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Nausea
Ongoing nausea can begin in the stomach, the brainstem, the inner ear, or hormones. We trace the signal: motility, vestibular input, blood sugar, the vagus nerve, toxins, and medications.
What you may be noticing
A low, rolling queasiness that sits with you through the day. It may be worse in the morning, after meals, in the car, or when you are anxious. You eat less and avoid foods that once felt safe. Sometimes it comes with dizziness, headache, or fatigue.
Nausea with severe headache, chest pain, abdominal pain, confusion, persistent vomiting, or signs of dehydration needs urgent care. If you might be pregnant, confirm that first.
Why it is rarely one thing
Nausea is coordinated by the brainstem. It receives input from four main sources: the gut through the vagus nerve, the inner ear through the vestibular system, the bloodstream through a chemical sensing area called the area postrema, and the higher brain through emotion and memory. Any of these can turn nausea on.
This is why chronic nausea rarely has one answer. A slow stomach, gallbladder dysfunction, or SIBO can signal through the vagus. Vestibular migraine and motion sensitivity signal through the balance system. Low blood sugar, hormonal shifts, medications, and toxins such as mold signal through the blood. Anxiety and anticipatory dread signal from above. Not a stomach problem alone, but a brainstem receiving a mix of messages.
Because the brain is the master system, I work from both directions: clearing the inputs that keep sending the signal, and calming the brainstem that receives it. The vagus nerve carries most gut information to the brain, and it also carries calming signals back down, which makes it a powerful place to begin.
Patterns we look for
- Gastric emptying and upper gut motility.
- Gallbladder function and bile flow.
- SIBO and microbiome patterns.
- Vestibular function and migraine features.
- Blood sugar swings and meal timing.
- Pregnancy and hormonal cycle patterns.
- Medications and supplements, especially those taken on an empty stomach.
- Autonomic balance and POTS features.
- Histamine and mast cell patterns.
- Cannabis use, which can cause a cyclic vomiting pattern.
- Mold and toxic burden when symptoms began in a particular building.
How I evaluate it
The comprehensive functional neurological exam assesses the vestibulo-ocular reflex, saccades, smooth pursuit, balance, brainstem reflexes, and autonomic responses to standing. Vestibular and autonomic findings often explain nausea that labs miss.
Functional labs may include a comprehensive metabolic panel, liver and gallbladder markers, lipase, a thyroid panel, fasting glucose and insulin, a pregnancy test where relevant, B12, and breath testing for SIBO when indicated. I coordinate imaging and gastric emptying studies with your physician.
How we address it
- Rule out urgent and structural causes with your physician.
- Identify which input is driving the signal: gut, vestibular, chemical, or emotional.
- Calm the brainstem with vagus nerve stimulation: slow breathing with a long exhale, humming, and gentle device-based options where appropriate.
- Add gentle clockwise abdominal vibration or massage, following the direction of the colon, unless you are pregnant, have a hernia, recent abdominal surgery, or unexplained abdominal pain.
- Stabilize blood sugar with regular protein-rich meals, and support motility and bile flow.
- Address vestibular contributors with brain-based vestibular rehabilitation.
- Use gentle supports such as ginger, which has research support for nausea, with your care team.
When the brainstem receives clearer signals, the stomach can finally settle.
Book your Comprehensive Functional Medicine Eval/Neurological Exam today to discover what the contributing root causes are that are underlying your health concerns.