Highlights- 📚 Dr. Terry Wahls was diagnosed with multiple sclerosis in 2000 and became wheelchair-bound by 2007.
🌿 She created a supplement cocktail for her mitochondria, which slowed down her decline.
🚶♀️ She started using electrical stimulation of muscles (e-stem) and saw significant improvement.-
🥦 Dr. Wahls redesigned her Paleo diet based on the supplements she was taking and saw further progress.-
💪 She regained the ability to walk, ride a bike, and even completed an 18.5-mile ride.-
🧪 Dr. Wahls conducted several clinical trials and consistently found that people were able to implement her regimen and experienced weight loss and improved health markers.
❓ The mechanism behind her approach is still being studied.(Note: This summary has been condensed and edited for clarity)
Hey guys, it's Dr. Justin Marcheigani here. I am with Dr. Terry Wahls, really excited for today's podcast. If you don't know about Dr. Wahls, she has an amazing history of recovering from multiple sclerosis, which is a serious debilitating autoimmune issue, using natural medicine, functional medicine principles, nutrition, supplementation. We're so excited to hear her story. She is a professor at the University of Iowa College of Medicine, and she's a powerful story. We're going to dive in, and we're going to look at the things that have helped her, as well as the patients that she sees, and talk about her upcoming studies as well, and see if maybe you're a good fit to be in that study. Dr. Terry, welcome to today's podcast.
“Hey, thank you so much for having me.”
“Excellent. Well, I'd like to just start off with your story. I mean, let me just pull this up real quick. I mean, I want to show a picture here, if we don't mind, just because I think, oh yeah, a picture's worth a thousand words. Um, I'm gonna pull this up on screen so you guys can see it. So, so 2007, 2007, here you are. Pull this up on screen. Here you are, 2007, right here, you're in a wheelchair, October 1st, 2007, and here you are on a bike. Can you talk about that transformation? I mean, that is, well, so you know what happened is, I'm diagnosed with MS in 2000. I am a professor. I find the best medicine of the country. I find their best doc. I take the nose drugs. I, and within three years, at age 48, I'm in a totally Klein wheelchair. It's progressively more difficult to sit up, um, I'm having more and more trigeminal neuralgia. Uh, you know, I take mitochandrone, which is a form of chemotherapy. I take tysabri, the new biologic drug that we're also excited about, like that continues to decline, then I'm switched to cell subbed, and that's when I, it's very clear of my track to become bedridden by my illness. Uh, and I go back to reading the basic science, and, young Professor of Medicine, not neurology, so it's really hard work to read this basic science about the animal models for Parkinson's, Alzheimer's, Lou Gehrig's disease, ALS. There really isn't a whole lot of stuff about progressive MS in the animal Science World, but I decide that mitochondrial dysfunction is what's driving disability, and so I, I create a supplement cocktail for my mitochondria, slows my decline. I can tell when I take my supplements, my fatigue is not quite as severe as when I don't take my supplements, but you know, I'm thrilled, and I know that with progressive MS, secondary progressive MS, functions once lost will not come back, uh, and I can still use my hands. I can still feed myself. I can still wipe my own butt, and those are really valuable things. I, my, um, Chief of Staff calls me in to say, “Terry, we're going to assign you to the traumatic brain into a clinic. Um, you'll start in January,” so six months into the future. He describes the job, and I know that I'll be seeing patients without residence. I'll be examining the the vets myself, writing the notes, and when I tell Jackie, she says, “Terry, there's no way you can do that.” And like, well, I, I know, and so in January, I'll go to that clinic. I'd either do the job or I can't, and then I have to finally apply for medical disability. Um, two weeks later, uh, in the packet that for the research that I was having to review for the institutional review board is a packet for a study that uses electrical stimulation of muscles and people who are paralyzed, who are never going to walk again, uh, and they want to extend the study because people don't want to stop, so super interesting, and I asked my physical therapist if I can try that. He said, “You know, it's electrical stimulation muscles. We call it e-stem. It's for athletes. Uh, I can certainly grow bigger muscles for you, but I don't know that your brain can talk to the muscles. I might be putting more weight on your legs that you cannot use, and it'll be even harder to take the few steps that you can now take.” But it gives me a test session. It hurts bad, I mean really bad, but it's over, I feel great. He says it's probably the endorphins, and so we add the e-stem to my little tiny mat exercises that I'm doing before going to work. That's just 10 minutes, that's all I can tolerate, uh, and at the same time, I discovered the Institute for Functional Medicine, and they have, of course, on neuroprotection. Uh, you know, PowerPoint synchronized audio, and, you know, big notebook of cases, and I order that, and I work my way through that course, and have a longer list of supplements. Now, mind you, I've been on a Paleo diet for five years, uh, I have an increasingly complicated bunch of supplements I'm taking. Is this 2007 or eight? What year are we in now?”
“2007.”
“Okay, so this is wheelchair. This is where you're making the transformation. Okay, right, and I, I can sit up 10 minutes. If I sit up longer than 10 minutes, I, I can't function, and I lie flat in bed for, uh, 36 hours. So, and I didn't appreciate this at the time, but that meets the definition of being bedridden. Wow, if you can't sit up longer than 10 minutes. Uh, but you know, fortunately, I, I was just beginning to have brain fog, uh, and so it was very clear I was on track to become bedridden, probably demented, essentially, and because my trigeminal neuralgia was harder and harder to get to turn off, I would likely have it turned permanently on. And once it's on, light, sound, a breeze, light touch trigger the pain. Moving my tongue triggers the, the electrical face pain. So, if I try to speak, I get a jolt of pain, my head pulls down to the right, occasionally it's to the left. I, and so when the pain is turned on, uh, within a few hours, it's so intense, you know, if I'm trying to talk, it would come out like this, because as soon as I move my tongue, I get the jolts of pain. So, it's horrible to, to experience and traumatic for my kids to watch me have that level of pain. I, and so you know, in 2007, I've got this really, really grim future. Um, bedridden, demented, dying with intractable pain, and I redesigned my living will, my medical durable power of attorney, so that if I get to the point where I can't swallow, and I'm choosing to, I'm unable to communicate, there'll be no IV fluids. So, you know, um, thing there will be a, a final solution, uh, to my opinion, right. And I, you know, I discover, um, I've already been doing the paleo diet. I've been doing supplements. I've been adding e-stem, uh, and that's what I've been doing in the summer and fall, and then I had this really big Aha. And now, I laugh at myself that it took this long to have the AHA, like, “What if I redesigned my Paleo Diet based on the supplements that I'm taking, um, and figure out where those nutrients are in the food supply because I'd probably get more things that are good for me that, you know, science hasn't even named yet.” So, you know, that's more research to get that figured out, and I have this new way of eating, uh, December 26, 2007. You know, and keep in mind, I beat that brain fog. I can't sit up. I'm in either zero gravity chair or in bed uh, and I'm still staffing residents. I'm gonna have to start this new clinic in January, so I start this new way of eating. Uh, then the first week of Jan, first two weeks of January, I go to the clinic, the Direct Granger Clinic, and I'm just watching my partners. So triple, just watch my partners. Then, on the third week, I have to start examining the patients and start doing, you know, uh, real work. And that first day, I come home, and, and I tell Jackie, “Well, you know, that really wasn't too bad.” And then, at the end of the week, I told Jackie, “I think I can do this. This wasn't too bad.” And could I sit in a regular chair for supper? First time in years, I'm sitting in a regular chair, upright for supper, and that goes okay. And that's a big deal, to sit, you know, at a table with your family. Huge, for, for supper. Uh, and then, uh, at the end of January, my physical therapist said, “You know, Terry, you're stronger. Let's advance your exercises.” So, he asked me to do 10 minutes twice a day, then it's 15 minutes twice a day, and then we work up to half an hour twice a day. And then, in February, I, and this is, this stuns my, my partners, I take my walking sticks and I walk down the hall to mail a letter. First time they see me do that in about four years. Wow. Uh, and, um, you know, when I go to see my chief of staff, uh, pardon me, the Chief of Medicine, uh, at the University, which I have to do every two years, and he sees me walk into his office, first time that's happened in years. And so, I tell them, uh, what's happened, uh, show on my, uh, device, and he says, “Uh, Terry, a single case report can change everything.” He wants me to get a case report written with my treating medical team, which I do, uh, and, uh, then, uh, once we get that going, he calls me back and says, “Now, I want you to start doing clinical trials,” and it gets me the mentors, and we start doing those clinical trials. Wow. And then, so this all sort of begins with these conversations I'm having with him, uh, in April, uh, and then in May, a couple of weeks later, I, I have it in my head that I want to try riding my bike. So, and I haven't ridden my bike, uh, in six years. We have an emergency family meeting. Uh, Jackie, my wife, tells my 16-year-old boy, six-foot-five Zach, “You run alongside on the left,” and she tells my 13-year-old daughters, “Uh, you wing alongside on the right. She'll follow,” and we get in position, and I get on my bike, and I bike around the block. Now that 16-year-old boy, that big six-foot-five boy, he's crying. The 13-year-old girl, she's crying. Jackie's crying. Wow. And of course, what, what I really, at that moment, I, I still cry. Wow, unreal, because that is when the future could come back, uh, because who knows how much recovery might be possible. So, I bike a little more every day, and then in October, Jackie says, “Um, I've signed you up for the Courage Ride. It's 18.5 miles, hunt, and however far you go will be a triumph.” But, so once again, when I cross that finish line, everybody's crying. My kids are crying. Jackie's crying. I'm crying. And you know what? I still cry, thinking about what that meant, because it's like, okay, the current understanding of progressive autoimmune diseases is incomplete. Who knows how much recovery might be possible. And you know, that's why, when, when, uh, Dr. Rothman said, “Terry, we have to have you test this in others,” and the question is, “Can other people do this complicated stuff that you're doing, um, is it safe, and what is the effect size?” And, um, that's how my research life got launched, because I wasn't trained to do clinical trials, but I've since learned, and we've done seven trials, we're now into our eighth clinical trial. Wow.
Now, regarding all those clinical trials, have all the results been positive, like just kind of overall? Well, there are some very consistent findings. The first one is, people can do it. So, a big part of the question is, can people, uh, so the first study, it was very complicated. Lots of changes, diet, supplements, meditation, exercise, social stimulation, muscles, and people who are severely disabled, who are between cane and walker, you know, very severe disability, in, they could do it. They remarkably changed their diet. I added the meditation, the exercise, the supplements, the e-stem, uh, and the side effect, if you were overweight or obese, you lost weight without being hungry, uh, and, and they lost a lot of weight. So, uh, with, I have to have safety reports to the, um, uh, uh, a research review community, the Institutional Review Board, known as IRB. So, I kept having to send them safety reports every six months, uh, and in every trial that I've done since, if you're overweight or obese, you lose weight. Every single trial, uh, that has happened, uh, insofar in every single trial, we've not had any serious, uh, adverse events that were related to the diet. Uh, people do occasionally get hospitalized for things like motor vehicle accidents, scheduled surgeries, but my review committee agrees that that is not related to the study interventions.
Now, when you're applying a lot of this data, real quick, it's easy when you have a drug, right? You just say, okay, you know, you double blind, you placebo control. The problem with functional medicine is that you're applying so many interventions. You know, you work with the functional medicine practitioner like yourself, you're maybe the water's cleaner, you're adding meditation, some movement, you're improving sleep, maybe you're getting some sunlight, maybe you're applying some sauna, maybe you're doing some e-stim. How do you know which variable is the big needle mover, and is it different for each person? And does conventional medicine, does that hold them back from jumping onto this research, because you can't isolate the variables specifically, can you? So, um, let me address that.
So, the first study, the question was, could people implement this complicated regimen? So, that's a feasibility, and the answer we got is, yes. And people, um, 95% of the days, people were adhering to the diet. Uh, um, the supplement use was quite variable. There was 13 minutes a day of stress-reducing practice, uh, and 20 minutes a day of exercise. The people were profoundly disabled, and, uh, 60 to 70 minutes of electrostimulation, uh, every day. So, people implemented it, so that hit the feasibility. Uh, then safety, I've already told you, the biggest adverse amount was, you lost weight if you're overweight or obese. At the end, we saw that blood pressure improved, blood sugar improved, uh, and lipids consistently improved in that first study. Now, the criticism is, we don't know what the mechanism is. Now, the good news is, I have a freezer of blood, and so what I would like to be able to do is to go back and, uh, begin analyzing the freezer to say what were the molecules that changed, and so I, I'm beginning to look at doing that and analyzing, uh, those molecules. The, uh, and so I can begin to understand whether the molecular mechanisms. Now, from a functional medicine perspective, you and I know that everything in our physiology is connected. The hormones, the toxins, the nutrition, the exercise, the sleep, and so we know that it's very arbitrary and incorrect to say there's only one molecular pathway being manipulated, uh, and that is, of course, the fact that I have not yet been able to analyze the molecules is a hindrance towards this being accepted. So, being it, when you can go back into our freezer and analyze the molecules, that will be helpful. I keep writing grants, trying to investigate the multifactorial approach that we use. But because I, I have gotten so many, uh, criticisms for this complicated regimen, we then went from my multimodal, doing exactly what I've done for my recovery, to just studying diet. So then, we did some small pilot studies, just studying that, uh, and we're still doing studies studying diet, um, and I'm now writing grants proposing to study diet plus exercise because of the synergy, uh, the power of exercise plus diet. In my clinical practice, I see folks. I will tell them that the more interventions in terms of their lifestyle that we can do, that they can implement successfully, the more improvements to the physiology they will experience, and we talk about how successfully make behavior changes. Because I, you know, people taking drugs, even doing just a drug, 80% of the people will take the prescribed drugs for about eighty percent of the time. If, even if all I ask you to do is take a pill every day, it's hard to remember to do, to fit into your life. If I'm going to ask you to radically change what you're eating, to give up foods that are bad for you, that are plentiful, tasty, uh, everyone around you is eating, and to eat these new foods, new recipes, new ingredients, and to get the children in your family, the spouse in your family, to go on this journey with you, that's a very big ask. Right, yeah. So, that's a much more complicated, uh, decision, and furthermore, if you look at, um, beginning in World War II, we began to outsource meal preparation. We began eating in restaurants, we began eating fast foods, we began buying foods that have someone else have cooked, so canned foods, boxed foods Foods, yeah, you could get a meal, uh, and open up the box and boil the noodles, add the sauces, and it's convenient. It's cheap, it saves us time, it saves us money. I, and so fewer and fewer people know how to cook using ingredients. Fewer and fewer people are cooking anything at home, and the result is, the nutritional quality has steadily gone down, uh, the intake of food-like chemicals have steadily gone up. Yep, and our nutrition is compromised. And if you go look at Michael Pollan's book, “Omnivore's Dilemma,” he talks about that post-World War II, we were spending about 18 percent of our income on food, and now it's down to nine, so we've cut down the amount that we invested in quality food. It's cut down in half, and we obviously know the pesticides and everything else, you can imagine the nutrient density is probably dropped as well, correct?
“Correct, and if you look at the nutrients in food, you can look at apples, uh, hamburgers, chicken, uh, there's another ingredient that the USDA looks at, and they look at the vitamin and mineral content of these foods, and it has steadily declined over the last 75 years. So, we're eating fewer vegetables, and the mineral and vitamin content in those vegetables are steadily declining, 100 percent. And just to echo on that, Joel Salatin came in my podcast a few years back. He runs Polyface Farms, and he does a lot of, you know, pasture-raised eggs and meats. He compared his pasture-raised eggs to the conventional eggs at the store. He tested it for folate, his eggs had 20 times more folate than the conventional eggs. How about that?”
“Yes, so and then the other thing I can have your listeners think about, if you imagine what it costs to build your home, in terms of time, uh, and dollars, and so you've built your home, storm comes through, wrecks your home, flood, windstorm. So now you have to repair it. We all know it's going to cost me more dollars to rebuild that home, take away the trash, clean up the site, and rebuild it. If my brain is being damaged by my multiple sclerosis, and I have to rebuild the damaged brain, the spinal cord, the cranial nerves, or the peripheral nerves, if I have an autoimmune disease attacking my peripheral nerves, or cancer chemotherapy that attacked my peripheral nerves, it's going to take a lot more nutrition for my immune cells to come in, exactly clear away the damage, and then a lot more nutrition to rebuild a new the peripheral nerve, spinal cord, cranial nerves, and brain. We have to have better than good nutrition that you need to maintain good health and healthy aging. If you want to fix problems, you can't waste any of your calories on empty processed foods. You can't, you need all those calories to have the building blocks to clear the trash and rebuild it, exactly. And then when I explain this in those metaphors, a light bulb goes on, people get it. I said, ‘So that, that yummy delicious food is robbing you of what you need to rebuild you, 100 percent.'”
“Now, I wanted to highlight a couple of things. Is on your Wahls Protocol, you've, you started off with the Paleo template, and then you made some modifications. You know, it seems like you really emphasize more of the sulfur-rich vegetables, which are important for detoxification, obviously nutrient density, um, more of the leafy greens. You put more emphasis a little bit more on the organs, meat, organ meats, and fermented foods. You know, obviously, you, you cut out even things that, you know, your Paleo diet things, right? You cut out your grains, your dairy, you cut out your beans, your lentils. Did you also cut out eggs too initially?
“Yeah, I did. It did sort of explain all that. Yeah, healing journey, I discovered that eggs, I have a severe reaction to. It turns on my trigeminal neuralgia, and when I first started, and so if I eat an egg, which I love, eggs are so delicious, but if I eat eggs, it turns on my face pain. So, so I'm careful to not eat those. I started doing my clinical trials, uh, the IRB required me to use my protocol, uh, my diet. I, and I, um, it's a, we had a big debate over eggs. So, well, can you eat eggs? I said no. I said, well, but you can't. Yeah, we're requiring you to use your protocol. So, my first study was exactly my diet, my supplements, the exercises, e-stem, everything, uh, and then the next round of studies are based on the preliminary data from the first study. So, we continue to remove eggs. And I could, in my clinical practice, I tell people, we either have to test you for food sensitivity for eggs, or we take the eggs out, uh, preferably for three months, and then you can try the egg yolks, see if you tolerate them. If you do, that, we could try the whole lot, the whole egg, see if you tolerate that. And you get the yolk first because the yolk doesn't have the proteins, with more of the fatty acids, right? And the, it's the, the proteins that are more allergenic. It is the proteins are the problem. It, and I, I acknowledge that eggs are a superfood. If you tolerate them, they have choline, all those vitamins, uh, the centrifice, uh, it's just, sadness, fabulous nutrition, if you tolerate them. If you have an abnormal immune response, then not so good. Plus, imagine, good healthy cholesterol has to be a good building block for that myelin. Because with, with MS, is for listeners that are following, Dr. Wahls had multiple sclerosis, which is an autoimmune condition, primarily affecting the myelin sheaths that covers the nerves and the central nervous system. And so, it makes sense that if we're attacking that, immune-wise, you want to get to the triggers that are causing and provoking the immune response, but also provide more of the building blocks to help the raw material with that house analysis. You're going to need more of those building blocks.”
“Yeah, you know, it, there's a really interesting study in the mouse model of MS. They saw that compared to the little mouse that had the experimental autoimmune encephalitis, compared to the healthy controls, that their, their blood cholesterol dropped by about 25% when they developed the MS equivalent. And so then, they supplemented the mice with cholesterol, uh, and it reduced the severity of the disease, um, super interesting. In that, the additional cholesterol did not increase the blood cholesterol. And so, super interesting, their conclusion was, well, maybe cholesterol is not the, the boogeyman that we think, and I, I absolutely agree with that. Cholesterol is a key constituent of myelin. It's a key constituent of cell membranes, uh, we absolutely have to have that. Now, if your cholesterol becomes extremely elevated, in the 300 range, yes, that's a problem. I don't want people to have cholesterols over 250, um, but it also don't want them to have cholesterols below 200, because then it becomes hard. It becomes hard to make your vitamin D. It's hard to make your sex hormones, uh, your cortisol, uh, all sorts of things become problematic. Now, when you look at conventional medicine, right, and you look at the medications that they have me, most of the mechanisms involve immunosuppression, modulating immune response, or reducing inflammation in some way, shape, or form, but they're, they're kind of ignoring the root cause of how the immune system got so far out of whack to begin with. Can you just kind of draw a line between, because you're looking at this condition totally differently? You're like, ‘How are we getting to the root of how this came about where they're just trying to Band-Aid things and hoping they can prolong time and manage the disease progression?' Now, you slow it down, but eventually, you're going to get in that wheelchair, eventually, you're going to have all of these issues where you're like, ‘No, no, it doesn't have to be that way. We can actually stop it and then accelerate the healing.' Can you just get the hair and contrast the both?”
“So, the conventional drug development focuses on a single molecular pathway and what can I do to interrupt that single molecular pathway. Works super well for understanding physiology, and it's been working well for making a drug that can affect that single molecular pathway. Then you have to have a biomarker, and the MS world is, can I reduce the number of new enhancing lesions? And you have to show two studies where you've done that, and that's how the drug gets approved. So, it does a good job, a superb job, of turning off enhancing lesions, and we now know that what it does is, it adds five years to the time, how long it will take you to get into a wheelchair. And of course, as a person with MS, we've been in a wheelchair, you know, that's really wonderful news, get five more years. It doesn't stop the progress of the progression, it doesn't stop anxiety, depression, cognitive decline, those still occur. That doesn't stop the profound disabling fatigue.”
“Now, let's contrast that with studies about diet. And we have, we've done, as I said, seven studies, we're in our eighth. We, my lab did a what's called a network meta-analysis that looked at all the diet studies that had fatigue or quality of life as an outcome and use diet, 12 studies, total of 608 patients. They looked at low-fat, Mediterranean, anti-inflammatory, paleo, ketogenic, fasting, calorie restriction, and the usual diet. And for fatigue, it was paleo, Mediterranean, and low-fat diet, it was most effective, uh, with paleo being about 40% more effective than either Mediterranean or low fat. And for quality of life, it was paleo and Mediterranean that were effective, with paleo being twice as effective as the Mediterranean. To look at exercise, in exercise also is helpful for reducing fatigue, improving quality of life.”
“So paleo is more effective than Mediterranean. Do you think that's because of the higher quality saturated fats? Do you think because Mediterranean maybe still ate some grains and things like that? What's the difference in that?”
“So, this is a great question. I like to think of, uh, of this as the med, I tell this to my patients, standard American diet has about 250 grams of carbs in it. A Mediterranean diet probably has about 120 grams, yep, I agree, of carbs in it. A paleo diet would have about 100 grams of carbs. A ketogenic diet, a medium-chain triglyceride ketogenic diet, will have 50 to 80 grams. A ketogenic diet based on olive oil or dairy fat will have 25 to 30 grams, so. A Mediterranean diet, clearly much better than the standard American diet, absolutely. And then, if you take out gluten-containing grains, you reduce a bunch of the inflammatory components, and if you also go dairy-free, uh, now you really look like, uh, Wahls Level One, bingo, uh, and so, that's another step up. And then, when you're ready, you can go Paleo, uh, focus in on the organ meat, the fermented foods, uh, and then again, depending on the circumstances, I may encourage you to go lower carbs still, and think about a ketogenic diet. My current preference is an olive oil-based ketogenic diet, because I think olive oil has, there's so, so many studies showing the benefits for cancer, heart disease, and for cognitive decline, to add additional olive oil. So that's my preference. A lot of the conventional ketogenic diets, if you're out there Googling them, are heavy into eggs, which may be okay, uh, and very heavy into dairy. Dairy, they can be, that can be a problem, I see too, yeah, and that can be a problem, uh, uh, that people may have unrecognized casein sensitivity. Can they maybe look at some of the, you look at some of the earlier Atkins stuff, he put a lot of aspartame and soy protein in some of his bars, so there wasn't really the differentiation on the qualities of protein, or even going organic, and that, that's, yeah, I think there's been some evolution of that over the last decade or so, of like, okay, we learn, we keep improving, and so that, you know, the conversation is, it's you and your family, which of these dietary patterns will appeal most to you, given your culinary preferences, your cultural preferences, and that you think you and your family can do. If the family says, you know what, I could do the Mediterranean, but man, I just can't do Paleo, I'm like, okay, now let's do that, or they, yeah, the people I saw at, uh, the Iowa City VA hospital, uh, when I was doing the Therapeutic Lifestyle Clinic, we saw people who are disabled, not working, uh, out, living on food stamps. I taught them how to do Wahls Level One, and we could teach them how to do this, yes, it was a little more, uh, like a gluten-free Mediterranean diet, and that was affordable, and here in the Midwest, there's too many deer, so a lot of communities have controlled deer shoots, so people could go to their community lockers and get as much free venison as they wanted, uh, and so this became affordable, people living on food stamps could implement these diets, and they saw remarkable improvements in their health. That's great.
Now, I've seen some patients too that have severe autoimmune issues, and I know you're a big fan, and I am too, of eating good, high-quality, nutrient-dense vegetables, sulfur-rich foods. We know they play a major role with detoxification, micronutrients. But there are a lot of people talking about a carnivore diet being very helpful for severe autoimmune issues. What's your take on that?
“So, I know I've been speaking with the carnivore community for many years. Then please, write a case report, please write case series, so we know which patients are helped, what are the adverse events, on how to monitor these folks. So far, they have not published a case report or a case series, and we've offered to help them with that. You know, that will, my team would, even with medical students, who would love to write that up, but for whatever reason, they've not done that, uh, and then, well, I talked, uh, to them about doing a single arm, uh, uh, feasibility, safety, so again, prospectively put them on, so we could see what the adverse events were, uh, how to monitor, who the right people are. They have not done that, the result is, they, they talk a lot, but there's no published peer-reviewed literature, so we don't even. Sean Baker, I know Sean Baker's talked about doing something, some cases.”
“Oh yeah, he's raised, he says he's raised millions of dollars. We have communicated with Sean Baker, we've offered the help, uh, getting, uh, but so far, uh, nothing's come of it. Interesting, it's disappointing. I, I mean, I think it's interesting. It may be a very useful tool, but until we have some published peer-reviewed literature, yep, we don't know how to use it.
“Makes sense. I mean, you got the nutrient density on one side, and you have the anti-nutrients on the other side. Like, at one point with some people, the anti-nutrients may be greater than the benefit from the nutrient density. I think that's the answer.”
“So, uh, the Sean Bakers and the carnivores, um, they talk about the anti-nutrients in plants, uh, and, um, they want us to avoid all plants for that reason. However, our evolutionary history is that we've been eating plants for seven million years. And they will also talk about the benefits of hormetic stress, cold plunges, and saunas. Yep, wonderful. Uh, the benefits of high intensity, uh, interval training and strength training. Yep, we agree. But they don't want to hear about the benefits for medic stress from plants. That having, uh, these toxins in small doses give our phase one, phase two, uh, boost, uh, improve the efficiency of how our cells, through the biology of life. Which is why I stress the goal is 200 different plants in a year. Mm-hmm, lots of different plants. I don't want you eating a huge amount of the same plant every day. You know, kale, great, great, a great green, I really love it, but if you ate kale every single day, those anti-nutrients in kale could become toxic eventually. But if you had kale today, a Swiss chard tomorrow, a bunch of parsley the next day, uh, yeah, perhaps beet greens after that, and then collard greens, and you kept rotating your greens. Now, I'm getting the benefits, I'm getting that hormetic stress, uh, and for 200 different plants, pretty easy to do if you're eating a wide variety of spices and teas and rotating your vegetables. And also, cooking those foods are going to break down some of the antinutrients, whether you're steaming them or sauteing them. A big raw salad is different than putting them in a crock pot or a stew, or even sauteing them.”
“Yes, absolutely, absolutely. If you have a hard time, that's a good option. And, and in terms of how fermented, how much raw, how much cooked, um, that, I talk about, are you pooping rocks, logs, prickly logs, smooth logs, snake, pudding, or tea? And if you're having rocks, you need more fiber, so more raw, sure, and fermented. If you're having pudding, tea, you need less fiber, so now you need just soups and stews.”
“That makes sense. Now, your first book, you talked about it in ‘Wahls Protocol,' and then you went to, I think it was your, um, ‘Minding Your Mitochondria,' where you talked about more about some of the supplementation. What are some of your, your big three, your big five things that, that you have implemented yourself personally, or with patients, that have really helped accelerate healing, accelerate the mitochondria? What are those big things?”
“Well, yeah, I want people to improve their diet, uh, to the pace that they can do that, uh, and then, that's Foundation, that's foundation. And then, if you exercise, you're going to make more nerve growth factors, uh, and we need the nerve growth factors to drive, um, the cells, uh, to do the repair work. And so, the more exercise you can do, uh, again, moderate intensity, followed by a recovery, uh, period, uh, the better. Does it matter for resistance training or just like a zone two kind of cardio? Is there any preference to balance?”
“Oh, actually, there is, um, we know that balance train, uh, where you are working on standing on one leg, uh, good leg, then, uh, your weak leg, uh, super helpful. Strength training, super helpful. Cardio is super helpful, and flexibility. So, those, those are the four big components. The next most important thing is, you have to enjoy, you must be enjoying what you're doing. I, and so, I stress enjoyment first, that we find things that you enjoy doing. It can be walking, skiing, uh, biking, uh, swimming, uh, dancing. And then, as exercise becomes a part of your life, then I let people know that we know these four components all have a really big benefit. So, if you can find a way to add those four components to your routines, that would be helpful. But absolutely, the most critical is, it has to be fun, so you'll keep it up, 100%.
“That makes sense. So, getting back to the supplements, what were those big three or big five things that really, no, know your vitamin D level, uh, so at least 50, 50 are up, 50 to 70 or so, 50, 50 to 80. Uh, is ideal, and it has to be some from supplements and some from sunshine. We know that, uh, getting your vitamin D through sunshine is more effective than getting your vitamin D through supplements, and that's super interesting. Uh, I do both. I give people supplements, I tell them that I want to be sure they're getting a tan. We also know that fish oil, super helpful, uh, two to four grams of fish oil associated with lower rates of relapse, uh, and slower disability progression. Any preference with cod liver oil or different types of fish, um, well, grass-fed, um, pasture-fed, or more like wild, wild. I do, uh, and then, uh, ideally small wild-caught fish, you know, and, um, a mixture of cod liver oil, uh, fish oil, uh, uh, krill oil, uh, DHA oil, according to what people are comfortable with. Um, if you're using cod liver oil, if you're going to get some fully made, fully formed retinol, or vitamin A. If you are eating organ meat regularly, then it would not have you use cod liver oil. That makes sense, between vitamin A, vitamin D, and then, um, uh, I want people to have vitamin K2. Okay, it, it go with your D, you'll get more calcium into your teeth, bones, and in the animal models, vitamin K2 is super important for remyelination. Mmm, we don't have, we, you know, it, we're not going to study that in humans as well because we can figure that out in animals through autopsies of the little mice and rats, but you can't do that in humans very well, right. That makes sense, anything else, any, any CoQ10, PQQ, any, like, curcumin, or things like that?”
“No, these are all the things that are super, uh, beneficial to have, uh, curcumin's helpful, uh, CoQ is helpful, uh, NAD, uh, is hopeful, uh, resveratrol, quercetin, um, but you know, I'm mindful of supplement fatigue. So, I will look at the individual's comorbid states, uh, anxiety, depression, uh, insulin resistance, uh, hypertension, obesity, uh, and so we'll have the core, and then I focus on the comorbid problems, uh, and we'll supplement to address those comorbid problems. That makes sense, because you talked about the autoimmune MS aspect, and then you kind of drew that line between a Mediterranean diet doing better than kind of a Paleo template, and we also know the advanced glycation and products, and that insulin resistance can also irritate the nerves too. So, we're trying to one, decrease the autoimmune response on this side, but also two, not be glycating all these nerves and creating all this oxidative stress as well, is that fair to say?”
“Correct, correct. And we want to make these diet changes as a family. So, if what the family can do is the Mediterranean diet, that's fine, we'll have the family do that, and then you can decide, like, uh, you could make it a little bit more tweaked to be more Paleo-like, and then the family gets into like they can do a Paleo diet, but I want to be lower carb myself, and so I'm going to be a little more, uh, like a cue. So, you can have, uh, as a family, you want to agree, what are the things that we don't want? I don't want to have to see because it's too tempting for me. Uh, and ideally, there's a family conversation about, okay, we're gonna, what we're gonna remove from my eating space and what the family, uh, uh, is comfortable with. That makes sense, makes a lot of sense. Well, we'll put down below, I know you have a certification, Wahls Protocol, we're going to put the link down for that below as well as your MS study. Now, I know you did a study with, with Garrett Salpeter over at NeuFit, at NeuFit, very awesome, with his NeuFit device, which is awesome. Garrett's a friend of mine. I know he has this amazing device that really works on the stimulation, healing, recovery. Can you talk a little bit more about kind of the e-stem and kind of some of that study information?”
“Yeah, you know, a lot because, so for people who have, uh, motor disability now, uh, exercise, at least super important to get that function back. If you can add electrical stimulation to muscles, you can shorten the time to recovery, and you can deepen the amount of recovery. So, in my clinical practice, we, uh, we really encourage the use of e-stem for anyone who has a weakness in either hands or their legs, foot drop, uh, very, very helpful. Are you just applying that on the muscle belly and then just having them do simple movements? How, how much?”
“What we do is we identify hot spots where the nervous system is not working quite as well. So you're scanning it, we're scanning it, then we put the electrodes on, and have them exercise with current that will let them get a bigger, electrically driven exercise, plus the volitional exercise, and it really accelerates, uh, the recovery. Very good.”
“Well, we're going to put links down below here. Can you talk about the study you were talking about?”
“Yeah, this could be a good fit for the study, um, so for anyone with relapsing-remitting Multiple Sclerosis between the ages of 18 and 70, who live in the United States, Mexico, or Canada, and are willing to be randomized either a ketogenic diet, a Paleo diet, or continue their usual diet, uh, we, we want to have you, because I can't change the standard of care without a randomized, uh, clinical trial. Uh, and for those, those of you who are practitioners, that is Physicians, chiropractors, a movement professional, health professional, we have a certification program that is all done in the virtual space, uh, and we'd like to train you. Yes, uh, so, uh, you can use VIP for a discounted application fee, and if you would like to have a copy of our research papers, uh, you can go to terrywalls.com forward slash papers, and get a copy of that. Again, it's terrywalls.com forward slash MS study for the research, terrywalls.com forward slash certification for health professionals, and we'd love to get you trained, uh, and, uh, terrywalls.com papers for, uh, access to copies of our research papers. And I'll put the links in the descriptions if you guys are driving or exercising, don't worry, just click down below and you'll see the links there, right below.”
“Well, excellent, Dr. Wahls, anything else you want to leave the listeners with? Anything, any last tidbits at all?”
“You know, I used to think that the most important conversation was about, uh, which diet people should be on, and now I understand the most important conversation is about how we grow their motivations, because it's work to change habits, it's work to extinguish, uh, behaviors that I want to stop. You can ask anyone who's trying to get rid of smoking or alcohol, or that you want to stop eating all those yummy delicious foods that you know you shouldn't have, uh, that that's hard because we have cravings, uh, so now understand the most important conversations about what we can do to grow motivation to do the work of extinguishing the undesirable habits and do the work of growing the desirable habits, uh, in that we created a 15-step program, uh, uh, the Wahls Behavior Change Model, that has been very successful, and was extraordinarily successful at the VA, so they came, met with me several times, the national VA office, uh, and used several of these concepts in their Whole Health Clinic, and that's part of what we train, uh, the certification program for our practitioners, and that's what we use in our clinical trial. So, we can get people to be so successful at implementing these changes, together as a family. That makes so much sense. I find it's important that patients have a compelling future, a really important future pacing vision of what they want to achieve because, in the end, we're doing these things now, so we can have a better future tomorrow, and achieve the goals that we want. So, that why is so important. It makes the how and the what easier, right?”
“Absolutely. It's important. We can do hard things if we have a why. Yeah, powerful why, big why, make it super clear, focus on that vision, and it allows you to have the motivation to make these changes, and not a big deal, because your why is so big. So, I love that.”
“Okay, well thanks so much, Dr. Wahls, you have an awesome day.”
“Thank you.”
“All right, thank you.”
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