A Cleveland Clinic neurologist confirms multiple sclerosis is an immune-mediated disease, with modern immune-targeting therapies now suppressing new lesions and relapses in more than 90% of cases. The article also tracks how University of Iowa physician Terry Wahls became a prominent functional medicine voice as Trump-era health figures like HHS Secretary Robert F. Kennedy Jr. and surgeon general nominee Casey Means elevate “root cause” medicine in national politics.

The Move

• Terry Wahls, an internal medicine physician with MS, says she regained major function after combining a paleo-style diet, exercise, meditation, supplements and electrical muscle stimulation after worsening despite standard treatment.

• Her personal recovery story helped push functional medicine further into the mainstream, including among politically influential health leaders in the second Trump administration.

• At the same time, Cleveland Clinic neurologist Robert Bermel draws a firm line on the disease model: MS is driven by immune attack on the central nervous system, leaving lesions and disability if untreated.

Why it Matters for Care

• For bedside practice, the key takeaway is not to replace disease-modifying therapy with lifestyle programs. Bermel says earlier diagnosis plus effective immune-directed drugs can prevent relapses, new lesions and disability accumulation in more than 90% of cases.

• Diet, exercise, smoking cessation and management of metabolic risk may still matter — especially for fatigue, quality of life and function — but as adjuncts, not substitutes.

• The strongest diet signal in MS remains modest: Mediterranean and higher-fiber patterns have the best evidence, though data are still incomplete.

• Wahls-led studies reported fatigue improvements, including a drop from 5.7 to 3.3 on a 7-point scale in one small study, but most trials have been small, short-term or lacked controls.

Between the Lines

• This is partly a politics story about chronic disease messaging. Functional medicine’s “root cause” framing aligns with a broader populist critique of pharma, insurers and conventional medical institutions.

• There is also a business angle: a $66 billion alternative-medicine ecosystem, cash-pay practices, supplements and consumer microbiome testing create incentives that can blur the line between care and commerce.

• That tension helps explain why clinicians hear more patient interest in food-as-medicine, microbiome optimization and personalized testing even when evidence remains limited.

• It also explains the backlash: critics argue functional medicine often starts with biologically plausible ideas, then extends them beyond what rigorous trials support.

What to Watch

• Whether Wahls’ pending two-year MS diet study produces more durable evidence on relapse rates, disability or MRI outcomes — not just fatigue and quality-of-life measures.

• How federal health leaders under President Trump, Kennedy and allies translate “root cause” rhetoric into policy, coverage or research priorities.

• Whether insurers’ growing openness to functional medicine, including in-network arrangements for telehealth providers, expands clinician competition or patient demand for adjunctive services.

• And whether neurology societies, academic centers and payers draw firmer boundaries around microbiome testing, supplements and lifestyle protocols marketed for autoimmune disease.

Source: Straight Arrow News