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Dr. Wahls’ dramatic recovery from progressive, debilitating multiple sclerosis (she was wheelchair-bound at one point and unable to sit upright) using functional medicine principles continues to astound those who learn about it. She kindly returns to New Frontiers in this episode to give us her latest updates and refinements in her approach to healing. Tune in to learn how she weighs the importance of electrical stimulation (e-stim) vs. diet vs. supplements, e-stim dosing strategies that worked for her, and the surprising effects of e-stim on BDNF and depressive symptoms. Dr. Wahls also shares her recommendations for omega-6:omega-3 ratios, cholesterol targets and more. And, if you suffer with multiple sclerosis there’s a chance to screen for one of Dr. Wahls’ upcoming trials. You’re in for a tremendous treat! -DrKF
Multiple Sclerosis Recovery Updates: A Conversation with Dr. Terry Wahls
Dr. Terry Wahls’ story of healing from multiple sclerosis has been known in the functional medicine space and is now receiving accolades and positive attention in conventional medicine circles. Her popular TedTalk, “Minding your Mitochondria,” viewed nearly 4 million times, chronicles Dr. Wahls’ journey of healing and transformation using food as medicine principles with a specific focus on nutrients to support those powerhouses of cells: mitochondria. Since Dr. Wahls’ recovery, she has taught others how to use food, supplements, and electrical stimulation as medicine, and has also completed several randomized controlled trials looking at how her diet specifically —The Wahls Protocol—can help ease symptoms in autoimmune patients, with a specific focus on those with MS.
In this episode of New Frontiers, learn about:
- The experience that changed Dr. Wahls’ perspective on the value of supplements – at that stage, those that support mitochondrial health – in her initial healing journey
- How she refined her interventions over time, layering in and refining diet and e-stim interventions until she was achieving the progress she needed
- How she dosed electrical stimulation (e-stim) – her starting point, and then as her healing improved, as well as how she integrated it into her working day
- The effect on e-stim on BDNF (brain-derived neurotrophic factor) and depressive symptoms
- The value of e-stim for patients with spinal cord injury to maintain muscle mass and better glucose and lipid metabolism
- Transitioning from a vegetarian diet to eating meat (and her conversations with patients who are vegetarian)
- How we can’t rely on any one set of interventions to recover from disability – often we need “everything at once”
- Her target omega-6:omega-3 ratio of 4:1, and a total cholesterol target of 200 (or at least 170)
- Dr. Wahls’ most emotional moments during her healing journey, and the invaluable support she has received from family and friends
- After 8 trials and 24 published papers, Dr. Wahls is still going! And recruiting for her next upcoming study now:
- Register to be screened for participation in Dr. Wahls’ new study, “Efficacy of Diet and Quality of Life.” (For those aged 18 to 70 with relapsing remitting multiple sclerosis, willing to be randomized.)
Dr. Kara Fitzgerald: Hi everybody. Welcome to New Frontiers in Functional Medicine, where we are interviewing the best minds in functional medicine. Of course, today is no exception. Before I jump into my conversation with the amazing and wonderful Dr. Terry Wahls, I just want to give a shout out to our two big sponsors that make this podcast possible for me day in and day out, month in and month out, year in and year out. That is Rupa Health and Biotics Research. Two companies that I love and I want to give them a particular shout out today, because I recently got to hang out with both of them at the A4M in Vegas, where they kindly distributed both of my books. They’re way over there. The Younger You book, which hopefully you’re familiar with, but also the companion cookbook, Better Broths and Healing Tonics. I am most grateful to these companies for both being great companies and doing really good work and sponsoring our podcast.
Without further ado, I’m going to tell you a little bit about Dr. Wahls. Of course, she doesn’t really need an introduction, but I will tell you about her anyway. Dr. Wahls is an IFM certified practitioner. She’s clinical professor of medicine at University of Iowa, where she conducts clinical trials in the setting of multiple sclerosis. In 2018, she was awarded the Institute for Functional Medicine’s Linus Pauling Award, for her contributions in research, clinical care, and patient advocacy. By the way, I voted for you big time for that award.
Dr. Terry Wahls: Well, thank you.
Dr. Kara Fitzgerald: I really you wanted you to get it. She’s the author of The Wahls Protocol, A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principles and the cookbook, The Wahls Protocol, Cooking for Life. Learn more about her current studies. Patients, if you’re interested, or individuals if you are interested in joining, follow these links. Clinicians, if you are open to promoting her studies through your social channels and to your patient base, I know Dr. Wahls would be most, most grateful.
Learn about her study, Efficacy of Diet on Quality of Life in Multiple Sclerosis at wahls.lab.uiowa, that’s University of iowa.edu. Of course, this information will all be in the show notes for this podcast. Pick up a one-page handout for the Wahls at terrywahls.com/diet. Again, Dr. Wahls, welcome to New Frontiers in Functional Medicine.
Dr. Terry Wahls: Hey, thanks for having me.
Dr. Kara Fitzgerald: We’ve talked before. We’ve talked actually on many occasions over the years and it’s always nice to have you back. You’re always up to something really cool. I want to pick your brain. I wanted to pick your brain on your latest and greatest thinking around MS. I also want to ask you how things have changed since we first talked, since you first started this research.
Dr. Terry Wahls: Mm-hmm.
Dr. Kara Fitzgerald: But we can’t, I think, have a good conversation without going back in your story and talking about your own recovery journey from MS and trigeminal neuralgia. Can you give us a little bit of your background and your journey and then we’ll jump into where you are today?
Dr. Terry Wahls: Yeah. Before getting into medical school, I was an athlete. I competed nationally in Taekwondo, full-contact free sparring, had several concussions, because you got points for kicking people in the head. Were those concussions part of what increased my risk? Yeah, probably. In medical school, I followed a low fat diet and my symptoms began during medical school, episodes of electrical face pain.
Then seven years later, I had an episode of dim vision. 13 years later, after 20 years of trigeminal neuralgia, I had leg weakness, saw a neurologist and the diagnosis of relapsing remitting MS was made. I had two relapses. Really, my course was much more of a progressive MS. Within three years, I’m in a tilt, reclining wheelchair, I take mitoxantrone, I take Tysabri. I continue to decline and that’s when I go back to reading the basic science and decide that mitochondria drive disability and are the big driver for progressive forms of the disease. I develop a supplement cocktail, which does slow my decline, helps me just a tiny bit. Then, I discovered the Institute for Functional Medicine.
Dr. Kara Fitzgerald: Let me just ask you, I want to hear all of this, but I want to, A, how old were you when it really kicked in, then B, what was the supplement cocktail that helped a little bit?
Dr. Terry Wahls: I was 23 when I first started having symptoms. I’m 45 when I’m diagnosed, and when I’m 48, I’m in the tilt, reclining wheelchair. The things I start adding, coenzyme Q, B vitamins, methyl folate, well B vitamins. I didn’t know to methylate them yet. It was just B vitamins, creatine, carnitine. It was those four things that… At first, I couldn’t really see any difference. After six months, I said, “This is a waste,” and I stopped them. Then, I could not get out of bed.
Dr. Kara Fitzgerald: Wow.
Dr. Terry Wahls: For the first 24 hours, I was okay, but 36 hours I couldn’t get up and go to work. Now mind you, I have severe fatigue. I’m in a zero gravity chair at work, because it’s getting harder and harder to sit up. But I don’t have any mental fog, brain fog. I’m still going to work and functioning well. But again, 36 hours without my supplements, I didn’t feel I could drive to work. Then, after 72 hours, Jackie comes in and says, “Honey, why don’t you try taking your supplements again?”
I took them that evening and next morning. I was like, “Well, I think I’m back to baseline.” Yeah, I’m still exhausted, but I thought, “Wow, this is really interesting.” Two weeks later I stop everything. Again, for the first 24 hours I’m okay, but at 36 hours, I am not. I wait 72 hours before I take everything again. Then, the next morning I’m back to baseline. That’s when I was really excited, like, “Okay.” I’m clearly figuring out some stuff that my neurologist and my primary care doc don’t know to talk to me about.
Now, I’m much more interested in trying to spend a little bit of time reading more basic science, more supplement based studies. By then, I’m assigned to the institutional review board and I tell the IRB that I want to review the brain blooded trials. Now, I’m reading more studies that are mostly drug studies, occasionally a device study, and getting more comfortable reading the basic science. Gradually, I’m adding more stuff. At first, I would go to my primary care doc and have her add it to my med list, be sure there are no adverse events. Then, I quit doing that, just like, I would just tinker and then I would tell her what I was up to, when I went in.
Dr. Kara Fitzgerald: Let me just ask you, first of all, that’s awesome. I mean that’s a pretty nice cocktail design for your maiden voyage in this world. Hats off to you and I want to know, I mean, it clearly made a difference. It made a profound difference, but still not the impact that nutrition would later. Would you say that?
Dr. Terry Wahls: Yeah. When I took the IFM course, Neuro protection, I had a longer list and I have to admit, I no longer recall what were all the additional things that I was adding. Probably one of them, was that I switched to methylated B12 and methylated folate.
Dr. Kara Fitzgerald: Mm-hmm.
Dr. Terry Wahls: Then added more NAC, taurine, lipoic acid, magnesium. There may have also been some ribose in there as well.
Dr. Kara Fitzgerald: Sure.
Dr. Terry Wahls: But there was about 12 to 14 different things that I was taking.
Dr. Kara Fitzgerald: Can you give me a percent improvement with maybe your core protocol and then how you later evolved it? But I also want to go back and talk about your diet.
Dr. Terry Wahls: I want to stress to everyone; supplements did not get me out of my wheelchair.
Dr. Kara Fitzgerald: Yeah, that’s a huge-
Dr. Terry Wahls: The Paleo diet did not get me out of the wheelchair. I was still declining. But I was very grateful because I was declining more slowly and it was very clear that I’d had a very rapid decline. When I started tinkering with my supplements, I was pushing out and I was hanging on to the functions I still had. My hands were still working quite well. My brain was still working quite well. I had severe, severe fatigue.
In the summer of ’07, I was beginning to have brain fog and that’s why my chief of staff pulled me into his office to tell me that he was reassigning me to the traumatic brain injury clinic, that I would start there in January. Then, he described the job, I’d be part of a multidisciplinary team, I’d be doing primary care, there’d be no residents. I’d be doing the exams, writing the notes, doing everything myself. As I came home and I described that job to Jackie, she goes, “You can’t do that.” I’m like, “Yeah, I know. I probably can’t. In January, I’ll go to clinic and either I can do it and if I can’t, then I have to finally apply for medical disability. John is probably trying to force my hand.”
Dr. Kara Fitzgerald: Wow.
Dr. Terry Wahls: Because as chief of staff, you could detail me to any position and either I accept the detail, or you resign.
Dr. Kara Fitzgerald: Wow.
Dr. Terry Wahls: I was like, “Okay.” Then, it was interesting, it’s sort of like God was whispering in John’s ear, because two weeks… This is a distressing turn of events, then in the next IRB packet, is a study by Rich Shields, who studies electrical stimulation muscles in spinal cord injury.
Dr. Kara Fitzgerald: Yeah.
Dr. Terry Wahls: I think, “Wow, that’s really pretty interesting.” I do a quick search. There’s only 212 papers, so it doesn’t take long to scan 212 abstracts. They’re mostly are in athletes. A couple studies in cerebral palsy, a couple studies, certainly none in MS, but I convinced my physical therapist, he lets me have a test session. He warns me that I can grow more muscles for you, but I don’t know that your brain can talk to the muscles I grow. It’s quite possible that we will put more muscles on your legs that you cannot use. The few steps you can take are going to be furried still. Also says, “It’s going to be painful and you have a lot of issues with MS pain.” It definitely was painful. I mean, it was very painful. But when it was over, I felt great.
Dr. Kara Fitzgerald: After that first session, are you talking about?
Dr. Terry Wahls: First session, yeah. My first session, it did wonders for my mood and so Dave said, “Well it’s probably the endorphins.” Now, I’ve since learned that electro simulation also causes the release of a lot of nerve growth factor in BDNF.
Dr. Kara Fitzgerald: Okay.
Dr. Terry Wahls: That was doing really great things for my mood and I added E-Stim to my mat exercises and the amount of exercises I could do at that time, Kara, was 10 minutes. Because if I did more than 10 minutes, I couldn’t function. I got so I could do 15 minutes. Then he had me doing 15 minutes in the morning, five minutes in the evening, then 10 in the evening, then I get to do 15 and 15. Then, he told me, “Now if you can do 45 minutes of electrostimulation and you have to volitionally contract your muscles while you’re simulating them, you will grow more muscle. If you volitionally contract, I think you’ll be able to control those muscles. But if you just sit there and sort of ride the current and don’t have any volitional contraction, I don’t know that you can control the muscles. We might be helping you metabolically, but we’re not helping your function.”
I was really committed to like, “Okay,” I would do my little isometrics. Then the other thing that Dave said was, “You got a lot of weak muscles Terry. However, however much time you can fit into your day, you can stimulate as many muscles as you can fit into your day.”
Dr. Kara Fitzgerald: Wow.
Dr. Terry Wahls: My machine had two channels and so it was two muscles I could do at a time. I’m still working, I’m still working full time, so that meant I started taking my device to work and I would slowly increase the amount of electrical current that I was doing, because I was doing isometric contractions while I was at work. If I was staffing the residents or in the traumatic brain injury clinic, I had to have the current be small enough, that I wasn’t grimacing or grunting, I could have a normal conversation.
If I wasn’t staffing residents, if I was just in my office, I could dial up the current to as much pain as I could tolerate. I’d have 10 seconds of high intensity and 20 seconds of no intensity, where I could do some work and I’d go back to 10 seconds of very challenging level of pain. But I cannot adequately state what this was doing for my mood, that it was such a profound noteworthy impact.
Dr. Kara Fitzgerald: Would you prescribe this for somebody with depression or do you think it was because you were also, this was such a fundamental part of recovery? Yeah, go ahead.
Dr. Terry Wahls: Like many people with MS, depression is a very common symptom. Certainly I’ve struggled with depression throughout my adult life and this has been a very useful part of my self-care routine. I’m jogging now, but I still like doing E-Stim. I love doing E-Stim for the cognitive effects. I’ll still do it with some exercise and strengthening, but I also love it for the cognitive effects. Do I use it for my patients with depression? No. Do I recommend it for people who have motor deficits and they’re trying to more rapidly build their muscle gains? Yes.
Is this a really useful tool for people who have a spinal cord injury? Absolutely. Even for people who will never walk again, because they have transected their spinal cord. If you do electrical stimulation of muscles and maintain the muscle mass, you can greatly reduce the harm of inactivity. You can improve their glucose metabolism, you can improve their lipid metabolism.
Dr. Kara Fitzgerald: I have a lot of questions. I want to just put the story together with supplements, paleo, plus E-Stim and then when you started walking and you just mentioned you were jogging, so we’ll get to that. But before you do that, I just want you to color in what your diet was. When you first started doing supplements, were you eating this probably like the standard American diet? I’m just curious.
Dr. Terry Wahls: No, I’ve been a low-fat vegetarian for about 20 years. Two years into my MS diagnosis, my neurologist mentioned the work of Loren Cordain. I read his papers and said, Well, and it was a big decision to go back to eating meat. I did basically what looked like the AIP diet.
Dr. Kara Fitzgerald: Mm-hmm.
Dr. Terry Wahls: But at that time the Autoimmunity Protocol (AIP) was really still focused on what to avoid. They didn’t really structure on what to be eating. I was continuing to decline and I realized if it takes seven years to replace your nervous system and I probably had 20 years of damage to my nervous system, I didn’t know how long it would take for recovery to happen.
I was like, “Okay, at least I’m doing something.” It was not that I had a lot of sugar, it wasn’t that I had a processed diet, I was having beans and rice, then I’m having more… It took me probably about six months to reintroduce meat, because that was a process.
Dr. Kara Fitzgerald: Yeah.
Dr. Terry Wahls: What that diet was like before I redesigned it, I can no longer tell you, because I’m not really sure. But when I had my list of supplements that I was taking and I had the a- ha, like, “Okay,” I wondered where they are in the food supply, because if I go get the food that’s rich in these nutrients, I’m probably getting a lot of other collateral nutrients that are co-factors, that are very supportive as well.
At first, it was that list of food stuffs that I was eating. Then, when I changed my clinical practice and I wanted to teach my patients how to do this in the traumatic brain clinic, I had to come up with a concept that I could teach very quickly and that they could remember. When I was teaching this to the residents and the resident clinic, now I have only five minutes with a patient.
Again, I have to come up with an easy paradigm that people could use and remember. That was a lot of thought, like, “Okay, what does this look like?” That’s where I came down to three cups of greens, three cups of sulfur rich in the cabbage, onion, mushroom family and three cups of deeply colored, particularly blue, purple, black. Then we did have committed vegetarians. I had to figure out, “Okay, if you are vegetarian for your spiritual beliefs, well what does that mean, and how can we help those people recover as well?
Dr. Kara Fitzgerald: Mm-hmm.
Dr. Terry Wahls: I mean, I want to be very clear that my residents were so impressed at how effective I was at getting the veterans to radically change their diet. I impressed on the residents that patients know when you’re speaking from experience.
Dr. Kara Fitzgerald: Yes.
Dr. Terry Wahls: Versus theory. If you’re talking about how to improve diet and physical activity from your experience and your health transformation, they’ll be curious and they’ll be much more willing to try. Then, if you tell them, “Okay, start with an easy to achieve next step, pick your start date. Adding is way easier than subtracting. I recommend you start with the additions first and then work on what it is that you’re going to reduce and then eliminate. If you can do this as a family, you’ll be more successful.”
Then, the next question is, “You’ve been struggling for,” and I look at the chart for however long, many years or decades they’ve had with the main problem, “And it’s not been working out. When you’re ready, think of this as an experiment and you can decide that you want to give it three months or a month or two weeks.” I’d say about half my vets in the traumatic brain injury clinic would make these big changes.
Now, I’d see them back and six months later, they’d come back and say, “Well it was pretty amazing. It’s easier to get along with my family, it’s easier to get along at work and if I eat that junk, my headaches are back. I’m eating your diet doc,” but in my residence, they’d be very funny they’d say, “I can’t wait to see how you’re going to deal with Joe or Jane, because you know that they’re pretty set in the standard American diet.” They’d come, I’d have a brief conversation and very often the vet is like, “Okay, I’ll give it two weeks.”
Dr. Kara Fitzgerald: Yeah.
Dr. Terry Wahls: I’m like, “Okay, give it two weeks and see what happens.”
Dr. Kara Fitzgerald: That’s great. It’s your authenticity and it’s that you’re coming from a place of truth and your experience and there’s a lack of judgment. I mean, there’s just all the ingredients that make you such a-
Dr. Terry Wahls: I acknowledge that, I get this may not be the right time for you, that you got stuff going on at home. If it’s not, that’s fine.
Dr. Kara Fitzgerald: Yeah.
Dr. Terry Wahls: Pick a time when you think could be successful.
Dr. Kara Fitzgerald: Couple of thoughts that I have. One, I just want to say it popped into my head just again thinking about the E-Stim and the fact that it increases BDNF, brain derived neurotropic factor, which is extraordinary. In my work, in looking at epigenetics, we see hyper methylation of brain derived neurotropic factor. The gene is inhibited, it’s hyper methylated and shut down in depression, in PTSD, in conditions that are present in vets, here in the VA, as well as of course in MS.
I’m just, I’m curious, I’m just musing what the influence of E-Stim could be. There was an interesting study in vets with PTSD that showed cognitive behavioral therapy actually changed a PTSD associated hyper methylated gene, but it wasn’t BDNF, it was a cortisol associated hyper methylated gene. But nonetheless, it was just cognitive behavioral therapy made a difference. I just bet E-Stim would, just as if E-Stim would.
Dr. Terry Wahls: I bet it would. Mm-hmm.
Dr. Kara Fitzgerald: Yeah. Of course the diet intervention I’m sure does as well as the supplements. But so you layered in, you started with the supplements, and you were eating a diet that would’ve been-
Dr. Terry Wahls: I started with changing my diet.
Dr. Kara Fitzgerald: Oh, you did. You did the paleo, then supplements.
Dr. Terry Wahls: I did paleo first, then I did supplements. The paleo community wants to say that paleo got me out of the wheelchair.
Dr. Kara Fitzgerald: Okay.
Dr. Terry Wahls: The supplement community wants to say the supplements got me out of the wheelchair. The E-Stim want to say that that was enough to get me out of the wheelchair, I had to do all of it. I mean I was profoundly disabled.
Dr. Kara Fitzgerald: Yeah.
Dr. Terry Wahls: It’s helpful and the more of the components that you can do, the more of the dose you can do, the more rapid recovery can be. Then, people will ask, “Okay, has anyone else gone from your level of disability to jogging?” Certainly in my clinical trials we have some amazing videos of people who had remarkable improvements. You aren’t going to get out of a wheelchair to jogging or walking without a lot of work. The more severe the disability, the more work that’s going to be required. We still though found people who, one lady took 126 seconds to get up out of a wheelchair, walk eight feet, turn around and come back and sit in her wheelchair. At the end of the year, she could do that task. She still needed her walker, but she could do it in 43 seconds.
Another lady, who had primary progressive MS, profound disability, it took her 21 seconds to make that task. In just three months, she’s down to 15 seconds, doesn’t need a walker anymore and her fatigue is dramatically less. By the end of the year, her fatigue is completely gone. Now, she still is… I ran into my primary progressive patient when I was… Because I still travel state recruiting patients and she’s standing up telling everyone, “It’s 10 years since I was in Dr. Wahls’ study. If I hadn’t met her, I would be bedridden or dead. I’m playing in the senior center polka band,” and she’s doing the polkas. “If I stop doing the diet or I begin cheating on the diet, I can’t function.” It’s sort of like you’re at a revival meeting and my previous study participants will stand up and they’re sort of witnessing to the crowd.
Dr. Kara Fitzgerald: Do you have a video of that? That would just be really amazing if they were open to allowing themselves to be filmed. It would just really be powerful.
Dr. Terry Wahls: It’d be fun.
Dr. Kara Fitzgerald: Yeah, it would be. Just quick, thinking about your history, your timeline, experiencing concussions in Taekwondo, when you were very young, before the onset of MS and just following an extremely low fat diet, I mean, those are things that you would in somebody who may have a family history of MS or another neurodegenerative potential, I mean, would both of these be avoided?
Dr. Terry Wahls: Well, it’s sort of interesting. There are studies that suggest a low fat diet can be helpful. Now, because it’s the ratio omega-3 to omega-6, that it’s also important, not just the total dose. It’s possible to do low fat and do okay, but you need to have enough total cholesterol to make all of your hormones. I just want to have the caveat that diet is really complicated.
Dr. Kara Fitzgerald: Yeah.
Dr. Terry Wahls: I think that the key thing is got to get rid of the sugar, and processed foods. We need probably a lower carb diet, plenty of protein. Everyone knows that what I study are the ketogenic diet and the paleo diet and I’ve been very pleased with that. We’re writing grants now to also study the Mediterranean diet. For your patient, I think you have to find out if your patient is emotionally committed to a low fat, and they may have a family history of heart disease, they may have had their parents have early heart attacks and strokes and so they are more comfortable with the low fat diet. Then you have to really work on their ratios, know their omega-6, omega-3 ratios, know their total cholesterol, be sure that they have enough fat.
Dr. Kara Fitzgerald: Yeah.
Dr. Terry Wahls: If they’re going to do low fat, we want to help them do it as safely as possible.
Dr. Kara Fitzgerald: What is an optimal ratio? Six to three.
Dr. Terry Wahls: Four.
Dr. Kara Fitzgerald: Okay, four to one.
Dr. Terry Wahls: Correct, four to one and I want the total cholesterol preferably to be 200.
Dr. Kara Fitzgerald: Okay, so four to one, that’s omega-6s to omega-3s.
Dr. Terry Wahls: Correct.
Dr. Kara Fitzgerald: Which is achievable. That’s not so difficult.
Dr. Terry Wahls: You can do that with a low-fat diet. I want to be sure that the total cholesterol is at least 170. Preferably 200.
Dr. Kara Fitzgerald: Yep. Okay. All right. Well, I really appreciate you spending time, a lot of time on the background. It was the combination of all of them, but you were out of your wheelchair when you added in the E-Stim for a certain period.
Dr. Terry Wahls: I added the E-Stim. I was maybe getting a little bit better. I was beginning to sit up a little more easily and then I redesigned my diet and it’s a very intentional way. Then, at four weeks into that, it’s clear that my brain fog is less, my energy’s better. My physical therapist says, “Terry, I think you’re getting stronger. I’m going to advance your exercises.” He gives me these little tiny weights, one pound weights.
We advance my exercises. The speed of my recovery, now I’m able to do a little more E-Stim. I’m getting sessions in the morning and sessions in the afternoon. I’m beginning to add a little E-Stim at work. I’m slowly increasing my E-Stim dose and I began walking. People at the hospital are like, “Oh my god, Dr. Wahls, you’re walking.” Then, I decide I want to try riding my bike. We have this emergency family meeting and Jackie tells my 16 year old boy, six foot five, a big strapping football player and my 13 year old daughter, they’ll run on either side of me and she’ll follow and I bike around the block.
That big 16 year old boy, he’s crying, 13 year old daughter, she’s crying. Jackie’s crying, I’m crying. You know what, I get emotional talking about that now, because when you have a progressive neurologic disorder, one of the things that you do, is you let go of the future. You learn to take each day as it unfolds. Even though I had been walking around the block, I’d been walking around the hospital, I’d let go of the future and I didn’t know what any of that meant until I rode my bike around the block.
That’s when I understood that the current understanding of MS was incomplete and who knew how much recovery might be possible? Then a few months later, Jackie signs me up for the Courage Ride, which is 18.5 miles. When I had to take a few breaks while we were biking, because that was a big jump, because I had been up to eight miles. I was going from eight to 18, but I crossed the finish line. Once again, everybody’s crying and that really changes how I think about disease and health and changes the way I practice medicine and it will change the research that I do.
Dr. Kara Fitzgerald: It’s such an extraordinary story. When was that? When did you do that?
Dr. Terry Wahls: That was the fall of ’08. In October of ’07, I cannot sit up. I’m having brain fog and I’m thinking like, “Okay, I’m finally going to have to take medical retirement. It’s clear, I’m on track to become bedridden, demented and probably die with intractable pain.” One year later, I do this 18.5 mile bike ride and my chief of medicine at the university calls me into his office and says, “I want you to get a case report written up.” I go like, “On me?” He said, “Yeah,” then I start working on that. Then calls me back says, “And I want you to write up the protocol and do a safety and feasibility study to see if others with progressive MS can implement your program. Then we’ll see do we hurt anyone and what the effects of the study says.” I’m like, “Well that’s not the kind of research that I do.” He goes, “I’ll get you the mentors. That’s the kind of research you’re doing now.” I saluted and of course that launched everything.
Dr. Kara Fitzgerald: Yeah.
Dr. Terry Wahls: We’ve done seven trials. I’m in my eighth trial now. We’ve published 24 papers out of those seven trials. I’ve got probably another six that will come out in 2023. When I first started talking at the local organic grocer and the local churches and then the community colleges, I was banned as a speaker. I was condemned for creating false hope, for having a dangerous message, but we’ve made a lot of progress. I go to these MS meetings. The neurologist right now, stopping me saying, “Can I get a picture with you? My patients would really value that.”
My team is presenting, we have posters, we do oral presentations and now more and more people are agreeing that diet really matters, that exercise matters, that my message that you got to fix the diet, that adding meditation or mindfulness strategy would be really helpful in asking the patients to work with physical therapy to ensure lifestyle, physical activity and exercise is really very helpful. What had been so dangerous is moving. We’re getting closer towards that being embraced as appropriate care. I predict in another five years it would be considered malpractice to not be talking to your MS and neuroimmune patients about those things.
Dr. Kara Fitzgerald: Incredible.
Dr. Terry Wahls: Yeah.
Dr. Kara Fitzgerald: What a revolution.
Dr. Terry Wahls: My team did a network meta-analysis, looking at all the diet studies.
Dr. Kara Fitzgerald: Yes. Good. I was going to ask that.
Dr. Terry Wahls: I can’t tell you what we found yet because we submitted it through neurology. Neurology accepted it. There is an editorial. My postdoc was interviewed for their podcast and I don’t quite… We’re still waiting on the page proof, so hopefully that will all be coming out very soon. The momentum is continuing to build that diet really matters, that there are a number of diets that have some very exciting and interesting research behind them. We’ve known for a long time exercise matters and we’ve known for a long time that meditation and mindfulness is helpful. I had this crazy wild ass idea that you ought to, if you have a terrible disease and you’re disabled, you ought to be doing everything that you possibly can.
Dr. Kara Fitzgerald: Yeah.
Dr. Terry Wahls: We’re still writing grants, we’re working on another grant for progressive MS and I keep submitting these proposals and I keep wanting to do multimodal interventions and reviewers who grew up doing drug studies that can look at one molecular pathway, don’t like my multimodal interventions. My team and I debate, we do some single interventions, which is why I’ve done so many diet studies, but I keep submitting proposals to do diet and exercise or diet and multimodal, because if you want to recover function, then you want to support the network as comprehensively as you can.
Dr. Kara Fitzgerald: Amen. Yeah. Mic drop. Just a couple more questions. I know we’re just, we’re at time here. Would you say diet, the optimal diet is somewhat individualized? Or is there one diet that’s-
Dr. Terry Wahls: Well, of course it’s going to be. There’ll never be one diet that works for everybody.
Dr. Kara Fitzgerald: Is there a certain eating pattern that got a little more legs?
Dr. Terry Wahls: Well, of course. The modified paleo diet, very helpful. Mediterranean diet can also be helpful. Ketogenic diets can be helpful. Would an intermittent fasting diet that’s well-structured be helpful? Yes. Fasting patterns, maybe that evidence is not quite so clear. The one diet that’s terrible is the standard American diet. Before you send me on my way, I have to tell people about my study, Efficacy of Diet and Quality of Life.
Dr. Kara Fitzgerald: Yes.
Dr. Terry Wahls: We’re looking for people aged 18 to 70 with relapsing remitting multiple sclerosis, who are willing to be randomized. You’ll have to come to Iowa at baseline month three and month 24. Our primary outcome is quality of life. However, another really, really interesting hypothesis is, relates to brain volume loss. Because if you have MS, the rate of brain volume loss is three times as fast as occurs in healthy aging. It’s sort of a bummer. I’m hypothesizing that if you improve your diet, whether it’s the keto diet or the modified paleo diet, or if you’re in the usual diet arm and you follow our tips to improve your diet, we can get you to healthy aging rates of brain volume loss.
I fully, because people who enroll in dietary and intervention studies, enroll because they want to improve their diet and they’re willing to do so. Now, the intervention arm gets more support. The usual diet arm will just get a monthly tip sheet from us. But if they follow those tips, they’ll improve their diet and their brain volume loss will look like healthy aging as well. I fully anticipate everyone will improve. Will they all improve the same? That we don’t know. Which diet will be better? Paleo or keto? I don’t know. Paleo is probably easier. Keto, it’s a little more challenging, but tremendous health benefits for both of those diet patterns. Following our tips would be really helpful for people in the usual diet arm.
Dr. Kara Fitzgerald: Any new interventions, anything coming down the pike that you’re paying close attention to? You developed your core plan really over a decade ago now.
Dr. Terry Wahls: Yeah.
Dr. Kara Fitzgerald: You’ve been tweaking it a little.
Dr. Terry Wahls: Right. Right. We keep tweaking it. Every time I do a clinical trial, we make some minor adjustments. The intervention diet is not the same diet that’s described in my book. It’s been tweaked a little bit. Supplements are a little bit different than what we have in our book. My plan is to always keep learning, keep tweaking. My plan is to live to 120, still doing research, still teaching the medical students, still teaching the new postdocs and hopefully playing and in my garden and picking berries with the little people in my life.
Dr. Kara Fitzgerald: That’s beautiful and posting it on social, it’s always fun to see your meals on social. Now, when are we going to learn these tweaks? Where will these tweaks be available or are they available?
Dr. Terry Wahls: Well, the best place to do that is to be in my clinical trials. Then you get to really learn those tweaks.
Dr. Kara Fitzgerald: Yeah.
Dr. Terry Wahls: Come be in the trials. Then the other question is will I write another book? Maybe. I am doing a MS summit this summer and so you’ll hear some of those tweaks then. We’ve created a remyelination course. I recorded the first six modules this summer and I’ll record the next six modules, I think my team has that slated for January. Actually, I’m really stoked about that remyelination course. That is phenomenal.
The first six has to do more with the interventions. The next six modules has to do with assessing where you’re at, and then the science of how we actually implement all the stuff that I’m teaching you to do. Because these concepts don’t do you one bit of good if you can’t implement them and you don’t know how to interpret them in the context of your circumstances.
Dr. Kara Fitzgerald: For folks to find you, it’s just terrywahls.com. Right?
Dr. Terry Wahls: Correct.
Dr. Kara Fitzgerald: Or excuse me, is it just terrywahls.com?
Dr. Terry Wahls: Terrywahls.com. Then for Instagram, it’s doctor, drterrywahls.com.
Dr. Kara Fitzgerald: We will list everything in the show notes folks, so that you have no trouble finding Dr. Wahls and her extraordinary work. Once again, Terry, just again, we’re thrilled to have you on New Frontiers.
Dr. Terry Wahls: Thank you so much. Please screen. Please see if you could be part of our study. If you have progressive MS, screen, because we will be starting a progressive MS study probably in about nine months.
Dr. Kara Fitzgerald: Fabulous. We’ll post the details. Okay. Cha-cha.
As always, thank you for listening to New Frontiers in Functional Medicine, where our sponsors help bring the very best minds in functional medicine, and today is no exception. Not everyone can be a sponsor on my platform, and I so appreciate the good work, relentless research, and generous support from my friends at Rupa Health, Biotics and Integrative Therapeutics. These are brands I know and trust in my own clinic and can confidently recommend to you. Visit them at RupaHealth.com, BioticsResearch.com and IntregrativePro.com, and please, tell them you learned about them on New Frontiers.
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Dr. Terry Wahls is an Institute for Functional Medicine Certified Practitioner and a clinical professor of medicine at the University of Iowa where she conducts clinical trials in the setting of Multiple Sclerosis. In 2018 she was awarded the Institute for Functional Medicine’s Linus Pauling Award for her contributions in research, clinical care and patient advocacy. She is the author of The Wahls Protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principles, and the cookbook, The Wahls Protocol Cooking for Life.
Learn more about the current study Efficacy of Diet on Quality of Life in Multiple Sclerosis at https://wahls.lab.uiowa.edu/ and accesss the Wahls™ Diet here.
Wahls Protocol® mobile application
Wahls one-page diet handout
About Loren Cordain
Wahls new Remyelination Course
Efficacy of Diet on Quality of Life in Multiple Sclerosis, current study recruiting here.
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