Rhonda: Good morning. Dr. Rhonda Patrick here. We're at Paleo f(x) 2014 in Austin, Texas. I'm sitting here with Dr. Terry Wahls who you may recognize from her famous TEDx video entitled, "Minding Your Mitochondria" where she talked about the importance of obtaining micronutrients from your diet to not only prevent diseases of aging, specifically neurodegenerative diseases and autoimmune diseases like multiple sclerosis, but also how you can obtain micronutrients to reverse some of these diseases as well. And she also has a recent book got called "The Wahls Protocol" which we'll probably talk about in a minute. So, thank you, Dr. Wahls, Terry, for joining us.

Terry: Oh, thank you. Very pleased to be here.

Rhonda: Yeah. So, tell us a little bit about your findings on how important certain micronutrients are for...

Terry: Oh, sure.

Rhonda: ...mitochondrial function and how that relates to, you know, diseases.

Terry: Sure. Well, you know, like you in medical school I had to memorize all sorts of reactions involving mitochondria which mostly I forgot. But sadly, we never got taught what we needed to eat to fuel those mitochondria. And as I became ill with the progressive MS and was confined to a tilt-recline wheelchair, I got motivated to start reading the rats and mouse studies, and started reading about other diseases, the shrinking brains. And that led to being turned on to mitochondria and then being turned on to what were the things I could do to help my mitochondria, which then led me to Dr. Ames' work and the interest and passion in micronutrients.

Rhonda: Right. So, mitochondria are so important for so many different cellular processes inside your body. I mean, they literally are the energy producing machine, so to speak. And I guess something that you found very interesting was that these mitochondria require certain micronutrients.

Terry: Right. So, as I think about it and I communicate the message, you need the whole family, B vitamins, you'll need minerals, magnesium, zinc, sulfur, you need to protect the mitochondria from poisons like arsenic, lead, mercury. And then because mitochondria are really packaged membrane factories because it's in the membrane where all these reactions happen, the essential fats are critical. And what makes it a little bit crazy, our low fat society is very damaging to membranes because membranes are fat. So, you need saturated fat, cholesterol, omega-3 fats, omega-6 fats.

Rhonda: Right. You know, something really interesting since you mentioned the membrane, the fluidity of our... So, all of our cells have cell membranes and of course, mitochondria are also made of membranes. And as we age, the fluidity of these membranes become more rigid and...

Terry: Yes. Phosphatidylcholine ratios change.

Rhonda: Yes. Phosphatidylcholine. Exactly. Phosphatidylserine, these things they become more rigid and what ends up happening is that some of these micronutrients can't get in as readily as they could when we were younger. So, we actually think in our research at the Ames Lab that as we get older, we may even need higher levels of some of these micronutrients to help, you know, kind of overcome that.

Terry: To overcome that, slow the aging process. And I think the quality of the diet, the quality of the food, the micronutrient content, the vitamins, minerals, essential fats, the antioxidants, that's really where health is. I really don't think the macronutrient ratios, fat, carbs, protein is that critical because a very flexible metabolic capacities in our cells. At least from my perspective, the most critical thing is am I getting these essential fats? Am I getting the B vitamins, vitamin C, vitamin A, vitamin K? Am I getting sufficient minerals? And of course, a sufficient supply of antioxidants.

Rhonda: Absolutely. And research tells us that actually we're not getting enough of those micronutrients. In fact, you know...

Terry: Oh, absolutely, we are not.

Rhonda: Fifty-six percent of the U.S. population is deficient in magnesium. And magnesium as you mentioned is important for mitochondrial function. It's a cofactor for almost every single DNA repair enzyme in our body.

Terry: Oh, really? I didn't know that.

Rhonda: Yeah. So, you actually...you can't repair your damaged DNA. So, we're talking about diseases of aging. We're getting insidious damage. Normal mitochondrial metabolism is generating pro-oxidants, right?

Terry: Yes, yes.

Rhonda: And these pro-oxidants, they're a normal byproduct from normal metabolism. But, you know, in addition they end up damaging DNA, damaging lipids, and proteins. And that happens, it accumulates over time of age.

Terry: Well, you know, one of the things... This takes me back to an interesting observation I had as I recovered and I started adding more greens into my diet. So this is, you know, after four years of tilt-recline wheelchair. I discovered I had this incredible craving for green. So, I was probably having oh, easily, 9, 12 cups of greens everyday, raw, cooked.

Rhonda: Wow. Nine to 12 cups.

Terry: Of greens. You know, I'm a big lady, over, you know, six-foot tall. And then I got well enough that I felt like, okay, I could travel, go to scientific meetings again. And I went, and when I got away from my food, I crashed. I was...in about 36 hours I could tell cognitively I was declining, energy declined. And I'd come home and my significant other would have a huge salad bowl of greens and I would devour that. So, then the first couple years I would travel with bags of greens because I just realized I had to maintain that high intake of greens. Six years later, I don't need as many greens. I have more nutritional reserve so I can travel and my vegetable intake will dip somewhat, but I don't become symptomatic with fatigue and brain fog now. But it really took me about four and a half years to fill my tank apparently...

Rhonda: Right.

Terry: ...from all of that micronutrient deficiency that probably contributed to my illness.

Rhonda: Yeah. Absolutely. I think, you know, when you have...when you're in a disease state, not only do you need micronutrients to just maintain normal function, but you need these micronutrients to...it's they're getting sucked into this of fighting off...

Terry: To all the repair work, that's...

Rhonda: Yeah. All this repair work is going on. So, it's like there's sort of a triage going on here where you're getting...these micronutrients are being shunted into this repair work, but then all the other processes that require the micronutrients are sort of getting the short end. And so, this is, you know, this is something that we think are, you know, Dr. Bruce Ames who is my mentor, we think that this is something that happens normally where there's a triaging of certain micronutrients that are going to the short term, things that are needed for short term survival.

Terry: Now, you'd be very pleased. I discussed the triage theory in my new book. I talked about Dr. Ames' work and the critical role of micronutrients in that. If you're not getting enough, your body is going to maintain the most critical life functions, but the long term health will obviously decline.

Rhonda: Right.

Terry: And we create this huge micronutrient deficit, this huge hole that you have to dig out of. So, I can, you know, convey to my patients that you've got a very, very deep hole. So, not only you're not meeting the nutritional requirements for maintenance. If you wanna heal, you have to go far beyond the recommended daily allowance of nutrients so you can dig out of your mincronutrient deficit.

Rhonda: Right, right. Yeah. We think magnesium is one of those micronutrients where even though it's required for every DNA repair enzyme, you know, repairing your DNA isn't something that is required for short term survival. You can have damage to your DNA, you can require mutations and be fine because it takes a certain, you know, amount of hits to eventually have something which will be mutagen or cause cancer. And so, having magnesium in your DNA repair enzyme is not as important as maintaining your heart beating, and making sure you don't go into cardiac arrest. And also another really prime example of that would be vitamin K. Vitamin K and this we showed is, you know, it's an essential for blood clotting and we think that's probably a short term function. You wanna make sure your clotting is happening, you don't wanna hemorrhage out and bleed out. But vitamin K also is important for preventing calcification of your vascular system, brain, vascular, arteries. But, you know, that's something that doesn't affect us until later on. You can have calcium buildup and it takes maybe, you know, a couple of...a few decades. So, you'll start to have...

Terry: Right. So, you have already reproduced.

Rhonda: Right. So, you know, the thing is is that while you think you're getting enough magnesium or vitamin K, you actually may be getting enough to maintain your short term and prevent, you know, acute clinical disease to something that's manifested right now, whereas in fact there's insidious damage that's happening. And this insidious damage is going to rear its ugly head, you know, much later in life or earlier on.

Terry: Well, that's why I'm such a huge proponent of greens, you know?

Rhonda: Yes.

Terry: Having three servings of green a day which sounds shocking to so many people, I think is so health promoting. Gives you so much magnesium, it helps you have a plenty of vitamin K on hand.

Rhonda: Let me stop right there. So, did you hear that? Magnesium, gives you magnesium because magnesium is at the center of a chlorophyll molecule and that's why green plants are high in magnesium. And vitamin K is actually part of the phosphorus source of the plants. So, you get vitamin K and you get magnesium from these green plants. So, you know, nature sort of color-coded micronutrients in a way, you've got the beta-carotenes that are red, the dark greens which have magnesium and potassium also. And so, it's kind of nice. I think you mentioned in your TEDx video, I remember talking about getting a lot of colors.

Terry: Yes, yes. Yeah.

Rhonda: And you're absolutely right. Nature has color-coded the micronutrients...

Terry: Absolutely. And I think that makes it, at least according to my plan, easier to design a micronutrient-dense diet because you can follow the colors, you get your greens.

Rhonda: You don't have to think about it. Okay? Just, yeah, get a wide range of colors.

Terry: The greens, yellow, red, blue, purples. And then I talk about the sulfur rich vegetables. I'm sure you have some comments about the critical role of sulfur in the brain...

Rhonda: Yes. Definitely.

Terry: ...and in our detoxification pathways.

Rhonda: Yeah, sulfur... It's interesting, when I was doing my graduate work, I was studying mitochondrial structure, and function, and metabolism. And I found some early papers from like the 1970s where I found sulfur was necessary to maintain the inner membrane structure of the mitochondria.

Terry: Oh, excellent.

Rhonda: Interesting, right? Interesting.

Terry: Yes, yes.

Rhonda: And when they depleted rats of sulfur and they looked at like their liver mitochondria, I mean, the structure of them was like there was huge holes in the structure. And so, if your...

Terry: Interesting.

Rhonda: ...membrane structure is not proper, your mitochondrial metabolism's...

Terry: Can't work.

Rhonda: ...not gonna be proper. And if your mitochondria aren't working properly when they're traveling during...down the long axons to get to the synaptic cleft where they're, you know, needed to make energy for nerve transmission, I mean, they're not gonna get there. They're not gonna be able to do that. Sulfur also is very important. It's an important thiol group, and these thiol groups are very important reducing agents. And so, they're potent antioxidants. Things like the glutathione is a very...it's a thiol containing antioxidant. So, these...

Terry: You know, and unfortunately, so many people, the public think, "Well, I don't have any of that noxious flatulence."

Rhonda: Right.

Terry: And so, because they're afraid of offending people when they pass gas, they quit eating sulfur containing foods, leading to this intracellular depletion and body depletion sulfur with lots of negative consequences.

Rhonda: Right. Yeah. Another thing about like, the sulfur, I think garlic also has very...

Terry: Yup. Garlics.

Rhonda: ...beta-mercaptans and stuff. Very high sulfur containing which is why they're very noxious.

Terry: Right.

Rhonda: And probably also cause flatulence.

Terry: And so healthy for us. So, I'm a big proponent of the cabbage family, garlic family, and mushrooms.

Rhonda: Sulforaphane which are in the cruciferous family, they're actually important, they activate tumor suppressor genes. So, they actually...it's one of those epigenetic changes where they activate tumor suppressor genes and end up selectively, you know, killing off precancerous cells in the body which is why people...

Terry: It's a good deal.

Rhonda: Yeah. People always talk about eating broccoli and cauliflower, you know, to fight off cancer.

Terry: Brussels sprouts. Kale, collards, yes.

Rhonda: Right.

Terry: Very good stuff.

Rhonda: And you like mushrooms.

Terry: I love mushrooms.

Rhonda: So, what's the...

Terry: So again, mushrooms will have some sulfur, B vitamins, beta-lactams, and can be very potent to add stimulating natural killer cells.

Rhonda: Oh, wow. Didn't know that.

Terry: So, I'm very fond of mushrooms for those benefits.

Rhonda: Yeah. I like mushrooms, but that there's some preliminary research from our lab which I probably can't talk about too much because the person working on it hasn't published it yet. But there is something in it called ergothioneine which is in mushrooms. And actually it's been found to be accumulated in mitochondria and we think it's a new antioxidant in mitochondria. So, hopefully that will be published soon.

Terry: Published soon.

Rhonda: Yes. I mean, some of that what I mentioned is already known. So, it's known that it's in mushrooms and it's known that this stuff accumulates in mitochondria.

Terry: So, briefly, I'm diagnosed with relapsing-remitting multiple sclerosis the year 2000 on the basis of a history of visual dimming 13 years earlier, weakness of the left leg. I had an MRI, my brain and spinal cord have lesions at the level of my neck, the spinal fluid was abnormal with oligo bands. I was diagnosed with relapsing-remitting MS. I then, being an academic doc, wanted to see the best people in the country. I went to the MS clinic at the Cleveland Clinic, took the latest drugs, still within three years my disease had transitioned to secondary progressive. And in that phase, you're steadily declining, there's no more improvement. I took mitoxantrone and then I took Tysabri. It was apparent that conventional medicine was failing me. I was headed towards becoming demented and bedridden ultimately from my illness. That's when I decided to start taking matters into my own hands. I began reading the mouse and animal models of MS, decided mitochondria were key, did more research, found some micronutrients that were helpful, took those. It slowed my decline, but I was not recovering.

The summer of 2007, I discovered the Institute for Functional Medicine, took their course Neuroprotection: A Functional Medicine Approach for Common, Uncommon Neurologic Syndromes. I had a longer list of micronutrients that I was taking, then I had what was really the most brilliant awareness, that I should get these nutrients from the food that I ate instead of synthetic compounds. So, with more research, I again reorganized my diet. I'm gonna back up for just a moment. I'd gone to Paleo in 2002, taking gluten, dairy, and eggs out at that time, but had still declined. Fast forward to discovering functional medicine, being more in tune with micronutrients, I did more research, figured out where these 20 nutrients were in the food supply, reorganized my diet using Paleo principles to maximize these nutrients, started my diet. Within three months, I'm able to walk using a cane between exam rooms. Within six months, I can walk throughout the hospital without a cane. I get on my bike for the first time in about six years, paddled around the block.

My family and I were all crying because now, I realized I was changing the world. I had no idea what to expect, but possibly, I could continue to improve. And nine months later, I'm able to do an 18-mile bike ride with my family. The following year, I do a trail ride in the Canadian Rockies. I identify and decide that I plan to do a clinical trial. We get some senior scientist to help me design the trial. I write the grant, get funding, and in October 2010 we start the clinical trial. And in fact, we've published. Our first [inaudible 00:16:59] that through the protocol showing that it's safe, it's well tolerated, people can do it, and most important, we have dramatic impact on fatigue. Very exciting.

Rhonda: Wow.

Terry: So, we now have 20 people who've gone through. We anticipate about five more papers coming in. Very, very exciting stuff. And of course, this has totally transformed how I see disease and health, it transformed my clinical practice, it transformed my clinical research.

Rhonda: And we hope it's gonna transform the public's opinion of...

Terry: Yes. Absolutely.

Rhonda: ...this. I mean, so...

Terry: Of treating MS, and treating, frankly, all autoimmune and chronic diseases. Because the root of the problem begins in the cell, and the root of the cell's health is the micronutrient environment.

Rhonda: Right. So, people, there you have it. Dr. Terry Wahls was diagnosed with a autoimmune disease, MS. Conventional medicine failed her, these pharmaceutical drugs she was taking were not helping her. In fact, it seems as though the disease progression continued on.

Terry: Continued, $40,000 a year. Anyway.

Rhonda: She decided to take matters into her own hands. She figured out a common mechanism that was common between a lot of brain dysfunctional disorders which was mitochondrial function is very important. She figured out that micronutrients were important for mitochondrial function and that most of our diets are lacking in micronutrients. And then she was able to not only consume these micronutrients and keep her disease at bay, but she was also able to reverse it. And then she went on from there to actually to get funding, and start doing research on other people to see if her protocol what she was...the micronutrients that she was taking in would work for other people that have MS. And so, this is absolutely great. She was able to crowdfund some of this research and she is still looking for crowdfunding. So, if you are interested in donating to help Terry Wahls' research on the importance of micronutrients to reverse some of these symptoms of MS, and the disease itself...

Terry: And other autoimmune disease.

Rhonda: ...and other autoimmune diseases, you can help her out, terrywahls.com is her website. You can donate whatever amount you want. Also she's got a book called "The Wahls Protocol" where she discusses...she talks about her personal story and then she discusses specifically the micronutrients and also some of the macronutrients.

Terry: Yes. And how to get this through food. We talk about other lifestyle issues. It's a very lay-friendly, step by step program that you can begin to take your life back.