Dr. Terry Wahls is a cutting-edge clinical researcher, educator, and doctor at the University of Iowa Carver College of Medicine and a passionate advocate of nutrition and lifestyle medicine.
Inspired by her own (victorious!) battle with multiple sclerosis, Dr. Wahls has pioneered the use of dietary changes in treating autoimmune conditions. She has published peer-reviewed scientific papers demonstrating that lifestyle medicine is effective autoimmune medicine. In doing so, she has helped revolutionize the way the medical community and the public think about autoimmunity, medicine, and health, in general!
Here, Dr. Wahls answers all our questions about her personal health journey, the role of diet in chronic disease, and the steps we need to take to make nutrition a high priority in medicine.
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This is part of Nutrishatives’ Ask an Expert Series where we chat with movers and shakers in health, wellness, nutrition, and medicine about their careers, their current work, and their expert opinions on… well… their area of expertise!
For our readers who aren’t familiar with your harrowing health journey, could you briefly talk about your diagnosis and how your health has changed from the early 2000s to today?
I am an academic internal medicine physician, skeptical of special diets, complementary alternative medicine and taught my trainee physicians to be skeptical.
Then in 2000, I developed problems with my left leg, stumbling. I saw a neurologist, had an MRI of my brain, spinal cord, spinal tap, blood work, and nerve conduction velocities. My neurologist diagnosed me with multiple sclerosis.
I knew I wanted to treat my disease aggressively, so I sought out the best care from people who were doing clinical research. I saw the best people at the Cleveland Clinic, took the latest drugs. And I only had one relapse involving my right arm. (If I had been in a drug trial that would have been a huge success.)
But I was getting steadily weaker. My Cleveland Clinic doctors introduced me to the work of Loren Cordain and the Paleo Diet. After 20 years as a vegetarian, and after a lot of prayer and meditation, I went back to eating meat, giving up all grain, all legumes, and all dairy.
I continued to steadily decline and converted to the progressive phase of my illness. There would be no more spontaneous remissions.
I took chemotherapy, then I took Tysabri, but I continued to decline.
So, I went back to reading the basic science — about animal models of MS, Parkinson’s, dementia, Huntington’s, and ALS.
I decided mitochondria were key and developed a supplement protocol to support my mitochondria. It helped the fatigue slightly. The speed of my decline slowed.
“Finally, I had my big a-ha moment and redesigned my paleo diet based on the nutrients I was taking in supplement form… and that is when the magic began.”
By 2007, I was so weak I could no longer sit up in a regular chair. I was in a zero-gravity chair with knees higher than my nose. I could only walk 10 feet using two walking sticks. Worse yet, I was having more severe problems with trigeminal neuralgia and beginning to have brain fog.
My chief of staff had assigned me to the traumatic brain injury clinic in January, 6 months down the road. I would be seeing patients directly as part of a team, with no residents. I would be examining patients, a job I would not be strong enough to do.
And then I saw a neuroprotection course offered by the Institute for Functional Medicine. I took the course and had more supplements to take. I added meditation and electrical stimulation of muscles to my physical therapy program.
Then, finally, I had my big a-ha moment and redesigned my paleo diet based on the nutrients I was taking in supplement form. This diet is now organized into the Wahls Diet — and that is when the magic began.
Within three months of the new diet, I was walking with a single cane.
In six months, I was walking without a cane, my pain was gone, my fatigue was gone, and the brain fog was gone.
Within 9 months, I was able to bike around the block.
In 12 months, I could bike 18.5 miles with my family.
How I thought about disease and health fundamentally changed. How I practiced medicine changed. And the focus of my research changed.
We doubt that there is anyone who isn’t floored by your amazing story of recovery using nothing more than tenacity, self-experimentation, food, neural stimulation, and exercise. Even for nutrition and functional medicine nerds like us, who absolutely believe in the power of nutritional and holistic medicine, it is astonishing (in the most positive sense)! What reaction do you tend to get from more conventional medical practitioners and researchers when they hear about your healing journey?
My partners were initially thrilled by my recovery. But as I focused less on drugs and more on diet and lifestyle, they became more uneasy. Then the local MS clinical advisory group banned me as a speaker for “creating false hope”.
I had to explain this to the chief of medicine and chief of staff. I reviewed the science behind what I was doing and met with the chief of the complementary/alternative medicine clinic.
Then, I learned that I needed to document that I was offering non-FDA approved alternatives to improve cellular physiology and to add disclaimers to public presentations, etc.
After this, though, I began a clinical trial. And as that research unfolded with remarkably positive results, our results were published, and our grants funded I went from banned to brilliant.
In your TEDx talk in Iowa City, you said something that really jumped out at us. Talking about the health of the mitochondria in your brain, you said, “In medical school, I had to memorize countless reactions involving my mitochondria, but I never learned which compounds my cells could manufacture and which I needed to consume… [.]”
That is absolutely amazing to us! Why, in your opinion, do medical schools not teach the role of nutrition in the function of key biochemical processes? Are there steps we could take to help combat the lack of nutrition education in medical school?
There is so much competition for educational time for medical students — so much information is lost that should be included.
As more drug/pharmacology and basic science are taught than nutrition, lifestyle medicine is crowded out. But more schools are beginning to include more health behavior curriculum and more on health coaches.
There is also finally more research on diet/lifestyle that is happening.
In 2009, I was only one doing dietary intervention study for MS but now, in 2019, there are 12 dietary intervention studies (ours the largest) and even more health behavior studies. And there are plenty of diet/lifestyle studies on other neurological diseases as well.
I have advocated for schools requiring students to master health behaviors — therapeutic diet, stress reduction, and movement practice — including a test to demonstrate proficiency.
It would help them survive medical school and make it more likely that they would use those concepts with their patients.
In your health story on your website, you mention that your first instinct was to search the literature for new drugs in development, then (when those were years out from FDA approval) to look for compounds you could buy in concentrated supplements and, only after these started helping, did you think about turning to whole foods.
Do you wish you’d been given the tools in your studies that would have allowed you to skip straight to whole foods as medicines?
Does it upset you that you had to do the trial-and-error process on your own and that these simple, healthy treatments weren’t already laid out in the literature for you?
I followed what I had been taught: first drugs, then supplements, then exercise. Eventually, I had the “a-ha” to consider food.
Now that more research into eating plans, dietary interventions, health behavior, and health coaching interventions are happening, the data will be more available to the next round of students and the public.
That is the beauty of the internet. It is easier to find this information. It is easier for patients to publish their healing stories, easier to find the research, and more people are able to do health behavior research.
No, I am no angry. I am grateful for my journey. It had to happen exactly as it did so I’d be motivated to relearn all the chemistry and physiology and rethink my approach to disease and health.
It was an inspired step to look at the nutrients your nerves needed for optimal health and decide to see if you could ease your symptoms by boosting the levels of these nutrients in your body! This, of course, made it fairly easy to decide which foods you wanted to include in your healing diet. But how did you decide which foods to cut from your diet (dairy, grains, starches, etc.)?
I had read through Loren Cordain’s work and his papers. His rationale for removing lectins, reducing starches, and adopting an ancestral health point of view had sound science behind it. I decided to adopt the Paleo diet (after 20 years as a vegetarian) but continued to decline.
Removing inflammatory foods was not sufficient. I also needed to focus on what to add.
You’ve tested your diet and functional medicine routine on yourself and other multiple sclerosis patients and the results speak for themselves!
Have individuals with other neurological disorders or other chronic conditions tried your protocol in clinical trials? Have the results been similar? Who would you recommend trying your diet and wellness routine?
I have used these concepts in primary care clinics for people with:
- heart disease
- liver disease
- mental health problems
- other autoimmune issues
These people were often living on disability income or food stamps and they were able to implement the concepts and achieve remarkable regression of their illnesses. These patients saw:
- a need for fewer and fewer medications
- normalizing blood pressure
- normalizing blood sugar
- stabilizing mood levels
- reduced pain
- normalizing weights
When we tested the protocol in the traumatic brain injury clinic, people saw
- improved function
- resolution of headaches
- resolution of persisting neurologic problems
- improvement in mental health issues
In the therapeutic lifestyle clinic, patients saw:
- reductions in pain and fatigue
- improved moods
Other conditions that have responded to our protocol include:
- age-related cognitive decline
- myasthenia gravis
- rheumatoid arthritis
- chronic pain following amputations
- chronic back pain
Certainly, this is the program for those who want to have the best function possible and for those who want the healthiest brain as they age.
What would you say to someone newly diagnosed with a chronic condition, be it multiple sclerosis or any other incurable disease? What is the single first step you would recommend they take to move towards health through their condition?
The best strategy for treating any chronic symptom is to improve cellular function by improving health behaviors — as many additional healthy behaviors as the person can add.
Sometimes people can add many health behaviors all at once, more often it is one at time. I usually have people start with diet — removing the most common inflammatory foods (sugar, gluten, casein, eggs) and ramping up vegetables. We may have to teach them how to cook again and minimize processed foods.
The recommended diet includes
- 9 cups (measured raw) of vegetables:
- 3 cups of green leafy vegetables
- 3 cups sulfur-rich vegetables (cabbage, onion, mushroom family) and
- and 3 cups of deeply-pigmented vegetables
- protein (we have vegetarian or meat-based approaches)
- healthy fats (no processed foods, trans fats, or refined oils)
We then add a stress-reducing activity of choice and a movement activity of choice.
It is really helpful to find a support group who can support your journey to add more healthy behaviors.
Cellular health is where healing can occur. Stop the destruction (remove the inflammatory foods), support the repair (vegetables, healthy fats, protein, and meditative practice), and add the signals to rebuild (movement).
Life is a series of self-correcting chemical reactions. Remove the harmful and provide more of the proper building blocks — and we are often surprised by how much healing can happen.
If you’d like all the details of Dr. Wahls’s diet, check out her book: The Wahls Protocol: A Radical New Way to Treat All Autoimmune Conditions Using Paleo Principles
What message do you wish everyone took away from your health journey?
I had years of uncontrolled facial pain. These electrical zings were from trigeminal neuralgia that was hard to stop. I feared that it would someday turn on and never turn off.
Now with the lifestyle changes, the pain is gone.
But if I consume gluten, dairy, or eggs, the pain turns on 6 to 24 hour later.
I have learned to observe my response(s) to the environment and use my facial pain as a signal that I came into contact with a trigger. Now, I can always identify the problem and take corrective action.
I teach people to observe their response to environmental triggers and improve the optimization of their diet and lifestyle.
People get better and better control of their environmental factors, enjoy better cellular health, better function, more joy, and more peace. It is a joy to watch.
If you could get everyone in the world to make a single healthy lifestyle change, what would it be and why?
Drop the sugar, processed foods, gluten, dairy, casein, and eggs and replace them 100% with vegetables for 100 days and see what happens.
What impact would you like to have on the world?
I want to create an epidemic of health through teaching.
I want to:
- inspire patients and the public to emphasize cooking at home
- teach children to cook and eat vegetables
- teach medical students the critical nature of cellular health and the role of diet
- help train health coaches
- teach grandparents the critical role of vegetables
- inform politicians about the critical role of cooking at home
- and teach researchers and clinicians the critical role of health behavior research in keeping all of us healthier
What one question have you never been asked in an interview that you have always wanted the opportunity to answer?
Question: How do you make making these lifestyle changes easier?
Answer: These are hard changes to make. To be willing to give up familiar, addictive foods and begin eating unfamiliar foods is hard.
Our microbiome creates cravings for sugar, gluten, and dairy. It is very uncomfortable.
People benefit from having a “why”. I have learned to ask people what is your underlying mission in life, why are you here, what is your legacy. We discuss the hero’s journey — what do they need to learn and what is their gift back to their tribe.
When they can answer those questions, I ask what do they want their health for and then help them relate their mission in life to why they want to make healthy behavior changes.
It is much easier to do the work to adopt the desired health behavior then.
Are you struggling with a chronic autoimmune condition and would like to learn more about managing your symptoms? Head over to Dr. Terry Wahl’s website for excellent resources or to sign up for one of her classes!