Nutrition to Recover From Illness - with Dr. Terry Wahls | The Empowering Neurologist EP. 19

Hello everyone, Dr. David Perlmutter here. Today I'm going to have the great pleasure of introducing to you Dr. Terry Wahls. Dr. Wahls is really an amazing individual, and I think you're going to certainly have a great experience when you hear the story that she has to tell. But first, let me say she's a clinical professor of medicine at the University of Iowa. And a staff physician at the Iowa City Veterans Affairs Hospital, where she's involved in teaching medical students and also the residents. She sees patients with a variety of issues, traumatic brain injury, as well as complex chronic health conditions that often include autoimmune conditions, and we're going to learn quite a bit about that. She's involved in conducting clinical trials, but Beyond that, Dr. Wahls is actually a patient with a chronic progressive neurological disorder called secondary progressive multiple sclerosis, or MS. Understand, this confined her to a reclining wheelchair for 4 years. She's had a dramatic recovery that she is going to describe. You can read about that in her book, The Wahls Protocol. In which she talks about how she upregulated or turned on the function of the mitochondria, the energy producers in each and every neuron of the brain and the spinal cord, really throughout the body, and also how this book relates to autoimmune conditions. So we're in for some real incredible, really incredible information. So let's get right to our interview. So here we are getting to talk to Dr. Terry Wahls. This is a really exciting interview for me. I've been looking forward forward to this for quite some time. Terry, welcome to the program.

Oh, thank you for having me.

So you've got a really interesting story, and we've talked about things over the, over the years, and it's really a remarkable story. In the introduction, I kind of alluded to the fact that not only are you a top-notch physician practicing functional medicine, but in addition, you had your own health issue, and perhaps still ongoing, And maybe tell us about how things were and then how they changed.

So, you know, back in 2000, I was diagnosed with relapsing-remitting multiple sclerosis. You know, and at that time, David, I was still physically active. I could cross-country ski. I could jog a bit. But I started having some trouble, weakness with my left leg, and went through a big workup, got the diagnosis. And decided to treat my disease aggressively. But within 3 years, things had not done well, and I had converted to the progressive form of the illness and soon needed a tilt-recline wheelchair. So things got critical.

When you say you treated your disease aggressively, you were pretty much doing what your mainstream doctors were telling you to do.

Oh, absolutely. You know, absolutely. I was a— I was an academic internal medicine doc, and so I believed in the best technology, the newest drugs. And so I sought out, you know, the best clinical research center in the Midwest, which was the Cleveland Clinic, saw the best people, took the newest drugs, which did not slow the decline.

You were just in a tailspin. You end up in a wheelchair. And then—

You know what? And I became so weak, David, I could not sit up in a regular chair as I am now. I needed to have A zero-gravity chair, which let me recline back, knees higher than my nose, and I worked using a laptop at work, and I had another chair like that that I used at home.

So was there an epiphany moment, or was your understanding that there may be another way kind of a gradual event?

You know, it was really a gradual event. Probably like many docs, when I was first diagnosed, I went to the literature, started reading it. And of course, I was upset pretty quickly when I saw the progressive nature of MS, that within 10 years, one-half are unable to work due to severe fatigue, and a third have problems walking. And Jackie convinced me to stop reading, said, all this is doing is getting you upset. Let's just find the best people in the country, go see them, and let them take care of you. That's what we did.

To no avail.

To no avail.

What happened next?

Well, it's an interesting timeline. Dr. Lail Stone at the Cleveland Clinic, who I liked a whole lot, saw that I was getting worse. In 2002, She mentioned Dr. Ashton Embry and Direct MS Charity, said that he had a son with MS that turned around with diet. She recommended that I check out his website, and she emailed the link. And that introduced me to Loren Cordain and the paleo diet. And so, you know, after 20 years of being a vegetarian, I Read about the paleo diet, read his papers, and decided that scientifically this made sense. And so with a lot of prayer and meditation, I went back to eating meat. But I continued to decline for another 5 years.

So 5 more years go by. 5, yeah. Dietary change, you've welcomed meat back into your diet. We're going to talk about that in a little bit. And now we are 5 years down the road. What's happening now?

Well, I'll back you up a little bit, David. So when I hit the wheelchair in 2003, I decided that I was pretty bummed, and I had a sense of how bad things might get for me. It seemed unlikely that the best conventional medicine could stop the decline into a bedridden and quite possibly demented life. And so I decided that the basic scientists in their mouse models and rat models would have the guidelines that would be used to guide clinical care in another 20 or 30 years. So I started reading about the mouse and rat models of shrinking brain diseases, you know, MS, Lou Gehrig's, Alzheimer's, Huntington's. And I would eventually Of course, at first, I'm looking for drug studies. And eventually, I realized, well, that's worthless. I can't get access to those drugs. And then I have the insight to start looking for vitamin and supplement studies. And I gradually am developing the theory that mitochondria are a big player in why brains shrink. And so then I start trying to find what can I do to support my mitochondria. And I gradually start taking these vitamin supplement mouse doses, ramp them up to human-sized doses, and I go see my primary care doc and say, yeah, I'd like to start these things. And she, bless her soul, adds one supplement at a time to my med list and says, well, there's no serious side effects, interactions, so why don't you try them one at a time? I start them. I don't know. I think it was 6 months later. I'm disgusted. Nothing has helped, and I think I'm wasting my money, so I quit. I must have quit on a Friday. I couldn't really get out of bed Saturday. I couldn't get out of bed Sunday. I couldn't get out of bed Monday. Monday night, Jackie comes in and says, honey, I think you ought to take your vitamins again. I take them. The next morning, I can get up and go to work. I think, wow, this is really interesting. A couple of weeks later, I decide again to stop my supplement cocktail. Again, a day and a half later, I can't get out of bed. I'm completely exhausted. I wait a couple of days, start them up again, and I'm again back up and going to work. So now I am very excited, like, okay, maybe they weren't doing— making me better, but they're clearly doing something for me. And now I'm very excited about reading the literature. And I'm beginning to feel like, okay, I'm finding things that my doctors are not telling me about. And so I feel hopeful for the first time.

Well, I think you said a few things already that are really very profound. And that is that you recognized at this stage that MS is a problem with mitochondria. And for those of you who are watching this video, again, remember the mitochondria are the small organelles, the small parts of the neuron and other cells in the body who have the responsibility of, yes, making energy, using fuel to make energy to power our cells. But beyond that, We know that the mitochondria are actually wielding the sword of Damocles, determining which cell will live or die. So they have a huge role to play in functionality, in this case, as we're hearing with Dr. Wahls, in the functionality of the brain cells. And as she— as you've talked about, you ramp up your supplements that are geared at increasing mitochondrial function, you realize significant benefit.

Absolutely. And so it's very clear that the speed of my decline is slowing. And of course, keep in mind, David, my neurologist at the Cleveland Clinic— and by now it's become too difficult to travel, so I'm just working here at the University of Iowa— and my neurology team here say functions once lost are gone forever. Nobody recovers when they hit secondary progressive MS. And I— Except that. So I'm just hoping to slow my decline. There's no hope of recovery, but I'm very cheered now that, in fact, I seem to be slowing the decline. And I keep reading. I add another supplement here and there, but decline is still happening. By the summer of 2007, I'm having severe fatigue. I'm exhausted by 10 in the morning. I'm beginning to have problems with brain fog. I've lost— I have these fancy electronic keys for my car, and I've lost them 3 times. I've lost my phone 3 times. And my chief of staff calls me in to say, you know, Terry, we're going to reassign you so that you'll be in the traumatic brain injury clinic doing primary care for the vets there. You won't have residents. You'll be doing direct patient care. And I need you to finish up what you're doing, so we'll have you start this at the end of January. So I go home and tell Jackie, and we both recognize that what the VA is doing is basically saying, you know what? We've redesigned your job enough times for you. It's time for you to come to terms with the fact you're going to have to take medical disability. So I'm depressed, I'm upset. But, you know, I'm realizing because of the brain fog, it may well be time. But I tell Jack that, well, we'll do this. I'll go off to clinic and either I'll be able to see patients or I won't. And then I'll have to finally file for disability. But of course, everything changes that summer.

Now, what was the turning point? Did you ramp up your supplements or what was the big deal here?

Well, there are 2 big events that happened that summer. The first one happened earlier in the summer. I was reviewing an IRB protocol for one of Rich Shields' studies. He uses electrical stimulation of muscles. In people who had been newly paralyzed with a spinal cord injury. And he does this to maintain muscle mass. He had asked for permission to extend the study because people didn't want to stop the electrical stimulation. So that was really pretty interesting. So I did a quick search on PubMed, found 212 articles, and so I started reading through these articles. And though they were mostly about athletes, there were a few with cerebral palsy, a few with stroke. And the stroke papers are really very interesting because they were doing this 5 and 10 years after the stroke, did e-stim, and began to get some recovery of function, which made me wonder, could I get some recovery of function using e-stim? I would eventually call my physical therapist and get a test session later that summer. I started doing some e-stim in clinic. About that same time, in one of my internet searches, I came across this organization, the Institute for Functional Medicine. I'm reading through it, Management of Complex Chronic Diseases. I'm thinking, well, this looks interesting. I'm looking over the faculty. They seem well-trained. Then I'm looking at their educational offerings, and they have this course, Neuroprotection: A Functional Medicine Approach for Common and Uncommon Neurologic Syndromes. I order that, and I get it, and I begin going through the PowerPoints and listening to the lectures. Mind you, David, this is when I'm still struggling with some brain fog. So, my kids are laughing at me going, Mom, you've looked at that slide. You've listened to it 5 times. Yes, I know. This is a lot of chemistry I'm having to rethink about again. So, it took me, oh, maybe a month and a half to get through all of that, and I had a longer list of supplements that I added, and I'm doing the e-stim. I feel like I'm beginning to sit up a little bit more easily. I'm not having to be as far back in my zero-gravity chair when I'm having supper. Then, let's see, it was in November that I had this other big epiphany, which I'm sure will resonate with you, David, is that— because now I've got 20 different vitamins and supplements that I'm taking. I thought, I wonder where they are in the food supply. I should get this stuff from the food. So I asked the dietitian that I work with, and she says, well, you know, I don't know, sir, I really can't help you. So then I go over to the Health Science Library and talk to librarians, and we're looking at some books, and I'm not really finding a good resource. And then I go back to the University of Google, and I start doing internet searches. Over the next month, I create a list of foodstuffs that I should be stressing. At the very end of December, and it really began December 26th, 2007, I reorganized my diet. It's still a paleo principle diet, so still no grain, no legumes, no dairy. But now, I'm really focusing on what to eat instead of what not to eat. The first thing I noticed is that my mind is clearer, and I'm having a little bit more energy. Fatigue is not as bad. Then, pretty soon, it's the end, about January 20th, when I have to go over and start seeing patients in the traumatic brain injury clinic. And so the first day in clinic, I'm just watching the physical medicine doc show me what he does. And at the end of clinic, I'm thinking, you know, I don't feel too bad. Because I had to sit up in a regular chair all day. I couldn't be in my zero-grav. Mm-hmm. So I thought, wow, that was pretty interesting. Then I went back the next day. And I was not exhausted. And at the end of the week, it was apparent that I probably could do this clock. It was not going to be a huge problem.

So, you know, the real emphasis here is that you targeted, and you continue to target, and you write about targeting energy production, basically.

Absolutely.

And, you know, as, as an extension, I think it's fair to indicate that this mitochondrial issue, this energy issue, is really rampant through our most pervasive chronic degenerative disorders, and even some infectious issues like chronic Lyme disease. I mean, you're seeing, I'm sure, patients with fibromyalgia respond to your program.

Oh, absolutely. Absolutely. You know, we've since created a therapeutic lifestyle clinic, And we see people with a whole host of problems. I do the medical symptoms questionnaire, and severe fatigue is the, like, most common problem that people have, brain fog being the second most common problem.

There are so many issues that we see in which people indicate brain fog, generalized fatigue, malaise, Soft tissue pain. It's not just the chronic fatigue, fibromyalgia, but it seems to be generally the endpoint of any of these diseases that are characterized by mitochondrial embarrassment.

Yes, yes.

So ultimately, you put together the Wahls Protocol, and I actually talked about it in the introduction, and you've had great success with the book. And what you're doing in the book is really giving people instructions step by step in terms of How they take this knowledge that you've stumbled upon, not easily stumbled upon, worked really diligently to find. And now you're actually implementing this protocol in dealing with a variety of issues, aren't you?

Yeah. You know, what's really fascinating is when I first got transformed, and it changed how I understood disease and health, and of course it would change The way I practice medicine in primary care. In the traumatic brain injury clinic, I'm talking to these vets about B vitamins and fish oil and eating lots of vegetables and giving up grain. My colleagues thought, you know, this was bizarre and they're complaining to the chief of staff. So I get warned for what they thought was unorthodox, not science-based behavior. I love it.

I've been there, done that.

And so my chief of staff and I had to have several conversations. I took 85 papers down to his office and went over them with him. And he would have eventually become very supportive. And within 5 years, the chief of medicine came to me and said, you know, Terry, we'd like to take you out of primary care and we'd like to create a clinic where you can do medicine the way you want to do it.

Oh my God.

And so it took us a year to get through all of that. But I've now had the Therapeutic Lifestyle Clinic for 2 years. And we've had continued success, continued growth. And the hospital director invited me to create a proposal to expand the clinic, train more providers.

So in your book, you made some comments that Vegetarianism may not be an ideal diet. Can you tell us why?

Sure. So vegetarians have a lot of potential problems. One is the carbohydrate-heavy nature of the diet. They'll have a lot of grains, a lot of legumes. The grains and legumes can have a lot of phytates and lectins, which in the genetically vulnerable person Increases the risk of having a very severe immune response, increasing the risk of autoimmune disorders, certainly adding to more insulin, and probably a greater risk of earlier cognitive decline. The phytates can bind minerals, leading to some mineral deficiencies. Many of our grains and legumes are grown with a lot of Roundup exposure. And the Roundup makes the binding of minerals even worse. So that's one big problem. Another big problem is the marked decreased intake in vitamin B12. And there's a much higher rate of B12 deficiency in vegetarians and in vegans. Most physicians will think A, won't think about it, may only measure the B12, and may require severely low B12s when they could have been looking at a more functional assessment to make sure they had sufficient reserve, or better yet, measuring their homocysteine and knowing that they have good B vitamin metabolism. Yeah. And then finally, not enough protein and probably not enough omega-3 fats.

Because you're getting those from fish oil, which are not vegetarian.

Correct.

Now, that said, you know, we do see that there are sources of DHA that are algae-derived, so they would qualify. But, you know, MS is a prototypic autoimmune condition, and as such, a lot of the research is really focusing on the gut and permeability of the gut and challenges to the immune system because of this Permeability issue. As you mentioned in your book, you find great applicability of your program for other autoimmune conditions.

Oh, absolutely. Mixed connective tissue disease, scleroderma, Sjögren's, myasthenia gravis, RA, lupus, all of those have done very, very well on our protocol.

These are really common problems these days, these autoimmune conditions, aren't they?

Very common. We see our children at younger and younger ages getting very serious autoimmune problems.

Allergic issues, hyperimmune issues as well. Absolutely. Dr. Wahls, if people want to follow you, get more information, where should they go?

I'd have them go to my website, terriwahls.com. They can follow me on Facebook, Terry Wahls, MD. They can follow me on Twitter, @TerryWahls, one word.

Great. All right. Well, thank you so much for your time, and more so, I want to say thank you for all the great work that you're doing and for being a bit of a disruptor. I think that's—

One more thing.

Sure, sure. Take your time.

We have a new clinical trial going on, and we're comparing the Swank Diet To the Walls Diet, and we are recruiting people.

So people can— again, we're gonna, we're gonna post the website.

Yeah, and I'll get you that info.

Yeah, for individuals who may have MS, the Swank Diet was really the prototypic first interventional type of approach diet-wise for treating MS from a long, long time ago. And I'm going to tell you right now, I'm going to put my nickel down that I think the Wahls Program is going to be far superior. I mean, you know, the Swank Diet basically didn't incorporate any supplement or other lifestyle issues. I mean, I think, you know, here's a study that was really a geographic observational report that went into the development of the diet.

Right.

But I think now that we mechanistically understand autoimmunity better, the microbiome, the role of mitochondria, I think you are really, really at the forefront, the top of your game. And again, I was about to say that thanks for being a bit of a disruptor. Look how much further you moved the ball down the field. It's really great.

Oh, it's very exciting. Yeah, it's very exciting. You know, even the MS Society, after my book came out, had to deal with all of the chatter in cyberspace. about the Wahls Diet, the Wahls Protocol, a paleo diet, that they called a wellness meeting where they had to reevaluate programming on diet and lifestyle and have made diet and lifestyle research a research priority. So—

Who knew?

All of the voices that you're igniting, I'm igniting, is changing the face of research now in the neurology world.

That's great, you know, because what you're doing is challenging the status quo. I always like the quote from Ronald Reagan who said that status quo is a Latin term for the mess we're in, and we have to challenge that. And it's disruptors like yourself who help move the ball forward. We're not always right, but at least we're there to challenge the status quo, and I think that's really very, very important.

It is very exciting. It is very exciting.

Well, I hope to see you soon. I'm sure that I will. And I enjoyed seeing you recently at the American College of Nutrition. So we'll talk soon, and thanks for your time.

Thank you. Bye-bye now.

Bye, Tara. Well, that was a real interesting experience, wasn't it, to learn what Dr. Wahls has Uh, experienced in her own life, how she then wrote about it, and how she now utilizes these discoveries in the actual clinical practice of medicine with terrific results. And again, this is her book called The Wahls Protocol, available everywhere. I would really encourage you to get this book and read it. A lot of great health information. Hope you enjoyed today's interview. I'm Dr. David Perlmutter. Thank you.