Reversing Multiple Sclerosis (MS) Through Low-Carb Nutrition ft. Dr. Terry Wahls

Reversing Multiple Sclerosis (MS) Through Low-Carb Nutrition ft. Dr. Terry Wahls

Authored by Zhill Olonan and Geoffrey Woo • 
July 10, 2019
 • 24 min read
recoveryself-helpnutrition

Dr. Terry Wahls' journey is truly the embodiment of the popular motto, “Taking health into your own hands”.

In the year 2000, Dr. Wahls was jogging every morning. Just three years later, she found herself confined to a wheelchair suffering from chronic pain and brain fog.

Despite having access to the latest drugs from reputable establishments like the Cleveland Clinic, it wasn’t until a radical change in her diet (The Wahls Protocol) and additional interventions like neuromuscular stimulation that Dr. Wahls finally felt she was on the road to a form of recovery. Now, she can walk, work, and has since even completed an 18-miler bike race.

This episode contains a fascinating, deeply personal dive into the ties between nutrition and disease management that you won't want to miss.

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Transcription

Geoff

Dr. Wahls, great to have you on the program.

Terry W.

Thank you so much. I'm always glad to chat.

Geoff

So folks that aren't aware of your personal story here, perhaps that's a good jumping off point to describe your formal training and background and how you got interested in the dietary nutritional side of treating yourself.

Terry W.

Yeah. So I'm a Professor of Medicine here at the University of Iowa and I was teaching medical students, residents, running primary care clinics here at the VA in Iowa City, University of Iowa. I came in 2000. At that point, I'm a very conventional internal medicine doc, very skeptical of functional medicine, anti-aging, restorative medicine, complimentary alternative medicine. I definitely believed in the latest drugs, the newest technology, and at that point I'm being evaluated because I've developed a new problem with some stumbling and weakness in my left leg.

I ultimately see a neurologist, get MRIs of my brain, my spinal cord, a nerve conduction velocity test, lots of blood tests. I have lesions in my spinal cord. I have abnormal spinal fluid. My neurologist reminds me that 13 years earlier I'd been evaluated for a bout of dim vision in my left eye. So the conclusion is that my episode 13 years earlier was optic neuritis, and that what I'm having right now is relapsing remitting multiple sclerosis. Like many physicians, I immediately turned to the research and begin reading the latest Pubmed.gov and I see that within 10 years of diagnosis, one half will be disabled due to severe fatigue and a third will need a cane, walker, or wheelchair.

And, again, being a conventional academic physician, I decide that what I want to do is treat my disease aggressively so I seek out the best MS center that I could find that's doing clinical research. That's the Cleveland Clinic. I see their best people. I take the newest disease-modifying drugs and I continue to go downhill. After two years, my Cleveland Clinic physicians tell me about the work of Loren Cordain and I read his papers, his books, and decide after 20 years of being a vegetarian, following a low-fat diet, thinking that was the most health-conscious thing that I could do, I decided to go back to eating meat. I give up all grain, all legumes, all dairy. I continued to decline. My physicians told me that I've converted to secondary progressive multiple sclerosis and that functions once lost are unlikely to return.

So they recommend that I take mitoxantrone. The side effects of that are higher activation of viral infections, fungal infections, tuberculosis, secondary leukemias, lymphoma, leukemia, congestive heart failure, but I'm more terrified of becoming potentially bedridden and demented so I gladly sign up to take my mitoxantrone. I take several rounds and I continue to decline. Then they switch me to CellCept. I continue to decline and now I have oral ulcers and have a lot of bruising and bleeding.

At this point, I'm reaching the conclusion that taking the newest drugs from the best people in the country at the best center in the country is not likely to stop my slide into a bedridden and demented life. I have trigeminal neuralgia as part of my MS symptoms, which means, in addition to my progressive weakness, I have sensory problems with episodes of electrical face pain across either the right side of my face or the left side of my face. That's getting more difficult to control. I'm needing higher and higher doses of Gabapentin.

And so I decided to go back to start reading the basic science because I know how bad things are going to get, bad. And as I'm reading the animal models of MS, of Parkinson's, of ALS, of Alzheimer's, I decide that mitochondria are the drivers of disability and I slowly began developing a supplement cocktail to support my mitochondria. After about six months, the conventional side of me is really pissed off and I decide that I'm wasting my money on all these supplements. Nothing's happening. I'm certainly no better. And I stop everything. And 36 hours later, I realized, "Man, I am even worse off than I was before." I can't really get out of bed. I'm exhausted. I go three more days and my spouse says, "You know, honey, I think you ought to take these again." And so I take my supplements and the next day I can get up and go to work. And I think, "Wow, this is phenomenally exciting."

So two weeks later, I do the same thing. I stop all my supplements and, 36 hours later, I have worsening fatigue. So now I'm very excited that I'm learning stuff that my neurologist, my primary care doc aren't telling me and I'm even more excited about reading the literature, experimenting on myself. The university and the VA, in trying to help me by redesigning my job multiple times, had placed me on the Institutional Review Board. So I tell the IRB that I would like to review all the brain-related studies, and so I'm getting more and more comfortable reading brain clinical trials. And I'm slowly adding more supplements and I reach the conclusion that, "Okay, they aren't helping me. They're not improving me, but they're clearly doing something. And if all they do is slow the speed of my decline, that's a pretty great thing."

And so I'm immensely grateful and, as many people with a progressive neurologic disorder, I'm reaching that period of acceptance, like, "Okay, I'll just take each day as it unfolds. I don't know what it means, but I appear to be slowing down my decline at least somewhat." Now keep in mind, I've had a very rapid decline to go from being still athletic and jogging in 2000 to be in a wheelchair in 2003 to in 2007 being unable to sit up in a regular chair.

Geoff

I was just going to ask about the emotional state. I mean, you're a classically trained doctor. You know the prognosis is not optimistic. I mean, you look at the curves and all of that. I am just curious, you know, rewinding back to 2000 just on the emotional side, about the mental resiliency to realize that the percentages and probabilities weren't great, but you're doing everything to prevent decline. All of that. I'm curious to rewind your thoughts and get into your mental state there.

Terry W.

Sure. So in 2000, you know, I'm reading the literature, getting really quite agitated when I see that the progressive nature within 10 years, unlikely to be working due to fatigue and likely to have gait disability. And so I get really agitated. My spouse sits me down and says, "You've got to stop reading the literature. It's just getting you upset. We'll find you the best MS center in the country. We'll go there. Let them take care of you." And I agree to do that.

So I stopped reading the literature. We find the best people and I start taking the drugs and I let them manage me. As I'm getting more disabled, I'm really having to re-imagine my life as this more disabled individual. I have young kids. At diagnosis, my son was eight, my daughter was five, and I had presumed that I'd be teaching them resilience and perseverance by teaching them cross-country skiing, wilderness travel, backpacking, kayaking, doing martial arts, doing the athletics. And of course, it's very rapid. That is not going to happen.

Geoff

You're teaching them by you surviving. Yeah.

Terry W.

By realizing that my kids were watching, and so I'm thinking if my most important purpose is to have emotionally resilient and economically stable kids, then all I've got is to teach them that life's not fair, but to get up and go to work every day anyway and you do the best you can.

Geoff

Power to that. So as you are declining, it sounds like there's a couple breakthroughs around realizing that maybe a root cause here was a mitochondrial dysfunction and then looking at the supplements and it sounds like that started to get you on a path towards, "Okay, maybe I can start taking some of the interventions into my own hands." Was there an initial paper that sparked that? What was the initial supplement? What was the initial kind of combination that-

Terry W.

The initial paper was by Beal, B-E-A-L, and he was talking about bioenergetics and it was decided for Parkinson's. And so he was talking about lipoic acid and carnitine. And so he had a few other papers and, at the time, lipoic acid, carnitine, and creatine were Poor gas, had carnitine in creatine were the initial three that I used. Then I added coenzyme Q in there. And at that time, I'm still taking a variety of prescription meds. So I'm making an appointment with my primary care doc to check on these supplements and the drug interaction and there's a long conversation. My primary care doc was not entirely comfortable with all of this and so that was a vigorous debate that I had to work through and they wanted me to do things one at a time. And so we did that one at a time, adding those supplements and that's part of why it took several months to get this sorted out.

And then, you know, when nothing much happened, after a few months of that, I just, again, the skeptical conventional person said, "This is crazy. I'm just making expensive urine." And I quit everything in disgust. It was interesting. It was about 36 hours later, I was definitely more fatigued, had difficulty getting out of bed, and I just thought, "Okay, maybe I'm getting the flu. Who knows what." And on the third day, my wife says, "You know, honey, I think you ought to take these again." And so I took them and then, the following morning, I felt better. And I thought, "Wow, that's interesting." And so, two weeks later, I did the same thing. I stopped them all. It took about 36 hours and it's sort of like suddenly I'm out of gas, out of energy, and just really couldn't function very well.

Geoff

I mean, it's a proper wash-out period, right? You're basically running a proper n=1 clinical trial on herself, a wash-out period to test an intervention. There was some signal, maybe it's placebo or a coincidence. Let's wash out. Let's try again. And you got some signal.

Terry W.

And it's like, "Wow. That was really interesting." So now I review an IRB protocol that uses electrical stimulation of the muscles in people who've been acutely injured for their spinal cord and acutely paralyzed. So it gets me curious is that a strategy that will work for MS? So I read 212 papers. It doesn't take that long actually and I convinced my physical therapist to add that to my very tiny physical therapy program that we've got going for me.

Oh, another month later, I come across the Institute for Functional Medicine's course on neuroprotection. I order that course and I take that and I have a longer list of supplements. They talk a lot more about mitochondria. I'm really excited about that. I add these longer list of supplements and not a lot's happened yet, but now I have another really big "aha" moment and that is like, "What if I redesign my diet that I'm taking in supplement form and I'm going to redesign my foods because I'll probably pick up more nutrients in the food than are in the supplements?" And so that's a little more research. Dieticians don't know. The librarians don't know. So it's more Internet-based search and the Linus Pauling Institute for Micronutrients turns out to be very helpful.

And so I've restructured my diet. I've reduced my meat, ramped up the vegetables in a very specific way, and I start this new way of eating in December. And then it's time to go off to my clinic and the first week I just watch. And I should be able to just watch. You know, how hard is that? I can sit in my wheelchair sort of reclined back and then the second week I am beginning to examine these patients. And at the end of the week, I realized, "You know, I actually did that and it wasn't too bad." And by the end of January, it's clear that I can actually do this and I'm beginning to think that, you know, my mental clarity is actually a little bit better, my energy is a little bit better, and my pain is less.

And in three months' time, I begin to realize that, in fact, I am feeling strong enough that I decide I'm going to try walking with a cane. And then I'm soon walking without a cane and then I decide after a family meeting, because my family all has to weigh in on this, that I'd like to try biking because I am walking around the block. And so they decide I can try biking and so I bike around the block. I'm crying. My wife's crying. My kids are crying because it was at that point that I- It was at that point that I've beginning to realize that I really am recovering and that who knows how much recovery might be possible.

Geoff

Yeah, and I want to re-underline this point because essentially what is traditional medical consensus is that this is monotonically decreasing function. This is progressively getting worse. You may be able to slow, but you're not going to get better. So, I think just for clarity for the listener, what are the core aspects of the Wahls protocol that you were implementing and testing and doing research on?

Terry W.

So, the Paleo diet, and I've structured the Paleo diet in a very specific way. I want to remind everyone that the Paleo diet, as described by Cordain, what I just emphasized, the removal of grains, dairy, and legumes was not enough. I continued to decline. I added supplements for my mitochondria, which were clearly helpful, but was not enough. They slowed my decline but did not lead to my recovery. The e-stim, which was helpful in improving my muscles was not enough. It was when I really structured the diet in a very precise way to ramp up the nutrients. I added meditation. I continued to work closely with my physical therapist. It's really this very comprehensive diet and lifestyle problem designed to optimize my mitochondria, optimize detox, optimize muscle strength training, and lower my cortisol. It was that whole package together that led to really a dramatic improvement in strength, endurance, and mental clarity over the next 12 months that was really just dramatic.

Geoff

Fascinating. And then I'm curious in terms of the 2010 setting up the clinical trial or acquiring the funding for that. What was the end result there? How did that go? And fast forward the last nine years to 2019 in terms of you refining this protocol.

Terry W.

Right. The manufacturers of electrical stimulation device, they gave us devices that we could use and some supplies, so that was in kind support. A group in Canada that I'd reached out to that had originally facilitated my understanding of the Paleo diet, Ashton Embry's group, Direct MS, they had to come up to Canada. I gave a lecture, met with their board, and they gave us a very small amount of pilot funding. And then the university supported me with in kind support from undergraduate research volunteers, and a PhD student worked in the lab, and she got her dissertation from our experiment. So I put together the support from a variety of sources, and my chief of staff at the VA gave me two days a week unfunded time to do the work. So the VA helped, the university helped, and the Direct MS charity, the Canadians, and the manufacturer of the therapeutic electrical therapy device helped.

Geoff

Awesome. So as you were going and running this what was the end size and what were the end results?

Terry W.

We got 20 people through 12 months, and the primary outcome was what would effect on fatigue severity. We also measured quality of life. We measured anxiety, depression. We measured walking function. We measured hand function. And in the second group of 10 we measured their MRI results as well. We have some biomarkers, and we have a freezer full of blood that we hope to analyze as we can get some more curious investigators. The primary outcome, though, was would people do this. And then secondarily was it safe. And then secondarily what was the effect on fatigue quality of life. But the primary outcome measure was simple would people do it.

Geoff

Right. So this is more of like a phase one, then. This is more of a safety and compliance study rather than a pure efficacy study?

Terry W.

This is a safety and feasibility study. So the most important question was would people do it. The answer was yes. Was it safe? The biggest problem was if you were overweight you lost weight.

Geoff

Which is reasonable.

Terry W.

The other requirement was that ... So I got through my first 10. Then I had to report back to the IRB the safety, the adverse, could people implement this. And I needed to be able to show that there was a trend in the correct direction.

Geoff

Mm-hmm (affirmative).

Terry W.

Well, there wasn't a trend. There was a stunning p-value in terms of reduction in fatigue. It was very large. The fatigue scale does from seven, total fatigue in every aspect of your life, to one, no fatigue in any aspect of your life. So that dropped by 2.38 points, so that's a huge, huge drop in fatigue. And the p-value was less than 0.0008, so very large, very significant. We were given permission to do the next 10, and they too could implement it. It was safe. And once again we had a very large, very significant drop and fatigue severity.

Geoff

I mean, if this was a drug this would've been a blockbuster drug, right?

Terry W.

Oh absolutely.

Geoff

I'm curious to hear your thoughts as you see this data, which is pretty stunning in terms of, again, in the context of traditional consensus. This is a progressive monotonically decrease in function, and you're able to, boom, pretty drastically improve fatigue.

Terry W.

But in all fairness this is a single-arm safety and feasibility study, so the next thing you have to do is a randomized study, which we did.

Geoff

Yup.

Terry W.

We were able to do a much shorter, so we just did a 12-week intervention because we could see that you get a big change within 12 weeks. And we did it with relapse and remitting MS, 12 weeks. Again, you came in, you had your baseline assessments. Then you got randomized. You either got trained on the diet or not. And we just did diet, so we simplified the regimen. And again we showed large, dramatic reduction in fatigue, improvement in quality of life, improvement in motor function in the intervention group as compared to the control group.

Then we did another pilot study comparing the ketogenic diet, Wahls diet to weight loss control. In that study that is under review ... But anyway I'm smiling, fun results. Now we have a much larger study funded by the multiple sclerosis society comparing a low fat diet to the Wahls diet. It will be analyzing the data from that study this time next year. We have enrolled 96 subjects, so we'll have a much larger group. And again it's randomized, so that is going to be really exciting to look at those results when we're all done. We'll see what we find.

Geoff

Very cool. I'm glad you touched on the ketogenic diet because that's definitely a topic that we've discussed a lot in our community on the HVMN program. Obviously there's interesting data on the application of ketogenic diet for epilepsy and some early data around neurological conditions. I was actually curious to get your thoughts on is the Wahls diet ... Are you producing ketones? Are you restricting carbohydrates and grains enough where you're producing ketones?

Terry W.

No, we don't product ketones. The original diet when we looked at baseline people would come in about 220, 240 grams of carbs at baseline. At 12 months they'd be about 100 grams of carbs, so markedly less. We weren't measuring ketones, but I doubt that they're ketogenic in general at 100 to 110 grams. In my third study we did have a ketogenic arm, so in that arm people were in ketosis. I've written about why I think ketogenic diets may be superior and may be beneficially. Certainly whenever there is a mitochondrial component to the illness there's a reason to think that ketogenic eating may be very beneficial. I think you'll still want to address the other nutritional components. You'll still want to address gene expression and microbiome issues. It would have to be very thoughtfully applied. A lot of the ketogenic diets are designed around dairy, have a lot of casein in them, have a lot of egg in them, which from my read of the literature would rev up inflammatory cytokines.

Geoff

IGF1, all the growth factors.

Terry W.

It's going to create a lot of problems. I think it depends on how your ketogenic diet is constructed whether the benefit of being in ketosis it will be a benefit or will you have created a lot of inflammation because of the IGF1, because of the lectins from the casein and the lectins in the eggs that you aren't getting the benefit that you could have. I used a MCT version that I think has fewer lectins in it. It might be that fasting mimicking diets would do better. It might be that periodic fasting would do better. These are certainly areas that we want to investigate. I find myself for years I was very much in ketosis. Now I'm much more into seasonal ketosis where I'll do intense ketosis during the winter, but it's summer now, my berries are coming in, and I'm eating my berries so during summer I'll have more carbs. And then during winter I'm back in much more of a ketogenic diet.

Geoff

Interesting, so it's a cyclical, almost seasonal ketosis.

Terry W.

A seasonal ketosis. The other thing that I like to do is periodic fast. I like to do periodic water fast.

Geoff

How long are your fasts?

Terry W.

Seven days. And that's a long fast. Now, some very interesting changes in terms of stem cells happen when you have that longer fast, interesting changes on nerve growth factors and hormonal signaling.

Geoff

Yeah, BDNF as well, brain derived neurotrophic factor.

Terry W.

Great stuff, however it's also challenging for your cortisol, it's challenging for your thyroid, it's challenging for your sex hormones. So how often should you do a period fast? I think that is in question. Who's the right candidate for periodic fast? That's in question. You certainly ... I think it's worth considering, but you absolutely want to do that in collaboration with your medical team.

Geoff

One thing I want to highlight and echo back is the formulation of the ketogenic diet. I think be definition essentially your body producing ketones, but the way you induce that ketogenesis can be very different. As you were saying you can go something with high casein, high egg, which there's trade-offs and benefits in cons there, pros and cons there, but if you're really triggering growth factors, inflammation then you might be triggering some of the negative effects, and how do you balance that, versus a cleaner, more MCT oil or exogenous ketones or ketones esters inducing ketosis. There's definitely some nuance there.

Terry W.

And the thing I want to remind everyone is when we're in ketosis your hormonal signaling, and your brain is interpreting this as you're starving for nutrition, so my brain and my body is shifting towards it's not a good time to reproduce. I should be sort of hibernating, so I'm shifting my hormonal signaling towards more that hibernation state. I'm not reproducing. I am doing some signaling changes that are great for repairing neuro degeneration, and of course I've got a screwed up brain with my progressive MS, so that is a good thing. But for a long-term optimal health is signaling to my body that there's not enough nutrition and that I'm starving is that really good for long-term health? Maybe not.

Is it good for seasonal particularly if your ancestors came from an area that had winter then you probably have some reasons to think that you've had hundreds, maybe thousands of generations that have been used to seasonal starvation during winter, and that was apparently okay because we had reproductive success. But I don't know that we have any societies that have really shown us from an evolutionary basis that it's okay for your body to think it's been starving for nutrients for years on end.

Geoff

Yeah, I agree. I think that's an open question. That reminds me of the cyclical keto diet that was done on animal model on rats over at the Buck Institute showing that a cyclical keto diet was, I believe, even more effective than a permanent keto diet on longevity and health span for for mice. So, reflecting kind of your observation that ... I think it's right. It's an open question whether it being the actual state of the ketosis is actually optimal for longevity, but there is pretty exciting data around HDAC inhibition, some of the epigenetics of having ketones in your system as a signaling molecule. So, I think it is quite a bit to unpack.

Terry W.

So, I like to think of the ancestral model as a way of thinking through what would have my ancestors done. Then I like to look to functional medicine to figure out, "Okay. So, what were the molecules doing?" What does science tells us are the molecular mechanisms as to why these ancestral principles may have had greater reproductive success? And then, I can sort of use the combination of those two things to think about, "Okay. How would I replicate that a little better, a little more effectively and still get the conveniences of living with my computer in going to work and how can I merge the two?

Geoff

I mean, it sounds like to me the ancestral best practices seem like a good directional signal of hypotheses to test. Right? I think that's where you're taking it. Like, these are a reasonable set of hypotheses that generations of us have been living around. We should understand the mechanisms of action here. Do you feel like that's becoming more popular in traditional medical thinking? I think in terms of what I've seen, there's definitely I think a shift of opinion towards diet, towards lifestyle.

Terry W.

So, in 2008 when I started talking around town about diet and lifestyle people were very alarmed, very concerned. I got banned as a speaker for creating false hope. I had to explain to my chief of staff and the chair of medicine, so I got counseled on how to speak more cautiously and document my medical records more cautiously about changing physiology. And it was probably very helpful to have gotten that. Then we do our clinical trial. I had to do a pretrial where people analyzed my diet to show that my crazy diet that excluded whole food groups were still nutritionally sound. No obvious serious nutritional deficits.

And then, I was able to do my clinical trial and my partners were very upset that I'm doing the same diet intervention for everyone because you got to personalize things and I'm like, "Well, we all have cells and Mitochondria. That's crazy." And then, in 2014 in Clinical Trials.gov there are four dietary and veterans studies. I'm doing three of the four for MS. There's one other study that's studying low fat. Now, in 2019, so 10 years after I've doing these dietary intervention studies there are now 12 dietary intervention studies and I'm involved in four of the 12.

I mean, it's exciting because now we have ketogenic, modified Atkins, a fasting mimicking diet, low-glycemic index, gluten-free, modified Paleo, Mediterranean, and low fat diets that are being investigated. So, we've made a lot of progress as we figure out that diet impacts the gene expression, it impacts the microbiome. And now that my basic science colleagues have a little bit more of the mechanisms that we can test in animal models and we're willing to do this in human studies, more studies are being being done.

Here at the university some of my partners are so intrigued and they're excited to be working with me because their response is in every other circumstance, every other disease state they make an animal model, study the animal model for decades, and then they finally do a clinical trial in humans. I'm the first one that has studied it in humans first and now we're making animal model studies to understand what's going on with the dietary interventions that I created.

Geoff

Yeah, absolutely. I think it's pretty ... It must be really vindicating or rewarding. Again, this is 19 years since your initial diagnosis in 2000 and it's also become not just a personal battle, but it's really at the forefront of an intervention that might be able to help a large population of a very bad prognosis disease.

Terry W.

Well, my first mission was helping my kids grow up to be healthy, happy, healthy adults that were financially successful. But now, my mission is to create an epidemic of health and to teach the public and clinicians that the best way to treat chronic disease is to create health and the best way to create health is by teaching people why health behaviors are so powerful. And to teach them these radical things known as vegetables are good for you, that cooking at home is critical, that learning how to meditate and to move are critical to your health, and that the real drivers of chronic disease are sugar, white flour, and processed foods that are radical changes to our food supply.

That we can eat meat and survive, we can eat vegetables as long as we still have some meat and survive. If we eat white flour, sugar, and processed foods, we wreck our microbiome, our microbial metabolites and we're going to die of chronic disease.

Geoff

I mean, it sounds like in 2010 you started doing the studies and it's been nine years. I think you've been very cautious in particular about how you state the results and claims, which I think is the discipline and the evidence required to do this properly. I think on the podcast or on the industry side I can kind of make broader strokes here, but I think you've done nine, 10 years of work to even get to this point where you have promising data on these dietary interventions, which is worth mentioning. That there's a lot of hard work and we've done some human studies over at HVMN and I just know how involved and detail oriented and ... It's just a lot of details behind the scenes.

Terry W.

Yeah. It's a lot of work. It's exciting, it's exhilarating. It's hard to sleep at night because it's so exciting, it's so fun. And we're planning the next studies and we do this through philanthropic support. We're going to compare the Wahls protocol, that lifestyle in newly diagnosed MS patients to usual care. Getting drug therapy in MS patients and we're starting our IRB application and we'll plan to begin enrolling people into that study this fall as we wind down my current study.

Geoff

Interesting. I want to ask one question. This might be more speculative, but I think when you're talking about refined carbohydrate, sugar intake, these seem to be critical causal factors for some of the Metabolic Syndrome, diabetes, obesity epidemic, and I think this is ancillary related. And the question is, does your understanding of the ideology of MS change given your understanding of how to treat it or is this still a genetic factor plus diet intervention on top triggering MS?

Terry W.

We have some genetic vulnerabilities. There are probably 200 to 300 different genes that increase your risk for MS and for any autoimmune condition. The vast majority of folks who have that gene won't develop MS with the autoimmune condition. It's this very complicated interplay then between the genes that you have, your infection history, your vitamin D level, you're a food that you ate at birth, whether you are vaginal or a C-section birth, what you're eating currently, your social network, your life events.

That all of that complicated stuff interplays to develop an autoimmune condition, which autoimmune condition you develop, and if we don't address all these root causes, what will be the next autoimmune condition that you develop? And you'll keep developing them until you're disabled and die. So, it's complicated. The vast majority of risk, probably 95% is diet, lifestyle, environmental stuff.

Geoff

One of the questions I always like asking towards the end here is if you had infinite money, infinite resources, infinite human subjects or animal subjects to tinker with and be God over, what would that study look like?

Terry W.

Newly diagnosed MS patients. Clinically isolated syndrome patients come in and we evaluate them with a full functional medicine assessment, including an MRI and spinal taps. We train them on the Wahls diet, therapeutic diet lifestyle and we're able to tailor it based on the functional medicine assessment. And we compare that to people getting usual care, newly diagnosed. We do the same evaluations, but we don't do anything with that. We just let them get conventional therapies and we give them support, the intervention group support over the year. Bring them back, repeat all the measures, and we see what happens to their disease activity, to their function, and we see what happens to their microbiome, to their auto antibody markers, to the inflammatory cytokines, to their hormonal status.

It would probably cost me a couple of million bucks. It would be fabulous. You know what? Ideally, you have about 50 people in each arm. We're trying to do 20 in each arm and to freeze a lot of bio specimens. Right now I'm still trying to raise money, so I could get the analysis of all these bio specimens. We're going to collect them and conduct the studies and I'm still out looking for people to help fill in for the analysis of all the biomarkers that we'd like to do.

Geoff

100%. I think this is super exciting work, so where do people follow along? Where do people figure out how to support or contribute or stay involved?

Terry W.

First thing, if you just go to Terry Wahls.com/Research Papers, you can download the various research papers that we have. So, that's a great place to start. You could go to Terry Wahls.com/Diet, get a one page summary of the diet that we've originally studied and are continuing to investigate. So, I would start there, and then if you want to learn more ... You're a healthcare practitioner, think about coming to my in-person seminar where we train practitioners. We have members of the public that come to that seminar. They don't stay quite as long as my practitioners, but they learn a great deal as well. It's really just so transformative and if you want to reach out and support the study, we have links to that at Terry Wahls.com. You could contact my team at customer support at Terry Wahls.com and we would put you in contact with our development officer who could assist with making a donation to the research project.

Geoff

Incredible. Again, this is a fascinating conversation and just an inspiring story of just both personal resilience, and then turning that resilience into really just a very productive scientific question and path. So, I'm very excited to follow and see the published work and hopefully it turns out well.

Terry W.

Well, we'll learn a great deal. It's going to be just tremendous, whatever we find in my current study and whatever we find in the next study, comparing the Wahls Protocol to usual care. It's important work, transformative work, and we're thrilled to get to do that.

Geoff

All right. Thank you so much, Terry.

Terry W.

Thank you.

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