The Doctor's Farmacy: Episode 14 with Dr. Terry Wahls - Transcript

Dr. Mark Hyman: Hello. This is Dr. Mark Hyman and welcome to The Doctor's Farmacy, a place for conversations that matter. Today, our guest is Dr. Terry Wahls, who is an extraordinary physician who cured herself of multiple sclerosis, which doesn't seem like a sentence you could even say. But here she is to prove it and I can share with you that she is an extraordinary woman who's really pioneered a new way of thinking about how we treat chronic disease. She's a clinical professor of medicine at the University of Iowa. She's the author of the Wahls Protocol: How I Beat Progressive MS Using Paleo Principles and Functional Medicine, and, of course, the cookbook that goes along with it, The Wahls Protocol Cooking for Life: The Revolutionary Modern Paleo Plan to Treat All Chronic Autoimmune Conditions. That's a big promise. We're going to get into that. Dr. Mark Hyman: You can learn more about her work at TerryWahls.com. She hosts the Wahls Protocol seminar every August, where anyone can learn how to implement the protocol with ease and success. You can follow her on Facebook and Twitter and Instagram and learn more about her MS trials by reaching out to her team at [email protected]. Dr. Mark Hyman: This is an important thing because we have to research these things. Now, she's basically had a story that has rocked the world of multiple sclerosis, which is ... She was this active human, who basically became debilitated from MS and was barely functioning in a wheelchair. Tell us, Terry, how you found your way to health through this approach that you call the Wahls Protocol. Dr. Terry Wahls: Well, thank you Mark. It's such an honor to be here with you and I'm so glad to count you as a very good friend. I'm a academic internal medicine doc. I was very skeptical about diet and lifestyle and supplements and complimentary alternative medicine. I couldn't understand why people wasted billions and billions of dollars on all that - Dr. Mark Hyman: [inaudible 00:02:01] take all those stupid supplements. They'll just give you expensive urine, right? Dr. Terry Wahls: Yep. Absolutely. I was very skeptical. But God has a mysterious way about him or her. So, in 2000, I was diagnosed with MS. Dr. Mark Hyman: 18 years ago. Dr. Terry Wahls: 18 years ago. But, in retrospect, my symptoms began during medical school in 1980 with episodes of electrical face pain, which I stoically put up with. I could figure out that they were worse with stress and gradually more frequent, more severe. In 2000, I had a weakness in my left leg, got a big workup, including MRIs of my brain, spinal cord, spinal tap. And they said, "Well, this is relapsing-remitting MS." And being all I - Dr. Mark Hyman: This is a very bad diagnosis. Dr. Terry Wahls: A bad diagnosis and I looked at the literature and saw that within 10 years, half have difficulty walking, needed a cane, walker, or wheelchair. And half won't be able to work due to severe fatigue. So, I wanted to treat my disease aggressively. I sought out the best center doing research here in the Midwest. That was the Cleveland Clinic. Saw the best people, took the newest drugs. Within three years, I [inaudible 00:03:18] to a recline wheelchair. Dr. Mark Hyman: Well, that's good progress. Dr. Terry Wahls: Yeah. So I definitely was not going in the right direction. That's when I started researching. I started reading PubMed. I would begin experimenting on myself. I adopted the paleo diet, honest, basically on the recommendation of my Cleveland Clinic physicians. Dr. Mark Hyman: Really? Dr. Terry Wahls: So that was pretty interesting. I continued to go downhill. I took Tysabri, continued to go downhill. I switched to CellCept. I continued to go downhill. Dr. Mark Hyman: And these are powerful immunosuppressants. Dr. Terry Wahls: Very powerful. But I was happy to take them because I knew I was headed towards becoming bedridden, possibly demented. I was having more and more trouble with severe pain that was very difficult to control. So I was thrilled to take these drugs in attempt to stave all of that off. As I read PubMed, I started experimenting with supplements and would eventually figure out that supplements targeting my mitochondria helped my fatigue, somewhat. And I was slowing the speed of my decline. So I'm thrilled. I'm grateful. And I'm really excited about reading PubMed. Dr. Mark Hyman: Grateful from a wheelchair. Dr. Terry Wahls: Very grateful from a wheelchair. Very, very grateful. And then, by the summer of '07 - Dr. Mark Hyman: You're a glass-half-full person, clearly. Dr. Terry Wahls: Clearly. Clearly. By the summer of '07, I was so weak I could not sit up in a regular chair. I had a zero gravity chair. I'm fully reclined or I'm in bed. I'm struggling to walk ten feet using two walking sticks. My boss calls me in and tells me he's assigning me to the traumatic brain injury clinic in six months. So I'll be seeing patients without residents. And I know that, of course, that means ... What he's really saying is, "Terry, we are done redesigning your job for you," and I'll be forced to take medical disability, finally, at that time. Dr. Mark Hyman: Yeah. Dr. Terry Wahls: That's a difficult summer but two months later I discover, in one of Google searches, the Institute for Functional Medicine and I took the course on Neuroprotection in the midst of my brain fog. So it was a bit challenging but I got through it. It had a longer list of supplements, a little deeper understanding of the things I could be doing for my mitochondria and for my brain. I added that. And then I had another really, really big a-ha moment. Like, "Yeah, I should take this list of supplements and redesign my paleo diet to maximize the nutritional intake." Dr. Mark Hyman: Yeah. Dr. Terry Wahls: So, I redesign my diet - Dr. Mark Hyman: Because you're going to be eating paleo cookies all day and that's not exactly very good. Dr. Terry Wahls: Yeah, and that's not the right thing. So, I restructured my diet and within a month, my fatigue was markedly reduced; my mental clarity was clearly improving. In three months, I get up and I'm walking with a cane. Dr. Mark Hyman: You got out of your wheelchair. Dr. Terry Wahls: I'm out of my wheelchair, walking around with a cane. In nine months, I'm on my bike and I pedal around the block for the first time in six years. And in twelve months, I do a twenty mile bike ride with my family. Dr. Mark Hyman: Unbelievable. So it was a year. Dr. Terry Wahls: A year! Dr. Mark Hyman: Now, take us a little bit slower through what you did, because you - Dr. Terry Wahls: I did a lot. Dr. Mark Hyman: ... ate the Paleo diet. Then you did the drugs. But then you went to this neuroprotection - Dr. Terry Wahls: Plan. Dr. Mark Hyman: ... mind to a [inaudible 00:06:56] that you learned from there what you could do to optimize your systems. Dr. Terry Wahls: So, optimize my system. I also added in electrostimulation of my muscles. That as a technique that athletes have been doing for decades to speed the recovery from athletic injuries. So my physical therapist had agreed to let me add that. So I was doing that. I had gone back to adding meditation at night. So I had added that back. And then, I had this very intensive nutrition. So I had ramped up my vegetables to nine cups of vegetables a day. Dr. Mark Hyman: Which is 18 servings. Dr. Terry Wahls: 18 servings. Dr. Mark Hyman: Not the five to nine. Dr. Terry Wahls: Yeah. 18 servings. So a small amount of meat, lots and lots of vegetables. Dr. Mark Hyman: And it's very specific groups of vegetables, right? Dr. Terry Wahls: Very specific groups. Dr. Mark Hyman: Which had very specific medicinal effects that you talked about. Dr. Terry Wahls: Exactly. It's all designed very intentionally around my mitochondria, around detox, around myelin production, around brain structures, neurotransmitters, based on science in a very methodical way. I did all this, Mark, not to get better because I had completely accepted what my neurologist, primary care docs had told me for years. Dr. Mark Hyman: It's a one-way street. Dr. Terry Wahls: It's a one-way street. Functions once lost with progressive MS are permanently gone. So I was doing all this so I could have the limited function that I had a little bit longer. Dr. Mark Hyman: And not get worse. Dr. Terry Wahls: And not get worse. So I was thrilled to do all of that to not get worse, but ... And the other thing that's really interesting, Mark, is as I was getting remarkably better ... As part of having a progressive, neurodegenerative disease is, you get to the point where you take every day as it comes, one day at a time. No expectations, not what it means. Dr. Mark Hyman: Mm-hmm (affirmative). Dr. Terry Wahls: So I'm remarkably better. I'm thinking more clearly; my pain is gone, which is a huge deal for me. I - Dr. Mark Hyman: Pain is a big symptom in MS. Dr. Terry Wahls: Pain is a huge symptom. It was a huge problem for me, as well. So my pain is gone. I'm walking. I'm thinking. I'm biking. Actually, it wasn't until I biked that I realized, "You know, I think I'm getting better." Because, until then, I was just taking it one day at a time. Dr. Mark Hyman: Yeah. Amazing. Dr. Terry Wahls: The day that I biked, it was on Mother's Day. I'm crying; my wife's crying; my kids are crying and that's when I understood that who knew what the future would hold. That, clearly, neurology has it wrong. Dr. Mark Hyman: Yeah. Dr. Terry Wahls: Clearly, neurology has it wrong. Who knew how much recovery might be possible. Dr. Mark Hyman: That's a very hopeful story. And I'd love to know what exactly you're eating. People are probably listening, going, "What are the 18 servings of vegetables you ate and what groups were they in. What do they do?" Dr. Terry Wahls: Okay. First, I think the most powerful one is all these greens. So, I was having tons and tons of green, leafy vegetables. I was probably having six to nine cups, measured raw. Dr. Mark Hyman: So, collards, kale, spinach, what? Dr. Terry Wahls: Collards, kale, a little bit of spinach. I really craved kale in a huge way. But I'd have collards; I would have Swiss chard. I had lots and lots of salads, would have some cooked greens. I was very big into cabbage family vegetables. So, cabbage, broccoli, turnips, rutabagas. Lots of it raw, some cooked. But I was also very, very big into raw. Garlics. Lots of garlic, shallots, onions. Dr. Mark Hyman: Because they have sulfur. They boost glutathione. Dr. Terry Wahls: Sulfur. Boost the detox, boost your ability to make gamma aminobutyric acid, intracellular glutathione. And then, very much into mushrooms. Mushrooms stimulate and prime adaptive and innate immune cells. They also stimulate your ability to make nerve growth factors. Dr. Mark Hyman: Yeah, medicinal mushrooms are powerful. Dr. Terry Wahls: Very powerful. Dr. Mark Hyman: They have all kinds of amazing ingredients that aren't in other foods. Dr. Terry Wahls: And garlic and mushrooms are medicinal foods across many, many cultures, across all the continents. So these are medicinal foods with a lot of ancient cultural wisdom. Dr. Mark Hyman: So, greens, brassicas, garlic and onions, and mushrooms. Dr. Terry Wahls: And then color. So the polyphenols are a marker for color. Again, it's study after study. The more color you have, the lower the rates of heart disease, diabetes, obesity, cardiovascular disease - Dr. Mark Hyman: So eat the rainbow. Dr. Terry Wahls: ... cancers. So you want color. Furthermore, blue, purple, black, a lot of studies showing you can have measurable improvement in cognition in as little as 16 weeks using just a cup of blueberries, in placebo, double blind crossover trials. That's hardly any time at all. Dr. Mark Hyman: No. That's amazing. Not Skittles though. Dr. Terry Wahls: Not Skittles. Dr. Mark Hyman: Those are colorful. Dr. Terry Wahls: Those are the wrong kind of color, my friend. So, again, 3 cups of deeply pigmented stuff. Then, fats. Fats have a critical role. All of our cells are wrapped in fat. They're fat wrappers, the cell membranes. And our brain is 60-70% fat. Dr. Mark Hyman: Mm-hmm (affirmative). And all your nerve coverings which get destroyed in MS are also fat. Dr. Terry Wahls: Fat. And they need arachidonic acid; they need eicosapentaenoic acid; they need the docosahexaenoic acid; they need Omega-6 and Omega-3 fats. So, I needed to have more fat in the diet. Dr. Mark Hyman: Did you use saturated fat? Dr. Terry Wahls: You know, actually, I did. I used lots of fat. So, would have flax oil, hemp oil in the dressings that I'd use. And then we would cook in saturated fat. I'd use coconut oil. I'd use bacon fat, duck fat. That's because for years I worked at the vet. So I would teach the vets ... My favorite recipe was bacon and greens. You cook up some bacon, take the bacon out, leave the bacon fat, dump in the greens, stir them around until they're wilted, add the bacon back. If you didn't like, just double the bacon the next time you make it. And my vets would go like, "Oh my God, you mean I can eat bacon? That actually sounds like it would taste wonderful." Dr. Mark Hyman: Yeah. Dr. Terry Wahls: I would have lots of avocados, as well. I'd get into nuts and seeds. So, what is remarkable was the speed at which I could see the difference. In 30 days ... So, it was in - Dr. Mark Hyman: Think about it. You took all these drugs. They didn't work. But when you used food as a drug, as medicine, it actually worked faster and better. Dr. Terry Wahls: Very fast. That's exactly what I saw in clinic. I was able to teach my residents in clinic as well, that food is the most powerful medicine. And it works amazingly fast. Dr. Mark Hyman: Faster, better, and cheaper than most drugs. Dr. Terry Wahls: Yes. Dr. Mark Hyman: And it's an amazing substance. And when people understand it's not just calories, as we learn in functional medicine, it's information and they can go, "Wait a minute. I can upgrade my biology by putting better information in." Dr. Terry Wahls: Into your body. Dr. Mark Hyman: Yeah. Dr. Terry Wahls: Absolutely. Absolutely. Dr. Mark Hyman: Besides the food, that's powerful, and the stimulation, and the meditation, you also probably did other things. Were there diagnostic tests that you did on yourself that you discovered anything was off or out of balance? Dr. Terry Wahls: Two years into my recovery, I thought, "Well, I'm sure toxic load was a big issue in all of this." Keep in mind, I have been walking around, hiking now; I've been biking, very little pain. So I'm in great shape. And I finally did a 24-hour heavy metals challenge test and I was diffusely toxic in everything. Dr. Mark Hyman: Yeah. Dr. Terry Wahls: In everything. Dr. Mark Hyman: All your metals were high. Dr. Terry Wahls: All my metals were high. I think there were only four that were not high. I was even high in uranium, thorium, thallium. Dr. Mark Hyman: Thallium is ... Kale is now ... In California, the ground has thallium in it. Dr. Terry Wahls: We have so poisoned our soils with many of our fertilizers are relatively toxic. So, yes. Unfortunately, many of our foods are toxic. Now, the other thing that I should tell you, I repeated all of that four years later and everything is gone. Dr. Mark Hyman: Amazing. Dr. Terry Wahls: So, who knows how incredibly toxic I was in the very beginning. Dr. Mark Hyman: Before. Right. Dr. Terry Wahls: In the very beginning. Dr. Mark Hyman: How did you get rid of them all? Dr. Terry Wahls: Well, when I designed my protocol, I designed it around boosting the detox enzymes. That's why I stressed the greens, the sulfur, the color. I added in there some N-acetylcysteine and some algae, as well. Dr. Mark Hyman: Some binders to get the metals out and things to help regulate your glutathione. Dr. Terry Wahls: The other thing, six months into my recovery, I was able to overcome my heat intolerance. Dr. Mark Hyman: Yeah. With your saunas. Dr. Terry Wahls: So I got a sauna and I have been saunaing [inaudible 00:16:59] ever since. Dr. Mark Hyman: Amazing. So, it's basically food, supplements, electrostimulation - Dr. Terry Wahls: And very basic supplements. B vitamins, N-acetylcysteine and algae. That's it. Dr. Mark Hyman: That's it. No vitamin D? Dr. Terry Wahls: Well, yes. There is vitamin D in there, of course. Dr. Mark Hyman: Because there's evidence around vitamin D and MS. Dr. Terry Wahls: Yeah. Plenty of vitamin D. And I also use sunlight. Dr. Mark Hyman: Sunlight. Yeah. Dr. Terry Wahls: Sunlight is more effective than vitamin D orally. Dr. Mark Hyman: You put sunblock on your face but the rest of your body it'll definitely be a good one because you don't want to age fast. Dr. Terry Wahls: Yeah. Dr. Mark Hyman: But, yeah. It's powerful. I agree. So you've taken this insight that you have from your own healing and you've done an extraordinary thing, which is, you've created a model that you use to treat patients and to train other physicians and providers and to do research in this space. You were at the VA in Iowa and had done amazing work with people who had very little resources, not a ton of money, couldn't do a ton of testing. People think functional medicine is always all about testing, it's all about supplements, but you really were able to show that it really is primarily food and lifestyle and it's just a few basic things that can make a huge difference. Tell us about what you learned in that process. Dr. Terry Wahls: I had my personal transformation and then I started talking about food and exposures and I changed how I practice medicine in my traumatic brain injury clinic. I'm really focused in on diet and lifestyle and I have to deal with physician complaints because I'm not practicing like my colleagues. So I had to meet with my chief of staff, go over what I was doing and why, bring down my papers. And I get some coaching on how to documenting the medical records so I could pass peer review and make sure everybody was - Dr. Mark Hyman: Happy with you Dr. Terry Wahls: ... comfortable with what I was doing. Happy. So, we got that - Dr. Mark Hyman: God forbid you're telling people to eat better. Dr. Terry Wahls: Yeah. So, I got that down. And then, because I was having such great results, the chief of medicine came in and told me he was pulling me out of primary care and would I open up a clinic where I could practice the way I wanted to practice. I said, "No. I won't do that. Here's why I'm refusing. You need to get endorsement by the chief of staff and the director of the hospital because we just want to be sure that they know what I'm going to do and that they approve of this." Dr. Mark Hyman: They're behind it, yeah. Dr. Terry Wahls: So I thought that was probably going to be the end of it. Two weeks later, he came back and he said, "I have the endorsements. We're good." Dr. Mark Hyman: That's so great. Dr. Terry Wahls: So we got the endorsements going. Then, we decided that we'd call it the Therapeutic Lifestyle Clinic. So it was very clear to my referring physicians and to the patients that this was all about diet and lifestyle, that I'm not prescribing drugs. Dr. Mark Hyman: And diet and lifestyle as treatment, not just - Dr. Terry Wahls: As treatment. Dr. Mark Hyman: ... prevention. Like, therapeutic lifestyle. Dr. Terry Wahls: It was therapeutic and you could come ... You had to be referred in by a physician. It could be for a mental health problem, a medical problem. We saw people from all sorts of issues. I met with primary care and some specialty clinics and said, "Give me your most ill people who are willing to use a therapeutic diet and lifestyle. I'm using no drugs. It's just going to be diet and lifestyle." We did this through a series of group classes. Dr. Terry Wahls: The first class was, here's my story; here's the concepts of the therapeutic lifestyle. We talked about functional medicine, therapeutic medicine, diet, lifestyle, detox mitochondria, all of that stuff. Then I invited people to either just go back to the doc and say, "This is too hard," or, "I'll work gradually on my diet and then meet with the dieticians," or, if they would commit to being gluten-free, 100%, lots of vegetables for 100 days, they could come work with me. We'd have a group intake where I'd meed with them for two weeks as a group to do their timeline of their health experiences. Then they would meet with the dietician for two hours. We'd have a cooling class and help them reimagine breakfast and lunch and reimagine their relationship with food. Dr. Mark Hyman: Very practical. Dr. Terry Wahls: Then we would see them once a week for skills class. As many people as could fit in the room could come get the skills classes. We'd have a support group of six to twenty-two people at a time that we'd see every other month. In the labs that I've had, a CBC, vitamin D, homocysteine - Dr. Mark Hyman: Very basic. Dr. Terry Wahls: ... fasting lipids. That was it. Dr. Mark Hyman: Mm-hmm (affirmative). Dr. Terry Wahls: And the kind of supplements, B vitamins, fish oil, vitamin D. And then, I could tell people if they want, on their own, to go buy NAC and algae, methyl B-12, methyl folate, and that was is. Now, before I got the lifestyle clinic going, when I was just in my traumatic brain injury clinic, no labs, I only get to see people twice a year for twenty minutes. Dr. Mark Hyman: Wow. Dr. Terry Wahls: And even in that clinic, we had stunning success. Dr. Mark Hyman: Amazing. Dr. Terry Wahls: So that's why - Dr. Mark Hyman: You've done research now on this. Dr. Terry Wahls: Yes. Dr. Mark Hyman: How has the research gone and what have you learned and can you share some of the most exciting things that you've discovered in your research? Because this isn't just an idea or something that's on the fringe, you've actually been in a major academic center doing the hard work, proving the model, and seeing extraordinary changes. Dr. Terry Wahls: The very first things is we call a safety feasibility study. Dr. Mark Hyman: Is it safe to eat 18 cups of - Dr. Terry Wahls: Is it safe to eat all these vegetables? Dr. Mark Hyman: ... 18 servings of vegetables? Dr. Terry Wahls: Is it safe to do a stress reducing activity? Dr. Mark Hyman: Is it safe to meditate? Dr. Terry Wahls: You know, my chair of medicine, Paul Rothman, had me write a case report up from my own personal story. Then he called me back in when that was posted. "Okay, now we're going to have you do a safety study." I said, "Well, this is outside ... This is the type of research field that I'm in." "Yes. I'll get you the mentors." So he helped with getting the mentors onboard. We designed the study. Then I had to get the funding. So I worked with a philanthropist in Canada that gave me the funding to get the safety study going. So we wrote up the protocol that copied everything that I did, the supplements, the meditative program, the exercise, e-stim, and we codified the diet. Dr. Terry Wahls: We got funding, got it through, and then the clinical research unit refused to give me permission because the diet was not safe because it excluded food groups. Dr. Mark Hyman: Like grains and beans and dairy? Dr. Terry Wahls: Yeah. Right. So it got declined. So I was required to do a pre-study on myself to show that it was nutritionally sound. We did that. The dietician who analyzed my diet, who's been doing dietary assessment research for 35 years said, "This is the most nutrient dense diet I've ever analyzed." Dr. Mark Hyman: Well, anybody that knows about the food groups, how that came about was it was a way to sell more agricultural products, meat, dairy, grains, vegetables. Those were food groups that had nothing to do with science. It had to do with marketing. There is no biological requirement for grains or even dairy. Dr. Terry Wahls: Yes. So, once we finally got permission, we ... Then I was required to have a safety report that I would fill out backed with IRB, the institutional review board, after we did the first 10 subjects. That worked out really ... I also know because I had money to do 20 but that worked out very well, because we had great success with the first 10. So I went back to my Canadian philanthropist and I said, "You know, we had such great success. How would you feel about getting MRIs on the next 10?" And he said yes. So we have those MRIs. As a matter of fact, we showed those results on those MRIs earlier this week here. I was able to show that brain volume is protected by following the Wahls Protocol. Dr. Mark Hyman: Was the myelination improved? In the brain of MRI patients with MS you see these white matter lesions, right? Dr. Terry Wahls: We analyze total brain volume and for disability, brain volume is much more strongly associated with disability than whether the white matter lesions or acute lesions. So we're mostly very, very curious about was what happens with brain volume. Originally, I was really disappointed because we still had brain volume loss overall for the group but brain volume loss in progressive MS occurs much more rapidly, two to three times as rapidly, in progressive MS than it does in healthy aging. We're able to show that our brain volume loss was less than even healthy aging. Dr. Terry Wahls: So we are protecting our brain to extraordinary level in that first study. So we'll be submitting that for a publication in a journal. We're very excited for that. We had remarkable reduction in fatigue, remarkable improvement in quality of life. Dr. Mark Hyman: In the neurological symptoms? Dr. Terry Wahls: In the neurological symptoms. We're also able to show that in half of our folks we had remarkable improvement in gait. Dr. Mark Hyman: In walking. Dr. Terry Wahls: Which is remarkable with progressive MS because none of them should've improved. Dr. Mark Hyman: Right. Dr. Terry Wahls: The fact that we had clinically meaningful improvement in gaits in half was really quite remarkable. The next study that we did was a randomized study, which is a weightless control. We did just did the diet in relapsing-remitting MS folks. They came in, we did assessments. We randomized them to either get trained on the diet or to wait for 12 weeks and then get trained on the diet. Again, we were able to show that fatigue went down, quality of life improved and motor function, again, improved. Dr. Terry Wahls: Now we have a study funded by the National Multiple Sclerosis Society comparing the low saturated fat diet and the Wahls diet. Dr. Mark Hyman: Because the Swank diet was a low fat diet - Dr. Terry Wahls: Very low fat. Dr. Mark Hyman: ... that was recommended for MS patients. Dr. Terry Wahls: Only by Dr. Swank. The conventional neurologists, for a long time, have steadfastly held there's no scientific prospective study that has shown that diet has anything to do with MS. Now, fortunately, as there have been to understand the role a diet has on epigenetics, on the microbiome, that conventional neurology is catching up to us and saying that it does matter. Dr. Mark Hyman: Yeah. It's amazing. Dr. Terry Wahls: They are catching up. Dr. Mark Hyman: It's amazing that food is the single biggest information input we have to our bodies every day. Dr. Terry Wahls: Yes. Dr. Mark Hyman: It controls every function of our biology and yet, how could it not be connected to our health, right? Dr. Terry Wahls: Well, it is so challenging to do good dietary studies because if you do a food-based intervention study ... Supplement studies are easy. That's like a drug study. But if you do food ... Now, if I'm going to do it well, I have to convince you, Mark, to give up foods that you love; start eating foods that you don't like, you don't know how to make; get your family to do it with you so you can sustain it. There's a real ar to training you to be wanting to do that and then another art to measuring what you actually did. This is complex research to do. It's expensive to do. Dr. Mark Hyman: Yeah. Dr. Terry Wahls: Far more expensive than drug studies. That's one of the reasons that there's so little research. Dr. Mark Hyman: Yeah. That's true. So you also are exploring not just MS, but other brain issues. Dr. Terry Wahls: Yes. Yeah, yeah. Dr. Mark Hyman: Talk about the kind of things besides MS that you're working on and what kind of results you're seeing. Dr. Terry Wahls: In my lifestyle clinics, again, we were able to keep track of who's coming to see us. Pain was the number one reason that people would come in. Then autoimmunity, metabolic problems like diabetes, heart disease. In terms of the types of neurologic problems that people would come in, Parkinson's, myasthenia gravis, cognitive decline, Alzheimer's, of course traumatic brain injury, PTSD, mood disorders. Dr. Mark Hyman: Pretty much everything for which we have very poor treatment to [crosstalk 00:29:44]. Dr. Terry Wahls: Poor treatments. Poor treatments. And certainly, what we would consistently would see, some of the first things that people would notice is fatigue going down, energy going up, mental clarity improving, brain fog diminishing, irritability diminishing. Dr. Mark Hyman: Quality of life improving. Dr. Terry Wahls: Quality of life, absolutely improving. Now, because the VA has an electronic medical record, I was also able to get my quality improvement people do some analyses for us. We were able to show that the hemoglobin A1c was coming down, the body mass index coming down, blood pressure coming down. At the same time, that the number of medications - Dr. Mark Hyman: Was coming down. Dr. Terry Wahls: ... that was coming down, as well. And the pain medications, coming down. And the narcotic use, coming down. Incredibly exciting stuff. Very, very gratifying. In the thousands of followers that I have, routinely, I'm being contacted by people who are telling me that their treating physicians had given up on them saying there was nothing that they had to offer them for a condition, which I, of course, have never heard of, and they're telling me that they've implemented the Wahls Protocol and that their functions are improving. Dr. Terry Wahls: So then I'm Googling what are these conditions. Some of them are autoimmune, some of them are neurodegenerative. And, very consistently, it's a similar pattern that I see. Energy is improving, mental clarity's improving, pain is diminishing. Dr. Mark Hyman: The protocol is antiinflammatory. It's detoxifying. It's mitochondrial boosting. It's got repairing. Dr. Terry Wahls: Absolutely. Dr. Mark Hyman: These are all the foundations of creating health. So, when you do that, regardless of what condition you have, people seem to get better. Dr. Terry Wahls: I'm trying to teach people that what we need to be focusing on it the creation of health, that this is your best treatment for whatever chronic disease you have. Dr. Mark Hyman: Yeah. You don't do a lot of treating the disease you treat - Dr. Terry Wahls: You create health. Dr. Mark Hyman: Health. Right. Dr. Terry Wahls: You create health. Dr. Mark Hyman: And the disease goes away as a side effect, as I often say. Dr. Terry Wahls: It will often diminish. And depending on the person that, yes, you may still die from your cancer. You'll have a higher quality of life. You may still die from your Huntington's but you'll have higher quality of life. And what you may discover is that your previously untreatable problem that your physicians say, "I don't have anything to offer you," you may discover that it can be stabilized. The steepness of the decline can be slowed or, to everyone's amazement, you may discover that you, in fact, are slowly but steadily improving. Dr. Mark Hyman: Like you. Dr. Terry Wahls: Like me. Dr. Mark Hyman: How many stories do you hear like your story? Where someone really was in a wheelchair and they get up and they're good and they're riding their bike 20 miles. Dr. Terry Wahls: You know, just today. I've had several physicians tell me that they've had ... [inaudible 00:32:38] from Hungary that he had people coming to him in the wheelchair who's out running marathons. Dr. Mark Hyman: Unbelievable. Dr. Terry Wahls: I'm like, "I'm not doing that yet but I'm hoping." Dr. Mark Hyman: That's so amazing. It's so powerful. Multiple sclerosis is an autoimmune disease. Dr. Terry Wahls: Yes. Dr. Mark Hyman: So, your focus on the neurological stuff and the pain stuff, but how does this apply across autoimmune disease and what are the ways in which it can be used to help with that? Dr. Terry Wahls: Certainly this has been very, very helpful for Hashimoto's thyroiditis and we've had people with rheumatoid arthritis, who were severely disabled, have resolution of their pain and marked improvement in function. I've had people with psoriatic arthritis. Again, marked improvements in function. People with psoriasis, marked resolution of their skin problems. So, certainly this is a great approach for somebody with autoimmunity. And people with diabetes, high blood pressure, heart failure. I've had folks with hearth failure who were told that they're going to be needing a heart transplant. Dr. Mark Hyman: Transplant. Yeah. Then what happened? Dr. Terry Wahls: Well, their ejection fraction keeps improving. Dr. Mark Hyman: That's the how much blood their heart can pump, which goes down with heart failure. Yeah. Dr. Terry Wahls: Yeah. Dr. Mark Hyman: That's impressive. Dr. Terry Wahls: I keep telling them, you got to be eating liver a couple times a week, heart once a week and - Dr. Mark Hyman: I mean, it sounds too good to be true but the truth is that when you look at the principle of creating health, there are certain foundational concepts here. The right food, exercise, stress reduction, sleep, the right nutrients. It doesn't matter what disease you have because when you provide the body what it needs, it often can recover. It's not like there's one treatment for MS, another diet for cancer, another diet for Alzheimer's, another diet for rheumatoid arthritis or psoriasis. It's the same principles that you can apply to all these things. Dr. Terry Wahls: You know, when I was first changed how I was practicing medicine, my chief of staff was calling me up and saying, "Terry, your colleagues are saying you're using the same treatment for everyone. You just can't do that." [inaudible 00:34:43] I said, "Well, I think we all have mitochondria. I think we all have liver, kidneys, brains. We all have cells. We need to provide the building blocks. I'm just trying to create health and we'll see what happens." Dr. Mark Hyman: Yeah, and you just follow those principles of functional medicine and it just ... You're like, "Okay, I've never seen this disease before and yet ..." Dr. Terry Wahls: We'll just see what happens. Dr. Mark Hyman: Yeah. It's powerful. I think that ... I want to get a little bit into the diet again, because you said you came into this through the paleo track and then you sort of modified it to add ma ton more veggies, which I sort of jokingly called it the [Pegan 00:35:20] diet, which is basically very low glycemic. But one of the principles, if people aren't aware what a paleo diet is, is it removes grains, beans, and dairy. Why would you remove those foods? Dr. Terry Wahls: And I want to clarify for your audience, the paleo diet did not fix me. Supplements did not fix me. I've been vegetarian 20 years, lots of grains, beans, legumes and it was a lot of prayer and meditation, and I went back to eating meat and I had lots of meat. I was still having eggs. I had some vegetables. I continued to go downhill. I added the vitamins and supplements. Continued to go downhill, albeit more slowly and my energy was better when I took my supplements. Very, very grateful. Then, when I had my longer list of supplements, thank you Catherine Willner and [Jay Lundbern 00:36:15], I appreciate all you've done for me. Dr. Mark Hyman: Those are neurologists that focused on functional medicine - Dr. Terry Wahls: On functional medicine. Dr. Mark Hyman: ... and repairing the brain. Dr. Terry Wahls: Then, when I said, "Okay. Where is all this in the food," and I redesign my paleo diet. This was all about ramping up these vegetables. Now, my amount of meat it was really pretty modest. I have two palm sizes of meat one to two per day. That's six to twelve ounces of meat per day. Then nine cups to fifteen cups of vegetables per day. Now, we weren't talking about the microbiome back there in 2007, but what I was doing was really ramping up my microbiome, as well. I was ramping up my ability to detoxify and I was ramping up the enzymes involved in producting on my mitochondria - Dr. Mark Hyman: Antioxidants. Dr. Terry Wahls: ... in making the detox pathways more effective, intracellular glutathione more effective. It was providing that structure. Dr. Mark Hyman: You went to the Farm-acy. That's F-A-R-M-A-C-Y. Dr. Terry Wahls: Absolutely. Dr. Mark Hyman: That's why I call this The Doctor's Farmacy because it's really about how to use food as medicine. And that's what you did. Dr. Terry Wahls: And so, the reason to remove the beans, grains, legumes, has to do with something called lectins. Again, this depends on your genetic predisposition. And I think I probably am one of those people who are vulnerable to lectins, that I probably have a severe inflammatory response. If I have gluten, or dairy, or eggs my face pain triggers and I have horrific, incapacitating levels of pain in 6-24 hours. Dr. Mark Hyman: Well, that'll get you off the gluten. Dr. Terry Wahls: That'll get me off the gluten. I can have hummus on occasion. Occasional use of hummus is fine. Eggs would get me into big trouble. Dr. Mark Hyman: Is it the lectins? I mean, are there other inflammatory things in those foods? Because, when you cook, for example, greens and beans properly, you can reduce - Dr. Terry Wahls: You can reduce the lectins. You can soak them, sprout them overnight. You can reduce them. In my book, I did create a protocol for vegetarian and vegans because I do think it's really important to recognize that you have people who are spiritually very committed to being vegetarian, vegan. So I wanted to be sure that I could help them do that in a way that's very optimal. And in my clinics, even at the VA, we have vegetarian, vegans that I would help. Dr. Mark Hyman: I mean, there are some people that do thrive on that diet and other people don't. Dr. Terry Wahls: Right. Dr. Mark Hyman: And I think you really have to pay attention to your body instead of a dogma or a belief. Dr. Terry Wahls: Yes. Dr. Mark Hyman: I think your body's going to tell you what works and what doesn't. Dr. Terry Wahls: And there are people who do not do as well eating the paleo diet. Dr. Mark Hyman: Because people say meat is inflammatory. Dr. Terry Wahls: Well, I think a diet that is ... Many of my paleo friends, whom I love dearly, eat meat and very few vegetables and I think they're going to get ... That's a problem. Dr. Mark Hyman: Yeah. Dr. Terry Wahls: I think that can be inflammatory. I would much rather have moderate the meat and do some intermittent fasting and have more vegetables with them. Dr. Mark Hyman: I love the 9-15 cups of vegetables a day. Dr. Terry Wahls: Cups. Not servings, cups. Dr. Mark Hyman: That's right. 18-30 servings of vegetables and I think it seems overwhelming but it's not that hard. Because, one, there's almost no calories in them. Dr. Terry Wahls: Yes. Dr. Mark Hyman: Two, they're delicious and you can eat a lot and get full. I mean, I literally will binge on veggies. I'll make three or four side dishes of veggies to ... The protein's a side dish. Dr. Terry Wahls: Yeah. And, at the VA, I tell people, "I don't want you to be hungry." It's two palm servings of meat and then as many vegetables as you're hungry for. It's fine to have fat, to have plenty of olive oil, flax oil, walnut oil, hemp oil. But there's no need to be hungry. If you're still hungry, eat more vegetables. Dr. Mark Hyman: And do you find that the patients who are vegan or vegetarian do as well in terms of the recovery from autoimmune or MS? Dr. Terry Wahls: Potentially, yes. There are some folks who really need to figure out how to address the B-12 issues and may have some issues with lectin. Sometimes it can be more challenging but the vast majority of folks, the vegans and vegetarians, I can work with and do very well. Dr. Mark Hyman: What have you learned through this journey of your own health and then treating this patients, building this programs, running the Wahls Protocol, hearing feedback? What is some of the surprising things that you've learned that work, or maybe that don't work, things you've had to change or rethink? What have you learned? Dr. Terry Wahls: Over time, I've come to appreciate more and more the importance of personal resilience, of understanding what is it you want your health for, what is your personal mission, why is it you're doing this - Dr. Mark Hyman: Meaning and purpose. Dr. Terry Wahls: Meaning and purpose and connection because I have to connect to all of that to have you to be willing to do the hard work that it takes to sustain the diet and lifestyle changes. I've also come to appreciate that this is a family intervention, not an individual intervention. The families who do this together are very successful. The person who does it alone with their family not supportive, not eating and doing the diet lifestyle with them, will struggle. Dr. Mark Hyman: It's all about community, right? Dr. Terry Wahls: It is about community and family. Dr. Mark Hyman: So powerful. And that's how your groups are so successful because people do it together. So, one last question. If you were queen for a day and you could change anything in healthcare, food, medicine, what would it be that would make the world a better place. Dr. Terry Wahls: Oh, absolutely. I would reach out to our children. I want our children to learn how to cook. I want all of our schools to grow gardens. I want to have Home Ec and to teach kids to cook beginning in first grade. I want to have our churches have - Dr. Mark Hyman: Teaching kitchens in every school. Dr. Terry Wahls: Kitchens in every school and in every church and every synagogue, every mosque, every temple. We need our families to be cooking and eating together as a family and eating lots and lots of vegetables. Dr. Mark Hyman: I love that. That is a great vision. I think we need to understand that cooking is a revolutionary act, that it will help us take back our food from the food system. The convenience is killing us. And that we need to reinvent how we think about food, because, one, it's pleasurable. It's fun. It's delicious and it's easy and it's cheap to cook your own food if you know what you're doing. Dr. Terry Wahls: By teaching people how to cook, we made it affordable for people with food stamps. If we're going to create an epidemic of health, we have to teach our young people and all of our current families to cook again. And that you can adopt the Wahls Protocol on food stamps but you'll have to learn how to cook. Dr. Mark Hyman: Absolutely. That was what I saw with this family in South Carolina where I went down as part of the movie Fed Up. They lived in a trailer on food stamps and disability. A family of five, morbidly obese, diabetic, renal failure, on dialysis, hypertension, pre-diabetes, almost diabetes in this 15-year-old kid. They didn't know how to cook. They had two generations of that family that didn't know how to cook. I showed them how to cook one meal, gave them a little guide on how to eat well for less. They live in one of the worst food deserts in America and they lost 200 pounds in the first year as a family. The son gained a bunch of it back because he went to work at Bojangles. Then he got himself together and he lost 140 pounds and he's now going to medical school. So, it's - Dr. Terry Wahls: It can happen. Dr. Mark Hyman: It can happen. Thank you so much for showing us that one person with determination and courage can go up against a system that doesn't support what they're doing and can actually make a real difference and change the world. It's inspiring for all of us, not just your own recovery, but what you've shown can be done with a little bit of grit and determination. So thank you, Dr. Wahls, for being on The Doctor's Farmacy, a place for conversations that matter. If you've liked this podcast, please subscribe, leave a comment, a review. We'd love to hear from you. Makes a difference for us. Share this with your friends and family on Facebook and Twitter and social media. We'll see you next time on The Doctor's Farmacy. Dr. Terry Wahls: Hallelujah.