AUTOIMMUNE Disease, Multiple Sclerosis, Holistic Protocols, & Metabolic Health | Dr. Terry Wahls

we have so wandered so far from our evolutionary roots um the diet we eat is so radically different we ha we eat continuously we eat a lot of sugar we eat a lot of fructose we eat a lot of highly high glycemic index foods so we are continuously forcing the release of insulin we have disrupted our microbiome we are eating uh so many synthetic compounds in our diet putting them on our skin so all of those factors will drive insulin resistance all of those factors increase our vulnerability to autoimmunity [Music] hello everyone welcome to a whole new level this is dr casey means co-founder and chief medical officer of levels i am so excited for today's conversation dr terry walls needs no introduction but i am so excited to do one because i have been a huge follower of her work for over 10 years and it has had a profound impact on my life professionally and personally as one of the first entry points and first exposure into functional medicine for me so i am incredibly grateful dr walls is a clinical professor of medicine at university of iowa and also maintains a prolific research career she's had over 60 peer-reviewed scientific abstracts posters and papers and her personal story is incredible she has experience as a patient being diagnosed with multiple sclerosis over 20 years ago an autoimmune disease that left her in a wheelchair and on a path towards being bedridden and she took her health into her own hands she scoured the literature to understand if there were any possible treatments for ms and ultimately developed the walls protocol which is the nutrition and lifestyle program to treat all chronic autoimmune diseases which reversed her disease process restored her health and allowed her to get out of her wheelchair and back on her feet her learnings turned into an incredible book called the walls protocol and she gave a tedx talk that has over 3.5 million views on youtube called minding your mitochondria which everyone should go out and watch um after listening to this podcast she's inspired countless individuals to make the choices to support their health and vitality and i am so excited to welcome you dr wallace the podcast and to dig in specifically to the relationship between blood sugar metabolic health and autoimmune disease welcome to a whole new level hey thank you so much dr means so for those who may not be familiar just to kind of start off the conversation can you define for people what an autoimmune disease is a framework for thinking about this process in the body and and how autoimmune diseases may be similar from a root cause perspective even though uh they may look uh very different from each other from a symptom perspective okay so when i was in medical school a few years ago we were taught that autoimmune diseases are the immune cells attacking self we don't really know why they for reasons entirely unknown must be genetic at that point we didn't even blank infections and all we had uh was pregnazole uh and then we started adding some other uh immune suppressing drugs and ours understands gotten a little bit more sophisticated uh but we appreciate that there are um hundreds of genes that increase the risk and there's still this long list of unknown environmental factors in the conventional approach still focuses uh entirely on immune suppression uh and of course that's not the approach uh that i take in orders of the approach that i teach i focus on what are all the modifiable lifestyle factors that we can address so we focus on creating health and as a byproduct you may discover that your chronic diseases begin to get under better control and then begin to regress and then we have to begin to reduce and often eliminate a prescription medication after prescription medication in your book the walls protocol you talk about seven specific ways that all autoimmune diseases are similar and characteristics that are really universal amongst different autoimmune diseases can you talk about uh these principles and and both describe what they are but also how you came to this realization well um i'm going to take you back to my health journey here for a little bit you know so uh 40 years ago during medical school i started having these electrical face paints uh and they build over a period of of the next seven years uh uh i have an episode of visual dipping uh see a neurologist can't explain that fortunately they don't connect my face pain and visual dimming because they could have diagnosed ms then fortunately for me they did not um i uh 13 years later after it had my two kids then i developed leg weakness see the best people take the newest drugs and so within three years i'm in a typical client wheelchair uh and that's when i decide like you know what it's pretty clear i'm gonna come bedridden demented and the trajectory of my face pain is such that it's more frequent more severe far more difficult to turn off i'm already on maximum dose of meds i'm already going to the pain clinic i've already gone to multiple pain centers i am likely to have my face pain turned permanently on at that point light sound triggers my pain speaking triggers my pain swallowing triggers my pain and i'm taking high dose saliva when these episodes turn up so i'm like okay i've got young kids i have to do everything that i possibly can so i can still read i went to pubmed and i started reading the basic science you know at first i was looking for drug development studies then i had this big aha like i can't get these drugs so i switched over to start reading nutraceutical studies and started with a supplement cocktail and so i created this supplement cocktail uh yeah and i was focusing in on cognitive decline alzheimer's hygiene's disease als because the nature of my disease had been a slow progression looked much more like a progressive ms even though i'd had two relapses in my entire you know at that point 27-year history of my disease and it appeared to me that the root problem was mitochondria that they couldn't make enough energy so my supplement cocktail was focused on mitochondrial uh nutraceuticals and after six months you know they i was no better so i was pissed off and i stopped a little uh and i couldn't get up couldn't go to work uh and after on the third day uh my wife jackie says honey why did you take the supplements again i mean what's it gonna hurt so i i take them the next day i can get up and i can go to work now mind you i'm still struggling with fatigue but i'm like oh my god that was really cool so two weeks later i do the same thing i stopped by supplements wait three days start them up the third day and i can pop back up and go to work now mind you by popping up is hardly popping that much but you know i could at least go to work and i was like this was empowering like oh my god there is something to this so now i am really excited about reading the literature so every day i i'm scanning and reading a paper or two after my family's out god debated i'm still okay with the key that i can get by with four to five hours of sleep a night so i could spend my time reading not realizing that that was probably not a very smart thing to be doing i and you know for years i really focused on fixing my mitochondria with supplements uh and so i get a gradually more complicated supplement cocktail you know and i climbed i have them take their course on functional medicine have a little deeper understanding uh at a longer list of supplements and then a couple months later i had this really big aha like what if you know because i'd already uh switched from being a vegetarian to a paleo diet based on uh lauren cordain's work and his papers um but i had this idea like what if i took this long list of supplements and said where are they in the food supply and i got them from the food so it was the first decision that i said i'm going to focus on creating health i and so that was more research that i had to do and the linus pauline institute on micronutrients was very helpful they helped me identify with food sources and so in the early days i had these long list of foods that i was uh stressing on my diet and this new focus started on december 26th and within a month i i i was not as exhausted i and my physical therapist said no terry you're getting stronger and he began to advance my exercises and within three months i i do this really radical thing i get out of my wheelchair and i walk down the hall and mail a letter and my colleagues are like oh my god dr walls you're walking you're walking uh yeah so i and that's stunning and then you know three months after that um i well maybe it's about four months after that i decided i want to try bike riding again and we have this emergency family meeting it's on mother's day and we say that i can try riding my bike uh you know my son's going to draw alongside on the left my daughter zap's going to jog alongside on the right and jack's going to follow on her bike and i push off that wobbles a little bit but i catch my balance and i'm biking and my kids are crying jackie's crying i'm crying if you look at my eyes closely see i'm crying reliving that moment because that's what i figured out because up until then as part of the adaptation to living with a progressive neurodegenerative diseases you let go of the future you take each day as it unfolds and so even though i was remarkably better walking around the neighborhood i was still taking each day as it unfolded and all of my physicians for seven years had said you've got secondary progressive ms functions while it's lost we'll never come back so i didn't know what was happening i just knew that day by day but the day i rode my bike i knew that the current understanding of ms was incomplete and that who knew how much recovery might be possible uh and in fact uh at four months after that i do an 18.5 mile bike ride with my family once again we're all crying you know what my kids are crying my wife's crying and i'm crying uh when i finish uh that bike ride i and so that really transformed uh how i thought about disease and health that transformed the way i practice medicine and it would transform uh my mission in life and the way i conduct my research and now back back to your question i i know i i sort of got sidewinded by my uh story there no no i i'm i'm speechless hearing it and i mean i've heard it you know in your book and in your ted talk but hearing it from you i mean i'm i'm i'm bowled over and i am just so grateful to you for the work that you put in to dig deeper and to challenge the convention and um you know the approach the philosophy that we were really indoctrinated with in medical school um and and go to some of the pre-clinical research you know the mouse research and actually um put together a whole new framework for thinking about health that was really based on systems biology and around giving the cells what they need to function properly um yeah it was this was all about uh uh thinking uh about the cells uh when i once i zeroed in on okay the mitochondria i've got to get the nutrition right for the mitochondria of course i was thinking supplements what were all the supplement cocktails which would get complicated and then i would uh that ifm course was helpful uh but still nobody was talking about the microbial yet uh because we didn't know about that um yeah and it's sort of embarrassing now to realize how long it took me to i think okay i i had made some dietary changes that were important but what if i structured instead of thinking about what to avoid what i should be eating and i could use all these things that i said report from mitochondria figure out where they were the food supply and probably other really important molecules would come along as well uh and i mean i want everyone to know that i i did not get better from that supplement cockpit you know people have heard about my use of electrostimulation muscles i did not recover as much as i love e-stim i did not recover the magic was when i shifted my thinking to creating health am i doing everything that i can and by maximize my nutrition using food to the very best that i possibly can have i gone back to meditation and i had so i re we did that and i was at always stayed on the exercise bandwagon um so i i get you to work very hard with my physical therapist but it's the creation of help when we focus on treating disease we get it wrong but we even when we focus on those mouse model pre-clinical studies we're still going to get those wrong because they're focused on understanding a pathology one molecular pathway and health and life are deeply interconnected all of that metabolic pathways are so richly interconnected with checks and balances that when we focus on pathology we will not be able to correct health but we focus on health on what are all the things that underpin health and add them incremental by incremental step that's when the magic happens for me and that's when the magic happens and the patients i take care of i love that so much and something that i think in a lot of ways you really got me started to think about which now is the dominant way i view health and medicine is that we have to focus on the cell all health and disease comes from either cellular function or cellular dysfunction this is the the basic one of the building blocks of our bodies obviously there's the atomic level as well but these are these beautiful machines that are working so hard but they need specific things to function properly and you know they need the avoidance of other things to function properly and that's where that really beautiful relationship between food and the cell comes into play because like you said supplements may have a few of these things that the cell needs but food has thousands of chemicals that we don't even know about what some of these are that that that give this beautiful machine what it needs to to to generate health for us and so you know a lot of what we're really kind of in part trying to do at levels is to match what the body's needs are with what you can give it if we can have more awareness to what the body needs inside this black box we can then you know better serve it and um and so that's sort of the concept we talk about a lot with biologic observability how do we see inside the black box more but i think a point that that you make that is so important is that when we focus on real whole cleanly grown foods we're fighting most of the battle here you know we're getting those thousands and thousands of chemicals in plants that are going to do such good work for ourselves yeah and i believe that number's actually about eighty thousand ah in constituents it's wonderful that viable yeah yeah and that and that's implants and then if we you know go into the uh animal proteins and to the fungi as well uh then that number becomes even larger uh and so and if we think about our ancestral beginnings whether we go back as homo sapiens you know 250 000 years or we diverge from the primates six million years or when we became mammals 200 million years or when we were unicellular which are now billions of years we had this very long history of metabolic complexity that means that the solutions are aren't going to be a single molecule drug-based solution we have to be able to honor that uh complexity of our biochemical capital absolutely so well said and so what i'd love to to pick your brain about here is focusing on the micro mitochondria your ted talk is called mining the mitochondria this clearly became something that came up in the research for you showing that mitochondria and mitochondrial dysfunction may be really a centralizing factor in many of the different diseases we're seeing and mitochondria are really a core part of our metabolism and so i'd i'd love to hear um maybe this link between why mitochondrial dysfunction and when mitochondria aren't working properly how that can then lead to the body attacking itself in autoimmune disease what's that pathway between problems with our mitochondria which and unfortunately like western modern lifestyle in many ways are hijacking the mitochondria and making the dysfunctional and we can talk about some of the reasons for that um but then how that translates to being a feature that links all autoimmune diseases and the body then essentially turning on itself and and creating immune response against the body you know the way i um and i might be incorrect here but i see it more as an accelerant that if your mitochondria cannot generate energy efficiently uh then whatever disease processes you have will be accelerated um so if you have obesity that's going to be accelerated if you have insulin resistance that will be accelerated if you are in the program phase of your autoimmune disease which typically um we've identified five to ten years of progr uh before you begin developing auto antibodies and then another five to ten years and then you have systemic autoimmune disease so that that's one way as an accelerant another way that is their involvement in the cell danger response i and that's something i've become more aware of recently and when i gave my ted talk i don't i was not aware of the cell danger response and i don't think there's a lot of research on that yet um but what what happens is and if the cell is damaged either in it breaks and so now some of the contents the molecules that should reside inside the cell such as atp or the inner membranes of the mitochondria are now extracellular and so in the neighboring cells they see these damage associated molecular patterns okay and so they interact with the atp that's extracellular that will turn on and change the gene expression of that neighboring cell we'll say like oh my god terrible things are happening here my my kindred are dying call in the innate immune system so the innate immune system is very vigorously activated and so that what will again accelerate your immune dysfunction and will accelerate autoimmunity and that will continue uh until the actual the extracellular contents of intracellular compartments so the extracellular atp is no longer present in the neighborhood so i recently for example broke my wrist out nike i and so from those bony fragments i the atp would be disrupted in the immune system uh was called a dissolving and cleaning up uh the fragments and as part of the healing they will then call in the stem cells to come in and begin the uh repair the body callus and then it's healing to choose to go well then they will integrate and remodel the bone and the ligaments so that my wrist is now flying that requires a healthy mitochondria to do all all of those steps and if your mitochondria are not healthy you can get stuck in the addup first step but the overly aggressive innate immune system and we see that with coping 19 people dying at the rds of the cytokine storm if they manage to get through that and they get stuck at the next step then we see them developing severe pulmonary fibrosis and liver cirrhosis and they may need a heart lung liver transplant if they get stuck at the third step then we see the persisting um excess immune activation the long collar symptoms uh in the increased risk for uh autoimmune problems and so you have to you want to have healthy mitochondria so i i can respond appropriately the troubles you know when you break your arm or your burden burn your hand burn your skin or have an infection so i can deal with the problem quickly appropriately and then have complete resolution in heal very interesting um there's some some research suggesting that with several autoimmune diseases there seems to be increased prevalence or worsened disease severity in the context of elevated blood sugar or diagnosed metabolic dysfunction so type 2 diabetes or obesity i'd love to get resistance or insulin resistance yes and i'd love to hear your thoughts on where we are what is the landscape of our understanding of the relationship between metabolic disease i.e insulin resistance elevated blood sugar hyperglycemia and the onset or exacerbation of autoimmune diseases well um i'll talk about this in the context of ms uh and then i will conjecturize that it's probably indicative of all of the other uh major systemic autoimmune problems uh i was uh yeah i go to the american communities uh in the european uh big uh ms research centers uh in both of these uh scientific uh communities we're talking about the how if you have metabolic syndrome insulin resistance diabetes you have a much more aggressive disease much more rapid decline into disability requiring a cane walker wheelchair much more rapid decline into a cognitive impairment and then they also were talking about the rate of diabetes metabolic syndrome insulin resistance is about doubled in people with diabetes as compared to general public i which then got me it i said okay i went back to my team i said okay let's take a look so i i so regret that we did not measure the waist circumference of our most recent study like we should have done that but we did collect a number of other uh biomarkers that we then did look at i and so we did see that there is a higher rate of markers that suggest folks who are at a much higher rate of metabolic syndrome in the cohort that we recently studied and so it matched what people see or were reporting in the in uh other studies and i think that we already know that elibid glucose and some resistance metabolic syndrome uh worsens the risk for alzheimer's for early cognitive decline uh worsens the risk for cardiovascular disease for heart attack for sudden death so i think the mitochondrial dysfunction is really an accelerant this is a not enough energy that puts all of these tissues in strain and it will accelerate the disease process in addition because of the cell danger response we now know the mitochondria are deeply involved in recognizing cell danger that when a cell is damaged and is lysed in the inner contents spell out into extracellular space those molecules particularly atp are recognized by the cell membranes and that activates the innate immune system uh and then um that will address the pathogen the infection or as in when i broke my wrist the fracture in cleans up the debris and then the second step is the mitochondria involved that second step they'll call in the stem cells to do the repair work and then the third step which is reintegrating the repaired tissues back into the surrounding tissues so they can function normally and complete healing and resolve the inflammation and the mitochondria is involved in all three of those steps so it's both an accelerant and it's intimately involved in immune function and either accelerating immune function uh or failing to resolve the immune dysfunction uh so it has uh dual roles it i think is a very big player in autoimmunity but it's also a very big player in most of our non-infectious chronic disease states whether it's a mental health problem obesity diabetes cardiovascular disease and you've done quite a bit of clinical research in the ms population um and have have looked at several biomarkers in your research of metabolic health in this population and what do you see in your own data set in terms of um rates of increased blood sugar or insulin resistance or metabolic dysfunction in a population with ms versus um a non-autoimmune control population are you are you seeing higher rates of these that's a very consistent finding uh across most autoimmune disease states whether it's ms uh lupus ra um uh probably true for psoriasis although i don't know that i i certainly predict that uh of the hundreds of autoimmune diseases that they will probably have uh one half to two and a half times uh the rate of the general population of insulin resistance and metabolic syndrome and i'm curious what do you think is going on here in terms of the mechanisms in terms of sort of chicken and the egg is it that hyperglycemia induces you know mitochondrial dysfunction through increased reactive oxygen species and then that leads to this dysfunction that may lead to immune reactivity or is there something else going on where maybe something else is caught causing mitochondrial dysfunction and then that's leading to both metabolic disease and autoimmune disease or what's the model that we can kind of think about this relationship we've we have so wandered so far from our evolutionary roots the diet we eat is so radically different we ha we eat continuously we eat a lot of sugar we eat a lot of fructose we eat a lot of highly high glycemic index foods so we are continuously forcing the release of insulin we have disrupted our microbiome we are eating so many synthetic compounds in our diet putting them on our skin so all of those factors will drive insulin resistance all of those factors increase our vulnerability to autoimmunity all of those factors increase our vulnerability to serious mental health problems in chronic disease states so i think the root cause is that we have terrible diets we have tox exposures we have a lot of adverse childhood events in early trauma for our children we have a lot of chronic stress as adults and we don't have enough hormetic stress followed by sufficient recovery time so we build stronger muscles stronger bones and that we have more efficient metabolic pathways i feel like that that summary alone of all the different things that are impacting our core fundamental cellular biology from not working if we could just like print out that list and which you know of course if people read your book they're going to see this but and just and just focus on there are so many different aspects of our modern living that are ultimately um feeding into this common denominator which is mitochondrial dysfunction and poor cellular health and um while i feel like it can be overwhelming for people to think of all those things that need to be right you know it can almost seem hopeless i think it's actually really an opportunity because there's so many different areas that you can focus on you know to to do right by yourselves and what what i want people to do is to uh start small you know when i talk about behavior change i invite them to think about you know some aspect of uh their health behaviors that they could begin to improve so we get curious we're going to talk about diet we'll talk about meditation exercise sleep and you know in some of my studies we make you do everything all at once and in some ways that's easier uh in my clinical practice well that's going to be a very kind conversation like okay so here are the domains where do you want to start let's come up with a goal that you're confident you can really do because i want you to have a change that you can actually do as opposed to a change that you only do 50 and then we build on that success that's that's such such a wise approach you know giving people uh the sort of manageable entry points to start and maybe start seeing them that success and then using that as a way to really fuel and catalyze continued uh behavior change and um you know i used to insist that people you know do the walls diet first as a first step uh and i actually become a little more mellow about that now realizing that for some they have to meditate first and get their stress down more manageable uh and then they can begin addressing uh their uh food choices interesting so for each person sort of a personalized approach to what is gonna be foundational for the bigger behavior and what they're willing to do what they and their family are willing to do uh because even if i think it's got to be food if they think no no we want to do uh prayer and meditation well that's what they're going to do yeah and i i should meet them where they're at yes well shifting things into getting into some of the hard science here because a lot of our listeners really love the mechanistic um aspects you and i had a conversation recently about a really interesting um chemical media in the body called osteopontin and this was you've undercovered some really interesting work about how this chemical that is secreted in the in the adipose tissue um when it's high can have really negative and toxic effects on the brain and so this is sort of one of these links between metabolic disease high levels of visceral fat and visceral adiposity um this this cytokine i i'm not exactly sure how i would categorize it and then but then the degeneration neurodegeneration and neurologic disease can you can you describe for people what this relationship is and what we've learned about it so it's also involved in bone health so it's an important compound there we know that it is involved in immune regulation uh and people who have rheumatoid arthritis a systemic lupus uh ms are have been seen to have elevated levels of osteoportin i and then again i was when i was at one of my ms research meetings i was listening to researchers talk about osteopointing's effect on the microglia in the microglia are the monitors of the brain environment and depending if the microglia see the brain environment as hostile they will begin attacking the invaders and killing brain cells and killing myelin and killing synapses and leading to rapid atrophy of the affected parts of the brain or the microglia can see like this is a great environment everything looks good but i see a few strained synapses and parts of the brain that need nurturing support so i'm gonna go there secrete all of these nurturing compounds and i'll repair the myelin i'll repair the synapses and so microglia can be restorative or destructive and what intrigued me was they were discussing how high osteopontine accelerates the microglia to be very destructive which then got me into reading and so this has been known uh for some time uh this has been reproduced that osteopontin can shift the microglia to be more destructive in what drives high osteopontine insulin resistance too much central obesity i and so uh i have a freezer uh full of specimens uh and so we've been writing grants we just submitted a grant to look at our freezer in osteopontin was one of the biomarkers that we proposed to analyze so i'll be able to tell you hopefully and the funding cycle will run three years it'll be three years before i'll know this answer but hopefully in three to four years we can have this conversation and we'll be able to tell you what what we saw very very interesting i mean this is a that's a osteoponton i think is a word that most people hat is not on their radar yet and so it's really exciting to hear from you that this might be an area of you know of strong interest and also actionable interest because absolutely from what it sounds like if people can improve their insulin resistance their central obesity visceral adiposity that you might be able to actually reduce your levels of osteoportin and this could have been a downstream positive effect on our microglia correct and this might be one of the mechanisms how um it's through the microglia uh that why high blood sugars accelerate cognitive decline uh in worse than alzheimer's and worsened dementias it's probably through the microglia that's part of the mechanism would be would be my conjecture and we'd have to have some experiments to investigate that but it certainly seems plausible yeah so another autoimmune disease that i think is of great interest to the people listening to this podcast is type 1 diabetes because because mostly we focus on type 2 diabetes in the spectrum of really acquired insulin resistant resistance um and hyperglycemia that comes from that but of course this there's this whole other branch of type 1 diabetes that is autoimmune destruction of our pancreatic beta cells which reduce our insulin so it's less an issue of insulin resistance and more an issue of not having enough insulin around um and so i'm curious if if this disease state um also fits within the walls protocol framework and is there anything from the framework and what we know about mitochondrial dysfunction and microbiome effects on autoimmune predensity that that can be applied to type 1 diabetes well yes when we look at the uh dramatic uptick of autoimmunity since world war ii uh they talk about inflammatory bowel disease ms and type 1 diabetes that there are environmental factors that are tied in uh probably to the change in the food supply the dramatic increase of fructose uh the direct increase of sugar processed foods uh the increase of synthetic chemicals in our diet and the dramatic shift in our microbiome because of all the antibiotics all of those are a factor in why those three autoimmune diseases have increased so yes it's not just the uh infection that triggered the destruction of the pancreatic islet cells it is the environment that set that enviro that cascade up i'll also uh tell you that we've had uh certainly many many patients with type 2 diabetes tell us that they've reversed their diabetes using the walls protocol but i've also had many people with type 1 diabetes tell me that they've had dramatic improvement of their blood sugars in their management of their disease using the walls protocol there there was one uh lady who has a a fairly remarkable story uh she had pulmonary sarcoidosis in addition to type 1 diabetes i and was in icu uh because of her severe sarcoidosis on very high dose pregnancy to control her cyricoid and while she's in icu one of her neighbors here's my very first lecture that i gave here in iowa city uh and so the neighbor went to see julie and her husband to say when you get out of the hospital we're gonna cook for you because i know how life is just so difficult and the food they cooked was based on the principles that i laid out on that very first lecture which looks very much like the principles i teach in my ted talk and her sarcoidosis melted away stunning her physicians so she was able to get off uh her pregnancy her insulin control became you know much much better she her renal disease had been very severe she was on the brink of needing dialysis and her real function improved remarkably was no longer immediate threat for needy dialysis and then i finally met her about five years after the fact uh at another conference and she told me that story so uh part of why i'm sharing that whole story for you uh dr means is that and of course i had no idea of the impact that i had for julie that you don't know the ripple effect of these podcasts or no do i know the ripple effect uh of that ted talk uh or my or my books or the practitioners uh that i teach but the work we are doing is transforming the lives of millions and millions of people so i i so appreciate that you're taking the time uh to do these podcasts i appreciate that you are had the brilliant insight to create levels to give people the tools to get their insulin resistance under better control it will have this ripple effect of millions and millions of lives well thank you and i i think that is so so powerful i mean like i mentioned in the beginning the ripple effect of your work even in my own life has been profound and i i didn't have an autoimmune disease i actually just had a growing sense of questioning of the system i was in in medical school and picked up the walls protocol as a first year medical student and had my eyes opened um to a different way of thinking about things and of course now 10 years later here we are and it's just it is incredible the power of putting your ideas out there and i'm just so grateful to you and i i um and and many of the authors in this space who have really um put themselves out there by challenging the convention and digging deeper and asking the question why over and over and over again um when i first started having these public conversations let me tell you the neurology community was very upset severely condemned over and over again i but you know i fortunately i stuck with it i kept doing my little research getting our papers published uh writing our grants and i now have a joint appointment in neurology and my neurologic colleagues are co-investigators on my grants and i just got comments uh today from the chief of neurology on my current proposal and he's like oh my gosh terry this is very compelling very exciting and so i've come a long way in these um 11 years from being you know condemned as uh you know intolerably dangerous being seen as having these really interesting innovative ideas that now my con very conventional chief of neurology who is the chief of the uh ms clinic thinks are brilliant and visionary so it takes a lot of bravery to be one of those first those first voices and um and i think there's a lot of people who would say um like oh you know talking about dietary and lifestyle even today like dietary and lifestyle factors for treating disease is somehow subverting the standard of care and that's you know dangerous and but the proof is in the pudding you know people who first of all these are these are incredibly low risk strategies and people when when you're in this functional medicine world i think you and i composed to test this and you see patients just getting better so rapidly when they when they implement these these principles of diet and lifestyle based in improving cell biology it's incredibly motivating to keep doing this work you know when i first started changing how i practiced medicine people were complaining my chief of medicine chief of staff at the va called me and i had explained myself and then i had to go have the same conversation with the chief of medicine at the university who said terry you're going to lose your license because all we need is somebody to file a anonymous complaint you'll get inspected and uh you'll be inspected by people who don't believe in functional medicine integrative medicine so you need to learn how to talk about this so they sent me to uh work with the chief of the complimentary alternative medicine clinic uh and actually it i was very grateful that they did so i became very clear with my patients with the public that i'm help i'm focused on creating health we're going to really focus on modifiable lifestyle factors uh and we'll see how much what your body can do with that i'll have to watch you closely for your blood pressure your blood sugar and your current medication use so you don't become over medicated but we're going to focus on creating health using these basic lifestyle principles and when i shifted how i spoke to my patients that way and the residents i quit getting complaints and when i focused uh my clinical notes that way i quit getting complaints and my chief of staff and my chief of medicine said out of girl we appreciate that you're doing that you're gonna that'll be fine you'll build you'll be able to pass peer review because we need you to pass peer review terry i and so you know that's my caution uh when i train practitioners is that we we have to teach you how to talk about this because you and i get so excited it's so clear like oh my god this is treating and reversing so many disease states but we have to be very careful that what we're doing is we're create we're focused on creating health and monitoring current medication use and adjusting them so people aren't over medicated because that language will feel very comfortable to our conventional colleagues and very respectful as soon as i say i'm treating ms with diet and lifestyle that's not fda approved and that can be sanctioned and that will not pass peer review but if i say i'm focused on creating health by treating diet and lifestyle and we're going to watch your medications and adjust them so your blood pressure doesn't become too low your blood sugar doesn't become too low and then you can talk with your neurologist about what makes clinical sense to you yes everyone is very happy with that you know my mirage colleagues are happy with that my chief of medicine is happy with that my chief of neurology is happy with that and so we have to be careful that we teach our our functional medicine practitioners how to talk about this in a way that respects conventional medicine respects the patients respects the healing process because what we're doing is we're creating health it has a side effect sometimes not always but sometimes you regress a considerable amount of pathology as a side effect of creating health this is really a great discussion because i think it gets to um what most people in medicine really want which is positive impact and language has a lot to do with whether you can create the opportunity for impact because it matters you know and so how these things are talked about and you know position really does matter um in terms of being able to have people hear it in a way that lands um lands in a way that's going to have the most you know the most impact and so i think it's really such such brilliant and hard-earned uh such hard-earned um insights that are that are great for people listening because i know a lot of people have seen this podcast also are trying to create um health promotion in their own communities and i think what you're talking about applies to really anyone who's on that path um before we conclude there's one question that i just is lingering in my mind that i really want to take an opportunity to ask you which is which is something that i think other people might also wonder which is you know we've got all these different autoimmune diseases that look very very different from type 1 diabetes to rheumatoid arthritis to lupus to ms they all have very different clinical faces and what you talk about in the book is that there's there's really just a handful of core physiologic features that have kind of gone awry that can lead to all of these things how does that happen in the body where in one person it might look like lupus and one person it might look like rheumatoid arthritis and another person it's ms how do they show up at these different phases really interesting so we you know uh we have disordered immune function we have weakened mitochondria we have toxin overload we have hormone imbalance we have difficulty eliminating our toxins i and i have different sets of microbes in my gut and then i have different genetic vulnerability i and so depending on the microbes i and my genes when my immune system get gets revved up and i begin making auto antibodies that will begin clearing out that infectious problem or that food protein that i think is an infection if that protein has a similar amino acid sequence to another structure in my body in my brain in my joints and my lungs and my skin that part of my body is going to get damaged as i clear out that that problem protein whether it's an infection or a food protein i and my vulnerability uh so is a reflection of my genetics in my microbiome and the foods and the similar amino acid sequence between my structures and those various proteins and then i'll add to that so i and we can use myself as a a case in point um so as a youngster i have migraines that's an early proton i have really heavy periods uh and um i think that's just sort of a lot of women have miserable heavy heavy heavy periods uh and then when i decided i want to have kids i discovered severe severe endometriosis and end up going through ivf and by then i've already had 10 years of my trigeminal neurology which was a the autoimmune process involving my brain so i had an autoimmune process involving my brain i have asthma autoimmune process involving my lungs i have an autoimmune process involving the endometriosis and i have very mild psoriasis if if um you don't address the root causes you keep developing more auto antibodies more autoimmune processes and more parts of your body will become [Music] casualties in the autoimmune process development and so it's one of my messages to people is yeah you you may need disease modifying drug treatment for your autoimmune disease that you have but if you don't address the underlying root causes you will continue to develop other autoimmune processes through this molecular mimicry and you will pick up another body part casualty whether it's asthma or psoriasis or endometriosis or autoimmune thyroid disease or biceps so and besides you want to have healthy aging healthy brain and all that stuff so everyone whatever you got whatever chronic complex health problems you have you want to be sure that you're also doing everything you can step by step with your modifiable lifestyle factors yeah and you touched on something there that i think is also important in this metabolic health blood sugar conversation which is the concept of warped proteins and that these can be a trigger for the body to fight and i think i'd love for you to just touch on the relationship between glucose and warped proteins and glycation and how hyperglycemia might lead to some of this dysfunction in the structures of our body that then lead to the sense of the body being like what is this you know what was going on there and and does the average person need to be thinking about this even if they don't have diabetes like kind of control their blood sugar to prevent this you know i i think um we would be so far ahead in our healthy aging if we would all check our glucose and uh check for the possibility of insulin resistance i i think you know ideally i'd like to see every because you can be skinny and have insulin resistance you can be skinny you can not have any central obesity be thin on the outside and fat on the inside uh and so if you have elevated blood sugars you're going to be at risk for this uh glycation uh the sugar as uh being attached to the proteins and the proteins becoming oxidized non-functional in that will again be an accelerant for this autoimmune process it can be an accelerant for that cell danger response uh and so um and you know early we talked about how i wish we had taken the waist circumference uh and the hip circumference so we could have more easily measured metabolic syndrome but if you aren't looking for insulin resistance you're gonna miss the thin on the outside fat on the inside because we have so deranged our diets we have such terrible diets um for so long that i i would venture i don't know what the number is how many people what the percent accurate percent would be that actually have insulin resistance um but it is probably far higher than the rate of obesity i i don't know um because i don't know that anyone has done any kind of population basis uh to really look for that number i mean it'd be i would just love to see a big retrospective study looking at a large hospital system triglyceride to hdl ratio which is something we already have cholesterol panels on everyone and that would give us at least a hint at insulin sensitivity um which could be really interesting so anyone listening that might be good that's a good idea i could mention this that uh to my postdoc so let me it actually could be a great medical student chart review because literally every adult patient has that cholesterol panel and it'd be fascinating to see like who who's over one of a ratio who's over two who's over three uh does it correlate with bmi uh does it correlate with bread pressure it's actually this would be fun to work on a nice uh epi uh study for uh large data sets such as women's yeah uh health health initiatives so maybe because i'd love to know that number like we unfortunately don't have a threshold of like what is optimal or not some people say less than one so people say less than 2.5 and caucasians and 3.5 and you know uh people of african-american descent so it's it'd be interesting to look into just different thresholds um but i bet the number is very very high of of sort of a high rate of very high um it'll be high so what oh go ahead please well that then they could uh look at uh mortality risks uh according to those ratios so that could be a nice a very nice little epi study so yeah um well to wrap up i what i i i i want people to go read the book and and watch the podcast so that they know the full walls protocol but just a sort of actionable takeaway couple high-yield things people can do to support their mitochondrial health uh through diet and lifestyle um what would what would be some of your top recommendations so number one ditch all the sugar sweetened beverages number two ditch all the fructose all of those paleo friendly sugar substitutes that are all fructose get rid of those number three replace grain-based products with vegetables number four uh i'm a tall lady six foot tall so it's pretty easy for me to have nine cups of vegetables a day three cups of green three cups of sulfur three cups of color but i don't know how tall you are six feet okay look at that nine cups no problem uh uh and then uh if you're a meat eater you know six to twelve ounces uh meat if you're not a meat eater gluten-free grains and legumes for your protein perfect um well i hope that this conversation is is very um uplifting for anyone listening who does have is on the spectrum of autoimmune disease is dealing with these things i think the key message that we're talking about is that that you've promoted in such a beautiful way over the last over decade is that there is so much hope there is a lot that we can do but we do have to change the choices that we're making every day but these choices can be wonderful like including more beautiful vegetables and they they work um would you say that it's safe to say that focusing on improving metabolic health um can be part of a journey in moving towards uh improvement of of autoimmune disease like that as an area yeah let me be even stronger i think uh everybody with an autoimmune disease uh really should go investigate their metabolic health um i i told everyone we should you should know your glucose your insulin levels your a1c and uh answer that question do you have developing insulin resistance uh and if you do then we need to help uh have a strategy for dealing with that uh so yes if you have an autoimmune disease um i very strongly urge you to investigate do you have insulin resistance amazing how can people find you dr walls online terry walls t-e-r-r-y walls w-a-h-l-s dot com my instagram handle is dr terry walls and facebook and twitter is terry walls and i highly recommend following your instagram because you often do a meal recap of what you're having for supper and very frequently it inspires me to have a slightly healthier dinner because i i know what you're eating so very much recommend that but thank you so much for taking your time today to educate this audience and really appreciate you you being here dr wells thank you [Music]

Channel: Levels

Views: 53,583

Keywords: biohacking, biowearables, cgm, cgm life, continuous glucose monitoring, glucose monitoring, metabolic, metabolic fitness, metabolic health, metabolism, notion, notion hacks, notion tips, onboarding, onboarding tips, onboarding video, startup, startup advice, startup ideas, startup life, startup lifestyle, startup stories, startup tips

Id: fgoBKwGUwfc

Length: 64min 37sec (3877 seconds)

Published: Tue Jan 25 2022