Terry Wahls: Life and Career

Terry L. Wahls, MD, MBA, is an American internal-medicine physician and clinical professor of medicine at the University of Iowa Carver College of Medicine who spent many years as a physician at the Iowa City Veterans Affairs (VA) health system. She has secondary progressive multiple sclerosis (MS), and she built a diet and lifestyle program — the Wahls Protocol — that she credits with her own recovery and that she later tested in clinical trials.

This page follows her life and career in plain language: a farm childhood in northeast Iowa, a fine-arts degree in painting, medical school and two residencies, general internal medicine in Wisconsin, a business degree, the Iowa City VA and the University of Iowa, and a decade of health-services and patient-safety research. It then sets out her own multiple sclerosis course exactly as she has published it — the diagnosis in 2000, the decline into a tilt-recline wheelchair, the start of the Wahls Protocol in December 2007 and the recovery she describes — followed by the 2009 case report, her 2011 TEDx talk and the research program that grew out of it. The diet itself, the books and the trials each have their own page, linked under Connections.

Table of Contents

  1. An Iowa Farm Childhood and a Painter’s Degree
  2. Medical School and Two Residencies
  3. General Internal Medicine in Wisconsin
  4. A Business Degree and the Return to Iowa City
  5. Health-Services and Patient-Safety Research
  6. Multiple Sclerosis Diagnosis and Decline, 2000–2007
  7. December 2007 and the Recovery She Describes
  8. The 2009 Case Report and the 2011 Essay
  9. The TEDx Talk and Her Research Program
  10. Teaching and Research at the University of Iowa
  11. Key Research Papers
  12. Connections
  13. Featured Videos

1. An Iowa Farm Childhood and a Painter’s Degree

On her own website Terry Wahls describes herself as a fifth-generation Iowan who grew up on a farm in northeast Iowa. Her school district later inducted her into its Hall of Fame (1987), and that entry records a pre-medicine course at Iowa State University among her early studies.

Her first degree was not in science. She earned a Bachelor of Fine Arts at Drake University in Des Moines in 1976, in studio art. In her own words she “graduated with a bachelor’s degree in fine arts with a focus on painting.” She then turned to medicine, a path that took her back to the University of Iowa.

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2. Medical School and Two Residencies

Wahls received her Doctor of Medicine (MD) degree from the University of Iowa College of Medicine in 1982. Her postgraduate training, as she described it in an interview with the Student Doctor Network and as her Hall of Fame entry records, began with a residency in obstetrics and gynecology at Barnes Hospital, Washington University, in St. Louis. She then moved to a residency in internal medicine at the University of Iowa Hospitals and Clinics.

Asked why she settled on internal medicine, she answered: “It allowed me to have ongoing relationships with my patients, which I find very satisfying.” Internal medicine — the adult primary-care and hospital specialty — remained her field for the rest of her career, and she still teaches it today.

Her active medical career is usually dated from that 1982 degree: continuous clinical practice through her residencies, a large multispecialty clinic, the VA and the university, running for more than four decades.

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3. General Internal Medicine in Wisconsin

By the early 1990s Wahls was a general internist at Marshfield Clinic, a large multispecialty clinic in Wisconsin. Her published papers from those years carry the clinic’s Department of Internal Medicine as her affiliation. The exact years she spent there are not documented in the sources used for this page.

Her writing in this period was about the practice of medicine itself. In 1989 she co-wrote an essay on short-term medical service in the developing world. In 1991 she and two colleagues published a study of practice trends among general-internal-medicine departments in large multispecialty clinics, and in 1993 a survey of what made internists in those departments satisfied or dissatisfied with their practice. These are early signs of an interest that ran through her later career: how clinics are organised, and how that organisation shapes the care patients receive.

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4. A Business Degree and the Return to Iowa City

Wahls has been on the University of Iowa faculty since 2000, according to her own website, and her work in Iowa City centred on the Iowa City VA Medical Center. Her papers from 2004 to 2009 list the VA’s Medical Service as her affiliation. In 2001 she completed a Master of Business Administration (MBA) at the University of St. Thomas in Minnesota — the reason the University of Iowa lab page now gives her name as “Terry Wahls, MD, MBA”.

In 2000 she published “The master clinician project,” a paper on improving clinical practice, written from the University of Iowa. Her 2004 study, written from the VA’s Medical Service, compared ways of predicting how much care a VA primary-care population would use, one method based on diagnoses and one on medications.

Her later VA role, in her own description, was “director of the Extended Care and Rehab Service Line at the Veteran Affairs Iowa City Health Care System,” and her papers from 2017 to 2021 list that service line as her affiliation.

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5. Health-Services and Patient-Safety Research

Before multiple sclerosis research became her focus, Wahls built a body of work on a specific patient-safety problem: abnormal test results that nobody acts on. Working inside the VA’s highly computerised health system, she and her co-authors studied how often that happened and what it cost patients.

In 2006 she also co-wrote a pilot survey of primary-care clinicians on the barriers they faced in managing obesity. This health-services background — measuring outcomes, studying systems, writing them up for peer review — is the toolkit she later brought to her own diet research.

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6. Multiple Sclerosis Diagnosis and Decline, 2000–2007

Wahls has told her own medical story in her books, on her website and in her papers. What follows is her account, as she has published it.

She writes that she was diagnosed with relapsing-remitting multiple sclerosis in 2000 — the same year she joined the University of Iowa faculty. In the Student Doctor Network interview she put it this way: “After 20 years of clinical practice, I was diagnosed with progressive multiple sclerosis.” On her website she states: “By 2003, I had transitioned to secondary progressive multiple sclerosis.”

Secondary progressive multiple sclerosis is the stage in which, after years of relapses and recoveries, disability builds steadily. Wahls writes that she underwent chemotherapy to try to slow the disease. Weakness in her back muscles, she reports, meant that she used a tilt-recline wheelchair for four years; the University of Iowa lab page likewise says the disease “confined her to a tilt-recline wheelchair for four years.”

In 2008 she published three short personal essays in general medical journals — “Telling the world” in the Annals of Internal Medicine, “A daughter’s duty” in the Journal of General Internal Medicine and “The primer never written” in the American Journal of Medicine. They are listed below under Key Research Papers for readers who wish to read them in full.

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7. December 2007 and the Recovery She Describes

The turning point, in Wahls’s account, came at the end of 2007. “In December 2007, I began the Wahls Protocol®,” she writes on her website. The University of Iowa lab page describes her as having restored her health “using a diet and lifestyle program she designed specifically for her brain.”

The catalogue description of her 2014 book The Wahls Protocol summarises the program as a diet combined “with neuromuscular stimulation and gradual exercise”: food chosen for the nutrients she believed her brain cells needed, electrical stimulation of weakened muscles, and a slowly increasing exercise routine. Her research team’s 2019 paper dates the diet itself as “originally developed in 2008” by her, drawing on the principles of the Paleolithic diet and her own review of the scientific literature.

The result, as she reports it: “Within a year, I was able to walk through the hospital without a cane and even complete an 18-mile bicycle tour.” Her website adds that she now pedals her bicycle to work each day. Her own condition is still described, in her own words, as secondary progressive multiple sclerosis; this page records only what she has published about it.

The details of the diet — the nine cups of vegetables and fruit, the levels of the protocol and the later Wahls Elimination version — are set out on the Wahls Protocol diet page, and her reasoning about mitochondria and brain nutrients on the Minding My Mitochondria page.

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8. The 2009 Case Report and the 2011 Essay

Her recovery entered the medical literature in 2009 as a case report in the journal Cases Journal, written by a physical therapist, a neurologist, Wahls herself and two rehabilitation researchers from the University of Iowa. The report describes a 52-year-old woman with secondary progressive multiple sclerosis who had depended on a scooter and a cane for four years. She was treated with neuromuscular electrical stimulation and then with nutritional changes intended “to lower oxidative stress and excito-toxicity.” After eight months, the report states, she no longer used a scooter or cane and “rode her bicycle routinely 8 miles, including hills.”

The report does not name the patient, but a 2019 paper by Wahls’s own research group identifies it as her case. That paper states that the 2009 case report “documented Dr. Wahls’ personal use of the Wahls™ diet plus dietary supplements and neuromuscular electrical stimulation (NMES) to treat SPMS which improved mobility from <20 yards ... using bilateral support to biking and walking without assistance.” A case report describes one person; it is the starting point her group later built on with pilot studies and randomized trials.

In 2010 she published a case series of nine patients with progressive multiple sclerosis treated with electrical stimulation and home exercise in a physical-therapy practice; that work is covered on the exercise, electrical stimulation and stress reduction page.

In 2011 she published her own account in the Journal of General Internal Medicine, an essay titled “The seventy percent solution,” indexed under the keywords secondary progressive multiple sclerosis, recovery and nutrition.

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9. The TEDx Talk and Her Research Program

In 2011 Wahls gave a talk titled “Minding your mitochondria” at TEDxIowaCity. The University of Iowa’s own catalogue of her work notes: “Her 2011 TEDx talk about her recovery became widely viewed online.” She had already set out her ideas in a self-published book, Minding My Mitochondria, whose second edition appeared in 2010; The Wahls Protocol followed in 2014 and a cookbook in 2017 (see Books and Legacy).

From 2010 onward she turned her own experience into a formal research program. As sponsor or principal investigator on ClinicalTrials.gov she has led:

On 29 August 2016 the University of Iowa announced that the National Multiple Sclerosis Society had awarded her a $1 million grant to compare two diets — the low-saturated-fat Swank diet and her modified Paleolithic (Wahls) diet — in 100 people with relapsing-remitting multiple sclerosis and fatigue: twelve weeks on their usual diet, then randomization to one of the two diets for 24 weeks. Speaking of the earlier pilot work, she was quoted in the announcement: “In three months the fatigue was gone.” Her team also reports that in 2015 she developed the Wahls Elimination version of the diet, the version tested in that trial.

What those studies found is described on two pages: the multimodal pilot studies in progressive multiple sclerosis and the randomized diet trials.

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10. Teaching and Research at the University of Iowa

Today Wahls describes herself as “a clinical professor of medicine at the University of Iowa Carver College of Medicine in Iowa City.” Her own website and the university lab page say she teaches internal-medicine residents in their primary-care clinics and conducts clinical trials. Her 2022 review lists her in the university’s Departments of Internal Medicine, Neurology and Epidemiology.

The Wahls Lab page states that her research focuses on “the impact of diet and lifestyle on chronic disease,” especially multiple sclerosis and amyotrophic lateral sclerosis (ALS), with collaborations on gene expression, metabolomics and the gut microbiome. Her regular co-authors include nutrition scientists, epidemiologists, physical therapists and exercise researchers at the university.

Seen whole, her career runs in two halves that share one method. In the first she studied how health systems fail patients — missed results, delayed diagnoses — and wrote it up for peer review. In the second, after her own diagnosis, she applied the same habits of measurement to diet and lifestyle in multiple sclerosis, starting with herself and moving through case reports, pilot cohorts and randomized trials.

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Key Research Papers

  1. Wahls TL, Stene RA. Short-term medical service in the developing world. J Am Med Womens Assoc (1972). 1989;44(1):18-20. — PubMed PMID: 2926089
  2. Wahls TL, Stene RA, Olson KA. General internal medicine practice trends in large multispecialty clinics. J Gen Intern Med. 1991;6(2):103-7. — PubMed PMID: 2023015
  3. Wahls TL, Olson KA, Turney SL. Practice satisfaction and dissatisfaction in general internal medicine departments of large multispecialty clinics. J Gen Intern Med. 1993;8(10):578-9. — PubMed PMID: 8271093
  4. Wahls TL, Futz DN. The master clinician project. J Ambul Care Manage. 2000;23(4):9-21. — PubMed PMID: 11067097
  5. Wahls TL, Barnett MJ, Rosenthal GE. Predicting resource utilization in a Veterans Health Administration primary care population: comparison of methods based on diagnoses and medications. Med Care. 2004;42(2):123-8. — PubMed PMID: 14734949
  6. Forman-Hoffman V, Little A, Wahls T. Barriers to obesity management: a pilot study of primary care clinicians. BMC Fam Pract. 2006;7:35. — PubMed PMID: 16756673
  7. Wahls TL, Cram PM. The frequency of missed test results and associated treatment delays in a highly computerized health system. BMC Fam Pract. 2007;8:32. — PubMed PMID: 17519017
  8. Wahls T, Haugen T, Cram P. The continuing problem of missed test results in an integrated health system with an advanced electronic medical record. Jt Comm J Qual Patient Saf. 2007;33(8):485-92. — PubMed PMID: 17724945
  9. Wahls T. Diagnostic errors and abnormal diagnostic tests lost to follow-up: a source of needless waste and delay to treatment. J Ambul Care Manage. 2007;30(4):338-43. — PubMed PMID: 17873665
  10. Nepple KG, Joudi FN, Hillis SL, Wahls TL. Prevalence of delayed clinician response to elevated prostate-specific antigen values. Mayo Clin Proc. 2008;83(4):439-45. — PubMed PMID: 18380989
  11. Wahls TL. Telling the world. Ann Intern Med. 2008;149(1):61-2. — PubMed PMID: 18591640
  12. Wahls TL. A daughter’s duty. J Gen Intern Med. 2008;23(6):887-8. — PubMed PMID: 18080168
  13. Wahls T. The primer never written. Am J Med. 2008;121(6):549. — PubMed PMID: 18501239
  14. Wahls TL, Cram P. Proposed interventions to decrease the frequency of missed test results. Adv Health Sci Educ Theory Pract. 2009;14 Suppl 1:51-6. — PubMed PMID: 19669920
  15. Wahls TL, Peleg I. Patient- and system-related barriers for the earlier diagnosis of colorectal cancer. BMC Fam Pract. 2009;10:65. — PubMed PMID: 19754964
  16. Gordon JR, Wahls T, Carlos RC, Pipinos II, Rosenthal GE, Cram P. Failure to recognize newly identified aortic dilations in a health care system with an advanced electronic medical record. Ann Intern Med. 2009;151(1):21-7, W5. — PubMed PMID: 19581643
  17. Reese D, Shivapour ET, Wahls TL, Dudley-Javoroski SD, Shields R. Neuromuscular electrical stimulation and dietary interventions to reduce oxidative stress in a secondary progressive multiple sclerosis patient leads to marked gains in function: a case report. Cases J. 2009;2:7601. — PubMed PMID: 19918474
  18. Wahls TL, Reese D, Kaplan D, Darling WG. Rehabilitation with neuromuscular electrical stimulation leads to functional gains in ambulation in patients with secondary progressive and primary progressive multiple sclerosis: a case series report. J Altern Complement Med. 2010;16(12):1343-9. — PubMed PMID: 21138391
  19. Wahls TL. The seventy percent solution. J Gen Intern Med. 2011;26(10):1215-6. — PubMed PMID: 21253878
  20. Chenard CA, Rubenstein LM, Snetselaar LG, Wahls TL. Nutrient Composition Comparison between a Modified Paleolithic Diet for Multiple Sclerosis and the Recommended Healthy U.S.-Style Eating Pattern. Nutrients. 2019;11(3):537. — PubMed PMID: 30832289
  21. Wahls TL, Chenard CA, Snetselaar LG. Review of Two Popular Eating Plans within the Multiple Sclerosis Community: Low Saturated Fat and Modified Paleolithic. Nutrients. 2019;11(2):352. — PubMed PMID: 30736445
  22. Wahls TL. Dietary Approaches to Treating Multiple Sclerosis-Related Symptoms. Phys Med Rehabil Clin N Am. 2022;33(3):605-620. — PubMed PMID: 35989054

PubMed Topic Searches

  1. Wahls TL and multiple sclerosis
  2. Wahls T and missed test results
  3. Secondary progressive multiple sclerosis and diet
  4. Neuromuscular electrical stimulation in multiple sclerosis

Further Reading

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Connections