The Essential Guide To MS And Other Autoimmune Diseases

Sharon Stills, ND

Hello. Hello. Welcome back to Mastering Your Menopause Transition Summit 2.0. I am your host, Dr. Sharon Stills. I am thrilled, as always, to be here with you all and bring you all this fascinating, pertinent, and important information that’s going to help you on your journey. Today, we are going to be talking with the one and only Dr. Terry Wahls, who, as I’m sure many of you already know, is the queen of MS and has her own amazing personal story that she’s going to share with us. I just felt like it was so important to bring her on and have her be a part of this because autoimmune disease is on the rampage, and we see it much more in women. We see MS with declining estrogen levels. We see a lot of diagnoses, and we could see and sometimes overlapping of symptoms. I really wanted you to not only be inspired and learn, but just to have this in your toolbox so that you can always return and listen to this talk again if you’re ever confused or think something’s going on. We’re going to learn a lot today about a very important topic. Welcome. It’s great to have you here.

Terry Wahls, MD

Thank you for having me.

Sharon Stills, ND

My pleasure. My pleasure. I have to just start I ask everyone to share their story, but someone who has a story as profound and moving as yours, if you would share.

Terry Wahls, MD

In retrospect, my symptoms began during medical school in 1980. I’m just in my early twenties, and I ignored them. It’s not until really 27 years later, when I developed weakness in my left leg as I walked when I was 45, that I see a neurologist, and he says, Terry, this could be bad or really, really bad. And so I’m going through the workup. I think about the 27 years of worsening electrical face pain that I’ve had, and that’s very scary. So I’m praying for a fatal diagnosis because I’ve already figured out, Okay, you’ve got a progressive problem. This is going to be really bad. 

I am a physician. I do my research and see the very best MS. centers. I take the newest drugs, and three years later, I’m in a tilt-incline wheelchair. So I’m 48. That’s why I go back to doing the basic science. I developed the theory that mitochondria drive disability. I created a supplement cocktail that supports my mitochondria; it slows my decline, and I’m very grateful. My electric face pain turns on, and tears stream down my face as my ten-year-old daughter hugs me. I discovered a study using electrostimulation of muscles. I ask my physical therapist, Can I try that? He calls it E-Stim. He says it’s for athletes because, it says, it’s also, by the way, quite painful. He knows that I have a lot of MS pain. Gives me a test session. It does hurt a lot, but I feel really good afterwards, he says, that’s from the endorphins. I begin doing E-Stim, and I’m so weak. I cannot sit up in a regular chair anymore. I’m in a zero gravity, with my knees higher than my nose and my feet. My fatigue is very severe. My electrical face pain are more and more severe, and I begin to have brain fog. And my boss tells me he’s going to sign me to the Traumatic Brain Injury Clinic. Come January. Describes the job, and I’ll have to see patients without residents. And it’s a job that I physically can’t do. So I’m really quite bummed by all of this. 

I’m doing my E-Stim. I discovered the Institute for Functional Medicine. I take their course on neuroprotection. I have a longer list of supplements, and I’m taking them. Then, I had this really big aha. And Sharon, I’m so embarrassed now, in retrospect, about how long it took me to have this, aha. What if I redesign my paleo diet that I’ve been following for five years because I have been a vegetarian for 20 years? Before that, I was on a very low-fat diet, and I did more research to figure out how to get these nutrients that I’ve been taking in supplement form in the food supply. So now I have a very, very structured paleo diet. I start this new way of eating on December 26. As I said, I can sit up for no more than 10 minutes, which, by the way, meets the definition of being bedridden. I can take just a few steps using two walking sticks. Otherwise, I’m either in bed or in the zero-gravity chair. And the reason my chief of staff assigned me to the Traumatic Brain Injury Clinic was because he was forcing my hand, probably because it was time, because of the brain fog, to admit that I needed to apply for medical disability.

So I started this new way of eating at the end of December. I go off to the Traumatic Brain Injury Clinic. For the first two weeks, I am just watching my partners—my new partners, from my zero-gravity chair. In the third week of January, which is really the beginning of the fourth week of my very structured paleo diet, I have to get up out of my wheelchair, do the exam, sit down, write my notes, do an exam, sit down and write my notes. And at the end of the day, when I come home, Jackie asks me how it went. And I’m like, Well, it wasn’t too bad. At the end of the week, she goes, Well, hon, how was it? And I’m like, That wasn’t too bad. At the end of the month, I said, Honey, could we bring a regular chair in? I want to, because I’ve been eating from a zero-gravity chair, leaning back, probably making my family very nervous that I am going to choke as I eat. So I sat up, with my family for supper, and that was a big deal. Then my physical therapist says, Terry, you’re stronger. I’m going to advance your exercises. I have been doing just 10 minutes of exercise. But if I did more than that, I just couldn’t function. So he asked me doing 10 minutes twice a day, 15 minutes twice a day, 20 minutes twice a day, and half an hour twice a day. Then, I’m beginning to walk in the hospital using my two walking sticks in the hallway, and people are like, Oh, my God, are you on some new drug? No, no, no, no. I’m and I show them my E-Stim device, and then I begin walking with one walking stick, and then I begin walking with no walking sticks, and I am walking around the block. It’s still a short distance. But from being unable to sit up to walking around the block—not quite half a mile, that’s a pretty big deal. 

I tell Jackie, Honey, I’d like to try riding my bike, because we used to really be into bike riding. And she says, Well, honey, if things keep going well, maybe in the fall. Well, two weeks later, it’s Mother’s Day. And by the way, I decided I wanted to try riding my bike. And we have an emergency family meeting. Jackie tells my six-foot-five, sixteen-year-old son, Zach, You are alongside on the left. She tells my 13-year-old daughter, Zippy, You run alongside on the right, and she’ll follow. I got on my bike, and I biked around the block. That big 16-year-old boy, he’s crying; that 13-year-old girl, she’s crying. Jackie is crying. And as you can tell, as I tell the story, I cry again, because it was at that moment that I understood that the current understanding of progressive multiple sclerosis is incomplete. Who knows how much recovery might be possible, and so every day, I bike a little more. And in October, Jackie says, Hey, let’s sign you up for the courage ride. It’s 18.5 miles. And when I crossed the finish line again, we were all crying. My kids are crying; Jackie’s crying; I’m crying. And this fundamentally changes the way I think about disease and health. It will change the way I practice medicine, and it will change the focus of the research that I do. I have to go and get some tissues because my nose is running. Well, I can’t tell that story without crying.

Sharon Stills, ND

Yes. It’s powerful. It just makes you realize how much we take for granted. Even as you’re talking about just being able to sit up with your family to eat. There are a lot of things we take for granted that are such huge leaps when you’re dealing with. 

Terry Wahls, MD

Because when you cannot sit up in a regular chair for more than 10 minutes, you can’t go to the movies, and you can’t go out to eat. Driving up to Wisconsin to see family meant that we fully reclined my chair with straps that strapped me in. And your world becomes smaller and smaller and smaller.

Sharon Stills, ND

So how long ago was that when you did the bike ride?

Terry Wahls, MD

2008.

Sharon Stills, ND

So 15 years ago.

Terry Wahls, MD

15 years, and now I jog in my neighborhood. I can jog around the block. It’s not far; I jog a mile or mile and a half pretty comfortably. If I, of course, am tempted to try going farther, I try to make sure I don’t go too far and that my form declines because I don’t want to stumble and fall.

Sharon Stills, ND

So do you credit the diet as being the main thing that turned it around for you?

Terry Wahls, MD

I did the Paleo diet for five years, and I still declined. I took supplements for four years. Yes, I was tinkering. I was still declining, and the E-Stim stabilized things when I redesigned my paleo diet in a very specific way. Man, that’s when the magic happened. Things just became very remarkable, and then my physical therapist gave me permission to increase my E-Stim. I’m sure the intensity of working with a person who treated me like an athlete was why I was able to make the rapid recovery that I did. And certainly, if I came to your home, Sharon, and you accidentally gave me gluten, dairy, or eggs within 6 to 24 hours, my face pain would turn on. I’d have a truly incapacitating, horrific level of pain.

Sharon Stills, ND

That’s pretty powerful. And shows how our food truly is our medicine. You have the Wahls Protocol. 

Terry Wahls, MD

Correct. Before we get into that, I do want to because this is a menopause thing. I want to talk a little bit about menopause in MS and systemic autoimmune conditions. Because when we were young, in our twenties, we had relapses or exacerbations of your autoimmune diseases, whether it was rheumatoid arthritis, inflammatory bowel disease, psoriasis, or whatever systemic autoimmune thing you’ve got.

But beginning around age 40 to 45, there are far fewer relapses. We have immune senescence, so our immune cells are getting old, and we transition in the MS world to what is called the progressive phase of the illness. When I was diagnosed at age 45, in the age 48, and sometimes it’s between age 45 and 50 that people are really in the progressive phase of their illness. So at the time that I was diagnosed, I was transitioning to the progressive phase, and this is the phase where some women would never really get diagnosed with relapses. We may just see this slow worsening of pain, worsening of our fatigue, anxiety, and depression. And when we have difficulty walking because we’re stumbling, we’re tripping, we’re peeing our pants too much, pooping our pants too much, we end up seeing our gynecologist, our primary care doctor, who maybe sends us to a neurologist who gets the MRI, the spinal tap, and says, You have MS or you have the MS lookalikes, which are all these other neuroimmune conditions. I think it’s the absence of the sex hormones that really has this major impact on our immune system, that accelerates if you have MS or a new immune condition, accelerates the disability, and accelerates the damage that leads to our going in to see our physicians.

Sharon Stills, ND

Absolutely. Absolutely. That’s why I always teach that hormone replacement is not just to get rid of hot flashes; it’s really to protect the immune system, the gut, the brain, and the bones. It’s really for the prevention of chronic disease.

Terry Wahls, MD

That’s correct. I think we underestimate the impact of that menopausal transition for people with an autoimmune disease. 

Sharon Stills, ND

It’s very important stuff we’re talking about right now, whether you’ve been diagnosed, you have suspicions that something’s going on, or you’re on the lookout because you have a family history. It’s just really something I want. Everyone who’s listening, I want this in your attention span and in the realm of things to be thinking about. Because we don’t often think about this.

Terry Wahls, MD

Yes. Yes, absolutely.

Sharon Stills, ND

So tell us about, tell us about the research. Tell us about the protocol. Tell us about the diet—

Terry Wahls, MD

Yes. So what is this magical diet? We’ll talk about the things you ate. Because in my, I think my microphone—

Sharon Stills, ND

Sounds like it unplugged. I think it’s back now.

Terry Wahls, MD

Okay. So the issue with diet is it’s always easier. It is always much easier to have our diet when you add stuff. If you add in the last protocol, more green leafy vegetables—kale, collards, spinach, Swiss chard, cilantro, parsley, mustard greens, etc. Then the next category are the cabbage, onion, and mushroom family of vegetables. I call that the sulfur-rich family. And then the next category is deeply pigmented: beets, carrots, and berries. A good way of thinking about that is, when you look at the color, is the color going all the way through the food item? So an apple is red on the outside and white on the inside. I call that a starchy vegetable; it’s quite delicious. But it’s not going to have all the polyphenols that I’m looking for—cranberries, blueberries, peaches, and apricots. They’re pigmented all the way through, so they did meet that criteria. Then I want to be sure that you have plenty of protein, and while I think people know that I’m very, very fond of the Paleo diet, in my preferences, people eat meat because that’s a complete source of protein. I recognize that some people are vegetarians or vegans because of their spiritual beliefs. And if that’s the case, I don’t want to dishonor your spiritual practices. Then it’s going to be a gluten-free grain from whole legumes. We want to have plenty of omega-3 fats because omega-3 fats are important in the cell membrane. Important in the cell’s myelin. Important in the signaling molecules that are helping to calm and resolve our inflammation. There’s a big category called resolvents that are made out of omega-3s, and there are resolvins, protectins, maresins, etc. We also need some omega-6 fats, which are also part of the cell membrane. So nuts and seeds will be helpful for that. Then, I’m very fond of organ meats. Our ancestors would never have wasted the animals they ate from nose to tail; about a third of the animal carcass would be what we now call organ meats. By having bone broth, you have a more balanced source of your proteins. There is less overactivation of the mTOR pathways. Bone broth also is really healing for the gut lining.

Sharon Stills, ND

Are you looking for a certain amount of protein, like 30 grams per meal or total?

Terry Wahls, MD

Well, I think an easy way to think about that, because I try to keep things as practical for my folks, is that you want to have 6 to 12 ounces of meat per day. A really simple way to think about that is your palm: two palm-sized servings of meat each day. 

Sharon Stills, ND

And are you making sure that that meat is organic, grass-fed and finished?

Terry Wahls, MD

I want people to do what is the highest-quality food that they and their family can afford. So if you can do grass-fed, grass-finished, organic, regenerative farming and grow it yourself, that’s perfect. However, just be sure that you’re getting fruits and vegetables and plenty of protein. The people that I took care of in the VA, they were living on food stamps, shopping in rural grocery stores, and they were non-organic, but they still had really remarkable results.

Sharon Stills, ND

We talked about adding in all these leafy greens and the polyphenol rich veggies and the protein— 

Terry Wahls, MD

And healthy fats.

Sharon Stills, ND

The omegas. What about taking out?

Terry Wahls, MD

Oh, okay. So you get out of the good stuff. Now I have to take out the stuff that is wrecking your health. So sugar, all this added sugar—are these sugar-sweetened beverages really terrible for you? Get that, get that out. Processed foods; ultra-processed foods. And by that, I mean flour-based products used to make breads, pastas, and cereals; those are harmful. So reduce that. Then some categories: gluten, that’s the wheat, rye, barley, and many ancient grains, can cause an abnormal immune response in many people with an autoimmune disease; casein, which is the protein in dairy, likewise can cause an abnormal immune response, particularly if you’re gluten sensitive; and while mammals have been growing our young with milk for 200 million years, it’s very effective for growing infants, toddlers, and young people. But once your bones fuse, all those growth factors will either make you grow horizontally, make you fat, not so good for you, or make you grow cancer in pre-cancer cells. Also not so good for you. So, I think dairy is a problem once your bones are fused.

Sharon Stills, ND

Well, how do you feel about butter?

Terry Wahls, MD

Well, butter still has a lot of casein in it. So if you’re going to have butter, I’d rather you have clarified butter or ghee, because you can still get the fat with a much smaller load of casein. I can tolerate some ghee. If I have a little bit of ghee, it’s okay; if I have a lot of ghee, there’s going to be a problem.

Sharon Stills, ND

And what about as you’re drinking hydration, how important is it hydration or what you’re drinking?

Terry Wahls, MD

Do you want to be sure that you are penalized throughout the day? And what gets to be a little tricky is: how much do I need to drink? It depends on how much I’m sweating, what the weather is, and how dry the environment is. So rather than giving people a prescribed volume of fluid, I tell them that I want you to be having diluted urine and that you’re drinking perfectly some throughout the day.

Sharon Stills, ND

Okay. And so there’s the diet, which makes a time span.

Terry Wahls, MD

And I’ve not mentioned the fermented foods I’m very fond of, including fermented cabbages, sauerkraut, and kimchi. I also like to have fermented nut milks or coconut milk, yogurts, and kefirs. Those are super helpful. I will also make natto, which is a fermented black bean or fermented soybean as well, because that’s a really great source of spermidine compounds and stimulates autophagy.

Sharon Stills, ND

What about caffeine for the coffee lovers?

Terry Wahls, MD

There’s a really lovely measure, the Dietary Inflammation Index, and they look at vitamins, minerals, spices, polyphenols, alcohol, green tea, black tea, and caffeine. They do not look specifically at coffee, but the bottom line is that moderate caffeine, which I think is perfectly fine. If you’re a coffee drinker, that’s fine. The question I ask my patients is, Can you sleep at night? Do you have any difficulty finding sleep? Difficulty waking up too early or waking up and having a hard time falling to sleep. If you have a sleep problem, you’re going to have to back off on your caffeine intake. So maybe less tea, less coffee, stop it early in the day, or perhaps none at all. I tried drinking coffee early in my life. I enjoyed the taste of coffee, but it rocked my sleep. I could have a little bit of tea. I have to have it early in the day. Then I have to switch to caffeine-free tea in the afternoon or evening.

Sharon Stills, ND

What about feeding windows? Is the diet just free for all or do you like a feeding window?

Terry Wahls, MD

So our ancestors, for millions of years, had to work really hard to get their food, and they would also spend a lot of time without food. The availability of continuous feeding, I think, is very, very problematic. It really creates problems with our glucose metabolism and our cholesterol metabolism. So my preference is to get rid of the snacks and eat three meals if you only have three meals. Then, when you get comfortable, have two meals, and when you really get comfortable that you can think about having two meals closer together. And when you get comfortable with that. You could think about one meal a day, and some people in those circumstances may like to go to one meal every other day, and there are benefits for doing that.

We have a very strong biological desire to eat and to not feel hungry. There’s always going to be a tension of how frequently I want to eat and how comfortable I am with being hungry. If we can tolerate being hungry and having a longer period of not eating, that will stimulate autophagy. That will stimulate a lot of the anti-aging changes that are really great for my immune cells, that are really great for making stem cells, and that are really great for keeping my brain healthy and young. I like to eat every other day. Often, I will occasionally not eat for 24 or 48 hours, and I will occasionally do an intermittent calorie restriction. So fewer calories for 5 to 7 days and then go back to my usual eating pattern. All of those things are to stimulate my stem cells because, Dr. Sharon, my plans are to live to 220. So doing research, still having postdocs, still giving inspiring lectures, and having wonderful conversations with people like yourself on these summits around the world. Who knows what we’ll be talking about in another 50 years?

Sharon Stills, ND

Exactly. Well, we’ll save this video. And when we meet again in 50 years, we’ll kind of look back..

Terry Wahls, MD

And we’ll talk about it. Yes. It’s super fun.

Sharon Stills, ND

Yes, that would be a lot of fun. So when you are only eating one meal every other day on the days that you’re not eating, are you just focusing on staying hydrated with pure water?

Terry Wahls, MD

I have a lot of water and a lot of green tea. I’ll still be doing my workout, so I’ll be taking a cold shower and a sauna. I may be having my Phosphatidylcholine smoothie, which is a high-fat omega-3 and omega-6 pack, and then I’ll add some inulin to that as well. I may add a scoop of bone broth powder to that as well. So that would probably be about 300 calories.

Sharon Stills, ND

So a phosphatidylcholine smoothie. So the base is just water?

Terry Wahls, MD

It’s water. I’ll put in some phosphatidylcholine. I’ll put in some omega-3s, I’ll put in a little olive oil, I’ll blend all of that up, I’ll add some spices, and I’ll go through a variety of different spices that I’ll add to it, and then I’ll add some fiber. That way, I’m hanging out with my family as they’re eating, because I think that’s an important part of family life—sharing meals and conversations together.

Sharon Stills, ND

Yes, for sure. And you can, exactly. You can be fasting and still be part of the family events. I love that. I always do that phosphatidylcholine like Patricia Cain’s work, like the IV with the phosphatidylcholine. But I never thought of doing phosphatidylcholine smoothies. I love that. 

Terry Wahls, MD

Do it as a smoothie. I think that it’s one, it’s less expensive. There’s less risk of harm. It’s easier to sustain on a daily basis. So I can continue to wash my micelles with that PC smoothie. So yes. I’m using basically the BodyBio products. I’m very, very, very happy with their phosphatidylcholine.

Sharon Stills, ND

Yes, it’s a great thing to do because patients can come see me every day for the IV push. So that’s a wonderful, wonderful way to get it done.

Terry Wahls, MD

It’s very easy one.

Sharon Stills, ND

So with the food and then the eating windows and then are there supplements that like phosphatidylcholine.

Terry Wahls, MD

So there are supplements and things that I want everyone to be aware of and be thinking about. I want you to know your vitamin D level and vitamin D plus vitamin K, and your sunshine level. Many studies have said that your vitamin D from sunshine behaves differently than vitamin D from supplements. So I think it’s fine to take supplements. I do take vitamin D supplements, but I also get myself out every day and on the weekends. I make sure I have a great tan. I am having the immune effect of that sunlight, and I also do red lights; we get that photobiomodulation as well. Then, as I mentioned, omega-3s, olive oil, and plenty of fiber, there are various fiber sources. I will think about things like NAC and acetyl cysteine. I think that can be super helpful. I’m wanting to know people’s homocysteine levels and probably also at least their B9 and folate B12 levels. Depending on their nutrition exam, I will do additional vitamin and mineral levels so I can really personalize their nutrients. I may think about things like coenzyme Q, carnitine, creatine, lipoic acid, and branched-chain amino acids. We’re prickly when we hit menopause. My protein requirement goes up and my carbohydrate requirement goes down. I’m actually eating fewer carbs and more protein than when I was in my 40s. I stressed that to my patients, particularly when you hit 60, your protein requirement is much more important and your carb requirement is much less.

Sharon Stills, ND

Protein becomes clean. And I’m sitting here grinning because before we started our interview, I was out in my yard; I had to get my son; and I had to set my timer. I’m like, I don’t want to miss the interview. It’s too bright out here to bring the Zoom room out there. But yes, getting here, when I was in medical school, 25 years ago now, we had to write a it was like one of our first nutrition classes, and they said, You have to write a paper on your favorite supplement. And everyone was writing about vitamin C or B-Complex, And I wrote my paper on the sun.

Terry Wahls, MD

The sun is really profound. There are some more studies coming out now that the high-dose vitamin D supplements that many of us are using. High-dose vitamin D, which gets the bottom D levels in the top quartile, has been disappointing. I’m not surprised. I think anytime that we do a supplement, we’re going to be disappointed because life isn’t a single supplement; it’s always multiple compounds that interact. But vitamin D is a reflection of our sunlight as well. And yes, the vitamin D supplement may be helpful, but you need the sun. Getting a tan is what; for millions of years, humans stood out to get our vitamin D and rebalance our immune cells. I think getting, so I loved that you wrote about the sun.

Sharon Stills, ND

And low vitamin D levels, which at this point I checked and have for years, checked on all my patients. It’s almost like I expect to see them low. If someone comes in and they have a high one, it’s almost surprising. Because it’s also a reflection of we are inside. We’re not in nature. We’re not taking time to sit and enjoy the sun. If we’re in the sun; we’re using toxic sunscreen, we’re not getting the benefits. We’ve been made afraid of what gives us life.

Terry Wahls, MD

It is a huge problem. Another thing that we talked about was love and social connection. We all went through the pandemic, the isolation, and the trauma to a variety of degrees. Many of us had to relearn how to socialize and relearn those social skills. We relearned how to be connected, how to read nonverbal communication, and how to read facial expressions, both live and in person. Body language and proximity in person, like, How close can I sit next to Sharon, and is she going to be happy? At what point do I have to back off? Because I’m too much in her space, and when am I too far away that she feels rejected? Those are important things for us to understand, recognize, interact with, and value with each other.

Sharon Stills, ND

Yes, that’s for sure. Connection is key. I want to swing back a second. You were talking about protein and how important it is, and we talked about that a lot when we were talking about menopause and aging. I just want to remind everyone listening to check their hydrochloric acid levels because you have to absorb what you are eating. I find frequently that women; menopausal, perimenopausal, or even younger than that. I find that in kids, even. Our hydrochloric acid levels are not what they need to be. So we’re not utilizing what we’re eating. So if you’re doing a really good job and you’re eating like Dr. Wahls is talking about, then you definitely want to make sure you’re utilizing it.

Terry Wahls, MD

So Sharon, how do you check your hydrochloric acid? Are you doing it with the functional test? You do it with blood test? What’s your —-

Sharon Stills, ND

I definitely do like a betaine hydrochloric acid challenge where they’re taking it and we’re seeing, but I also look at things like globulin levels, phosphorous levels, and gastrin levels, and then I usually see a correlating high homocysteine and elevated MCV and MCH. The red blood cells are too big. I’m also seeing a concurrent B12 deficiency, and it starts like piecing together—they’re not absorbing their B12s, they’re not absorbing their protein, and putting. It usually starts all falling back on each other, and it’s like, Yes, you’re just not absorbing anything because you don’t have hydrochloric acid. So if we can fix that, we might not even need to supplement. So I’m looking at all those different things I just see. I do have a couple of quick questions before we wrap up. One of the things we talk about all the time and think about with autoimmune disease is that there’s a microbiome problem; there’s a leaky or permeable gut. So I’m wondering, do you find that by just following your diet, that kind of takes care of itself? Or do you have to go in and still really repair the gut?

Terry Wahls, MD

Typically, we have to repair the gut. I love asking people, Are you pooping rocks, prickly logs, smooth logs, snakes, pudding, or tea? Is it getting into your pants? The ideal is a smooth log or a snake. If you’ve got rocks, you’re going to need more fiber and fermented foods. If it’s getting into your pants, we need less. Then we talked about bone broth, and we talked about fermented foods, severe constipation, huge problem for people with neuroimmune conditions. Interestingly enough, that severe constipation often predates the diagnosis, much the same way it does for Parkinson’s and it does for cognitive decline, and Alzheimer’s. So that can be an indication that trouble is happening and we need to do something about that.

Sharon Stills, ND

Are you also seeing a big correlation with the history of Epstein-Barr? Are there other things that.

Terry Wahls, MD

There are 16 different bacteria and viruses that are associated with higher rates of MS and autoimmunity. Sharon, there are probably, most of us have been exposed to at least one, if not multiple, of these microbes. So to me, the real question is, when we see these papers that are so excited about identifying Epstein-Barr, have they overlooked the fact that the vast majority of folks who’ve been exposed to Epstein-Barr never got MS? So what were the environmental factors that allowed them to stay protected? That’s where I think all of the diet and environmental factors that you teach and that I teach can be very instrumental. 

Yes, there is a genetic vulnerability. I get exposed to probably many of these different 16 microbes that are the problem and either manage them or clear them well. And it’s not a problem. Once we get infected, that microbe is never gone; it’s always there. It is always there. It’s part of me. It’s my immune cells that keep it under control, and so that’s where diet and lifestyle have a huge role to play, to either keep it under control or let it escape.

Sharon Stills, ND

Exactly. What about Mercury? Do you see a huge correlation with Mercury?

Terry Wahls, MD

Oh, yes. There’s more evidence that people with MS and neuroimmune issues, we are more likely to have the SNPs that affect how we process mercury, cadmium, arsenic, lead, and some of the solvents. So toxins absolutely are part of this. What can we do to reduce our exposure? Again, work with people like yourself and myself to help improve the efficiency that my body can process and eliminate these toxins.

Sharon Stills, ND

Right. We’re swimming in a sea of toxins; they made the world today. It’s about now; it’s about reducing exposure. But you’re never going to get it totally reduced. So it’s teaching your body and supporting your body in how

Terry Wahls, MD

To process as well as you can

Sharon Stills, ND

Exactly. So do you expect that scientists are going to find a drug that’s going to help people grow stem cells and repair the damaged brain cells?

Terry Wahls, MD

We have all sorts of drugs that work really well in mice and in rats—spectacularly well. And they uniformly fail in people. That’s because we get to eat what we want. We have fights with people that annoy us. We go outside or not; we exercise or not. So it’s our diet and lifestyle, and what we ultimately find is that there are some compounds that may be useful in conjunction with a really great functional medicine approach. Yes, that may be. But we already know the things that work: fasting, learning, exercise, and social connections. 

Which is why I spend a week every month pretty darn hungry, because I know I’m growing my stem cells, and I want to have a lot of stem cells in circulation for as long as I can because I want to thrive, up until I’m 120. There are all sorts of things that we can do to grow our own stem cells. Will we someday find drugs that could do that? Yes, perhaps. That’ll be complicated because those same drugs would also unleash cancers that would have a hard time controlling. I would not be in any rush to be in any of those early trials. I would much rather grow my own stem cells through fasting.

Sharon Stills, ND

Exactly, and I think when you fast, and there’s such an emotional and spiritual perspective that happens when you’re fasting and you start to sit with your hunger and realize, like, you’re going to survive; it’s going to be okay.

Terry Wahls, MD

I think that’s why many of our religious traditions include fasting as part of the religious experience. That has been a consistent theme across probably all of our continents in most of our religious practices: to include purification practices and detoxification practices in fasting practices.

Sharon Stills, ND

And that’s a good point and very true. So too, to wrap up, like what? What is your research? What are you up to now?

Terry Wahls, MD

Oh, yes. Anyone who’s listening to this, we’re always looking for new research people. If you go to terrywahls.com/MSstudy, you’ll hear about my current study, which is on The Efficacy of Diet on Quality of Life, comparing a keto diet, the paleo diet, and the usual diet. We will follow people for two years. When you come to Iowa, baseline months three and months 24. We will measure patient-reported outcomes and clinical outcomes, and we will have a brain structure outcome that will let us measure changes in brain volume. One of my hypotheses is that as people improve their diet, we can get their rate of brain volume loss back to healthy aging. The drugs can’t do that. If we’re able to show that we can do it, that would be just spectacularly amazing.

Sharon Stills, ND

Wow, that. Well, you are amazing. Your story is amazing. The work you do is amazing. You’re just a total inspiration. 360 all the way around. So say that website again for everyone?

Terry Wahls, MD

Terry Wahls, that’s T E R R Y, Wahls, terrywahls.com/MSstudy.

Sharon Stills, ND

And you’re on Instagram? I know, I follow you there. You’re always cooking all such interesting stuff.

Terry Wahls, MD

Yes. Follow me on Instagram Dr. Terry Wahls. You’ll see what I’m eating, what I’m doing. Jackie does all these videos. It’s lots of lots of fun. I’m on Facebook, Terry Wahls and Twitter at Terry Wahls. But and then if you go to TerryWahls.com/email, sign up for my email, forward slash email. That way you get to have the weekly research updates where I’m giving you a few comments about a couple of the interesting research papers that talks about diet and lifestyle interventions for MS and other chronic health challenges.

Sharon Stills, ND

I got to sign up for that. I don’t think I’m on that list.

Terry Wahls, MD

I’m sure you’d enjoy it.

Sharon Stills, ND

Well, that’s fantastic. Well, thank you for coming here, being a part of the Menopause Summit, and sharing your wisdom. A lot of what you talk about, the diet, even if you don’t have an autoimmune disease or diagnosis, is just good, healthy living: fasting, moving your body, being connected, being in the sun, etc., etc. There were lots of juicy nuggets here that can really help you during your hormonal journey. So thank you for being here, and thank you to everyone for taking the time to listen. I know you were inspired and learned a lot today, so we’ll be back with another interview. Till then, bye.