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Episode 30: Transformational Approaches to Multiple Sclerosis and Autoimmunity with Dr. Terry Wahls

Transformational Approaches to Multiple Sclerosis and Autoimmunity with Dr. Terry Wahls

Transformational Approaches to Multiple Sclerosis and Autoimmunity with Dr. Terry Wahls

Listen to Episode 30

Summary (full transcript below)

My podcast this month is with Dr. Terry Wahls. Not only do I have deep admiration for her personal journey of healing from Multiple Sclerosis (MS). I appreciate her years of work at the Iowa VA, where she made FxMed available (and affordable) to vets, and researched her protocols.

Dr. Terry Wahls was a practicing primary care physician when she was diagnosed with relapsing-remitting MS. Despite treatment at some of the finest medical institutions in the United States, her health progressively declined until she could no longer walk. When she discovered Functional Medicine, she made a rapid turnaround. Soon she wasn’t just walking again, she was doing 20-mile bike rides. Today, Dr. Wahls conducts research using variations of her protocol, including intensive directed nutrition, progressive exercise programs, electrical stimulation, and the use of dietary supplements for patients with MS. In this episode of New Frontiers in Functional Medicine, Dr. Wahls talks with Dr. Fitzgerald about her physical and spiritual transformation, and how other patients with chronic autoimmune conditions can realize similar results.

In this podcast you’ll hear:

  • Dr. Wahls personal supplement, dietary, and physical training routines
  • Why it’s essential to personalize every health protocol
  • Best ‘standard of care’ lab tests for patients with MS
  • Key supplements for patients with MS
  • Cutting-edge gadgets that are being used for healing, including cold lasers, electromagnetic mats, and vibrating platforms
  • Special considerations for vegans and vegetarians
  • Which patients are good candidates for stem cell therapy
  • How to get patients enthusiastic about adopting new food and supplement protocols
  • How to score organic produce at farmer’s markets for pennies on the dollar
Dr. Terry Wahls

Dr. Terry Wahls is a clinical professor of medicine at the University of Iowa where she conducts clinical trials. She is also a patient with secondary progressive multiple sclerosis, which confined her to a tilt-recline wheelchair for four years. Dr. Wahls restored her health using a diet and lifestyle program she designed specifically for her brain and now pedals her bike to work each day. She is the author of The Wahls Protocol: How I Beat Progressive MS Using Paleo Principles and Functional Medicine, The Wahls Protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principles (paperback), and the cookbook The Wahls Protocol Cooking for Life: The Revolutionary Modern Paleo Plan to Treat All Chronic Autoimmune Conditions.

You can learn more about her work from her website, www.terrywahls.com. She conducts clinical trials that test the effect of nutrition and lifestyle interventions to treat MS and other progressive health problems. She also teaches the public and medical community about the healing power of the Paleo diet and therapeutic lifestyle changes that restore health and vitality to our citizens. She hosts a Wahls Protocol Seminar every August where anyone can learn how to implement the Protocol with ease and success. Follow her on Facebook (Terry Wahls MD) and on Twitter at @TerryWahls. Learn more about her MS clinical trials by reaching out to her team MSDietStudy@healthcare.uiowa.edu.

Clinical trials in which Dr. Wahls’ team is participating

The links to our Nations MS Society funded research
http://www.nationalmssociety.org/About-the-Society/News/National-MS-Society-and-University-of-Iowa-Launch

Two studies in Bastyr University that are asking patients with MS or Parkinson’s disease about whether they are following the Wahls diet. These studies are based upon surveys that are completed every 6 months and do not require visits to the study site.

Multiple sclerosis
http://bastyr.edu/research/studies/complementary-alternative-medicine-care-multiple-sclerosis-cam-care-ms

Parkinson’s study
http://bastyr.edu/research/studies/complementary-alternative-medicine-care-parkinsons-disease-cam-care-pd

Podcast Sponsors
Metagenics
Metagenics is a global lifestyle medicine company, offering products and programs exclusively to health care practitioners.

Biotics Research Corporation utilizes “The Best of Science and Nature” to create superior nutritional supplements, available exclusively to healthcare professionals.

Full Transcript

Kara Fitzgerald: Hi, everybody. Welcome, again, to New Frontiers in Functional Medicine, and I am Dr. Kara Fitzgerald. Today, I’m with Dr. Terry Wahls, who is quickly becoming a friend and mentor to me. I love her work. I’m just so proud that she’s part of our functional medicine tribe, and just absolutely, absolutely excited about the multi-faceted approach she’s taking, strongly rooted in functional medicine.

Let me tell you a little bit about her, and then we’ll jump right in. Dr. Wahls is a clinical professor of medicine at the University of Iowa, where she teaches residents. She sees patients in a therapeutic lifestyle clinic, and she conducts lots of clinical trials on the therapeutic efficacy of nutrition and lifestyle interventions to treat MS. I want to throw in that Terry’s also launching an ALS study, and she’s going to talk to you about how you can support her amazing body of research. We are very fortunate to have Terry as faculty at the Institute for Functional Medicine. Specifically, she’s in the energy module. She’s author- you probably know- of The Wahls Protocol: How I Beat Progressive MS Using Paleo Principles and Functional Medicine, and the cookbook The Wahls Protocol, Cooking for Life: The Revolutionary Modern Paleo Plan to Treat All Chronic Autoimmune Conditions. We love that book. We’re using it. My nutrition team absolutely loves this cookbook.

You can learn about Terry and her work at her website, TerryWahls- that’s W-A-H-L-S- dot com. Also, Terry does an annual seminar where she trains individuals- I’m assuming mostly these are patients, or consumers, to implement the Wahls Protocol, but I would imagine that there are clinicians showing up here as well. Terry, welcome to New Frontiers in Functional Medicine.

Terry Wahls: Hey. Thank you so much for having me.

Kara Fitzgerald: Absolutely. The fact that you’re in the trenches as a clinician, and you’re doing this research. A lot of research, actually. You’re really prolific. I just love it. I love it, love it, love it, and just really, really want to support you. Now, folks, again, just in case I forget, you will find on the transcription page a whole bunch of links to some of Terry’s publications.

All right. Most of us know that you, yourself, have MS. Give me your background, and this has obviously led to the creation of your work, your life’s work here. Give me your background, and then give me an update on how you’re doing today.

Terry Wahls: Yeah. You know, I’m a conventional academic doc at the university here. I was very skeptical of complimentary, alternative medicine, but God works in mysterious ways. I got to have the privilege of having relapsing-remitting MS. Saw the best people here, and at the Cleveland Clinic, and got steadily worse anyway. Ended up in a [inaudible 00:03:15] wheelchair, developed progressive MS, and took the biologic drugs. Continued to get worse, and would go back and start reading the basic science, experimenting with vitamins and supplements. Used the ancestral health paleo principles. Continued to decline, and then discovered the Institute for Functional Medicine, had a longer list of supplements. Probably flattened the decline, and then when I had the insight to take this long list of supplements and redesign my paleo diet using those supplements as a guide to create what I now call the Wahls Protocol, that’s when the magic happened, and when I had really relatively rapid improvement in mental clarity, improvement in my energy, and improvement in my physical strength so that I was up walking again, and then was even able to get on my bike and do a 20-mile bike ride that first year, which is stunning, the speed of my recovery.

Continued to improve for several years. Then I started developing intense back pain, and in 2015, over the year my back pain got severe enough I went in to see neuro, and we did a workup. I was glad to hear it was not my MS, but it was spinal stenosis, and so I ended up having surgery, and antibiotic-associated diarrhea. Lost a lot of weight, a lot of muscle mass. Really became very ill, post-op. It was a long slog back from that, but I kept doing my physical exercises, my PT, and I’m pleased to say I’m back up, able to walk a mile, a mile and a quarter, sometimes a mile and a half with my dog pretty comfortably. I can stand again without as much back pain, although I’ll probably never be able to stand for two hours to give a lecture, so I give my lectures seated in a captain’s chair. If it’s a short lecture, half an hour, I can get up and walk around the stage, but certainly my energy is fine. My mental clarity is fine. I’m writing books, writing grants, writing papers, doing research, and able to take my dog for hikes, so life is really very good.

Kara Fitzgerald: That’s wonderful. Yeah, I know. Whenever I see you, you’re always in amazing spirits, and just generous with your time with everybody. You know, out of curiosity, what were you doing prior to MS? What was your focus in clinic?

Terry Wahls: In clinic, I was doing primary care, just like all of the other primary care docs in the VA, and I was teaching residents. My area of research had to do with diagnostic error, and so I’d look at secondary data using electronic medical records, see what errors were being … Labs were being missed that were clinically significant, and we would survey our clinicians to find out what their experiences were with missed lab results. We had done that over several years, so that was a very interesting body of research that I had going, but yeah, it was interesting. I was going to stay in that body of research, but it was the chair of medicine who called me in after I recovered. He said, “You know what? You need to shift your research, because this is much more important.”

Kara Fitzgerald: Oh, man.

Terry Wahls: He helped me get some scientific mentors, because this was a whole new area of focus obviously, and that’s been very helpful. He got me plugged in with some very good people in exercise physiology, and our best people here at the university doing dietary studies. It’s all worked out beautifully.

Kara Fitzgerald: Definitely. It’s a “meant to be” story. It’s incredible. Your previous experience does sound fascinating, but yeah, thank god that you were led to begin to actually research this model that’s turned your life around, and so many others. I appreciate now, as I start to stick my toe into the process of clinical research, it’s challenging when you’re working with so many variables, so my hat’s off.

Terry Wahls: It is much easier to do mouse studies. It is much easier to do supplement studies. Doing human studies, you have to be willing to have all these multitude of variables. Then the other thing that was fascinating, when I started to do this research, many of the folks here at the university kept telling me, meeting with me, saying, “This is not how you do it. You gotta do it … Just pick what you think was the most important variable in the study, address that.” Fortunately for me, the institutional review board, and I’ve been a member of that, they had seen the rapid decline and this amazing recovery, and I met with the chair of the IRB, and we talked about my clinical trial, and he agreed that the question was, “Could anyone else replicate what I did?” We had to, in a very rigorous way, define what my intervention was, so it could be studied and replicated.

Even though it was complicated, it was incredibly messy, and we had all sorts of pressures to not approve that study and to just simplify it, the chair of the IRB said, “No. This is the first step. All we’re testing is, ‘Can anyone else do what Terry did? If they can, what happens?'” He called in the head of the Pharmacy and Therapeutics Committee who was in vigorous opposition. Said, “There’s no safety data,” other than what I had done. He said, “Okay. Tell us who needs to be excluded to make this safe, and what are the safety labs that Terry needs to do, and how frequently?” Once we got that worked out, then I went back through the reapplication process and the study was approved.

All in all, it took me about a year to get everything in place, to get the study approved. It would not have been approved had I not had the chair of the IRB on my side, and I also have since learned the reason the chair of the IRB was on my side was two factors. One, he had seen my decline and recovery, and the dean of the College of Medicine, who had been the chair of medicine earlier, watching my decline and recovery, had told him that he really wanted to have my study get approved. The goal was to help me figure out what all I would need to do to do this safely.

Kara Fitzgerald: Wow. That’s an amazing story of being in the right place, serendipity.

Terry Wahls: Yes.

Kara Fitzgerald: I want to underscore, too, that you failed standard of care. The big gun, biologics, you failed, and you were still declining. A lot of us have seen those images of when you were bedridden, and they’re stark.

Terry Wahls: Yeah. Absolutely. People should understand that I believed all that stuff.

Kara Fitzgerald: Yes. Right.

Terry Wahls: I still recognize that there’s a role for these very potent biologics, and yes, they can do great things, but functional medicine can do great things with much less risk.

Kara Fitzgerald: Yes. Yes. And you know what? I want to just underscore slightly about the process that you shared with us, because you had to individualize it. You failed standard of care, then you actually failed what I think sounds a little bit like almost entry-level functional medicine.

Terry Wahls: Oh, absolutely.

Kara Fitzgerald: Some of the basic interventions that we might start with people who aren’t quite as sick as you were at the time. You had to dive in and individualize … Really think about your condition and individualize it. Yeah, go ahead.

Terry Wahls: A lot of people say paleo diets will fix everything.

Kara Fitzgerald: Yes. That’s right. Right.

Terry Wahls: Well, I love the paleo diet, but it does not fix everything.

Kara Fitzgerald: No.

Terry Wahls: We do have to really understand where people are at, personalize things, and realize that as soon as any of us, myself included, say that this one approach will fix anything, it’s an invitation to be wrong. That we have to personalize and understand factors, and optimize all of them as well as we can.

Kara Fitzgerald: Yes. Yes. I do understand, and there’s levels to it. There’s entry-level functional medicine, but now you’ve drilled down and you’re focusing on neurodegenerative. MS primarily, but you’re moving into ALS, and some of the interventions, you can broad brush your program with other neurodegenerative conditions. Then we can get more individualized than that, obviously, but in your protocol, you’ve needed to individualize as much as possible, but then extrapolate so you can address more people.

Terry Wahls: Correct. Correct. I mean, I think there are parts to what I do can certainly be generalized to everyone, because improving mitochondria, improving nutrition universally is a very helpful approach. As we do that, you have to pay attention to how people are responding, and adjust the intervention based on people’s response.

Kara Fitzgerald: Tell me then, on that note, what your intervention is. I mean, actually, I’d like to hear not only what you’re doing in the research-slash-clinic setting, but where you’re at with yourself. What are some of the things you’re doing with yourself these days?

Terry Wahls: Okay. Myself, and I’ll sort of take you through my typical day. I like to have a 24-hour fast, so in the morning I’ll get up, I’ll take my morning cocktail of vitamins, supplements, nutrients and water, and I’ll drink water throughout the day. I might drink green tea, yerba mate, or a variety of herbal teas, calendula tea. Then in the evening, I’ll have my meal. My typical meal will be a big green salad, some cooked vegetables, usually in the sulfur-rich category, fermented vegetables with that, and then a protein source such as salmon. Tonight we’ll be having some brats, and we’ll be having beet greens and brats. It’ll be pretty yummy.

Kara Fitzgerald: Sounds good.

Terry Wahls: And then we’ll have cherries, because those are coming in right now, and I know a friend who’s coming to dinner has a peach tree, so we’ll be having some fresh peaches, and probably some chia pudding with those fresh berries, cherries, and peaches.

Now, the physical training that I’m doing, I have a yoga-Pilates routine that I do. I also swam this morning, and I do half an hour of cognitive training. I’ve gone back and forth between Brain HQ and Lumosity, and this morning’s workout was Lumosity. I do daily inversions, and I do that because of my back pain and scoliosis. While I’m inverted, I’m doing my positive affirmations, and I’m calling out to my stem cells to remodel my back and my disks while I’m hanging up inverted, and I’m calling my stem cells to come into my brain and remodel my brain and my spinal cord, and do the repairs there. I’ll do three four-minute sessions while I’m inverted. Because I’m not at the university today, I’ll take my dog for a mile, mile and a half walk this afternoon, or I may go out for a bike ride. We’ll see what that routine is.

Typically on the weekends, I try to get in a 40 to 60 minute sauna, in a near infrared sauna. I’ll get the temperature up to 140 to 160 degrees while I’m in the sauna. The infrared has a deep … I really sweat a lot more in the near infrared sauna. I also have a pulse, electromagnetic mat that I lay on from time to time. It also has the ability to synchronize binaural beats through the audio, and binaural beats through a visual sequence, so that really gives a very deep relaxation, so I’ll periodically train with that. I have a cold laser that I will periodically use in the prefrontal cortex to do a little more red light stim to my brain as well, and those are sort of the fun gadgets that I’ll use from time to time.

Kara Fitzgerald: Any protocols, brands? I mean, is this written down anywhere, or are these things that you’re just …?

Terry Wahls: Well, these are things I talk about at my seminar. There are a variety of brands that one can use for cold lasers that are available, and this is really experimental stuff. The cold laser, it will depend on the frequency, in terms of how much penetrance it will have. The cold laser has a long history of use in the physical therapy world for orthopedic injuries, musculoskeletal injuries, pain. More recently, it’s being recognized that it’s very helpful for the electronic transport chain, improving mitochondrial function, so of course that’s not surprising that I’m sort of intrigued and have been looking at this. Some interesting reports that it’s been useful in people with traumatic brain injury, helping them recover function. It’s been used as another way of stimulating the acupuncture points, which you can use with an electrical stimulator, or you could use with these cold laser stimulators, so it’s been written up in that sense as well.

Kara Fitzgerald: That’s great. Are you-

Terry Wahls: Again, these are some of the devices that I talk about during my seminar in the health professional workshop, [inaudible 00:18:51].

Kara Fitzgerald: Folks, you can find out about Terry’s seminar at her website. Are you doing e-stim these days anymore?

Terry Wahls: I do not. I did e-stim … This is sort of interesting. I did e-stim for years. Four years, in fact, and I was doing it essentially all of my waking hours, so I would do it while I did my physical workouts, and then I would do it while at work, and when the current was going on, I’d have an isometric contraction that I would do at the same time as the current, and it would build more muscle mass. The current also stimulates release of endorphins or nerve growth factors in the brain, and so for several years, my elecrophysiology team was very concerned because there’s no safety data on doing e-stim for as many years as I was doing, and they understandably were concerned about the safety of what I was doing. I’d periodically try and come off, but never cared for the dip in my mood or cognitive abilities as I tried to come off.

Then another one of my physical therapy team members brought me into his lab, and showed me their work on vibrating platforms. I thought, “Well, this is pretty interesting.” I got a vibrating platform and started doing my strength training on that, and once I was doing that, then I was able to stop the e-stim. I did not mention that. As part of my strength training workout, I do strength training on a vibrating platform. That will induce more nerve growth factor release and endorphin release, and my theory is Dr. Shields’ [inaudible 00:21:00] theory, that the vibrating platform also releases a lot of endorphins and nerve growth factors, and so I was getting enough of a [bollus 00:21:12] from my vibrating platform that I wasn’t experiencing a relative lack as I dialed back from my hours of e-stim.

Kara Fitzgerald: That’s really wonderful. I know I’m prescribing e-stim under you’re … You’ve given me some really good tips for that, for folks who don’t have a vibrating platform, but I’m assuming, again, you’ll talk about this at your seminar?

Terry Wahls: Correct. Correct. We talk about all these devices that I use, and I certainly explain that this is all experimental stuff, but here’s the rationale and potential benefits for using these devices, and then invite people to consider adding them to their practice with the caveat that this is all off-label use, and so we can try them, pay close attention, and monitor their use carefully.

Kara Fitzgerald: Let me just confirm, because I said this early in the podcast, but let me just get it from you. Clinicians, this would be rich for clinicians as well as [crosstalk 00:22:16]?

Terry Wahls: Oh, yeah. The three days, you really learn the essence of the diet and lifestyle that I talked about in my book, what I’ve learned since writing the book, and of course that’s now four years old, so I’ve learned a fair amount, so we’ve made some adjustments. We have a lot more research out of my lab that we talk about, plus people get a chance to see me teach these complicated concepts to 300 people at a time, including how you do your own timeline, how you do your matrix, how you get people to really tap into their internal motivation, to be willing to do this big, big job of giving up the foods and lifestyles to which we’re addicted, and to go on this journey.

Then on the fourth day, we talk … This is where I talk about the devices, why to use them, how to use them. We’ll have some devices on hand so people can see the devices. Then I go through some more advanced therapeutic stuff, really, that I’ve learned since writing my book. What I think is really the most compelling, Dale Bredesen’s doing some great work on Alzheimer’s, and I talk about the stuff that he’s published in his research, and how that compares to types of interventions that I do. What we do that’s similar, what we do that’s slightly different, and then we go through cases, and I rely on my rich years of experience where, in the VA, I had a very narrow toolkit of labs that I could order, basic primary care labs, and a very narrow toolkit of interventions. Diet, lifestyle, fish oil, and B-vitamins.

Kara Fitzgerald: Right.

Terry Wahls: That’s everything I had to work with, and motivating people to actually do the things that we ask them to do. I’ll talk about the kinds of cases that I saw, the evaluations that we could do, and how we tapped into getting them willing to go on this journey. I contrast this to Dale’s work, which is really quite brilliant. He comes to it through the lens of a mouse scientist who has done brilliant work, really understands the mechanisms, and was down the path of drug development. He has a different point of view in how he relies on testing and personalization that way, and my point of view is, I took care of people on food stamps.

Kara Fitzgerald: Yes.

Terry Wahls: And we had the VA resources to use, and that was my toolkit, but I also got pretty amazing results. I’m trying to let people know that we can do amazing things with limited resources, and there are times where the Dale Bredesen in-depth approach is needed, when you can’t get as far as you want with my approach.

Kara Fitzgerald: You know, it’s just yet another wonderful gift to all of us that you are. You’re doing this like MacGyver, you know? You’ve got some thread, and you’ve got really simple interventions, and you’re working with a population that doesn’t have ready access, as a rule, to functional medicine, and you’re in there making these changes and publishing on it with simple, not necessarily easy, but simple, basic tools. Just give me the low down on what research, the interventions that you’re doing and research. What are the main arms that you’re looking at?

Terry Wahls: In my very first arm, we did essentially the stuff that I did, so a fairly nuanced vitamin, nutriceutical intervention. It’s a very intense diet, and daily meditation, and a daily strength training program. Then the real work was using motivational interviewing to help people be willing to go on this journey with us. We’re still publishing, out of all of that data. Right now, we just published the gait papers, so there are videos embedded in the papers, so people can finally see the amazing videos we have of gait before and after the intervention. We are now analyzing the MRI data we have from that study. Science is a painfully long process, so it will probably be another year before we get that MRI paper out, but that will be the next paper coming out of that first study.

The next study we did was just a diet only study, and a study of relapsing-remitting MS, and again, we could show improvements in energy, improvements in motor function, both the hand function and walking ability. The next study was a look at the ketogenic diet, the original diet, versus weight loss control. There I learned that people do not want to enroll if they have to be in a control group, and so there’s a lot of learning that I got there. Interestingly enough, the original diet is just as good as the ketogenic diet, and that’s not what I expected. I thought the ketogenic diet would be better, but it’s not, at least in that small, very small, small pilot study.

What we’re doing now is the elimination diet, the Wahls elimination diet, in a parallel group to the Swank, that’s a low saturated fat diet. That study was funded by the MS Society, and we’ve got another year and a half of recruitment to go in that study. Now, in this study, we’re freezing blood as we go, and we’re freezing poop, so we’ll be able to do a microbiome analysis, and we’re going to be able to do some really detailed future studies looking at advanced lipids, advanced oxidative stress markers, and we’re writing the grants right now to get the lipid studies done, and I’m working on grants to get the microbiome studies done.

Then as we’ve mentioned, we’ve been working with some philanthropic donors to get an ALS study going, where I compare essentially the same diet that I’m using in my MS study now as a safety study for people with ALS. We’re doing that, Kara, because we’ve had a surprising number of individuals who are in my tribe, that follow me, that are reaching out saying, “I have ALS. I’ve done your diet, and it stabilized my disease.” That was pretty interesting. Then, we’ve had a significant, a large donor for the university likewise have ALS, and we assisted him and stabilized his disease, so he’s helping me pull together fundraising so that we can hopefully get our safety study up and going. I’m optimistic. We’re close. We’re two-thirds of the way to our fundraising goal, so that we’d be able to get that study up and going.

Kara Fitzgerald: People, again, there’s a link on your site, right? TerryWahls.com, to donate?

Terry Wahls: Yes. Yes.

Kara Fitzgerald: If you’d like to participate. It’s really exciting stuff. I wanted to just circle back about some of those basic labs you did. What are they? What were the basic labs, and if you could layer on some more sophisticated panels, what would you think about?

Terry Wahls: Sure. Now, I worked at the VA. I’ve loved the VA since, but I have 17 years at the VA, and while I was doing my functional medicine practice, and we had three years, almost four years of the lifestyle clinic, the agreement was I could do that, but I could only use basic primary care labs. What we worked out was a 25 hydroxy vitamin D, a highly sensitive C-reactive protein, fasting lipid, a hemoglobin A1C, B12, folate, and a homocysteine level, and I would do a creatinine, and a CBC. It was just that, and I would work to optimize every one. My goal was to get the homocysteine under seven. If the B12 and folate were low, I’d use ordinary B vitamins. If the B-12 and folate were in the top quartile of their reference range and the homocysteine was low, then I would talk to the vet and see if they had the economic resources to buy methyl B-12 and methyl folate on their own.

We would talk about a low glycemic index diet to get the triglycerides under 100, and the HDL-triglyceride ratio less than three. We would work on vegetables, of course, as the primary intervention. If people were open to being a paleo eater, we’d have them do that. Actually, that was much more popular than being a gluten free eater. People would rather be paleo, but we still had a number of vegetarian and vegans who were doing that for their religious beliefs, and we worked with them. And of course we had a number of folks who were living on food stamps. That was very, very common, and so we’d work with them on how to implement these concepts as hunters, fishermen, going to the local food banks. In Iowa, deer are a nuisance, and a lot of communities have controlled hunts, with frozen deer meat in the locker for anyone who would want to pick up the deer meat, so deer meat was quite common.

People were pretty open to learning how to forage and grow more of their own food using container gardens. A lot of the vets taught me some very helpful tricks about how to get better food. One that I thought was the most brilliant, Kara, was to go to the farmer’s market, and you walk around the farmer’s market, and you ask people, “What’s the best prices you could give me for the rest of your stand?” At the end of the farmer’s market. People were often able to find people who would sell out the rest of the produce that was organic or sustainably grown for pennies on the dollar at the last 15 minutes of the farmer’s market.

Kara Fitzgerald: What a great idea. “I’ll swing by later. I’ll give it all to you for five bucks.” Something like that.

Terry Wahls: Yes. Yes. “I just don’t want to have to haul it away.” Right?

Kara Fitzgerald: That’s a great, great tip. Listen, any comments on the vegetarian-vegan crowd? How did they do? Were you able to kind of observe them, or did you [crosstalk 00:34:16] it?

Terry Wahls: Yeah. They could do okay. You had to be sure that you had fixed their B-12 deficiency. You had to fix their iodine deficiency. You’d fix their trace mineral deficiency, and that you reduce the lectin exposure by having them soak and sprout their seeds. If you soak the nuts and seeds, the legumes, for 24 hours and rinse them, they cook much more quickly, and you’ve markedly reduced the lectin, so they’re less inflammatory, and you’ve markedly reduced the phytates, so the minerals are much more readily absorbed.

Kara Fitzgerald: Could you say that they did as well as the other group? Can you make any kind of statement?

Terry Wahls: Well, I could say we did well for them, because it was important to them for their spiritual beliefs, and you have to respect that.

Kara Fitzgerald: Absolutely. Absolutely.

Terry Wahls: You have to respect that.

Kara Fitzgerald: Absolutely. Okay. Now, the other question. Clearly, you’re a phenomenal coach, and your team is phenomenal. I mean, there’s a lot of energy, just positive energy. Just the power of how you’re transforming the paradigm. Give me some idea of how you got people to just really become enthusiastic about adapting the diet, and even those folks that you had involved in the lifestyle aspects? How did you do it?

Terry Wahls: In my lifestyle clinic, we have skills classes that people could come to, and the vets, as they came to the skills classes, they taught me a lot. The favorite class, two classes, were “What is Your Life Mission?” And having people clarify what their life mission is, and then how implementing these diet and lifestyle changes help them be more successful in their mission of raising successful children. “Being more effective in my church.” We have to have them understand what their purpose is, and why making these changes reinforce that purpose. It really helps a lot with their resiliency.

Then people love, love, love, love our conversation about the hero’s journey. As a quick refresher, just of Campbell, great book on the hero’s journey, and the principles are overarching principles across many, many cultures and religions, is that your society’s facing a terrible struggle and is losing. The hero separates from society and learns some important truth, and then comes back to society and reengages in the fight, bringing this important truth with them to that fight. Now, in the rest of the world, that hero might still die, but the fact they came on this journey is greatly honored. In our society, we know the hero’s going to win, and the society will be victorious.

We ask people, what is it that they’re going to have to learn to reengage in their struggle, and what will this hero’s journey look like? That just has this tremendous resonance with our vets. I talk about that in our seminar, and say, you know, “You might be a Luke Skywalker, or you might be a Martin Luther King, or you might be a Mother Theresa in this hero’s journey. There are many ways that we can manifest that, but what is the way you’re going to manifest this?” We talk about how we have the pleasant life. You can still have enjoyment in your life today, even if you’re bedridden. When I was nearly bedridden, I could still enjoy my life, helping my daughter memorize her lines for her children’s play, and I could have the good life by the fact that I loved gardening, and I couldn’t garden anymore, but Jackie could take me out to the garden stores, and I could help her pick out the flowers and design the garden, and she could take me outside, and I would lay in the grass while she planted the garden. I could still enjoy life with my unique contributions as a gardener, although I couldn’t do the physical task anymore.

Kara Fitzgerald: Yes.

Terry Wahls: I could have a meaningful life, as I was teaching the medical students about how to be a better doctor by giving them lectures as to the experience of being diagnosed and having to reinvent my life as a progressively more disabled person. None of this required recovery, but it gave me immense meaning, and when you have this meaningful life and you’re giving back to society in some way, it provides much more resilience for enduring whatever trauma you’re going to have in your health as it unfolds. It gives people much more strength to be willing to do the hard things that we ask them to do.

Kara Fitzgerald: Yeah. I’m guessing that they supported each other? Did they develop interconnections in the study?

Terry Wahls: Yes. Yes. Yeah. In my lifestyle group, those pure classes, and our groups, support groups and skills classes were immensely successful, and I think what was a huge part of why we had so much success in my lifestyle classes. In my research group, we don’t have a way to create peer groups. It’s not been part of our structure, because that’s just another layer of complexity, so I did not add that, but we do talk a lot about mission and resilience, and we use motivational interviewing, asking people what their purpose is, and then using the motivational interviewing technique in terms of inviting change, and then using the power of silence to let people tell you how they’re going to interpret these concepts in their life.

Kara Fitzgerald: That’s such an embodiment of the functional medicine principles. You’re just living all of them. This is the matrix woven through and through.

Terry Wahls: Without functional medicine, it’s very clear without the functional medicine, without the work that I’d done with the paleo world, and my reading all of this basic science, I’d be bed-ridden and demented, so yeah. I have this immense sense of gratitude to functional medicine, to the ancestral health movement, because without those communities, I’d have been totally screwed.

Kara Fitzgerald: Yeah. Well, and you know what? You might be bed-ridden if you had just implemented the physiological aspects of the interventions, and not the spiritual, and the psychic. [crosstalk 00:41:45].

Terry Wahls: Correct. Correct. It was all necessary for me. It was all necessary.

Kara Fitzgerald: That’s really beautiful. Let me just ask you a couple of things here, as we kind of head to the end of our interview. Once again, just walk through what you would suggest a starting supplement protocol might be.

Terry Wahls: Well, of course I’m doing a family history to get a sense of the probability of B vitamin difficulty or detox pathway difficulties. I nearly always will be wanting to measure the vitamin D and fix the vitamin D levels with supplements. I like to have people start somewhere between 2,000 and 5,000 while I’m waiting to get that level, and then adjust things further. Fish oil capsules, somewhere between one and four grams, depending on their circumstances. If they’ve had a traumatic brain injury and have never had any fish oil, I’ll start them on four grams, or if they’ve not had traumatic brain injury, I would start them on one to two grams and see where we’re at there. If we’ve had a lot of toxin exposure, and in my population at the VA, toxin exposure certainly was nearly always a big factor, I would like to have them on some algae, and on some NS acetylcysteine.

Kara Fitzgerald: Okay. Good. Thank you, and I know you’ll cover this again in your seminar. Something you and I have chatted about a handful of times is stem cells.

Terry Wahls: Stem cells, yes.

Kara Fitzgerald: Where are you at with that right now? What are you thinking?

Terry Wahls: I’ve gone to some stem cell lectures. I’ve been a lecturer with them, and when I look at the literature, I see that stem cells are really, really good for orthopedic injuries and trauma to speed recovery. I see that stem cells have been associated with helping people get over the hump of recovery from a neurodegenerative process, and the groups that do stem cells, and that’s all they do for a neurodegenerative process, have to do stem cells monthly to keep that recovery going. If, on the other hand, you happen to get an individual who does functional medicine to get them tuned up, and as you and I know, functional medicine for many people will be enough, and the person gets recovery from their degenerative process, but not for all. For that individual, a stem cell therapy may offer some benefit, but I would urge them to do stem cells with a functional medicine practitioner, and I would use only autologous stem cells. That is, stem cells from someone who is doing fat harvest from the individual, and giving the stem cells back. I would not use umbilical cord or cord blood stem cells, because I think the risk for graft versus host disease is great, and I don’t think any of those practitioners are using functional medicine, so they have to keep doing the stem cell transplants.

Now that I’m doing private practice, I have seen people who have done medical tourism, spent huge amounts of money, shocking amounts of money on the stem cells, and derived no benefit, and then started working with functional medicine and started seeing benefit. If you don’t get to the root cause, the stem cells, they might give you a transient benefit, but then you’ll have to keep doing the stem cells. If you get to the root cause and you see some benefit, but it’s not quite enough to get to where you want, there may be benefit for adding stem cells to that.

Kara Fitzgerald: Got it. That’s a really nice overview of it. Folks, if you’re interested, I did a podcast in May with Dr. Tami Miraglia, who is using specifically autologous stem cells with a functional medicine approach, if you want to check that podcast out. I think really exactly what’s … Actually, you introduced me to her.

Terry Wahls: Yeah. The thing that I like about Tami is that she’s part of a research group-

Kara Fitzgerald: Yes. That’s right.

Terry Wahls: -that is doing a repository, or registry research, so they’re keeping track of everyone and publishing outcomes data. If you’re going to do stem cells, only do it with someone who’s got a patient registry, and really only do it with someone who’s also doing functional medicine.

Kara Fitzgerald: Are you enrolling … Well, you did mention you’re enrolling in some clinical trials right now. Can anybody listening to this who might qualify, I mean …

Terry Wahls: Yeah. I would have them reach out to us at MSDietStudy@HealthCare.UIowa.edu. We have a couple of studies that you’ll hear about. One is the parallel group where we have Swank diet versus Wahls diet, but you have to come to Iowa to be in that study, and you have to complete the questionnaire to know, do you qualify or not? Then you’re also given links to a survey only study, and anyone can be in that who has MS or a clinically isolated syndrome, or optic neuritis. Those are questionnaires that are completed twice a year for five years, and they’re doing it for the Parkinson’s patients, and they’re doing it for the MS patients. The beauty from that is, that study, you can participate from anywhere in the world.

Kara Fitzgerald: That’s great. Okay. Lots of options. We’ll have that website for everybody, or was it an email address?

Terry Wahls: It’s an email address. I’ll send a link to you so you can have it in the show notes, for both studies.

Kara Fitzgerald: Okay. Fabulous. Now, are you taking on patients yourself, or is your new clinic? What about that?

Terry Wahls: We’ll have a clinic a couple days a month, so yes, and it’s no surprise I have a two-year waiting list to get in to see me. We’re also trying out doing an intensive weekend program where people can come have a little more in-depth experience with this as well. We have a couple ways that people will be able to interact with us.

Kara Fitzgerald: You are teaching in the modules now, in the energy module at IFM.

Terry Wahls: Yeah.

Kara Fitzgerald: I know, I know. I know that a lot of us certified IFM clinicians are familiar with your work, so people who need access might consider reaching out to a certified IFM practitioner and asking. Asking if they’re using the Wahls.

Terry Wahls: Right.

Kara Fitzgerald: All right. Well, listen. It was just absolutely a delight to talk to you. I just, just, just love your work. Love it, and you have been so generous with all of us in teaching us, and just moving the paradigm forward. You know I’m just a big fan of yours, and I want you to have the Linus Pauling. I might as well take this platform to … [crosstalk 00:49:27] happy for you.

Terry Wahls: One day, that would be fun.

Kara Fitzgerald: I think you deserve the Linus Pauling award. You folks, that’s our big annual Institute for Functional Medicine Award. Girl, I’m on your team there. Thank you.

Terry Wahls: All right. Well, it would be fun. It would be quite an honor.

Kara Fitzgerald: Yeah. Yeah. It would be deserved, so I’ll send this podcast around to the appropriate people and hope they listen. Thanks again, Terry.

Terry Wahls: You’re very welcome.

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