This book is pretty great. The entirety of the first few chapters where Dr Terry Wahls tells her own story of illness and then enormous recovery from illness through her own research and where she explains that the body is a self healing system so long as it is given the raw materials it needs to do so are all so quotable. I would like to quote whole pages of it and send it to people!
It's so well done. The content is great and it's been so finely edited that it reads very well too and gets right to the point with no waffling. A lot of information is condensed into a very short space. It's an enlightening and inspiring read with just the right amount of facts and personal information about the author.
There are three levels of the Wahls protocol. The Wahls Protocol, Wahls Paleo and Wahls Paleo Plus which is the most strict and is for those that are the most ill. I'm only really a supporter and recommender of the third level of the protocol, Wahls Paleo Plus.
The other two protocols contain things like soy milk and yogurt and cheese (ugh!), soy flour, potato flour, packaged gluten-free foods such as crackers. Many allowed foods are extremely high in carbohydrate and anti-nutrients and very low in nutrients. This seems to be because the author is trying to make the programs easy to adjust to for those coming off a very junk-filled diet, which makes a lot of sense from that perspective and from the point of view of getting subjects in a study to adhere to the diet properly which is more likely if it contains a more of the foods they are used to.
But from a purely nutritional standpoint it's really not ideal. I and many ill people I know would be a lot sicker, fatter and have blood sugar all over the place if we ate the estimated 244 grams of carbohydrate on the Wahls Protocol, or even the estimated 178 grams of carbohydrate on Wahls Paleo. I doubt I was even eating anywhere near so much carbohydrate even before I went on a lower carb diet to treat diet-related insulin resistance issues and weight gain from same. One listed breakfast contains two whole cups of sweet fruit in it, a massive amount to eat at one sitting. The book also (bizarrely) claims that all three Wahls Protocols will improve blood sugar numbers. In my opinion for some of us at least this is only true for the ketogenic (or near ketogenic) Wahls Paleo Plus program.
Wahls Paleo Plus includes nutrient dense foods such as 6-12 ounces (180 - 360 g) of meat daily (some as organ meat and some as wild caught fish), coconut oil and milk in abundance for high ketones, 6-9 cups of vegetables daily depending on your size (and less than this if you're a very petite woman) mixed between greens, high sulfur veggies and colourful veggies, seaweed or algae eaten daily, cultured foods eaten daily such as homemade coconut yogurt or sauerkraut, up to 4 ounces (120 g) of soaked and sprouted or dried nuts and needs daily, up to 1 cup of fruit daily with berries and other low carbohydrate fruits preferred (as part of your 6-9 cups), plus olive oil, ghee and animal fats as desired.
The high amount of ketones produced from MCTs in coconut oil mean you can eat more vegetables and still stay in a ketogenic state. Roughly just over a third of daily calories are to come from coconut oil: 4-6 tablespoons of pure oil or the equivalent in coconut milk. The diet is roughly 65% fat by calories.
Wahls explains that Paleo Plus is a modified MCT ketogenic diet. Ketogenic diets have been shown to be beneficial for many types of neurological and other diseases and are very safe. Switching over form a sugar burning metabolism to a fat burning metabolism can take 3-6 weeks however, and can make you feel awful at first. Some recommend making this change gradually, while other find it easer to just get it over with and jump right into it (as I did). Once you're keto adapted the mental clarity and extra energy it brings you is pretty amazing, as is the loss of the need to eat quite so often. Fat is a slow burning fuel, while sugar burns fast like kindling, as nutrition expert Nora Gedgaudas has explained.
Wahls recommends doing urine ketone strips to measure your ketosis but adds that blood ketone tests are far more accurate. Some blood sugar monitors can also take ketone test strips and will give you a ketone measurement using just a drop of blood. To be in ketosis numbers should be between 0.5 and 3. It's so great to see an extremely specific and detailed food plan for serious disease so we can make sure to get every benefit out of our diet that we possibly can. The information was so helpful, even though I was doing most of the recommendations already.
Wahls also supports ideas such as:
* Supplements can in some cases be helpful, but they can never replace a nutrient dense and healthy diet. A proper diet must always come first. Foods contain many beneficial cofactors and other compounds not included in supplements and many that we have not yet even discovered or named.
* Getting evaluated for potential food allergies, toxic load issues and more personalised nutritional needs by a practitioner of functional medicine is a very good idea. The Institute for Functional Medicine can help you find a provider in your area.
* Drugs are not the answer. Let food, good wholesome food be thy medicine.
* "Between the unexpected, unpleasant events in our lives and our response to those events is a space, and in that space we have a choice in deciding what our response will be. We can either give up or get up each day and do our best."
* "Epigenetics is how your environment talks to your genes. Our cells are capable of reading the state of our environment and activating or deactivating genes. This means that, based on the choices we make, we can turn on genes for health or turn off those health-promoting genes. In other words, it is your health behaviours such as diet and activities, that determine whether the health-promoting or the health-robbing genes are active. For some conditions, such as cystic fibrosis or hemophilia, our genes are an important factor, often the cause of the disease. But for the obesity, heart disease, mental health and autoimmune epidemics that are driving up the cost of health care in the U.S. and around the world, there are no single genes that are the culprit. Instead, for each of these problems, multiple genes are involved, and they interact in a complex way with the environment."
* We need to stop blaming our genes for our illnesses and work on making the best of the 70% that is under our control.
* "Yes, it does cost more to eat vegetables. But you will pay the price either way--for food that restores your health and vitality or for doctor visits, drugs, surgery and loss of work due to health problems."
* "Functional medicine is really looking at health of the cell. And what can we do to help the individual make the environment for their cells, an environment for doing the biochemistry life more ideal. So that comes down to the fruit you eat or do not eat, the quality of the air you breathe, the water you drink, the toxic load that is in your body is a result of the exposure you had over a lifetime because if you couldn't get the toxins out the day you were exposed to them, they get parked in your fat and did you know that your brain is 70% fat? So if you can't get the toxins out you had today with your whatever your exposure was, you're parking it in your fat and your brain which is going to create havoc over time."
Hard to argue with any of that! I agree with all of it. Most of the above are quotes from Dr Wahls, from her many websites. Functional or holistic medicine just makes so much sense. It treats the actual cause of diseases, rather than just blindly drugging everything and focusing on endlessly chasing and minimising symptoms.
There are 3 basic principles of the type of medicine discussed by Wahls and others in this same field:
A. Get the good stuff in. Give your body the fuel and tools it needs to work at an optimum level. Good food, nutrients and all the proper vitamins, minerals and antioxidants. Make sure you aren't deficient in any of the major nutrients as the different nutrients all work together.
B. Get the bad stuff out. Make sure your body can detoxify out all the toxic substances and toxic by-products of bodily processes properly. Stop as many toxins from getting in in the first place, and do things which aid detoxification to get rid of the ones you have.
C. Reduce your body's total load. The total load concept is that lessening the body's overall burden/work and stress level in one area, will improve health generally and improve the body's ability to heal because the body's total load (or burden) is lessened. Fixing one problem frees up bodily resources that can be then be used to help other parts of the body function getter or to heal. In other words, you need to look at the body as a whole in order to heal, and not just the one part of the body that is generating the most symptoms.
A special note to M.E. patients on the Wahls protocol:
Myalgic Encephalomyelitis is a neurological disease similar in some ways to MS, which also causes demyelination and mitochondrial dysfunction as well as significant vascular and cardiac issues.
For those with my particular neurological disease, Myalgic Encephalomyelitis, it is important that activity levels be kept always within very strict limits, or else relapse will occur. (Death is also a risk in M.E. if overexertion is severe. This is not about symptoms or feeling fatigued, but a problem of cardiac insufficiency, reduced circulating blood volume and POTS and so on which is serious and non-negotiable. Overexertion always causes a worsening of the disease.) But of course activity levels can and should be raised slowly to keep in line with health improvements in M.E. - this is something that happens naturally anyway.
For those unfamiliar with the disease, many M.E. patients are housebound and almost entirely bedbound (and far too ill to use wheelchairs for even small periods of time in a day or week) and limited with even basic communication and reading; which is also part of why I am trying hard to summarise the work of Wahls for them as much as possible. Daily stretching, balance work and cardiovascular exercise is probably a great recommendation for almost everyone but should be omitted by M.E. patients unless they can do this without becoming more ill or symptomatic. The advice on pushing through symptoms is also not relevant to M.E. patient as many are severely ill due to doing exactly this for many years.
Also, Wahls says: 'It is common to have some level of detoxification (more fatigue, headache) in the first week which resolves and then improves markedly by week two.' I would say that for M.E. patients this statement is not quite right and is an enormous understatement. M.E. patients will often have quite severe healing reactions to supplementation and changes in diet. These can be severe enough to make a patient no longer able to feed themselves or do other tasks of daily living, as well as leave them in agony. They can also last FAR longer than just a week!
It is important for anyone ill to make the dietary changes gradually, and for patients with M.E. this caution should be taken very seriously. Jumping in with both feet too fast could leave you very very ill for months afterward. Healing reactions are a good sign that healing is occurring, but need to be controlled so they don't become overwhelming. Switch to the full Wahls Paleo Plus diet over a few months at least. Slowly but surely is the way to go! Improvements will almost certainly be slow too, so patience is necessary there as well, especially when the illness has been severe for many years or even several decades or more.
M.E. patients will also often do far better eating cooked veggies rather than raw, which can be too difficult and painful for us to digest and may not cope at all well with prolonged fasting. (For more M.E. patient-specific tips and cautions see the HHH and HFME websites.)
This diet is described as an MS diet, but really this diet is the diet we have all evolved to be best suited to. All of us need such a nutrient-dense and low-toxicity diet, and so I hope people with all sorts of diseases look into the Wahls diet and not just those with neurological diseases. The diet can also help where there is not yet a correct diagnosis. We all need the right amounts of the nutrients that enable healing, no matter what disease we have.
For some people following this diet plan will be enough, but for others a higher level of intervention will be required in addition to the diet. The first step toward healing has to be an excellent diet and good gut health, combined with minimising toxin exposures. If more help is needed then, as Wahls explains, it is best to see a Functional medicine expert so that it can be determined what extra supplements or other supports you may need. The key is learning about your own 'biochemical individuality.' There are so many tests now which can be done to determine where your detoxification pathways are failing, which nutrients you need more of or have problems utilising or why your gut is still not functioning right.
For those that can't find or can't afford to see a Functional medicine expert, or cannot see any medical expert due to being housebound etc., an excellent companion to Wahls book are the books by Functional medicine experts such as Dr Sherry Rogers. Dr Rogers tells you exactly which tests may help you, how to treat more complex gut problems and how to go about following a more intensive detoxification regime involving a detox cocktail and FIR sauna use. Dr Rogers books are to some extent `do-it-yourself' health books but ideally Dr Rogers recommends that you get well with the help of a qualified practitioner that will be able to order the appropriate tests for you, and also help you interpret them.
Dr Sherry Rogers writes in `Detoxify or Die',
`I have to laugh when people ask me if I do alternative, herbal, acupuncture or holistic medicine. 'No,' I reply. 'We do state-of-the-art medicine. In other words, we find the biochemical, nutritional and environmental causes and cures rather than blindly drugging everything. Sure, herbs are gentler, safer and more physiologic than drugs and holistic medicine attempts to incorporate many diverse modalities, etc. But there is no substitute for finding the underlying biochemical causes and cures. This is real medicine. This is where medicine should and would have been decades ago, if it had not been abducted by the pharmaceutical industry.'
Following a super-high-quality diet is also the foundation of Dr Rogers' treatment plan and so starting with the Wahls diet (which is the best there is, along with Primal Body-Primal Mind) and then moving on (if necessary) to follow Dr Rogers' advice on advanced detoxification techniques just makes so much sense. The best book of hers to start with is Detoxify or Die. It is just brilliant and very easy to read as well. It has so much good information and support for sauna use and so much more. Her book 'The Safe, Effective Way to Prevent and Heal Chronic Gastrointestinal Disorders' is also excellent.
In addition to books by Dr Sherry Rogers I'd also recommend books and articles by Dr Lawrence Wilson (particularly his book on sauna use), Dr Klenner, Dr Abram Hoffer, Andrew Saul, Sally Fallon and Mary Enig and any and all of the vitamin C and orthomolecular experts such as Linus Pauling and Dr Thomas Levy. Other excellent books on diet and nutrition (with huge amounts in common with the Wahls diet) include the BRILLIANT Primal Body-Primal Mind by the also brilliant Nora Gedgaudas as well as books on the GAPS diet for the treatment of dysbiosis and a diet-based plan to heal the gut.
Gut health is so important and if gut health is poor, then your body can't properly use all the wonderful nutritious food you are eating. Many of us need to heal the gut first of all, and this may at first involve supplements such as Betaine HCL, enzymes and probiotics, as well as dietary changes, as these books explain. All of these books, along with Wahls book, are far more than just standard Paleo diet books.
Combining the excellent Wahls diet with the advice on detoxification by Dr Rogers (including the use of an FIR sauna and a daily detox cocktail and 'oil change' nutrients and digestive supports) has seen me finally start to slowly improve my health since 2009. I'm slowly improving month by month from a very severe neurological disease - thanks in part to the work of Nora Gedgaudas, Dr Wahls and Dr Rogers, and others like them - that has left me housebound and almost entirely bedbound for many years. I have been housebound and almost entirely bedbound (and far too ill to even use a wheelchair, or even the phone) for over 10 years and I got ill when I was just 19. Getting slowly worse and worse year after year was terrifying, especially when I was so ill and disabled already.
I wish so much I had had this information early on in my disease, rather than coming to it more than 10 years in. Healing is so much easier the earlier you start it.
I wont know how much of my damage is irreversible until I improve a lot more (a LOT more I hope!) and find out where I plateau. But for those that have been ill 'only' 5 or 7 years or less, or that are not severely ill, I do think these approaches could be curative or very close to it. At the very least they will undo as much damage as can be undone which is what this book very sensibly promises.
My big dream is to get to a 30% function level, where I can live independently.... I'm still so far away from that currently, but I am at least making slow but sure progress now! Being able to cook a little this last few years after 8 years or more not being able to even make myself a cup of tea has been just so wonderful. Cooking myself an egg is a joyful experience! It is so wonderful to now each month be getting small UNsymptoms and UNdisabilities!
I have learned so much about health that I would never have known if I had not become so ill and been forced to learn it!
The basic information in this book is wonderful, though I'm admittedly not a fan of high fibre supplement recommendations (as the GAPS diet book explains, many of us get far worse gut issues with extra fibre and can benefit a lot from lower fibre foods), outdated information about how raw vegetables are easier to digest than cooked ones and come with their own enzymes which do some of this digestion for you (actually cooked foods are *far* easier to digest than raw!), a fairly low salt diet and no guidelines on making sure to get a healthy minimum amount, or recommendations of iodised sea salt and not unrefined sea salt. Gut and sugar issues are barely mentioned and the supplements section is very minimal and basic while many alternative therapies such as Reiki and acupuncture are recommended.
A high dose calcium supplement is recommended despite most good nutritional experts saying calcium tablets are not needed almost ever and can be harmful. No warnings are given on supplements which can often be poorly tolerated and need to be started carefully at lower doses such as NAC and silymarin. No information is given on sulfur food sensitivities or the need many have to take supplemental HCl to digest protein. The book also doesn't specify to only buy B complex vitamins that don't contain synthetic folate or the inferior form of B12. Only the basic B12 test is recommended along with a small dosage of methyl B12 which is a strange omission considering how inaccurate the B12 test is known to be (you can test high and actually still have a serious B12 deficiency causing demyelination!) and how many people have B12 deficiency causing demyelination misdiagnosed as MS or at least coexisting with MS. Again, this is a diet book only primarily.
The Wahls diet is said to be useful for patients with diseases other than Multiple Sclerosis, and it certainly is. But this book contains a ton of information which is heavily based on the symptoms and other characteristics of the MS patient and may not fit those of us with other neurological or autoimmune etc. diseases quite so well. Symptom checklists were very MS-based and many symptoms and issues seen in non-MS diseases were not mentioned. A fairly high degree of functioning is also assumed throughout, as is illustrated in the extensive Wahls diary instructions and the information on demanding daily stretching, balance and cardiovascular exercises and advice to push yourself to do things and to keep working. Issues with an inability to stand long to prepare food (for example) and hypoglycemia are not really even discussed. The book aims to get through a lot of information in a short time and to be primarily about detailed dietary information and about MS so this is not even really a criticism, just an observation. It's totally fair enough it's an MS based book as the author has MS after all. For non-MSers you just need to skip certain sections and do some extra reading elsewhere on some issues is all.
I bought the hardcover edition as I read a review saying the Kindle version didn't display the tables at the end of the book well. It's a very well designed hardcover. The smaller size makes it easy to read and hold and the typography and book design is excellent inside as well. There is no small unreadable type or text too close to the spine of the book so you can't read it without cracking the books spine. The small case study or facts boxes scattered throughout the text are easily defined from the main text, not too long and although printed sometimes in (annoying to read) italics still quite easy to read. I can also loan this hardcover version out to friends, which is another huge reason it's better than a Kindle edition as well. (Kindle titles should be far more loanable!) Get this hardcover edition I say, it's better than the Kindle version and also the earlier paperback edition of the book that came out a few years ago too. Much more polished. I give it 4.5 stars.
The Wahls Foundation is a nonprofit organisation raising funds to do research on this diet. Buying this book helps fund their research. Reading more of her ideas online is so helpful. I'd highly recommend watching all her free videos online (watch out for the loud sound on some of them - ouch!), plus her Facebook page and blog and website. They are all so helpful.
Dr Wahls is the real deal and is clearly motivated by a genuine desire to help ill people improve their health. I wish her and her Foundation all the best and thank them for all their wonderful work. This is real cutting edge medicine.
Wahls explains it takes 1 year to replace all your skin cells, 1-3 years to replace the cells in the liver and kidneys, 15 years to replace heart muscle cells, and 7-10 years to replace myelin. No drug will ever be able to do this for you and only you can do it for yourself. So why not get started rebuilding yourself today!
Best wishes for future health to anyone nutrition-nerdy enough to read this far!
Jodi Bassett, The Hummingbirds' Foundation for Myalgic Encephalomyelitis and Health Healing & Hummingbirds