RHR: A Functional Medicine Approach to Multiple Sclerosis and Autoimmune Disease, with Dr. Terry Wahls

Autoimmune disease occurs when the body’s normal immune defenses go awry and, rather than attacking pathogens, attack the body itself. And I believe that the underlying mechanisms for autoimmune disease are similar, regardless of what the condition is or where it manifests in the body. In this episode of Revolution Health Radio, I talk with Functional Medicine practitioner and clinical professor of medicine Terry Wahls about her remarkable journey treating her own progressive multiple sclerosis. Through research, diet, and lifestyle changes, Terry restored her health and has since created the Wahls protocol to help transform the lives of people with autoimmune diseases.

In this episode, we discuss:

• Terry’s background
• The Wahls Protocol for treating multiple sclerosis and autoimmune conditions
• Wahls’ research and clinical trials
• Wahls’ behavior change protocol

Show notes:

[embedded content]

Chris Kresser: Hey, everybody, Chris Kresser here. Welcome to another episode of Revolution Health Radio. This week, I’m really excited to welcome Dr. Terry Wahls back on the show. For those of you who don’t know Dr. Wahls, she is a Functional Medicine practitioner and a clinical professor of medicine at the University of Iowa, where she conducts clinical trials.

In 2018, she was awarded the Institute for Functional Medicine’s Linus Pauling Award for contributions in research, clinical care, and patient advocacy. Dr. Wahls has multiple sclerosis [(MS)], and through her own research and investigation into diet came up with a protocol that allowed her to make an incredible recovery from secondary progressive MS, where she was confined to a tilt recline wheelchair for four years. She restored her health using [a] diet and lifestyle program, now known as the Wahls Protocol, which led to her going from being in a tilt recline wheelchair to riding almost 20 miles on her bike and walking. It’s really quite an inspiring and amazing story. I’ve talked to Dr. Wahls before on the show about the Wahls Protocol, but I wanted to have her back because she has just published a new study that indicates pretty remarkable improvements with the Wahls Protocol for [MS].

Now, even though Terry’s focus is MS, and the studies she’s doing are specifically about MS, I have found as a clinician that the Wahls Protocol can be really transformative for autoimmune disease in general. And that’s because the underlying mechanisms for autoimmune disease are similar, regardless of what the condition is or the ultimate manifestation of that body attacking itself ends up being, whether it’s thyroid, Hashimoto’s [disease], or the joints, rheumatoid arthritis, or the gut, ulcerative colitis or Crohn’s disease, that underlying process of autoimmunity is the same. So this show and Terry’s protocol are relevant to anybody with autoimmunity or immune dysregulation, not just folks with MS.

We’re going to talk a little bit about Terry’s story and background on the Wahls Protocol for those of you [who] are not familiar with it, and then we’ll review some of the research that has already been done, which is really groundbreaking. And then [we’ll discuss] this most recent study that showed incredible effects for the Wahls Protocol and some of the new research that Dr. Wahls is working on that I’m personally really excited about. I really enjoyed this episode, [and] I hope you do, as well. I bring you Dr. Terry Wahls.

Chris Kresser:  Terry, it’s such a pleasure to have you back on the show. I’ve really been looking forward to this.

Terry Wahls:  Oh, great. Thanks so much for having me.

Terry’s Background

Chris Kresser:  I think most of my listeners know who you are and have probably heard you before on this podcast and others, but for those who are newer, can you talk a little bit about your story? How did you come to this moment in time and maybe [give] a brief synopsis, and then we’ll dive into the research.

Terry Wahls:  So I’m going to take you back 20 years ago, [I was] out walking with my wife, a half-mile from home, my left leg grows weak. Dragging it, I hobble home. The neurologist says, “Terry, this could be bad or really, really bad.”

Chris Kresser:  Oh.

Terry Wahls:  Three weeks later, I hear “multiple sclerosis.” Being a professor of medicine, I’m like, “Okay, I’ll treat my disease as aggressively as possible.” Three years later, I hear “tilt recline wheelchair.” I take [unclear] infusions, Tysabri infusions… Nothing helps. I’m too weak to sit up at my desk. The trigeminal neuralgia (that I’ve had getting worse for 27 years) is continuing to get worse. By 2007, I can’t sit up. My trigeminal neuralgia is much more severe. But I’ve been reading the basic science, I’ve discovered ancestral health, I’ve discovered Functional Medicine, and I discover the electrical stimulation of muscles. I integrate all of that stuff and begin implementing that.

It’s astounding. My pain stops. My mental clarity improves. My physical therapist says, “Terry, you’re getting stronger.” And three months later, I’m sitting up at my desk, I’m beginning to walk with a cane, then without a cane. And then I’m able to bike around the block. My kids are crying, my wife is crying, I’m crying. And then, three months later, I do an 18.5-mile bike ride. And once again, everyone’s crying, my kids are crying, my wife’s crying, and I’m crying. And this really changes how I think about disease and health, it changes the way I practice medicine, and it will change the focus of my research. And now I’m on this mission to let the world know that you know what? Diet and lifestyle have a really big impact.

Chris Kresser:  Right. It’s an inspiring story and, of course, I’ve heard it before. But every time I hear it, I still get chills because it really flies in the face of what the conventional idea is behind [MS] and other autoimmune diseases, which basically, it’s a life sentence and there’s nothing much you can do other than take medications and experience a progressive decline in function over time.

Terry Wahls:  We have drugs that are really good at turning off inflammation. So we’re slowing down the time from new diagnosis to secondary progressive when you’re in the wheelchair and things are relentlessly downhill. So instead of being about a 10-year decline, now it’s a 15- to 20-year decline. But the brain atrophy is still occurring, disability is still occurring, [and] fatigue is still very, very difficult to treat. And now we’re finally admitting cognitive decline is very common. People are having to exit the workforce because of fatigue and cognitive decline.

The Wahls Protocol for Treating MS and Autoimmune Conditions

Chris Kresser:  In this process, you created your own protocol, which is what led to this incredible improvement, which is now known as the Wahls Protocol. Can you give us an overview of that since, of course, this is what the research has been based on?

Terry Wahls:  During my own recovery, I had discovered the Paleo diet about 2003. And without a doubt, it slowed my decline but didn’t reverse it. And I was really focused on what to remove. All grain, all dairy, [and] all legumes. But it wasn’t until I started focusing on what to add when I had this long list of micronutrients that my research said were really important to the brain that Functional Medicine said were really important to the brain. And I said, “Well, where are they in the food supply?” And that took some more research. When I first started, Chris, I just had [this] long list of foods that I knew I needed to be eating. But once I started teaching people, I couldn’t just give them a list. I needed to think about how to organize this stuff into quick, easy-to-learn digestible lessons. And that’s where [I] came up with focusing more on what to eat.

So three cups of green leafy vegetables, kale, spinach, chard, three cups of cabbage, onion, mushroom family vegetables, and three cups of deeply pigmented things like beets, carrots, [and] berries. Protein. And while I do have an option for vegetarians and vegans who are committed to that for their spiritual beliefs, my preference is that people eat meat, fish, and liver and heart and organ meats. And I also like to see them have some seaweed, some fermented vegetables, as well.

Chris Kresser:  So you’ve got two books about this, The Wahls Protocol, which introduced this protocol and provides the basis for it, and then The Wahls Protocol Cooking for Life. Today, we’re going to talk a little bit more about the research side. So for folks who need the basics and the details about how to get started with this, I would just refer you to those two excellent books.

If you haven’t heard Dr. Terry Wahls’ story about how she beat progressive MS using Paleo principles and Functional Medicine, you should. In this episode of RHR, I welcome Terry back onto the show to talk about her most recent research and the Wahls Protocol. #chriskresser

Wahls’ Research and Clinical Trials

Chris Kresser:  I want to talk about the research you’ve done so far, maybe, again, a brief update there, like what’s already been done. And then [we’ll discuss] the new study that we’re excited about.

Terry Wahls:  So the sequence is first we had the case report, which was basically my story, [and] then we had a case series. Then we did what’s called a safety and feasibility study. [It was a] small single-arm study with other people with secondary and primary progressive MS, who we asked to do everything that I did, diet, some targeted supplements, meditation, exercise, electrical stimulation of muscles. I wanted to see could they do this complicated regimen and what was the effect? And so people could do it. We radically changed their diets, they added meditation, exercise, and e-stim, and they had a remarkable improvement in quality of life, production, [and] fatigue. [They had] improvement in mood and improvement in verbal and nonverbal reasoning.

And half of these folks, Chris, had improvement, clinically meaningful improvement in walking, which is astounding because with progressive MS, by the time you’re needing a cane [or] walker, we expect a 10 to 20 percent decline every year. So, as a group, we held them flat. So that’s astounding. If you hold [folks with] progressive MS flat, that’s huge, because right now, people are paying about $90,000 a year for medications to try to be held flat, [which] we did with diet and lifestyle.

Chris Kresser:  Right. So a question just for the listeners’ clarity, was that comparing against standard care and were the people in the study taking any medications? How did you approach that?

Terry Wahls:  So this [was] in 2010; there really were no approved drug treatments for secondary or primary progressive MS. So some people were on drugs that they had been on when they had relapsing-remitting MS and continued even though it was not [U.S. Food and Drug Administration] approved. And we asked people to stay on their drugs, make no changes. I know that many of the folks who had improvements stopped their drugs, although we told them please, don’t stop the drugs.

Chris Kresser:  Right.

Terry Wahls:  They did because they were doing so much better.

Chris Kresser:  Yeah.

Terry Wahls:  And it’s a single-arm study. So [we were] just comparing them to baseline.

Chris Kresser:  Right, right.

Terry Wahls:  The next two studies were small pilot, randomized controlled studies, and these were waitlist design. So [they came] in, and [then we were] doing just a small diet study, because [we were] getting some money and people wanted to have simpler studies. So it was a diet-only study. And [they] got in, we randomized, we did all these assessments of walking, thinking, fatigue, quality of life, and then we randomized [them] to either get the intervention or to wait 12 weeks, and then get the intervention. And again, we saw that people would make big changes in their diet and lifestyle. In that, fatigue would go down, quality of life would go up, hand coordination improved, and walking [improved]. Walking for 25 feet didn’t really change because these people [weren’t] as impaired. Walking for six minutes improved slightly, although not clinically significant. But it’s a very brief duration. And then we had more pilot data, and that’s when [we were] able to get the funding from the [National] MS Society to do the study that we just completed and published.

One of the things that we observed, Chris, is when you do a randomized controlled trial for diet, people who are randomized to the diet arm often drop out because if you’ve decided you want to do a diet study, you know you want to do the intervention arm. Therefore, when we proposed this study to the [National] MS Society, we proposed a design that had an observation period and then you measure the patient-reported outcomes, the clinical outcomes at the beginning of the observation period, the end of the observation period. Then you repeat all the assessments and randomize them at that point. Then we train them either in the low saturated fat Swank diet or on the Wahls diet and give them some support while they’re learning these new recipes, new ways of thinking, cooking, [and] preparing their food. Then [we] bring them back in 12 weeks, repeat all the measurements, then with less support, have them continue again for another 12 weeks and bring them in again.

So we had four measurements, two without any interventions and two with interventions. And we saw that if you eat the Standard American Diet, fatigue does not improve, quality of life does not improve, walking endurance, that is how far you can walk in six minutes, does not change. Then we randomized them and we had randomization tables to be sure that people were equally fatigued in the two groups. So both groups were statistically and clinically identical. Our primary outcome was with the fatigue severity scale score, which is a measure of fatigue improved, that is to have less fatigue statistically and clinically do better for the Wahls group, then the Swank group at 12 weeks. Our secondary measures were a more sophisticated fatigue scale called the modified fatigue impact scale. And the patient-reported outcomes on quality of life, physical health, mental health, and walking endurance at 12 weeks and everything at 24 weeks. What we saw was that the Swank and Wahls diet[s] both had reduced fatigue, the fatigue severity scale score at 12 weeks. [The] Swank [group had] slightly greater reductions than [the] Wahls [group]. Statistically and clinically not significantly different.

Now, it is interesting to note, and probably not surprising, that as you went on to 24 weeks, the fatigue reductions continued to further improve. And now [the] Wahls [group] had more fatigue reduction than [the] Swank [group], although again statistically and clinically not different. However, if we look at the quality of life measure, the mental health, physical health, quality of life, the Wahls group [had] significantly clinically and statistically greater improvements than the Swank [group] at 12 weeks and even more so at 24 weeks. That difference, the clinical significance is five points in the Wahls group had either 14 or 17 points for mental health and physical health. And the Swank group did not have significant change for mental health at 12 [weeks], although they did get it finally at 24 weeks. And they had improvement in physical health at 12 [weeks], in 24 weeks, that was clinically significant, not as great as what the Wahls group had.

The walking endurance did not change much at 12 weeks for either group. And I should also note, Chris, that we had put actigraph[s] on people, so we had step counting. We knew how active they were. But we’d also told them don’t add exercise. This is a diet study. We don’t want you to add any new exercise programs. And they didn’t, so we’re not surprised that walking did not change at 12 weeks. It was interesting to see at 24 weeks, walking did improve for the Wahls group. And it was clinically and statistically significant improvements at 24 weeks. And it had a p-value of .08. So it didn’t quite hit a p-value of .05 for a difference between Wahls and Swank. But it was getting close.

Chris Kresser:  So the Swank diet, just for people who are not familiar, is basically a low-fat, no red meat, skinless poultry, low-fat dairy, whole grain type of diet, correct? Kind of like the circa 1985, 1990, 1995 American Heart Association diet. Yeah. Okay.

Terry Wahls:  I want to make a couple more comments, though.

Chris Kresser:  Please.

Terry Wahls:  We improved the Swank diet by doing the Swank.org diet, which had been influenced by my work. And so they were now saying in addition to having less than 15 grams of saturated fat, we want you to have four servings of vegetables. We told them, please have four servings of vegetables. So people did increase their vegetable intake. We also said [to] have four servings of whole grains. So they increased their fiber. And they [had] chicken breast, turkey breast, and whitefish for their protein sources. Very little fat overall.

Chris Kresser:  Were there any qualitative differences or subjective differences in terms of people[’s] feelings about the diets?

Terry Wahls:  Well, actually, this was pretty interesting. Swank [was] the first neurologist who said diet matters. And he said that in the 1960s. [In] the 1980s, he wrote his book, I think it was in ‘85, The Swank Diet. And he was the only one saying diet matters. And [of] the patients he followed, 250, he lost about half of them. He had 144 he followed for 50 years. And the people who stayed on his diet were more likely to still be walking, still working, and had lower all-cause mortality. So [it’s] interesting stuff. And I think, by telling them [to eat] more vegetables, more whole grains, we improved the quality of his diet. And the Swank.org people certainly improved on his diet, which is great.

But since his diet was the only diet available until my book came out in 2014, in the people who wanted to do [the] diet, he had a big following. And when people came to enroll in our study, [they] had to be willing to be randomized to either one. So we had an equal number of folks who said, “Well, I don’t want the Wahls diet; I only want Swank.” So they refused to be randomized. We had an equal number saying, “I don’t want the Swank diet; I just want the Wahls diet.” So actually, I felt pretty good about that, that there was an equal level of enthusiasm for the two diets.

Chris Kresser:  Yeah, I think part of the message here, too, and I often bring this up, is it really depends [on] what the starting place was. If someone is going from a Standard American Diet with highly processed refined food, lots of flour, sugar, etc., and they move to the Swank diet, or the American Heart [Association] diet, or even a vegetarian or vegan diet for some period of time, they’re often going to improve just from what they’re removing from their diet than what they’re adding.

Terry Wahls:  Absolutely.

Chris Kresser:  My bias is they’ll probably get more benefit from something like the Wahls Protocol over time, and I think this recent research bears that out. But I think a lot of people get confused when they see that someone improves with a vegan or vegetarian diet or a Swank diet. It’s obvious to me why that would happen if they’re coming from a Standard American Diet.

Terry Wahls:  Oh, absolutely. We have another project that we’re doing right now, which is a meta-analysis of all the diet studies. And so when we [have] that paper out, Chris, I’ll call you so we can talk about that because that will be a very interesting discussion of this observation. Okay, so we have a lot of diet studies out there. What’s the effect size of the various interventions? And which interventions are most helpful?

Very few people who do diet studies have dieticians on the team. And so they often don’t ask the question of what was the diet like beforehand? What is the diet like now? How did the nutrient intake change? So we have the 17 or maybe 43 vitamins, minerals, essential fats that we’ve said we have to have in the diet. But there are hundreds of compounds that we now measure in our dietary software. And there are 50,000, maybe 200,000, known dietary compounds that interact with our physiology. So if you’re going to do a dietary study, in addition to analyzing the clinical outcomes, I think you ought to also be analyzing the food. How did the food change? And how did all those dietary chemicals change? The 17, where we have [Recommended Dietary Allowances], the 43 that we’ve identified as important, and the hundreds that we have in our database. How did that change? And how does that correlate with changes in our physiology? And I’ll let you know when I have those papers out because we’ll be analyzing [those] data, as well.

Chris Kresser:  Yeah, that’s fascinating. So [it seems to me that] one of the challenges that there has been with that is quantifying all of that. So are you talking about measuring food and food intake? Are you talking about measuring the impact of food on serum markers of nutrient status, or metabolomics, or some of the newer technologies that are available?

Terry Wahls:  The vast majority of folks doing dietary research just measure some clinical outcomes, [as] they might have clinical outcomes, patient-reported outcomes. They don’t bother with anything nutritionally. We had people keep track of what they ate, do weight and food records. So we analyzed [those] data in the nutrition data software. We have a paper that’s coming out now that just looks at those 17 key nutritional elements. So we’ll say: what are the dietary risks? And then we can go back and look at the database where we have hundreds of the dietary chemicals. And we can look at how does that change and what are the relationships between those chemicals and clinical outcomes? That’ll be really interesting.

Chris Kresser:  Right. I agree.

Terry Wahls:  Then the next thing that we have is a freezer full of frozen serum and frozen plasma. And we are also writing grants so that we can analyze the metabolomic change. And we could analyze how that changed, also, because we have a freezer full of, should I say the word poop?

Chris Kresser:  You can. Yeah, we talk about poop all the time on this podcast.

Terry Wahls:  Yeah. So we have a freezer of poop, as well. So how did the poop change?

Chris Kresser:  Yeah, fascinating. I’m excited about that. Because with all the new sequencing technologies, metabolomics, and we know from a lot of great research now that there’s so much more than just the essential compounds. And you mentioned the kind[s] of levels of the 17 essentials and the next layer out and the next layer out from there. And there’s so much going on there that I think we’re just scratching the surface in terms of our understanding of it. I’m excited to see how artificial intelligence and other things that are happening will help us make sense of all this in the future.

Terry Wahls:  Yeah, I think about this in terms of I have my genetic information, I have my epigenetics, then I have all the food and all the microbiome, and all of the compounds I’ve been exposed to, and all the biological interactions follow that. And, of course, that’s huge, big, big data to analyze. So you need bioinformatics people to help you make sense of all of that.

Wahls’ Behavior Change Protocol

Chris Kresser:  Yeah. You mentioned earlier that you have a process for helping people adopt the diet in the study protocols. Because obviously, this is a really big change for a lot of folks, especially if they’re coming from a Standard American Diet. It’s not often as simple as just saying, “Hey, here’s the handout that describes the diet. Good luck with that. See [you] in a few weeks.” I know you have the Wahls behavior change protocol. What are you layering in there?

Terry Wahls:  Well, knowing is not the same as doing. And we acknowledge that people have to have a reason to want to do this work and that it is going to be worked to create these new habits, extinguish old habits, and learn new things. So we go through a process of inspiration [and] hope. My story and our case reports are part of that and teaching the mechanisms by which some of these things can work. So we teach that during the intake. And then we also ask, “What do you want your health for? Why do you want to be doing this? And so when things get a little difficult, what would keep you inspired?” And a very telling question that we have is, “Is there something or someone that you care so deeply about? If [they were] in a house that was beginning to be on fire, that you had to run into the house to save without thinking, and tell us who that is or what that is. And now, can we relate your decision to work on being part of this study, to being more effective with that person?” And if we can create that relationship in their mind, then they’re going to be much more interested in [and] willing to do this work.

Chris Kresser:  Yeah, I love that it’s right out. We talk a lot about motivational interviewing and finding the motivation for change in our [ADAPT] Health Coach Training Program. And so many years now of research show how crucial that is for people actually being able to stick with it. Another question that I get a lot as a practitioner is, “Where are the practitioners?” Because I often have a long waitlist, and we can’t see as many people as we would like to, and like you, I have a practitioner training program. We’ve trained almost 600 people, now from 22 countries. And that’s great, but it’s still a drop in the bucket. Right?

I know you’re working on this. How can people find someone? There’s a lot. Your books are so great, and I know a lot of people are out there doing the Wahls Protocol on their own. And then there’s also a group of people who want that extra help. So what can they do?

Terry Wahls:  We have a couple of options. One is that we’ve created a consumer course, the Autoimmune Intervention Mastery Course. That’s online, [and] we have people accessing that from all over the globe. And then to help people be more effective going through that, several times a year, I run the coaching program where I am once a week answering their questions and talking through that. So they get seven weeks of those coaching calls. That’s been really helpful. And then for people who want a more intimate, really small group conversation, then we have the Radical Health Upgrade. And again, a couple [of] times a year, I’ll take a handful of people through that. And that’s a 12-week program.

We have created online virtual training for practitioners that [is a] series of online modules and lessons, and they have virtual interactions via Zoom as we are now. And for my practitioners, we have monthly support calls where people can submit questions, we discuss cases, and we have guest lecturers come talk to them. I’m thinking, Chris, I should have you come talk to my practitioners.

Chris Kresser:  That’d be great.

Terry Wahls:  They would certainly love that, as well. And I’d be happy, if you have to have something somewhere, I’d be happy to chat with your people, as well.

Chris Kresser:  And then you have this event coming up, right?

Terry Wahls:  Oh, yeah.

Chris Kresser:  Amplify. I think that’s in mid-October. [Note: this event date has passed, but recordings can still be purchased on the Amplify website.]

Terry Wahls:  October 16th.

Chris Kresser:  A virtual event. Tell us a little bit about that.

Terry Wahls:  Well, I’ll give a couple of talks. A really great talk I have on neurodegeneration, neuroinflammation, and then I’m going to give people an update on the ACTRIMS research presentations on MS. Then we’ll have a really wonderful talk from Ken Sharlin on [amyotrophic lateral sclerosis], Dale Bredesen on Alzheimer’s cognitive decline. Garrett Salpeter is going to talk about electrical stimulation and neuromuscular reeducation and how his program has been able to really help people reconnect their brain and their muscles, even though they may have really severe progressive MS. He has some amazing stories. Because I had a profound level of disability, electrostimulation of muscles [had] a huge impact on my recovery. So I’m very excited that we’ll have Garrett there talking about how to use that e-stim to accelerate recovery.

Chris Kresser:  Great. And that’s for practitioners and health professionals, right? That event?

Terry Wahls:  Yes, yes, yes. Absolutely.

Chris Kresser:  Okay. [I] just want[ed] to clarify that. Well, awesome, Terry. It’s always so fun to talk to you and hear about what you’re up to. You’re a force of nature, [with] all the various things that you’re doing to move this forward, and really, I think provide hope to people who have this diagnosis. That’s what it’s really about, right? There’s a light at the end of the tunnel now, whereas I think before, there wasn’t as much to be hopeful for.

Terry Wahls:  It was very grim.

Chris Kresser:  I think that’s an amazing gift that you provide people, so thank you.

Terry Wahls:  In 2007, the future that was staring at me, Chris, was bedridden, demented, intractable pain for my trigeminal neuralgia. And I’m just so grateful that I can bike, I can hike, I can, when I used to be able to travel like everyone else, travel the world, and inspire others. Let them know that we can reverse really significant disabilities with Functional Medicine, ancestral health, and some of these aggressive rehab techniques. And I’ve made it my mission to make it possible for the public to access these concepts, and for clinicians who want to learn these concepts, so we can train them, as well.

Chris Kresser:  Cool. Yeah, I am excited about that. Because I’ve already seen the impact of this with so many, the rising rates of autoimmune disease in general. And I’m so glad to be able to refer people to this. We actually [are in the process of doing] a seven-week workshop on healing autoimmune disease naturally with Functional Medicine and, of course, the Wahls Protocol was one of the dietary approaches we included in there. So I’m happy to be able to share it and pass it on because it’s such a great approach. And I’ve had so many of my own patients that we’ve recommended it to that have done so well on it. So thank you again for doing all the work that you do and sharing this with us. [I] definitely would love to have you back when you have that [systematic] review on all of the diet studies. It would be fascinating.

Terry Wahls:  Yeah, that will be a very interesting conversation.

Chris Kresser:  All right, Terry. We’ve talked about some of the resources you’ve got. Where’s the best place for someone to find out about all of this stuff?

Terry Wahls:  Go to TerryWahls.com. There, you can find the consumer courses, [and] you can find the practitioner courses. We’d love to support you in your healing journey.

Chris Kresser:  Great. Well, I miss seeing you at the in-person conferences. We don’t have any more at this point. So hopefully, that will become a thing again, and we’ll see each other at some point at one of those.

Terry Wahls:  That will be wonderful.

Chris Kresser:  All right, take care, Terry. Thanks again. Thank you, everyone, for listening. Please send your questions to ChrisKresser.com/podcastquestion, and we’ll talk to you next time.