Dietary Interventions for Autoimmune Disease with Dr. Terry Wahls

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Hey, this is JJ Virgin. Welcome and thanks so much for joining me. This is Ask the Health Expert. Here I put the power of health in your hands and give you access to the top people in health and wellness. In each episode, I share safe ways to get healthy, lose weight, heal your gut, detox, and lots more. So if you want to get healthy and get off the dieting for life merry go round, I'll give you strategies that will help you look and feel better fast. Today we are talking about autoimmune disease and what you can do with diet and lifestyle to reverse it, to not just slow it down, but actually reverse it. And I will tell you that when I wrote the Virgin Diet, which is a modified elimination diet very similar to what we're going to be talking about today, I had people who had autoimmune disease all of a sudden coming to me saying, oh, I've been using your diet for autoimmune disease. I'm like, huh. Then I met Dr. Terry Wahls. And you may know Dr. Terry Wahls from her amazing TEDx talk, Minding youg Mitochondria or from her book, the Wahls Protocol, A Radical New Way to Treat All Chronic Autoimmune Conditions using Paleo Principles. And also she has a cookbook as well. That's fantastic. But I met her and I was like, holy smokes. This is a woman who was in a wheelchair and is now out, you know, biking, etc. The stuff she's had to go through to show people how diet can change ms, change autoimmune and change a whole lot of other stuff has been crazy. She is one brave, courageous practitioner. And so I am super excited to be going through some dietary interventions with her today, talking about her research. If you have anyone in your family with autoimmune disease, if you would like to not to not get autoimmune disease, if you would like to be live your best health, you really want to pay attention to this interview with Dr. Terry Wall. She's a professor at the University of Iowa. She's been doing a lot of clinical trials on testing the efficacy of diet and lifestyle to treat Ms. She's been getting crazy, amazing results and really changing the process, the thought process out there where when she started people were like, you can't do that. That's dangerous and risky. She's like, diet and lifestyle to now people realizing this really has to be the foundational approach. So I am really honored to have Dr. Terry Walls with me today and I'll be right back with her. Stay with me.

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All right, welcome back to the show. You're a crowd pleaser, Dr. Terry Wells. I'm so happy you're here.

Well, I'm thrilled to be here with you again, JJ.

Now, how many people have seen your TEDx talk, Minding youg Mitochondria?

You know, last time I checked, is 3.9 million.

It's just crazy, isn't it? And if you haven't heard the story, I'd love you just to start there with, because now you are just a preeminent expert in autoimmune disease, especially Ms. How'd you get here?

Well, we'll take you back. You know, it was 20 years ago, out walking with Jackie, my left leg grows weak, dragging it at Hubble Home. The next day, I see the neurologist who says, you know, it could be bad or really, really bad. And then for the next three weeks, I'm going through the workups, and I'm thinking about the trigeminal neuralgia that's been plaguing me for 20 years. And so actually, JJ, I'm praying for a fatal diagnosis because I don't. I don't want to be disabled. Three weeks later, I hear it's Ms. I see the best people take the newest drugs. But my face pain is getting more severe. I'm getting weaker. We move on to mitoxantrone. We move on to Tysabri in nine minutes. So recline wheelchair. That's when I decide I have to do everything that I can. I go back to reading the basic science, and I develop theories that mitochondria are driving my illness. So I, again, based on the basic science, I start a supplement cocktail. I have adopted the Paleo diet. It's the autoimmune intervention protocol, the AIP diet. And I'm still getting worse, although it's slower. So I'm grateful for that. By 2007, I cannot sit up. I begin to have brain fog. My. It's clear I'm headed to becoming bedridden, demented, probably intractable pain. That's when I discovered The Institute for Functional Medicine. I take the course on neuroprotection. I discover electrical stimulation of muscles. I convinced my physical therapist to let me have a test session, which hurts really bad, by the way, but I feel great at the end. And I feel like my therapist says it's probably the endorphins. So we begin doing that three times a week. Then it gets me a homegoing device, and I do it every day. Then I have this really big aha. Which will resonate with you is what if I take my list of supplements and I go figure out where they are in the food and I redesign my paleo diet based that. So December 26, 2007, we start this. And in the next month, I realized that my fatigue is less, my pain is less, and my physical therapist says, you're getting stronger. I'm going to advance your exercises. And a couple months after that, I do this radical thing. I mail a letter walking down the hall, stunning everyone because they haven't seen me walking in the hall for four years. Then on Mother's Day in 2008, we have this emergency family meeting because I want to ride my bike, which I haven't done in six years. And so Jack decides that my son will run alongside on the left, my daughter will run on the right, and she'll follow behind. And I push off and I actually bike around the block. My son is crying, you know, big 16 year old big, because Zach is six five, so he's really big. So he's crying, my daughter's crying, Jackie's crying, and I'm crying. And then in three months after that, we do an 18.5 mile bike ride with the family. Once again, everybody's crying. This fundamentally changes how I think about disease and health. It changes the focus of how I practice medicine, which, by the way, gets people really upset. And I have to go have this big meeting with the chair of medicine and the chief of staff to defend what I'm doing and why. But fortunately, they ultimately, I win them over and they support what I do. My chairman at the university wants me to get a case report written up, which I do. Then a case series, which I do. And then he says, terry, we need to have you do a safety and feasibility study to see can other people do what you've done. Is it safe?

Is it safe to change your diet and eat more healthy foods? Right.

And to add meditation, to add it.

Oh, boy, now you're really getting out there. And just to be clear, you know, you got diagnosed with Ms. First of all, you'd had this trigeminal neuralgia for 20 years that I think you told me about before. Like, people tend to have a high suicide rate because the pain's so bad.

The pain is so bad. So the way to really think about this, jj, is you get a jolt of electricity, either here or here, that radiates down your face. And when it first began, it was little twinges, unpleasant for a few days, then unpleasant for a few weeks, and then over the years became more and more Electrical. By 2007, when it would turn on, sound would trigger it, light would trigger it, speaking would trigger it, swallowing would trigger it. So I wouldn't swallow, so I just drool. I'd go into the pain clinic, get injections, then I would take IV Solubedrol. And so I'd come to terms with, I'm going to be bedridden, I'm going to be demented if my pain turns on permanently. I had changed my living will, my durable pal of attorney, so that if my pain turns on and I choose to stop swallowing, there's no feeding tube and no IV fluids. That gave me actually a lot of peace to know that I would not have to endure that electrical pain indefinitely.

And there's really nothing except trying to manage the pain for that. Correct?

Correct. Correct.

And then for the ms, I mean, people who have ms, it's just a slow deteriorating disease for most people.

Right.

We have these really great drugs that turn off the relapses very well. And what they've done is they've taken the time to wheelchair, on average, severe gait disability, wheelchair walker, from 10 years to 20 years. So they've slowed it down, but they haven't stopped the neurodegeneration. And you and I are not surprised because they haven't addressed nutrition, hormonal imbalance, toxic loads, mitochondrial infection, mitochondrial processes. So they can turn off one part of the immune system very effectively to stop the acute relapses, but they haven't figured out how to make the microglia calm. And you and I know that's a diet and lifestyle proposition.

Well, and even bigger, like, so you just described two things that were going on with you that are progressive diseases. They don't stop and they don't reverse.

Correct? Correct.

And then you go through and you use diet and lifestyle, dietary interventions, supplements and lifestyle modifications, and you don't just slow it down, you stop it and reverse it. And yet they. There is this resistance about what you're doing as to whether it's safe.

Oh, yeah. Oh my God. Enormous resistance.

Why? I mean, you hear this and it's like, it's so insane that it's hard to wrap my brain around, you know.

When your understanding of the world changes people, we deny that, deny that, deny that until the evidence is overwhelming. I'm really blessed that the chair of medicine was a rheumatologist who, when I walked in for the first time in four years, he was thrilled. He thought, sure, it was the Tysabri. And I explained that. No, no. Went through everything and said, actually I was off all disease modifying drugs by then. And he said he saw the importance of that and when we get the case support, then the case series and said it's so important to do a small clinical trial to see if other people can do this. And so he helped me get the mentors to write that trial and get it going. So I really have to thank Paul Rothman for, you know, having the vision. And he supported me now. And he was criticized, I was criticized. There were a lot of people very.

But criticized for what? For what? Like, what were you criticized? And here's the thing. You're an md, you're a researcher, you're a professor. Like, you know, it's not like you're.

But it was very different. It was a different kind of research because what the NIH funds is molecular pathway by molecular pathway. People thought I should do research, but I should pick one supplement, one little intervention. So if it helped, we'd know. Fortunately, Paul Rothman said no. The question is, could people do the complicated thing that you did, Terry, do you hurt anyone? And then what is the effect size? And we can begin to break it down later. If it works. Of course, what we're able to show is we could get people to radically change their diet, to begin meditating, to begin exercising, and to begin doing E stim in the circumstance where you anticipate a 10 to 20% worsening every year once you hit the progressive phase as a group, we stopped the decline in terms of their walking and hand function. In half of those folks had clinically meaningful improvement in walking and hand function. We had a really dramatic reduction in fatigue severity, improvement in quality of life, improvement in verbal reasoning and nonverbal reasoning. That was just so, so striking. JJ the biggest problem, side effect was if you were overweight, you lost weight and got back to a healthy weight. So I had to do safety reports every three months because people were losing so much weight.

So the safety, I mean, it sounds so crazy, but it's one of those Great things is when you start to give people drugs, have these side effects, and diet, lifestyle, have all these side benefits.

Yes, yes.

You know, and so you might not need the medications you had anymore. You might not.

Yeah, I certainly see that clinically. When we started using these concepts in my. In the clinics at the va, blood pressures were improving, blood sugars were improving, people were reducing prescription med after prescription med. We're eliminating drugs. We had much less pain. We had better weight, of course, better blood pressures, better hemoglobin, A1Cs. Unfortunately, I never found an economist to help me analyze the change in cost, but certainly because we were reducing prescription drugs over time, there would have been a tremendous cost saving as well.

Well, it seemed like you'd have cost savings on prescription drugs and. And then also the impact of the change in quality of life.

Quality of life and I'm sure the consumption of services over time. I retired from the VA in 2016 so I could expand my research, teach these concepts to the public and to practitioners. And the VA has incorporated some of what I've taught in their whole health clinics. The Iowa City VA added staff, and there was so much demand that they now teach classes using these concepts. We're having just a wonderful impact.

I want to dig into the research and then also some of the things that some of the parts of the protocol. We're going to take a quick break. We'll be right back and dig into that.

Some people think nature is like this, but actually it's like this. That's why Columbia engineers. Everything we make for anything nature can throw at you. Columbia engineered for whatever.

All right, so let's dig into this research because how much now? Because I know the first thing you had to do was start to prove that these diet and lifestyle things that. That meditation and eating healthier foods was safe. So let's walk through. You did the first trial. How many trials have you done? And now what's the latest that you've been doing?

Four published trials. Probably 15 papers out of those four published trials. Two trials that are. Well, actually three trials are going on right now. And the usual sequence is you do a single arm safety trial. We did that. Then you do small pilot studies again, that are randomized. This time we did just diet, modified paleo diet versus a weightless control, and again, improved quality of life, reduced pain, fatigue, and better motor function. Then we did a much larger trial funded by the Ms. Society, where we had an observation period for 12 weeks. Then you get randomized to a low saturated fat diet or the modified Paleo diet, basically the Wahl's diet. We did the Wahls elimination diet. We took nightshades out, lots of vegetables, 612 ounces of meat. The low saturated fat diet. We actually improved. We had four servings of whole grain, four servings of vegetables, and limited fat to 15 grams of saturated fat. They got five calls to the dietitian, then they repeated their assessments. Then they came back 12 weeks later. We let the Walls elimination group reintroduce the nightshades one group at a time so they could figure out which nightshade, if any, were troublesome to them. I repeated the assessments. What we saw is that of course, quality of life fatigue was stable during the observation period. So no surprise, after the intervention period, the fatigue, quality of life, walking, endurance thinking improved in both groups. Now for some of the measures. Quality of life, walking endurance walls was definitely better than the Swank group. Interestingly, fatigue severity was the same in both groups improved over observation. The more sensitive measure, modified fatigue impact scale was significantly better in the Wahls group in walking endurance at 24 weeks, significantly better in the Wahls group. My interpretation from that is the standard American diet is bad. You and I know that. And it's going to lead to continued worsening of the Ms. Symptoms. Improving the diet is going to be helpful. It'll reduce fatigue, improve quality of life. The Swank diet was certainly much, much better than the standard American diet. When we analyzed the quality of the diet, the Swank diet did improve from usual observation period. The Wahls diet had more improvement in more of the micronutrients than the Swank diet. So perhaps it's not surprising that the Wahls group did better in several of those measures. I'm really excited to say that we're now recruiting for a study that will be two years that will compare a ketogenic diet, the modified paleo elimination diet and dietary guidelines diet. And it will include MRIs, blood biomarkers, something called serum neurofilaments. Clinical measures and patient reported outcomes will have much longer duration. That will be probably the longest, largest Ms. Study with the most interesting biomarkers. Very, very exciting stuff.

What's interesting, Terry, is, you know, you talked about and you said, all right, it helped with all these things with Ms. And they lost weight, their blood pressure went down, their blood sugar stabilized. Like there were all these amazing things.

All these great things are happening. Yeah.

So, you know, beyond ms, what else is this diet? What else could someone be using this diet for?

So in my clinics at the va, we'd use this for people with all sorts of autoimmune conditions. Rheumatoid arthritis, psoriatic arthritis, psoriasis, anxiety, depression, high blood pressure, metabolic syndrome, diabetes, prediabetes. And we know by the way, people with autoimmune conditions are much more likely to have all those comorbid problems, mental health issues, more likely to develop high blood pressure, obesity. So it's helpful that this approach, diet, stress reduction, more movement is helpful not only for the autoimmune condition, but for all of those comorbid problems and the people we see in our clinics and literally the thousands and millions that we have following my work, you know, that have followed my book, they contact us jj and say they have a condition that I've often have never heard of that their treating physician couldn't help anymore. They had discovered my book, began implementing it, and they now have hope that they could stabilize their genetic problem or often greatly improve their quality of life. Even though it's a genetic disorder, or even though it's a serious autoimmune disorder that was progressing despite the best conventional disease modifying treatments that when they added diet and lifestyle, their cells could work better. I have people with muscular dystrophy who follow me and are tremendous devotees. This is a genetic disorder that they swear they can tell they are so much better by following the Wahls protocol.

The Wahls protocol is a book. Just if you're listening, this is a book that you want to get. Because I think one of the big takeaw here is this book is for everyone. You know. Yes, someone with Ms. Is highly motivated and will make the shift. But imagine if we just all ate this way, lived this way, how much would change? You know, it like, it would be incredible. Now it's for a lot of people, it takes that, that scariness of a disease to make that lifestyle change. But what if we could get that done sooner? You're listening right now going, so this never happen. You look at autoimmune diseases and they are the biggest thing happening to our health right now.

Yeah, you know, we probably have 25 million with an autoimmune disease and then another 75 million that have the autoimmune protone. Headaches, fatigue, pain, infertility, migraines that don't have a clear diagnosis, they may have autoantibodies or they may even be pre autoantibodies. If we follow them another five to 10 years, those folks are at very high rate for developing a systemic autoimmune problem. If during that pre diagnosis phase I can get to them and get them started on the Wahls protocol. We can regress the damage, resolve the headache, the infertility, the migraines, the brain fog, the mental health symptoms. And they never develop the inflammatory bowel disease or rheumatoid arthritis or Ms. That they weren't on the track to develop.

Now one of the things I love that you do is travel with your cabbage.

Yes.

Just, I mean this is when I think of Dr. Terry Wahls. I think of you walking into an event with your cabbage and I'm like, this is just so great. So can you walk us through? I know you're going to give us a nice one page summary. Everyone can get and download of your program and you of course want to watch the TED talk and get the book. But can you walk us through some of the dietary changes like some of the key elements of the protocol?

So key, more vegetables. We're talking green leafy vegetables. One group, the cabbage, onion, mushroom family, another group, I call that sulfur rich. And then the third group, deeply colored beets, carrots, berries. And then want to have sufficient protein. You can do it as a meat eater or as a vegetarian, if that's your spiritual belief. Then if you want to advance, I have levels that you can take a bit deeper. With level two, level three in the elimination diet, I want people to start where they and their family can succeed. So the first thing, add in all those vegetables. Then I want you to remove the three inflammatory foods, gluten, dairy and eggs. And also want you to get rid of the added sugar.

Amen. Hallelujah on that one. And I just want to add one thing before you keep going. You said something so key that I think we don't stress enough is add before you take away. Yes, you know, add before you take away. If all you thought first was like, let's add in some of these non starchy vegetables and we'll start crowding out the other stuff. So step one, add before you take away. Next one, when you talked about gluten, dairy, eggs, you know how much that warms my heart and lowering the sugar. Can you just talk briefly? Because I know one biggest questions I get asked was like eggs. What about eggs? Why eggs?

Well, so eggs are a great food if you tolerate them, but you will never know if they're a problem for you until you take them out. So I want people at the very least take out gluten, dairy and eggs, preferably for six months. Sometimes people can't do that and they'll just do three months or even a Month. The protein in egg whites can cause an abnormal immune response, activate your innate immune system, which can lead to irritated microgliat, which lead to mental health issues and can lead to achiness fatigue. That prodrome that I, that I've mentioned, we've had many folks who take out the gluten, dairy, and eggs, and they're like, you know, I can do it. I can only do it for two weeks. And actually, my students who volunteer in my lab, I have them follow the study diet for two weeks just so they can see what it's like. And then they're like, great, I can go back and have pizza and beer. And then they feel like, oh my God, a semi just ran over them. And they're like, oh, I guess I do have a problem with these foods.

You know, it's so interesting. Like, of the thousands of people I've pulled off gluten, my take on it is it is so rare for someone to go, I actually feel great when I eat that. I think the only time that I ever hear that is when they really didn't get it out. You know, you just never hear, I pulled this all out of my diet, and then I went back and ate the pizza and felt fabulous. Never once.

It just does not happen. Now I tell people, if you can do it six months, particularly for the eggs, you'll have the best chance that you can reintroduce them and tolerate them well. If you pull it out for a short time, the memory cells aren't gone, and you're more likely to have an abnormal immune response. So it's always a conversation with folks, how long are they willing to try this experiment? The other thing that I stress is this is an experiment. You're the principal investigator, and you want to do your science accurately so you know you have good results. Take the food out. We can decide when you start your experiment how long you want it to be. And while I recommend six months, you can decide that all you, all you can manage is two weeks or a month. You pick out how long it is, but actually take it out, be 100%, be meticulous, and then you can, when you reintroduce it, preferably do one ingredient at a time. So when you feel terrible, you know which one to blame. But, you know, sometimes my vets would take, you know, gluten, dairy, eggs out for two weeks, then start them all up, feel really terrible, and come back and say, okay, you made me a believer. I they are still out and I'm eating all those vegetables.

It is fun. I have found, you know, in the virgin diet, I'll, I'll start with the week and then I'll go, okay, we're going to do three weeks. And I'm like, can we agree we could do anything for three weeks and we just. Because I know that the longer you get them starting to feel good. I think most people have no idea what feeling good feels like.

Absolutely.

And you know, right. And as they start to go, oh my gosh, like they don't. Their idea of what normal. And I hate to ever use new normal. I'm so tired of that. But like what we've adapted to as normal, of living in this like gassy, bloated, achy, you know, brain foggy state from this, you know, ultra processed food is not normal.

You know. And unfortunately what I observed is people have forgotten how to cook. They don't know how to shop, they don't know how to meal plan. And so we have to go through a process of teaching those skills so they could learn how to plan their meals, their groceries so they consume all the food they buy so you don't have waste and how to shop. So in the va, we separately would have classes for all of that. In my programs that we run for our patients, we have classes for those skills. I teach my practitioners that that is key to your success is finding ways to teach your clients and your patients those skills.

Well, all they really have to do is follow your social media because you have awesome. I mean you're in your garden, you're showing your food that you're making. It's fantastic. So highly recommend following Dr. Terry Wahl's social on your Instagram. So someone hearing this. And again, if you go to jjvirgin.com wahls that is Dr. Terry Wahls w a h l s so jjvirgin.com wAhls you'll be able to get the summary of the process and we'll also put the links for the book and her TEDx talk. But someone says, okay, I need in on this. How would they work with you and your team?

Well, so if you go to go to our website, we'll see that we have a wide variety of options for you. We have just started seeing patients again. So people who need intensive support, we'd love, love to see you. We also have an online course, the autoimmune Intervention Mastery course. That is really great, great support. And you can get that with seven weeks of coaching. And then we have the Radical Health Upgrade which again is online and virtual, which is 12 weeks of a much smaller, more intimate group support with me and with individual support with my health coach. We have levels of support from the online course to very intensive one on one patient.

You're also training other practitioners, correct?

Yes, yes, we train practitioners. As a matter of fact, we just did our case series this morning. We have people with health licenses, physicians, nurses, movement nutrition professionals. We have health coaches. People with a health related license or certificate is eligible. We have this spring enrollment happening right now.

Awesome. This is so fantastic. It's crazy to me what you've had to do to get this happening, to get this research going and to get diet and lifestyle accepted as safe and.

Effective in that diet and lifestyle should be part of the treatment plan for people with Ms. We have made so much progress. When my TED Talk first went viral, I was interviewed by a wide variety of neurology folks who in the end would condemn me for creating false hope. It was wild interviews.

What are we without hope?

Because I was creating false hope? Because I was just telling my story and saying, you know, this is the research that we've got going. And that was very upsetting. But, you know, I did my interviews, I kept doing my research in that time period. Our publications are being cited, cited, cited. I've joined the Ms. Society Nutrition subcommittee. Our group has analyzed the dietary intervention studies in Ms. We'll be publishing that soon in jj. All of those studies are happening because of that TED Talk, because we led the way in doing dietary interventions. Of course, they're all little tiny pilot studies like our initials were. But I'm so excited that now at the Consortium of Ms. Centers, there are more clinicians saying, you know what, diet does matter, that we can't just rely on the drugs, that we got to be talking about diet and lifestyle with our patients.

Well, you did that. And you know, it takes a brave hero to do that.

You have to have a lot of perseverance. You have to realize this is a marathon and you just gradually, steadily grind away.

So thank you for grinding. You are making the big dent in healthcare worldwide and it is amazing. And again, I want to remind everybody listening, this is not just a diet for Ms. You heard all of the side benefits for this. This is a foundational approach to health. And so grab it@jjvirgin.com wal that's w a H L S. I'm going to put Dr. Terry Wahl's website, the book link and the TED talk and everything that you need to look at. And again, bless you for giving people hope. Because without hope, we have nothing. So.

Absolutely. And jj, let me throw in one more thing, one more link we should give you. We're recruiting for a new clinical trial comparing ketogenic diet, Wahls diet and dietary guidelines for two years. We expect all three groups to improve. The exciting thing is we're going to follow them for two years. You have to have relapsing, remitting Ms. And live within 500 miles of Iowa City. Cool.

All right. We will get that out there, too. And I just so appreciate you and your time and your courage and your perseverance and everything about you.

Well, I love everything that you're doing, jj. You have such a huge impact in the health and wellness space, too. It is so marvelous.

Mutual admiration society.

Absolutely.

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