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Natural Awakenings Central New Jersey


Terry Wahls on Managing Autoimmune Disease With Lifestyle Interventions

Feb 27, 2023 09:30AM ● By Noelle Citarella, MS, RDN, CDN, IFNCP
TERRY WAHLS Managing Autoimmune Disease

Jonathan D. Sabin/

Terry Wahls, M.D., is a certified practitioner at the Institute for Functional Medicine, as well as clinical professor of medicine at the University of Iowa, where she conducts clinical trials testing the effect of therapeutic diet and lifestyle to treat multiple sclerosis (MS) symptoms. She is the author of The Wahls Protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principles, as well as an accompanying cookbook, The Wahls Protocol Cooking for Life. 

When Wahls was diagnosed with MS and later relegated to a tilt-recline wheelchair in the early 2000s, she decided to fight back. Drawing upon her medical background, she identified certain nutrients that were critical for brain health and started taking supplements. The disease’s progression slowed as a result, spurring her to dig deeper. Since then, through rigorous scientific study and numerous clinical trials, Wahls has developed groundbreaking dietary and lifestyle recommendations that alleviate autoimmune disease symptoms. No longer bound to a wheelchair, she bikes to work every day and stands as a living testament to the power of tenacity and strenuous scientific inquiry.

What are the key components of the Wahls Protocol? 

The protocol is a lifestyle that supports steadily improving health of everyone, not just MS patients. It focuses on eating more vegetables and fruits, and ensuring sufficient protein. It reduces or eliminates added sugars, ultra-processed foods, dairy and gluten-containing grains. While the diet may get more complex, a great place for anyone to start is including more non-starchy vegetables, less processed food and more meals cooked at home. The protocol also includes lifestyle interventions, such as time in nature, meditation, mindfulness and physical activity. Even for patients who are wheelchair-bound, going from chair to bed, exercise will improve their quality of life. It is a way of approaching living that creates a more healthy, nurturing environment.

What excites you most about your current MS study?

Seeing what happens with brain volume and quality of life. We hypothesize that lifestyle changes will get the rate of brain volume loss to match that of healthy aging. MS patients have brains that are shrinking three times faster than in healthy aging. This increases the risk for anxiety, depression and early cognitive decline. Our study will be the largest and longest dietary intervention study done in the setting of relapsing-remitting MS. We are recruiting people ages 18 to 70 diagnosed with MS. During the participants’ three visits, they will complete surveys, conduct functional tests, provide blood and saliva samples, and get an MRI. The participants will be divided into three groups. One will follow a modified paleo diet; the second an olive oil ketogenic, time-restricted diet; and the third will be the control group. We are optimistic that the first two groups will get to healthy aging, and the control arm will likely improve, as well.  

What is metabolic flexibility, and how do you improve it?

Fasting improves metabolic flexibility—the ability to switch between protein, fat and glucose for fuel. Fasting for two days increases stem cells. While periodic fasting is beneficial for metabolism and regenerative processes, it is hard to sustain because of our strong biologic drive to eat and dislike for being hungry. An easier dietary pattern to sustain long term is time-restricted eating in a window of six to eight hours. Our current clinical trial incorporates this eating pattern. 

Is there anything you know now that you wish you knew when you were getting started?

How important managing stress is. When I was diagnosed with MS, I could tell that stress made my symptoms worse. I feel I would have done much better had I maintained my meditation. I am fond of hormetic stress, that “sweet spot” where stress could be beneficial. Without stress, our bones and muscles disappear. Without the stress of having to learn, our brain disappears. We just need an equal measure of relaxation and recovery. 

What is your takeaway on lifestyle modifications and multiple sclerosis? 

You can reverse symptoms of MS and restore function. You can have a great and meaningful life at your level of function. It is important to find joy, gratitude and purpose in life as it's unfolding now, and doing so will help with the energy and commitment needed to do the work that can change the direction of your healing journey. 

To learn more about Wahls’ studies, visit To participate, visit or contact the study team at [email protected].

Noelle Citarella is a registered dietitian specializing in neurological nutrition and autoimmune disease in the Buffalo, N.Y., area.

Tick Talk

Spring officially sprung on March 21. We have turned our clocks ahead. We are looking forward to warm winds, sunny skies and the smell of fresh cut grass. The daffodils and tulips have recently bloomed and we are just starting with the yard work that comes with the warmer weather.  Sadly, another season has started ramping up.  Tick season.

•             The best form of protection is prevention. Educating oneself about tick activity and how our behaviors overlap with tick habitats is the first step.

•             According to the NJ DOH, in 2022 Hunterdon County led the state with a Lyme disease incidence rate of 426 cases per 100,000 people. The fact is ticks spend approximately 90% of their lives not on a host but aggressively searching for one, molting to their next stage or over-wintering. This is why a tick remediation program should be implemented on school grounds where NJ DOH deems high risk for tick exposure and subsequent attachment to human hosts.

•             Governor Murphy has signed a bill that mandates tick education in NJ public schools. See this for the details.  Tick education must now be incorporated into K-12 school curriculum. See link:

•             May is a great month to remind the public that tick activity is in full swing. In New Jersey, there are many tickborne diseases that affect residents, including Anaplasmosis, Babesiosis, Ehrlichiosis, Lyme disease, Powassan, and Spotted Fever Group Rickettsiosis.

•             For years, the focus has mainly been about protecting ourselves from Lyme disease. But other tick-borne diseases are on the rise in Central Jersey. An increase of incidence of Babesia and Anaplasma are sidelining people too. These two pathogens are scary because they effect our blood cells. Babesia affects the red blood cells and Anaplasma effects the white blood cells.

•             Ticks can be infected with more than one pathogen. When you contract Lyme it is possible to contract more than just that one disease. This is called a co-infection. It is super important to pay attention to your symptoms. See link.

A good resource from the State:


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