EP 165 WTH?!?: How Dr. Terry Wahls Beat Progressive MS with Diet and Functional Medicine

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Welcome back, everybody. Dr. Greg Eckel. And this is what the health and I have a treat for you. We're going to talk multiple sclerosis and the state of the research and ongoing research with Dr. Terry Wahls. She is an Institute for Functional Medicine certified practitioner and conducts clinical research using functional medicine principles in the setting of multiple sclerosis. In 2018, she was awarded the Institute for Functional Medicine's Linus Pauling Award for her contributions in research, clinical care and patient advocacy. Dr. Wahls has secondary progressive multiple sclerosis, which confined her to a tilt recline wheelchair for four years. So she knows this disease process intimately. She restored her health using a diet and lifestyle program which we also utilize with our patients. Thank you, Dr. Wahls. And she designed specifically for her brain and now pedals her bike to work every day. She's the author of multiple Wahls protocol books which we will have links to in the show notes and a cookbook to boot. And I'm going to also really highlight today and I'm going to really get into it with Dr. Wahls on her research and enrollment. Welcome aboard, Dr. Walls.

Hey, thank you for having me.

I am so excited. I always learn so much with you on the show and I love sharing your information with our audience. And let's start out on just kind of the personal story behind Dr. Wahls for those that are new to what the health and you suffered with multiple sclerosis, as I said in your intro, and severe pain. So tell us how you got here today.

So during medical school, that was back in 1980, I started having twinders of electrical face pain that would ultimately be diagnosed as trigeminal neuralgia that would be progressively more severe over the next 20 years. I then develop weakness in my left leg and I see a neurologist and am diagnosed with relapsing, remitting multiple sclerosis. And he says, by the way, you know, we saw you had an episode of dim vision 13 years earlier that was probably optic neuritis and you know, MRI of the brain, spinal cord and a spinal tap. So I had a lesion in the brain, one in the spinal cord and abnormal spinal fluid consistent with multiple sclerosis. I do my, I start reading the basic, you know, the, the research on PubMed. It's very upsetting because I see it's a progressive disease that within a very short time people are unemployed. So very distressing. My family convinces me to stop reading the research, that we'll go find the best Ms. Center in the country they can Take care of you. We'll. We did that. Took the newest drugs, but within three years, I'm in a tilt recline wheelchair. And it's very clear that, you know, if I think of the 20 years I've already had with my trigeminal neuralgia, that I clearly have a progressive illness. And so I go back to reading the basic science. I decide that mitochondrial dysfunction are what's driving disability. I create a supplement cocktail for my mitochondria, which slows my decline. I'm very grateful. I'm still declining. I discover a study using electrical stimulation of muscles in people who are paralyzed. We're never going to walk. I convinced my physical therapist to give me a test session. Hurts like hell. But when it's over, I feel great. We add electrical stimulation to my regimen. I and I'm doing this tiny little workout. 10 minutes every morning before I go to work. If I do more than that, I can't work now. Fortunately, my brain is so clear, my trigeminal neuralgia is relentlessly worse. My chief of staff calls me in and tells me he's reassigned me to the Traumatic Brain Injury Clinic. I'll have to go there in January. Describes the job. I'll be seeing patients without residents. And I'm like, there's no way I can. In my head, it's like, there's no way I can do that. But I'm doing molecule stimulation. I discover the Institute for Functional Medicine. I take their course on neuroprotection. I have a longer list of supplements. And they talk all about the mitochondria. And then I have this big aha. And Greg, I laughed at how long it took me to have this. What if I redesign my paleo diet based on the supplements I'm taking? I do some more research to figure out where these ingredients are in the food supply. And I've redesigned my paleo diet to maximize the nutrients I was taking in supplement form. Now I start this new way of eating. December 26, 2007. At that time, I'm unable to sit up. I'm in a zero gravity chair with my knees higher than my nose. That's how I see patients with or staff the resident clinic. That's how I interact with my family. At home, I can take just a couple steps with two walking sticks. Otherwise, I'm in the tilt recline wheelchair. I begin to have brain fog. As I said, my trigeminal neuralgia is relentlessly worse. It's clear to me I'm on track to be bedridden by my illness, probably demented in due time by my illness, and possibly dying with intractable pain. So I start this new way of eating. Then January comes, and I have to go to the traumatic brain injury clinic. The first two weeks, I watch my partners. The third week, now, I have to start seeing patients. And, you know, I come home Monday night and I tell my wife, Jackie, you know, that wasn't too bad. I end at the end of the week on Friday, and I come home and say, you know, I think I can do this. And, honey, could I sit in a regular chair for supper? So we swap out my zero gravity chair. I sit in a regular chair and I eat supper. First time in years I'm having supper with my family.

One week on the diet?

Well, no, no. So I had been, you know, following a paleo diet for five years.

Okay.

I had, over the summer, added electrical stimulation of muscles.

Got it.

And then over the fall, I did my research. Where are these ingredients in the food supply? So now I restructure my paleo diet based on mitochondrial needs.

Yes.

And three weeks into this, actually, it's probably about four weeks into this, I'm saying I want to sit up at a regular chair for supper. First time in years. And my physical therapist says, terry, you're stronger. And he has me doing my exercises 10 minutes twice a day, then 15 twice a day, then 20 twice a day. That leads to my starting to walk in the hallways at the hospital with my two walking sticks, then with one walking stick, then with none. And then on Mother's Day, we have an emergency family meeting because I want to ride my bike, which I haven't done in six years. And so Jackie tells my son, who's 6 foot 5 and he's 16, Zach, you, wrong side on the left. She tells my daughter, who's 13. Zeb, you run alongside on the right. And she follows. I bike around the block. My son is crying, that big 16 year old boy. My daughter, the 13 year old, she's crying, Jackie's crying. And if I relive that moment, you know, the tears come again because that's when. That was the day hope comes back. Because if you have progressive neurologic disease, you let go of the future. You. You just take each day as it unfolds. But then it's like, how much recovery might be possible. So I. I'm biking a bit more every day. In October, Jackie signs me up for the courage ride. 18.5 miles. And when I cross that finish line, you know, once again, we're all crying.

Yeah.

And this, you know, fundamentally changes how I think about disease and health. It will change the way I practice medicine and it will change the focus of my research for sure.

And, you know, thank you so much for sharing your story. And I, I could hear that really every day. It's so inspiring to hear what you went through and the resolve. Right. Because it was five years prior that you change your diet, but you didn't really get those results to, to, to get the drive. What do you, what was it in you to allow you to stay on it? Yeah.

Being a mom, having two kids.

Sure.

Because my kids are watching. And so I could either give up and that was plenty of despair. Clearly I had a very difficult diagnosis. Things were getting worse. Yeah. I, but if I gave in, I'm teaching my kids that when life is difficult, you give up.

Yeah.

Or I just keep doing the best that I can, doing my little simple workouts, which were getting, of course, smaller and smaller and smaller. And that my kids had chores, which they both complained bitterly about, particularly when they were 10. And then I'd say, well, yes, it's not fair that you have chores and your friends don't, but my chore is to go to work. Your chore is to do the laundry.

Right.

And so, you know, my 10 year olds would stomp their feet and say, mom, I think you're glad you have Ms. So you can lecture me about chores. And now they're horrified that I tell that story. But, you know, that's age appropriate for a 10 year old. Indeed. But knowing that my children were watching and that I had fewer and fewer tools to teach them how to be successful adults.

Yeah.

So. And my tool was that, well, I'll do all that I can and I'm not going to complain. I'll do my little workouts as best I can. I was doing my paleo diet, eating as well as I could, as I understood.

Yeah.

Taking my supplements because I figured out if I didn't take my supplements, my fatigue was worse. So like, okay, I've said, you know.

You noticed that worked.

And then I'm doing the electrical stimulation.

Yeah.

And my, my, you know, the, in the Matrix, the movie the Matrix was out. So my kids thought, you know, this is sort of like the Matrix. You're rebuilding your muscles and. Yep. This is exactly like the Matrix.

I love it. Hey, before we go too further, there's a little bit of a static or grumbling with the, the microphone. I just want to make sure that we get that cleared up.

You know what? My Ethernet's not plugged in, so let me go take care of that.

Okay, I'm going to pause this.

Okay, perfect. Well.

Well, it is your story. You're living it. You're inspiring. Thank you. And keeps shining brightly. And that's what I love about you. You're also doing some amazing research as a result of all of this. So will you share where you're at with that?

So we're doing a trial called Efficacy of Diet on Quality of Life. It is comparing a ketogenic diet, a paleolithic diet to usual diet. People come to Iowa City, we get all their baseline assessments, then we randomize them to one of those three diets. We give them some support to adopt those diets. They come back in three months for another visit, then come back at a 24 month for a final visit. This will be the largest, longest diet study in the study of Ms. It will have MRIs. We are super excited. We are recruiting 156 people. We've got either 129 or 130 randomized. As of today, we have 26 more to get in. I am super hopeful, Dr. Greg, that you can help me get those last 26. I'm going to pull out. Well, that's right. Well, we'll get you the links. You can go to terrywalls.commsstudy we have a little video that tells you more about the study and a link to screen. When you complete the screen, you'll be asked if you want to be part of our database for future studies. Because we do it. Some studies that don't require travel, that are virtual only. This study does require travel. You have to just be willing to come to Iowa. You can live in Canada, the United States or Mexico. But key, you have to be willing to come to Iowa.

Got it. And that's for two trips, three trips.

Three trips, three trips. Zero, month, three and month 24.

Perfect. And the criterium because I have heard actually from some of our patients that they didn't qualify. So I was wondering if there's specific criteria.

Yeah, so a couple of things. If you screen and you're sure you should qualify but you didn't, please email us because there's no back button. People sometimes, you know, make a mistake filling out the form. Okay, we, we need you to be, be between the ages of 18 and 70, have relapsing, remitting multiple sclerosis. We also, if you have had your gallbladder out or if you've had oxalate kidney Stones, you can't get in. If you have clinically significant heart disease, liver disease, kidney disease, you can't get in. If you've had a history of an eating disorder and you were currently anorexic or have bulimia, if you have difficulty with severe depression, schizophrenia, bipolar, you can't come in.

Got it. Awesome. Well, we're definitely be sure to highlight that in our emails and in the show notes here.

Yeah, that'd be super helpful.

What have you been finding in the research? There was recently some dietary interventions with Ms. That got published. I'm wondering what that was showing.

Yeah. So there was a recent study that looked at wheat in a mouse model of Ms. In wheat consumption. In a human clinical trial looked at the impact of eating wheat on immune cell function and they saw that while gluten is a protein that's in wheat, but there are several other proteins in wheat and that it's not just gluten that is the problem in that a low wheat diet compared to a higher wheat diet in the mouse and in humans had differences in the activity of the immune cells and, and the reactivity. So the presumption is we're beginning to understand the mechanisms of why a gluten, a high wheat diet may be a problem and a low wheat or a no wheat diet may be beneficial.

Interesting. Do you know were they using organic wheat in the study or that.

I can't comment.

Got it.

You know, and I can't comment. Was sprouted wheat less a problem than non sprouted wheat? These are nuanced issues. Now there's another study that we just published. Super interesting. This is a quasi experimental design that means that people can choose to be in the which arm they're in. And the two arms were taking DMT standard of care in newly diagnosed relapsing, remitting Ms. Or clinically isolated syndrome on a DMT or newly diagnosed clinically isolated syndrome in newly diagnosed relapsed remitted Ms. Had declined a dmt. So taking no disease modifying treatments in that arm, we taught them a modified Paleolithic diet, a 478BR, breathing meditation and a brisk walking program and we followed them for a year. Now, this study was due to start enrolling in March of 2020, which meant we had to immediately rewrite our protocols into a virtual study, which we did. And so we were able to use validated quality of life questionnaires, fatigue questionnaires, mood questionnaires and mental clarity questionnaires. And then we abstracted medical records for adverse events for Relapses and compared the two groups. So the question we were asking was, was declining DMTS and using basically the Wahls protocol, a modified paleolithic diet, meditation and exercise, not inferior to standard disease modifying treatment. We're comparing these two groups not to say that the lifestyle was better, we just want to say it was not worse. We went to the research to say what are the limits that would say that for each measure the measure was equivalent. Then we ran those proposed limits by the study neurologist to be sure he agreed. The statistician, the neurologist blessed the limits that we used. What we found is that in fact for quality of life, physical quality of life, for fatigue measurements, for anxiety, depression, and for perceived deficits questionnaire, that's mental clarity, diet and lifestyle was not worse than disease modifying treatment. Now the other thing that we did was we captured how many relapses occurred and we found that we had four relapses in the folks in the health behaviors arm and one relapse in the DMT arm. We should keep in mind that according to the research, published research, you anticipate 0.7 relapses per year if you're not on DMT. So we had 29 people in. You would have predicted 17 relapses. Yeah, we only had four. Wow. So certainly the health behavior group did have more relapses than the DMT group. However, for those people who can't take DMTs, they're trying to get pregnant, they delivered and they breastfeed. They don't want to take a DMT while they're breastfeeding or that they're having adverse responses to the DMTs that health behaviors. So this is the first prospective report on what happens taking no DMTs and just using diet and lifestyle. It's not as good as DMTS for reducing relapses and enhancing lesions, but it's certainly very, very, very much superior to eating the standard American diet, doing nothing, not meditating and not taking an active compound.

Wow, that is awesome.

It's very positive.

That is very positive. That lifestyle modifications, which, you know, it's interesting to me grow up in the naturopathic Chinese medicine world where it's ingrained in the philosophy and the, the education that of course it makes sense. Right. But it's nice to have the research to support it.

Well, absolutely. And you won't be able to do a randomized controlled trial, but at least we're able to get a prospective look at what's happening. It Would have been lovely to get gotten the MRIs. It would have been lovely to have gotten the clinical assessments. But you know.

Yeah.

Such as life, you have to, you have to be willing to adapt.

Yeah. You at the end of the show or I'll actually, I'll just share it now. There's a great new mitochondria test coming out on the market. Called me screen out of UCSD and he Patel which I will make an introduction for you because I know that you will.

Yeah.

Be very interested in it. I'm very excited for the research that we're setting up here at the energy for life centers with regards to that, some questionnaires, et cetera. But what are you. What have, what has surprised you in the research that you've come across lately?

Well, actually one thing that was super interesting were the number of retractions that were happening in the cancer world is a huge deal that, you know, peer reviewed, published research that is used to justify FDA approval for a bunch of these very costly cancer drugs, immune drugs. And there were 31 papers that were affected that are retracted. That's a big deal. That is a big deal. And you know, doing research, making sure that you have a good statistician to do the stats, that you are rigorous in your process is important.

Yeah. How do you manage that as clinician and researcher? You know, I know you're growing in this realm, but so one of the.

Things that we do, because my university in part of the world assumes that I have a conflict of interest because I write books, I create programs to teach clinicians and teach public how to improve their diet. And I do that for a variety of diets. So people are afraid that I may have a conflict of interest if I do research about diet and lifestyle interventions. So we always have a. I always disclose there's maybe a perceived conflict of interest. I have to fill out the circumstances, the conflict of interest, research committee review, all of that and then they devise a plan. And the plan that consistently gets devised is that we end up with three people doing stats. One person who cleans all the data, hands it over to the statistician who will analyze the data and write a report. And as part of the manuscripts, every manuscript that we generate, that statistician is masked to diet assignment. Then a third statistician reviews his analysis and writes a report to either disagree or confirm. This is. And of course, I have no contact with the data.

Right.

I just designed the study and my postdocs write the manuscript. They write the first draft, we give them Feedback and we disclose on all the manuscripts, you know, the websites, the courses I teach, blah, blah, blah, and, you know, the diets that I follow. So we try to be as transparent as possible with the university, as transparent as possible with the publications and that. We have three statisticians on the study now, fortunately, my postdocs can act as a statistician and do the data cleaning and then we have two senior statisticians that do the analysis and then the overview of the analysis.

Got it, yeah. So you've got a robust institutional team.

There, which is to make sure. To make sure that what we're doing is fair and honest.

Yeah, yeah. And good research. Right?

And good research, yeah.

What I recently saw you give give a lecture on modified citrus pectin. Is this something that you. You've been.

So there's a compound called galectin 3 that can make a polymer and that is part of a biofilm that can lead to damage in our tissues, damage in the gut, microbiome. And modified citrus pectin is a. You might think of it as a cleaner that can wash away the Galectin 3 biofilms. It has some really nice research in the setting of cancer. It has good research in the setting of microbiome problems. And for people with autoimmunity, microbiome problems drive the disease process.

Got it. So. And that would be at the heart of multiple sclerosis.

It's at the heart of Ms. And if you think of the systemic autoimmune conditions, lupus, ra, inflammatory bowel disease, there's often a component of severe fatigue, of anxiety, depression, some brain fog. These are neuroimmune symptoms. And I would say most of our autoimmune diseases will have some component of neuroimmune symptoms. So Ms. Is the one that we classically think about.

Yeah.

But you know, we have 3 million people with Hashimoto's who have cognitive issues. Yeah, all of those people have. Are having neuroimmune symptoms for sure.

Is there any concern with it kind of leeching out beneficial minerals or vitamins or. It's really specific to biofilms or modulation?

Well, I'd say it's really specific towards biofilms. I think this is probably much safer than clay zeaxite. And so for detox support, I really like this. For microbiome support, I really like this.

Love it. And is there anything linking it with mycotoxins or beneficial use there?

I've not used it myself. The study of mycotoxins, although anticipate that it would be helpful because I know the lime stocks will use a lot of Pectisol or the modified Citrus pectus for lime. So I am thinking the people who are treating mold likewise are probably using it there as well. Yeah.

Well this has been awesome as per usual with you. Any any action items for folks that have made it to the end of the interview today?

Well, the first thing is please screen for our clinical trial and be part of at least our database for future trials. We also have studies that are involving cancer related fatigue, fibromyalgia and long Covid. And Dr. Greg, I'll make sure you have those links. And those studies are all virtual so you don't have to come to Iowa. You can you still have to be a Canadian American or Mexican, but you can participate virtually. So please be part of those studies as well.

Awesome. Well Dr. Walls, it's always a pleasure. Thank you so much you all, viewers and listeners of what the health. If you got something out of today's show, please go out, give us a five star review and put down what you're going to take. What are you sharing with others? This is where the information comes from. That's what we have. This platform is for you. Yes, you listening right there. So thanks for tuning in and we'll see you real soon.