I am so excited to talk with Dr. Terry Wahls, author of the book The Wahls Protocol, and an incredible researcher looking at how lifestyle changes can help multiple sclerosis (MS) patients control their symptoms and stop the functional decline that so often comes with MS.
In this episode, Dr. Wahls talks about how her own diagnosis of MS took her from being super active to a full reclining wheelchair. Not satisfied with the existing methods of treatment, Dr. Wahls dove deep into creating a diet focused on autoimmune health. Listen in as Dr. Wahls describes her milestones on the way to a full recovery plus what she’s doing to manage her recovery now — including her use of electrical stimulation throughout her healing journey and how it’s evolved over the last two decades.
Additional Note: For any patients who are interested in signing up for the study that Dr. Wahls mentioned on this podcast, please visit https://wahls.lab.uiowa.edu/join-study
Garrett: Welcome to the Undercurrent Podcast. This is MS Awareness month and I am delighted and honored and incredibly excited to have Dr. Terry Wahls on the show today. She is a medical doctor, a professor at the University of Iowa medical school, a researcher and author of the Wahls Protocol, which is a book that I’ve purchased many times and gifted many times and have recommended many times and just absolutely love. And she is an incredible teacher, lecturer and inspiring human being. And I’m just so excited to be able to have this conversation with you. Dr. Wahls thanks for joining us.
Dr. Terry: Thank you, Garrett. I love your work and what you were doing as well.
Garrett: Thank you. That means a lot. And to help us kick off the conversation here, I know some people listening have seen you speak, read your book, some haven’t, but for everybody, whether they have, or haven’t heard it before, I think that your story is just so inspiring and so instructive and that we can learn a lot from it. So can you please share a little bit about your story, where you were, an outdoors enthusiast and experienced martial artist and then you had MS.
Dr. Terry: So we’re going to sort of tell us in real time. Imagine 20 years ago, I’m out walking with Jackie, my left leg becomes weak dragging at [02:29 inaudible]. I see the neurologist the next day. He says, Terry, this could be bad or really, really bad. So at night in bed, lying next to Jackie, I think about the 20 years of worsening electrical face pains that I’ve had. So as I go through the workout for the next couple of weeks, actually I’m rooting for a fatal diagnosis because I don’t want to become disabled. Three weeks later, I hear multiple sclerosis. I treat my disease aggressively, find the best MS center. Take the newest drugs. Three years later, I hear tilt reclined wheelchair.
I began Novantrone and then [03:14 inaudible, taking more and more aggressive drugs. My electrical face pain turns on, tears stream down my face as my 10 year old daughter hugs me. But I am a physician. So at that point, I go back to reading the basic science night after night and begin experimenting on myself based on what I’ve learned. I’ve already dropped the vegetarian diet, had adopted the paleo diet. I’d continued to decline. I developed theories that mitochondria are the big drivers. I developed the supplement cocktails to support my mitochondria. I discover instead of using electrical stimulation of muscles and asked my physical therapist. Can I try that? My test session hurts bad really bad, but when it’s over, I feel great. And I begin doing Estem as part of my physical therapy.
And my physicians say, Terry, you have very progressive MS. Functions once lost, will not come back. And that’s why I’ve been so aggressive with my drug treatments. But I ask myself, am I doing everything that I can? I’ve been on the diet for five years? I’ve been taking supplements. I’ve been doing the Estem. I add in meditation. I redesign my paleo diet based on all the science that I’ve been learning. And I relentlessly increase my Estem. Three months later, the electrical pains are gone. The fatigue is gone. My mental clarity is improving. Three months after that I am walking throughout the hospital, first with a cane then without a cane and three months after that, it’s on mother’s day.
And we actually had to have an emergency family meeting because I want to try riding my bike. And Jackie decides that, because I haven’t done that for six years. She tells my son’s Zach to drag alongside on the left. My daughter Zod on the right and she’ll follow on our bike. And I push off and the bike wobbles, but I catch my balance and I bike around the block. My son is crying, my daughter’s crying, Jackie’s crying, I’m crying. And you can sort of hear that I’m crying as I tell the story. And then three months after that, Garrett, I do an 18.5 mile bike cry with my family. And once again, I’m crying, Jackie’s crying, I’m crying. And this really changes the way I think about disease and health. It will change the way I practice medicine and it will change the focus of my research.
I want to make clear at my Nader in 2007, I’d spent four years in reclined wheelchair. My face pains were relentlessly worse, difficult to turn off. I was very clear. I was looking at becoming bedridden, demented, probably having continuous intractable trigenal neuralgia.
And I was too weak to it up like I am now. I had a zero [06:38 inaudible] chair with my knees higher than my nose. And I had changed my living well and my durable power of attorney to say if my face pain turns on so intensely that I stopped swallowing because it triggers pain that there’d be no tube feedings and no IV fluids and actually gave me a great deal of comfort that I could maintain that control if my life got that grim at the end.
Garrett: Wow. And the transition you were able to make, I mean, I’ve talked to you and heard and read your story. I knew what was coming and I still get chills and still get tear up myself, hearing it. It’s so inspiring to have that transformation. And it’s in an area where people often are told that it’s just a one way street down the decline road and there’s really very little you can do.
Dr. Terry: Yeah. Once you hit the progressive phase, the spinal cord is shrinking. The brain is shrinking. Axons are being cut and neurons are dying. And I had been taught, all my neurologists had told me that functions once lost at that phase of the illness are gone forever, which is why I’d been thrilled to get continually more aggressive with my drug therapy.
Garrett: So to help everyone understand, at least at a foundational level for people that don’t know, can you describe what MS is, and also give us your best take on what causes it?
Dr. Terry: So MS is a combination of a neuroinflammation in neurodegeneration. Early on there’s inflammation, acute relapses. If you do an MRI of the brain, there’s acute enhancing lesions with lots of inflammation. That cools off, the symptoms reduce or remit and function improves at least somewhat, sometimes completely, sometimes just partially. That worsening relapsing phase will go on for a few years to maybe 10 years, maybe 20 years, depending on that person. And then there’s very little inflammation. Now, the neurodegeneration is much more prominent and that’s where the brain volume is shrinking. The spinal cord is shrinking and there is no acute relapses, but there’s this steady march of worsening symptoms, of worsening disability.
And even though we have drugs now that are really good at treating off the inflammation, they’re slowing down the time to that conversion to the progressive phase. So now on average, instead of it being 10 years, it’s 15 to 20 years. But people still end up in that phase of that slow, relentless decline. And there’s a lot of theories. Are there better drugs that can stop that? I’ll give you my take as to, okay. So why do we develop MS? Everyone agrees there’s genetics that are at risk 200 to 300 different genes that increase your risk. Each gene, a tiny amount, there’s just a couple genes that increase your risk really significantly. And then there are 16 different microbes that if you’ve been infected with them, that increase the risk for an autoimmune problem.
Garrett: Before we move on from that, when you talk about the genes, when you say there’s a couple hundred genes that are relevant here, and most of them increase a little bit, some more significantly. How significantly is that? I mean, is it a fraction of a percent?
Dr. Terry: A half of percent to a percent. The genes that are most aggressive might increase your risk 15%. So the vast majority who have that gene never get the autoimmune problem, never get MS. And of those 16 different microbes that increase the risk. Again, the vast majority who get infected with that microbe never develop autoimmunity. So my neurology colleagues are saying, well, there’s a host of unknown environmental factors that are very, very important, because even in identical twins, the vast majority of identical twins do not both get MS, only 30% will, even if they were raised in the exact same household.
So there are these other environmental factors. And from my perspective, as someone with expertise in integrative functional medicine, I’m thinking about your diet choices, your toxin exposures, your early life trauma, your physical trauma, current psychological trauma, your hormonal balance, your microbes living in your mouth, your gut on your skin, all of those factors. And that’s what I evaluate and that’s what I help people optimize. And as we do that, we can often stabilize their disease and then begin to improve function. And then we are often needing to reduce and eliminate medication after medication because as their cells can do the chemistry of life more appropriately, then we have to watch them carefully so they’re not over medicated.
Garrett: Thank you for that. I think that’s a wonderful, accessible, and yet very deep and insightful description there. And I’m glad you went into that description of how genetics and certain microbes can increase the risk, but the epigenetic environmental factors that determine which genes are turned on or not are vitally important. It’s not just your genes are a death sentence or we’re prisoners of our genes, we have say in which ones and how they get expressed.
Dr. Terry: Absolutely, absolutely.
Garrett: And so I really, really appreciate that description. So one of the things that really strikes me about the Wahls protocol and the research that you’ve done is that you compare it, it being the Wahls Protocol to the traditional standard of care, which you mentioned are these drugs. So the drugs that you describe, you started taking the drugs that you describe, that delay or change the trajectory of MS and delay the progression of symptoms or the regression of function. Are those pretty much all immune suppressing drugs, is that the standard of care?
Dr. Terry: The standard of care is an immune suppressing drug of some type and it will block some portion of your normal immune cell pathways. And what I would remind everyone is my immune cells are vitally important for inspecting my environment, identifying that a cell has been damaged and then repairing that damage cell. There is wear and tear that happens all the time with aging. So I need a healthy immune system to keep me working well and to protect me from infections and conversions to cancer cells. I have enough gray hair, when I went to medical school, I was taught that my brain was sterile, the urine was sterile, the blood was sterile and that poop didn’t really matter.
Now, we know in fact that the poop, the microbes in my gut matter a whole lot. And when we do DNA RNA examination of all of my tissues, that in fact, I have a lot of microbes throughout all my body and my immune cells keep the ones that are harmful at bay and a cooperative relationship with the ones that actually help me run the chemistry of life.
As I age, the immune cells become gradually less effective at keeping everything at bay. And so I’m going to be at risk for activation of these microbes that have been living in my body sharing my space.
The immune suppressing drugs are very, very, very effective at treating off those acute inflammations. At present we don’t have a drug that’s effective at the neurodegeneration phase. What we have that is effective for that is diet and lifestyle, addressing all of those epigenic factors, all of those factors that are part of the Wahl’s Protocol, that lets your immune cells function more properly, your mitochondria function more properly, helps reset your hormonal balance and helps reset your circadian rhythm. I predict that it’s going to be very hard to find drugs that will stop the narrative generation. More and more of the neuro neuroscientists are embracing diet and lifestyle, and more and more of the neurology, the best neurology clinicians are embracing diet and lifestyle.
Garrett: That is a trend that I hope grows and continues. And I think you’ve been a major catalyst in your work and your research. So definitely want to acknowledge what you’ve done to help really shift the dialogue and strategy in that realm and into that direction. So that’s excellent work there. And I think it’s also a great segue. So if we’re talking about, look, these immune expressing drugs can stop the acute inflammatory damage, but they also come at a cost of disrupting immune function, making people either age faster. We talked about, you just mentioned about how immune function, immune cell function changes with age and how they get less effective at performing these various functions.
And also leave us more susceptible to other illnesses or diseases because the immune system can’t fight them off as effectively. So then that makes us really eager for an alternative. So what is the Wahl’s protocol and how is that a viable alternative?
Dr. Terry: Well, and I want to make clear that for some people they make the decision, they have a really great function at initial diagnosis, few lesions, they dive deep into the Wahls protocol and wait on the drugs. Others have more severe disability, a more aggressive disease course, more lesions when they get their MRIs and they decide to do drugs in the Wahls protocol. So it does not have to be either or, that really can be a clinical decision based on what feels most appropriate given your current status.
Garrett: Thank you for clarifying that too. I might not have framed it up in the exact most fair way, but yes, that’s very good.
Dr. Terry: So you can do drugs or the Wahls protocol. You can do the Wahls protocol. You can do drugs alone and decide you don’t want to do the Wahls protocol. I don’t recommend that one because you’ll have more neurodegeneration. The Wahls Protocol, people have heard a lot about the diet, which I think is a big piece and they might think the paleo diet, that’s enough. I have to remind everyone. I started the paleo diet in 2002. I hit the wheelchair in 2003. In 2007 I’m so weak I cannot sit up. I have brain fog. I have relentlessly worsening pain, and I’m clearly on the edge of having to take medical disability. And I’ve been adding supplements for mitochondria.
So the paleo diet wasn’t enough, even as defined by the autoimmune protocol. Supplements were not enough. It was when I redesigned the paleo diet in a very specific way. I’d already taken out dairy, grains, legumes. And then I took my list of nutrients that I learned about through functional medicine, through my review of the basic science instead of where are they in the food supply? And now I’m much more focused on what do I need to be eating. And so at a really high level, I ramped up my vegetables, more greens, more green leafy vegetables, kale, charred, spinach, turnip greens, cilantro, parsley, basal. More sulfur rich cabbage family, onion family, mushroom family. More deeply colored beets, carrots, berries. I was stressing more salmon, grass-fed, grass fish, meats. I went back to eating liver once a week. I grew up eating liver once a week.
So we dove back into that.
I rediscovered sauerkraut fermented foods, seaweed. If I was having nuts and seeds, I always ensure that they had been sprouted or germinated and added seaweed. When I redesigned my paleo diet, instead of just focusing on what to remove, I focused on what to be sure that I was adding. The speed of the change was really quite remarkable. Pain fatigue, mental clarity, huge difference within three months. My physical therapist said, you’re getting stronger. We’re going to have you start lifting weights. Now, mind you, they were small weights and he let me increase the amount of Estem that I was doing. And so steadily I was increasing my Estem and I had a device that I used at home. They had a small portable device that I took with me to work so I was getting more muscles [21:54 inaudible].
I was weak everywhere. And so my physical therapist had a huge athletic practice. I’d been an athlete before entering medical school. So I’m eternally grateful to my physical therapist because he put me on a rehab program like he would for his athletes. And so this was a very intensive program. I was down for working at it that hard. I saw him daily for weeks. Then I saw him twice a week for about four years. And I got to do that because I was making steady, remarkable progress. So there’s the diet, there’s the physical therapy, the electrical therapy, we had meditation and mindfulness as well.
In my book, I talk about supplements. I talk about detox. And I also talk about finding your why, because in my clinical trials, in my clinical practice, as people go through the process of adding new health behaviors or extinguishing disease promoting behaviors, that’s hard work. You can think of the last time that you’ve broken a bad habit, it’s a lot of work. And being honest with our patients that, yes, this is work, but why are you willing to do this? What do you want your health for? For whom would you run into a burning building to save without even question? For whom would you run over broken glass to save without even question? And then if we can help them identify that and the link, the work that we’re willing to do, at a pace that they can be comfortable being successful, then we’ll have tremendous success. And often I have to scale back their next goal to a small enough action that they could achieve so that we could have success and then build on success, then build on success.
Garrett: That’s beautifully said. And I like when you talk about finding your why, and getting into that motivation. Some people might hear that and think, oh yeah, that’s nice, but that’s just kind of wo wo, tell me what to do. And no, the reason for that is that it gives you the energy. What gives you the beliefs, that motivates you to do the behaviors, that actually then create the change? And like you said, it takes work. It takes diligence, it takes being consistent for a long enough period of time to see changes. So it’s not just some pie in the sky thing. It actually is what one of the major influencers that drives this meaningful change,
Dr. Terry: The why has to really speak to your heart. As I was going through my decline. When I was diagnosed, my son is eight, my daughter is five. And at that point, I’m still jogging, still biking. We’re still camping, canoeing and skiing. Within a year a lot changed. Within two years a whole lot has really changed. And I’m having to reimagine how I’m going to teach my children the skills that they’ll need to be successful adults. I had thought I was going to teach them those things through wilderness travel, through doing martial arts together, through doing sports together. And so for me, my why was like, well, I want my children to be successful. I have to reimagine parenting.
And one of the things that I did do right from the very beginning was I knew full well that my neurologist who saying, back off on my physical activity and exercise was like, well, yes, I have to back off, have to do things differently. But by God, I have to keep exercising to hang on to what I can do as long as possible. So when I couldn’t run anymore, I was contemplating putting in a [26:41 inaudible] pool. I was sort of fussing about the money. And my mother says for heaven sakes, Terry, if this lets you continue to do your workouts and your kids who are really young gets to play in the pool with you, it’ll be the best money you ever spend, put the pool in. And so I did. And every day I would get up and I would swim, do my aquatic exercises in my pool. And in my head, I’d be saying your kids are watching because they will assimilate that I’m continuing to work and do the best that I can.
Garrett: That’s right. They pay so much more attention to what we do and who we are than what we say.
Dr. Terry: Absolutely. So I could either model giving up and saying, whoa is me, life is terrible, it’s not fair. Or I could model you go to work, you do your workout and give them more chores. And my two kids would not surprisingly complain about having to do more chores than their friends. And I’d be very empathetic, like, yeah, well, that sounds so difficult that you have to know how to do the laundry and your friends don’t. Yeo that’s hard, but I can’t do it. I have to go to work. My chore is going to work earning money and your chore is doing the laundry and they stomp their feet and say, mom, I think you’re glad you have MS so you could lecture me about chores.
Garrett: That’s a great perspective. I mean, it really is an important piece of all this and I’m glad that that was a powerful why and a powerful motivating force for you. Before we move on, just from this segment here on the Wahls protocol. I know you had started using some supplements and then got very intentional about finding the food sources for those. So where do you kind of fall in that now? Obviously a lot of nutrient dense foods, are you in the camp of let’s try and get everything from foods or get some supplements or, I mean, obviously it depends on someone’s situation?
Dr. Terry: So there are some things that I recommend to everyone understand, vitamin D very important. It is a vitamin and that’s also a hormone. We have vitamin D receptors throughout our brain, throughout most of ourselves. And if we don’t have enough vitamin D we’re going to be at risk of having a much more aggressive MS, more relapses, more rapid decline, more mental health issues. So I urge everyone to know your vitamin D level. And then if you’re low, either get yourself out and get a tan, because your skin will make the vitamin D or take supplements. If you take supplements, you have to continue to monitor your level. So the level does not excessive. I also recommend knowing your homocystine which is the measure of how effectively you can utilize your B vitamins. If you’re homocystine is high then I recommend investigating your B vitamin levels and supplementing appropriately to get your homocystine in the optimal range.
Then the other things I would encourage everyone to know is their blood sugar levels, their lipid levels. And if you can, your insulin levels, so we can know that your metabolism, that is how you handle blood sugar is optimal. And if not then there are things that I’ll suggest to improve that. And that your cholesterol and your triglycerides are okay and your HDL good cholesterol is okay. And I may tweak the diet recommendations based on that. Now interestingly I’ve had many people say like, oh my God, you have meat in your diet, your cholesterol’s going to be really terrible. Consistently in all of our trials, total cholesterol falls, the good cholesterol HCL cholesterol improves, triglycerides fall and the LDL falls.
So thus far we’ve had really favorable changes as people implement the Wahls diet. And the studies. I have really moderated the amount of meat. There’s a lot more vegetables sufficient amount of meat. But I’m not wanting people to have cholesterols of 300, 400, that’s definitely not optimal. And I’d make some big changes if that occurs.
Garrett: What would your max level be 250?
Dr. Terry: So if we look at all-cause mortality, the best level for cholesterol is 225. If your cholesterol goes lower than that there’s a higher rate of anxiety, depression, homicide, infections cancers. If your cholesterol goes above 225, there’s a higher rate of cerebral vascular disease and a cardiovascular disease. So I will look at the person’s medical history, and I may agree that we already know they have diabetes and strokes. So I may want their cholesterol to be closer to 200 or 190. I may already know that they have severe mental health issues. And so I want their cholesterol to be closer to 250. So I look at their current symptoms, their current medical issues, and I’ll adjust the cholesterol that I’m willing to have them have slightly based on that.
Advert: Have you picked up your copy of the NeuFit method yet? In this book, Garrett helps you reconnect with the nervous system and improve outcomes at every stage of rehab and fitness. Based on Garrett’s proprietary neufit methodology and neubie technology, the solutions in this book will introduce you to a framework for overcoming virtually any physiological challenge. Take the first step in enhancing recovery, boosting performance and optimizing health in ways you never thought possible. Now available on Amazon in hardback, paperback, or Kindle. And now back to the show.
Garrett: That’s very good, very good advice there. I mean, it’s a little, flies in the face of some of the conventional wisdom where historically people wanted to see, doctors wanted to see cholesterol, sub 200 at these lower levels. But it is so interesting to see this research showing for longevity, for healthspan and lifespan that, like you said, 225 is really.
Dr. Terry: Is really a good number. And it depends on the person. Is mental health the big driver of your quality of life. Is anxiety, depression, irritability, rage the big issue. If that’s the case, a higher cholesterol will be very helpful.
Garrett: And is that because cholesterol helps the brain, it’s the building block of hormone?
Dr. Terry: Cholesterols. Yeah very important for making hormones. Cholesterol is very important for making Mylan. Omega-3, omega 6 fats. We can’t manufacture those. We have to consume. We can make cholesterol. But we do so relatively inefficiently. So if you happen to be someone who has very low cholesterol and you have mental health issues, changing the diet to increase your cholesterol may be a very helpful mental health strategy.
Garrett: Great content there. Let’s turn now. I mean we could talk in depth about micronutrients and all these things. For people who are interested in a deeper dive, I would highly highly recommend reading the Wahls Protocol and learning more about the sulfur nutrients and B vitamins and how that fuels your mitochondria and all that. It’s fascinating, there’s a whole, very deep discussion there. And one of the things I want to ask you about, can you share with everyone some of the research that you’ve done and the research that’s ongoing. You have the Wahls research program. Wahls research fund and are doing some really fascinating work. So can you share with everyone who’s listening your work on that front?
Dr. Terry: So the very first study I did was case supported myself, case series of other folks with progressive MS. Who were able to significantly improve. Then you do a single arm study again with progressive secondary and primary progressive MS, where we use essentially the same thing that I did. Supplements, modified paleo diet, meditation, exercise, electrical stimulation and losses. We showed that people could implement this complicated regimen, even though they had severe disease, severe disability. And that we had a remarkable reduction in fatigue, improvement in quality of life, reduction in anxiety and depression, improved thinking, and what is truly remarkable, that as a group, we held them flat in terms of their walking function and their hand function. And with progressive MX, you anticipate as a group that they’d be getting worse 10 to 20% each year. And half of those folks had clinically meaningful improvement in their walking and hand function.
In fact we have some videos from the study showing that people went from needing a walker for long distances, to being able to jog. And so I have people coming in and needing two walking sticks to walk, to walking stably without any walking sticks. Now it wasn’t everyone. And we saw that the more disabled you were, that it took longer, 9 to 12 months to see those kinds of gains. So motor function takes more time to rebuild the connections, to rebuild the muscles, to do the work. The fatigue, mental health, pain, those changes we could see within three months. But for the majority of our folks, gate changes would take 9 to 12 months. So then we just started doing smaller pilot randomized studies, where people came in, you got your baseline assessments, and now we’re studying relapsing remitting, either got the modified paleo diet, or you stayed in your usual diet.
And again, we showed reduction in fatigue, improvement in quality of life, improvement in motor function. Then the larger study that we’ve done most recently was comparing a low saturated fat diet, also called the Swank diet, a modified paleo elimination diet, also called the Wahls elimination diet. And for that, we had people come in, baseline assessments, observe them on their usual diet for 12 weeks, repeated all the assessments, fatigue, quality of life, walking endurance. Then we randomized them to the Swank diet or the Wahls diet, repeated the assessments at 12 weeks and at 24 weeks. What we’re able to show is that both Wahls and Swank reduce the fatigue severity and the fatigue severity scale was, really equivalent for both Wahls and Swank, which was a bit surprising. The quality of life both improved Wahls more so than Swank, both through physical health and mental health. Walking endurance, which is how far you can walk in six minutes did not change for either group at 12 weeks, which probably was not surprising, because we told people don’t exercise unless your physician tells you to, gives you an exercise prescription, because this is a diet so we want to see what the effect of the diet is.
But then at 24 weeks, the Wahls group had clinically meaningful improvement in walking endurance. The P value for the difference between the Wahls and the Swank group was 0.08. So not quite statistically significant, but certainly very, very interesting. We also looked at what’s called working memory and what was very interesting there was at 12 weeks, the Swank group was better than the Wahls group, but at 24 weeks, the two groups were equivalent, not quite clinically significant but statistically very different than baseline. So interesting stuff.
Garrett: And to the degree that the Swank diet and the Wahls diet both helped is that because the commonalities are removing processed food, getting towards more nutrient-dense foods, those the commonalities?
Dr. Terry: So the common things are we reduce the trans fat. We reduce the added sugars, reduce the processed foods. We ask people to eat more meals at home, cooking their own food. So I think that was helpful. This was sort of a big discussion. We improved the quality of the Swank diet by telling them, have four servings of grain, preferably whole grain. Have four servings of vegetables. And when people came in, both groups had about one and a half servings of vegetables. So the Swank group got up to about three and a half servings and the Wahls group got up to I believe, six and a half servings. So they both really improved the quality of their diet. We have another paper that came out that looked at the change, the micronutrient intake between the two groups. And we showed that both groups had a remarkable improvement in their vitamin mineral intake from baseline to 12 weeks and 24 weeks. The caveat in the Wahls group, because there was no dairy, unless you were having box milks with added calcium, your calcium intake went down.
Garrett: And one of the conversations you and I have had over the years, you told me a great story about how you encourage people, how you convince people to eat more vegetables, which was essentially add butter. Was that the punchline? Can you share that story?
Dr. Terry: So here’s the story, when we created this new clinic, therapy lifestyle clinic, I’m talking to my vets. We make them green smoothies. We make them vegetables. So here’s the basic recipe. Ideally you want to have some organic bacon, fry up two to four strips to the level of [42:32 inaudible] that you want. Take the bacon out, chop it up, put in your vegetables, cook two minutes. You could add a tablespoon of lime juice or lemon juice. If they seem a little bit bitter to you add the chopped bacon. If it’s not delicious, double the bacon and do it again. And the vets are like, yeah, actually that does sound pretty good. And they come back and say, you’re right doc, that was delicious. You see, when we went low fat, we made vegetables bitter. When we put the fat back in that softens the bitterness.
If they still seem a little bit bitter, just add some lime juice, lemon juice or a little vinegar, and that will take care of the bitterness for you very well. So you can use clarified butter also known as gee. You could use bacon fat, duck fat, chicken fat. If you are worry about your cholesterol, then we have people steam their vegetables, pour lots of olive oil afterwards, because when you heat olive oil to 180 degrees, you break down a lot of those great antioxidants, terrasol for example. So steam, bake or roast and then add olive oil with your favorite herbs liberally, it’ll be quite delicious.
Garrett: I think when you’re talking about getting people to go from one cup or one serving to six plus servings of vegetables that reminded me of that. And for some people they’re thinking, how can I do that? How can we really do it? How can I get my family to do it? How can I get someone who’s resistant to do it? And that adding, I think I said, add butter, added bacon is often a good tool.
Dr. Terry: And it’s really helpful if you take out the grain based flour based products, because people are thinking like, I’m not going to give up my breads, my pastas, my cereals, and I can’t add 6 cups of vegetables. Well, if you replace all of that bread, pasta flour based products with vegetables, because I don’t want you to be hungry. I just want you eating foods that nourish your body’s more effectively. And it was very funny, when I was talking to my vets and saying, okay the goal is nine cups of vegetables and the response would be like, so is that a month or a week. They would laugh and say, no, that’s a day.
But we would have them come back for their monthly group support meetings. And we’d have a mixture of folks new to the process and more senior who had more experience. And so the old timers would help the newbies understand how they made it work in their lives and how much better they felt. And of course it’s much easier to have another veteran talk with them about how this food can be delicious, how they could travel with it. And it would help bring the newbies on. The peer to peer discussions are often more effective than myself or my dietician.
Garrett: Yeah, absolutely. That’s a great insight there and really good strategy as well on how to get people to introduce vegetables or increase their vegetables in a very enjoyable, not just palatable, but downright enjoyable way.
Dr. Terry: Yeah. They can be completely delicious. And the same thing with liver, we taught people how liver could be really quite delicious prepared properly as well.
Garrett: Now I have to ask the follow up question. What is your go-to strategy for preparing liver?
Dr. Terry: So the very tastiest is baking some bacon for about 10 minutes. So it’s just partially done. Then I layer chicken livers on the pan. Lay the partially cooked bacon strips over that, put it back in the oven. And I want the chicken livers to be pink, not bloody but pink. The bacon will be done, that just sort of melts in your mouth. Another thing you can do is boil chicken livers with a bacon wrapped around the chicken liver. And then the third way is to saute lamb liver, so it’s still medium rare. So it’d be a little bit of juice coming through it and serve that with of course a big pile of fried onions.
Garrett: My mouth is watering. That’s awesome.
Dr. Terry: My family knows if they want to make a special meal for me, that we’re going to make some kind of liver.
Garrett: That’s excellent. That’s a great tip. And that’s something that just can make a huge difference. It is by many measures, the most nutrient dense food in the world and definitely something that I hope everyone listening. If you’re not already use this as a encouragement to try liver.
Dr. Terry: Yeah. Give it a try. If you cook it all the way through, so it’s dry, like cardboard, it’s not going to be as tasty, so leave it medium rare, it will be much more tasty for you.
Garret: Awesome. And before we totally move on from the research topic. I think you also have one study that is either just about to get underway or is underway. Can you tell us about the latest?
Dr. Terry: So this is efficacy of diet on quality of life. We are just now screen people and enrolling people. So we’re looking for someone with relapsing and remitting multiple sclerosis. Living within 500 miles of Iowa City. You’ll come in, get baseline assessments, including non-contrast MRI and then would be randomized to a ketogenic diet, a paleo diet or dietary guidelines. You’d come back in three months for repeat clinical assessments, blood work, and then come back basically in two years from the first visit to repeat the MRI and clinical assessments. We are very, very excited, this will be one of the largest and longest dietary studies and it will include MRIs.
And again, you can be on drug therapies or you can have decided that your disease is mild enough that you’re not on drug therapies. So this is not in conflict with any kind of decision about DMTs. We simply need to have confirmed relapsing remitting multiple sclerosis. I’ll make sure you have the links to our study brochures and to our study so people can take the screening survey to see if they’re eligible.
Garrett: Perfect. Yes, we will absolutely share that. Thank you. And one thing that I just want to acknowledge is the depth and breadth of studies that you are undertaking, I think is amazing for the quality of data, the quality of findings that you’re able to get and funding this to get this many number of people and can do the MRIs and do everything.
Dr. Terry: Oh, this is huge. This is two and half million. We have a gift from the Carter Chapman Shree family foundation that is funding this study. So this is a very big deal. The previous study was funded by the MS society. Very big deal. We keep writing grants to the NIH. Everyday Optimist, I think they will be funding us. They certainly are getting more open and more comfortable with dietary intervention studies. They’re getting more comfortable with why a multimodal study that includes exercise diet, a stress reduction will have greater probability of success.
Garrett: Well here’s to them starting to fund research like that. And in the meantime, I’m so grateful for the work that you’re doing, and I’m excited to see the outcomes of this study. Obviously it’s a couple of years before we’ll have all the data, but it’s very exciting.
Dr. Terry: Yeah. This will be five years running this study. So that’s a big deal.
Garrett: That’s a big undertaking and definitely, I want to acknowledge the work that you’re doing there. It’s very, very cool. It’s going to really, again, help move the needle here, help get people more aware of what these interventions can do and speak to the people who are more resistant and over time as the data piles up, I think people are going to start paying more attention.
Dr. Perry: When I look at the MS meeting I’ve been going to, there are more discussions about diet, more discussions about exercise, about lifestyle and more clinicians are agreeing that there is something to addressing the diet and lifestyle. And they finally are embracing that it’s not an either or.
Garrett: Yes. And that’s a great reminder. It does not have to be, but if you’re on, even if you’re taking drugs to help slow decline, you still have to eat, you still have a lifestyle and you might as well use one that’s going to help you rather than harm you.
Dr. Perry: Absolutely. Absolutely.
So for our last few minutes here, I want to ask you a little bit about your experience with the newbie. I want to shift, because several people with MS have heard about us through you and we certainly appreciate the opportunity to work together. And when we first talked, it was interesting to hear, you were describing how with the Wahls protocol and with these interventions, you’re able to help stop the decline. And also you talked about your experience using electrical stimulation. And if you could make that, be made more effective, be made more widely available to people and help restore function that had been lost. So I guess my first question is, has your belief changed? In the beginning you were told that you can’t restore function once it’s been lost, so has not changed?
Dr. Terry: Absolutely. And there’s more research agreeing with me. So I was the first one who did any published research using electrical therapy for progressive MS. And now there are more studies in people who aren’t walking, who are walker dependent, or are wheel scooter, wheelchair dependent. And they’re showing that by adding electrical therapy, you improve quality of life, improved mood and where they may not be improving walking, but they are improving the amount of power they can generate in their legs and very important, they’re improving the metabolic health. They’re improving blood sugar control, blood pressure control and their blood lipids. And there’s a lot more recognition that theological therapy for people who will never walk because they’ve had two extensive of a damage related to a stroke, a spinal cord injury, that doing Estem for all of the metabolic health benefits and the quality of life benefits, very valuable.
For those folks who still have some information that goes from your brain out to your muscles. If you will volitionally contract your muscles while you’re doing your Estem, you can in fact improve function, you can improve power. You can improve use of your hands, improve use of your legs, improve core strength, improve walking. We’ve seen that clinically. I know Garrett has seen that. There are more researchers that are investigating this and are agreeing that electrical therapy can greatly improve function. Now, when I talk to patients about that, I want them to understand this is not in place of exercise. This is supporting exercise. And if you will think of this as augmented athletic training and that the reason I was so successful was I came at this within athlete’s mindset and I trained harder than I ever trained when I was a black belt athlete training for the Pan American trials. I put in more hours, more time, more effort and I got amazing results.
Garrett: And can you actually talk a little bit about what you did with electrical simulation, how many hours a day and things like that because that’s fascinating too?
Dr. Terry: So FDA approved is an hour. My physical therapist said to maintain muscles, it’s 15 minutes a day. To grow more muscles it’s 45 minutes a day. You gotta do volitional contraction while you’re doing that. You’re weak everywhere, so however many muscle groups you can fit into your day, fit in. But you’re really weak on your core. So do your abs, your butt and your back. So that’s three muscle groups that would be about two hours worth of work. I’ve just laid that out for you, if you can somehow fit that into your day. And when you start, because I was so weak, we started at 10 minute blocks. That was all I could handle. So over a period of many months, I got, so I could do 45 minutes in the morning, 45 minutes in the evening. And then I’m like, okay, I’m still working. So I have to fit this into my day at work.
So I would hook myself up and I would turn on my current. And if I was staffing residents, it had to be pretty mild current so I could do it isometric, talk to my residents, grunt or grimes, no big deal. And so that’s what I’d do when I’m staffing residents. So I’d have a 10 minute isometric contraction by gut while I’m talking. And then 20 seconds, I’d be sort of relaxing. And then when I was in my office and I wasn’t staffing residents, then I could turn the current up until I’m like [grunting sound]. So I did a lot more current. I never quite disclosed to my physical therapist, how much I was doing because I was afraid he would take my advice away, because it was so far beyond FDA approval.
They kept saying, wow, you are getting stronger. So let’s have you, he kept advancing me exercises. He would have me lift more weights. And I was making remarkable progress, but I was spending a lot of time thinking about how to fit in because I was still working and I couldn’t just do only exercise because I wanted to keep working. So I had to fit it into my tasks of daily life.
Garrett: And just to be clear for everyone, this is in the early 2000s? This is when you, Dr. Wahls had your symptoms? When you were making your recovery in the early 2000s? This is before we met, this was not the neubie, this was older, generations of electoral stimulation.
Dr. Terry: Much older devices. And then we met several years ago. And at that point, I’m still using the previous devices. I met Garrett, tried out the neubie and it is a different kind of technology. So I hooked myself up to that and I work with Garrett and his team in terms of what exercises I’m doing now, how to advance and make further progress. And I’m back to working in the morning, working in the evening. I don’t carry my neubie off to the university to go to work. But I have my morning workout and my evening workout. I will say in addition if I happen to be watching a movie with my family. So I’m sitting in front of the TV. I’m back to what I was doing before as I hook myself up and I’m doing my isometric while I’m watching the movie because I love current and that’s since the very beginning.
My original physical therapist aaw that. I just really had a very big cognitive and mood effect from using current that I could tell if I wasn’t using current, my mood was down. My mental clarity was down. If I was using current I had much greater mental energy, much happier mood. He said it’s probably the endorphins. We now know also it’s related to the nerve growth factors that released in the brain and probably locally in the muscles as well. It does a lot of really great neurotrophic factors for you.
Garrett: Yes, definitely. Definitely. And since we started working together a few years ago, you had already made, a majority of your recovery had already gone on these long bike rides. So can you share a little bit about what you’re still working on or what we’ve been working on?
Dr. Terry: Yeah. so the biggest limitation right now is arthritis in my back. And I probably developed the spinal stenosis because of the years of weak back muscles that led to this arthritis in my back, which is what led to back pain. And so I saw standard physical therapy, got some relief, met Garrett, began working with his physical therapist on my back program, and that has really managed my back pain very effectively. So I can continue to walk, hike and bike. The limitations I had from the MS, that’s not the problem, the problem now is the spinal stenosis which is sort of a secondary problem from the years of weak torso that led to the arthritis in the back. But it has been very effective at maintaining that core strength for the back, which lets me continue to walk and hike with my family. Without it I would be having a lot more struggle with my back pain.
Garrett: Very good. Thank you for sharing that. And for, Wahls warriors, for patients who are already doing the Wahls protocol, have MS or another neurodegenerative disease and are working with the neubie, what would you tell them in terms of your keys, in terms of consistency, in terms of specificity, what would you say are the keys to success?
Dr. Terry: You want to have a physical therapist with Garrett’s team help you design the exercise program and they will talk with you about the exercises you need, what settings to be using and then keep checking back in. Because as you progress, you want to be progressing the exercise to probably a slightly different exercise to continue to improve your strength, your balance, your coordination, and more current is good. Current is good.
Garrett: Yes. Yes. Well said as. It’s like nutrients, it’s like an inverted U-curve. A lot of people don’t get enough nutrients or don’t get enough stimulation. Of course you can have too much, but finding that optimal amount is the key. And for you, at one point it was hours and hours a day, and now thankfully it’s a little easier to work into the system.
Dr. Terry: It easier to manage, just do a morning session and an afternoon session.
Garrett: Yes. Awesome. That’s great. Thank you so much Dr. Wahls. For people who want to learn more about you obviously buying the Wahls Protocol, it’s in virtually all bookstores,it’s available online. Search for Wahls Protocol. What are the other places to find you in terms of your website, look up your research, best places to follow along your journey?
Dr. Terry: So go to Terrywahls.com Follow me on Instagram, Dr. Terry Wahls. Facebook and Twitter at Terry Wahls. Sign up for the diet cheat sheet @Terrywahls.com/diet. Read our research papers at Terrywahls.com/research papers.
Garrett: Fabulous. And I imagine a lot of people listening to this are going to be interested in checking out some of those links, because this has been wonderful, really inspiring, educational and Dr. Wahls. I just love getting to spend this time with you. I’m so grateful to you for your work and for so generously sharing your wisdom and experience with everybody on this podcast. Thanks again for being here.
Dr. Terry: Thank you for your work with current. It is so needed.
Garrett: Alright. Thanks everybody for tuning in. We will see you on the next episode of the undercurrent podcast.
Outro: Thank you so much for listening to the undercurrent podcast, if you enjoyed this episode please consider leaving a review and be sure to subscribe and stay up to date as we release future episodes.