By Dr. Yoon Hang Kim, MD, MPH | Board Certified in Preventive Medicine | Integrative, Functional, and Lifestyle Medicine Physician & LDN Expert

Few stories in the world of integrative medicine illustrate the power of a root cause approach more vividly than that of Dr. Terry Wahls. A board-certified internal medicine physician and clinical professor at the University of Iowa, Dr. Wahls was diagnosed with relapsing-remitting multiple sclerosis (MS) in 2000, progressed to secondary progressive MS within a few years, and by 2003–2004 was confined to a tilt-recline wheelchair despite receiving the best conventional disease-modifying therapies available. Her neurologists told her that functions lost in the progressive phase were unlikely to return.

And yet, within roughly a year of implementing an intensive, self-designed protocol grounded in functional medicine principles, she went from wheelchair-dependent to riding her bicycle for miles—a result that conventional neurology would have considered essentially impossible.

Her story deserves careful attention, not because a single case proves a treatment works, but because it raises questions that every clinician practicing root cause medicine should be asking.

The Limits of Conventional MS Management

Multiple sclerosis is a chronic autoimmune and neurodegenerative disease in which the immune system attacks the myelin sheath surrounding neurons in the central nervous system. Standard disease-modifying therapies—interferons, glatiramer acetate, monoclonal antibodies, and sphingosine-1-phosphate receptor modulators—are designed primarily to reduce relapse rates and slow the accumulation of new inflammatory lesions on MRI. They do this with varying degrees of success.

What these therapies generally do not do, however, is address the broader metabolic and environmental milieu in which the disease operates. They do not restore mitochondrial function in damaged neurons. They do not repair the microbiome. They do not replenish the micronutrient deficiencies that are increasingly recognized in autoimmune populations. And in secondary progressive MS, where neurodegeneration outpaces inflammation as the primary driver of disability, conventional therapies have historically offered limited benefit.

Dr. Wahls experienced this firsthand. She was not undertreated. She was receiving care from top academic neurologists. And she was still declining.

The Functional Medicine Pivot

What distinguishes Dr. Wahls’ approach—and what makes her story so relevant to those of us practicing functional medicine and integrative medicine—is that she did not simply add another pharmaceutical to the stack. She reframed the entire question.

Rather than asking, “What drug can slow this disease?” she asked, “What does my brain and my mitochondria actually need to function, and how do I deliver it?”

This is the quintessential root cause medicine question. It shifts the clinical lens from suppressing downstream pathology to supporting upstream physiology.

Her initial forays into this territory involved supplementation—B vitamins, coenzyme Q10, alpha-lipoic acid, omega-3 fatty acids, and other nutrients with demonstrated roles in mitochondrial bioenergetics and neuroprotection. This slowed the decline modestly, but she remained severely disabled. The breakthrough came when she translated that supplement list into a food prescription, asking which whole foods could deliver the same nutrient density in a bioavailable, synergistic matrix.

The result was what we now know as the Wahls Protocol.

Inside the Wahls Protocol: A Systems-Based Intervention

The Wahls Protocol is not a single-variable intervention. It is a multicomponent, systems-based program that reflects the core principles of functional medicine: identify and address the root causes of dysfunction across interconnected physiological systems.

Nutrient-Dense, Anti-Inflammatory Nutrition. The dietary framework emphasizes a high intake of non-starchy vegetables and fruits—often described as nine cups per day—with specific emphasis on three categories: leafy greens for minerals and vitamins, sulfur-rich vegetables (cruciferous vegetables, alliums, mushrooms) for detoxification and glutathione support, and deeply pigmented produce for polyphenols and antioxidants. Protein comes primarily from high-quality animal sources, including organ meats for their exceptional micronutrient density, along with wild-caught fish for omega-3 fatty acids. Seaweed provides iodine and trace minerals; fermented foods support gut microbial diversity.

At the elimination level, the protocol removes gluten and dairy—two of the most commonly implicated triggers in autoimmune conditions. In its more advanced tiers (Wahls Paleo and Wahls Paleo Plus), the protocol further removes grains and legumes and can incorporate ketogenic macronutrient ratios, reflecting emerging interest in ketone bodies as an alternative mitochondrial fuel source in neurodegenerative disease.

For those of us working in integrative medicine, this dietary framework should sound familiar. It is fundamentally an elimination diet built on ancestral nutrition principles, optimized for mitochondrial support and immune modulation—exactly the type of intervention that root cause medicine would predict should be beneficial in a condition driven by immune dysregulation and mitochondrial failure.

Neuromuscular Electrical Stimulation (E-Stim). One of the less-discussed but potentially critical components of Dr. Wahls’ recovery is her consistent use of electrical muscle stimulation. She began using e-stim on atrophied trunk and leg muscles while still wheelchair-bound, and she has described it as a “large part” of her recovery. The rationale is straightforward: neuromuscular electrical stimulation can activate motor units that voluntary effort can no longer reach, maintain or rebuild muscle mass in the setting of disuse atrophy, and leverage neuroplasticity to reestablish functional motor pathways.

This is an important point for clinicians to note. Nutritional and metabolic optimization may create the conditions for neural repair, but without active neuromuscular rehabilitation, the functional gains may not materialize. The combination matters.

Lifestyle Medicine. The protocol also incorporates structured exercise and physical therapy (progressed as function returns), sleep optimization, stress management, and reduction of environmental toxin exposures. These elements are entirely consistent with a systems-biology approach to chronic disease and reflect what the integrative medicine community has long recognized: that complex chronic illness cannot be adequately addressed by targeting a single pathway.

What This Means for Clinicians Practicing Root Cause Medicine

Dr. Wahls’ story is compelling, but I want to be clear about what it does and does not demonstrate.

A single case—even a dramatic one—does not prove that the Wahls Protocol modifies the disease course of MS in a generalizable way. Dr. Wahls herself would acknowledge this. She was a highly motivated physician-scientist with the knowledge, resources, and determination to design and implement an extraordinarily intensive program. Individual variability in disease course, genetics, microbiome composition, and adherence all play significant roles.

What her case does demonstrate, and what her subsequent research program at the University of Iowa is beginning to substantiate with controlled trials, is that intensive nutritional and lifestyle interventions can meaningfully improve fatigue, quality of life, and functional outcomes in people with MS. Her research group is now investigating the mechanistic underpinnings of these effects through gene expression analysis, metabolomics, and microbiome profiling.

More broadly, her work validates a principle that those of us in functional medicine have observed repeatedly across conditions: when you supply the body with what it needs and remove what is harming it, the capacity for recovery can exceed what conventional prognostic models would predict.

This is not anti-conventional medicine. This is medicine that asks a wider set of questions.

Relevance Beyond MS

While the Wahls Protocol was developed in the context of MS, the underlying principles—mitochondrial support, anti-inflammatory nutrition, gut health optimization, neuromuscular rehabilitation, and comprehensive lifestyle modification—are broadly applicable across the spectrum of autoimmune, neurodegenerative, and complex chronic diseases that functional medicine practitioners encounter daily.

In my own practice, I see similar dynamics in patients with conditions ranging from autoimmune thyroiditis to chronic fatigue to neuropathy. The specific protocol varies, but the framework is consistent: identify the root causes, support the terrain, remove the obstacles to healing, and give the body the tools it needs to repair.

Dr. Wahls’ contribution is that she put herself through this process in the most visible and well-documented way imaginable, and she then had the scientific rigor to formalize it into a research program. For that, the integrative medicine and functional medicine communities owe her a significant debt.

The Bottom Line

Dr. Terry Wahls’ journey from wheelchair-bound MS patient to bicycle-riding clinical researcher is a powerful illustration of what becomes possible when we move beyond symptom suppression and embrace root cause medicine. Her protocol—intensive nutrition, neuromuscular rehabilitation, and comprehensive lifestyle modification—reflects the systems-based thinking that defines functional medicine and integrative medicine at their best.

It is not a cure-all. It is not easy. And it requires the kind of sustained commitment that many patients will need significant support to maintain. But it represents a direction of inquiry that conventional neurology has historically overlooked, and the growing body of clinical trial data from her lab suggests that this direction is well worth pursuing.

For patients with MS and other complex chronic conditions, the message is one of informed hope: the body’s capacity for repair may be greater than we have been taught to believe, provided we give it what it needs.

Dr. Yoon Hang Kim is Board Certified in Preventive Medicine and an Integrative, Functional, and Lifestyle Medicine Physician & LDN Expert specializing in root cause approaches to complex chronic conditions. He operates Direct Integrative Care, a membership-based telemedicine practice. Learn more at www.directintegrativecare.com.