0:02

Welcome to the Healthy Brain Toolbox. I'm Dr. Ken Sharlin, neurologist, speaker, author, and host for this show. In each episode, I interview influential people whose work impacts how we live and how we think. My guests are leaders in the health and fitness industry, physicians, scientists. Authors and public servants. Here, you'll find conversations that break down barriers, expand your horizons, and give you the tools you need to protect your health and nourish your aging brain.

Dr. Ken Sharlin: 0:39

Welcome to the show. Today we have the incredible Dr. Terry Wahls, pioneer in functional medicine and a true champion of brain health. overcoming the challenges of Multiple Sclerosis with her innovative Wahls Protocol, she's here to share valuable insights on how diet and lifestyle can enhance brain function. We're gonna take an even deeper dive into some of her. Research over the last decade and how her research has been informed by her own personal journey. So get ready to unlock the secrets to a happier and healthier mind. And I know whether you're affected by MS. Parkinson's or Alzheimer's or even ALS, she's gonna share some really important information about what you can do to improve your situation and get back in the driver's seat. So without further a do, Dr. Terry Wahls, my dear friend and colleague. Welcome to the Healthy Brain Toolbox Podcast.

Dr. Terry Wahls: 1:41

Hey, thanks for having me, Ken.

Dr. Ken Sharlin: 1:43

It's great to have you. Let's just get right into it. You're not new to the scene and many folks have heard about your journey, but for those who haven't just a brief synopsis how you got here, if that's okay.

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Dr. Terry Wahls: 3:52

Yeah, so I'm a internal medicine physician by training. In 2000, I developed leg weakness, got evaluated, was ultimately diagnosed with relapsing reiding Multiple Sclerosis. At age 45 I saw the best MS centers in the country took the newest drugs. And by age 48, I'm in a tilt recline wheelchair. My disease has transitioned to secondary progressive MS. I take mitoxantrone does not help. I take Zare when it's first released. That does not help. Then I'm switched to CellCept and Ken, that's when I really start reading the basic science, begin tinkering with my own self-care. I start with supplements for my mitochondria, which help my fatigue a little bit. I'm super grateful. I've already been adopting the Paleo Diet. I discover functional medicine. I have a longer list of supplements, which I take. I discover electrical stimulation of muscles. My physical therapist adds that to my rehab program. Then I have this big aha like what if I designed my Paleo Diet based on this long list of mitochondrial supplements? When I start that in December of 2007. I'm so weak I can no longer set up. I'm beginning to have brain fog in my trigeminal neurologist. Much more severe, more frequent, much more difficult to turn off. So it's very clear I'm on track to become bedridden by my illness. Probably demented by my illness and quite possibly dying with intractable pain. However, I redesigned this, my Paleo Diet. I continue my stimulation muscles in it. Within three months, my fatigue is markedly reduced. My brain fog is resolved and I am definitely stronger. And I begin walking in the hospitals, stunning my colleagues. For the first time in six years, I bike around the block with my family and then in October, a year into this program, I'm able to do an 18.5 mile bike ride. Now, this really changes how I think about disease and health. It will change the focus of my clinical practice and it will change the focus of my research. And I've since, made it my mission to teach other clinicians how to approach MS and chronic disease and to teach the public that there's so much that is under their control that will change the direction of their healing journey.

Dr. Ken Sharlin: 6:19

Now you've been on faculty at University of Iowa for quite a long time. Were you doing research even before

Dr. Terry Wahls: 6:30

Yeah, I've been doing research since my arrival in 2000. But I was doing health services research and so it was a different kind of research analyzing secondary data. And so when, I said my chief of staff and the chief of the medicine of university directed me to first write up a case report on my recovery and then to start doing a safety and feasibility trial. And I said, I don't know how to do human studies and Dr. Rothman said, this is really important, Terry. I'll get you the mentors and this is the direction I want you to take. And so I did that.

Dr. Ken Sharlin: 7:09

So you had to look inside yourself, so to speak, and reflect on your own personal journey. As you started to shape what really has become the research that you've been involved with in the last decade. When you sat down and really started to think about, okay, pencil to paper, what am I gonna do? How did that evolve?

Dr. Terry Wahls: 7:30

It is super interesting. The first question, and it was Paul Rothman that helped me think about this. He said, Terry, the first question is, can other people with progressive MS who are as disabled as you can, they implement this very complicated program. So the question is can they do it? So that's feasibility and safety. Can you harm anyone? So it'll be a single arm study. Everyone gets the intervention and the first job is to clearly, precisely write out what you did so that you can create a protocol, you can test to see is it safe and is it feasible. And so that, that was the first two trials that we did.

Dr. Ken Sharlin: 8:09

And those two trials, they solely focused on the nutrition component where you were asking your participants do anything else?

Dr. Terry Wahls: 8:18

We asked them to do basically my whole program. So it was a modified Paleo Diet targeted supplements, a daily meditation, daily exercise that were mat based. And show and taught them how to do electrical stimulation of muscles targeting the abdomen, the buttocks muscles, basically the core muscles of walking.

Dr. Ken Sharlin: 8:42

I met Dale Bredesen for the first time back in about 2016, and he was sharing his sort of journey as a neurologist and anti-aging researcher and so forth, and his interest in Alzheimer's and how he evolved his protocol for Alzheimer's disease. But he was met with a lot of criticism and pushback because he realized that in order to address Alzheimer's disease, that the approach had to be multimodal in traditional research, we have one single focused intervention and we evaluate the efficacy of that intervention. So I'm just wondering, you were actually able to tackle this. Early on in terms of bringing in all these different modalities, not just to food. How did you frame that?

Dr. Terry Wahls: 9:37

And that was again we have to thank Dr. Rothman because many of my colleagues were saying, Terry, you gotta pick one mechanism. And Rothman said,"oh, no, Terry, we're testing. Can other people do what you did? Could they do this very complicated regimen?" So what you need to do is precisely mimic your own protocol. When I was first disapproved by the IRB'cause I said, too many supplements. This is too complicated. It's not safe. And so I took them out, and then they disapproved that again, said no, you have to do your protocol. Unfortunately by then Paul Rothman had become the dean of the medical school, and he spoke with the IRB and said. We'll get Dr. Wahls some additional mentors on her team so she can address the safety concerns, but you need to let her test her protocol. That was remarkable for her recovery, and so I addressed all of the concerns. It took me about a year to get all of that. Done. But we did finally get approval and we did first 10, then we did 20 and we were able to show that the adverse event was that if you're overweight, you lost weight without being hungry. That was the adverse event and the only adverse event that we had.

Dr. Ken Sharlin: 10:52

It's funny, we actually see that a little bit too as we implement these principles in the clinic where sometimes the challenge is to impress upon folks that nutrient density as well as meeting, caloric and macronutrient needs are all critical. Sometimes the satiation. Comes early, especially when fats are increased. I would imagine that's probably a major part of it. But people's weights settle down. Now sometimes what we see is some folks think they've lost too much weight, and I look at their BMI and your BMI is 23.8. It's absolutely normal. We just have this lens, I think, in our country that we look through and say, what is a normal body weight? Just by visually inspecting folks. Americans have gotten quite big over the years, so maybe our lens needs to be adjusted.

Dr. Terry Wahls: 11:44

Correct, correct. It used to be 21, 20 was considered a healthy, very appropriate BMI, in our study, we never had anyone become underweight people might get down to BMI of 19 and 20. And what we saw is people often had their BMI drift down to what it was when they were 20 years, 21 years old.

Dr. Ken Sharlin: 12:06

So before we move forward with the research, I'm just curious because there are a lot of folks out there who do take supplements and you and I know that there are a few supplements out there that you have to be careful with that there are some toxicities. Eventually you can reach toxicity levels with vitamin D. Theoretically with things like selenium and zinc at high levels it. There's some literature on carcinogenicity, potentially triggering cancers at very high levels. We are always worried about very high levels of purine in our clinic, but other other nutrients are really of no concern and I'm more focused on. The pathways that they are involved with. A given person may need more folate or may need more B12, as when it comes to looking at things like the methionine cycle. But my question is, for those listening or watching, where were the concerns that the IRB had in terms of safety?

Dr. Terry Wahls: 13:05

They said that there were no animal safety studies that I think we had eight supplements that we had included that may have been nine. And their concern was all those supplements were not safe. So then I took them out. Then they came back and said, but it's not your protocol. You gotta put'em back in. And then we had to add safety labs. And they wanted to be to be sure that I was paying for all of these supplements and paying for the devices that I was recommending. So that meant I was gonna have to raise a lot more money to do the study. So perhaps they thought that would keep me from being able to do the study.'cause now I would have to pay for everything. But we secured funding from a device maker to pro provide in kind for the device and a supplement com company to provide in kind donation for the many of the supplements, not all. A charity out of Wisconsin pardon out of Canada provided some additional funding as well. So we're able to basically secure the over a hundred thousand dollars worth of funding support.

Dr. Ken Sharlin: 14:08

That's great. Yeah. As there's a kind of a distinction between a food and a drug and the semantics as well as the regulatory language when it comes to supplements are largely considered the food component of the FDA and less regulated less. There but there still has to be careful language, I should say, around how we talk about supplements that we could say AIDS or supports MS, for example, but we're not allowed to say a treat, it's a treatment for MS. So I think it's interesting that the IRB would've said, not enough research because we're approving the food, but we're not approving the supplement initially, and yet the supplement is essentially from a regulatory perspective of food.

Dr. Terry Wahls: 14:55

Yeah, unfortunately, the IRB has gotten a little more comfortable with what I'm doing, and I think the world has gotten more comfortable with the idea that diet, lifestyle, modifiable lifestyle factors are a major part of wellness and support for people with MS.

Dr. Ken Sharlin: 15:15

So to reiterate the basic findings of the first study were?

Dr. Terry Wahls: 15:20

The first one was that people could actually do this complicated regimen. They could change their diet, they could exercise, they could meditate. We had basically 90% adherence. So 90% of the days they were doing the stuff that we asked. There was a remarkable reduction in fatigue, severity, improvement in quality of life and half, and this is remarkable, Ken. Our disability level was between Cane and Walker as a group, and half of these individuals had a meaningful improvement in walking. And now most, for most of them, that improvement didn't show up until about the ninth month. A couple folks had that improvement show up very early as early as three months. But with progressive MS the standard expectation is that 15% worsening year by year. So the fact that half had significant improvement in walking function is really quite remarkable.

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Dr. Ken Sharlin: 18:14

So ultimately you got a lot of traction with your research and what, tell me what the evolution has been since the original study.

Dr. Terry Wahls: 18:23

We could not get additional funding to do a follow up randomized control trial of the progressive study. So then I switched to doing diet only studies, and we've done studies in Ketogenic Diet, Paleo Diet, Low Saturated Fat Diet, modified Paleo Diets and consistent. What we find is when people move away from the standard American diet. Fatigue is reduced, quality of life is improved. The study the parallel arm study comparing the Swank Diet and the Wahls Diet showed that both diets led to reduced fatigue, improved quality of life. The Wahls group was better for in some, but not all of the measures. And the other thing that was super exciting about that study we analyzed something called the MS. Functional Composite, which measures functional disability and we're able to show that people's functional disability lessened over time when they were following either the Swank or the Wahls' diet. And then we did a follow-up study where we pooled a couple of our earlier, smaller studies that had a paleo arm and a control arm. And again, we're able to show that the paleo arm has reduced functional disability within 12 weeks.

Dr. Ken Sharlin: 19:43

There, there were some differences between the Swank diet and the Wahls Diet. In terms of outcome, perhaps slightly better, if I could say, with the Wahls diet, mental clarity, your thoughts what some of the fundamental differences are that may have led...

Dr. Terry Wahls: 20:00

i'll talk about what's similar and then what's different. So both diets, we increased the vegetable intake. The Swank diet had more grains. The Wahls diet had fewer grains, so the Wahls Diet had lower, was lower carb than the Swank diet. We also have probably more green leafy vegetables and more berry consumption. The the fact that both diets reduced the ultra processed foods is probably why both diets were helpful. I think the Wahls diet was more nutrient dense, had lower carbs, and a little higher protein. We also know that because we've measured the microbiome and we have been able to show that the makeup of the microbiome at baseline would predict. If you are gonna respond well to Swank or well to the Wahls' diet, there's a slightly different microbiome that says you're gonna do great on Swank in a slightly different microbiome that says you'll do great on Wahls. What that suggests to me, Ken, is that depending on the microbiome, because when we eat food, the food is acted on by our microbiome, makes smaller molecules that get into our bloodstream that influence my immune cells and my brain. And there's this big interaction between everything that I'm eating and the microbes that I have. I think there'll be a time someday in the future, Ken, that when you and I see patients will ask for saliva, urine, blood poop, we'll send it off to the lab. And probably four to eight weeks later, we will get a report that will tell us. Based on your genetics, your microbiome, your nutrient levels, these are the diets that will be most effective. These are the diets that will be least effective. These are the supplements that we think you should add, and maybe we'll add some probiotics as well for optimal health outcomes. And then the family can have a family meeting and decide which of these diets that we think we could implement successfully as a family, which would be a struggle. And then we can have a much more effective collaborative relationship to support people in a more successful healing journey.

Dr. Ken Sharlin: 22:13

I always, I've thought of the microbiome as something that's ever evolving, ever shifting, ever changing, just depending on what a person's habits, and other factors are leading up to that moment in time. It makes sense to me that the snapshot of the microbiome in the beginning of this study imply a better success with one diet approach than the other. But let's say they were, was some kind of crossover. The person who would appear to be a better candidate for Wahls diet is given the Swank diet. Vice versa. What happens to the microbiome over time is, in other words, as a person who adopts the Wahls diet, eventually have a similar microbiome to the person who actually should have been on the Swank diet in the beginning.

Dr. Terry Wahls: 23:07

Correct. So our microbiome will shift somewhat as we change our diet. Absolutely. And we also on a slight sidebar, we know if we have lots of fermented foods, six servings a day. I am shifting my microbiome in a way that is sustained. So that's part of why I really encourage my participants, my followers, my tribe to work at steadily increasing the amount of their fermented foods they include in their diet'cause that will help restore I think a healthier microbiome for them. But we don't know. We also have a sense that the microbiome gets established largely in the first two and a half years of life. And while we can have a little bit of an influence, it will always tend to want to regress back to that 2-year-old, that two and a half year old Terry Microbiome or that two and a half year old Ken Microbiome.

Dr. Ken Sharlin: 24:03

Now the microbiome is critical, but there are other pieces. There are other of what we might call the systems biology that clearly play a major role here. You and I shared an article just in the last day or so about diet and MS diet and its influence on oxidative stress. I think you've been aware that oxidative stress and mitochondrial function are critical to this. What have you learned about that?

Dr. Terry Wahls: 24:33

I think if the oxidative stress is high, your mitochondria are not making enough energy in that. It is really gonna strain your mitochondria in your brain. It's gonna strain your synapses. It's gonna strain your oligodendrocytes. You won't have as much myelin and you're gonna have more brain atrophy. You'll also have accelerated aging in the brain, and you'll have accelerated acquisition of disability. Oxidative stress, really important to pay attention to because it's a marker of how healthy your mitochondria are.

Dr. Ken Sharlin: 25:06

So the mitochondrial are critical. And sometimes I think of in the clinical application of all of this, what happens when, we're outside of the research setting and just wanna do this. There's a little bit of a hook involved, meaning it's not deceptive, it's not but it is a little bit of what I'm almost might call neurolinguistic programming, meaning. If I say, in order to make my MS better, I'm gonna focus on my mitochondria versus I'm gonna focus on my autoreactive B and T cells or whatever. In reality, everything is connected, so I can't really just focus on my mitochondria because it's gonna, whatever I do is gonna affect everything else as well. It's gonna affect. My microbiome, it's gonna affect my detoxification pathways. It's not just about one thing, the work seems to clearly highlight that fact that solutions to disease are not single mode, and the drivers of disease are not single mode. And it's not just about mitochondria. It's not just about the immune system. It's not just about toxicity. So that have to evolve these approaches that address all of these at once.

Dr. Terry Wahls: 26:20

I'd like one of the things that I learned is to talk about creating health that my colleagues seem to understand. If we're in to create health, that's a multimodal intervention. We're talking diet, we're talking smoking, we're talking exercise, sleep, stress and that's really, plays into how you and I think about medicine. Is that it's a multimodal systems approach to supporting physiology. And by creating health, we are more effectively treating disease. If I talk in my medical records that I'm working on creating health while observing the effect on disease, adjusting medications downward, so I'm not overtreating all the comorbid problems. Then my colleagues that were very upset with me in the beginning of my journey. Now they felt much more comfortable when I shifted my language in the public and in my clinical records that I'm focused on creating health and watching. So that I'm not overmedicating people in the event their health improves.

Dr. Ken Sharlin: 27:25

It really implies a very big shift because traditionally you go to the doctor for the doctor to do something for you or to you. Whether that's here's a prescription or perform a surgical procedure to somehow ameliorate or mitigate the effects of a disease or an illness, when in reality this is more of an a bilateral engagement, we are a team. I'm here to support you. Maybe you're in fact the captain of the team and not me. You've hired us. Meaning, in our clinics, it's myself, Valerie, Rachel, Corey, and so forth to support you. But you have to do the work. Which leads me into the question of the Wahls' behavioral change model, because that everything, we can talk about supplements all day. We can talk about kale and the microbiome and eating fermented foods and all this other stuff, if you're not ready to make the changes, nothing's gonna

Dr. Terry Wahls: 28:22

It's gonna be tough. And that's where, my work with the VA. I worked with addiction experts, health psychologists our therapeutic lifestyle clinic, the veterans and my own healing journey to create this 15 step process to help people identify. What they really wanted in life because this has to speak to their heart. And then we broke it down into small step by step nudges along the way to get clarity as to. If my health could improve a little bit, what would I like to be doing again? Who is it that I care deeply about? And now I can have a clear goal of what I want to bring back in my life if my health could improve just a little bit. We have been enormously successful with helping people create this journey of why I wanna do this work, what my goals are, and how to make it easier to succeed and harder to fail.

Dr. Ken Sharlin: 29:22

In light of that. Just on a personal experience, what personal rituals or mindsets or strategies have helped you stay consistent? What can you share with those listening to the podcast and what have you found to be the most common sort of themes for folks that really gravitate.

Dr. Terry Wahls: 29:41

A question that is very revealing is if your home was beginning to have smoke roll out of the windows is there someone or something that you care so much about that you would run in to save risk your own life without even thinking you'd run barefoot, even over broken glass to go save without even thinking. Usually it's like my children, my grandchildren my spouse, maybe my brother or my sister, my parents. Occasionally it's my dog. Very occasionally it's my cat, but nearly everyone within just a few seconds know who they would rush in to save. And then my next question is, what would you like to be doing with that person again, if your health improved just a little bit. Now they have a goal. And then we help them bring it down to, okay, so we're gonna help you imagine. What are some small steps that you could take to make it easier for you to achieve that goal? And when, and we can discuss, do you wanna work in the nutrition domain, the exercise domain, the sleep domain, stress domain, social connection domain. At first, we have'em start in just one domain. But we have to go through that process of why it matters to you. What is the goal that you'd like to be doing again, and then what's the domain you wanna work on? And then find a little goal, a little action, so you can be successful, and then you build on successful action after successful action.

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Dr. Ken Sharlin: 32:58

One of the things I've learned about coaching is that it seems to have to come from a place of, I feel, rather than I think.

Dr. Terry Wahls: 33:07

Absolutely, it has to speak to your heart. If it doesn't speak to your heart. We're, we aren't addressing the issue that matters to you.

Dr. Ken Sharlin: 33:16

Excellent. So that brings us to the big, hairy, audacious goal that Terry Wahls has change the standard of care so that diet and lifestyle are central alongside pharmaceuticals. What milestones your mind are going to make that a reality and, how does your own story fuel that vision?

Dr. Terry Wahls: 33:39

What I see when I go to the big scientific meetings for the MS or the clinical meetings for MS Care and I've been doing that for eight years now. I see many more talks about nutrition and more talks about exercise. And I find that, very gratifying and satisfying. The other thing that I see is I. People are stopping. There are more people staffing me every year when I go asking for photographs with them and their clinical team or them and their research team. I'm also seeing in the presentations my work being cited. And the other thing that, that was super fun, the last meeting that was at there are several. Presentations that had copies of my book their presentation as well. So I went up and chat with them afterwards and that was really quite lovely. So the whole, i whole idea that food, diet and lifestyle is being talked about more, and those of us who are researching diet and lifestyle are being talked about much more. And people are acknowledging that my TED talk and my books and my public education of the public has driven behavior change in the public. That the public is much more interested in improving their diet. Now, not everyone wants to improve their diet to a Paleo Diet. Some folks wanna do the Mediterranean diet, that's fine. Some folks wanna do the Swank diet. That's fine. Yeah, I just want people to. Believe that diet really matters and begin improving a diet according to what you and your family culturally can do.

Dr. Ken Sharlin: 35:21

Yes. It's certainly probably not one approach and it would sit, I would think that the diets are largely more informed their nutrient density. Overall, and probably a few common themes are important, as you say, avoiding the ultra processed foods avoiding the foods that quickly become sugar in the body. Arguments about whether we should be eating beans or not seems secondary.

Dr. Terry Wahls: 35:48

You know it. And what I think is most relevant is I look at the patient. I look at what are their comorbid issues. Do they have insulin resistance? Do they have evidence of metabolic syndrome, diabetes severe obesity? Those people probably are going to do better on a lower carb, higher fat diet. People who are very insulin sensitive. It. It's not as important. They could do very well on a Mediterranean or a Paleo Diet. People with a more severe psychiatric disorder may there's really interesting preliminary data and pilot data on the benefit of a ketogenic diet for those individuals. I really want to look at the individual. And then we also have to acknowledge that orthorexia can be a problem and can lead to severe malnutrition as well. So I have to look at the risk of orthorexia and the family dynamics and acknowledge that a family intervention is far more successful. So I want to, and we do this in our clinics, we do it in our clinical trials, is I want people to have a family negotiation. What are we going to add to our nutrition plan? What are we going to reduce and what are we going to eliminate?

Dr. Ken Sharlin: 37:07

Absolutely. I have been of course to some of those big meetings as well as a neurologist. We were at the Parkinson's Congress last September in Philadelphia, and I was pleased to hear some talks about things like, mindfulness and diet and even like the effects of pollution on neurodegenerative diseases. And I certainly adhere to the idea that we've got to do the research, we want the evidence-based medicine. what I would say seems to be too often missing is what I would call the real world experience reports, because ultimately, that gap between what's happening in a structured research trial and how to implement that in a everyday clinic situation is going to be really critical. It'd be interesting to take a poll of neurologists who read articles like the one we just shared about an MS specific diet and oxidative stress and say, and then say. Oh, I'm gonna have, how can I do this in my clinic? How can I implement this?

Dr. Terry Wahls: 38:14

One of the things that we've been doing with our medical students I have medical students during the summer working in the Wahls lab. We have been abstracting the electronic medical records for people with MS here at the University of Iowa. I'll I'm super excited to see what observe when we compare people who are following a a diet of some type. And those who do not report following any kind of diet in terms of what happens with clinical symptoms that are reported to the neurologist in MRI findings that are seen on the MRIs. So we will have gone through. I think four 50 charts by by the end of the summer. Now this has taken us several years to, for all this to happen. So hopefully next year you can have me come back and I'll tell you what we end up finding Ted.

Dr. Ken Sharlin: 39:07

What do you think it's gonna change though in the end, to really see this as part of everyday practice in clinics all around the world?

Dr. Terry Wahls: 39:14

It's a 30 year journey and we're only 15 years into this the fact that at the major neuro meetings, there are more and more presentations talking about modifiable lifestyle factors. I think it's very encouraging. I think, there are many more neurologists that begin to say Diet matters, exercise matters. Sleep is important. When we will begin training the youngsters so that our neuro department invites me to be part of those lectures that's gonna be a big milestone. I'm hoping that will happen. I have lectured them a couple times. So I'm gonna reach out and try and get myself invited back to their curriculum. But I certainly predict that in the next 10 years. This will become very routine that will have hopefully more FDA approved treatments for a variety of neurologic conditions. But people will be told, just as important as this FDA approved treatment is addressing the modifiable lifestyle factors, including better nutrition better sleep exercise in some sort of stress management practice.

Dr. Ken Sharlin: 40:25

No I have this hybrid clinic in which we do see folks with health insurance, Blue Cross Blue Shield at, Cigna, UnitedHealthcare, the whole nine yards Medicare, Medicaid. Very often they want this style approach, this integrative, multimodal approach. In general as the time commitments involved as well as just what insurance is willing to cover or not cover has been a bit of a barrier. But and under Medicare, you probably know that I. Unless you're in kidney failure or you're already diabetic, Medicare does not cover outpatient dietician work for you. But under many private plans, actually there is a code that can be used to at least get you a handful of visits with a dietician who say is trained in the Wahls protocol, have to of course, find that dietician, but Dr. Wahls can can probably guide you to that through her website. But at any rate it is possible to get some of that guidance. So hopefully there will be more and more.

Dr. Terry Wahls: 41:29

It will be easier now. In the meantime the public. More of the public is becoming aware that yes, this is important through things like this wonderful podcast that you're doing, Ken through the outreach social media education that you do, that I do, the books that, that we're writing people are finding ways to educate themselves that yes, there are things that they can be doing.

Dr. Ken Sharlin: 41:54

Now the Wahls protocol has been largely synonymous with Multiple Sclerosis, but I know affected by other chronic conditions often gravitate toward the Wahls protocol. You are getting into some studies looking at other conditions and how the Wahls approach affects these other conditions. And I know in that there's a new book in the works. More broadly broadly addressing a more broad way of that, that this is not really just about one disease, and can you elaborate on that?

Dr. Terry Wahls: 42:28

We're studying fibromyalgia, we're studying long COVID cancer fatigue as well. I'm we'll be adding rheumatologic autoimmune diagnoses like lupus, rheumatoid arthritis Sjogren's yes. These concepts, certainly in my clinics at the VA and my private clinic work across a wide variety of chronic disease states, not just autoimmune disease states. They also work for a wide variety of mental health conditions as well. When you're working on creating health, what you discover is it helps reverse many chronic diseases.

Dr. Ken Sharlin: 43:05

And it speaks to the fact that most diseases have common root causes or common mechanisms in play. Whether we're talking about oxidative stress as we, I. Touched on earlier in chronic inflammation, changes in gut health, including the microbiome. so these health strategies are so universal, so wide reaching. Like I said, a drug has a single target. By and large, a food has many targets. And food truly is medicine, not just the cliche of food is medicine. And that's, it's sometimes it's hard I find for folks to wrap their head around that a little bit because we're so used to seeking out healthcare for a given disease and it's. And we're very driven by the diagnosis to the extent that sometimes until a person actually has a diagnosis for a given set of symptoms, they're really not ready to take action on things they could do anyway, regardless to, to mitigate the effects of that, of those symptoms they're experiencing.

Dr. Terry Wahls: 44:13

We also see that people may have a prodromal period of one to five, occasionally 10 years of these gradually increasing symptoms that don't lead to a specific diagnosis before they develop. Their neurologic disease, whether it's schizophrenia, Parkinson's Alzheimer's or Multiple Sclerosis, and it's probably true for many of our disease states that there's this long brewing dysfunction where people don't feel well. They may be checking in with their physician, but they don't get a diagnosis. And unfortunately the physicians are not tuned into saying, but if we work on creating more health, these annoying symptoms may greatly reduce.

Dr. Ken Sharlin: 45:05

Really it says we need to reframe what, when we talk about modifiable risk factors, you know what happens when you go to your doctor for your annual preventative checkup? They, they check your blood pressure, your pulse, maybe your temperature, your respiratory rate. They get you on the scale. Maybe they calculate your BMI and then, maybe they'll. Check a cholesterol level and things that I don't I don't even go full transparency. I don't even go to a primary care doctor anymore because I got so fed up with the silly things that were being checked. I don't need my blood chemistries and A CBC checked on a regular basis because that's really not the low hanging fruit, so to speak. It says that we should have this panel of biological markers that look at some of these. Underlying mechanisms, the, that lead to these prodromal issues. Dr. Sharlin, your oxidative stress marker, Sharlin, your inflammatory biomarkers, like you say, the saliva, the poop, the urine, the blood. You know what really is going to define. Preventative medicine in the future, and then really having that report. And then of course, hopefully the proliferation of health coaching under third party payers. Medicare usually leads the way so that we can address these problems, before they truly become a problem. Before we wrap up, Dr. Wahls can you give us just a little bit from your new book?

Dr. Terry Wahls: 46:33

Right now the, so the working title is the Wahls Spectrum. We hope to have it out the summer of 2026. And we will be talking about the Wahls' behavior change model. So we'll get to hear all 15 steps and that. The essence is if I can teach you how to create health, you'll probably grow younger, healthier, and more vital in the process. And if you have a chronic disease already established, likely, you'll see the indices for that disease steadily decline. So come to terrywahls.com/trials and sign to be in our registry. We're looking for people with any kind of chronic disease. Come to terrywahls.com/diet to get a one page summary of my diet. And if you follow me on Instagram at Dr. Terry Wahls, you get to see what I'm eating and doing. And you get to see my garden. It's lots of fun.

Dr. Ken Sharlin: 47:32

That's great. Folks have been listening or to, or watching this podcast make sure you're checking out what Dr. Terry Wahls has provided to us today. I'll have things for you in the show notes, so you have a reference. You have the links, you can go in there, connect, check out her practitioner database, find a Wahls practitioner near you to work with is very important. You can see what other listeners are doing. If you want to share some comments as well, give us a rating and a review. Share the show with a friend if you would kindly consider that. And again, Dr. Wahls as always very inspiring and informative information that you've shared with us today. So thank you so much.

COMMERCIAL BREAK: 48:20

Hi everyone. Dr. Ken Sharlin here with the Healthy Brain Toolbox. I'd love to hear from you. If you have general questions about brain health, neurology, or the science of keeping your brain sharp. Send them to questions@healthybraintoolbox.com. I'll be reading your questions on the upcoming episodes. Please remember, these need to be general questions, can't answer personal medical questions, or provide individual medical advice. So if you've ever wondered about brain health strategies, lifestyle tips, new research, or the future of neuroscience, send those questions in. I look forward to hearing from you and who knows? You might even hear your question featured on the show. Thank you for tuning into the Healthy Brain Toolbox podcast. I hope today's conversation gave you new insights to protect and nourish your brain. Be sure to subscribe, leave a review and share this episode with anyone looking to take control of their health. Until next time, stay sharp and keep learning.