124: Diet Changes For Autoimmune Skin Conditions Like Scleroderma w/ Dr. Terry Wahls

Autoimmune skin conditions like scleroderma can progress rapidly. However, safe, well-researched diet and lifestyle changes could slow down the progression of the skin condition. 

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My guest today is Dr. Terry Wahls, an Institute for Functional Medicine Certified Practitioner and a clinical professor of medicine at the University of Iowa, where she conducts clinical trials.

In 2018, Dr. Wahls was awarded the Institute for Functional Medicine’s Linus Pauling Award for her contributions in research, clinical care and patient advocacy.

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.

Dr. Wahls is the author of The Wahls Protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principles. The updated and revised edition of The Wahls Protocol launched 3/17/2020.

Join us as we discuss how diet can impact autoimmune skin conditions, and Dr. Wahls's latest book.

Have you used diet and lifestyle changes to improve your skin condition? Let me know in the comments!

In this episode:

  • Dr. Wahls's journey with MS
  • Other conditions that Dr. Wahls has seen success with using the Wahls Protocol
  • Why the Wahls Protocol might be helpful for autoimmune skin conditions
  • Scleroderma
  • What does “nutrient-dense” mean?


“As your cells can do the chemistry of life more properly, typically the dysfunction that led to whatever the underlying disease state is, with whatever the skin condition might be, whether it's an autoimmune problem or a degenerative problem will likely begin to calm and self heal.” [23:05]

“The most important lesson to learn is you want to focus on creating health. And to do that, it's about health behaviors. It is about improving, giving yourselves more of what they need to run the chemistry of life, and to get rid of your body and out of your lifestyle, the types of factors that promote disease.” [23:31]


Find Dr. Wahls online

Get The Updated and Revised Wahls Protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principles here

Download the FREE one-page handout for the Wahls™ Diet here

Pick up a copies of Dr. Wahls's research papers here

Genova Diagnostics

Healthy Skin Show ep. 049: Why Are My Skin Rashes Making Me So Tired?

Follow Dr. Wahls on Facebook | Twitter | Instagram

124: Diet Changes For Autoimmune Skin Conditions Like Scleroderma w/ Dr. Terry Wahls FULL TRANSCRIPT

Jennifer: Hi everyone. Welcome back. I am incredibly honored today to have a colleague, as well as someone who I consider a good friend, join me for the first time ever here at The Healthy Skin Show.

Jennifer: And it's a big deal because the work that she is doing is literally changing lives. It is mind blowing every single time I talk to her and hear about all the amazing things that she is up to. Researching, like she actually does research, which is huge. And so you guys might know who she is. If you don't, this is your crash course and introduction into the work of Dr. Terry Wahls.

Jennifer: Dr. Wahls is a clinical professor at the University of Iowa where she conducts clinical trial testing, the efficacy of therapeutic lifestyle to treat multiple sclerosis related symptoms. In addition, she's the author of The Wahls Protocol, How I Beat Progressive MS Using Paleo Principles and Functional Medicine, and the cookbook, The Wahls Protocol, Cooking for Life, The Revolutionary Modern Paleo Plan to Treat All Chronic Autoimmune Conditions. And she's got a new edition of her book coming out. We'll talk about that. Dr. Wahls, thank you so much for being here.

Dr. Wahls: Thank you for having me. I love chatting with you.

Jennifer: Every time I see you, you're up to these amazing things. So for anyone who's not familiar with your work, you actually started out working on your own health. This journey began with you. Could you give us a brief synopsis of how you got into this?

Dr. Wahls: Sure. So I'm a conventional internal medicine doc. I was very skeptical of special diets, supplements, all that jazz, but God has a mysterious way about him or herself. I started having problems with my left leg. I got evaluated. It was found to have multiple sclerosis. Now I sought out the best people I could find in the country, took the newest drugs and went steadily, relentlessly downhill. Within three years, I needed a tilt-recline wheelchair. I take more potent drugs, including the new biologic drugs. I continue to go relentlessly downhill and that's why I decided like conventional medicine clearly is not going to stop my slide into a bedridden, demented and quite possibly intractable pain due to trigeminal neuralgia.

Dr. Wahls: So I'm studying the basic science, I'm reading ancestral health principles. I discovered functional medicine, read through that, and I began experimenting basing on everything that I've learned. And ultimately I create a diet and lifestyle program designed for my mitochondria and my brain cells in an effort to slow my decline, because I know with progressive MS, recovery of function is not possible. And to my surprise, actually I was quite stunned, I'm up walking again, I'm walking with a cane then without a cane. I get on my bike for the first time in about six years. And then within a year of making these changes I'm able to do an 18.5 mile bike ride with my family. I'm off all disease modifying drugs. My medications, a trivial dose of Gabapentin for the intractable pain that I used to struggle with for years and years.

Dr. Wahls: And so, this radically changes how I think about disease and health. It radically changes the way I practice medicine. And along the way, my chair of medicine tells me to get a case report written up, which I do. And then he calls me back and says, I want you to change the direction of your research. And by then, he'd become the Dean of Medicine. And so when the Dean of Medicine calls you in to give you marching orders, you salute and say, “Yes sir.” And he got me some key mentors and we launched trials. We've done four trials, all of them very successful. And we're getting ready to launch our fifth trial. So it's been an amazing journey really over the last twelve years.

Jennifer: Yeah. And watching your story, when we first met, I feel like at least five years ago, seeing your before and after photos and watching your progress and then what you've been able to do with … You are working with veterans at the VA. It's not like an expensive protocol loaded with like the most expensive supplements and injectables and all sorts of crazy stuff that is cost prohibitive to the regular person.

Dr. Wahls: Correct. The VA noticed the success I had in clinic, invited me to create my own clinic, which we did. We called it The Therapeutic Lifestyle Clinic. And I did the evaluations using VA labs or basic primary care labs. And I was taking care of people living on food stamps, disabled, usually not working and helping them get their food from small rural town grocery stores. So using easily accessible foods, accessible labs, and very, very basic supplements if supplements were added. So when people say like the Wahls protocol or functional medicine is only for the wealthy, I'd say, “Well, I have eight years of experience doing this for people who are living on food stamps. And we had tremendous success.”

Jennifer: Yeah. And I know for somebody listening to this, they're going, “Wait, are we talking about MS? The thing is that I've discovered from talking to you is that the Wahls Protocol is no longer just for MS. It sounds like you've had success in other areas with other conditions. Would you care to share a little bit about what those conditions are off the top of your head?

Dr. Wahls: Yeah, so the first two clinics I worked this in was the traumatic brain injury clinic. So a lot of concussion, mental health issues, anxiety, depression, PTSD. And then in my primary care clinic, so high blood pressure, obesity, diabetes, and a lot of autoimmune issues, rheumatoid arthritis, systemic lupus, fibromyalgia. And then when we established the Therapeutic Lifestyle Clinic, then I went to the pain clinic into primary care and said, “give me your most difficult patients who are not responding to your treatments. I will take care of them, but they need to know, no drugs are coming from me. We'll just be using diet and lifestyle, and so if they're open to working on diet and lifestyle, send them my way.” We saw, again, a wide variety of people. Pain was often the leading problem and we had tremendous success.

Dr. Wahls: In that, we saw a lot of folks with psoriasis, interestingly enough, and we were able to stabilize and regress their disease. So people came to us with a variety of skin components to their illness that often typically would resolve. Their pain would diminish, their brain fog would diminish their energy would improve, their need for pain meds would reduce, their need for the prescription medicines in general would reduce. The one thing that would tend to improve, the other thing that would improve, a lot of sexual dysfunction. For the ladies, severe periods, menstrual irregularity, infertility, and decreased libido. So that would improve. For the men, and again, these are young guys in their 20s, erectile dysfunction, loss of libido. And so they'd come back very excited about the improvement in mood, and the improvement in their love life, their sex life, and their ability to get along much more effectively with their partners.

Jennifer: Yeah. And so to kind of circle toward the skin component of this, do you have any suspicions or thoughts on why for people who have some of these chronic, probably more on the autoimmune side of things, skin issues, why the Wahls Protocol might be helpful?

Dr. Wahls: Sure. So there are many, many skin conditions that have an autoimmune component and so decreasing that excessive abnormal immune response, both the innate immune response and the adaptive or antibody immune response, very, very helpful. And so it's not surprising then that those conditions greatly calm down, reduce as people implement the protocol. Now, people can get a little bit of improvement if they just sort of implement the protocol. We have to go through that, “If you really want to know, can the Wahls protocol help you, you have to do the experiment correctly and actually do the whole protocol 100% for a hundred days. And then you can evaluate, okay, it helped or it didn't help. If you do it just sort of like 70% 90% you're reducing your risk for heart disease, reducing your risk for cancer, but you aren't going to really answer the question, can I turn off my autoimmune component of my skin disease?”

Jennifer: Well and I think you bring up a good point, too, about making sure to … and this is important and I talk a lot about this on The Healthy Skin Show, that we do have to manage our expectations of what's possible with alternative options and even medications to some degree. So, in the case of something like, let's talk a moment about scleroderma, where someone's disease process progresses toward severe fibrosis in different tissues. If they do this, what is your thoughts on it? Because I know people would be like, I would love to reverse it, but …

Dr. Wahls: Again, it depends on our disease state. A lot of diseases once entrenched are going down so rapidly that we cannot get the person back to a fully healthy disease state. One of the things we can do is slow down the rate of progression. So for example, I have folks with Huntington's disease, we implement my protocol and they slow down the progress. People with ALS, slow down the progress. Very, very glad for that. And then I have people say with scleroderma, we can slow down the process. Sometimes we can stabilize the progress. And then I've had some folks tell me that, in fact, they discover that they're having a regression of symptoms and they're certainly doing better. They're not yet healthy young and have fully supple skin again, but the fact that they've either greatly slowed down the speed of their decline, stabilize their disease or beginning for the first time to see even the tiniest shred of improvement is a dramatic, dramatic change and improvement from what conventional therapies have to offer.

Jennifer: Exactly. And that's a very good point. And I know too, like you know, people say, “Well, is there any way that I should be if I don't have MS, like if I have scleroderma or if I have psoriasis …” Do you, it sounds like you don't, but are there any tailored tweaks that they should make?

Dr. Wahls: Sure. So depending on the disease state, I will make tailored tweaks. I may make the diet more of a low lectin diet. So it's the same Wahls protocol diet. But now I also take out nightshades. And if they're having legumes or grains, I put them through a pressure cooker to reduce the lectins. And if they're having nuts and seeds, I sprout them. Again, to reduce the lectins. So that makes the diet as minimally inflammatory as I can. And so, in general, I don't start people on a low lectin diet, but it depends on the severity of their illness. I may start them on that low lectin diet, if they're willing.

Dr. Wahls: It's always a negotiation between how much change are you willing to do at 100%, then the severity of your disease. Because whatever a dietary change you're going to agree to, I want you to do it 100%, so we can know is this dietary change sufficient or do I have to up the game in some way?

Jennifer: Mm. That's really interesting. And so as far as fibrosis is concerned, is there anything that you're familiar with that could like help as far as vitamins or food or nutrients in general, or is that something that it's more where you are in the disease process?

Dr. Wahls: Well, mostly it's where you in the disease process. There are some things that I would certainly want to think about. Adequate vitamin C, adequate amounts of magnesium. I think those two things. I know cat's claw is sometimes recommended as an additional supplement. Sufficient vitamin E might be recommended. But my caution for folks is nearly every supplement study fails in science. Our nutrition is a very complex interaction, a synergy between all of the components. So you really want to have a maximally nutrient dense diet and some targeted supplements may be useful. I think it may be a circumstance where if you have the economic resources to get a thorough nutritional eval such as a Genova Diagnostic NutrEval to identify do you have any insufficiencies based on your genetics and what you're eating that have to be addressed. That could be definitely very worthwhile, because if you have insufficiencies we absolutely want to get those taken care of for you.

Jennifer: And I want to talk a moment about your definition of nutrient dense, as far as the Wahls protocol is concerned. Because if somebody is not entirely familiar with what just the general diet looks like, what would they anticipate? Because you've got a new book, a revised version coming out. So is there any changes to the protocol? What are the differences now?

Dr. Wahls: So the low lectin version, the Wahls elimination diet, it's clearly spelled out and who would benefit from doing the Wahls elimination diet. So we put that in there. I've put a lot more information about the benefits of fasting in terms of longevity and how that can reset your STEM cells. Which by the way, actually as I think about it, I would probably be very worthwhile for scleroderma because we're trying to get STEM cells for the reparative capacity. So exploring the discussion that I have on fasting in the book would be quite worthwhile.

Dr. Wahls: And then another thing I spend a lot more time on has to do with how we do behavior change, because when we're doing diet and lifestyle change, our brain is too wired to do the stuff that rewards us immediately and avoid things that are uncomfortable. And over thousands and millions of generations, people who did that had greater reproductive success. Which is why it is so hard to do things for future benefit and to forgo pleasure today for future benefit. Which means it is phenomenally difficult for all of us to change our behaviors, to give up sugar, to give up white flour, to give up all those yummy foods that are terrible for us. Give up the processed foods that are really terrible for us. And so I spent a lot more time talking about that and discussing how we can be much more successful as we try to change our behaviors for future benefit.

Jennifer: And with the Wahls protocol, someone should anticipate a lot of vegetables. Do you want to talk about that?

Dr. Wahls: Yes, yes, yes. These radical things known as vegetables. So I love the paleo diet, but I've taken their recommendations, dialed back the meat so we don't have so much mammalian target of rapamycin, and ramped up the vegetables. And so we have the goal is nine cups of vegetables for a guy. Should be no problem. For a tall lady like me, six foot tall should be no problem. For a petite person like you, six cups might be a more reasonable. So there's no need to overeat, but I want that distributed between leafy greens, sulfur containing, so that's a cabbage, onion, mushroom, family, vegetables. And deeply pigmented things like carrots, beets, berries. And I've done that for some very specific reasons on the nutritional benefits, which I go into in more detail. And then I remove foods that are particularly inflammatory, the gluten containing grains, casein, that is the dairy proteins and eggs.

Dr. Wahls: And I provide a structure for people who are vegetarian or vegan for their beliefs. And then I provide a structure for meat eaters and we upped the game with fermented foods and these wonderful superfood known as liver and heart. Tremendously good for us. Oysters, mussels, shellfish, tremendously good for us. And then we talk about who might benefit from ketosis and the many ways you can get yourself into ketosis. It's not just the high fat diet. And I explain how to monitor yourself if you're in ketosis, to be sure that you're tolerating it well and that we've selected the proper fat for you. And then who needs to go on the low lectin version of the diet.

Jennifer: What type of fats are included in your diet? I know that you like more of like pasture raised options if you do eat meat, right? So like tallow.

Dr. Wahls: So my preference is if you're going to cook with the fat, it should be saturated fat. So tallow, lard, duck fat, chicken fat, clarified butter, coconut oil. That's great for cooking. If you're going to use the fat cold, then olive oil. Extra virgin olive oil. Blend it with some fresh green herbs, make yourself a fresh pesto. Drizzle it over everything, lots of it over everything you eat. Fabulously good for you.

Jennifer: What about avocado oil? The rise in avocado oil. Avocado oil's everywhere.

Dr. Wahls: So avocado oil, sesame oil, cold, is fine. I would not cook with it. So what's really very simple is if it's liquid at room temperature, do not cook with it because you'll damage the oil when you heat it and you'll lose a lot of the goodness in that oil. If it is solid at room temperature, it's okay to cook with. So my preference is, and if you want to avoid saturated fat for your health reasons, then roast, bake, steam, boil and pour your olive oil, herb mixture over it after you've cooked it.

Jennifer: That's great. That is an awesome tip. I appreciate that. Everybody listening is probably like, “Yes, we're getting some good food tips for at home.” And it's funny because when you fly, because you're always traveling to lecture, I always catch you on Instagram eating purple cabbage.

Dr. Wahls: Yes! So traveling can be fairly toxic. And so to help my body metabolize the various toxins I'll encounter, I take a head of cabbage with me. And so I slice it in. I'll take a big slice that I'll eat en route, another one that I'll eat on the way back. Then I'll have a few more slices that I can have while I'm at my destination. So maintaining those nine cups of vegetables. So I don't get my nine cups of vegetables, I don't have as much energy. I can tell. And so this just makes traveling so much easier. The other tip that I do is I take a bottle of organ meat capsules with me. So I have my organ meat along the way. I have my cabbage along the way so I can maintain nutrient density.

Dr. Wahls: And then the third tip that I have is I tell my waitstaff that if I get gluten, dairy, or eggs, we'll be calling the ambulance. It's unsafe. So I'd like to know what is safe to eat or should I just have tea while I'm here? Their eyes get big and then they'll have the chef come out and chat with me and then we sort out is there something safe to eat or am I having tea? And because I do periodic fast, skipping a meal, going into a fast, it's not a big deal. Having gluten, dairy, or eggs is a big deal because that turns on my face pain to really incapacitating levels pretty quickly. So it's very important to me to know that my food is clean and if it's not clean, it's not worth risking having my pain turn on. And then I'll just have tea.

Jennifer: So what's most interesting to me with all of this as I'm listening to you talk about different conditions that this protocol can help, is that for someone listening to this, because I get these questions a lot about but I have parapsoriasis or I have nummular eczema or I have … People kind of get stuck in their diagnosis, essentially. What is your thoughts on that when it comes to a protocol like this? Is it like, “Hey, you know you have this but it's okay. This could be helpful if you were to give it a shot for a hundred days.”

Dr. Wahls: What I want your listeners to think about is quit focusing on the disease. Start focusing on I want to create health for my cells. And for me to create health for my cells, that means I need to reduce the oxidative stress, help my mitochondria work well, be sure my cells are flooded with nutrition. And so the Wahls protocol will do that. And as your cells can do the chemistry of life more properly, typically the dysfunction that led to whatever the underlying disease state is, with whatever the skin condition might be, whether it's an autoimmune problem or a degenerative problem will likely begin to calm and self heal.

Dr. Wahls: And I spend a lot of time in my clinics at the VA and my private clinic and my research is what the most important lesson to learn is you want to focus on creating health. And to do that, it's about health behaviors. It is about improving, giving yourselves more of what they need to run the chemistry of life, and to get rid of your body and out of your lifestyle, the types of factors that promote disease. Once you get that aha, now you begin to realize we're treating many of our disease states the same ways as soon as we began to focus on creating health. And I certainly expect that would be very true of your audience as well, Jen. To get them to focus on creating health for their skin and that's about food, meditation, sleep, social bonding, finding people who will support you as opposed to tempt you to make unhealthy choices.

Jennifer: Absolutely. Absolutely. And that's why I was so excited to talk to you and I invited you on the show, because not just are you pursuing research that shows the efficacy of what you're doing, but you're so entrenched. You live this. It's not just a protocol. You are the living, breathing, you do that. And for all of you listening, I have spent many hours, just myself and Dr. Wahls talking, and this is literally how she is. And I have such incredible respect for her. And I was so excited to talk about this new book, which I want to make sure everybody knows the name. It's called The Wahls Protocol, A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principles. I mean, this is a big deal.

Dr. Wahls: This is a big deal. If you look at the health and wellness writers out there, I'm really the only one that does any scientific studies that investigate any of the claims that I make that have validated that the diet actually is nutritionally sound. You can follow it the rest of your life and you aren't going to create any problems. In fact, you'll dramatically improve the quality of your nutrition. And that's a really big deal.

Jennifer: It's huge. It's huge. And I have great respect for that. I mean, I want to do everything that I can to make sure that everyone knows about this new addition in your work. And I am so deeply appreciative to have you here on the show. And perhaps one of these times we can have you come back and dive into some other topics, because I feel like we only had enough time to kind of scratch the surface at this point.

Jennifer: But I just want to thank you so, so much and I want to make sure too that everybody can, you've got like a bunch of different goodies and things like that. Your Instagram is a fantastic way to check you out and to follow you. I love it. And we're going to put all of the links in the show notes for this episode. So it is super easy for everyone to take a look at and access, but if you are thinking like, what's the one book? If you're just going to buy one book around a diet lifestyle change this year, this would be the book.

Dr. Wahls: Yes, for sure. Let's change your life. Get your life back on track.

Jennifer: Yes, absolutely. Well, thank you so much for joining us, Dr. Wahls.

Dr. Wahls: You're very welcome.

“As your cells can do the chemistry of life more properly, typically the dysfunction that led to whatever the underlying disease state is, with whatever the skin condition might be, whether it's an autoimmune problem or a degenerative problem will likely begin to calm and self heal.”