Almost 37 million people have viewed Terry Wahls’ inspiring TEDx talk from 2011 entitled “Minding your mitochondria” as of the time this book review was written (see the video below).

In the above video, Dr. Wahls describes how she recovered herself from symptoms of secondary progressive Multiple Sclerosis with the use of deep and targeted nutrition as well as lifestyle changes. She went from being in a reclining wheelchair to walking, biking, hiking and horseback riding. Her success inspired countless numbers of people with the idea that a disease isn’t destiny and that there are many interventions – especially dietary changes – that can improve health.

She produced books about what she specifically did to achieve her recovery, and this review covers her latest thinking found in the second edition of her book The Wahls Protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principles. “I don’t want you to have to wait for FDA approval to try the low-risk but powerful interventions described in the Wahls Protocol,” she wrote.

What Is the Wahls Protocol?

So what is the Wahls Protocol? It’s Dr. Wahls’ method of achieving improvement of symptoms for almost all chronic health conditions by addressing root-cause issues such as toxicity, nutritional deficiencies, gut dysbiosis, immune dysregulation, inflammation and mitochondrial dysfunction found in people with autoimmune conditions as well as those with other chronic health conditions.

The protocol encompasses dietary interventions (described below), exercise, e-stim (the use of a specific electronic device that causes muscles to contract) and lifestyle changes that lower the stress response.

What Are the Wahls Protocol Dietary Interventions?

There are four stages of making dietary changes in the Wahls Protocol. Readers can pick and choose the level at which they’d like to start. Dr. Wahls challenges people to commit to the protocal 100% for at least 100 days because that’s the minimum amount of time for some healing to occur noticeably. If a person cheats or backslides from the protocol after that time, there’s a really good chance that the return of symptoms will be a compelling reason to stick to the protocol. Dr. Wahls writes of the “gift of pain” in her face that occurs if she hasn’t been strict with her protocol; the pain is a reminder that the protocol works and to keep following it.

The following elements of the diet are key to all levels of the protocol:

  • Nutrient-dense foods
  • High-fat foods
  • High fat level from a macronutrient perspective
  • Seasonal and local foods
  • Elimination of eggs for at least 100 days
  • No gluten, no dairy, no eggs
  • Few, if any, legumes
  • “Clean”, unprocessed foods

The stages of the protocol are:

Wahls Diet

In this beginning level, readers are instructed to add in nine cups of vegetables and fruits a day. These nine cups include:

  • Three cups of leafy greens
  • Three cups of naturally colored vegetables and/or fruit
  • Three cups of sulfur-containing vegetables such as onions, garlic, mushrooms and cruciferous vegetables

In addition, this beginning level requires a gluten-free/dairy-free diet that is full of organic, grass-fed and/or wild-caught foods. Vegetarians and vegans can choose this level but will need to add in meat, fish or seafood to move up to the next level.

Wahls Paleo

This level builds on the previous level and further eliminates problematic foods that can compromise gut health. Note that Wahls Paleo is Dr. Wahls’ unique twist to the Paleo diet. In addition to the Wahls Diet, patients:

  • Reduce all gluten-free grains, legumes and potatoes to two servings per week
  • Add in seaweed or algae
  • Add in organ meats
  • Add in fermented foods, soaked nuts and seeds as well as some raw foods

Wahls Paleo Plus

This is the most challenging level, as it is her version of a ketogenic diet, which is a high-fat, low-net-carbohydrate diet. Because it is high in fats and low in carbohydrates, the body and brain can run more efficiently on long-burning ketones rather than on quickly used and problematic glucose. Dr. Wahls writes that this level is also the most therapeutic level.

In addition to incorporating the elements of the previous two levels, Wahls Paleo Plus:

  • Eliminates all grains, legumes and potatoes 
  • Eliminates cooked starchy vegetables, although a small amount of raw versions is still allowed
  • Eliminates all fruit except for one daily serving of berries
  • Adds in coconut oil and full-fat coconut milk or olive oil depending on a person’s lipid profile. In Dr. Wahls’ version of the ketogenic diet, readers are encouraged to use coconut oil specifically because of the medium-chain triglycerides (MCTs) that are documented to be beneficial for those with neurological or psychlogical issues, as well as those with cancer.
  • Increases the total amount of fat in the diet
  • Has patients eat only once or twice per day within a 10-hour-or-smaller window of time
  • Reduces the nine cups of vegetables from the previous two levels to six cups (or less, if the person is smaller)

Wahls Elimination Diet

This low-lectin diet can be combined with any of the three previous levels at a any time. By removing foods with high levels of inflammatory lectins such as nightshade vegetables (tomatoes, potatoes, etc.), peanuts and seed spices, the body can more easily calm symptoms of inflammation such as pain, fatigue and cognition problems. Other suspected problematics foods are also encouraged to be eliminated. This level is meant to be a temporary phase of about three to six months. After that time, problematic foods are reintroduced to check for continued sensitivity and symptoms.

What Else Is in the Book?

This book is truly an inspiration, and most of the principles and advice in it can be used for people, including children, with most chronic health conditions. A strict ketogenic diet may not be suitable for most children, so check with your child’s doctor before proceeding.

There is a growing body of peer-reviewed, medical-research evidence that shows that these dietary and lifestyle interventions are helpful for those with other autoimmune conditions, diabetes, cardiovascular conditions, mood disorders and neurological disorders such as Alzheimer’s, ALS, Parkinson’s and autism.

The book is extremely comprehensive and well researched, owing to Dr. Wahls’ ability as the author of over 20 peer-reviewed, medical-research studies. She backs up her claims with a multitude of other studies that can hopefully begin to persuade not only her medical peers but also people suffering from chronic health conditions.

In addition to dietary advice and evidence-based research, The Wahls Protocol includes:

  • Resources
  • Recipes
  • Troubleshooting tips
  • Anecdotes for Wahls Warriors
  • Information on certain lab tests
  • Advice on certain supplements
  • Tips for reducing toxic load
  • Exercise advice
  • Thoughts about certain alternative therapies
  • Tips for reducing stress and why this is important
  • Tips on what to include in a daily diary

We believe this book should be a reference guide for forward-thinking health professionals and their patients who would like a solution that doesn’t rely solely on pharmaceutical interventions.

About Terry Wahls MD

Dr. Terry Wahls is a clinical professor of medicine at the University of Iowa where she conducts clinical trials.

She is also a patient with secondary progressive multiple sclerosis, which confined her to a tilt-recline wheelchair for four years. Dr. Wahls restored her health using a diet and lifestyle program she designed specifically for her brain and now pedals her bike to work each day.

She conducts clinical trials that test the effect of nutrition and lifestyle interventions to treat MS and other progressive health problems. Learn more about Dr. Wahls’ clinical trials here. She also teaches the public and medical community about the healing power of the Paleo diet and therapeutic lifestyle changes that restore health and vitality to our citizens.

Nancy O'Hara MD
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