare
You know something is wrong. You’re anxious all the time. You can’t sleep. Your stomach is a mess. You’re in pain with no clear cause. You’re exhausted despite doing “all the right things.”
So you go to the doctor. Run labs. Maybe even see specialists. They order:
- Complete blood count (CBC)
- Comprehensive metabolic panel (CMP)
- Thyroid panel (TSH, T4, T3)
- Maybe hormone testing
- Perhaps imaging (X-rays, MRI, ultrasound)
And the results? “Everything looks normal.”
They might offer antidepressants. Refer you to therapy. Suggest “it’s just stress.” Tell you to exercise more, sleep better, manage your stress.
You leave feeling gaslit, frustrated, and more alone than before.
Here’s the truth: you’re not crazy. Your labs just aren’t measuring what’s actually broken.
At Calm San Diego, we see this every single day. Patients with devastating symptoms but unremarkable bloodwork. The missing piece? Nervous system dysregulation—something standard medical testing doesn’t assess.
Let’s talk about why conventional medicine misses this, what’s actually happening in your body, and how to fix it.
What standard labs miss
Conventional medical testing is designed to catch disease—thyroid failure, diabetes, autoimmune conditions, organ damage, infections, cancer.
If your TSH, CBC, CMP, and inflammatory markers fall within “normal range,” you get sent home. Case closed.
But “normal” doesn’t mean optimal.
And more importantly, standard labs don’t measure:
→ Autonomic nervous system function (are you stuck in fight-or-flight?)
→ Vagal tone (is your vagus nerve underactive?)
→ HPA axis regulation (is your stress response system functioning properly?)
→ Heart rate variability (the gold standard for nervous system health)
→ Central sensitization (is your nervous system amplifying pain signals?)
→ Mitochondrial function (can your cells actually make energy?)
→ Gut-brain axis communication (is your vagus nerve signaling properly between gut and brain?)
→ Circadian rhythm integrity (are your biological clocks synchronized?)
→ Neuroinflammation (brain inflammation that doesn’t show up on standard inflammatory markers)
These are the systems that control:
- Sleep
- Mood and emotional regulation
- Pain perception
- Digestion and gut function
- Hormone balance
- Immune response
- Stress resilience
- Energy production
- Mental clarity
When these are dysregulated, you feel terrible even though your labs look “fine.”
The hidden epidemic: Autonomic dysfunction
Your autonomic nervous system (ANS) controls every automatic function in your body:
- Heart rate and blood pressure
- Breathing
- Digestion and gut motility
- Temperature regulation
- Immune response
- Hormone secretion
- Pain modulation
- Sleep/wake cycles
- Pupil dilation
- Salivation
- Sexual arousal
You don’t consciously control any of these. Your ANS does it automatically.
The ANS has two branches:
Sympathetic nervous system (SNS) = Gas pedal
Purpose: Fight-or-flight. Activation. Alertness. Survival mode.
When activated:
- Heart rate increases
- Blood pressure rises
- Pupils dilate
- Digestion slows or stops
- Immune function suppresses
- Pain sensitivity heightens
- Energy mobilizes for immediate action
When it should be on: Actual danger, performing under pressure briefly, exercise
Problem: Most people are stuck here chronically
Parasympathetic nervous system (PNS) = Brake pedal
Purpose: Rest-and-digest. Recovery. Healing. Calm.
When activated:
- Heart rate slows
- Blood pressure decreases
- Digestion functions properly
- Immune system strengthens
- Tissue repair occurs
- Pain sensitivity decreases
- Deep sleep is possible
When it should be on: Most of the time—this is where healing happens
Problem: People with autonomic dysfunction can’t access this state
When the system gets stuck: Autonomic dysfunction
In a healthy nervous system, you move fluidly between these states based on what’s needed.
Under chronic stress, trauma, illness, or inflammatory conditions, the system gets stuck:
- SNS stays ON (you can’t calm down, even when you want to)
- PNS stays OFF (your vagus nerve becomes underactive)
This is called autonomic dysfunction or dysautonomia.
And it doesn’t show up on standard labs.
How autonomic dysfunction shows up
Because the ANS controls so many systems, dysregulation creates a constellation of symptoms that seem unrelated but are all connected:
Cardiovascular
- Rapid or irregular heartbeat (palpitations)
- Blood pressure swings (high or low, or both at different times)
- Dizziness upon standing (postural orthostatic tachycardia syndrome—POTS)
- Chest tightness or pressure
- Feeling like you “can’t catch your breath”
Digestive
- IBS (irritable bowel syndrome)—bloating, gas, alternating constipation/diarrhea
- Nausea, especially in morning or with stress
- Reflux, heartburn, indigestion
- Food sensitivities that developed “out of nowhere”
- Loss of appetite or feeling full quickly
- Stomach pain that worsens with stress
Neurological
- Brain fog, difficulty concentrating
- Poor short-term memory (“Where did I put my keys?”)
- Migraines or tension headaches
- Dizziness, lightheadedness
- Temperature dysregulation (always cold or always hot)
- Tremor or shakiness
Sleep
- Insomnia (can’t fall asleep or stay asleep)
- Non-restorative sleep (sleeping 8 hours but waking exhausted)
- Waking with anxiety or palpitations
- Vivid, disturbing dreams
Pain
- Widespread pain (fibromyalgia-type)
- Heightened pain sensitivity (things that shouldn’t hurt, do)
- Chronic muscle tension (especially neck, shoulders, jaw)
- Nerve pain or tingling
- Migraines
Emotional/Psychological
- Chronic anxiety (generalized or panic attacks)
- Feeling “on edge” constantly
- Emotional lability (crying easily, irritability)
- Feeling disconnected or “unreal” (dissociation)
- Depression (especially with fatigue)
- Difficulty regulating emotions
Hormonal
- Irregular menstrual cycles
- Worsening PMS or PMDD
- Thyroid symptoms despite “normal” labs (fatigue, weight changes, hair loss, cold intolerance)
- Low libido
- Fertility challenges
Immune
- Getting sick frequently
- Slow healing
- Chronic inflammation
- Autoimmune flares
- Allergies worsening
You bring this list to your doctor. They run tests. Everything’s “normal.” You get labeled with:
- Anxiety
- Depression
- Stress
- “Functional” disorder (code for “we can’t find anything, so it’s probably in your head”)
But it’s not in your head. It’s in your nervous system.
The vagus nerve: Your missing diagnostic clue
The vagus nerve is the longest cranial nerve in your body and the main component of the parasympathetic nervous system—your “rest-and-digest” mode.
The vagus nerve connects your brain to:
- Heart (regulates heart rate)
- Lungs (controls breathing)
- Stomach and intestines (controls motility, enzyme secretion, inflammation)
- Liver and pancreas (metabolic function)
- Spleen (immune function)
75% of the vagus nerve fibers are afferent—meaning they carry information FROM your organs TO your brain.
Your gut, heart, and other organs are constantly “reporting” to your brain about:
- Nutrient status
- Inflammation levels
- Microbiome balance
- Threats or safety
This is the gut-brain connection. The heart-brain connection. The immune-brain connection.
When vagal tone is HIGH (healthy), you experience: ✓ Stress resilience (recover quickly from challenges)
✓ Deep, restorative sleep
✓ Efficient digestion
✓ Emotional balance
✓ Low inflammation
✓ Strong immunity
✓ Appropriate pain perception
When vagal tone is LOW (problematic), you get stuck in sympathetic overdrive: → Chronic anxiety, panic attacks
→ Insomnia or unrefreshing sleep
→ Digestive issues (IBS, bloating, reflux, constipation)
→ Chronic pain and heightened pain sensitivity
→ Emotional dysregulation
→ Weakened immunity
→ Hormonal imbalances
→ Brain fog
Low vagal tone is the hidden driver of most “medically unexplained” symptoms.
And your doctor isn’t testing for it.
How to measure what your doctor misses
Heart rate variability (HRV)
The gold standard for measuring nervous system health and vagal tone.
What it is:
The variation in time between heartbeats. It sounds counterintuitive, but a “healthy” heart doesn’t beat like a metronome—it has variability.
Why it matters:
High HRV indicates your nervous system is flexible and responsive—able to shift between sympathetic and parasympathetic as needed.
Low HRV indicates your nervous system is rigid and stuck—usually in sympathetic dominance.
What the numbers mean:
- High HRV (60-100+): Healthy vagal tone, good stress resilience
- Moderate HRV (40-60): Declining function, increased stress load
- Low HRV (20-40): Poor vagal tone, autonomic dysfunction
- Very Low HRV (<20): Severe dysregulation, high risk for health issues
How it’s measured:
Wearable devices (Apple Watch, Oura Ring, WHOOP, Polar chest straps), smartphone apps, or clinical-grade monitors
At Calm San Diego, we measure your HRV before treatment and track changes throughout your protocol. It’s objective proof your nervous system is regulating.
Chinese Medicine diagnosis
While Western medicine looks for disease, Chinese Medicine looks for patterns of imbalance—and it’s remarkably good at identifying what standard tests miss.
Pulse diagnosis:
Your pulse reveals the state of Qi, Blood, Yin, Yang, and organ systems. A skilled practitioner can feel:
- Strength or weakness of various systems
- Whether you’re in excess or deficiency
- Heat, Cold, Dampness, or Dryness
- The quality of blood flow and nervous system state
For example:
- A wiry pulse indicates Liver Qi stagnation (stress, tension, emotional holding)
- A thin pulse indicates Blood or Yin deficiency (depletion, exhaustion)
- A rapid pulse indicates Heat or hypermetabolic state
- A deep, weak pulse indicates Kidney deficiency (depleted reserves, burnout)
Western correlation: Pulse quality reflects autonomic state, HPA axis function, and cardiovascular health.
Tongue diagnosis:
Your tongue is a map of your internal landscape:
- Color reveals Blood and Qi status (pale = deficiency, red = Heat, purple = Blood stasis)
- Coating shows digestive function and pathogenic factors (thick coating = Dampness, yellow = Heat, no coating = Yin deficiency)
- Shape indicates deficiency or excess patterns (swollen = Dampness, thin = Blood/Yin deficiency)
- Cracks or trembling reveal Yin deficiency or internal Wind (nervous system instability)
Symptom pattern recognition:
The constellation of symptoms tells the story. For example:
Pattern: Liver Qi stagnation
- Irritability, mood swings
- Digestive issues that worsen with stress
- PMS, breast tenderness
- Tension headaches
- Chest or rib tightness
- Sighing frequently
Western correlation: Sympathetic overdrive, high cortisol, HPA axis dysregulation
Pattern: Heart Blood deficiency
- Anxiety, palpitations
- Insomnia (difficulty falling asleep)
- Poor memory, concentration
- Easily startled
- Vivid dreams or nightmares
Western correlation: Overactive amygdala, low GABA, inadequate parasympathetic activity
Pattern: Spleen Qi deficiency
- Fatigue after eating
- Bloating, loose stools
- Brain fog
- Easy bruising
- Low appetite or nausea
- Weakness in limbs
Western correlation: Poor vagal input to gut, low stomach acid, impaired nutrient absorption, hypoglycemia
Pattern: Kidney Yin deficiency
- Night sweats, hot flashes
- Insomnia (waking at 3-5 AM)
- Anxiety with restlessness
- Tinnitus, dizziness
- Lower back pain
- Feeling “wired but tired”
Western correlation: HPA axis dysfunction, dysregulated cortisol rhythm, depleted stress reserves
These patterns are diagnosed through pulse, tongue, and symptom analysis—not lab tests. Yet they’re real, measurable through functional assessment, and treatable.
Common patterns of dysregulation
Pattern 1: The “wired and tired” pattern
What it looks like:
- Exhausted all day but can’t fall asleep at night
- Mind racing despite physical fatigue
- Relying on caffeine to function, then can’t wind down
- Anxiety with exhaustion
- Digestive issues
- Feeling “on edge” even when nothing is wrong
What’s happening:
- Western: Chronic sympathetic activation, HPA axis dysregulation, cortisol imbalance (high at night when it should be low), low vagal tone
- Chinese Medicine: Liver Qi stagnation with Kidney Yin deficiency—stress depleting your reserves
Why labs are “normal”: Your cortisol might still be in “normal range” but the rhythm is off. Standard one-time cortisol tests don’t capture this. You’d need salivary cortisol testing at 4 time points throughout the day to see the dysfunction.
Pattern 2: The “everything hurts” pattern
What it looks like:
- Chronic widespread pain (fibromyalgia-type)
- Pain moves around or spreads over time
- Fatigue that makes pain worse
- Sleep doesn’t help
- Stress makes everything worse
- “Normal” sensations feel painful
What’s happening:
- Western: Central sensitization—nervous system amplifying pain signals, neuroinflammation, low vagal tone, HPA axis dysfunction
- Chinese Medicine: Qi and Blood stagnation with deficiency—not enough flow or nourishment, often with underlying Liver Qi stagnation and Kidney deficiency
Why labs are “normal”: Inflammatory markers (CRP, ESR) might be “normal” because neuroinflammation (inflammation in the nervous system) doesn’t show up on standard blood tests. Your pain is real—it’s just neurological, not structural.
Pattern 3: The “my gut is destroying my life” pattern
What it looks like:
- Bloating after every meal
- Alternating constipation and diarrhea (IBS)
- Food sensitivities multiplying
- Brain fog after eating
- Anxiety and gut symptoms intertwined
- Exhaustion, poor nutrient absorption
What’s happening:
- Western: Gut-brain axis dysfunction, low vagal tone, leaky gut, dysbiosis (bacterial imbalance), visceral hypersensitivity
- Chinese Medicine: Spleen Qi deficiency with Liver Qi stagnation—digestion weak and stressed nervous system attacking it
Why labs are “normal”: Standard GI labs (colonoscopy, endoscopy, celiac panel) often come back clear because they’re looking for disease (IBD, cancer, celiac). Functional disorders like IBS don’t show structural damage. Vagal dysfunction and autonomic imbalance aren’t measured.
Pattern 4: The “I can’t sleep no matter what I try” pattern
What it looks like:
- Can’t fall asleep (lying awake for hours)
- Wake at 3 AM and can’t get back to sleep
- Sleep feels light and unrefreshing
- Tired all day but “wired” at bedtime
- Tried melatonin, magnesium, sleep hygiene—nothing works
What’s happening:
- Western: Nervous system won’t allow transition to parasympathetic mode, HPA axis dysregulation (cortisol high at night), low vagal tone, poor sleep architecture
- Chinese Medicine: Heart Blood or Yin deficiency, Liver Qi stagnation, Kidney deficiency—Shen (spirit) can’t settle
Why labs are “normal”: Sleep studies might show “normal” sleep stages (if you sleep during the study at all). But sleep architecture quality, nervous system state during sleep, and cortisol rhythm aren’t typically assessed.
How we treat what standard medicine misses
At Calm San Diego, our Nervous System Reset Protocol addresses the dysregulation standard medicine doesn’t measure:
Step 1: Measure what matters
We use:
- HRV testing to assess autonomic function objectively
- Detailed symptom intake to identify patterns
- Chinese Medicine diagnosis (pulse, tongue, pattern differentiation)
- Review of any existing labs to rule out actual pathology (we’re not against Western medicine—we integrate it)
This gives us the full picture—what’s measurable AND what Western labs miss.
Step 2: Vagus nerve activation
Targeted acupuncture to stimulate vagal pathways:
Auricular (ear) acupuncture directly activates the vagus nerve:
- Ear Shen Men, Sympathetic point, Heart, Kidney points
- Immediate shift in autonomic state
- Research shows improved HRV within minutes
Body acupuncture points shown to improve parasympathetic activity:
- PC6 (Inner Gate): Calms anxiety, regulates heart, improves vagal tone
- HT7 (Spirit Gate): Anchors Shen, reduces anxiety, improves sleep
- ST36 (Leg Three Miles): Tonifies Qi, improves digestion, activates parasympathetic response
- CV17 (Chest Center): Opens chest, calms Heart, regulates Qi and emotions
- GV20 (Hundred Convergences): Calms Shen, clears mind, regulates autonomic nervous system
Breathwork training to strengthen vagal tone:
- Diaphragmatic breathing
- 4-7-8 breath
- Physiological sigh
- Practices you can use at home to self-regulate
Research shows this approach:
- Reduces anxiety by 40-50%
- Improves sleep quality
- Lowers cortisol
- Reduces inflammation
- Normalizes digestion
- Improves HRV (objective measure of nervous system regulation)
Step 3: Pattern-based treatment
We customize treatment based on YOUR specific Chinese Medicine pattern:
For Liver Qi stagnation:
- Acupuncture: LV3, GB34, LV8, GB20, PC6
- Herbs: Xiao Yao San (Free and Easy Wanderer)
For Heart Blood deficiency:
- Acupuncture: HT7, SP6, ST36, BL15, BL17
- Herbs: Suan Zao Ren Tang (Sour Jujube Decoction) or Gui Pi Tang (Restore the Spleen)
For Spleen Qi deficiency:
- Acupuncture: ST36, SP6, CV12, BL20, BL21
- Herbs: Si Jun Zi Tang (Four Gentlemen) or Shen Ling Bai Zhu San
For Kidney Yin deficiency:
- Acupuncture: KI6, KI3, SP6, HT6, LV8
- Herbs: Liu Wei Di Huang Wan (Six Ingredient Rehmannia)
These formulas have been used for centuries and are now being validated by modern research showing they:
- Regulate neurotransmitters (GABA, serotonin, dopamine)
- Reduce cortisol and normalize HPA axis
- Improve gut barrier function
- Reduce neuroinflammation
- Support mitochondrial function
Step 4: Lifestyle integration
Nervous system regulation requires support outside the treatment room:
Blood sugar stabilization:
Prevents cortisol spikes that worsen anxiety and disrupt sleep. Protein + fat breakfast, avoid high-sugar/high-carb meals.
Sleep hygiene optimization:
Consistent bed/wake times, morning sunlight, evening wind-down, cool dark room.
Stress management practices:
Not just “relax more”—actual tools like breathwork, grounded movement (walking, gentle yoga), boundaries.
Movement that supports rather than depletes:
Gentle exercise that activates parasympathetic (yoga, tai chi, walking in nature) vs. intense exercise that further activates sympathetic when you’re already depleted.
Supplements tailored to your needs:
- Magnesium glycinate (nervous system calming)
- L-theanine (reduces anxiety without sedation)
- Omega-3s (anti-inflammatory, neurotransmitter support)
- B-complex (nervous system support)
- Adaptogens matched to your pattern (Ashwagandha, Rhodiola, etc.)
Case study: Rachel’s “normal” labs, debilitating symptoms
Presenting concerns: 35-year-old woman with:
- Severe anxiety and panic attacks (daily for 18 months)
- Insomnia (taking 2+ hours to fall asleep, waking at 3 AM)
- IBS (bloating, alternating constipation/diarrhea)
- Chronic fatigue (despite sleeping)
- Brain fog affecting work
- Heart palpitations
- Muscle pain (neck, shoulders, back)
Previous medical workup:
- Complete blood count: Normal
- Comprehensive metabolic panel: Normal
- Thyroid panel (TSH, Free T4, Free T3): Normal
- Hormone panel: Normal
- Cardiac workup (EKG, echocardiogram): Normal
- Colonoscopy: Normal
- Brain MRI: Normal
Diagnoses given:
- Generalized anxiety disorder
- IBS
- “Functional” disorder
Offered treatments:
- SSRIs (tried, intolerable side effects)
- Benzodiazepines (helped acutely but concerned about dependence)
- Antispasmodics for gut (minimal help)
- “Manage your stress better”
Rachel felt: invalidated, hopeless, broken
Our assessment:
Western measures:
- HRV: Severely low (score 26/100)—indicating poor vagal tone and stuck in sympathetic dominance
- Autonomic dysfunction with HPA axis dysregulation
- Gut-brain axis dysfunction
- Central sensitization component to pain
Chinese Medicine diagnosis:
- Primary pattern: Liver Qi stagnation with Heart Blood deficiency and Spleen Qi deficiency
- Pulse: Wiry (Liver), Thin (Blood deficiency), Weak in Spleen position
- Tongue: Pale body with thin coating, slight quiver
This pattern explained EVERYTHING:
- Liver Qi stagnation → anxiety, irritability, IBS worsened by stress, muscle tension, palpitations
- Heart Blood deficiency → insomnia, panic, poor concentration, easily startled
- Spleen Qi deficiency → bloating, fatigue after eating, brain fog, loose stools
Nervous System Reset Protocol treatment (12 weeks):
Phase 1-2: Acute (Weeks 1-4)
Acupuncture: 2x per week
- Vagus nerve activation: Auricular Shen Men, Sympathetic point, PC6, HT7
- Smooth Liver Qi: LV3, GB34, LV8
- Nourish Heart Blood: HT7, SP6, ST36, BL15, BL17
- Tonify Spleen Qi: ST36, SP6, CV12, BL20
- Calm Shen: Yintang, GV20, Anmian
- Release somatic holding: GB21, SI11, BL10 (neck/shoulder tension)
Herbal formula: Modified Xiao Yao San (Free and Easy Wanderer) to smooth Liver Qi + additions to nourish Heart Blood and tonify Spleen
- Taken 2x daily
Nutritional changes:
- Blood sugar stabilization: protein + fat breakfast, balanced meals
- Anti-inflammatory: eliminated gluten, dairy, processed foods temporarily
- Warm, cooked foods to support Spleen Qi (avoided cold/raw)
- Bone broth, fermented foods, dark leafy greens
Supplements:
- Magnesium glycinate 400mg before bed
- L-theanine 200mg 2x daily
- Omega-3s 2000mg daily
- B-complex
- L-glutamine (gut lining repair)
Lifestyle:
- Morning sunlight
- Evening wind-down (dim lights, warm bath, 4-7-8 breathing)
- Reduced caffeine
- Gentle walks (not intense workouts that further activated sympathetic)
Phase 3: Active (Weeks 5-12)
Acupuncture: 1x per week
- Continued vagus nerve work
- Adjusted points as patterns evolved
Continued protocols with modifications
Results after 12 weeks:
Anxiety:
- Panic attacks reduced from daily to 1x per month (mild)
- Baseline anxiety decreased 70-80%
- Able to handle stressors without spiraling
- Feeling grounded and present
Sleep:
- Falling asleep within 30 minutes
- Sleeping through night 5-6 nights/week
- Waking rested
Digestion:
- Bloating 80% resolved
- Regular bowel movements
- Can eat wider variety of foods
Energy & cognition:
- Brain fog completely resolved
- Sustained energy
- Work performance improved
Pain:
- Muscle tension reduced 70%
- Palpitations resolved
HRV:
- Improved from 26 to 67 (good range)
- Objective proof of nervous system regulation
Medications:
- Off benzodiazepines completely
- Reduced SSRI by 50% with MD oversight
Rachel’s words:
“For 18 months, I was told my labs were fine so I should be fine. But I wasn’t. I felt crazy, broken, like I was failing at life. No one could tell me what was actually wrong. Angela was the first person who looked at me and said, ‘Your nervous system is stuck. That’s why you feel this way. And we can fix it.’ She was right. Everything was connected—my anxiety, my sleep, my gut, my pain. It was all my nervous system. I finally have answers. I finally have my life back.”
When to consider nervous system dysregulation
You might have autonomic dysfunction if:
- Your symptoms are diverse and seem unconnected (anxiety + gut issues + pain + sleep problems)
- Standard medical testing shows “normal” results
- Symptoms worsen with stress
- You feel “wired but tired”
- Medications don’t work or cause intolerable side effects
- You have a history of chronic stress, trauma, or prolonged illness
- Multiple doctors have told you “it’s just anxiety” or “learn to manage stress”
- You’ve tried “everything” with minimal improvement
The bottom line
Standard medical testing is valuable for catching disease. But it’s not designed to measure nervous system function—and that’s often where the problem lies.
If you feel terrible but your labs are “fine,” you’re not crazy. You’re not making it up. You’re not being dramatic.
You’re just looking in the wrong place.
Your nervous system is speaking. We know how to listen.
Ready for answers?
Book your nervous system assessment
📍 Calm San Diego
San Diego, CA
We specialize in finding what conventional medicine misses—and fixing it.
