Can You Eat to Reverse Multiple Sclerosis?

If you have a loved one with multiple sclerosis[1], (as I do), you’ll love what this next post is about. It features the inspiring story of Dr. Terry Wahls[2], who reversed her multiple sclerosis after seven years of deterioration — simply by changing her diet. That she did it within 8 months and went on to complete an 18 mile bicycle tour is nothing short of miraculous. No drug has ever been able to claim the same results. Coming across her story late last year was the best Christmas present ever.

Dr. Wahls is a professor of internal medicine at the University of Iowa, where she teaches, and does rounds in a traumatic brain injury clinic. This conventional medical doctor had the courage to step outside the medical paradigm.  Initially diagnosed with relapsing-remitting MS in 2000, she went the conventional route and was taking chemotherapy drugs and other immune suppressants in an attempt to slow the disease.

By 2003, Dr Wahls transitioned to ‘Secondary Progressive Multiple Sclerosis’ (the more advanced form), and had to begin using a tilt-recline wheelchair because of weakness in her back muscles. In MS, the immune system becomes sensitized to and attacks proteins in the myelin sheath which protects the axons of the central nervous system.[3]

Like anyone with a degenerative condition, she wanted to forestall further deterioration as long as possible. Because of her medical training, Dr. Wahls knew that research in animal models of disease is often 20 or 30 years ahead of clinical practice. She stayed up late each night to scour through
peer-reviewed research and analyze the latest articles on multiple sclerosis research.

She knew that most of the studies were testing drugs which would take years for FDA approval so she turned instead to the research on vitamins and supplements important to mitochondrial and brain health. As she continued to research late into the nights, she came across studies showing that over time, brains of people with MS tended to shrink. This spiked her curiosity and led her to research other diseases that share similar brain shrinkage, namely Huntington’s, Parkinson’s and Alzheimer’s diseases.

One thing common to all these degenerative conditions is poorly functioning mitochondria. Mitochondria are like little ‘batteries’ in your cells that manage the energy supply to the cell.   If you forget to feed them, your cells wither and die. Muscles shrink, brain volume drops. Other cells in the body are also compromised.

Getting Better but not Quite There

In doing her research, Dr, Wahls discovered that three nutrients in particular were essential for proper mitochondrial function: 1) omega-3 fats – i.e., from fish or krill oil; 2) Creatine (a compound that is involved in the production of energy in the body); and 3) Coenzyme Q10 – preferably in the ‘reduced’, best-absorbed version known as Ubiquinol which has 3 times the antioxidant potential of standard Co-Q10. After taking these supplements, her decline slowed somewhat but she was still in a state of declining health.

The Big Change – Getting Nutrients from food

By the fall of 2007, Wahls had an important ‘aha’ moment. She wondered what would happen if she changed her diet so that she was getting these important brain nutrients not from supplements, but from the foods she was eating. For her mitochondria to thrive at their peak efficiency she needed B vitamins, sulphur and antioxidants. Dr. Wahls also wanted to eat all the foods that helped to make myelin – notably B1 (Thiamine), B9 (Folate) and B12 (Cobalamin), fish oil and iodine.

To accomplish all of this, she adapted a standard Hunter-Gatherer diet (basically eating what a caveman would eat) which included roots, seeds, nuts, oily fish, grass-fed meats, organ meats and natural iodine from sea vegetables.   She also ate 9 cups of non-starchy vegetables and berries each day.  (To make this easy to remember it`s 3 cups of greens, 3 cups of sulphur-containing vegetables, and 3 cups of colourful vegetables and berries.

Sulphurous vegetables include kale, broccoli, cabbage, Brussels sprouts, cauliflower, garlic, onions, chives, leeks, mushrooms, asparagus, etc. Starchy vegetables such as potatoes or grains such as rice were not eaten unless her 9 cups of other vegetables were eaten first. Tips on eating ‘the Wahls way’ can be found on her website:http://www.terrywahls.com/eating-the-wahls-way?EID=18923451&CID=3395727 You can also purchase Wahl’s book, Minding my Mitochondria, to read up more on her research, recipe and menu suggestions.

She called this way of eating ‘Intensive Directed Nutrition’ and it is easy to see why. She soon found she had more energy and felt better. Within 3 months she was able to get out of her wheelchair and walk down the halls at work using one cane. Later, by adding exercise and other therapies Dr Wahls progressively got better.

Why Cruciferous Vegetables and Sulphur?

Sulphur is responsible for hundreds of biochemical reactions in the human body. Together with antioxidants, sulphur helps the mitochondria to survive. By weight, sulphur is one of the most abundant minerals in the body – the average person contains about 140 grams of it at any one time. Sulphurous vegetables also help with creation of a potent antioxidant – glutathione – which may help prevent further damage to neurotransmitters. Additionally, you need sulphur for the synthesis of Taurine, an amino acid needed for proper functioning of the muscles and central nervous system. Sulphur also aids detoxification processes in the kidneys and liver.

Foods to Avoid

The diet of the typical North American is so poor in nutrients that they do not have the building blocks to feed the mitochondria or to make/repair myelin. It is very important to remove from the diet all refined or pre-packaged foods and Omega 6 oils and fats. You find Omega 6 fatty acids in corn fed meat, corn oil, safflower and vegetable oils, soybean oil, margarines and fried foods. That does not mean that one must remove all fats and oils from the diet however. ‘Healthy fats’ such as fish oils, flax seed oils and extra-virgin coconut and olive oils are encouraged.

Anything inflammatory and processed must be removed – so no sugar, high fructose corn syrup, aspartame, allergens, dairy, grains, or legumes. Peanuts and soy beans are legumes and raw dairy or fermented dairy still contains casein, so they must be removed from the diet.  Dairy, grains and legumes are implicated in auto-immune reactions for people with MS, so they must be avoided even in small amounts.[4] Small amounts of high-antioxidant raw cacao beans, and raw honey are allowed occasionally. Those who cannot manage going grain-free are encouraged to try going gluten-free first, but faster results are expected when the guidelines are strictly followed.

MS and Eggs

Organic, free-range, antibiotic-free eggs (if tolerated), are recommended because they contain choline – which together with inositol – is critical for myelin sheath repair. Synergistically they work to create natural lecithin in the body. Making it this way means that one does not have to rely on soy-derived lecithin.

Generally, people with autoimmune diseases should not have egg whites due to a problematic protein in the egg white called ‘lysozyme’. Usually it is harmless, but it can bind to some proteins and inhibit trypsin, preventing it from doing its job to digest protein. Some of lysozyme`s compounds can pass through the gut wall and aggravate damaged guts. Avidin, another substance found in egg whites, binds to a B vitamin called Biotin, which is responsible for fatty acid synthesis and blood sugar regulation. Even when well-cooked, Avidin continued to inhibit Biotin absorption by about 30 percent.

So how do you know if you are sensitive to egg whites? One way to find out is to eliminate eggs at first and add them back after a few weeks. They may be eaten if there is no reaction to them. The same thing can be tried with nightshade vegetables (tomatoes, eggplants, potatoes) which can sometimes cause joint pain in some people.

If you find you cannot get your choline from egg yolks, alternate sources of choline include beef liver (highest source), chicken and turkey, scallops and shrimp, salmon, collard greens, Swiss chard and cauliflower.[5]

You will also find choline in sesame and flax seeds. Inositol is found in high amounts in legumes (not allowed in this diet), however you can get inositol in high amounts from grapefruits, oranges, mandarin oranges, cantaloupe, rutabaga, blackberries, artichokes, okra, kiwi fruit, and nectarines.

How else can you Rebuild Myelin and prevent its Destruction?

The term ‘balanced diet’ is the key. The myelin sheath is composed of about 75 percent fat and cholesterol and the rest is protein[6].

The first building block is Omega 3 fatty acid, which you get from pure fish oils, wild fish and grass fed meats.  Organ meats – which traditional societies have always eaten – are recommended once a week to get natural cobalamin or B12 into the body. Organic liver is especially good for B12. Natural iodine from sea vegetables not only helps with myelin repair but would also aids the liver and brain to clear out mercury and other heavy metals from the body.

Vitamin B1 (Thiamine) helps to get energy into the muscles but it also helps with myelin repair. Eating 3 cups of greens a day helps provide B vitamins and folate – vitamins which keep your brain to keep it from shrinking. (Indeed, many people who have tried this diet report marked clear-thinking and removal of the ‘brain fog’ they had earlier).

Lecithin is made up of phosphoric acid, choline, linoleic acid, inositol and several B vitamins.  To get it from food, aim for grapefruit, oranges, tangerines, sesame and sunflower seeds. Add some grated ginger for antioxidant punch and you have a delicious fruit salad.

Daily broths made from grass-fed meats and bones, are also recommended.  Long-simmered bones and meats release minerals, collagen and glycine (gelatin), which your body uses to carry out heavy metals, repair damaged collagen, and help form protective barrier in the mucosal lining of the gut. Haivng daily broths is a great way to avoid `leaky gut`  - a term to describe, loose `tight junctions’ in the gut, which might be contributing to auto-immune reactions generally.

Antioxidants from spices such as turmeric are part of the diet because of the wealth of animal and human studies showing that its curcumin component helps to prevent oxidative damage.[8] Just how curcumin might work to prevent demyelinization remains unclear, but researchers at Vanderbilt University believe it may be interrupting the production of IL-12, a protein that plays a key role in the destruction of the myelin by signaling for the development of neural antigen-specific Th1 cells, immune cells that then launch an attack on the myelin sheath.[9]

Another way to rebuild lost myelin is to submit the muscles to the ‘stress’ of daily exercise – more on this later.

The Use of Fats and Oils with Multiple Sclerosis

Unlike other MS diets which suggest drastically reducing saturated fats, Wahls is saying that healthy fats – from cod liver and salmon fish and oils, walnuts, chia seeds, ghee from a grass-fed, pastured animal, extra virgin olive and coconut oils … and even lard… are fine.

Ghee, or clarified butter, by the way, has had the milk proteins poured off, so essentially it is classified as a`fat` and not a dairy food. Keep in mind that you need trace amounts of copper to activate these healthy fats so that they can go to work repairing the myelin. Food sources of copper include dried oregano and thyme, pumpkin seeds and sesame seeds.

Cod liver oil is high in vitamin D, an oil-based vitamin that plays a critical role not only in prevention but treatment of demyelination in MS patients. A study published in The Journal of the American Medical Association in 2006 found that Vitamin D significantly reduced the risk of demyelination.

How much vitamin D3? Wahls believes that Vitamin D should be over 50 ng/ml but under 100 ng/ml to obtain the best benefits – lowered risk for autoimmune disease, cancer, cardiovascular disease and high blood pressure. How do you know how much you need to get there? Take a test every 1- 3 months and take 4,000 IU vitamin D3 daily, or more if needed. At levels over 150 there is an increased risk of excessive calcium in the blood, hallucinations, psychosis, and kidney damage.

Interestingly, the concentration of omega 9 oleic acid (a type of healthy saturated oil found in olive oil and avocados), is lower in the myelin of people with MS.   Oleic acid promotes the production of antioxidants in the body and slows the development of heart disease. Oleic acid is also used to formulate `Lorenzo`s oil` which helps patients with adrenoleukodystrophy – another demyelinating disease.

Creation of New Neurons and Synapses and more Energy

With properly functioning mitochondria, Dr. Wahls hoped that her body would get maximum energy from glucose, a key factor in reducing or eliminating the fatigue so common with MS. With more energy you can exercise and do more.  Wahl`s high-antioxidant diet would not only increase protection of the neurons but increase production of neurotrophic factors – a family of proteins responsible for the growth and maturation of new neurons and synapses.[7]

A Synergistic Approach: Hitting MS with many things at Once

With her intensive daily nutrition foundation in place, Dr Wahls continued to research supplements which might help to feed the mitochondria. Supplements, she points out, can be helpful, but a nutrient-intense diet must always come first. There is wisdom in this — brightly coloured vegetables and berries may contain beneficial cofactors and compounds not included in supplements which scientists may not discover or name for years, even though they work.

Today Dr. Wahls uses 200 mg B complex, 200 mg of Coenzyme Q 10, 1 g of Alpha Lipoic Acid, 600 mg of Acetyl L Carnitine, 120 mg of Gingko, 2 g of N Acetyl Cysteine, 2 g of Taurine, 2 g of Glutathione, 200 mg of Resveratrol, and enough Lithium Orotate to yield 13 mg of elemental lithium, on a daily basis.

Putting it all together

By December 2007 she had combined intensive directed nutrition with a program of progressive exercise, electro-stimulation of muscles[10], and daily exercise. Daily exercise, even for those who cannot walk, is excellent because any ‘stress’ to the muscle causes the body to produce new myelin and development of new neurological pathways. Exercise also leads to decreased production of inflammatory proteins. Various animal experiments have shown that exercise increases ‘neurotrophins’, a family of proteins induce the survival, development and function of neurons.

The results stunned her physician, her family, and even herself. Within a year, she was able to walk through the hospital without a cane and even complete an 18-mile bicycle tour. Instead of becoming dependent on others, Wahls regained the ability to commute to work on her bicycle, and to do her rounds on foot without the need for canes or a wheelchair.

Up from the Chair and Helping Others
Grateful to have her energy back, Dr. Wahls has spent the last three years researching, lecturing and speaking about her journey to wellness and shares how others may help themselves with intensive directed nutrition. Dr Wahls now has enough energy left over to start writing up research grants again. She has brought together an interdisciplinary team to conduct clinical trials using intensive, directed nutrition and neuromuscular electrical stimulation to combat advanced Parkinson’s disease and both secondary and primary progressive multiple sclerosis.

This time she is conducting a randomized intervention clinical trial on Nutrition and Neuromuscular Electrical Stimulation and Secondary Progressive Multiple Sclerosis. You can read about it here: http://clinicaltrials.gov/ct2/show/NCT01381354?term=wahls+sclerosis&rank=1

To help raise awareness and funds for her research and her non-profit foundation, Dr Wahls has recorded many of her public lectures. Fifty percent of the profits from the sales of the lecture DVDs and audio CDs are used to support clinical nutrition in the area of nutrition, massage, exercise, and neuromuscular stimulation. These resources are available on Dr. Wahl’s website: http://www.mindingmymitochondria.com/

In the meantime, here are a few words from Dr. Wahls:

“There is a lot we can do to restore our health without needing a physician. Here are ten suggestions for how you can help spread the word.

1. Talk about Minding My Mitochondria on Facebook and Twitter.

2. Tell your friends that you have read this fabulous book that is changing your life.

3. Tell your co-workers the reason you have so much more energy is due to Minding My Mitochondria.

4. Tell your family that Minding My Mitochondria is changing your life and could change theirs too.

5. Write a review for Amazon. It is easy. Just a paragraph, written from the heart, will be fine.

6. Write a review for your local paper. Or a letter to the editor.

7. Buy the book for a friend or a member of your family whose health you’d like to see improve.

8. Interview Dr. Wahls for your local newsletter, club, or paper.

9. Follow the suggestions Dr. Wahls makes in Minding My Mitochondria. As you become a healthier, more vibrant you, others will ask what your secret is.

10. When others ask what led to your looking 6 months younger than the last time they saw you, tell them why. That your mitochondria are healthy again, thanks to Minding My Mitochondria. Be healthier, more vibrant, more energetic.”

[1] Multiple sclerosis (MS) is a chronic, degenerative disease of the nerves in your brain and spinal column, caused through a demyelization process. Myelin is the insulating, waxy substance around the nerves in your central nervous system. When the myelin is damaged by an autoimmune disease or self-destructive process in your body, the function of those nerves deteriorate over time, resulting in a number of symptoms, including: muscle weakness, imbalance, or loss of coordination, astigmatism and vision loss, and muscle tremors.

[2] Dr Wahls is a clinical professor of medicine at the University of Carver’s College of Medicine, where she teaches Internal Medicine. She has published over 60 peer-reviewed scientific abstracts, posters and papers and is currently conducting clinical trials on how a nutrient-intensive diet can help to reverse MS symptoms.

[3] Research has shown that fragments from foreign proteins (i.e., from infectious agents and foods) can activate myelin-sensitive immune cells through cross-reactions. Many new foreign proteins were introduced into the human environment by the agricultural revolution, 10,000 to 5000 years ago. Some new proteins have crossed over to humans from domesticated animals (e.g. Epstein Barr virus) and from completely new food types such as dairy, grains and legumes. Humans have been around a lot longer than 5,000 years, and our gut flora has not evolved enough or become sophisticated enough to know what to do with some of these grains and legumes.

[4] The role of lectins and legumes in MS is interesting. According to Dr Loren Cordain PhD, a top nutrition researcher, lectins from grains, legumes and tomatoes may be involved in activation of the myelin-sensitive T cells. It has been long known that protein fragments derived from various foods such as milk and from gut bacteria can activate myelin-sensitive T cells through molecular mimicry. For this to happen, however, the foreign protein fragments must get across the intestinal barrier. One possible way for this to happen is by way of disrupted cell junctures or a “leaky gut”. Even if one does not have a ‘leaky gut’, various lectins will still attach themselves to various protein fragments in the gut from foods and gut bacteria and then transport themselves across the intestinal barrier by means of the Epidermal Growth Factor receptor. In this way they act like a “Trojan Horse” by bringing the “enemy” past the protection of the gut wall. Epidermal Growth Factor was discovered by Stanley Cohen of Vanderbilt University along with Rita Levi-Montalcini. Both received the Nobel prize in Physiology or Medicine in 1986.

[5] See: World’s Healthiest Foods: choline. http://whfoods.org/genpage.php?tname=nutrient&dbid=50

[6] Schmidt, Michael A, PhD., Brain Building Nutrition: How dietary fats and oils affect mental, physical, and emotional Intelligence. Frog Books, Colorado, December 2006.

[7] In the brain these factors are important for learning, long-term memory as well as regeneration and growth of nerves. Studies suggest these brain-derived factors play a protective role against amyloid beta toxicity – a type of plaque that seems to build up in the brain as we get older.

[8] Natarajan C, Bright JJ. Curcumin inhibits experimental allergic encephalomyelitis by blocking IL-12 signaling through Janus kinase-STAT pathway in T lymphocytes. J Immunol 2002;168;6506-6513. Available at:http://www.jimmunol.org/content/168/12/6506.full.pdf Researchers gave injections of 50- and 100-microgram doses of curcumin, three times per week over a period of 30 days, to a group of mice bred to develop the experimental form of MS known as EAE, and then watched the mice for signs of developing MS-like neurological impairment. By day 15, the mice that did not received curcumin developed EAE to such an extent that they developed complete paralysis of both hind limbs. By contrast, the mice given the 50-microgram dose of the curcumin showed only minor symptoms, such as a temporarily stiff tail. Mice given the 100-microgram dose fared best of all; they appeared completely unimpaired throughout the 30 days of the study.

[9] Natarajan C, Bright JJ. Peroxisome proliferator-activated receptor-gamma agonists inhibit experimental allergic encephalomyelitis by blocking IL-12 production, IL-12 signaling and Th1 differentiation. Genes Immun2002;3(2):59-70. 2003. Available at: Natarajan C, Bright JJ. Genes Immun. 2002 Apr; 3(2):59-70J Immunol. 2002 Jun 15; 168(12):6506-13. J Immunol. 2002 Jun 15; 168(12):6506-13.http://www.ncbi.nlm.nih.gov/pubmed/11960303.

[10]Neuromuscular Electrical Stimulation involves the application of electrodes and electrical input to various muscle groups over the body with goal of strengthening the muscles. The technique was pioneered in the Soviet Union to improve athletic performance and is still commonly used by athletes, especially for healing muscle damage. Today portable NEMS machines are available and it is a do-it-yourself therapy.
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