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RHR: Treating MS and Autoimmune Disease with Dr. Terry Wahls


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Revolution Health Radio podcast, Chris Kresser

We’re back after a long hiatus and our first show of 2014 is really exciting. I interviewed Dr. Terry Wahls, who many of you, I’m sure, have already heard of. She is a physician who has made remarkable progress with her multiple sclerosis using Paleo principles and functional medicine.

We haven’t talked a lot about MS on this show, so I thought it would be fantastic to have her on and discuss her own experience as well as her research with other patients with MS and her upcoming book, The Wahls Protocol.

In this episode, we cover:

3:22 What did Chris eat for breakfast on the book tour?
8:10 How Dr. Wahls beat progressive MS
12:30 Conventional MS treatment approaches
17:13 The importance of getting nutrients from food (not supplements)
19:55 What exactly is MS?
26:52 The Wahls Protocol for treating MS and Autoimmune Conditions

Links We Discuss

Full Text Transcript:

Steve Wright:  Hey, everyone.  Welcome to another episode of the Revolution Health Radio Show.  This show is brought to you by ChrisKresser.com.  I’m your host, Steve Wright from SCDlifestyle.com, and with me is integrative medical practitioner, healthy skeptic, and newly a New York Times bestselling author, Chris Kresser.  How are you doing today, man?

Chris Kresser:  I’m good.  It’s good to be home.  I have to say I really enjoyed the book tour.  It was actually a lot of fun and was not as hard on me as I feared that it would be, and at the same time, I’m really glad to be home and happy to be back recording a new episode here.

Steve Wright:  Yeah, this is our first one for 2014, and I think we need a big round of applause here for the success that you have and have had with the book and everything you’ve been doing on the road.

Chris Kresser:  Well, thanks.  As I said, it’s been fun.  It was really great to get out and meet people face to face that have been following my work and reading the blog, listening to the show.  I met several patients face to face that I hadn’t had a chance to meet yet, people I’ve been working with long distance, and definitely happy with the success of the book.  Yeah, it’s been a big learning experience, it’s been lots of fun, it’s been rich all around, so I’m grateful that I had the opportunity to do this, and as I said, I’m happy to be home.  How about you, Steve?

Steve Wright:  Well, there’s nothing like home base, I definitely know.  I’ve been on the road a lot in January but not quite like you’ve been on the road.  When you can get back into your environment where you get to control things and it’s your bed, that’s a big deal.  Plus, with your family.

Chris Kresser:  Yeah, I’d say the biggest thing was missing my family, missing Sylvie, in particular.  But they came up to Portland and finished the rest of the West Coast tour with me, which was nice, Portland, LA, San Diego.  The second biggest thing was missing home-cooked meals.  I mean, I don’t eat out a lot.  We cook most of our own food, and it was a drag to have to eat out nearly every single meal for almost three weeks.  In some places, I was able to stay in suites, like an Embassy Suites type of place that had a kitchen, and so I was able to prepare at least maybe one meal a day, but because of how hectic my travel schedule was, even when I had a place with a kitchen, in some cases I was in a town for less than 24 hours, so I didn’t really even have time to go to the store and get stuff.  So, I’m really, really excited to be able to cook my own food again.

What Did Chris Eat for Breakfast on the Book Tour?

Steve Wright:  Nice.  And rather than asking what you ate for breakfast today, why don’t you share what your go-to breakfast option was on the road, like, in those cities where you literally don’t have time to hit up Whole Foods or something like that?

Chris Kresser:  Well, fortunately breakfast was pretty easy because I would typically have eggs or an omelet of some kind if they had it and bacon and then potatoes.  And instead of toast I would ask for a side of spinach, like steamed or sautéed spinach, which they usually have because they often will include it in omelets.  In the summertime, I might have also asked for tomatoes or something.  They’re not that great in the winter in most places, so I was just sticking to the green veggies.  But that was a pretty standard breakfast that I could have just about anywhere, and of course, it varied in terms of quality depending on where I was, but it was pretty easy to find that.  Lunch and dinner were sometimes harder.

I wrote a blog post a couple weeks back about how to stay healthy on the road with some of my reflections from the book tour, and generally nowadays in major cities it’s pretty easy to find a place, a restaurant that has some meat or fish, a non-starchy vegetable, and a salad or perhaps a starchy vegetables like potato or maybe even sweet potato or winter squash or something.  So, that was my pretty standard fare for lunch and dinner, and you can get that at all kinds of different restaurants, not even just American food restaurants or steakhouses, but many ethnic restaurants you can also get some version of that if you know what to ask for or if you just ask for it.  So, I didn’t find it to be really that problematic in terms of the types of foods I was eating, but as we know, vegetables oils are typically used to cook with in restaurants except for some of the higher-end restaurants that have started to go back to using traditional fats, and you just never really completely know exactly what’s in the food, and you don’t have full control over it, as you mentioned.  So, even though I was doing a pretty good job in terms of finding the right things to eat, the oils were not what I would use at home, and then generally restaurant food is not as simple as what I eat at home.  I really like to eat simply, and restaurants tend to go out of their way to kind of make it fancy, and I’m always trying to tell them to make it simpler for me because that’s what works for me.  And so, despite all of my efforts, the novelty wore off very quickly.  Let’s put it that way!

Steve Wright:  Yeah, I can tell you that even a couple days in a row of eating out every meal, I’m already starting to feel it.  Even making the same selections that you’re talking about, doing my best to eat at the best restaurants, it doesn’t feel the same.

Chris Kresser:  No, it’s not.  So, yeah, it’s good, good, good to be back.  I’m happy.  Sorry I missed you in Boulder.  I know you were away, but I’m coming back there in April, so hopefully we’ll be able to hook up then.

Steve Wright:  All right.  Hopefully it’s not during PaleoFX.  Will you be there?

Chris Kresser:  No, it’s the weekend before that.

Steve Wright:  OK, good.

Chris Kresser:  I will be at PaleoFX, too.  I just confirmed that.

Steve Wright:  Congratulations.  We were asked to speak there as well, so we’ll see you.

Chris Kresser: That’s awesome.  So, we have a really exciting show today for our first show of 2014 and back after a long hiatus.  We’re going to be interviewing Dr. Terry Wahls, who many of you, I’m sure, have already heard of.  She is a physician who has made remarkable progress with multiple sclerosis, which she was diagnosed with in the year 2000, using paleo principles and functional medicine.  We haven’t talked a lot about MS on this show, so I thought it would be fantastic to have her on and discuss her own experience as well as her research with other patients with MS and her upcoming book, The Wahls Protocol, where she shares the details of all of that.  So, let’s bring her on the line here, and we’ll get the show started.

Dr. Wahls, welcome.  Glad you could join us.

Dr. Terry Wahls:  Thank you.

How Dr. Wahls Beat Progressive MS

Chris Kresser:  Can you tell us a little bit about your story?  I’m sure many of my listeners know of you and have heard your story, but for those who haven’t, can you tell us a little bit about the background for this book and how you got into this?

Dr. Terry Wahls:  Sure.  I have multiple sclerosis.  It was diagnosed in 2000 on the basis of an abnormal weakness in my left leg and some stumbling that I was doing.  I had MRIs of my brain and spinal cord, a spinal tap.  I had lesions in my spinal cord, I had a history of dim vision 13 years earlier, weakness in my left leg, so I had two lesions disseminated in time and space.  I was told to proceed to get disease-modifying drugs, and so I decided that I would get a second opinion at the Cleveland Clinic, one of the internationally recognized MS centers, and they said, “Yes, you have MS,” and strongly urged me to begin one of the ABC drugs, and I started Copaxone.  Over the next three years, I had only one episode of weakness that was involving my right arm, so that would be a success, but the problem was I had continually declined and my disease had converted to secondary progressive MS.  I needed a tilt-recline wheelchair.

I should tell you that I had found Loren Cordain’s work in 2002, and after decades of being a vegetarian I had gone back to eating meat and had eliminated grain, legumes, and dairy, but had continued to decline.  When I hit the wheelchair, I started reading the research literature on animal models of MS, Parkinson’s, dementia, Huntington’s disease, and decided that mitochondria were key.  I managed to find some vitamins and supplements that were helpful to mitochondria, and that seemed to slow down the rate of my decline, but I was still declining.

By 2007, I had difficulty sitting up in a standard chair; my back was so weak.  I could walk very short distances using two canes.  And that’s when I discovered the Institute for Functional Medicine.  I took their course, Neuroprotection:  A functional medicine approach for common and uncommon neurologic syndromes, and had a much longer list of nutrients that were really important to my brain.  I started taking those.  Not much happened, but then I had this really brilliant insight that I should take this long list of nutrients and get them from the food I was eating.  So, with more research, I figured out the food stuff that would supply those nutrients, reorganized my diet using paleo principles but to target these particular nutrients, and that’s when the magic began to happen.  Within three months, I was walking with a cane between exam rooms.  In six months, I was walking without a cane, and within the year, I was able to get on my bike and start biking again after not having been able to do so for five years.

Chris Kresser:  Wow.

Dr. Terry Wahls:  And then I was even able to do an 18-mile bike ride with my family.

Chris Kresser:  That’s amazing.  Tell us a little bit about what those nutrients are.  We might be jumping ahead here, but since you mentioned them, and I’m sure you go into much more detail in your book, but maybe just an overview.

Dr. Terry Wahls:  In the very big sense, we need the whole family of B vitamins and vitamins A, C, K, and E, of course.  Minerals are cofactors so the vitamins can do their job, and so there are the major minerals and some trace minerals that are very important, including things like iodine and selenium.  Then a wide range of antioxidants that are very, very helpful.  All in all, I end up with 31 nutrients that I’ve identified that the science has said are critical for brain cell growth, and those are the nutrients that we now track and be sure that we have a diet designed to maximize intake of those nutrients.

Conventional MS Treatment Approaches

Chris Kresser:  Right.  So, you’ve made this remarkable progress maximizing the nutrient density of your diet, eliminating food toxins, and using some functional medicine principles, but tell us, what’s the typical approach to MS?  If someone were to find out they had MS and went to a conventional doctor who wasn’t thinking in these terms, what would be done and what is the efficacy of those treatments and the prognosis?

Dr. Terry Wahls:  For a long time, there was absolutely no treatment that was available.  And then the first set of treatments were the ABC drugs based first on interferons and then on Copaxone.  And these drugs would reduce the number of attacks or relapses by about a third.  At the time, they were pretty expensive, $700 to $1000 a month, and they were injections.  The interferons were more likely to cause problems with depression, fatigue, and a lot of muscle pain, particularly if you took the Avonex or the Rebif.  Copaxone had slightly different sets of problems, a little more heart palpitations and some problems with shrinkage of tissue where you would inject, so people could run out of injection sites.  Now they have these much more expensive drugs that are very specific at turning off the immune system, things like Tysabri and Gilenya, that cost between $36,000 and $51,000 a year.

Chris Kresser:  Wow.  And are these covered by insurance companies typically?

Dr. Terry Wahls:  Well, it would depend on the type of insurance that people have.  They are sometimes covered, sometimes not.  And they’re very effective at turning off the acute relapses, the inflammation sequence.  But the problem is if you turn off part of our inflammation response so effectively, because inflammation is a key function in our body’s ability to repair and defend itself, people have a very extensive list of side effects, including death.

Chris Kresser:  Yeah.  I know you’re actively researching.  I imagine you’re in communication with a lot of colleagues who also treat MS.  What has been the response to your experience and now your research and your work with the book?  Are you finding that it’s being well received in the medical community?  Are you finding skepticism initially that then transforms into more open-mindedness?  What has that been like for you?

Dr. Terry Wahls:  Certainly here at the University of Iowa, when I first recovered, we did grand rounds and I presented my case and the theories about why I thought I recovered, and the response there was sort of twofold.  About the half the audience thought this was the most brilliant grand rounds they had ever seen, and the other half thought this was strange and were very critical of it.  And people correctly criticized me and said, “Yeah, you need to do the research,” and so we did that.  We wrote the grant, got funding, and we have the research going on now testing this protocol in others with MS.  And every year, twice a year, we have our research day.  We put up our posters, people see my preliminary data, and the data is very exciting.  So, people are coming by, talking to me, asking to be part of my study team because they know I’m freezing a lot of blood and people are very curious.  They’re proposing to do analyses on the frozen blood to try and figure out why I’m seeing the very exciting results that we’re getting.  As a result, now I’m doing research seminars around the university, and I’ve been invited to do seminars around the country, and now last fall I was in China talking about my work.  So, the word is beginning to get out.  People are interested.  And I’m certainly quite confident that many, many neurologists are having to talk about food because their patients are coming in and saying, “What about that TED talk?  What about food?”

The Importance of Getting Nutrients from Food (Not Supplements)

Chris Kresser:  Mm-hmm.  So, let’s talk a little bit about food.  I have always emphasized the importance of obtaining nutrients from food whenever possible, and I have my reasons for that.  I’d be curious to hear your take on that and why once you’d discovered all of these nutrients that were beneficial for brain health, why you didn’t just take a bunch of supplements instead of emphasizing the importance of getting them from the diet.

Dr. Terry Wahls:  Well, this was sort of a long process for me.  The first step was I started adding animal protein and eating meat again in 2002.  Then in 2003 when I hit the wheelchair, I started reading and adding some vitamins and supplements to my diet.  And then when I got the functional medicine piece, I added more vitamins and supplements.  And then, thank goodness, I sat down and reflected on that if I did this through food, I would get these specific nutrients in their natural milieu along with all the cofactors.  I wouldn’t be taking synthetic compounds that were probably a mixture of racemic forms of the compounds.

Chris Kresser:  Right.

Dr. Terry Wahls:  And in addition, I would probably be getting all of the related compounds that were biologically active.  I think food is so filled with more information for our cells than we realize.  I feel very strongly that food is critical.  When we take the vitamins and supplements, we’re more likely to get synthetic forms, more likely to get them out of proportion, and for, I think, many things in our body, it’s the ratios of various amino acids, ratios of fats that provide a tremendous amount of information for our cells.

Chris Kresser:  Yeah, those are essentially the same reasons I recommend it, and this concept of food synergy, which is so fascinating, I’ve found a few papers on it even in the literature that really make it clear that there’s so much about the interaction between various nutrients in foods that we still don’t even understand yet, and when we isolate nutrients and take them, as you pointed out, perhaps out of proportion or in different proportions than they are delivered in a food, we don’t really know what the long-term effects of that are.

Dr. Terry Wahls:  And the synthetic compounds, you know, lipoic acid made synthetically.  Is that biologically the same as what we’re going to get eating organ meat?  I think not.

What Exactly Is MS?

Chris Kresser:  Yeah, I agree.  So, tell us a little bit about, stepping back, a bigger picture of MS.  Is it like many other autoimmune diseases?  Is the incidence increasing significantly now over the last several years?  And maybe we should even talk a little bit about just what is MS and how it affects people for those that aren’t familiar with it.

Dr. Terry Wahls:  Well, let me step back to, what is MS?  It was first described in the 1800s as there was a lot of white scarring in the brain, so that’s why it was called multiple sclerosis or multiple scars.  And over time, they decided that the immune cells were attacking the myelin, or the fatty insulation on the brain, leading to these scars.  When you have an acute attack, that’s called a relapse.  Things get worse.  Your brain or spinal cord is able to create a few more sodium channels, and it can bypass that scar for a while.  The longer you have the disease, the more likely you are to have parts of the brain and spinal cord deteriorate and the axons, or the connecting wires, begin to break.  In that phase of the disease, that’s called the progressive phase.  And you can either be primary progressive so you never have acute relapses, you’re just slowly deteriorating, and we think there are a lot of breakages going on in those connecting wires.  Or you can have the relapsing-remitting, where you have acute worsening, you get better, acute worsening, you get better.  But after 10 years or so, about half of these people will convert to the secondary progressive phase, where now the axons are breaking and there’s steady deterioration despite the best treatments.

In the US, about 400,000 people are diagnosed with MS, and what we see is the rate of diagnosis is increasing and the age of first diagnosis is dropping.  I believe the youngest person that has been diagnosed was diagnosed at age 6, so it’s certainly very troubling that people are being diagnosed earlier and earlier.  And of course, now there’s a push to use these disease-modifying drugs and a lot of enthusiasm for these very, very potent drugs like Tysabri and Gilenya coming on board.

Chris Kresser:  What do you attribute this increase in incidence to and the earlier age of diagnosis to?

Dr. Terry Wahls:  Well, I think autoimmunity, in general, has increased, and part of the reasons are the increased toxic load, the more heavy metals, plastics, and solvents in our food supply, air and water, so that increases inflammation.  In addition, the low vitamin D.  Physicians have made us terrified of the sun, so people are putting on sunscreen, which is toxic in itself, and blocking the tan also blocks the ability to make vitamin D, so I see epidemics of vitamin D deficiency.  And then I have grave reservations about the genetically modified organisms.  Is one of the unintended consequences of GMOs in the genetically susceptible person increasing the probability of some type of autoimmune problem?

Chris Kresser:  Mm-hmm.  You mentioned earlier when we were talking about the importance of the mitochondria in MS.  Tell us a little bit about that and why it’s so crucial to understand.

Dr. Terry Wahls:  Let me remind the listeners about mitochondria.  About one and a half billion years ago oxygen became in abundance in our atmosphere, and that killed off about 90% of all the living bacteria.  There were a few bacteria that learned how to use this poisonous compound oxygen to create energy very efficiently, and these little tiny bacteria were engulfed by larger bacteria.  And this new super-bacteria was very effective, very efficient, and over time, that efficiency allowed it to develop a multicellular organism and then an animal that could walk and move and eventually that would become us.  So, all of our cells have these ancient bacteria that are living in all of our cells that are producing our energy more efficiently.  The brain, the retina, and the heart are the most packed cells with mitochondria per cell because you have to produce so much energy to think, so much energy to see and, of course, to maintain our heart.  For many, many people with MS – and frankly many conditions – they’re experiencing huge problems with fatigue, exhaustion, or brain fog, and that’s really a very good clinical sign that the mitochondria are not producing the energy as efficiently.  And the reasons for that most commonly are nutrition and toxic load.  Chronic co-infections could be doing that as well, but nutrition and toxins are really the most common.

Chris Kresser:  Is there any conventional testing or functional testing that you use to determine the function of the mitochondria, or do you just look at it using clinical signs and symptoms?

Dr. Terry Wahls:  In an integrative practice or a functional medicine practice, one can use something like Genova Diagnostics NutrEval that has a very nice assessment of how efficiently the electron transport chain and the citric acid cycle are working for that person, and that really is a terrific test.  In fact, we’re using that test in our clinical research.  In my clinical practice, I don’t have access to that type of integrative lab testing, so there I rely on history and some very basic lab tests that I talk about in the book.  In my experience, a good history and paying attention to the signs of the fatigue and brain fog is very revealing.

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The Wahls Protocol for Treating MS and Autoimmune Conditions

Chris Kresser:  Right.  Tell us now a little bit more about your protocol, and I’m not sure if you’re at liberty to discuss your research and its status either in general or more specific terms, but if so, I’d be curious to hear about that and what the actual protocol is in broad brushstrokes and maybe a little bit more about your book.

Dr. Terry Wahls:  Sure.  The protocol is we have the diet, which is paleo that’s been very structured.  Then I teach people how to meditate.  We do a mantra-based meditation.  We also teach some very simple self-massage of the face and hands.  We design an exercise program specific to that individual since people with MS in our study, some folks are walking with a cane and others are struggling to walk with a walker, so there’s a big difference capability there.  And we also use neuromuscular electrical stimulation of the muscles.  So, we would design an exercise program, we’d design an electrical stimulation program specific to them, and then we would advance that as they would tolerate that.

Now, in terms of our research, we’ve presented our preliminary data at the 2011 Neuroscience Conference and got a hot topics award for that.  And we were able to talk about the significant drop in fatigue that we were seeing early on.  It’s sort of interesting, Chris.  Because this is such a radical new intervention, the institutional review board told us that we could do 10, and we’d have to file a safety report to make sure we didn’t hurt anyone, and then we could do our second 10.  So, we have now published the results of our first 10, and that just has been accepted, sort of in the process of getting through, so that will be coming out certainly very soon.  But again, it’s our first 10, very exciting results.  I’d say that the most important thing is we were able to show that people could do it, no one was harmed, and that we see very exciting data, particularly in the effect on fatigue.

Chris Kresser:  Right.  And what’s the time length of the intervention and the study period?

Dr. Terry Wahls:  The study period, it’s a year, although we will be following people for a total of three years.  And then the second group of 10, because our results were so exciting, I went back to the agency that funded us and talked to them about adding an MRI at baseline and the end to the second 10, and they said yes.

Chris Kresser:  Oh, great.

Dr. Terry Wahls:  So, we’ll have MRIs that we’ll be able to talk about, and we’ll have a functional MRI so we know how the blood flow to the brain changes.  And it’ll be very interesting to be able to compare that to outcomes.

Chris Kresser:  Great.  Yeah, I look forward to seeing that research.  And the book, I imagine this is geared towards a lay audience, correct?

Dr. Terry Wahls:  Yes.  We worked very hard to make this very approachable and very, very readable.  In addition, I have all the references for all my physicians and scientific and nutrition colleagues in the back of the book.  We have these amazing appendices that show people the nutrient density for all those 31 nutrients I said were so important, how much there is in the average American diet, in the Wahls Diet, the Wahls Paleo, and the Wahls Paleo Plus.  So, nutritionists who are frightened about, “Oh, my gosh, they’re taking away these very important food groups,” will be able to see that, yes, we did take away some big food groups, but the nutrient density exceeds the RDAs two- to tenfold depending on the nutrient and which dietary level you’re in, so no one’s going to be in trouble eating this diet.

Chris Kresser:  That’s great.  So, someone who has MS and is interested in this approach will be able to buy this book and do a lot of it on their own and maybe use it as a springboard for discussion with their physician.

Dr. Terry Wahls:  Correct.  And I do spend some time coaching people on how to talk to their doctor, how to talk to their neurologist or their primary care doc, and that for most people, even if their neurologist is not comfortable, the primary care doc will likely be very comfortable talking about nutrition and monitoring some of the labs that I suggest.

Chris Kresser:  Yeah.  It seems like primary care doctors tend to be a little more open-minded about these things than specialists, at least in my experience.

Dr. Terry Wahls:  Yes.

Chris Kresser:  So, tell us a little bit about what’s next for you.  You have this next group of 10 people that you’re going to be studying, and what are some more intermediate or long-term plans in terms of this research or your work in general?

Dr. Terry Wahls:  We have now some studies that are looking at what’s the impact of just doing e-stim and exercise, and then I have another study what’s the impact of just doing the diet without the electrical stimulation of muscles or exercise.  I’m writing the grant to study this in fibromyalgia, again using the diet, and then having conversations with a Parkinson’s researcher here about the possibility of studying this in that group.  Certainly in my clinical practice and in my many followers, it’s clear that this approach has dramatic impact for many, many disease states.  This is much more than MS, of course.

Chris Kresser:  Sure.  Many autoimmune diseases share some common mechanisms, so we might expect it to work well for several other autoimmune conditions and perhaps several other neurological conditions, as you pointed out.

Dr. Terry Wahls:  Yeah, we have some great stories of people with Parkinson’s who have experienced dramatic improvement and were able to get back to work, back to very functional lives.

Chris Kresser:  That’s amazing.  My last question for you is, aside from the diet, which obviously has been the cornerstone, it sounds like, what other things have led to the biggest change for you?  You mentioned that you’re doing e-stim and also meditation and tailoring exercise programs for people, but on a personal level, outside of the diet, what have you found has had the biggest impact on you?

Dr. Terry Wahls:  For four years, I really did a lot of e-stim with my workout.  That was probably very helpful.  What I see clinically for many of my patients and in our trial is people can be doing the diet really well, doing their exercise and e-stim, and they seem to be getting stuck, not really improving.  And when I sit down, we often uncover this high level of stress over something, a family conflict or a financial issue, although I will say family conflict usually has been number one there.  And I help people realize that the diet is certainly the bedrock, but if your cortisol is still through the roof, that is so inflammatory that if you don’t address that high cortisol state, you’re likely to get yourself stuck.

Chris Kresser:  Right.

Dr. Terry Wahls:  So, we initially work very hard on helping people get the diet down, I think that’s very important, but when people get stuck – and that happened to me, too, because I’m a bit of an overachiever and I get too much stress going on, and so I had to get back into a very deliberate program of meditating twice a day.  And now that I’m much more careful and prioritize that much more highly, things are going very well again.

Chris Kresser:  Yeah.  I have a similar experience personally and also in my work with patients.  I see a lot of people who focus almost obsessively on diet, and of course, we need to focus on what we eat probably more than anything else, but I’ve had a similar experience where people can get really stuck when they’re only paying attention to that and neglecting other things like sleep and especially stress management, so it’s interesting to hear that that’s been a factor for you as well.

Dr. Terry Wahls:  Personally, yes, and in our clinical trial, yes.  That certainly has caught my attention.

Chris Kresser: Yeah.  Well, The Wahls Protocol, it looks like it’s going to be out on March 13 this year.  Is that correct?

Dr. Terry Wahls:  Yes, that is correct.

Chris Kresser:  I’m sure it will be a fascinating read for anybody.  I certainly plan to buy it.  And of course, if you’re dealing with MS and any other neurological condition or, I would say, any other autoimmune condition, you’d be a great candidate for this book.  Thanks so much for joining us, Dr. Wahls, and good luck with your ongoing research.

Dr. Terry Wahls:  Thank you very much.

Chris Kresser:  My pleasure.

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Join the conversation

  1. If you have not watched Terry Wahls Ted Talk, I recommend you do so ASAP. https://www.youtube.com/watch?v=Fs7jqqdv5eg She is very clear that pharmaceuticals did not help her- in fact, they hurt her.

    I recently had an abdominal MRI that showed nothing, and doctors want to do a million other scans to see what’s wrong. Once I started reading about MS, I noticed I have all the symptoms. But I refuse to go the modern medicine route – I can’t imagine paying $2,000 or $5,000 a month for medicine that will make me worse.

    Isn’t it much better to pay an extra $200/month for groceries that will really heal my body from the inside out. Thank God for Terry Wahls!


  2. Does anyone here have mythensia gravis? It’s like MS- but worse.

    I have seen that it’s often misdiagnosed because it ‘mirrors’ others like MS.

    It makes muscles weak and causes all sorts of issues. Its an AI disease but blocks receptors of acetylcholine which presents all sorts of problems within itself for brain function.

    Any ideas of how to deal with that outside of anti-inlmmatory? Would the idea be to simply increase choline with nootropics?

  3. Does anyone have any suggestions for how to approach the Wahls diet with many of the fruits and veggies being difficult to digest? I have MS and Celiac disease. I do not eat dairy or gluten, however, I also have IBS and a confirmed diagnosis of SIBO via a methane breath test. When I eat certain veggies, I have so much stomach pain and bloating. Avocados are out of the question as are certain high FODMAP fruits. It becomes quite frustrating when you are so limited. I do seem to fair well with white rice, however, I’m worried it is silently causing brain inflammation and worsening the MS. Any suggestions would be greatly appreciated!

    • Melissa check out Dr Chutkan. She’s a Gastroenterologist that just wrote a book on the importance of the gut Microbiome. I recently watched her being interviewed by Dr Mercola and she was having good results with very serious conditions e.g. Ulcerative coilitis, IBS, IBD, Chrones, etc. using diet as opposed to the hardcore drugs and antibiotics etc.

  4. “So, all of our cells have these ancient bacteria that are living in all of our cells that are producing our energy more efficiently. ”

    Is this correct? Bacteria inside our cells?

    • Well, now they are referred to as organelles, one of many different kinds found in all our cells. Kind of tiny micro-organs in our cells, but they are believed to have originally evolved from bacteria. A mutually beneficial relationship between the bacteria and cells which over time have allowed us to evolve to the species we are today.

  5. I was diagnosed with Ulcerative Colitis in 2008 and ofcourse prescribed the usual drugs to deal with this . After being given high doses of prednisone and a course of mercaptopurine,which I later found out was actually a chemotherapy drug I thought better of imbibing this pharmaceutical poison and researched diets instead . After following the Specific Carb Diet for 6 months, and ofcourse not taking the pharmaceuticals, I was in remission . So I have a firm belief that diet can have a much better outcome on autoimmune disease than any prescribed drug . However now I have Fibromyalgia ( I believe triggered by and extremely stressful period of life ) . It is a nightmare but I am determined to beat this as well . My Dr ( yes medical Dr ) and I are trying out the gut-healing approach . 6 weeks in and I do feel better . But yes I do agree that there are at least 3 components to any protocol that can be used to combat auto-immune disease – 1 stress -reduction. 2 diet and supplementation 3 exercise/ physical therapy . Just a note – I have a diagnosis of Benign Joint Hypermobility Syndrome which I believe underlies the tendency toward inflammatory diseases that I have . I think it creates a predisposition situation as I know others who have it and have co-morbid inflammatory illnesses .

    • Congrats on your progress.

      regarding fms, do you experience soreness or stiffness. where on your body and when is it most painful.

  6. Hi, is there any reason one with rheumatoid arthritis should avoid red meats or other foods? Except the obvious sugar, fructose, PUFA and grains?
    Thank you so much in advance! 🙂

    • I looked at this recently and concluded that red meat should not be a particular concern for those with rheumatoid arthritis. I wrote about RA here: http://www.drdobbin.co.uk/Rheumatoid_arthritis
      The reason for much of the press coverage against red meat seems to derive from a 2004 study: http://onlinelibrary.wiley.com/doi/10.1002/art.20732/pdf I looked at this and did not find it particularly convincing given the possibilities of plenty of confounding factors.

      • Thank you so much! Any knowledge of dairys in this matter? Especially todays dairys: pasteurized ? Any evidence this should be avoided? Except neutral fermented yoghurt?
        Any prebiotic on iherb.com you could recommend? My practise is in Norway 🙂
        Thank you again, so much!!!

        • The best treatment for RA is borax and minocin (not generic minocycline). Mycoplasma infection is thought to be the culprit. If these treatments fail, it is usually because there are other infections that need to be treated. read the Healing section at website http://www.arthritistrust.org.

          I know dairy can affect me but it will effect me more if there are other infections going on in my body that are not brought under control. Otherwise I generally keep it at bay.

      • T isn’t just meat vs. no meat, but the manner in which the animal was raised. Those raised in stressful, confined feeding lots, fed GMO corn and fodder sprayed with mineral depleting Roundup result in products that are more acidic, and inflammatory in nature. Products from animals out in the field, eating grass, and exposed to sunshine produce more healthful meat of a greater nutritional benefit. And the minerals in this healthy animal are absorbed through the food. Minerals are the cofactors activating vitamins, and needed by your joints and tendons. Also, Vit. D is a crucial antionflammatory vitamin. levels in the lower range of lab values are associated with inflammatory conditions, many of which may go into remission when raised to optimal health levels.

  7. On the AIP or Whals Protocol, do symptoms often get worse before they get better? I have done the AIP 2 times, for a month each, but then didn’t transition well out of them for different reasons (vacation, holidays, frustration at feeling worse)…going back to normal paleo too quickly to learn anything. So i’m trying again, this time for the long haul. i’m only 3 weeks in, but as happened last time, my symptoms (20 years undiagnosed of severe weakness often keeping me from walking well or at all, torso contractions, extreme exhaustion and brain fog to the point of mumbling and staring at the ceiling for long periods) are getting worse. And others are cropping up, like joint pain, which I never have. I’m making sure to get enough carbs and fat, and am packing in the nutrition with a Whals 9 cups of goodness a day approach, and doing all the other lifestyle stuff like yoga, sun, good sleep, journaling, serious stress reduction, laughter etc.

    Anyone have thoughts on this? On the Autoimmune Paleo or Whals Protocol, have any of you gotten worse before you started stabilizing and then getting better?

    I don’t have any problem with commitment to continuing the program and reintroductions 100% this time, as long as I don’t think it’s exacerbating my condition for some elusive reason….. Thoughts?

    Thanks everyone! Chris and Terry, I’m incredibly grateful for the time and energy you have put into developing your research and curiosity, and for sharing your findings with us all….it’s an incredible gift. tara

  8. Some of the information shared here is truly spectacular. There are some interesting points and opinions about why autoimmune disorders are increasing. I have to say though, I am reading more and more about healthy diets and their links to diseases and illnesses. We have become lazy about food; whether it’s processed or fast food or just junk. Fresh fruit and veg doesn’t tend to be on the menu in many households. I remember eating so much of it as a child, just picking peas from the pod, or collecting carrots or potatoes from the garden and we just don’t seem to do that any more.

  9. Dear Dr. Wahls, thank you very much for sharing all this information!

    I hope you don’t mind me asking you a couple of questions. Your protocol seems to really go into the detail on typical autoimmune diseases, such as multiple sclerosis, arthritis and others. I would really appreciate hearing your opinion on somewhat less popular disease called focal-segmental glomerulosclerosis (FSGS). It is a kidney disease that had very serious complications. It is usually treated with immunosuppresants, such as methylprednisone and cyclosporine. However, from what I understand there is no consensus on whether it is an autoimmune condition or not. So, I would appreciate your opinion on whether your protocol can be helpful for this condition or not. Also, additionally.

    I am curious how would you modify recommendations, given in your book for this particular case.
    1. Would you recommend high carb or lower carb ketogenic diet? I’m gravitating towards higher carb because I workout regularly, so I think it is important to ensure enough carbs. At the moment my doctor sees no reason in any dietary restrictions as my kidney function is fine on all indicators except for proteinuria (protein in urine).
    2. It is easy to assess the effectiveness of a given dietary intervention if it has an immediate effect on one’s pain and well-being. But it’s not the case with FSGS. There is no pain per se and proteinuria is certainly not something that can go away in a matter of days or weeks. I tried switching form just Paleo to Paleo autoimmune protocol for a while (excluded eggs, dairy, coffee, nightshades and certain spices), but have no noticed zero effect. So, how would you go about assessing the effectiveness of this (or any other) protocol in a relievable and quantifiable manner?
    3. Is it possible that food can cause/aggravate my problem if I don’t notice any adverse reaction to any type of foods. I have been eating pale for several years already (started in about 2010 and was diagnosed in June 2013). However, even if I eat wheat I have no adverse reaction at all. It is the same with dairy and other potential suspects.
    4. Related to this I would really appreciate any advice on reducing side-effects of the above-mentioned drugs by lifestyle, dietary or supplementation intervention without reducing their therapeutic effect or making it less predictable.

    I would really really appreciate any help or advice from either Dr. Wahls or anyone else who has something to say.

    To others: if you yourself are not in position to comment on this, but know someone who potentially might be, I would really appreciate if you could share the contacts.

    Thank you very very much in advance!

    • Hi Jack,
      I too have fsgs and am very interested in all the questions you asked here. I’ve tried being vegan, gluten free, dairy free, corn free, nut free, and now doing the PAI diet strictly but still seeing no results. Could you let me know what information he gave you? Thanks so much.

  10. To talk about MS treatment and not to lift a finger to prevent MS does not help with trust. Maybe the doctor has been too brainwashed with his education.

    The National MS Society continues to be a government front to keep the true cause of most MS suppressed.

    There has been an explosion of MS in many countries over the 20th century. These correlate with vaccination.

    The best way to prevent MS is – do NOT have your child vaccinated. Vaccination is the path to many devastating chronic illnesses.

    • It is the first time I have read of such a connection between vaccination and ms, however several researchers say there is this link between ms and aspartame-(NutraSweet).

      • Aspartame wasn’t approved until the 1980s. The explosion of MS was happening before that. Aspartame is a red herring. This is not to say that aspartame can’t make the condition worse. I mostly don’t eat or drink anything with aspartame.

        The following is taken from the National MS Society website on history.

        “Just before World War II, an important
        breakthrough occurred. An animal model
        of MS was developed out of research on
        vaccines. It had been known that people
        vaccinated against viral illnesses, especially
        rabies, sometimes developed a disease
        resembling MS. It had been assumed that
        this occurred because the virus in the
        vaccines was not completely inactivated,
        and so it attacked the myelin. In 1935, Dr.
        Th omas Rivers at the Rockefeller Institute in
        New York City, demonstrated that immune
        cells, not viruses, produced the MS-like
        illness. By injecting myelin he knew to be
        virus-free into laboratory animals under the
        proper conditions, he could induce their
        immune systems to attack their own myelin,
        producing a disease very similar to MS.”

        The thing to note is that the Rockefeller Institute is connected to human depopulation programs. Vaccines are a major part of that program.

        Almost all the “patient advocate” groups in US and around the world for the chronically ill, cancer etc are actually covertly run by the military intelligence agencies. They have many functions.

        • Ref Priori’s comment: “Almost all the “patient advocate” groups in US and around the world for the chronically ill, cancer etc are actually covertly run by the military intelligence agencies. They have many functions.” What rubbish. The military is the biggest for making sure all of its people get every vaccine imaginable. But you would have us believe that those same military folks are involved in a sinister plot in which they help poison us with vaccines. How many military people do you know, honestly? If you knew any, you would know that the military has been stretched incredibly thin fighting radical Islam. There just isn’t enough military to do the kind of goofy things you imply. And military involvement in a domestic context has been against the law for decades.

          • You have no history of what has gone on in the military for last 100 years against military personnel.

            Here is one example.
            There were 800 thousand coalition troops from 28 countries involved in Iraq Desert war. Over 430 thousand are listed in the Gulf War Registry with Gulf War Illness. Only one country – France – had very few casualties. Guess which country didn’t get vaccinated – France. The few who did get sick were mixed in with other countries troops hence got vaccinated. The Pentagon claimed they lost 2 million vaccination records to boot.

            The wars they are fighting are FAKE. They have been artificially created.

            Many of the military’s best pilots during late 90s resigned because they didn’t want to take the vaccination shot. The powers that be follow no official laws.

            Whether one knows someone in the military or not is irrelevant.

            • Your argument is illogical. On one hand you claim ultra secret military intelligence folks are helping to perpetrate a world wide vaccination plot to destroy all humanity. But you also claim the military is itself a victim. And it is relevant if you know anyone in the military, since if you did, you would know how far fetched your first argument really is. They are real people, patriots, and free to leave the military easily. But again, your former point doesn’t fit with the latter. Eat and exercise well, get more sleep.

              • The military is not one big – one for all, all for one.

                You see, this world is just a gigantic hierarchical pecking order of power where the layers below are expendable to the layers above.

                Betrayal and treason are the norm in the upper echelon of every major political and military structure of this world.

                The ones at top follow the motto – side with the winners.

                Even the ones in military intelligence may end up casualties or dead due to the power structure above them. Not sure who is safe.

                Most military people are at the bottom layer. They are like most people in the population. They either have dulled consciences and/or dulled awareness. So they are a support structure for these attacks against them.

                The grassroots population is dominated by sociopaths. So the power structure has plenty of people to turn a blind eye to their lies, atrocities and treason. They don’t care if the government tortures or murders people either.

                Most compassionate people embrace lack of awareness (most sociopaths also) so become no different than sociopaths. Most live unaware of what is happening around them. They prefer it that way.

                Every political power structures in this entire world are dominated by violent political structures. Without a population dominated by dulled consciences and dulled awareness, such a power structure couldn’t easily exist.

                The general population is in a violent codependent abusive relationship with the powers that be. One can’t exist without the other.

                This is why most of the population of
                nazi germany marched in lock step with all the lies, atrocities, treason and wars.

                When they wheeled out a murder and torture facility called guatanamo bay, the last excuse not to know something very terrible is wrong went away.

                Most people in virtually every society in this world marches in lockstep with their ruling structures where they imbibe the lie and live the lie as a way of life.

      • Focus should be on the epsilon toxin.

        Study has showed that people with multiple sclerosis had a 10 times higher level of antibodies against the epsilon toxin than people without the condition.

        This is definitely clear evidence that MS is caused by a microbe. Of course the powers that be already know what causes MS.

        They want to claim epsilon is just a food bacteria but MS among Amish is virtually non existent. They pinpoint grass grazing animals. They neglect to mention that it is produced as a biological warfare weapon. They even tout their front man Saddam Hussein as producing some.

        MS people are betrayed in the most extreme ways by people who purport to help them,

    • correlation does not mean causation. i’d be careful to jump to conclusions. probably it is a combination of different things that is to be blamed and not any singe isolated thing. as for dr. wahls, her decades long vegetarianism could have been a cofactor that triggered the disease. noone really knows.

    • Wrong question. Dont mess with your blood less you know what you are doing. Your question reveals you dont.

  11. Great conversation!
    I think we’re approaching a tipping point around health and wellbeing. This is a great example where conventional medicine relying on a technology bias of pills and surgery cannot match the bodies own ability to heal itself.
    And, the key is the worldview held by each group: the technologists have a narrow one-track, one ideal solution mindset. Whereas the biological group look at the integration of the whole system. And Dr Wahl hits the key note around the importance of eating real food because of the co-factors involved.

    • It has nothing to do with bias. It is about global depopulation (killing and disabling) agendas of the powers that be. There is a large scale assault being carried out on people’s health.

      • Yeah, and UFOs and aliens are all over the planet. It is much simpler though. Power and money what is driving the world, not some evel interests. Find a way to make truckloads of cash by using the wahls protocol and it will be all over the world tomorrow. The powerhungry greedy beasts always rise to top of society. It is human nature. Pacifists stay at bottom.

        • We are way past the point where this can be debated. Evidence is all over the place. What makes your view so fallacious – The federal reserve has virtually unlimited ability to print up as much money as they want. The US dollar being the international currency makes this possible. This is where the large transfer of wealth occurs. The “profit motive” reason allows the government to hide and fund their covert operations in full view while allowing people to sleep peacefully at night. btw As far as aliens, they have been here for tens of thousands of years.

          • yeah, and how does this contradict what i said? it is all about money and power. but this place is not the right place to discuss this. and as for the aliens, well, no comment…

            • For the top of the power structure., it’s about power, control and their agendas. Not money or greed.

              For their sociopath minions and front men on much lower levels of power who take orders from above, they may or may not be motivated by money or greed. Same with much of the remainder of the population.

              • What a dark, dark world view you have. And it its way, overly simplistic. It sounds quasi-Marxist, a philosophy unblemished by success. This has gone far afield from celebrating the good work Dr Wahls has done. I think you are sadly imbalanced, out of touch with reality and simply wrong. I will write you no more.

  12. I have an advanced copy of Dr Wahls book, which i found very enlightening. One question though: I wonder why Dr Wahls doesn’t allow eggs in any of the three versions of her diet. I mean, she allows all other autoimmune-triggering foods (e.g. nuts, shellfish), but why not eggs? This is the biggest difference between Paleo and her diet(s) and I thought I should ask.

    • Eggs are not allowed because Dr. Wahl’s herself has an egg sensitivity, so eggs were excluded in her personal protocol. Quite rightly, the Institutional Review Board insisted that her initial clinical trial reproduce her own personal protocol precisely. Eggs are *probably* not a problem. But not eating eggs was part of her amazing come-back from where she was in 2007. Who knows? Eliminating eggs may have been all it took. We don’t know.

  13. This is fantastic stuff, a good BEGINNING. I have a chronic condition called Friedreich’s Ataxia(FA) and even though FA is a child’s disease, I have scraped along in my spastic world for several decades beyond our average-normal lifespan. Over these years (after much experimenting), I think there is a multi-facetted approach needed for me and for Dr. Whals patients: diet(Paleo) + Lifestyle(exercise + energies). Most MD’s are interested in expansion of their own expertise rather than returning to what a human needs to live and to thrive !
    IDEA #1 … follow the ‘leaky-gut’ road. One of the biggest problems is that GMO’s steal minerals from gut cell walls >>> making gut cells shrinkage >>> gaps in tightly-knit formation of cells. Can be rectified by abstaining from GMO’s for a minimum two weeks. Add L-glutamine(10g/day) + bone broth to heal gaps. The liver is the major detoxifier – so increase its detoxifying capabilities with N-acetyl-cysteine + Milk thistle complexed with phosphatides + an immune modulator + a brain-cortisol modulator (Brain Shield) at http://www.lef.org .
    IDEA #2 … TO EXERCISE disabled people often fail because the muscle movements must be coordinated and rhythmical (on top of other efforts). A chi machine MAY help, but to get a full-body aerobics workout (like a rebounder), it would probably be good to enter a swimming pool (with floatation devices), then have a small motor attached at-one- end to yank and then release. At the other end (tied to the feet), the person would go through a PASSIVE up-down-up AEROBICS workout.
    IDEA #3 – Has much to do with vitamin D3 and its extreme shortage (like in the (30K-40K IU range + K2) and sun-avoidance. The difficulty is lack of UV, from too much sunscreen + SLEEPING INDOORS. Moonlight is but a reflection of the sun’s array. Since there is no filtering agent on earth’s dark side (no Van Allen belts) we get a full UV at night. This IMO a leading cause of the D3-UV deficiency. [Its like improving your sense of hearing only to be faced with more noise.].