博主按：据说这是主要靠严格的饮食疗法治愈多发性硬化症的唯一病例。病人自身是美国爱荷华大学医学院的医学博士，一位女士。这应该是宝贵的资料，所以我把她的文章转贴一下。

The Seventy Percent Solution
Terry L. Wahls, MD
University of Iowa Carver College of Medicine, Iowa City VA Medical Center, Iowa City, IA, USA.
KEY WORDS: secondary progressive multiple sclerosis; recovery;
nutrition.
J Gen Intern Med
DOI: 10.1007/s11606-010-1631-3
© Society of General Internal Medicine 2011
I loved practicing Tae Kwon Do. The forms are precise, crisp
like an elegant dance. But I most especially loved the thrill
of sparring. Stepping into the ring, ducking, dodging, kicking,
and flying in spinning tornado kicks; I loved the surge of
adrenaline that came with the controlled combat of tournaments.
I competed nationally, even winning a bronze medal in
the trials for the Pan American Games.
But that was a long time ago. A lot has happened since
then—medical school, an internal medicine residency, a son,
a daughter. I became an academic general internist, and I
developed a chronic disease.
Like many with an autoimmune disease, my troubles had
begun two decades before the diagnosis: loss of stamina and
strength, problems with balance, bouts of horrific facial pain,
dips in visual acuity. When I developed the foot drop, the
diagnosis was made: multiple sclerosis (MS).
What caused my immune cells to begin their assault on my
brain?Mydoctor said that genetics accounted for only 10 to30%of
the risk ofMS; the rest was due to some combination of unknown
environmental factors.He never toldmewhat I could do to address
those unknown factors, only offering interferon and copolymer-1
to reduce the risk of relapse. He said that fewer relapses would
mean less disability, a greater chance that I’d still be walking,
working, and living my life as I once knew it ten years later.
I started the injections right away. Over the next four years
I had only one relapse—a transient weakness of the right arm.
Still, I grew steadily weaker, losing more and more function
and activity tolerance. Jogging left me first. Then, standing for
any time became difficult. Ultimately, despite my use of the
most current pharmacotherapies, walking and even sitting
was tiring, so I needed a tilt-recline wheelchair. It was
increasingly apparent that, with time, becoming bedridden
due to my illness was inevitable. I was at a crossroads.
***
Physician self-experimentation, driven either by passionate
belief in our ideas or refusal to go quietly to our demise, has
occurred for centuries. I had only two options: accommodation
and acceptance of deepening disability despite optimal treatment,
or increased involvement in my own health care.
Though I had once been a fighter, I was now exhausted. Still,
I wanted to walk—even a few steps—as long as I could. I began
my own study of the literature, reading article after article on
PubMed, knowing that the seeds for today’s clinical care were
laid years, sometimes decades earlier in the basic science
literature. I hoped to find a magic bullet that would halt my
worsening disability.
At first, I looked for recent articles testing new MS drugs in
animal models. Eventually, realizing I could not access those
drugs unless I was in a clinical trial, I turned to articles
concerning neurodegeneration of all types—dementia, Parkinson’s
disease, Huntington’s, and Lou Gehrig’s disease. Convinced
that mitochondrial failure drove much of MS-related
disability, I immersed myself in this literature over the next
four years, gradually relearning much of what I had forgotten
in my basic science years: cellular physiology, biochemistry,
and neurophysiology.
I found basic science articles testing various nutrients to
slow animal models of neurodegeneration, so I translated
mouse-sized doses to human ones and began my selfexperimentation
with B vitamins, omega-3 fatty acids, alpha
lipoic acid, coenzyme Q, and L-carnitine. I slowly added more
vitamins and supplements to my list of brain nutrients. The
rate of my decline slowed and I was grateful. However, although
my decline had slowed, I was still declining. My disease was
reclassified as secondary progressive MS, meaning there were
no FDA-approved treatments capable of restoring my lost
function. Walking became more difficult. Even taking a few
steps using two canes exhausted me.
Then in the summer of 2007, another metamorphosis
began. Reviewing a study protocol for the University of Iowa’s
Institutional Review Board, I learned about neuromuscular
electrical stimulation and wondered if it might help me. I
searched PubMed, finding 212 articles—three involving cerebral
palsy, two involving stroke, the rest involving athletes, but
nothing involving MS.
Still, I wondered whether neuromuscular electrical stimulation
might allow me to walk for another year or two. I
asked my physical therapist to let me have a test session. He
told me that e-stim (as he called it) was not an approved
treatment for MS—that it was painful, exhausted most
athletes, and that while it could grow muscle, there was no
guarantee that my brain could to talk to these new muscles.
This potentially dead and useless muscle weight might make
the small amount of walking that I could still do even more
difficult.
But he did let me have a test session. He was right. It did
hurt. A lot. But to my surprise, when I was finished, I was not
exhausted. In fact, probably because of all of the endorphins
released by the e-stim, I felt the best I’d felt in years. My
therapist implemented a program of e-stim coupled with daily
exercise.
At the same time that I began e-stim, I had an important
epiphany. What about nutrition? Was I getting all the micronutrients
that my brain needed? I returned to the literature.
Bourre’s1,2 review on the impact of micronutrients on brain
function and structure led me to add sulfur amino acids, kelp
(iodine), resveratrol (flavonoids), and vitamin D to my daily
regimen. As good as the article was, it did not list all of the
building blocks needed for optimal brain health. I decided to
think more critically about food. If I ate more foods that
contained the vitamins, minerals, and essential fatty acids that
I was taking in pill form each day, I might get important
building blocks that had not yet been identified.
Identifying the food sources for those critical nutrients was
not easy. The medical literature didn’t have that information,
nor did the registered dieticians with whom I consulted, nor did
I see it in the food science literature. I turned eventually to
Google, which did help me, nutrient by nutrient, to understand
where various micronutrients I was taking by pill each day
were located in the food supply. My new diet was nine cups of
vegetables and fruit each day, grass-fed meat, and wild fish.
Determined to optimize everything I could to help my brain
heal, I next looked more deeply at the environmental factors
associated with poorly explained neurological and psychological
symptoms. Two stood out: food allergies and toxic load.
Food allergies can cause a myriad of neurological and
psychological symptoms, typically without any abdominal
complaints, decades before diagnosis and are very difficult to
identify. My best option was to eliminate the most common
offenders: gluten, dairy, and eggs.
I also learned about toxic load—increased mercury stores in
the brains of people with dental fillings, high levels of the
herbicide atrazine in private wells in Iowa, the strong
association between pesticide exposure and neurodegeneration,
the association of single nucleotide polymorphisms
involving metabolism of sulfur and or B vitamins, and
inefficient clearing of toxins3,4. Having grown up on an Iowa
farm—with exposure to plenty of pesticides and herbicides, a
mouthful of mercury, and tens of thousands of toxic chemicals
registered with the Environmental Protection Agency—I knew
there was not one single test to determine which, if any, toxins
were being stored in my fat and in my brain. Deciding my best
option was to improve my ability to excrete toxins,5,6 I added
already-methylated folate and B12, more sulfur amino acids,
and fiber to my regimen.
***
Physician self-experimentation sometimes does not go as
anticipated. I had wanted to only slow my descent; I had no
hope of recovery. The unthinkable—the unimaginable—happened,
stunning me, my family, and my physicians.
Two months after starting my e-stim and intensive nutrition,
I could again sit in a standard desk chair without being
exhausted—for the first time in years. At three months, I could
walk between exam rooms in the clinic. At five months, I could
walk to the clinic, and at seven months, I could bicycle around
the block. A year after starting e-stim and intensive nutrition, I
was able to bicycle 18 miles, and the following year I rode a
horse on a trail ride in the Canadian Rockies.
As a result, I’ve changed how I practice medicine. Now I
focus on teaching my patients how to optimize their nutrition,
reduce their toxic load, and reduce their risk of food allergies—
often seeing their blood sugars improve, blood pressures fall,
and angina resolve.
Three years into my healing, I am again experimenting. This
time, it is a real experiment, with an IRB-approved protocol. I
am testing my interventions in others with secondary progressive
MS. So far, our results are promising.
In Science in 2002, Willett7 noted that 70 to 90% of the
risk for diabetes, heart disease, cancer, and autoimmunity is
due to environmental factors. The genes do not drive most
chronic diseases. It is the environment. It is time we stop
blaming our genes and focus on the 70% under the
individual’s control. That is the real solution to the health
care crisis.
Corresponding Author: Terry L. Wahls, MD; University of Iowa
Carver College of Medicine, Iowa City VA Medical Center, 601
Highway 6 West, Iowa City, IA 52246, USA (e-mail: Terry.Wahls@va.
gov).
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