We recently sat down with Dr. Terry Wahls to discuss diet and MS. Dr. Wahls is a clinical professor of medicine at the University of Iowa and a staff physician at the Iowa City Veterans Affairs Hospital, where she teaches medical students and resident physicians, sees patients in traumatic brain injury and therapeutic lifestyle clinics with complex chronic health problems that often include multiple autoimmune disorders, and conducts clinical trials. She also lives with secondary progressive multiple sclerosis, and has personally found great benefit in treating her MS through a specific program she calls the Wahls Protocol™.
What is the Wahls Protocol? How did it come about?
The protocol is a diet and lifestyle program that was designed specifically to help support mitochondria in brain cells function more optimally. Mitochondria are ancient bacteria that got absorbed by larger cells a billion and a half years ago because they could utilize oxygen more effectively to generate energy for the cell. They’re like bean shaped power plants that generate the energy that every cell needs function. Our cells that need the most energy have the most mitochondria per cell – brain cells, retina (eye) cells, heart cells have tens of thousands of mitochondria per cell. And many scientists now believe that in many neurodegenerative diseases including MS, malfunctioning mitochondria are at the core of why damage to the brain becomes progressive.
The Wahls Protocol came about over the course of several years, because of my own personal journey with progressive MS. As my health continued to decline, I started reading basic science studies involving MS, Parkinson’s, Alzheimer’s, Lou Gehrig’s disease and Huntington’s disease. I started taking vitamins and supplements that appeared to slow the speed of my decline. And eventually, I transformed my diet from a vegetarian diet to a Paleo diet.
I discovered the Institute for Functional Medicine, took their course on neuroprotection, and gained a deeper understanding of brain cell biology, of the impact of the microbiome, and of food sensitivities. They had a longer list of vitamins and supplements that I added. My decline slowed, and then I had the insight that I should reorganize my diet to get the same nutrients I had been taking in pill and supplement form from food. That diet is basically now what I call the Wahls diet.
I also resumed a daily meditative practice, and I worked with my physical therapist to add electrical stimulation of muscles to my physical therapy routine. Cumulatively, that really transformed my life from being in a tilt recline wheelchair – so weak that I could not sit up in a regular chair anymore – to no longer experiencing fatigue within three months. In a year I was walking without a cane and biking so much I could do an 18 mile bike ride with my family.
Do you have any tips for people who have trouble consistently following a strict diet?
We treat everyone in our clinic and in our clinical trials as if they have a food addiction. We ask people to get all of the foods excluded in the diet out of the house. We also ask families to make a commitment to follow the diet when they are in the presence of the patient or clinical trial participant, and to be respectful of the challenges of following the diet. For example, you don’t come home and say, “Wow, that pizza and beer was just so fabulous!”
What do you think is the role of this diet in relation to more traditional treatments like disease modifying therapies?
In our clinic and in my clinical trials, whenever I start people on diet and lifestyle regimens, I tell them to stay on their current treatment plans, whatever they may be. People sometimes arrive very excited that they’ve discovered my work, and they often say they want to drop their immune modulating medication and start my dietary protocol. My immediate response is “NO.” You do not stop your current treatment. You add in the diet and lifestyle changes. Down the road, if you experience remarkable reduction in fatigue and improvement in function, then in my opinion, it may be appropriate to have a conversation with the healthcare provider who is prescribing your immune modulating medication about whether or not you want to attempt a trial of tapering that treatment. I always want people to continue to work with their other healthcare providers and keep them informed about their work with me.
Can you explain what research you have done or are doing around diet and MS?
I have a therapeutic lifestyle clinic at the Veterans Administration hospital where I work. In our clinic we use diet and lifestyle approaches to treatment. It’s been running for 18 months, and we are just now getting ready to look at what we’ve learned so we can write the case studies from that experience. We treat a wide variety of autoimmune problems. In addition to MS, we treat lupus, rheumatoid arthritis, fibromyalgia, severe diabetes, post-traumatic stress disorder and mental health issues. I have a new study comparing care in the therapeutic lifestyle clinic with more traditional care in the rheumatology clinic for people who have rheumatoid arthritis. We will be monitoring fatigue, quality of life and disease activity.
We’re in the middle of the first study in which we follow people for three years – we have another year and a half until it will be complete. We’ve published one paper, reporting preliminary data on 12 months. A second paper was just accepted that reports on the whole cohort with 12 months of data. We also have plans for additional papers describing the gait changes and MRI changes.
We’re also finishing up a very small pilot study that compares my original Wahls diet with the ketogenic (high fat, adequate protein, low carbohydrate) version of my diet and includes a control group. There again, we are primarily looking at improvements in fatigue.
How can people learn more about the Wahls Protocol and find these papers as they come out?
I have a website, terrywahls.com, which has links to papers and abstracts. As additional research results are released, they’ll be added to the site. My book also outlines the protocols that I used for my own healing and that I use in my clinical practice as well as generalities about the protocols that we’re studying in our clinical trials.
Because so many people have asked for more support, we’ve created programs on the website using online content to provide more intensive support. You can also find information on the site about in-person seminars and video courses.
What makes you most excited about this area of research?
I see this protocol working across so many autoimmune and degenerative states. So, that is clinically extremely gratifying to see. Now as a researcher at the University of Iowa, I’ve given various research seminars presenting our data, showing the videos of before and after gait changes. I’ve saved frozen blood from my research, and I am inviting the basic science community here at Iowa to approach me with ideas about how we should analyze the blood to look for what has changed, pre- and during the course of the 12 months. We are just sitting down now to map out what kind of analyses we’re going to do, and I am excited to see the level of enthusiasm the University of Iowa – as well as the interest that the MS Society, and other universities and organizations – have in this work.
Understandably, when I first started doing this, many people questioned why I was talking to the public before I had randomized control trials supporting that this approach works. I feel morally compelled to do this. In 2007, after seven years of decline, it was apparent that I was headed toward becoming bedridden with significant cognitive issues.
I feel that this protocol dramatically improved my function. But I know it could have gone the other way. I hear stories of people with advanced MS and that easily could have been me. So I feel morally obligated to let the world know about this approach. If people want to wait for the randomized control trials, that is completely understandable. But if they want to begin eating a more nutrient dense diet, begin a meditative practice, and work with a physical therapist for an exercise program, I want as many people as possible to have that possibility. I am just so grateful. I’ve been blessed to find something that I feel stopped my disease.
Find information about Dr. Wahls' upcoming workshops, speaking engagements, lectures, webinars, and more here.
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