How To REVERSE Autoimmune Disease & MS With Functional Medicine! | Terry Wahls & Mark Hyman

This is not an MS treatment. This is a health treatment.

I can bike, I can hike, I'm pain free, and I do really very well.

People can get better from all sorts of things when they change their diet.

You don't need to be hungry, but you're not eating junk.

So, Tara, you went from like reclining wheelchair to riding your bike 20 miles a day. How many people see that level of change?

You know, in terms of the whole population? I don't know, Mark.

Are you seeing cases like yours where people are recovering or?

Yeah, yeah, I am. So one of the individuals in our study, Dawn, she was using a cane for short distances, walker for long distances. She had severe fatigue. She was making arrangements to sell her home, move to assisted living because Her son was finishing grad school and she knew she couldn't manage once he moved out. She enrolled in our study.

Wow.

And she was struggling driving 15 minutes to work. Okay. So by the time the study ended, her son graduate, moves out, and we followed people for three years, by the way. So at that point, she's taking her dog hiking for miles. she's doing Pilates and weightlifting. She doesn't really like jogging, so she didn't take up jogging, although she can run. And her son's moved six hours away and she's comfortable driving to see him. I saw it done before the pandemic when I was out giving some lectures in the community. So it was 2019. And, you know, she looks great.

That's incredible.

And, you know, so she's still working. She would have been disabled and unemployed. Another patient from our study, again, that I saw in 2019, with primary progressive MS. Again, primary progressive MS, when she enrolled with us, she needed bilateral support to walking six. She had profound fatigue. Her score was 6.7 on a seven-point scale.

Wow, that's pretty bad.

So profoundly bad. So she's walking comfortably now. And, you know, so we enrolled her in 2010. So now it's nine years later when I saw her, she's walking, doing well. She is in a band, a geriatric band that she plays in.

Wow.

Yeah, so it's very fun at my talk. She stands up like a revival. And she's telling everyone in the audience about her experience in the study and how transformative eating the study is. And then here's the other interesting thing that she also noted, Mark, is that she's telling the audience that if I stop the Wall's protocol, I'm exhausted and I can't walk.

It gets worse again.

It gets worse. So she can tell within 24 hours, if she's backing off on the diet.

So basically this approach seems to put it in remission, but it doesn't cure it. Is that it?

Well, I don't think anyone with the chronic disease is ever cured. We control it, we restore physiology, we can improve our health. But if I came to your house and had gluten, dairy, and eggs, my trigeminal neurology would turn on within 24 hours. So I would have incapacitating pain.

Technically you're cured if you don't eat that stuff. Let's say if you're diabetic, your A1C is perfect, but you know, if you eat sugar, it goes up. Well, yeah, I guess maybe somebody else wouldn't.

So you always have the tendency toward it. So I'm very careful to not claim cure, but I'm careful to say I'm very well managed as long as I take care of myself following the Wells protocol. You know, I can bike, I can hike, I'm pain free. and I do really very well. And that is true for all of us who have, whether it's anxiety, depression, diabetes, insulin resistance, as long as we are managing our diet and lifestyle, we can have a rich, full life, relatively normal physiology, no evidence of disease, and do great. But if I think I can go back to that previous diet and lifestyle and not get sick. That's incorrect. Right, I agree.

It's like, I have this patient once who was diabetic and I told him what to do and he did blood sugar went to normal. He says, Dr. Hyman, now my blood sugar is normal. Can I go back to eating my carbohydrates? I'm like, no, you can't. In terms of the autoimmune in general issue for people, do you suggest they just try the Walsh Protocol? Is there another strategy you'd have for them?

So I want to figure out where they're at. I want them to know what they want their health for. So we deal with the mental, emotional, spiritual, and then we have them start with the walls protocol. And I stress this is a family intervention. So it's a negotiation. What is the family willing to do and to do all of this together? And, you know, depending on the circumstance, I might put them on the walls elimination diet. I might. run them through food sensitivity testing so we can be very precise. Or they may need to start at the Mediterranean diet because that's all the family is willing to do. So there's a clear negotiationist. What are you willing to do? Because whatever the intervention is, I want it to be a hundred percent. Doing the walls diet at 50% is not very helpful.

Yeah, cut down from six diet Cokes to three a day, right?

Doing the Mediterranean diet a hundred percent. is better than doing the wall side at 50. So I want, I want to have a negotiation. What can we do 100? And for, you know, and in my VA practice, sometimes what we had to start was meditation because people had to start, we had to find a lifestyle intervention that they could do 100. And when they mastered that, then we could begin adding the next layer and the next layer and the next layer.

Amazing. Let's shift a little bit because we've been talking about a multiple sclerosis and your latest book is really about the autoimmune spectrum, not just MS, which is part of that. So why is this effective for that? And what are the things that people can do if they have an autoimmune disease?

I want to get back to, so why do we develop an autoimmune process? Why does my innate immune system get overly activated? Why do I begin to develop autoantibodies against specific structures in my body? And so there's only a few basic reasons why that's going to happen. If I don't, if I have an autoimmune disease and I take disease modifying drugs, but I don't address the root causes that led to the autoimmune process, people will develop another autoimmune diagnosis, right, about every five to 10 years. And so, and I certainly see that, you know, in my tribe, people come in, they see me, and they've had several autoimmune diagnoses. And as I work with them, they get better control of all of their conditions. So, so because the Walsh Protocol, while I designed it obviously for myself and it's focused a lot on the brain, it addresses the root causes of why these autoimmune processes are developing. It helps psoriasis, inflammatory bowel disease, rheumatoid arthritis, allergies, asthma, myasthenia gravis, MS.

You.

Know, and frankly, people reach out to me, tell me that they have, you know, a disease that I have to look up because I've never heard of it.

I.

And their Physicians had given up hope, and they had stumbled on my work, implemented my work, and are steadily improving.

Yeah.

And I've also had people with genetic disorders, muscular dystrophy, for example.

Yeah. Tell us about that.

Who, you know, found my work. It actually has been coming to my seminar since the very first one. And he talks about, yep, he still has muscular dystrophy, but he's far more functional since implementing the Wahl's protocol, and he's not getting worse.

I think it's important to understand from people that, you know, that people can get better from all sorts of things when they change their diet. And you know, I've seen this across the spectrum in my practice. So what you're speaking to is such an important fundamental principle.

People with cystic fibrosis, people with Charcot Marie Tooth disease.

Yeah.

It makes a lot of sense that if you have the standard American diet, standard American lifestyle, you're going to accelerate the damage from those genetic diseases. If we help you address diet and lifestyle, gentle hormesis, you will have the best quality of life and best to function given your genetic circumstances.

I think that's right. I mean, Terry, I think we think of Down syndrome or cystic fibrosis or muscular dystrophy as these intractable progressive conditions which are autosomal dominant inherited conditions that you can't really modify or change. If you have a gene that affects folate metabolism or vitamin D metabolism, you can modify these are called mild, you know, single-nucleotide polymorphisms are just slight variations in our genes. They're not mutations. These are mutations and they profoundly change your biology. But what I found again, like you, just observation in my practice is I've had many patients like this. So, I don't know, let's see if we can help you. Let's do this. Let's look and see under the hood what's going on. What's often amazing is they have the worst metabolic health you can imagine. Their metabolic and biochemical pathways are all messed up and haywire that there are certain sort of you know, functional things that go wrong that you can modify through understanding the biology of the disease. And whether it's a mass, whether it's, or whether, I mean, sorry, whether it's a muscular dystrophy, whether there's, you know, mitochondrial issues, or whether there's, you know, whether there's, you know, Down syndrome, whether it's huge insulin resistance and inflammatory Pathways and methylation problems, you can really impact them by changing their diet, by certain types of supplementation. And it was striking to me to see that, you know, where people can have really dramatically improved quality of life.

You're not curing Down syndrome or muscular dystrophy, but you are modifying the course of the the disease and you're actually.

Improving their overall health and quality of life.

Absolutely. Absolutely. Yeah, I spent a lot of time trying to tell people the goal is to have the best function that we can for you. And the way to do that is nutrition, sleep, stress management, and consistent gentle hormesis.

Absolutely. Absolutely. For people don't understand autoimmunity, as a single you know, entity like MS or colitis or Crohn's or Hashimoto's, you know, it's common, but it doesn't add up to massive numbers when we look at it all together. So when you look at all autoimmune diseases together, it's 80 million people, which is more than people almost that have cancer, heart disease, and diabetes combined. Okay, there's a lot of people. And the question for you today, Terry, to start with is, you know, how has your thinking changed since we last talked? How has your regimen changed? Do you incorporate the same principles? Are you adding new things? What's different about your approach now?

We're adding new things. I also have learned just how critical it is to deal with the mental, emotional, spiritual so that people are willing to do the work. Creating new habits, creating new daily practices, It takes effort. And for people to go on this journey with me, I need to spend more time on that mental, emotional, spiritual side. So I spend more time there. And then yes, we have created this really wonderful robust process mark, the Walls Behavior Change Model that actually has 15, 16 steps to help people make these changes. step by achievable step. And we personalize the diet and lifestyle recommendations to match what they're willing and ready to do.

That's amazing. And Terri, what have you noticed about your own health? Working with us over the last, I don't know how many years it is now, over a decade, right?

Yeah.

What have you learned? What has changed? What are things have you changed in your own routine?

Well, you know, I spend a lot more time thinking about hormesis, so that mild to moderate stress. And I do it in a wide variety of ways. I do temperature hormesis.

So talk about hormesis. What is that?

So hormesis is a time where you have a mild to moderate stress on your physiology covered by, followed by sufficient time for your physiology to repair, get back to homeostasis and rebuild itself. so this is why strength training is so powerful. This is why high intensity interval training can be powerful. But you have to allow enough time to fully recover. It's also why temperature training is so powerful. So I take saunas probably six to seven days a week and I'll take them up to, and now this will shock your listeners. I could take a sauna up to 125 degrees comfortably, 140 degrees comfortably. even 160. But then, of course, I follow that with a cold shower. And I do cold showers in for five minutes. And in the evenings, I'll do an ice bath.

Ah, sounds fun.

Yeah. So, you know, it's a relaxing way.

To go to bed. Just jump in an ice bath.

You know, and what's interesting, Mark, is you do that ice bath. Yeah, it is the fastest way to fall asleep. I have the deepest sleep on the days that I do an ice bath. Really?

And you don't follow it like a warm thing. And before you go to bed, you get in bed freezing.

I get in bed freezing. But, you know, my, my wife does complain about the cold legs.

Well, you're saying it's kind of heresy in some ways because we always learn with multiple sclerosis that you never put people in a sauna. You avoid the heat. It's really bad for them.

Right.

Well, that, and then it's better to.

Fall asleep with a hot bath. So you need to very gradually increase your temperature stress. So many people with serious autoimmune conditions have difficulty with autonomic dysfunction. And they'll have a lot of difficulty with temperature hormesis. So they'll have to come at this very, very slowly. And as they heal and recover, lower their inflammation, and lower the inflammation in their brain, they'll find that they can increase their temperature hormesis. And so we start with a room temperature bath and a slightly cooler bath or slightly warmer bath and gradually expand the temperature with which they can tolerate. But absolutely, you can't put people immediately into a cold shower or an ice bath. or immediately into a sauna if they have a neuroimmune condition, they will not tolerate it.

Yeah, but after over time they can use the same for you now. Yeah, I think it's interesting. You know, we talk about hormesis. It's not a concept that most doctors know about, most people know about. I certainly hadn't heard about it until the last decade or so. And essentially what you're talking about is a stress to the body. It's sort of like what doesn't kill you makes you stronger, which is how intermittent fasting works or prolonged fasting or exercise. When you exercise, you're creating a stress to the body. Those actually help sort of cause a trauma or a stress, which then creates a healing response in the body. And that's what you're.

As long, as long as you have sufficient time to fully recover, you know, and for years when I was an athlete, you know, because I, I did long distance running. I did martial arts. I did not spend enough time in recovery, so. and many athletes do this. We train so hard, we don't spend sufficient time in recovery. And actually, we probably would have made faster gains if we would pay a lot more attention to recovery as well.

What does recovery look like?

So in my patients, we talk a lot about this that I want them to have their stress of their exercise or their temperature stress, but then they have to have a sufficient duration of the recovery before they can go back to that stress again. So many of my patients, you know, they're severely disabled. So for them, a two-minute exercise may be all they can do and still function for the rest of the day. And so We discuss, you do the gentle exercise and can you function normally later in the day? How long does it take for you to recover? And then gradually increase their exercise.

Interesting. Now, Terry, you know, we talk a lot about the food is medicine. We're going to get into that a little bit more, but you sort of touched on it a little bit about stress and how that played a role, particularly in your case of getting MS. Can you talk more about that and the stress of medical school? and what happened to you?

Well, you know, my trigeminal neuralgia began during medical school. And yet, looking back, you know, I grew up on a farm, physically very active, lots of vitamin D, probably really a very good diet. Went into medical school, became a vegetarian, went very low fat, was no longer outside. So my vitamin D levels plummeted. I was certainly not taking supplements. I was not sleeping at night very much. We certainly had enormous amounts of stress in going through those clinical rotations. It was during my third year of medical school that I started getting my facial pains, the zingers, as I call them. And I would have them for the next 20 years. And they were gradually getting worse. and, you know, that was during my clinical practice. I was very ambitious. I I was in a physician leadership again, a high stress job. My zingers were getting worse. And then I developed motor symptoms and had weakness in my left legs.

Wow. And the stress.

Clearly, stress was. Was. Was always there and was a big driver. that was happening just before the onset of my zingers. And then I had a transient episode of dim vision in my left eye. Again, that was associated with stress. And I had some severe work stress just before the onset of my left leg weakness.

And so you feel like how have you dealt with stress in a different way and how has that helped you with your MS?

It's interesting. During college, I learned how to do transcendental meditation. and during medical school, I quit that. And, you know, when I was diagnosed with MS, even though I knew that stress was a big factor, I did not go back to meditation. Oh, it was not until, you know, as in the wheelchair, I went back to reading the basic science. I was working on my diet again, discovered functional medicine. And then it's like, you know, I got to do everything. and that's when I went back to meditation. I thoughtfully redesigned my paleo diet. I discovered electrical stimulation. And I think it was the combination of doing all of that.

Yeah.

And so now my. My routine, Marcus, I get up in the morning, I do my meditations, then I'll do my exercise. then I do my sauna, then I do my cold shower. In that routine.

In the morning. How long does that take you?

It takes me about two hours to do all of that. And I, you know, I learned to put that in my schedule. And then in the evening, most evenings, I will again do a round of meditation and a ice bath.

Wow.

Yeah.

So you don't do a hot bath first, you just do the ice bath alone?

I do an ice bath.

That's brave. I like to do a sauna first. Yeah.

And sometimes saunas, they're really very nice. But you know, the reason I keep going back to the ice bath is the quality of my sleep is better.

Oh, really? Wow. I'm gonna try that. So you just get in a cold bath and how long do you stay there?

Well, I set my timer and I read for 20 minutes.

20 minutes, but not like ice bath.

So when you first start doing this, Mark, I just do a cool bath. And then after you've done that for a few days, just run only cold water, do a cold bath. And then, so now you're comfortable with the cold bath, then you have a bucket of ice. So you're in your bathtub with the cold bath. you dump your ice in, and then I'll freeze solid, you know, liter bottles of ice. So I have, because that keeps the ice longer when it's solid.

So do you use the Wim Hof breathing method? How do you get ready for going on the ice?

Yeah, I'll do a cycle of the deep breathing, and I just get in it. After you do it for a while, It's really very comfortable. I step in, I let my feet get used to it, then I settle down into the bath and grab my book and I start reading.

Wow. Okay, then I'm gonna try that. Maybe. I'm gonna try. I like the ice bath after the sauna. And 20 minutes is a long time. It's a long time.

Well, you get comfortable really quite quickly. you know, I, I quit, but, you know, the quality of my sleep is so much better when I do the cold bath, the ice bath. Yeah. So I end up going back to it. All right.

I want to switch topics a little bit because it's fascinating to hear all your conversation about harmesis and these various practices that help enhance your health. And I think there's a lot of those, whether it's hot and cold stresses, whether it's exercise, whether it's fasting, whether it's things like ozone or hyperbaric oxygen, these are all hormetic therapies. And there's, there's really cool machines in, in Europe they use for mitochondrial resuscitation, where they'll basically bring your oxygen level that to that would be if you were climbing Mount Everest, keep you up at that low oxygen level for a while, and then bring you back down to sea level. And that oxygen deprivation creates a stress that reboots your mitochondria. So there's a lot of ways to actually to do this. And it's really pretty, it's pretty amazing to see what happens to your body when you get a little stressed. It actually does so much better. Now let's talk about the research, because one of the arguments around functional medicine is that there's no evidence, it's lack of evidence, it's not evidence based, blah-blah-blah-blah-blah-blah, you know? You know, I mean, you know, your case alone should be written up as a, you know, medical miracle that I understand, but like it should be, it should be every neurologic society, every neurologist, it should be thinking, how did this happen? What's going on? The NIH should be spending billions of dollars funding research like this. And you're having to scrounge around from here and there. And, you know, even, you know, the MS Society first, you know, kind of shunned you and banned you. And now they ask you to speak and now they want your help. So you've done a lot of the hard work around the research. So let's talk about the clinical trials that you've done, what you've learned, what you've found, and what they've shown. Because your approach, and maybe for those who are just listening to this podcast for the first time, let's just sort of back up and go, what is the wolf's protocol? What is the concept of the diet? Why are the principles of the diet used in the way they are?

And what are the key take-homes around that? And then let's get into the research of how this works. So first we'll talk about the dietary approach. So the way you might think about it, and when I talk to the public is sort of a pre-walls diet is a Mediterranean diet, which everyone agrees is a great diet. More vegetables, legumes, more fish. So nice, healthy diet. And then the first level of my diet, we have people stress. And the goal is nine cups of vegetables, three cups of greens, three cups of sulfur rich vegetables. in the cabbage, onion, mushroom family, and three cups of deeply colored things like beets, carrots, berries. And then I want them to remove gluten, casein, and eggs because they're the three most common food antigens that can cause an excessive immune response.

No more waffles.

No more waffles.

You actually know what? I make cashew waffles. I make all kinds of great things. You can kind of cheat.

There are things you can do. So that's the first level. And you can do that as a vegetarian. And that is fairly close to a gluten-free, dairy-free version of a Mediterranean diet. Then the next level becomes more paleolithic. So we reduce the gluten-free grains and legumes to no more than two servings a week. We add in and stress organ meats, seaweeds, if you're going to have nuts and seeds, we suggest that you have them soaked and sprouted. Why organ meats?

Why organ meats? Because, you know, organ meats are something people avoid, right? Liver, kidneys, thymus. Yeah, well, they don't know how to make them.

They're actually delicious.

It seems like the poor man's food, you know, kidney steak and kidney pie and all that stuff. Yeah, yeah. What, what, what's the rationale for the, the organ meats?

Well, First off, our ancestors would have eaten those. They're a third of the carcass when you harvest an animal. So it would have been an essential part of the diet. And interestingly enough, if there was plenty of meat, they left the muscle meat behind and took the organs. So the liver, great source of vitamin A and the fat-soluble vitamins is so A, K, a moderate source of E, a great source of B vitamins, a great source of minerals that are very easily absorbed as opposed to the minerals in plants, which are a little more difficult for us to absorb. And then great source of coenzyme Q, creatine, so really, really marvelous nutrition for us.

And a lot of those are mitochondrial nutrients, right?

They are mitochondrial nutrients.

And which is important for healthy aging. Terry, it's interesting because if you look at, I've done this where you Google like liver nutrition facts, right? And then like, and then the nutrition facts for the most amazing vegetable you could possibly imagine or grain or bean. And it just, it's like, it's like Michael Jordan's high school basketball. It's like, it's that big of a difference. It's shocking. It's like not just a little bit. It's like three, four, five, 10 orders of magnitude more nutrients in liver than in almost any other food.

Correct. Correct. Absolutely. Which is- Liver is absolutely a superfood. The one nutrient it does not have is vitamin C. That's all right. So that's a good reason to eat your salads and your berries to get the vitamin C. Now, the caveat I'll have is for my carnivore friends who eat only meat, I have to caution them to be careful about how much liver they have because you don't want to overdose on vitamin A. So, liver is really great for you, six to eight ounces a week. So that's, you know, up to a half pound of liver a week.

And for the first, you know, the First Nation people in up in Alaska and everywhere, they actually would give it to the explorers because they wanted to kill them. So they give them polar bear liver. They literally die. It's not from vitamin A poisoning.

So liver is really great. It is our family's favorite dish.

So.

My family makes liver for me on my birthday because they know it's a special meal for us. We just really love that a lot.

For me, it was a poor man's meal because we were very poor in New York City when I lived as a kid with my mom and we lived in this tiny one-bedroom apartment and we'd have liver and onions and rice. And I thought that was like a fancy meal, chicken livers. I didn't realize it was like cause we're poor.

Well, you know, and it is actually quite handy because it is relatively inexpensive. You can get organic liver very inexpensively because the market doesn't understand how valuable that nutrition is. Another really great organ meat, of course, is heart. Heart is sort of like filet mignon. That is just so delicious, incredibly delicious. And then, you know, oysters, clams, mussels. those are all organ meats.

Oh, really?

Quite delicious.

What about the liver toxicity of liver? Because oh, liver is not with the waste basket of the body where the toxins go, isn't it bad to eat that?

So where the toxins go is really the fat of the animal. So people like bacon. So if you're worried about toxicities, be sure that your bacon is organic. If you're concerned about Liver is fatty. Liver is fatty. I would certainly have it be organic. And I think that is prudent. My preference is, you know, have liver, get it from organic animal.

So, Terry, just to summarize the dietary principles, it's getting rid of gluten, dairy, and eggs. Getting rid of grains and beans. It's getting rid of, obviously, all processed food, sugar, alcohol. Processed sugars, more vegetables, more, lots more vegetables. And tell us about your like nine cups of vegetables and the different kinds of vegetable categories.

Yeah.

Because I think it's really important to help you understand it's not just any vegetable that you need. You need vegetables that contain certain compounds.

Which are medicines for your body. So, we want to have lots of greens. Greens are a great source of carotenoids, lutein, zeaxanthin, mimosaxanthin. These are essential nutrients for your retina and also for your brain. because your eyes are really just extensions of brains. They'll reduce the risk of master degeneration of cataracts and dementia. You're also going to get a great source of vitamin K. And in neuroimmune conditions, MS, in cognitive decline, there's a severe in epidemiologic studies, the vitamin K levels are extraordinarily low in those population groups. So lots of reasons to get your greens. Now we're going to go on to why I want you to have cabbage, onion, mushrooms. So the sulfurs, really great support for your detox, great support for making glutathione, intracellular antioxidants, great support for your mitochondria.

Also, that's the broccoli family.

In the onion family.

Yes.

Also good for your blood vessel endothelial function. And then mushrooms. They're a wide variety of mushrooms that stimulate your natural killer cells, priming your adaptive and innate immunity. They also are associated with better nerve growth factor production in animal models and in human studies associated with much lower rates of cognitive decline in depression. Wow.

Well, I feel good about taking my mushroom powders every morning.

So take your mushrooms. I have mushrooms in my tea every day.

So amazing. Lots of reasons to have your mushrooms.

Okay, so that's the food part. Now you've taken the. No, no, you didn't get the colors yet.

So the color, you know, three cups of colors. And I want to have a wide. Okay, wait, wait, before you go, before you go on. So the government says five to nine servings.

A serving is half a cup.

You're talking about not five to nine. You're talking about 18 cups. just so people get the idea.

No, 9 cups.

18 servings. 9 cups, 18 servings. Right.

And I'm not trying to have you eat more than what your appetite will allow you. The point I'm trying to have you do is you eat some of your protein and we have strategies for vegetarians or meat eaters, and you eat lots of vegetables. You don't need to be hungry, but you're not eating junk. When you're hungry, you're eating these vegetables and we want to have sufficient protein and lots of vegetables. Now, when you do that, you're going to poop. People, and of course we have to make modifications for people who have inflammatory bowel disease who can't have as much fiber. So when we talk about this Mark, this is for the public. this is for what you start, and then you assess your response. And if you're having loose stools, you're going to have less fiber. If you're still constipation, more fiber, more fermented foods, more sauerkraut than kimchi.

Right. So that's the food part. Now you've taken this along with the lifestyle aspects and the stress and the exercise and muscle stimulation and hot and cold therapies and all these other modalities and you, you know, You've studied them. And one of the challenges for traditional medicine is that when we look at research, we like to study one thing. Let's study this drug for this disease in this patient. And- One molecular pathway at a time. Yeah, it's like, it's like, I was talking to a doctor or scientist about dementia and say, look, these patients in dementia is a syndrome. There's many causes for it. It could be the microbiome, it could be gluten, it could be toxins, it could be lime, it could be mold, it could be insulin resistance, and it could, you know, it could be a lot of- All of them. Right. And so it's all the more could be nutritional deficiencies or hormonal imbalances and all these things. And I said, you know, what's going on is that these patients need to support all these things in order to get better. And she says, well, let's just study one thing. I'm like, let's see if diet is important to eat. It's important to exercise. It's important to sleep right. It's important to, you know, to deal with stress. Are you saying we just study exercise but not diet and the rest? It just doesn't make any sense. It's like, let's just, let's just see if we can grow a plant by just giving it nitrogen. We won't get phosphorus, potassium, we won't get water, we won't give sunlight, we won't have a healthy soil, but we're just going to give it potassium and see if the plant can grow. Like it just doesn't make any, it doesn't make any sense. So you, you've been so pioneering and creating these multimodal interventions somehow where you look at multiple interventions and, and they pass by the review boards for the research and they're actually clinically far more.

Effective than anything we've seen for MS and, and these chronic. So autoimmune neurologic issues. I have a really unique reason I'm able to do this, Mark. So I was on the institutional review board for the University of Iowa for years before I became disabled. So they watched me become profoundly disabled and then recover, you know, walk and bike. I'm still on the institutional review board. And so when I came with my first protocol, Actually, the review board declined.

What?

Rejected the protocol. And the reason ultimately this all got to happen, the Dean of the College of Medicine called the head of the Institutional Review Board and said, I really want Terry's study to get approved, so work with her to meet whatever concerns you have, so she can do her little study because I want her to do that little single arm safety and feasibility study. So then the head of the IRB called me, arranged for me to meet with the Pharmacy and Therapeutics Committee because they were worried about the supplements. And then I, so we addressed the supplements. We had a pretty strict exclusionary criteria. We had to do a bunch of safety labs. so we got that part worked out. Then they were worried about the diet, this crazy diet, because it was, you know, excluding food groups, and nobody could follow this diet. So then I had to do a pre-study, and fortunately we had someone following the diet. That was me, so they analyzed my diet. And when the dietician analyzed my diet, she said, and she had done dietary analyses research for about 30 years. She goes, you know, I have never analyzed a diet that was this nutrient dense in all of my years of research.

Amazing.

So we got approval and we're able to do our little study. And now the people we enrolled had Progressive MS, secondary progressive, prime progressive. They were using canes and walkers. They had severe fatigue. Nobody with cognitive decline got in because we excluded those folks. We asked them to abandon, and they were having like five servings of gluten, dairy, and eggs every day, one and a half servings of vegetables a day. So really a standard American diet, no exercise, they're exhausted. At the end of 12 months, they're having on average eight cups of vegetables a day.

Wow.

So dramatic change. And they had a subservient, and they were fully compliant with their diet 90% of the days. And then on the exercise, doing the exercise and the Eastim every day, 75% of the days they had done their exercise in Eastim.

Wow.

The average meditation minutes, I think was 7.6 minutes per day and the self-massage was 3.6 minutes per day. So these exhausted people did remarkably well with this complicated multimodal intervention. It's impressive.

It's impressive.

Now the other reason I'm able to do my crazy research, Mark is, I'm not getting funded by the NIH.

I mean, they won't fund you.

They won't fund you. We write grants, we get scathing reviews, we just got another grant back scathing reviews and we'll revise.

Negative.

Negative. Yeah, negative.

Why? What are they saying? Well.

You know, the reviewers clearly have a pharmaceutical point of view. They didn't think people could do the diets. The Swank and the walls diets were too unpalatable. People wouldn't follow the diet. They thought it was unrealistic that we're going to follow people for two years. Why are we doing MRIs? Because you need drugs to have a favorable impact.

Oh, my God. But crazy.

Okay, so. So we have. We have that challenge now. the benefit I have, Marcus, because my work has been actually effective at transforming people's lives. We've transformed the lives of people who are cold calling the university saying, I believe in what Dr. Walls is doing. I'd like to support her research.

It's a fund to fund you.

They say fund our research. And so that's how I That's how I funded the first study, the Safety and Feasibility Study. It was a group out of Canada, founded by Ashton Embry and his wife, Joan. They gave us the funds for that first small pilot study. And we had a PhD student that helped me run that study. And the university and the VA gave me time, which of course is hard to get. to run the study.

So what did the study find?

Well, that was that very first study, which we showed that people could radically change their diet. They could do the meditation, the exercise, and the fatigue severity. And on fatigue severity scale score goes from seven to one, seven total fatigue in every aspect of your life. One, no fatigue. It dropped 2.38. points and 0.45 is clinically meaningful. So that's a huge drop. And the anxiety remarkably went down. Depression remarkably went down. Verbal memory, non-verbal memory and performance went remarkably up. And half of our folks had improvements in their 25-foot walking time. For Progressive MS, when you anticipate a 20% decline per year, if we, as a group, we held them flat. So as a group, that was remarkably-.

They didn't get worse, which normally they do. That's why it's called Progressive, right?

Yeah, that's why they call it Progressive.

Right.

So that's very exciting stuff.

So that was the first study that people could tolerate it, they would do it, and then they didn't get worse and they often got better. and had a reduction in fatigue. What were the next follow-up studies you did and what did they show?

So the next study was a small study again, funded by our donors. And now we just did the diet. It was randomized, a relapsing-remitting study. And in 12 weeks, so shorter duration, so it's less costly to run, people again could radically change their diet. Fatigue went down, quality of life went remarkably up, and the speed, what you could do a 25-foot walk, remarkably improved. And the hand function also improved compared to the control group.

So you just got a $2 million gift to support your study on the sort of clinically isolated syndrome and relapsing remitting MS. So talk about that.

Yeah, that was a very exciting study. We're about to launch that just before the pandemic. We're going to have newly diagnosed MS clinical isolated syndrome folks, baseline assessments, baseline MRIs, basically give them the Walls protocol and have monthly support calls, bring them back in a year, repeat all the assessments. including the MRIs. And then the pandemic happened. Unfortunately, we had not started our study. So we had to redesign everything and reimagine the study. So the study is now a virtual study and it has three arms. Again, newly diagnosed, folks who have been offered drugs and have declined drugs. And we basically put them on the Wahl's diet, a stress reduction program, and an exercise program. And we do virtual assessments every three months, monthly support calls. Then the control arm are folks who are again newly diagnosed and are taking disease modifying therapy. and they can have whatever diet and lifestyle interventions that they want. And then the third arm, we said that we need a third arm now because we can't get the MRIs the way we hoped. What we're doing is we're abstracting the medical records here at the University of Iowa of newly diagnosed folks with MS and clinical isolated syndrome. And we are counting in everyone from their medical records, their number of lesions, the number of relapses, and the progression of symptoms or remission of symptoms during that time period. So we will probably have it'll probably be another eight months, eight months of data collection, and then we will analyze our data.

So, you know, with MS, there's often white matter changes in the brain. In other words, there's scarring in the brain that you can see on an MRI. Do you see changes in that as well?

We're going to find out. I do know that in our intervention arm, we do have some folks who are having more relapses who have elected to go on drugs. We are also having some folks who have had their follow-up MRIs and lesions have disappeared, and they're not having relapses. and their neurologists are like, wow, this is really amazing. We'll see what happens at the end. Certainly the vast majority of folks in our intervention arm are reporting symptoms are going down, their motor problems are reduced, their sensory problems are reduced, Vision is improving.

Impressive, impressive. So how is this research being received now? What's different about it? Because it seems like you hit a lot of resistance at the beginning. MS Society wouldn't even talk to you. You're a quack. And now they're wanting to talk to you, work with you. What are you seeing?

Why all this was happening? I think the TED Talk went viral. I got a book deal. The book was a bestseller. The MS Society monitors social media. and they saw that when my book came out, all of the attention, which led them to prioritize and create a wellness conference. And they actually tracked me down and got me to the wellness conference. I was one of the scientists there.

That's amazing.

And then they made a priority to fund dietary and lifestyle research and funded our really the wave study. So that one was funded by the MS Society.

So great, Terry. And the work you're doing is so important and putting the foundation of research behind it and showing the efficacy. And I think, have you seen your neurological colleagues who specialize in MS start to change at all what they're doing? Have a different view? Are they still stuck in the diet doesn't matter? Like where are we at?

Well, we're sort of making a lot more progress. There's more research that the microbiome is altered. There are more people doing dietary intervention studies. Now we have some small studies about calorie restriction, fasting, ketogenic diets, the paleolithic diet, Mediterranean diet, Swank diet, McDougall diet. So all these small studies. Our WAVE study is the largest study to date. We have a protocol in front of the IRB. for a couple more studies that I'm really excited about. One is a study of the online program that I run. So we're going to evaluate the dietary intake and whether or not that is associated with changes in quality of life and fatigue. So that's going to be very, very exciting because if an online program can do those things, and that makes this available to everyone. And then we have plans for another study, a big study, Wahls Diet, ketogenic diet, dietary guidelines that will include MRIs at baseline and at two years. And that will be a study funded by a, again, a very generous donor.

It's amazing though, you think this should be something funded by the NIH, right? This should be funding by the government. And now we're having private donors doing it, which is fine, but it's unfortunate that you can get millions and billions of dollars to study drugs, but you can't get five cents to study lifestyle or nutrition.

And that's because this dedication to thinking we can understand biology, molecular pathway by molecular pathway, But biology is a network of balancing and counterbalancing pathways. Absolutely.

And I think if we're going to.

Create health, we have to study complex systems and you have to support the entire system. That's right. I mean, that's what functional medicine is.

It's treating the system, not the individual symptoms or diseases. And then when you do that- It's the only way to create health. I mean, you're not actually treating MS. You're just creating a healthy person by getting them off crappy food, getting real diet, get an exercise, reduce stress, sleep better, take a few supplements, optimize your pathways, metabolic pathways. I mean, you're not really treating MS specifically, right? Correct. And that's what people don't realize. This is not an MS treatment. This is a health treatment. And for anybody with an autoimmune disease, it's going to be a very powerful model.

You know, when I first had my recovery, my partner started complaining. about what I was doing, and I got called in. They had to speak with the chief of staff and the chief of medicine at the university. And then I got sent to the complementary alternative medicine clinic, and my chief of medicine sat me down and said, Terry, you got to talk about it differently because you're making people upset. And what I learned in the way I shifted my conversation mark, was that I told my patients that we're going to monitor your drugs and your disease, but we're going to focus on supporting your, how your cells run the chemistry of life. And we'll just watch, see if I have to adjust your medicines if you run the chemistry of life a little bit better. And so we're going to do it through diet and lifestyle. And that's what I documented in the chart that I'm supporting their health, and then we will watch for side effects on their medicines.

Yeah.

So I had to learn how to talk about in a way that was more comfortable for people and to make sure that people did not think I was treating disease, that I was working on creating better health.

That's why we say, you know, functional medicine is a science in creating health, and disease goes away as a side effect.

That is exactly right. And what we're simply doing is monitoring the drugs to be sure people are not over medicated. Oh, exactly.

Right. I had a huge problem when I wrote my book, Blood Sugar Solution, because people started following the book and it was a number one bestseller and people were following the program and we're getting all these calls. My blood pressure's too low. My blood sugar's too low. I'm like, yeah, you don't need your medication. So I had to put in a big warning. It says, if you're on medication, this program can be dangerous because it will prevent you from needing those medications. And if you're taking them, your blood sugar and your blood pressure are going to go too low, so you need.

To taper off them with your doctor.

Yeah. Yeah.

So we did that as well. We put all these warnings in my, in my reprints in the book to say you gotta, if you're on meds, you have to work closely with your doc because you may need to read steadily.

Exactly. So let's switch topics a little bit. I want to talk about the microbiome. You mentioned it briefly, but I remember years ago, even 20 years ago, I had an MS patient. she said to me, Dr. Hyman, well, I have irritable bowel. And whenever my irritable bowel gets bad, my MS gets better. My irritable bowel is better. My MS is better. And I was like, oh, noted, noted. Like I, when patients say that stuff to me, I pay attention. And that was before even the word microbiome was in the culture at all. And in functional medicine, we always address the gut. We always address the gut as a way of dealing with inflammation. And MS is an inflammatory disease. So what What is the story of the microbiome and MS and why is there such a link and how does it all connect? And what do we do about it? Yeah. How does the Wahl's Protocol affect the microbiome?

Well, we have a greater appreciation that your microbiome is talking to your T cells, your T regulatory cells, it affects your immune tone of how how many pro-inflammation molecules you're going to make and which immune cells are going to be active. We also know if you have a leaky, you probably also have a leaky brain and these immune cells and these inflammatory molecules are getting into your brain and activating the immune cells in your brain called microglia. And your microglia are continually sensing the environment and either making it very inflammatory, which is causing a relapse, or very reparative, which is rebuilding the myelin that's been damaged. And that is going to depend on what you're eating and what you're doing. And so it's part of why I talk to my patients, are you pooping rocks, logs, snakes, pudding, or tea? put in your tea, you need less fiber. If it's rocks or dry logs, you need more fiber and more sawdust and kimchi. If you've got snakes and they're getting into your pants, then you probably still need to have less fiber. Snakes are ideal, but only if they don't get into your pants.

Okay.

It's not way easier than, you know, the Bristol chart one to seven.

That's the best description of poop I've ever heard. A little graphic and visual, but I think we all get the point.

Yeah. You know, everyone laughs and they all get it. They all understand it. And they understand, you know, snakes in the pants are a problem. So a lot of times in functional.

Medicine, we treat the gut directly. Like we, we really focus on gut reparative therapies, the 5R program in functional medicine. Do you need to do that with the walls protocol, or do you just do the general approach and it works? Or do you need to dive in there and see, oh, this person has extra gut inflammation or they have lecithin.

Mania or they have this and that parasite? you know what is interesting, Marcus? When I went through my personal transformation, my only clinic practice was at the VA. At the VA, you really can't do any functional medicine labs, zero. And the supplements I could get were B vitamins and fish oil. And that was it. And what I discovered is, by basically doing the Wahl's Protocol, man, I was reversing disease left and right. And so, what I learned was behavior change, group clinics, group visits, and the power of starting with the walls protocol, listening closely to how people responded in making adjustments based on their response.

But if someone has a parasite or really bad gut, don't they need probiotics, don't they need other things?

They may. They may, and there's no doubt if I could have done functional medicine testing, it would have, I could have recovered people more quickly. And there are people who I couldn't recover as well as I would have liked that had I been able to do functional medicine testing, I could have probably done better.

Yeah, incredible. So the microbiome is a huge role in our immune system and across the spectrum of diseases. And as back from inflammation. We've talked about that a lot on the podcast. I do think that the work you're doing is so radical because it does affect everything. It affects your nutrient levels, it affects your microbiome, it reduces inflammation, it helps to optimize the function of all the systems in your body that you were talking about. You want to know my secret for living a long and happy and healthy life? Well, all I have to do is check out my weekly newsletter, Mark's Picks, where I share my favorite tips for health, longevity, well-being, and lots more. Check it out and the link below. So, Terry, you know, your work is so important. You've touched so many millions of people and you're bringing hope where there was none, especially in the field of MS. It's one of those horrible conditions that, you know, I've treated so many patients and it's remarkable when you follow these principles and I followed similar principles over the years treating these patients with great success. And hopefully this will get more into the mainstream. But what you've done is you've created access points. You've got your books, you've got your cookbook, and also now you have these online programs so tell us a little bit about the online programs. If people are listening and they want to join, where would they go? How do they find it? What is the program?

Several times a year we have a free five-day challenge, and that is five days of lessons that people get from me, two lessons a day, to help you on your journey of adapting diet and lifestyle. And then we have the autoimmune intervention mastery course, again, which is online. So we have people from all over the globe. There are five modules, lots of lessons within each module to take you through the emotional aspect, the food aspect, the exercise movement aspect, and the supplements and supplemental. What are the additional things that you can do? And in the online course, you also get access to seven calls, group calls, where I come in, provide more information, answer questions, and provide a lot more clarity.

Hey, YouTube. If you like this video, you're going to love the next one.

Well, it's always getting to the root cause. You know, we always look for the root cause and functional medicine here at the UltraWellness Center. Everything's designed, all the tests that we do, all the work that we do, and the way we think about things is to get to the root cause. and we know that the, the auto, it's an autoimmune process that drives thyroid disease, particularly Graves, in this, in this case that we're talking about. And 75 to 80% of your immune system is in your gut. It's gut, it's gut, it's called gut, gut Associated lymph, lymph tissue. And so why? Because you have everything that you eat has organisms on it, has compounds in it that can potentially threaten your health. So your immune system has to be on high alert all the time, making sure that there is, there's no disruption, nothing gets into your system that could cause you to be ill. So we look at the gut microbiome and, and, and the function of the, the gut almost first and foremost when it comes to autoimmune diseases, because that's where you're going to find the majority the triggers.

So the gut is always a key thing to think about because 70% of your immune system is in your gut. And if you have an autoimmune disease, you have to treat your gut.

I don't think that there's one person with an autoimmune disease I've treated that hasn't had some gut issue that had to be dealt with that was part of reducing their autoimmune process and getting them into remission.

Okay then. Wow. And what's really fascinating is that It just recalls this patient of mine who was about a 40 year old woman who had Graves disease and was struggling and did not want to be on medication long term and was willing to do whatever it took. And she turned out she had real gluten issues, she had terrible gut issues and we did a really and she had parasites. I mean, we did a really aggressive gut repair program and we optimized her health and her vitamin D and we improved her diet. And what was amazing was that her antibodies for Graves went to zero, her thyroid normalized and she's completely fine now and off medication, which is just really striking. to me because that's something I never learned was possible in medical school.

Yeah.

And, you know, you know, I've had a case where, again, you get to the root cause and, yeah, was gut a major issue?

Sure.

But in my particular case, it was a woman who's 55 years old. She came with a diagnosis of Graves, like I said, many do, and she just didn't want to, you know, do the traditional therapies. So when she came in, she was also menopausal within the last two years. And she, that was the main, the other main issue with her.

So.

And also, she had gut issues. She had bloating and distension and constipation, some loose stools. So with her, you know, one of the things that works, and I, you know, when you want to treat somebody, you're, it is perfectly appropriate to try to understand that the, the mechanism, the pathway of the way the organ works. in this case thyroid. TPO, thyroid peroxidase antibody, thyroid peroxidase is an enzyme that's blocked with a pharmaceutical agent that is very harmful. Botanical agents can oftentimes, because we get many of our medicines from botanicals, so botanical agents can oftentimes be very effective. In this particular case, L-carnitine can act as a thyroid peroxidase inhibitor.

No.

And so using L-carnitine was one of the first things I did with this particular woman. And before our next follow-up, she was already beginning to have some relief from her symptoms just using L-carnitine. And then because she was menopausal, estrogen can have an impact on your autoimmune state. So balancing hormones is really important. When you think about hormone replacement, there's always been a concern, particularly with women, about the possible impact on the breast and breast cancer. What I will say is that there are now studies that are showing that early in menopause, using hormone replacement for a short period of time can have a very beneficial impact on brain aging. There's reduction in Alzheimer, development of Alzheimer's for women who have estrogen early in their menopausal state. It also reduces the autoimmune state. And because estrogen does play a role in balancing the inflammatory and anti-inflammatory sides of the immune response. So I actually put on hormone replacement. That's why you see most of the.

Case of autoimmune disease in women.

Yeah, and 40 to 50, you know, 40 to 60 range. So I balanced her hormones and then of course, you know, we worked on her gut microbiome. which is always a critical piece.

Yeah. And, you know, the other thing you did was you got her off gluten and you put her on an anti-inflammatory diet.

Yep.

Right.

Yep.

And you gave her the raw materials for helping her thyroid. Yeah.

And I, you know, yeah. And I think it's really important when we say we work on the gut, you know, we have to remember that when we work on the gut, we have a very programmatic approach that can be adopted and adapted to the various conditions people have. But it's that 5R approach, you know, it's basically, let's find out what may be a trigger. So there are triggers to, you know, there are some, you know, bacterial and parasitic triggers to thyroid autoimmunity. One of them happens to be Blastocystis hominis, which is a parasite that, you know, has been implicated in triggering antibodies that will go after the thyroid.

That's interesting because that patient that I mentioned, that's what she had. She had this parasite.

Yeah.

Which we're going to talk about on another podcast.

Yeah, we are. So when we look at the gut, we're going to look and so we're going to need to, we know we need to look at the gut carefully.

So talk about what is really driving this problem and what is Graves, what is hyperthyroidism and what does it do to people? How do they feel and how do people know they have it?

Right. So hyperthyroidism is when the thyroid gland is producing way too much thyroid hormone. That's T3 and T4. And so when they're being overproduced, then you're going to have symptoms that are going to cause you to lose weight, feel sweaty, have palpitations, be anxious, have thinning hair, lose your hair, have thinning nails. Graves' disease happens to be the most common. It's about 60 to 70% of people with hyperthyroidism. our graves. It happens to about one in 200 people, women more than men, 10 to 1. And it usually peaks around in the ages of 40 to 60 years old, but it can happen younger. So that's like the overview of Graves' disease. Now, the most, as you said- and.

What are the symptoms?

The symptoms are some of the ones I just mentioned, which are going to be weight loss, sweating, thinning, thinning nails, hair loss, skin, palpitations. When it gets really diarrhea, atrial fib.

Yep. And when it gets really bad, you.

Can have heart failure, you can have hormone imbalance, and you can have anemia.

Yeah.

And insomnia. People can't.

I had a friend. I had a friend call me who was like, I can't sleep. I don't know what's wrong. Yeah. And we get to our history. It's like. And I lost 20 pounds, and I wasn't trying.

I'm like, like.

Oh, okay.

Yeah.

Yeah.

So most people, as you said, have hypothyroidism. It's less common. I think one percent of thyroid disease or two percent is, is hyperthyroidism. Graves is the most common. But when you have it, it can be really debilitating and it can be really hard to treat. And as you said earlier, in conventional medicine, the treatments haven't changed in 50 years, and they're quite harsh. and functional medicine really gives us a great opportunity to get to the root causes of what triggers graves and allows us to then treat our patients in ways that make sense for the biology and their life environment.

Yeah. So, it's really, you know, the symptoms can be quite dramatic for people, right? Absolutely. And as you mentioned, some of the complications are serious. It's not just about having a racing heart. heart or insomnia or diarrhea, you can get eye damage so your eyes can bug out of your head.

Right.

Yeah. So, you get heart failure, right? Yeah. Yeah.

That can happen. And, you know, the reason why that happens, and I think we're going to have to just jump right into this part of it, is the autoimmune process. Graves is an autoimmune disorder, just like Hashimoto's, which causes hypothyroidism. And so, you can't get away from talking about thyroid disease without talking about the autoimmune, you know, our immune system, autoimmunity, why we have it, why it's getting worse, and what some of the major triggers are. So the eye disease is actually antibodies that are being made against your thyroid. They're called thyroid, thyroid stimulating hormone receptor antibodies or T-Rabs. And they're made specifically against the receptors on the thyroid. So when those antibodies hit those receptors, it doesn't destroy those receptors, it actually triggers them to make more thyroid hormone. But we have, it's a very nonspecific interaction, and those antibodies can also trigger like antigens in other parts of the body. They happen to be in the eye, where there are thyroid-stimulating receptors, and also in the lower extremities. So, you can get the deposition of all these antibodies in the eye that cause the graves' eye disease and also pretibial myxedema.

And that's because- that's like fluid retention in your legs.

Fluid retention in your legs where you get a destruction of the tissue underneath the skin of the tibia or your shin. And you can see it's thickened and fluid filled and it's not nice looking and it's not nice feeling. So those are the things that are the hallmarks of graves and they're all related to that autoimmune antibody response.

What's interesting also is that autoimmune diseases often come in clusters and with graves you see people often with other autoimmune diseases.

You do?

Like what?

So some of the other autoimmune diseases can be you can actually get Hashimoto's. Hashimoto's is one of the other autoimmune diseases.

You can have low and high at the same time. You can.

You can definitely have that. You can have diabetes, which is an autoimmune disease.

Type one diabetes.

Type one diabetes.

Biotin. Right.

That's what you.

Biotin is a common one in your skin. Yep. Anemia and. And autoimmune things like arthritis, rheumatoid arthritis, lupus. Right. Yep. and then what's interesting is also celiac disease.

Well, there's a link between celiac disease because gluten is a huge trigger for autoimmunity, particularly creating antibodies against the thyroid.

Okay, so that's a kind of a good overview of the prevalence of it, what the symptoms are, what the complications are. It's often not that hard to diagnose when people are that sick. you can kind of tell, but it's subtle sometimes. What tests did doctors do to find out traditionally whether you have it? Yeah. So we're going to get to one.

Of the tests we do in functional.

Medicine that are quite different. So, yeah.

So the traditional test that you, how you find it is looking first at your thyroid functions. So you're going to be looking at somebody. The key thing is, is the clinical symptoms. Right. It's not always tests. People come in and they have symptoms, then you have to start to use your your medical cognition and everything you know about medicine to figure out, okay, what do I think is going on? Well, once you realize what the symptoms are, then you start to understand, you know, this is the thyroid. So you're going to look at the thyroid and you're looking at what we call the TSH, which is a thyroid stimulating hormone. And if that's really, really low, that means that the thyroid is producing way too much thyroid hormone. and your pituitary gland is being suppressed so it doesn't make enough of this thyroid stimulating hormone. Let me just back up for a second. Your pituitary gland drives your thyroid.

Yeah.

And it sends a signal to the thyroid. It's called the thyroid stimulating hormone. So your thyroid- TSH. Yeah, TSH. And so your thyroid is sort of lazy. and so it has to be reminded to work. So the pituitary's responsibility is to send out this signal all the time so you're going to have this certain normal level of TSH reminding the thyroid to work. And as long as it's doing its job and nothing's impairing it from doing its job, then it's going to function great and it's going to make thyroid hormone, T4 and T3. T4 and T3 go to the cells. Now, T3 is the active form of thyroid hormone. and inside the cell, T4 gets converted to T3, then it goes into the nucleus where it causes the DNA to start to transcribe and make enzymes and proteins that upregulate metabolism. And that's exactly what it's supposed to do. Now, if you don't make enough thyroid hormone, then you're going to experience hypothyroidism and a slowdown of your metabolism. And if you make too much, you're going to have a uptick in your metabolism and everything that goes along with that, and that's called hyperthyroidism. So what happens is, and what are the tests?

So the test.

So when we go for the test, the TSH is going to be suppressed if the thyroid is making too much. The pituitary is going to shut off. So the feedback system tells your TSA.

Shut off and then the other hormones go up. Yep. But there's also antibodies, which is. Right.

So now we're going to. So once you realize they have hyperthyroidism, then you want to check for antibodies. And the main one you check for is thyroid stimulating hormone receptor antibodies. And if those are positive, it's 99% sensitivity and specificity for Graves' disease. That's the main test.

And there's also a radioactive iodine test, right?

Yeah.

So after you do that, you can do a radioactive uptake to see if the person has maybe some other reason for having that hyperthyroidism, which can be an adenoma or multi-nodular toxic goiter.

And so, what are doctors, once people are diagnosed with this, what are the treatments? Because it seems like they haven't really changed much since 40 years since I graduated medical school.

Yeah, they haven't changed much and they're pretty harsh. And, you know, one, you know, so there's methimazole, which is basically a Thyroid peroxidase enzyme inhibitor. Thyroid peroxidase is the enzyme that the thyroid uses to bind iodine together to make thyroid hormone. And so it blocks that. And so you just reduce the production. Methimazole can have some significant and poly polythiourasil PTU particularly can have some, you know, very impactful side effects like, you know, hepatic toxicity.

So.

And you're going to be on them for 18 months, up to 18 months to get into remission. And so they're not, they're not really, they can be harsh and they can have lots of adverse reactions. And a lot of the, most of the people that I see in your ultra wellness Center, they come to me with Graves. I don't have to make a diagnosis.

They come.

And the reason why they come is they don't want to be on methimazole and they don't want to have, you know, iodine, the, the next therapy. is radioactive iodine destruction of the thyroid.

So basically nukes your thyroid.

Yeah, basically nukes. So you're going to get, you're going to get, you know, I I-131, which is iodine tagged with, you know, a radioactive molecule. And when that it's iodine. So now this radioactive material gets absorbed into the thyroid that's going, wants to use that iodine. But then that radioactive material breaks down to Xenon and Xenon. destroys the thyroid or parts of it and reduces the production of thyroid hormone. Again, pretty harsh. You're radioactive and you're not, you can't breastfeed, you can't be around kids, you can't touch people, but yeah, not in your whole life. It can be up to two weeks of the treatment. And then finally, there's just take the thyroid out.

So basically, like nuke it, take it out or poison it. Yeah, yeah, yeah.

Poison it, nuke it or rip it out.

Okay, well, I mean, sometimes that's necessary. deal with symptoms or people can use beta blockers if their heart's racing and so on. Which is perfect. Which is okay. But the question is how do we deal with this in functional medicine that's.

Different and if they're wellness or how do we think about this condition? This gets into the testing we do in functional medicine. So one of the first tests I do is a stool analysis. And that stool analysis is not only going to tell me about the balance of good bacteria, which are your commensals and your bad bacteria. I always say that those are the those are the bacteria that realize that poop is a great party, great place to live, and they come and hang out, but they may not do anything for you unless you have a really bad diet, you're under too much stress, you're not taking care of your gut microbiome, you're eating processed foods and sugars, you're eating lots of GMO foods that have lots of glyphosate on them, and your microbiome is disordered. Now all of a sudden, those hanger oners are now they're just going to multiply and they're going to push your good bacteria out. And when that happens, then the good bacteria can't modulate your immune system, can't help you, doesn't make the compounds that you need. As we know, 70 to 90% of your serotonin is actually made by bacteria in your gut. So, you need to rebalance that. we're really careful about doing that. We want to know not only that balance, but how's your digestive system working? One of the things that allows the gut microbiome to go into this disorder is you're not making enough gastric acids. You're under too much stress. When you're under stress, then your fight-flight response takes over and suddenly you don't want to have an appetite when you're running away from the bear. So, your appetite goes down, you start making less gastric acid. And when you're under chronic stress, this chronic loss of stomach acid allows bacteria and parasites and viruses to get into your intestinal tract where they can wreak havoc. Oh, yeah.

That's another reason to worry about stress is more parasites, right? More parasites.

Another.

Another.

So really, it brings it all on. So we really. We really work on the gut.

We work on the gut, you get. the food sensitivities. And, you know, I haven't, we'll see a disease that I've never really treated or that is not that common. And I'm like, well, gee, I, I don't really know all the time. You know, I don't know if this is going to work. Right. But then I go back to first principles in functional medicine and look at what are the root causes of disease, what are the causes of whatever it is, inflammation or metabolic disease. And then I can usually zero in on what their story is and listen from their story. I'm like, yeah, yeah. you know, I've been eating tuna every day for 30 years or, you know, like I basically have this terrible stomach issue that blah, blah, blah, blah, blah. And I go, oh, you know, so you start to kind of find the clues in the patient's story and you follow the threads and you start to do the diagnostic tests that help you and then you start to peel the onion and treat all these problems. And so, you know, your treatment isn't just take this PTU drug or get your thyroid nuked or take it out. It's like, oh, we have to change our diet. Oh, we have to deal with stress. Oh, we have to take the right nutrients to optimize the levels. Oh, you have heavy metals, you have to take care of that. Oh, we have pesticides, we have to figure out how to get rid of that. So we basically go through a process, a therapeutic process that's based very strategically on that patient's story and their specific labs. And it's no, there's no two people.

That are the same who have any particular disease or graves or anything else. Yeah, I'm just gonna echo everything you just said, Mark, because We have this conversation. This is the work that we do. We get to the root cause and then we use treatments that make sense for each person's specific biology and their life environment. And there's not a patient that comes to me, or it's a rare patient that comes to me, that we don't find multiple reasons why their health is either currently compromised, or is this set up for being compromised in the future because of all of those particular areas you just talked about? It's not a matter of people have toxins, it's how much. And then the genetics determine how well they're going to detox those toxins. And so we also know that you have genetics that drive your immune system, but we have places to look. We do a lot of antibody testing to help us identify do you have an autoimmune process and where is the trigger? And so, and we could go through every, you know, every biologic system that we look at with all the testing that we do and, and explain in detail how we're using those tests in those biologic areas, toxins, the HPA access, you know, energy production in mitochondria. We do specific tests that we'll look at mitochondrial function. All of those things have to be addressed. It's never one thing. It's multiple layers.

And that's the whole problem with traditional medicine. It's like reductionist. It's Graves disease. You get this drug, a seal later, that's it. Nothing else. And we're like, no, no, 10 people with Graves might have 10 different issues, and we need to treat them in 10 different ways, and we need to find out what their cause is and how to optimize their system. You want to know my secret for living a long and happy and healthy life? Well, all I have to do is check out my weekly newsletter, Mark's Picks, where I share my favorite tips for health, longevity, well-being and lots more.

Check it out and the link below. You know what, 20 years ago, or maybe it's longer than that, maybe 21, 22 years ago, you were at Canyon Ranch and you had the opportunity to, you know, hear Jeff Bland speak. And you got the fever early on, right? I did, I did. 20 years ago, I just started my own conventional family practice. and I was a conventional doc for, you know, it was, it took me about 15 years, but even in my conventional practice, I always had that, that holistic approach. I was writing nutrition programs. I was putting together exercise programs for my patients and my diabetics. I had a weight loss program specifically for my diabetics. However, the pressures of the insurance industry, the pressures of my discipline and family medicine were such that it was see as many pages as you can make the diagnosis, use a pharmaceutical agent. And about six, you know, probably 13, 14 years in, I started to say, you know what?

This is not right.

This.

There's something wrong because my patients aren't getting better. No, I'm maintaining disease. And then I found functional medicine, and that changed everything.

Changed everything.

It changed everything.

So.

Where you would have come to me with grave disease 10 years ago, and I would have sent you to the endocrinologist who would have put you on methimazole, a beta blocker, and then talked about having you go to an ENT doc who's gonna take out your thyroid. I would have been right on board. You know what? I saw the light. And I can tell you, in my time as a functional medicine doc, now board certified in functional medicine, the IFM, I think I have helped more people leave their disease behind actually be better than I did in 20 years of private practice in conventional medicine.

Wow. So that's a big statement. Hey YouTube, if you like this video, you're gonna love the next one. Click on it to check it out today.

Inflammation, which is what I had, widespread inflammation in my nerves, inflammation in my gut, inflammation in your brain, in my throat, exactly. It doesn't qualify as a treatable disease. Inflammation.

Right. That's what I was joking. Say functional medicine doctors.