Why is the Wahls diet making me much worse, is it possible?

[dc10]

Ive been following the Wahls diet 100% strictly for 7.5 months now, and i am so much worse,
my E.D.S.S has gone from 5.5 to 6.5 - 7.

Bare in mind, for the last 4.5 years i have been taking 2mg LDN (low dose naltrexone) which has kept me in remission - the SPMS stopped progressing, and while i didnt improve, my symptoms remained the same with no deterioration,

I started the diet in April this year and for the first few weeks didnt notice much, my Nocturnal enuresis improved a bit though,

then as time passed i got worse and worse, my legs are weaker, bladder more frequent/incontinent,

i am seriously considering stopping the Wahls diet now, as this cant be right, getting worse on a organic veg/fruit, free range meat/fish, seaweed diet!

i have always been slim/underweight, so was 135 ish pounds when starting the diet (im 5'11" male), and as i eat so few calories being on this diet, now weigh 115 pounds

the only variable was an infection i got in my coccyx which cleared after 1 week of oral abx, but didnt notice any worsening till 6-8 weeks after finishing the abx.
- but as i didnt want to take abx as was on the diet, i first tried many natural ways to clear the lesion, so it wasnt till 8 weeks later from noticing pus in my underwear, to then taking abx.
but whilst the coccyx was infected i had no infection symptoms like fatigue, loss of appetite, fevers, night sweats, chills, aches and pains.


So before i give this diet up, does anyone know if its even possible for a diet like the wahls diet to make your MS worse? what would cause this?
could it be the fact i consume organic free-range red meat twice a week?

i have been tested for food intolerances and it only showed a mild intolerance to cows milk, tomatoes, and peanuts - none of which i have eaten on the diet anyway!

over the last few weeks im feeling even worse - mobility wise, so cant help but think the diet is doing this, as ldn has always stopped the deterioration.

any thoughts and opinions please?

[jimmylegs]

you have bloodwork showing nutrient deficiency right.. i think that has to be at least part of it dc.. you'd have to review your version and look in detail for imbalances, not easy..

[dc10]

no i just had one copper imbalance that was tiny,
Copper was 10.7 and the range was 11-20

any other thoughts on how the wahls diet could make me worse?

[DougL]

i have always been slim/underweight, so was 135 ish pounds when starting the diet (im 5'11" male), and as i eat so few calories being on this diet, now weigh 115 pounds

Perhaps, your body is complaining about too few calories and that is making your MS worse.

115 pounds and 5'11" - you need to add weight not lose

might be time to consider changing the diet to see if things improve.

[dc10]

Good point Doug and i have thought this,
but as the wahls diet says to only eat non-starchy vegetables, limit fruit, eat meat, and have very small amounts of starchy veg/nuts/seeds, its impossible to eat more calories,

this is a typical days diet:

9am: an oyster + a Smoothie = cup of brocolli, cup of spinach, 2 carrots, handful of mixed berries, slice of melon, tbsp flaxseed oil, ginger, curcumin, water

12pm: Either a chicken liver or 2 oysters + Big bowl of blended vegetables=soup, includes chicken bone broth and approx 5 cups= mixture of kale, cabbage, carrots, onions, spinach, leeks,and others

3:30PM: 2X chicken mince pattys + baked red onion + cup of chicken bone broth + cup of matcha green tea

6-7pm: Either 2x salmon fillets, lamb or beef + 5 cups of veg, including at least 1 cup of suplhur/greens/colors

8pm: 1/2 a Bowl of lunch's soup

in total i must eat 11-12 cups of vegetables per day - dr wahls says to at least 9 cups daily. - i ensure 1/3 is suplur rich veg, 1/3 greens, 1/3 colors - i eat meat with 2-3 of the meals
I have a pudding after lunch and dinner of usually a 2" chunk of coconut meat and 1/2 a date
sometimes 1/2 a plum
All the food is organic and fresh.

i do vary the meats and how i cook the veg each day, but the meals are usually the same size

[dc10]

i think i may have found the reason for my worsening"
Anemia!

People who are restricting calories can develop anemia. Anemia occurs when there are not enough red blood cells in the body.
signs and symptoms of anemia can include fatigue, shortness of breath, pale skin, irregular or fast heartbeat, dizziness, cognitive problems, cold hands and feet and headache.

http://www.livestrong.com/article/29045 ... z2Eg55aPzg

while i dont get all symptoms My fingers/hands hve been freezing all day long for months so much so that i have been wearing gloves! and this is in the warm house, all day!
i also get sleepy earlier in the day.
i always wondered why my hands are always so cold,

Blood test results from 6 weeks ago:
White cell count - 3.25 - x10^9/L - 3.0-10.0
Red cell count - 4.08 - x10*12/L- 4.4 - 5.8 LOW
Haemoglobin - 13.1 g/dl - 13.0 - 17.0
Lymphocytes- 24.3% 0.79 - x10^9/L - 1.2-3.65 LOW

So as my red cell count is low and haemoglobin on the border line, doesnt this sug gest i have developed anemia due to the diet,


the freezing fingers make sense if it is

[jimmylegs]

reminder:
http://www.thisisms.com/forum/regimens- ... tml#p15460

The first thing to understand when beginning nutrition investigations, is the unfortunate language of the lab. Specifically, the term 'normal'.
The 'normal' range is often quite a broad range which in many cases includes both sick and healthy people.
There is a much smaller range within the normal range that can be described as 'optimal'.
For example, at one lab i'm aware of, the normal range for zinc is given as 10-20 umol/L. ms patients average in the low teens. healthy controls average in the high teens.

reposting from our other conversation:

http://www.thisisms.com/forum/natural-a ... ml#p201371

i had a hunt around for my old search for a copper target, and here is the relevant piece:
"so, 100-114 ug/dL or 17.3-18 umol/L looks like a plausible 'sweet spot'."

there's another case study i had found previously where copper deficiency mri findings resembled those seen in b12 deficiency. note the part about resolution of mr findings, verrry interesting. in that case the patient's serum copper level was only 50 ug/dL (7.85 umol/L!). 10.7 umol/L converts to 68 ug/dL so you're not in quite as bad shape, but definitely a long way from 100-114 ug/dL (or 17.3-18 umol/L)

Copper Deficiency Myeloneuropathy Resembling B12 Deficiency: Partial Resolution of MR Imaging Findings with Copper Supplementation
http://www.ajnr.org/content/27/10/2112.full.pdf
"Serum copper and ceruloplasmin levels were markedly decreased at 0.05 ng/mL (0.75–1.45 ng/mL) and 1.37..."

so. i'd say definitely yes, amendments are required.

the copper post i did previously has a bunch of research, also a little bit on healthy food sources too (you should be okay in that regard). here's the link anyway (lots of other interesting info to read)
general-discussion-f1/topic19529.html#p188525

your zinc levels still need to go up, but it looks like the copper is more important in the short term. here is some wiki info on supplemental forms (needs a little cleanup apparently):

"Different forms of copper supplementation have different absorption rates. For example, the absorption of copper from cupric oxide supplements is lower than that from copper gluconate, sulfate, or carbonate... Many popular vitamin supplements include copper as small inorganic molecules such as cupric oxide. These supplements can result in excess free copper in the brain as the copper can cross the blood-brain barrier directly. Normally, organic copper in food is first processed by the liver which keeps free copper levels under control... copper absorption is enhanced by ingestion of animal protein, citrate, and phosphate. Copper salts, including copper gluconate, copper acetate, or copper sulfate, are more easily absorbed than copper oxides..."

so, the takeaway point seems to be, avoid cupric oxide. my zinc supplement is balanced with copper citrate, but i haven't had copper levels done in a while so who knows what my current absorption is like!

given all that, i wonder what form of copper you are supplementing? if it's a good form, consider a short term therapeutic megadose at the upper limit (10 mg/d) for two weeks, then wash out and retest. backup for the upper limit here: http://hc-sc.gc.ca/fn-an/nutrition/refe ... bl-eng.php by the way i think RDAs are ridiculous by and large. they're only about preventing deficiency, not ensuring optimal health.

and here is the text of my copper research, rather than just the link provided in the original post

http://www.thisisms.com/forum/general-d ... ml#p188525

...any thoughts on why your copper levels might be low? for example, low dietary copper (see below), or supplementing zinc without balancing copper, possibly higher dietary fructose, higher dietary fat, etc....

also, recall the 'normal range' tends to include plenty of sick ppl, so you could be on the low side and possibly still account for some of your symptoms (more on the reference range vs healthy average below).

RESEARCH
fyi...
Clinical significance of the laboratory determination of low serum copper in adults.
http://www.ncbi.nlm.nih.gov/pubmed/17727313
"Abstract
BACKGROUND: Low serum copper is often indicative of copper deficiency. [JL edit: ie low normal *and* deficient - low normal does not equate to healthy] Acquired copper deficiency can cause hematological/neurological manifestations. Wilson disease (copper toxicity) is associated with neurological manifestations and low serum copper, with copper deposited in tissues responsible for the toxicity. Low serum copper can also be observed in some carriers of the Wilson disease gene and aceruloplasminemia. This study was undertaken to determine the clinical significance of low serum copper.
METHODS: The Mayo Medical Laboratories', Metals Laboratory database was reviewed over a 9-month period to identify patients who received their care at the Mayo Clinic and had low serum copper. The medical records were analyzed to determine the significance of the low copper.
RESULTS: In six of the 57 patients with low serum copper, the low copper was due to Wilson disease. In the remaining 51 patients, copper deficiency due to an underlying cause was identified in 38 as a reason for the low serum copper. The most commonly identified neurological manifestation of copper deficiency was myeloneuropathy. Coexisting nutrient deficiencies and hematological manifestations of copper deficiency were often but not invariably present.
CONCLUSIONS: Copper deficiency, Wilson disease (or a carrier state), and aceruloplasminemia are all associated with low serum copper. The presence of coexisting neurological or hematological manifestations that are recognized sequelae of copper deficiency should be considered prior to making a diagnosis of copper deficiency. Gastrointestinal disease or surgery is a common cause of acquired copper deficiency. Even in patients in whom low serum copper is indicative of copper deficiency, the cause of the copper-deficient state may not be evident."

*wish* i still had full text access. will have to scout to determine possible 'coexisting nutrient deficiencies'.

here's another interesting study (yahoo, full text! hehe):
Copper Deficiency Myeloneuropathy Resembling B12 Deficiency: Partial Resolution of MR Imaging Findings with Copper Supplementation
http://www.ajnr.org/content/27/10/2112.full

that's really interesting, since b12 deficiency is a known syndrome which looks very similar to MS, but i have never heard or read anything before about ruling out copper deficiency before dxing MS.

COPPER DEFICIENCY SYNDROME
my fave vitamin syndrome web site, on copper - check this out for sure, long list of neuro signs and symptoms, you can compare notes:
http://neuromuscular.wustl.edu/nother/v ... htm#copper

A TARGET COPPER LEVEL
here's a healthy controls serum copper level (again, full text!) see page 30, tables 3 and 4 for the serum values
http://hera.ugr.es/doi/15028227.pdf
the mean level was 1.10 mg/l. (recall the copper-zinc ratio is important - notice that only in one case did the sick patients have higher copper levels than healthy controls, but all the sick folks had much lower zinc levels compared to the healthies)

anyway. si units for clinical data
http://www.unc.edu/~rowlett/units/scale ... _data.html
conversion factor: µg/dL 0.157 µmol/L

so since we're starting with mg/l which doesn't match, we'll say *1000 on the top to get µg, and /10 on the bottom to get dL, so overall multiply by 100 to get to ug/dL which gives us 110. *0.157 = 17.3 umol/L.

here's another study where mean serum copper in healthy controls was 114.84 (μg/100 ml) (which is μg/dL but hey, why be straightforward :S)
which converts over to 18.0 µmol/L:

Evaluation of serum copper and iron levels among oral submucous fibrosis patients
http://www.medicinaoral.com/pubmed/medo ... 7_p870.pdf
(table 1, p. e872)

so, 100-114 ug/dL or 17.3-18 umol/L looks like a plausible 'sweet spot'. did they tell you your exact result? if not, can you get it?

THE COPPER 'NORMAL RANGE'
reference range according to wiki is 70-150 μg/dL (11.0-23.6µmol/L ) which as usual is much wider than where you find the controls in health and disease research.
http://en.wikipedia.org/wiki/Reference_ ... lood_tests (you have to scroll right on the graphic table to find the ug/dL section)

interestingly, in this case the healthy controls mean does appear to sit very close to the centre of the reference range (110) aka peak of the bell curve. not always the case.

HEALTHY FOODS RICH IN COPPER
foods rich in copper: http://whfoods.org/genpage.php?tname=nutrient&dbid=53
eg Calf liver, Crimini Mushrooms, and Asparagus are excellent; Swiss Chard, Spinach, Sesame Seeds, Kale and Cashews are very good.

(interesting, many of those foods are also rich in zinc and/or magnesium).

it should be very interesting to see what resolves as your serum copper levels go up. just make sure you don't inadvertently drive zinc down with copper supplements!

almost lastly

http://www.acu-cell.com/crcu.html

Copper is an essential component of several physiologically important enzymes, including:
• cytochrome oxidase, which is necessary for energy metabolism, cellular respiration, and myelin formation,
• superoxide dismutase (SOD), which helps slow down age-related deterioration of the body, protects from developing chemical sensitivities (along with polyphenol oxidase), and it is important for normal humoral immune response,
• histaminase, which breaks down histamine, to control allergies and inflammation,
• lysil oxidase, which is necessary for the formation of the cross-links of collagen and elastin,
• tyrosinase, which is associated with normal pigmentation and keratinization of hair,
• dopamine-beta-hydroxylase, with which copper serves as a co-factor in the synthesis of norepinephrine, an important neurotransmitter and adrenal hormone that affects fatigue, mood and depression.

and, lastly - your zinc is down around 14 instead of 18, and your copper is down at 10.7 instead of 17.3, so not only are both low, but the cu:zn ratio is out of whack too. you should probably be aiming for .95 but you're down at .75 ... case study:

A neurological and hematological syndrome associated with zinc excess and copper deficiency
http://link.springer.com/article/10.100 ... -0?LI=true
from this page ^ you have to click 'look inside' to see the relevant numbers - the patient had zinc numbers often above 20 with no discernable source of the excess (wonder if they asked her about denture adhesives, a known possible cause of zinc toxicity), and the copper values were single digit. symptoms included anemia, neutropenia, paresthesias, weakness, sensory loss, myelopathy (spastic paraparesis) absent vibration and joint position sense to ankles, moderate impairment up to the knees, diffuse lower motor neuron ddisorder, atrophy/paralysis of muscles below the knee, marked sensory ataxia, diffuse symmetric degeneration of motor axons along with disorder of dorsal columns.

so. a more extreme example, her ratio was way down in the .40 neighbourhood, but again, you're at .75 not the 0.95 level suggested in research on healthy optimal levels...

by the way elevated copper and low zinc is also undesirable.. cu:zn ratio 1.5 or higher means it's time to look at zinc deficiency in the context of copper excess http://www.med.or.jp/english/pdf/2004_08/359_364.pdf

[jimmylegs]

Zinc-induced copper deficiency: a report of three cases initially recognized on bone marrow examination.
http://www.ncbi.nlm.nih.gov/pubmed/15762288
Abstract

Copper deficiency is a rare cause of sideroblastic anemia and neutropenia that often is not suspected clinically. The morphologic findings in bone marrow, while not pathognomonic, are sufficiently characteristic to suggest the diagnosis, leading to further testing to establish the correct diagnosis. Excess zinc ingestion is among the causes of copper deficiency. We present 3 cases of zinc-induced copper deficiency in which the diagnosis first was suggested on the basis of bone marrow examination. The first patient was a 47-year-old man with a debilitating peripheral neuropathy that had progressed during the previous 18 months, mild anemia, and severe neutropenia. The second was a 21-year-old man receiving zinc supplementation for acrodermatitis enteropathica in whom moderate normocytic anemia and neutropenia developed. The third patient was a 42-year-old man with anemia, severe neutropenia, and a peripheral neuropathy that had progressed during 8 months. The bone marrow findings in all cases suggested copper deficiency, which was confirmed by further laboratory testing and determined to be due to zinc excess. The morphologic features, clinical manifestations, differential diagnosis, and pathogenetic mechanisms are discussed.

as i said above "your zinc levels still need to go up, but it looks like the copper is more important in the short term. ... consider a short term therapeutic megadose at the upper limit (10 mg/d) for two weeks, then wash out and retest." and you could do an experiment after that - reduce dietary fructose, see if it helps you retain copper. i personally eat lots of veg and pretty negligible fruit, and i stay on target taking 50mg zinc balanced with 2mg copper. even if you only manage to find 2mg elemental copper in whichever form and take 4 a day as we recently discussed, it should help put things back on track.

[dc10]

thanks JL for all this info but at present with th brain fog, blurry vision qnd fatigue i cant absorb this info,
i will try when im feeling better though,i will continue to increase the copper
any thoughts on the anemia (as a result of the diet) causing my worsening?

[jimmylegs]

it is a lot of info. want me to increase my font size for the other posts? let me know

yes the diet may have contributed to the nutrient imbalance, possibly interfered with copper retention, resulting in anemia and that among other consequences of the imbalance is probably not helping you feel any better.

https://en.wikipedia.org/wiki/Copper_deficiency
Iron Transportation
The anemia caused by copper deficiency is thought to be caused by impaired iron transport. Hephaestin is a copper containing ferroxidase enzyme located in the duodenal muscosa that oxidizes iron and facilitate its transfer across the basolateral membrane into circulation.[1] Another iron transporting enzyme is ceruloplasmin.[1] This enzyme is required to mobilize iron from the reticuloendothelial cell to plasma.[1] Ceruloplasmin also oxidizes iron from its ferrous state to the ferric form that is required for iron binding.[4] Impairment in these copper dependent enzymes that transport iron may cause the secondary iron deficiency anemia.[1] Another speculation for the cause of anemia is involving the mitochondrial enzyme cytochrome c oxidase (complex IV in the electron transport chain). Studies have shown that animal models with impaired cytochrome c oxidase failed to synthesize heme from ferric iron at the normal rate.[1] The lower rate of the enzyme might also cause the excess iron to clump, giving the heme an unusual pattern.[1] This unusual pattern is also known as ringed sideroblastic anemia cells.

[lyndacarol]

Good point Doug and i have thought this,
but as the wahls diet says to only eat non-starchy vegetables, limit fruit, eat meat, and have very small amounts of starchy veg/nuts/seeds, its impossible to eat more calories,

this is a typical days diet:

9am: an oyster + a Smoothie = cup of brocolli, cup of spinach, 2 carrots, handful of mixed berries, slice of melon, tbsp flaxseed oil, ginger, curcumin, water

12pm: Either a chicken liver or 2 oysters + Big bowl of blended vegetables=soup, includes chicken bone broth and approx 5 cups= mixture of kale, cabbage, carrots, onions, spinach, leeks,and others

3:30PM: 2X chicken mince pattys + baked red onion + cup of chicken bone broth + cup of matcha green tea

6-7pm: Either 2x salmon fillets, lamb or beef + 5 cups of veg, including at least 1 cup of suplhur/greens/colors

8pm: 1/2 a Bowl of lunch's soup

in total i must eat 11-12 cups of vegetables per day - dr wahls says to at least 9 cups daily. - i ensure 1/3 is suplur rich veg, 1/3 greens, 1/3 colors - i eat meat with 2-3 of the meals
I have a pudding after lunch and dinner of usually a 2" chunk of coconut meat and 1/2 a date
sometimes 1/2 a plum
All the food is organic and fresh.

i do vary the meats and how i cook the veg each day, but the meals are usually the same size

dc10 – I also think that Doug has a good suggestion. As I look at your typical day's diet, it seems to me that you are restricting the AMOUNT of food too much. The human body does not need carbohydrates to be healthy, but protein and fat are absolutely essential! Try eating protein at every meal – maybe two eggs at breakfast; maybe a dollop of chicken salad for lunch; your salmon fillets, lamb, or beef for supper sounds good – do you like scallops? They are almost pure protein; snacks of nuts – and see how you feel. It may not be the Wahls diet making you worse, but that you are TOO restrictive with it.

I have read that restricting calories too much can result in a low metabolism or hormone imbalances. Perhaps your severe calorie restriction has led to low thyroid hormone production and a slow metabolism – cold hands and feet are most often described with this condition. Increased protein consumption will improve the rate of metabolism. You NEED fat in your diet; fat is your body's preferred form of energy; fat is used to make hormones; and the brain and the myelin around the nerves are mostly FAT. Coconut oil is VERY good for your body – consider frying a couple eggs in coconut oil every morning for breakfast! Or sauté your kale or other veggie in coconut oil.

[jimmylegs]

agree that this version of the diet is likely too restrictive for weight gain, but personally, i pick my battles. for example i will not waste my breath trying to get a vegetarian friend to eat fish and red meat. all i can do is say fine, then you had better be very careful with gluten, and you had better supplement this that and the other thing.

for a comparison, can anyone chime in with a wahls diet diary that has resulted in stable weight?

and as for adding calories, i have definitely gained weight since going from an over-restrictive vegan to a balanced whole food omnivore. i LOVE two eggs for breakfast sooo goood with onion, red pepper, mushroom and spinach mixed in. delish! i also eat healthy starch foods like sweet potato. do i eat a pile of them daily? no. but they are definitely regulars on the shopping list.

tonight for dinner i was lazy and had chicken cordon bleu, citrus rapini, and maple-roasted sweet potato 'fries'. prepared, ready to heat and eat for $6 tax in, yay local grocery store!

anyway. regardless, weight loss is yet another symptom of copper deficiency, although i don't know the mechanism exactly.
healthy copper rich foods include:
Sesame Seeds, Cashews, Soybeans, Barley, Sunflower Seeds, Tempeh, Garbanzo Beans, Lentils and Lima Beans.
these are the ones that really pack a punch in terms of percent of daily recommended amounts per serving.

as for highest nutrient density (not so much the highest actual mg of copper per serving),
excellent sources of copper include "asparagus, calf's liver, crimini mushrooms, turnip greens and molasses.
Very good sources of copper include chard, spinach, sesame seeds, mustard greens, kale, shiitake mushrooms, and cashews."

[dc10]

restrictive??

someone please advise how i could possibly eat more food in a day, and stay wahls diet kosher?
once the new load of coconut oil arrives, i will have 1 tbsp with my breakfast smoothie daily.
- by the way, i can only get the solid form of organic virgin cconut oil here, so just melt some in the pan before using.

i am consuming about 12 cups/mugs of vegetables every day, 2-3 servings of meat, a few pieces of fruit.
lunch and dinner are a heaped full plate of food, plus i have the 2 chicken burgers + a red onion in the afternoon, plus the after meals treats,
im shocked at myself at the quantity of food i eat!

(JL , im now up to 3x 2mg copper daily and 50mg zinc picolinate ;)
i cant eat legumes on the diet but have introduced nuts /seeds back in which should help with copper

[jimmylegs]

see this is exactly why i don't like to comment on people's diet choices! but it is a restrictive one in terms of cutting out various types of food, not sheer volume. and i don't think anyone would claim that 12 c of veg would have many calories.. and, you're feeling worse. get a few sweet potatoes in ya they're healthy! excellent call on the nuts and seeds, by the way

History and characteristics of Okinawan longevity food.
http://www.ncbi.nlm.nih.gov/pubmed/11710358
Okinawan food culture in the Ryukyu island is one of the world's most interesting culture because its consumers have the longest life expectancies and low disability rates. It is a product of cultural synthesis, with a core of Chinese food culture, inputs through food trade with South-East Asia and the Pacific and strong Japanese influences in eating style and presentation. The Satsamu sweet potato provides the largest part of the energy intake (and contributes to self-sufficiency), there is a wide array of plant foods including seaweed (especially konbu) and soy, and of herbaceous plants, accompanied by fish and pork, and by green tea and kohencha tea. Infusing multiple foodstuff and drinking the broth is characteristic. Raw sugar is eaten. The concept that 'food is medicine' and a high regard accorded medical practice are also intrinsic of Okinawan culture. Again, food-centered and ancestral festivities keeep the health dimensions well-developed. Pork, konbu and tofu (soy bean-curd) are indispensable ingredients in festival menus, and the combination of tofu and seaweed are used everyday. Okinawan food culture is intimately linked with an enduring belief of the system and highly developed social structure and network.

i personally think cutting out foods because of the potential harm is throwing out the baby with the bath water. and not only that, it's meant to protect a broken system that can't handle these foods. i prefer to fix the system and then eat whatever healthy food i want. i'm having cod, swiss chard and sweet potato for dinner tonight. nice anti inflammatory meal

glad that you're boosting that copper, hopefully you can retest in a couple weeks and be closer to 17.

[lyndacarol]

dc10 – I have been thinking for the last 24 hours about you and your question. I admire your dedication to the Wahls diet. To follow it faithfully and even eat more food in a day, you might consider juicing the vegetables. It is easier to consume the juice of many vegetables rather than all the fiber of the whole products.

The Wahls diet may have no connection to your worsening. Your diet contains absolutely nothing that should trigger insulin secretion; and yet, I believe your pancreas is still producing too much. This can be established by a "fasting blood insulin test," which I always suggest. IF this is the case, the excess insulin may account for your worsening EDSS numbers, weakening muscles, incontinence, and more.

I also encourage you and your doctor to investigate a low-functioning thyroid as the source of your worsening symptoms.

I don't recall the source, but I have read that LDN temporarily decreases insulin production – this may be the reason you found LDN to be helpful.