Reversing Multiple Sclerosis Using Functional Medicine | Dr. Terry Wahls
What this covers
My guest in this episode of The Doctor’s Farmacy is Dr. Terry Wahls, who has one of the most incredible stories of using food to recover from an illness I’ve ever heard. Dr. Wahls is the assistant chief of staff at Iowa City VA Health Care and a clinical professor of medicine at the University of Iowa.
Dr. Wahls is 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. She also hosts the Wahls Protocol Seminar every August where anyone can learn how to implement the Protocol with ease and success. You can learn more about her work from her website, www.terrywahls.com.
Tune into this brand new episode of The Doctor’s Farmacy for more!
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Dr. Hyman is a 10 time #1 New York Times bestselling author, family physician and international leader in the field of Functional Medicine. His podcast, The Doctor's Farmacy, is a place for deep conversations about the critical issues of our time in the space of health, wellness, food and politics. New episodes are released every Wednesday here on YouTube, and wherever you listen to podcasts.
Find him and more of his content all over social media:
Website http://www.drhyman.com/ Facebook https://www.facebook.com/drmarkhyman Instagram https://www.instagram.com/markhymanmd Twitter https://twitter.com/markhymanmd
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Dr. Terry Wahls demonstrates that progressive multiple sclerosis can be reversed through a nutrient-dense, vegetable-focused diet combined with targeted supplements, meditation, and electrical muscle stimulation—establishing that chronic autoimmune disease recovery is possible by addressing mitochondrial function, detoxification, and fundamental health-creation principles rather than relying solely on pharmaceutical interventions.
- Wahls reversed her own progressive MS from wheelchair-bound to 20-mile bike rides within one year by redesigning a paleo diet to include 9-15 cups of vegetables daily, targeting specific micronutrients for mitochondrial support and detoxification
- Randomized controlled trials and safety-feasibility studies show the Wahls Protocol reduces fatigue, improves quality of life, slows brain volume loss to less than healthy aging rates, and demonstrates clinically meaningful gait improvement in patients with progressive MS
- The protocol's principles—optimal nutrition, detoxification, mitochondrial support, stress reduction, and movement—generalize across autoimmune conditions, neurological disorders, and metabolic diseases, suggesting disease-specific treatment is less important than foundational health creation
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Cooking is not just a practical skill but a revolutionary act that allows people to reclaim control of their food from the food industry and convenience food system that is 'killing us,' and cooking is pleasurable, fun, delicious, and economical when done with proper knowledge.
“I think we need to understand that cooking is not a revolutionary act that it will help us take back our food from the food system the convenience is killing us and that we need to reinvent how we think about food because one it's pleasurable it's fun it's delicious and it's easy and it's cheap to cook your own food if you know what you're doing”
Wahls has learned through her journey that personal resilience, meaning, purpose, and sense of connection are critical for sustained adherence to therapeutic diet and lifestyle changes
“I've come to appreciate more and more the importance of personal resilience of understanding what is it you want your health for what is your personal mission why is it you're doing this meaning and purpose meaning and purpose and connection because I have to connect to all of that to have you be willing to do the hard work that it takes to sustain the diet and lifestyle changes”
Dietary intervention studies are more challenging and expensive to conduct than pharmaceutical intervention studies because they require participants to change habitual eating behaviors, prepare unfamiliar foods, coordinate family participation, and accurately track dietary adherence—explaining the scarcity of high-quality dietary research
“it's so challenging to do good dietary studies because if you do a food based intervention study supplement studies are easy that's like you know a drug toilet but if you do food now if I'm going to do it well I have to convince you mark to give up foods that you love straight eating foods that you don't like you don't know how to make get-get your family do it with you so you can sustain it and there's a real art to train you to be willing to do that and then another art to measuring what you actually did this is complex research to do it's expensive to do far more expensive than drug studies”
Thallium contamination is found in California groundwater due to fertilizer use, contaminating vegetables grown in that soil, and many fertilizers are relatively toxic, therefore significant portions of the food supply are contaminated with heavy metals from agricultural practices.
“thallium thallium is you know kale is now in California that ground is thallium and so so we have so poisoned our our soils that it was so with many of our fertilizers are relatively toxic so yes unfortunately many of our foods are toxic”
Medicinal mushrooms stimulate adaptive and innate immune cells and stimulate the ability to produce nerve growth factors, making them therapeutically important for neurological recovery
“very much into mushrooms mushrooms stimulate and prime adaptive and innate immune cells they also stimulate your ability to make nerve growth factors so yeah medicinal mushrooms are powerful”
The human brain is 60-70% fat by weight, and nerve coverings destroyed in multiple sclerosis are composed of fat requiring arachidonic acid, eicosapentaenoic acid, and omega-3 and omega-6 fats, necessitating increased dietary fat (especially unsaturated fats from flax, hemp oils) while reducing saturated fat intake
“our brain is 60 to 70 percent fat so your nerve coverings which get destroyed and ms are also fat fat and they need arachidonic acid that eat at cosa pentanoic acid they need the Cossacks annoyed acid they need omega-6 and omega-3 fats and so I needed to have more fat in the diet reduce saturated fat”
The National Multiple Sclerosis Society funded a study comparing the Wahls Protocol diet to the Swank diet (a low-saturated-fat diet long recommended for MS patients), reflecting growing recognition that diet affects MS despite conventional neurology's traditional position that diet has no scientific prospective relationship to MS
“we have a study funded by the National Multiple Sclerosis Society that comparing the low saturated fat diet and the walls died because a swank diet was a low-fat diet very low that was recommended for MS patients only by dr. Swank the conventional neurologist for a long time have convey steadfastly held there's no scientific prospective study that has shown diet has anything to do with MS now fortunately as they're being to understand the role of diet has on epigenetics on the microbiome yeah that conventional neurology is catching up to us and saying diet does matter”
Wahls has successfully treated vegetarians and vegans in her practice, though some individuals thrive on the paleo diet while others do not, requiring individual attention to body response rather than adherence to dietary dogma
“in mark clinics even at the VA we have vegetarian vegans that I would help there are some people to do thrive on that diet and other people don't and I thought you really have to pay attention to your body instead of a dogma or a belief yes”
Dietary and lifestyle interventions are family interventions, not individual interventions; families who implement the protocol together achieve the best results, while individuals attempting it without family support struggle
“I've also come to appreciate that this is a family intervention not an individual intervention that families to do this together are very successful the person who does it alone with their family not supportive not eating and doing the diet my lifestyle with them will struggle it's all about community”
Green leafy vegetables, cabbage family vegetables, and allium vegetables (garlic, shallots, onions) specifically boost detoxification pathways by increasing sulfur-containing compounds that raise intracellular gamma-aminobutyric acid (GABA) and enhance the body's ability to detoxify
“that's all for the sulfur my own boost the detox Boostability to bake gamma-aminobutyric acid intracellular”
Within 10 years of relapsing-remitting MS diagnosis, half of patients develop difficulty walking requiring a cane, walker, or wheelchair, and half become unable to work due to severe fatigue, making early aggressive treatment important
“I looked at the literature and saw that within 10 years 1/2 have difficulty walky need a cane walker a wheelchair and half won't be able to work due to severe fatigue”
Food groups (grains, beans, dairy, vegetables, meat) were defined by agricultural and commercial interests in food sales rather than by scientific evidence of biological necessity, and there is no biological requirement for grains or even dairy
“how that came about was as a way to sell more agricultural products meat dairy grains yes you know vegetables those those were food groups that had nothing to do with science I had to do with and and there is no biological requirement for grains or even daring yes”
Polyphenols (indicated by food color, especially blue, purple, and black pigments) are associated with lower rates of heart disease, diabetes, obesity, and cardiovascular disease in study after study, with measurable cognitive improvement from as little as one cup of blueberries in 16 weeks in placebo-controlled double-blind trials
“and furthermore blue purple black a lot of studies showing you can have measurable improvement in cognition in this little as 16 weeks using just a cup of blueberries as in placebo double-blind crossover trials that's hardly any time at all”
Lectins can be reduced through proper food preparation techniques (soaking, sprouting, overnight cooking), allowing vegetarians and vegans to include beans and grains in the Wahls Protocol variant if properly prepared
“when you cook for example beans and grains properly you can reduce reduced lecton so you can soak them sprout them overnight you can reduce them and so in my book I did create a protocol for vegetarian and vegans”
Sunlight is more effective than vitamin D supplements at producing beneficial effects in the body, with exposure to face and other body areas being important for systemic benefit.
“sunlight is more effective than vitamin D or you some luck on your face but the rest of your body oh yeah definitely be a good one eh fast but yeah it's powerful I agree yeah”
If she could change one thing in healthcare and food medicine, Wahls would mandate that all children learn to cook starting in first grade, all schools grow gardens, and all institutional kitchen staff be trained as champions of health—because family cooking and eating together are foundational to health
“I would reach out to our children I want our children to learn how to cook I want all of our schools to grow gardens I want to have Hallmark and to teach kids to cook beginning in first grade I want to have our true champions in every school kitchen in every school and in every Church and every synagogue every mosque every temple we need our families to be cooking and eating together as a family and eating lots and lots of vegetables”
Wahls' MS study showed clinically meaningful improvement in gait in half of her patients, which is remarkable because none of them were expected to improve given the progressive nature of MS
“we had clinically meaningful improvement in gates in half I was really quite remarkable then the next study that we did was a randomized study which is a waitlist control so people we did just the diet in relapsing remitting ms folks”
Food is not simply calories but information that can upgrade biology; understanding this distinction allows individuals to improve their biological function by choosing foods that communicate better information to their bodies
“it's not just calories they're learning function medicine it's information and they can go any minute I can upgrade my biology by putting better information and it's your body”
Two months after discovering the Institute for Functional Medicine and taking their neuroprotection course despite brain fog, Wahls redesigned her paleo diet to maximize nutritional intake based on her expanded supplement list and saw marked reduction in fatigue within one month
“I took the course on neuroprotection in the midst of my brain fog so this was it was a bit challenging but I got through it had a longer list of supplements a little deeper understanding of the things I could be doing for my mitochondria and for my brain I and I added that and then I had another really really big aha moment like yeah I should I should take this list of supplements and redesign my Paleo diet to maximize the nutritional intake so yeah I redesign my diet me eating paleo cookies all day and yeah exactly and I restored my diet and within a month my fatigue was markedly reduced”
In the first Wahls Protocol safety-feasibility study with 10 subjects, brain MRI analysis showed that brain volume loss in protocol participants was less than even healthy aging rates, whereas progressive MS typically shows brain volume loss 2-3 times faster than healthy aging
“brain volume loss in a progressive MS occurs much more rapidly two to three times as rapidly in progressive MS than it does in healthy aging we're able to show that our brain volume loss was less than even healthy aging right so we're we are protecting our brain to extraordinary levels in that first study”
Consistently across diverse patient populations in the lifestyle clinic, fatigue decreased, energy increased, mental clarity improved, brain fog diminished, and irritability reduced—with quality of life improving markedly
“what we would consistently would see some of the first things people would notice is fatigue going down energy going up mental clarity improving brain fog diminishing irritability dimensionality of life so quality of life absolutely improving”
In progressive neurodegenerative diseases, even if death remains inevitable, quality of life can still be substantially improved and lifespan can potentially be extended through health-creating interventions; some previously untreatable conditions can be stabilized, have their rate of decline slowed, or even show slow but steady improvement, as exemplified by Dr. Wahls' own case.
“you may still die from your cancer you'll have a higher quality of life you may still die from your Huntington's but you'll have higher quality of life and what you may discover is that your previously untreatable problem that your physicians say I don't have anything to offer you may fight you may discover that it can be stabilized these steepness of the decline can be slowed or to everyone's amazement you may discover that you in fact are slowly but steadily improving like you like me”
Wahls' lifestyle clinic model structured patient engagement through: group classes teaching her story and functional medicine concepts; an optional commitment level (gluten-free, vegetables-rich for 100 days to work with her); group intake meetings reviewing health timelines; dietitian-led cooking classes; weekly group skills classes; and bimonthly support groups
“we did this through a series of group classes the first class was here's my story here's the concepts of the therapeutic lifestyle we talked about functional medicine integrative medicine diet lifestyle detox mitochondria all of that stuff and then invited people to either just go back to the doc and say this is too hard or I'll work gradually in my diet and then meet with the dieticians or if they would commit to being gluten-free a hundred percent lots of vegetables for a hundred days they could come work with me we'd have a group intake where I'd meet with them for two weeks as a group to sort of do their timeline of their health experiences and then they would meet with dietician for two hours who would have a cooking class and help them reimagine breakfast and lunch and reimagine the relationship with practical and then we would see them once a week for skills class as many people sit in the room could come get the skills classes and we'd have a support group of six to twenty two people at a time that we'd see every other month”
Wahls' approach demonstrates that one person with determination and courage can oppose a system that doesn't support their approach and make real difference in changing the world
“one person with determination and courage can go up against a system that doesn't support what they're doing and can actually make a real difference and change the world”
The focus should be on creating health rather than treating disease; when health is created through proper nutrition, stress reduction, and lifestyle modifications, disease resolution occurs as a side effect
“I'm trying to teach people that what we need to be focusing on is the creation of Health that this is your best treatment for whatever chronic disease you have yeah you are watching the disease you treat you create health health right you create the disease goes away as a side effect”
Despite taking Tysabri and Saul Sect (powerful MS medications), Wahls continued to decline neurologically, becoming progressively weaker and more dependent on mobility aids, demonstrating that pharmaceutical monotherapy did not arrest her disease progression
“I took Tysabri continued to go downhill I switch to Saul Sept I continue to go downhill these are powerful and mean surprising very powerful but I was happy to take them because I knew I was headed towards becoming bedridden possibly demented”
Four years after the initial heavy metals challenge test, Wahls repeated the test and found that all previously elevated heavy metals had been eliminated, demonstrating that the protocol's detoxification-focused dietary components (greens, sulfur-containing vegetables, cysteine, and algae) successfully mobilized and eliminated accumulated toxins
“I repeated all of that four years later and everything is gone amazing so who knows like how incredibly toxic I was in the big war right how did you get rid of them all well when I designed my protocol I designed it around Boosie the detox enzymes so that's why I stressed the Greens the software the collar I added in there was some intensity of cysteine and some algae as well in minders to get the metals out”
Six months into her recovery, Wahls overcame her heat intolerance by using sauna regularly and has maintained sauna use since that time
“six months into my recovery I was able to overcome my heat intolerance yeah and so I got a sauna and I've been sunny and clear ever since”
The Wahls Protocol incorporates food, supplements (B vitamins, fish oil, vitamin D, NAC, algae, methyl B12, methyl folate), meditation, electrical muscle stimulation, and sauna use as core components—with food being the primary therapeutic agent
“I added in there I added in electrical stimulation of my muscles that was a technique that athletes have been doing for decades to speed the recovery from athletic injuries...I had gone back to adding meditation at night...I had ramped up my vegetables to like nine cups of vegetables a day...I also add in there...cysteine and some algae”
The Clinical Research Unit initially declined to approve Wahls's protocol safety-feasibility study because they considered the diet unsafe due to exclusion of grains and beans, forcing Wahls to complete a dietary validation study on herself to demonstrate nutritional adequacy
“the Clinical Research Unit refused to give me permission because the diet was not safe because it excluded food groups like grains and beans right there yeah right so so it got declined so I was required to do a pre study on myself to show that it was the traditionally sound”
A dietician with 35 years of dietary assessment research experience analyzed Wahls's diet and reported it was 'the most nutrient-dense diet I've ever analyzed,' validating the protocol despite its exclusion of conventional food groups
“the dietician who analyzed my diet who's been doing dietary assessment research for 35 years said this is the most nutrient-dense diet I've ever analyzed”
In Wahls's lifestyle clinic, pain was the number one reason patients came, followed by autoimmunity and metabolic problems (diabetes, heart disease), and neurological problems (Parkinson's, myasthenia gravis, cognitive decline, Alzheimer's, traumatic brain injury, PTSD, mood disorders)
“in my lifestyle clinics again we were able to keep track of who's coming to see us pain was the number one reason that people would come in then autoimmunity metabolic problems like diabetes heart disease in terms of the types of neurologic problems that people would come in Parkinson's myasthenia gravis cognitive decline Alzheimer's of course traumatic brain injury PTSD mood disorders”
Multiple sclerosis is an autoimmune disease, and the Wahls Protocol is particularly effective for autoimmune conditions including Hashimoto's thyroiditis, rheumatoid arthritis, psoriatic arthritis, and psoriasis
“multiple sclerosis is an autoimmune disease yes so your focus on the neurologic stuff and the pain stuff but how does this apply across autoimmune disease and what are the oh so much this can help with that you know certainly this has been very very helpful for Hashimoto thyroiditis and we've had people with rheumatoid arthritis who were severely disabled have resolution of their pain and marked improvement function I've had people with psoriatic arthritis again marked improvements in function people with psoriasis marked resolution of their skin problems”
The Wahls Protocol is effective for metabolic and cardiovascular disease including diabetes, high blood pressure, and heart failure, with patients showing improved ejection fraction (amount of blood the heart pumps) when consuming liver a couple times weekly and heart once weekly
“in people with diabetes high blood pressure heart failure I've had folks with heart failure who were told that they're gonna be needing a heart transplant and like what happened well yeah their ejection fraction keeps improving that's the how much blood their heart can pump it goes down with heart failure yeah yes I keep telling them you gotta be eating liver a couple times a week heart once a week”
Even in her traumatic brain injury clinic where she only saw patients twice a year for 20 minutes with no labs, she achieved stunning success using food and lifestyle intervention
“when I was just in my traumatic brain injury clinic no labs I only got to see people twice a year for 20 minutes and even in that click we had stunning success”
Two years into her recovery (approximately 2009), despite being in excellent physical shape from hiking and biking, Wahls completed a 24-hour heavy metals challenge test and found herself diffusely toxic across all measured heavy metals, including uranium and thorium
“Two years into my recovery I thought well I'm sure toxic load was a big issue in all of this so keep in mind I've been walking around hiking now I've been biking vertol pain so I'm in great shape and I fell I did a 24-hour heavy metals challege test and I was diffusely toxic and everything yeah everything all your medals were high all my medals were high I think they're only four that were not high as even high in uranium thorium thallium”
VA electronic medical record analysis showed that hemoglobin A1c, body mass index, and blood pressure all decreased in protocol patients at the same time that medication numbers decreased and pain medication and narcotic use declined
“the VI has electronic medical record I was also able to get my quality improvement people do some analyses for us we're able to show that the hemoglobin a1c was coming down the body mass index coming down blood pressure coming down at the same time that the number of medications was that rebound was coming down as well and the pain medications coming down and the narcotic use coming down”
The 15-year-old son from the South Carolina family initially gained back weight when working at Bojangles (fast food restaurant), but then lost 140 pounds and is now attending medical school, demonstrating that setbacks and environment changes don't preclude long-term recovery when motivation is sustained
“The son gained a bunch of it back they went to work at Bojangles and then he got himself together and he lost 140 pounds and he's now going to medical school”
The chief of medicine at Dr. Wahls' institution pulled her out of primary care and asked her to open a clinic where she could practice the way she wanted to practice because she was having such great results; Dr. Wahls negotiated for endorsement by the chief of staff and director of the hospital before accepting, and within two weeks both endorsed the new clinic, which was named the 'Therapeutic Lifestyle Clinic' to clearly indicate to referring physicians and patients that it focused on diet and lifestyle as therapeutic treatment, not just prevention.
“because I was having such great results the chief of Medicine it came in and told me he was pulling me out of primary care and would I open up a clinic where I could practice the way I wanted to practice and I said no I won't do that and and here's why I'm refusing you need to get endorsement by the chief of staff and the director of the hospital because we just want to be sure that they know I'm gonna do and that they approved it yeah and so I thought that was probably to be the end of it two weeks that we came back he said I have the endorsements okay so we got the endorsements going and then we decide that we'd call it the therapy lifestyle clinic”
The Wahls Protocol can be adopted on food stamps and is affordable for low-income families if people learn how to cook, as demonstrated by a South Carolina family in the 'Fed Up' documentary who lost 200 pounds in the first year on disability and food stamps without access to conventional healthcare resources
“but you have to learn how to cook absolutely that was what I saw with his family in South Carolina where I went down as part of the movie fed up and they lived in a trailer on food stamps and disability a family of five morbidly obese diabetic renal failure on dialysis hypertension pre-diabetes almost diabetes and this 15 year old kid and they didn't know how to cook and two generations of that family that didn't know how to cook I showed him how to cook one meal gave him a little guide on how to eat well for less and it was one of the worst food deserts in America and they lost 200 pounds in the first year”
By summer 2007, Wahls had declined to the point where she could not sit up in a regular chair, was fully reclined in a zero-gravity chair or in bed, could only walk 10 feet using two walking sticks, and her employer was removing her from patient care, forcing her toward medical disability
“by the summer of o7 I was so weak I could not sit up on a regular chair I had a zero-gravity chair I'm fully reclined or I'm in bed I'm struggling to walk ten feet using two walking sticks my boss cause man calls me and tells me he's assigned me to the traumatic brain injury clinic in six months I'll be seeing patients without residents and I know that of course that means what he's really saying is Terry we are done redesigning your job for you”
When the body is provided with the foundational building blocks it needs (right food, exercise, stress reduction, sleep, proper nutrients), it can often recover from chronic disease regardless of specific diagnosis, because all bodies have mitochondria, livers, kidneys, brains, and cells requiring the same essential inputs
“when you provide the body what it needs it often can recover so it's not like there's one treatment for MS another diet for cancer another diet for Alzheimer's another diet for rheumatoid arthritis or psoriasis like it's the same principles that you can apply to all these things you know when I was first changed how I was practicing medicine my colleagues my chief of staff was calling me and saying oh teri you and your colleagues are saying you're using the same treatment for everyone you just can't do that I said well I think we all have mitochondria I think we all have liver kidneys brains we all have cells we all we need to provide the building blocks”
Wahls consumed 9-15 cups of vegetables daily in her recovery protocol, primarily 6-9 cups of raw or cooked green leafy vegetables (collards, kale, spinach, Swiss chard) plus significant amounts of cabbage family vegetables (cabbage, broccoli, turnips, rutabagas), mushrooms, and allium vegetables (garlic, shallots, onions)
“I ramped up my vegetables to like nine cups of vegetables a day 18 serve 18 servings...so I was having tons and tons of green leafy vegetables so it's probably having six to actually six to nine cups motion raw collards kale collards kale a little bit of spinach I was very I really craved kale in a huge way but have collards I would have Swiss chard I had lots and lots of salads would have some cooked greens I was very big into cabbage family vegetables so cabbage broccoli turnips rutabagas lots of it raw some cooked but it's also very very big Interop garlic's lots of garlic shallots onions”
Vegetables have almost no calories, are delicious, and allow for high volume consumption that produces satiety; Wahls often prepares 3-4 vegetable side dishes with protein as a single side dish to maintain patient fullness
“I think seems overwhelming but it's not that hard one because one there's no almost no calories in them yes - they're delicious and you can eat a lot and get full I mean I literally will binge on Benji I'll make three or four side dishes of veggie - you know that the proteins a side dish”
Lectins—compounds found in grains, beans, and some vegetables—trigger facial pain in genetically susceptible individuals like Wahls, causing incapacitating pain within 6-24 hours of exposure; gluten, dairy, and eggs similarly trigger her pain response
“something called lectins again this depends on your genetic predisposition and I think I probably am one of those people who are vulnerable to lucked incivility response if I have gluten or dairy or eggs my face pain triggers and I have horrific incapacitating levels of pain in six to 24 hours”
Thousands of followers regularly contact Wahls reporting that their treating physicians had given up on them for previously untreatable conditions, but after implementing the Wahls Protocol, their functional status improved—suggesting applicability to rare and refractory conditions
“in the thousands of followers that I have you know routinely I'm being contacted by people who are telling me that they're treating physicians had given up on them saying there was nothing that they had to offer them for a condition which I of course I have never heard of and they tell me that they've implemented the walls protocol and that their functions are improving”
Some paleo diet practitioners eat meat and very few vegetables, creating an inflammatory diet; Wahls recommends moderate meat intake (2 palm-sized servings daily, 6-12 ounces) combined with 9-15 cups of vegetables daily and intermittent fasting to avoid this pitfall
“I think a diet that has made my paleo friends who might love the early eat meat and very few vegetables and I think they're gonna get that's a problem yeah I think that can be inflammatory and I would but tried to have moderate they meet and do some intermittent fasting and have more vegetables with them”
Wahls was diagnosed with relapsing-remitting MS in 2000, but her symptoms began in 1980 during medical school with episodes of electrical face pain that she stoically tolerated, gradually became more frequent and severe
“in 2000 I was diagnosed with MS and years ago 18 years ago but you know in retrospect my symptoms began during medical school in 1980 with episodes of electrical face pain which I stoic ly put up with I could figure out that they were worse with stress and gradually more frequent more severe”