Terry Wahls, M.D., is a physician with multiple sclerosis who developed the Wahls Protocol after experiencing severe disability from the disease. Her approach combines a nutrient-dense modified Paleo diet with exercise, electrical muscle stimulation, stress management, and other lifestyle measures.
Dr. Wahls reports that her own function improved dramatically, including progressing from using a wheelchair to riding a bicycle. Her experience led her to study dietary and lifestyle approaches in people with multiple sclerosis.
Importantly, the Wahls approach has now been studied in randomized clinical trials. Research has reported improvements in outcomes such as fatigue and quality of life for some people with MS. The findings are encouraging, although they do not establish that the Wahls Protocol cures multiple sclerosis or prevents long-term disease progression.
Terry Wahls was diagnosed with relapsing-remitting multiple sclerosis in 2000. Her disease later progressed, and by 2007 she was using a tilt-recline wheelchair despite receiving conventional medical treatment.
Wahls began studying nutrition, mitochondrial function, and the nutrients needed by the brain and nervous system. She developed a highly nutrient-dense diet emphasizing vegetables, particularly leafy greens and sulfur-rich vegetables, along with berries, meat, fish, and organ meats while eliminating or greatly reducing grains, dairy, and processed foods.
She reports that after combining this diet with exercise, electrical stimulation of her muscles, and other lifestyle changes, her function improved dramatically. Within about a year she was able to ride a bicycle again.
Her recovery is an extraordinary personal story, but one person's experience cannot establish whether a treatment works. What makes Wahls particularly interesting is that she subsequently began testing her approach in clinical studies.
The Wahls Protocol is much more than a low-carbohydrate diet. Its central idea is to provide the body and brain with high levels of nutrients that support mitochondria, cellular energy production, and nervous-system function.
The diet is based partly on a Paleo approach, which emphasizes foods available before modern agriculture and food processing—such as vegetables, meat, fish, eggs, nuts, seeds, and some fruit—while generally avoiding grains, highly processed foods, and added sugars.
Wahls puts particular emphasis on eating a large quantity and variety of vegetables. A commonly described goal is about nine cups of vegetables and fruit daily: three cups of leafy greens, three cups of sulfur-rich vegetables such as broccoli, cabbage, onions, mushrooms, and cauliflower, and three cups of deeply colored vegetables and berries.
Her protocol also eliminates gluten-containing grains and dairy and encourages nutrient-dense foods such as fish, fermented foods, seaweed, and organ meats. Different versions range from a modified Paleo approach to a more ketogenic version.
The program also emphasizes exercise, sleep, stress management, and electrical muscle stimulation when appropriate. It is demanding, but it provides an unusually specific lifestyle intervention that can be studied in clinical trials rather than simply described as “healthy eating.”
The most important study is the WAVES randomized clinical trial, which included 87 people with relapsing-remitting multiple sclerosis. Participants were assigned to either the Wahls diet or the Swank diet, a low-saturated-fat approach, for 24 weeks.
Both groups experienced meaningful reductions in fatigue and improvements in quality of life. The Wahls group showed particularly strong improvements in several quality-of-life measures. At 24 weeks, the Wahls group also improved its six-minute walking distance, although neither group had shown a significant improvement in walking distance at 12 weeks.
These results provide genuine clinical evidence that diet may improve important aspects of life with MS.
However, the trial was relatively small and lasted only six months. It did not establish that the Wahls diet prevents MS relapses, new or enlarging lesions on MRI scans, or long-term disability. Broader reviews of dietary research in MS have also concluded that there is not yet enough high-quality evidence to show that diet changes the long-term course of the disease.
The Wahls Protocol has several attractive features. It emphasizes whole, nutrient-dense foods, abundant vegetables, exercise, sleep, and stress management—all of which can contribute to better overall health. Clinical trials also suggest that the diet may reduce fatigue and improve quality of life for some people with MS.
The protocol is restrictive, however, and requires considerable planning. Eliminating grains and dairy can make it more difficult to obtain adequate amounts of certain nutrients unless the diet is carefully designed.
For someone with MS who is interested in trying the Wahls Protocol, the existing research provides a reasonable basis for discussing it with a physician or dietitian. It is best viewed as a potential complement to established MS treatment rather than a proven replacement for disease-modifying therapy.
The larger question—whether this approach can actually change the long-term course of MS—remains unanswered.
Terry Wahls’ own recovery from severe MS disability is remarkable, but her personal experience alone cannot establish that the protocol works for others.
The Wahls Protocol combines a nutrient-dense modified Paleo diet with exercise, sleep, stress management, and other lifestyle measures.
Unlike many lifestyle approaches to autoimmune disease, the Wahls diet has been tested in a randomized clinical trial.
The WAVES trial found meaningful improvements in fatigue and quality of life, with several outcomes favoring the Wahls diet.
It remains unknown whether the Wahls Protocol can prevent MS relapses, new or enlarging MRI lesions, or long-term disability.
The existing evidence makes the Wahls Protocol a serious area of study, but it is best considered a complement to established MS treatment rather than a proven replacement.
Dr. Wahls describes her experience with multiple sclerosis and provides a detailed guide to her nutrient-dense Paleo-based diet and lifestyle program.
A randomized clinical trial comparing the Wahls and Swank diets in 87 people with relapsing-remitting MS, with both diets improving fatigue and quality of life and several outcomes favoring the Wahls diet.
Dr. Wahls discusses multiple sclerosis, mitochondrial health, metabolism, and the thinking behind her diet and lifestyle approach to autoimmune disease.
Dr. Wahls tells the remarkable story of her decline from multiple sclerosis, her development of a nutrition and lifestyle program, and her subsequent improvement from using a wheelchair to riding a bicycle. She discusses the diet, exercise, and other lifestyle changes that became the basis of the Wahls Protocol.