How To Use DIET & LIFESTYLE To Treat Multiple Sclerosis & CURE AUTOIMMUNE Disease | Dr. Terry Wahls

I have progressive MS. Despite getting the best care from the best people in this country, I went steadily downhill for seven years. And I had this list of foods. I reorganized my Paleo diet, and it was stunning. The speed of the transformation. I've been studying dietary interventions in the study of multiple sclerosis now for almost a decade. And the intervention, especially the Wahls diet, so we have people Exclude dairy, exclude gluten, exclude eggs, and I ramp up their vegetables. The goal is nine cups. So, you know, and I'm a tall lady. If you're a man, nine cups should be easy. If you're a petite lady, it may have to be smaller, but it's divided equally between green leafy vegetables like spinach, kale, parsley, and then three cups of cabbage family, so cabbage, broccoli, cauliflower, radishes, onions, garlic, mushrooms, and then three cups of deeply pigmented stuff like beets, carrots, berries. And then we want to have protein, meat, fish, poultry. If the person is a vegetarian, we have some strategies for them so they can still have their complete protein. Then we stress good fats for you. A lot of omega-3, omega-6 fats. So grass-fed meat, if you can afford that, wild fish, nuts, seeds for the omega-6, grass-fed meats, wild fish for the omega-3s, plenty of olive oil, plenty of olives, avocados, seaweed, fermented foods. And then we ask people to give up sugar. and to get rid of the flour-based products. So they're really largely excluding grains and replacing all that with vegetables. First week's pretty tough for folks, but the second week they're feeling remarkably better. I have progressive MS, and despite getting the best care from the best people in this country, taking the newest drugs, I went steadily downhill for seven years. I was so ill at my nadir, I could not sit up as I am now. I had-- we didn't have problems with brain fog, difficulty with memory, focus. I had intractable trigeminal neuralgia, these sharp electrical pains across my face. Life was tough. And I had figured out that a supplement cocktail supporting my mitochondria diminished my fatigue somewhat. It had slowed the speed of my decline. I had adopted the paleo diet based on some recommendations I had from my neurologist at the Cleveland Clinic. But it's still the paleo diet didn't recover me. The supplements did not recover me. I discovered the Institute for Functional Medicine had their course on neuroprotection, which I took in the midst of my brain fog, which was a little tricky because I had Brain fog, but I slogged through that. I had more supplements, which I added. I was still, no dramatic recovery, but then I had this really phenomenal aha moment, like, what if I figure out where these nutrients are that I'm taking in pill form, where are they in the food? And I reorganized my paleo diet to stress those specific nutrients. So that was more research. The Linus Pauling Institute on micronutrients was a great resource. and I had this list of foods I reorganized my paleo diet. Now instead of focusing on what to remove, I focused on what to add. And it was stunning how the speed of the transformation. Within just three months, I went from being unable to sit up, struggling to walk using my walking sticks, to being able to walk throughout the hospital with the cane in six months, walking without a cane in nine months, Biking around the block. And in 12 months, being able to bike 20 miles again with my family. And that happened because I was so focused on realigning my diet, using food to get all of those key nutrients. It was breathtaking. Neuroinflammation is disordered or excessive inflammation in the setting of some sort of neurologic disease. This could be increased inflammation of the immune cells, the microglia. And you might see that in the setting of neuroinflammation, like multiple sclerosis. There's more appreciation that there's inappropriate inflammation in the setting of a variety of mental health diseases, including anxiety and depression and schizophrenia. So this is a much more common part of neuro psychiatric disorders that we had previously appreciated. Inflammation is a normal biologic response to any type of injury. It's how the body repairs itself after trauma or infection. When the inflammation occurs in the absence of injury, that's sort of an auto-inflammation. And the question is, why does that occur? And we're teasing that out more and more. This may be that we've had an alteration of the tissues because there's been insertion of a heavy metal or a bacterial particle, or that I may have had an infection with an organism that has a similar amino acid structures to parts of my own tissues. We call that molecular mimicry. Or that we develop a immune response to a food protein that has a similar amino acid sequence to my own structures. Again, that's a variation of molecular mimicry. And we're just beginning to appreciate more and more that there are a variety of these mechanisms that cause our immune cells to take this normal healing aspect of our ability to heal and repair. It becomes disordered and aggressive against otherwise normal healthy parts of our brain. In the brain, we of course have a wide variety of cell types that are doing the function of taking care of our brain cells. The microglia are part of the immune cells whose job it is to monitor what's going on, secrete the inflammation molecules to protect us. If there is a low-grade infection that is crossed over into the brain, The microglia are part of the cells that sense that and develop an immune response. So they're really a critical part of our protection system. When they get sensitized to molecules that look like normal brain structures, that is when we get into serious problems. So the microglia can get overactivated from a variety of circumstances. We're beginning to appreciate that the microglia are actually quite responsive to a number of our, I call them our lifestyle factors. So if I am being physically active and robust, they're getting a very helpful set of signals. If I'm sedentary sitting around all day, laying in bed because of whatever health challenges that I have, or my recreational habits and lifestyle habits that I don't move, then the microglia get a different set of signals. If I have a diet that is full of sugar and white flour, what I call the high glycemic index foods, again the microglia get a different set of signals than if I eat a diet that's full of these radical things known as vegetables. Or if I have a lot of fat, that is in the trans saturated fat location, I get a set of signals that are very inflammatory. If I have a lot of fat, the omega-3, omega-6 fatty acids, actually get very supportive signals. So we now believe that the microglia are great sensitizers in terms of what our lifestyle factors are. Do we have a set of health promoting lifestyle factors or do we have a set of increasingly inflammatory disease promoting lifestyle factors. So the microglia, again, the immune cells in the brain that are trying to sensors. A couple of examples of where things can go wrong. Let's think about someone who has a food sensitivity to gluten. And in that process they get sensitized. and they can begin attacking the myelin. Another compound that can be a problem has to do with the compounds in dairy. Butyrophilin, again, has a very similar structure to compounds in the brain, myelin oligodendrocyte proteins. And that, once you get sensitized in that formation, you will begin attacking structures in the cerebellum. And this can contribute to cerebellar ataxia. It can also be important in multiple sclerosis. And so those are part of the reasons I feel so strongly that anybody with a neuroinflammation problem, so if you've got multiple sclerosis, cerebellar ataxia, schizophrenia, if you have anxiety, depression, I strongly urge those folks to avoid gluten, and dairy meticulously for, I mean, very, very meticulously. You've got to read all the labels. Do it very precisely. Ideally for six months, but a minimum for three months. Get a sense. Can you reduce symptoms by cleaning up your diet and quieting those microglia? So in terms of why I want people to have more grass-fed meat, wild fish is that it increases the amount of omega-3 fats. And because of the chemistry that humans have, we can't make omega-3 or omega-6 fats. We have to eat those, and then we can further modify those fats to make some structures that are very important in our cell membranes and in our brain. So when people vigorously adopt a very, very low-fat diet, we sometimes make it too low, We don't have enough cholesterol, enough omega-3, enough omega-6 fats to make the cell membranes and some of the structures that we need for our brains. And that compromises our brain function, leading to increased risk for depression, anxiety, neurodegeneration, neuroinflammation. Our brain has brain cells. And you can imagine we have to have wiring between each brain cell. in that wiring needs to have insulation on it, just like the wiring in your house. All the electrical equipment has insulation on the wiring. Biologically, that wiring is wrapping of the cells tightly around that wiring to make something called myelin. So it's a very dense wrapping of cell membranes. That myelin needs a lot of fat, and so it needs a lot of cholesterol. It needs omega-3 fat, which will get further lengthened into something called eicosapentaenoic acid, dicosahexaenoic acid, and we make that from omega-3 fat. Now, the vegetarian sources of omega-3 fats that you'll see in chia seeds, I have to metabolize further to make eicosapentaenoic acid and dicosahexaenoic acid. We're not very efficient at that. we can convert about 5% of the vegetarian source omega-3 into the form of the omega-3 that I need to wrap around to make the myelin. That's not very efficient. So yes, my vegetarian friends will say, you can eat, get much more omega-3 from chia seeds than you'll get from flax, but you have to eat about 20 times as much. So you can do it, but you have to do it in a very, very thoughtful way. We also need omega-6 fats. which are in nuts and seeds to make those myelin. And we need a lot of cholesterol as well. So fat is a necessary part of the diet if you're going to have a healthy myelin and healthy brain. Glutathione is a molecule in all of our cells that is a very important antioxidant molecule because all factories have some waste products in the glutathione helps our cells deal with those waste products. It's also in the brain useful for making some neurotransmitters such as gamma-aminobutyric acid. Then, okay, if this molecule is so important, how do we make sure that my cells can make enough and that my brain has a great supply of glutathione? so it can make gamma-aminobutyric acid, which is a very important calming neurotransmitter. And for that, we want to have a lot of what I call organic sulfur. And that's a key part of why I stress the cabbage family, onion family vegetables that provides the sulfur and it helps induce the enzymes that our cells and our brain use to make glutathione. So, eat lots of garlic. Eat lots of cabbage family, broccoli, watercress, all of these vegetables in the sulfur family, cabbage family, onion family, great for supporting glutathione. I often ask, is it better to have things raw, cooked, or fermented? If you have things raw, you have more of the enzymes, the vitamins intact, but you can't digest them as well. It's more work to digest through the cell wall. If you have them cooked, you break down the cell walls so that's easier to digest, but you may have lost some of the water-soluble vitamins. If you have things fermented, then that bacterial actually creates more vitamins, more antioxidants, and you have more beneficial microbes. So each group has different benefits. It will depend in part on the health of your gut. if you're having a lot of problems with diarrhea, loose stools, perhaps inflammatory bowel disease, you may not be able to tolerate the raw or the fermented, and we have to do cooked things that are pureed at first. So I just have to really individualize that based on the person's personal health issues at that time. So examples of the brassica family or the cruciferous families, this is cabbage family. So cabbage, broccoli, turnips, rutabagas, radishes. And then if you go into the kale and collards, you know, there are literally hundreds of different variations, both in the kale and the collards. Watercress is quite lovely, garden cress. And so literally there are hundreds of different vegetables in that Brassica cruciferous family. Now in the Allium family, that's onions, garlic, shallots. And of course there are many different varieties of onions, many different varieties of garlic. And these will have different potency in terms of the sulfur content. And you can sort of get a sense of how potent that sulfur is by the amount of bite that will be in that garlic when you crunch on the garlic. The more intense the bite, the higher the content of the garlic. and then you can get further into garlic in terms of are some of these garlics fermented? And the black fermented garlic is another wonderful product, great for you, a long history of medicinal use, plus it is delicious. So we like adding a lot of black garlic into our diet. I particularly like the Brasca family, and I also like the Allium family because when you consume these foods, they will upregulate the phase one, phase two detoxification enzymes. And for many of us living in today's society, we've accumulated a lot of toxins. And so eating more brassica, more allium, increase your ability to metabolize, process, and eliminate those toxins. When I was a young person, I loved science fiction. and one of the books that really captured my imagination was a book about living spaceships and that the crew was talking with us to this living spaceship that would carry them from galaxy to galaxy across the universe. And I just thought like, wow, that is so cool that they have these living spaceships. And now I know I am the living spaceship that housed within me is this microbial universe of microbes that interact with my immune cells, that create these small molecules that will get into my bloodstream and up to my brain, influence my mood and my behaviors. In that we are transporting this microbial universe, that there are 100 times more microbes in us than human cells. When we, our ancestors, thousands, millions of generations ago, when we first evolved the gut, a billion perhaps a years ago, that at that time we're bringing the microbes from those ancient seas into the gut with us. And over time those microbes continue to evolve and they help us digest our food, they make vitamins, antioxidants, small molecules that get into our bloodstream that influence and speak to our immune cells. that help us conduct the chemistry of life, that help us set our immune cells in terms of how they're interacting with the proteins and other compounds and other microbes that they encounter. And that these small molecules will also get into our past our blood-brain barrier, and they will deliver neurotransmitters, they will deliver signals to our microglia, that make the microglia more active, more reactive, or calmer. We have this very intimate dance with our microbes to have our health. We want to have the correct mixture of microbes and microbial species so we can run the chemistry of life optimally. Our diet has evolved over time. It changes according to the seasons. It changes according to the locale. and it was very adaptive and flexible. And those microbes were adapted and flexible. And we had different sets of microbes. If we were in Japan, if we were in Australia, if we were in Asia, Africa, Europe, North South America, over time when we became farmers, we ate different foods and our microbes changed. And then we discovered sugar and white flour, we ate again different foods and our microbes changed. And when we developed trans fats and more processed foods, and we quit eating those vegetables, our microbes changed. And then we developed genetically modified organisms and pesticides and glyphosate in our food, and again, our microbes changed. And every time we had those changes, the signaling to our immune cells changed, and the rates of obesity and autoimmunity and mental health problems increased. It's deeply tied and connected to our microbes, which is deeply tied and connected to the food that we eat, which is part of why I stress changing our food, getting rid of the sugar, getting rid of the processed flour-based foods, and getting closer and closer to what our ancestors hundreds of generations ago would have been eating, which were a lot of vegetables, some meats, some nuts and seeds. We weren't eating sugar, we weren't eating flour-based products. We weren't eating all those yummy delicious foods and all these food-like chemicals that change our microbes and change how we run the chemistry of life. So the microbes in my gut will talk to the immune cells that live in my gut and about 70% of my immune cells actually live in the gut monitoring those interactions between the food proteins and my immune cells. And so depending on which microbes I have, those immune cells are more reactive, more aggressive, making more inflammatory molecules, or calmer, making less inflammatory molecules. There are an increasing number of studies that have looked at what microbes are in the gut for people with MS and people who don't have MS. and very consistently we see there's a different set of microbes. And of course this is somewhat different according to which part of the world that you're in. And so there's not one set definition for dysbiosis, but it's very clear that the person with MS and the person with autoimmune problems has a different mixture of microbes than the healthy individual. The microbiome There is a very potent connection between the gut health, immune health, and brain health. In the microbes in the gut, I have a very powerful way of interacting with immune cells, which then can calm or ramp up the inflammation in the brain. And so sugar-loving bacteria and sugar-loving yeast appear to ramp up the immune cell reactivity and ramp up the inflammation in the brain. My best advice, get rid of sugar, get rid of the high glycemic index foods. That will be very helpful. LPS is a bacterial fragment that can get into your bloodstream if you have leaky gut. And circumstances that increase the leakiness of the gut have to do with overgrowth of sugar-loving yeast, overgrowth of sugar loving bacteria, acid lowering medication, certain other meds, food sensitivities, all of these things can open up the gates allowing in completely digested food proteins and these bacterial fragments into the bloodstream. When they get into the bloodstream, the immune cells become a hyperreactive, increased inflammation, and that signal goes up to the brain as well, again activating the microglia. increasing the inflammation, increasing the probability of AMS flare, increasing the probability of other neurologic symptoms in other types of neuroinflammatory conditions. Lipopolysaccharides, also known as LPS, is a bacterial fragment from the gram negatives. It can be very inflammatory. We see that in a variety of autoimmune conditions. We can also see that when someone has a life-threatening gram-negative infection as well. Butyrate is a short-chain fatty acid. It's common in butter. And bacteria will ferment microbial accessible carbohydrates into butyrate or these short-chain fatty acids in the colon. That can be a strong reason for having increased fiber that is accessible by the microbes, hence microbially accessible carbohydrate, and will do this fermentation in the large colon. It's one of the reasons why I stress to my patients, monosaccharide movements. Be sure that you can pass them easily, that there's soft, ideally snake-like bowel movements. If your bowel movements are hard, more rock-like, that means you need more fiber. increase your fiber content, more about vegetables, more greens, or things like chia seed pudding, ground flaxseed, a green banana flour to have these soft, easily passed bowel movements. Now, the fiber we eat are microbes we use to create more butyrate. The butyrate will improve the health of the colonic mucosa, very important. They also speak to the immune cells which can calm the immune cells and make them less reactive, make the microglia in the brain again less reactive. Another compound that can speak to immune cells are helmets, parasites. And certainly when I went to medical school, we were taught that parasites were in fact parasites. There's another emerging body of research that is showing us that parasites may be more symbionts. It makes sense that if 80% of humanity has parasites living in their bowels, and some of the research has shown that when we dewormed large populations, which we thought would improve outcomes, actually did not improve outcomes at all and may have had the dewormed kids perform less well academically in school, it was shocking to us. These intestinal parasites may in fact be more symbionts in that they may be helping calm our immune cells. Some variety of research has shown where we've had large deworming efforts, we've increased the rates of Alzheimer's. So shocking research. I think there's certainly more to learn about this in the animal research world. We've been using helmets to treat and reverse things like asthma, like inflammatory bowel disease, and the animal models of multiple sclerosis. I think it's an intriguing area of research. We all have to watch that very closely. In these animal models, because it's much less expensive to study the pathophysiology of inflammatory bowel disease, multiple sclerosis, of rheumatoid arthritis, of asthma, using rats and mice. And so there are a variety of models for these serious autoimmune diseases with these models. In the multiple sclerosis world, this model is experimental autoimmune encephalitis, and we use a variety of agents to trigger this significant immune response to myelin and to brain structures. And it's these mouse models that we use to test are theorized pharmacologic drugs. And we've been using these animal models to test whether or not giving them cystic fibrosis or helminths infections, and would that stabilize the autoimmune condition, and can it reverse the autoimmune condition? And the answer is yes. Now, in the multiple sclerosis world, There is a group in Madison that has been using worms, pig whip worm, in people with relapsing remitting MS. They showed that those pig whip worms was well tolerated and that the number of acute MS flares was decreased. I believe there is a group in Argentina that, again, through observation, looked at people who've had worms and those who did not have worms and what their rate of relapse was. And there's a lower rate of relapse in people who have worms. And then if they treated people for the worm infestation, their rate of relapse increased. It's all very interesting stuff. There is a number of biochemical signals that our cells use to ramp up our inflammation machinery or to calm our inflammation machinery. NF-kappa beta or NF-kappa B is one of the molecular signals that our cells use to ramp up our inflammation producing machinery. This can be very helpful if we're fighting an infection. In the 250,000 years that humanity has been a separate species, most of that time, trauma and infection were the main causes of death. So when our evolution allowed us to produce NF-kappa B more effectively, that protected us from the infectious threats. When we lower our rate of NF-kappa B, there's less inflammation and that protects us from diseases of autoimmunity. Now our diet and lifestyle can either ramp up NF-kappa B or calm it down. Eating lots of sugar and white flour, sedentary life, ramp up NF-kappa B, increases the inflammation, which will of course cross over into our brain, speak to our microglia, and ramp up the inflammation in the brain, which if you have an autoimmune condition, makes it more likely you're going to have a flare of your MS activity, a flare of psychosis if you have schizophrenia, worsening of your anxiety and depression if you have a mood-related disorder. To calm that NF-kappa B, things like meditation, exercise, daylight, and eating these radical things known as vegetables can help calm that NF-kappa B back to more healthful levels. Melatonin is a compound that is manufactured in accordance with our light-dark cycle. And if we have sufficient daylight in the morning, we will have increased production of melatonin in the evening. That melatonin, as it comes up, improves our ability to sleep. and also improves our clearance of toxins during the night. Our absence of exposure to daylight makes it more difficult to make melatonin at night. Our fascination with our phones, with our computers, with artificial light, interferes with the light signaling, interferes with our ability to make melatonin, interferes with our sleep, and decreases our ability to clear toxins during the night. So my advice to improve melatonin, get outside, get sunlight, turn off your computers, use some blue blocking glasses in the evening, decrease your physical activity in the evening so that you can return to this more natural daylight pattern and sleep cycle. So if you're having difficulty falling asleep at night, The strategies I recommend are in meditation in the evening, you could use binaural beats that might be helpful, an Epsom salt bath, a cold bath before going to bed, melatonin, and of course getting more daylight earlier in the day. If you wake up during the night and you're having difficulty falling back to sleep, another dose of melatonin may be very helpful, a meditative exercise may be very helpful, and perhaps another dose of magnesium supplements may be very helpful. It's slightly different biochemical processes in your brain in terms of sleep initiation or sleep interruption. However, if you don't get any sunlight, you still are playing with your phone, your computer, you are exercising variously in the evening, it will still be difficult to get to sleep even though you take a melatonin supplement. It's fine to use that, but you can't supplement your way out of a terrible lifestyle. Vitamin A, retinol, is very important in speaking to immune cells and also important in cell differentiation. And so I talk to folks who have a disorder of immune dysregulation that you need more retinol. which means I want them to eat liver once or twice a week. Because converting beta-carotene to retinol requires some enzymes in our small intestine. And there's a considerable genetic variation with how efficiently those enzymes work. And some variations, there's a 70% decrease in the efficiency of those enzymes. So if you have an autoimmune condition, or if you have a precancerous condition or cancer, my advice is to increase your retinol and to have liver at least once, preferably twice a week. Vitamin D regulates and speaks to about a thousand different genes that we know of, and it's very important in immune cells. It's important again in cell differentiation. It's important in our brain. And so most of us that spend large parts of our day inside because of work and our recreational habits. For that reason, most people will benefit from taking a vitamin D supplement and having their vitamin D levels monitored and adjusting their dose to get their vitamin D level in the top half of the range. If you're taking vitamin D, that will increase your absorption of calcium from the foods that you eat, very helpful. You will then be at risk for depositing that extra calcium on your heart valves and your blood vessels. To counteract that, I also encourage you to have lots of greens. These greens are very rich sources of vitamin K. K1, the bacteria in your small intestine will metabolize that vitamin K2 and K7. Your ileum will absorb that, transport it to your liver, which will metabolize it further to vitamin K2 and K4. The vitamin K2 will help you absorb the calcium off of your heart valves and your blood vessels back into your bloodstream and into your teeth and bones, which is where we want that. And more importantly, the vitamin K2 will also go to your brain, where it will stimulate your brain stem cells that make oligodendrocytes to repair your myelin. So vitamin K2 greens very, very important in supporting myelin production. So I'm very fond of mushrooms. Mushrooms have a lot of benefits for us. Mushrooms in general will help prime the adaptive and the innate immune cells, making us better equipped to fight off infections, control such chronic infections such as Epstein-Barr virus, Lyme's disease, Chlamydia, Bartonella, very helpful. In addition, mushrooms like Reishi can be very helpful as adaptogens to help lower our stress response. That can be very helpful. And then mushrooms such as Lion's Mane have been in a number of studies been shown to increase nerve growth factors, which are important in the setting the hormonal milieu in the brain, to support brain cells, support development of more synapses, and to support just the overall health of your brain cells. So that's another reason why I include mushrooms in my sulfur-rich food category. So our ancestors consumed the whole animal. So we consumed the muscle meat, we consumed all of the organ meats, we would have been boiling up the bones to make broth and were adapted to that. When we consume only the muscles, we have a different distribution of amino acids that appears to overstimulate the mammalian target of rapamycin, which may increase the risk of cancers and excessive inflammation. If, however, we have more Bone broths, organ meats, we don't have this disproportionate distribution of amino acids and this less stimulation of the mTOR. So that's one reason to have the organ meats and the bone broths. Another reason to have the organ meats is that you'll have more retinol, you'll have more B vitamins, you will have more coenzyme Q. So there's a different nutrient profile. and furthermore, if we again look back at what our ancestors were doing, about a third of the products when you killed an animal would be what we now classify as organ meats. And that's what we, remember, we're eating that stuff. So about a third of our protein sources were a variety of organ meats. So I consider liver to be a superfood. Still, you only want to have it once or twice a week. but you want to have heart, you want to have plenty of bone marrow, tongue, gizzards prepared properly can be incredibly delicious. Bone marrow, again, it can be incredibly delicious, and bone broth is very, very healing. You know, my great grandmother would have had liver once a week. My grandmother would have had liver once a week. My mother would we had liverwurst so we can buy, for sure ate that. And as we developed more convenience foods, developed increasing taste for sugary white flour, we began to eat fewer and fewer organ meats. And unfortunately, we don't know how to cook. We have raised a generation of children that don't cook for themselves. or if they do cook, they're preparing box foods. And when we went more and more to low fat, we decided that we needed to avoid liver because there's a lot of essential fatty acids in that liver. It's a byproduct of our low fat interventions. You know, a lot of our traditional foods that we're still cooking and following the ancestral concepts are great for us. so the Korean foods, the Okinawans, the foods if you look at the pockets where we had these octogenarian societies, there's a lot of great eating there. And you know some of my folks will say, but some of these octogenarians are still eating lots of gluten and dairy and eggs, things that I say you shouldn't eat. But I'll tell you, they also do a lot of things. so correctly, social meaning, social bonding, physical activity, being outside. So yes, there's a lot that we need to tease out. And in those societies, they didn't have glyphosate, they didn't develop a leaky gut. So they may have the same genes that I have that put me at severe risk to gluten sensitivity, but it never got turned on because they never had the leaky gut. So that's part of why some societies can still tolerate foods that we can't because through the use of glyphosate in the leaky gut and the fact that we sensitized everyone who's got those genes, we can't tolerate those foods. If we had for generations no incidence of leaky gut, we might still have tolerated some wheat. But that train left the track a long time ago, about six million years ago. There was a new mutation in development of APOE. APOE changed, it spoke to about a thousand different genes. It changed some of the structures of our brain, improving brain size and the frontal executive decision making. It ramped up the NF-Kappa B, ramped up our ability to protect ourselves from infection, and it gave us a competitive advantage. And we grew our brains. quite a bit smarter. And that was the emergence of some of our early ancestors about six million years ago. Then about 200,000 years ago, there was another variation, APOE2, APOE3, pardon me. And that became more effective. And then about 80,000 years ago, we had APOE2. And again, that was more effective, a little less inflammation. Now, what we have discovered is APOE4 increases the probability of developing dementia. APOE3 is sort of our neutral risk. APOE2 is a much lower risk. If you have APOE4, you can still reduce your risk of developing dementia by diet and lifestyle. There's a group of APOE4 who are deeply connected in the internet space, talking to each other about what they can do using diets and lifestyle to protect their brains, because they don't want to have early Alzheimer's. They've reached out to me because they have discovered that following the Wallis Protocol, adapting the kind of diet and lifestyle interventions I talk about, has been very successful in their community. I've met with them, and I've met folks who have two copies of APOE4 in their 90s, following the Intensive Diet and Lifestyle Program, and they're doing great. they're playing chess, they're traveling the world, they are in great shape. So even if you have apoe4, don't despair. Use diet and lifestyle to maximize the environment for your brain as thoroughly as you can. And you can be very optimistic that you will still have great function into your 90s and 100 plus. In my clinical practice, when people have the following conditions, I think that they may have mitochondrial problems. so any kind of neurologic issues, any kind of retinal issues such as macular degeneration, any kind of heart failure issues. And so you can have normal brain as far as you know, but if you have issues related to heart failure, it's worth a mitochondrial tune-up. If you have declining vision related to macular health, absolutely worth a mitochondrial tune-up. And we've actually had some great success, folks with heart failure that we've been able to restore using aggressive dietary intervention. And likewise, we've been able to reverse, note that, reverse myocardial degeneration again using intensive dietary intervention. Because we accommodate to our existing diets and lifestyle interventions, we may not realize that were suboptimal. And so if I work with individuals to optimize their diet through intensive diet, sometimes very targeted supplements, they discover that they have more energy, they have greater mental clarity, they have more stamina, they have better mood, more concentration, more joy. And so it's certainly worth paying attention to your mitochondria, eating this very cleanly, considering whether or not you would benefit from a B complex, because you may discover that your energy actually is going to increase quite considerably. Fatigue is, I think, the most likely to improve your energy level. If you think back to your biology class, the mitochondria is a little oval squiggles in the middle, All those squiggles are membranes. So we need a lot of fats because mitochondria is a very membrane-rich organelle. You also need the B vitamins. You'll need minerals, particularly zinc, magnesium, and you need to protect the mitochondria from poisons like arsenic, lead, mercury, cadmium, pesticides, and glyphosate, ideally. So telomeres are a biologic marker of the age of my cell. The older I become, the telomeres shorten. And so there are some tests that we use in the lab to sort out how old that cell is biologically. The commercially available, you can use telomere years as one example, and that will give you your calendar age and then your telomere age. For myself, I have done that. I braced myself like, okay, I have a neurodegenerative condition, secondary progressive MS. So you'd expect my telomere age to be, you know, five to 15 years older than my calendar age on the basis of my progressive MS. My telomere age is 12 years younger than my calendar age. And that's really a testament to the effect of a very intensive diet and lifestyle program. And if you line up the photographs of me and you see this rapid aging, and when I was 52, I certainly looked like I was 15 years older than the calendar age. But in that intervening 12 years now, I steadily use this very intensive diet and lifestyle. and I keep looking younger and younger and younger. Although I'll confess my hair is a bit more gray, but I'd say my kids and my family indicate that I certainly keep looking younger and younger. Although no doubt I will soon begin to age once again. So the telomere is a great way to measure the biologic age of your cells. It's a great way of looking at your future longevity and it's another way of looking at health span. Lifespan, how long are you going to live? That's one thing. But most of us want to have health span. How long am I going to live fully healthy, with a clear mind, a physically capable body, to take care of myself, do the tasks of daily life, do my own personal cares, prepare my meals, go shopping, interact with friends and family. That's what I want. That's what I think my public wants. that's what I'm sure you want as well. You want health span. And the best way to get health span is through a therapeutic diet and lifestyle. Lots of vegetables, no sugar, no processed foods, walking, connections, physical activity, meditation, purpose in life, health span. The best way to lengthen your telomeres is it's all about therapeutic lifestyle. So this is about eating your vegetables, this is about walking, this is about connecting with friends and family, this is about having a clear purpose to your life. This is how you create health span. If you want to have a brain that's functioning well and a body that's functioning well into your 70s, 80s, 90s and 100, which I assume we all want, you should begin following a therapeutic diet lifestyle today because the damage that sets you up for early cognitive decline begins in your 20s. If you want to have a clear brain in your 80s, 70s, 90s, and beyond, begin today. Protect your brain today. It's your most valuable asset. We've certainly had people who have adopted the Walts Protocol who are athletes and discovered that they had improved athletic performance whether it's a strength-based sport or an endurance-based sport. I've also had people who've had weight issues who have been type 1 diabetic, type 2 diabetic who've adopted the Wahl's Protocol and discovered that weight melted away without being hungry and they've successfully kept their weight off for several years now, which is quite remarkable. We've had people adopt the Wahl's Protocol protocol with a wide variety of autoimmune problems, rheumatoid arthritis, lupus, Behcet's syndrome, psoriatic arthritis, myasthenia gravis, MS of course, and they've had great success. We've had people with Parkinson's who had so much tremoring they could no longer feed themselves or dress themselves. And they sent me photos of themselves hiking out here in the California foothills. We've had people with early Alzheimer's who are reporting that their mental clarity is improving and that they are able to function well again.

So.

And I've had people with macular degeneration who have gone back and their ophthalmologist says, you know, I don't understand. Everything's looking, you know, I must have made a mistake because you don't have macular degeneration anymore and that's really not a reversible disease. And that happens time and time again that people have diseases that they're told are progressive, are not reversible. They implement a therapeutic diet and lifestyle, they implement the walls protocol, their disease stabilizes, their need for medication declines. They are needing fewer and fewer drugs. They go back to their specialist who says, well, huh. You're definitely better. I must have made a mistake because you're better. And then sometimes that specialist sees this in another patient. and then another, and then they are converted themselves. And they begin handing out the Wallace Protocol to their patients because they realize that a therapeutic diet and lifestyle is the basis of health, is the basis of stopping the progression for many progressive diseases, and it's often also the basis of being able to regress the damage. We can't always tell who will recover, function or how much function they'll recover. But we can, with confidence, say if you don't use a therapeutic diet and lifestyle, your disease will progress. And for that reason alone, I encourage people to adopt a diet and lifestyle, to stop the decline, and to be optimistic that they will experience a reduced need for medication and steadily improving function. And they'll probably look younger and younger the longer they do this.

So, in osteopathic medical school, and you experienced it when you went to medical school, you have your first two years of brain wiring. But the basic science part was cool because you get to learn about how everything is connected. You have the biochemistry, the pathology, the microbiology, the physics of everything. And you're excited, and then you go into your clinicals, and that's where the lobotomy happens. It's like all of this interconnectedness that we learned, even in osteopathic medical school, there is still that disconnect. It went down to make the diagnosis, treat the disease. And quite honestly, as my career went on in medicine and I started being driven further and further from that ideal I had when I first went to medical school, I became more disenchanted with the medical system.

Yeah. Well, I think that's true. I think we really are, in a way, disconnected from the basic biology and functional medicine comes back right to the most elemental things we learned in the first years of medical school, how we make energy from food and oxygen, how our immune system works, how our biochemistry works. I mean, biochemistry was that class you took in the first year of medical school. You gutted your way through it, you hope you pass, and then you forgot about all of it. But in a sense, functional medicine brings all that back.

So, you have to learn about the.

Way in which your body works. So, we're interested in the mechanisms and the causes, not just the of the disease and the symptoms. And that's really the problem. Exactly. In medicine is we're focused on geography. Where is it in your body? Is it your stomach? Is your head?

But your headache might be caused by something going on in your microbiome.

Right?

Oh, yeah. We have a lot to talk about. Yeah.

So.

Exactly. And then. So when you're practicing conventional medicine with my mindset, and I was trying to build this whole life Wellness program, I was writing nutrition programs for my patients. I was writing physical fitness programs. I was helping people purify their training, helping them plan for a events. And that was really great stuff, but as time went on, Mark, here's something really interesting that warped. One is that I was being pushed more and more by insurance companies and health plans to meet these metrics. They're trying to measure quality of care and I had to meet these prevention metrics. But the prevention metrics were really measurements of disease once it was out of the box. Did you get all your women to get mammograms? Did you get all your young ladies to have their media test. Did you have, did they all get their pap smears? We're looking for disease out of the box. We're not helping people create a cancer-free zone in their body.

Right.

You know, a woman would ask me, so what do you think about mammograms versus thermography, Dr. Papantoniou?

I would say I'm more interested in.

Didn'T you invent the pap test, Papantoniou? Well, I had a feeling you were going to read that up. I was waiting for a good answer. So, yeah, your uncle, right? No, he's not my uncle. But I will tell you.

It's a pat test.

Yeah, if you give me a brief, a side piece little story. When I had my, I had to have surgery at the hospital for special surgery. It's right next to Cornell.

Yeah.

So a lot of people saw my name. I had nurses coming from other floors to come up to see if I was related to George Nicholas Papandreaou and George James Papandreaou. So my dad told me, and don't hold me to this audience, but my dad told me that we're like second.

Cousins once removed or something like that.

May or may not be.

-You get royalties from every package.

-Well, I was about to say, you're stealing all my thunder. I was gonna say, it doesn't really matter how we're relating, 'cause I get no royalties. That's the way it is. But the first person or two that asked me, I said, I think we're second cousins once removed, and they left deflated.

Oh, I came up all the way to hear that.

So the third person that came in.

I said, yeah, he's my granddad. Well, see, that's very funny. But getting back to her, you know, what you just said was very profound, which is that, Prevention as we think about it in traditional medicine is absolutely not prevention.

Exactly.

Early detection. Exactly. Do a colonoscopy so you can find a polyp or an early cancer. Do a Pap test, you can find early cancer. Do a mammogram so you can find early cancer.

How about not getting cancer in the first place? And that's what goes back to what I was just saying, you know, about the mammography. I would say to them, I'm not interested in finding out if you have early disease. I'm interested in helping you create a disease-free or cancer-free life or zone. And when we talked about hormones a little bit later, we'll talk about estrogen and xenoestrogens and how that creates that environment for women that where they're more likely to get cancer. But that's going back to the point we need to prevent, not just detect.

Yeah, and I think that's what people get sort of confused about because doctors don't learn how to truly prevent. They learn how to detect and what functional medicine is. It's really a science of creating health. So when you create health, you don't allow disease to show up, right? If you create a healthy system, which is going back to your osteopathic training, it's what functional medicine is, you absolutely don't have to worry so much about disease when you create health because the diseases often just go away as a side effect of creating health. You create an inhospitable environment. And we see this over and over again with diabetes and chronic illnesses where you actually figure out how to build and create the body's functional systems and treat the whole system, the diseases just kind of get better without actually treating them.

They do.

I don't treat disease anymore. And that's what we do at the UltraWellness Center here. We don't treat diseases, we create health.

And as a side effect, their symptoms go away and the diseases go away. Yeah, and it's hard work. You know, when I practiced traditional medicine, it got to a point where you weren't required to think necessarily too deeply because you have specialists, everything got siloed.

Right?

We learned that basic science of interconnectedness. We learned all the beauty of the organic organicity of the body and how it can heal itself, and then we forget it. And then we then not only do we lobotomize it in terms of our science and thinking, we do it as a system. We break it all up into organ systems, and then we're in trouble because now one silos not talking to the next, I would refer somebody for a rheumatologic problem. Very bright doctor would see my patient, and if it wasn't a rheumatologic problem, the patient came back and told me, nothing you could do for me, told me to go back to you. I didn't get even an idea of where else I should look or a collaboration of here's what I did find and here's what you might want to look next, but it's not in my purview. It was isolated silos. So developing, starting to think about functional medicine, it's really hard, well, before we think about functional medicine, it's really hard for a patient when they're sick to get better if nobody's integrating the whole message, all the data. And so as a family doctor, I took a lot of pride and I put a lot of emphasis in being that quarterback for my patient and trying to get as much of that information to integrate a good health plan for the patient, hopefully to get them better, then to help them not only be better, but to optimize the performance. And in functional medicine, we do that. And here's the really cool part is we have the time to do it. You don't have the time to do it in conventional medicine. So you have silos, you have no time, and now you're treating really chronic disease and you just can't do it.

Yeah, so I think that the point you bring up is really important because when we're trained in traditional medicine, the rheumatologists do their thing and they just focus on the autoimmune stuff. The gastroenterologists focus on their lane, the neurologists focus on their lane, and on and on. And people go from doctor to doctor and are super frustrated because they have all these symptoms. When people come in with 10 or 15 different diagnoses, I'm like, is this just a coincidence? And they're all treated separately. The headaches are treated by the migraine doctor, their rheumatology, doctors treating their joint pain, their gastroenterologist treating their IBS, and so on and so on. And they're getting different drugs for every different symptom instead of going, well, gee, is this just a coincidence or is there something linking all these things together? And how do we think differently about them? And that's what functional medicine is. It's a way of thinking differently. So you mentioned, you know, the rheumatology issue and you mentioned the gut. You know, the microbiome is one of those areas that is blowing apart our traditional concepts, right? So the microbiome is this ecosystem of bugs in our gut. It's trillions of bacteria. it outnumbers our cells by 10 to 1 and outnumbers our DNA by 100 to 1. And it has been linked everything from autoimmune disease to cancer, to heart disease, to diabetes, to obesity, to autism, to Alzheimer's. I mean, the list goes on and on. So when you go to the rheumatologist, they don't go, how's your poop? But we do, right? Absolutely. So let's talk about the gut in connection to some of these diseases. We treat something a lot that's called SIBO. Now, when I went to medical school, this wasn't even a thing. but essentially it means small intestinal bacterial overgrowth, which means bad bugs growing in the small intestine where there should be sterile that have an impact on our health. So what are the symptoms? How would people know they have it? And what kinds of problems are they connected to? And let's kind of get deep into what our approach to diagnosing and treating it's going to be.

Sure. So, you know, I just want to be a little cautious here because we're jumping right into talking about a disease. Well, it's not a disease.

It's a phenomenon. It's a phenomenon that actually causes all sorts of other problems.

We do have to give things labels, but it is a phenomena that's connected to many different parts of our body and getting somebody better involves the whole lifestyle spectrum and it involves us using something in the functional medicine realm that we call the matrix. And the matrix is looking at not diagnoses, but conditions.

Yeah, let's talk about the matrix. Tell us more about the- yeah. What is the matrix?

Yeah.

How does it differ from traditional diagnosis.

And why do we use it? So for me to tell you about the matrix, you have to swallow the red pill. Which one do you want to swallow? I think I'll take the red pill. Okay, take the red pill. That's the right pill. Okay. So anyhow, now I can tell you about the matrix. So the matrix is basically a construct that we have in our minds where When you start telling me, I have headaches, I have fatigue, I have belching, I have bloating, I have a diagnosis of Hashimoto's thyroiditis.

Migraines.

Migraines. They don't become the endpoint. They become part of the narrative of your disease. And we put together into a story we call the Matrix. And so we look at assimilation, which is the gut. We look at energy. that takes us from, you know, an idea of fatigue, we rattle it down on our brain to what are the things in the body that control energy, right? And so we think about mitochondria. When we think about energy, we think about toxins. How do toxins influence the rest of your well-being? We think about our transport system, our blood vessels, our lymph drainage, and the connection between lymph drainage in the brain and your gut, leaky gut, leaky brain. things that we'll talk about. And we think about the hormonal system, neurotransmitters to adrenals to thyroids. And we place this all in our mind in this matrix, this paradigm of thinking. And then we make the connections. We say, okay, what's SIBO? Okay, well, it's going to be symptoms, bloating, distension. I feel like you've used the term food baby. There's something always in my gut.

Yeah, when you have a food baby, you're something and you feel your belly bloat up.

That's called SIBO. Right, that is SIBO. You don't feel like you fully evacuate when you have a bowel movement. You're fatigued, you get depressed, and you can actually feel your depression and it's related to how your gut feels. I had that food baby, I'm anxious.

I feel depressed, it impacts my life.

And it can link to all sorts of other diseases, right? Fatigue, and then when we think about fibromyalgia, you know, we need to think about the gut and what's been impacted there, and we think about Parkinson's, 50% of people with Parkinson's actually have SIBO.

Yeah. Now, asthma.

Right.

And we don't know. We know there's an observational connection there. We don't know anything about causality, but it's something you have to consider when you're thinking about other diseases. So the fatigue, the brain fog, the potential inflammation and joint pain, all of the gut issues, that's SIBO.

Yeah.

And a lot of SIBO, we don't know all the causes. There used to be some standard ideas what the causes were, but now we know that it's hard to determine. So the use of proton pump inhibitors.

And other acid blockers, like Prilosec, Prevacid, all that stuff.

All that stuff. And then we have stress plays a major role. And so that's some of the cause. That's what SIBO can look like. And now, how do we address it? How do we go about it?

I was gonna back up for a second. You mentioned these acid blockers because you know, they're giving out like candy. You can buy them in the drugstore. They're over the counter now. And people think they're safe and fine. I remember when I went to medical school, they just came out, and we were told by the drug reps, these are very strong drugs. They completely shut down acid in the stomach. You never want to give them more than six weeks. And now people are on them for six decades, you know, and. And what they do is pretty frightening. Literally, they will help your heartburn. But the side effects, which are not really side effects, they're effects. We just don't like them, so we call them side effects. are bloating and diarrhea and distension, all the SIBO symptoms. And by the way, they cause osteoporosis and pneumonia and prevent B12 absorption and zinc absorption and mineral magnesium absorption. So they're not exactly the same.

I just have to say this, Mark. And, you know, is that this is my, this is the concern we all have for medicine when we've been unplugged. And this is the issue, is that we have pharmaceutical companies that provide medications to our patients support sick lifestyle that perpetuates disease.

Yeah, love those advertisements on TV where they're like, don't worry, eat your sausage and peppers and don't worry, just take this Prevacid. Take the purple pill. It's ridiculous.

It is. And so they have prepared, but on the functional medicine side, here's where the hard work is, changing the lifestyle to make it a healthy lifestyle. so people can be healthy, prevent disease. If they do get sick, then we help them change lifestyle because that can impact disease more than anything else.

If you love that last video, you should check out the next one for sure on getting to the root cause of all disease.

When you look at statistics for all types of neurodegenerative diseases, they're all on the rise for the most part. And we know that all developmental disorders are on the rise. And if you look at childhood developmental disorders, I mean, there's some stats that are saying that.