You Don’t Have to Choose: Conventional Care, Functional Medicine, and Targeted Supplements

In this blog, I’ll explain the different roles of your conventional medicine specialist and your functional medicine practitioner, share a few concrete nutrition steps, and review the supplements for autoimmune disease that I recommend most often for better brain health and longevity. I have also updated this post with new research on vitamin D.

Conventional vs. Functional Medicine: What’s the Difference?

First, let me explain the two roles.

Your conventional medicine neurologist, rheumatologist, or other autoimmune specialist is an expert in diagnosing and managing autoimmune disease with FDA-approved drugs. For MS, there are many highly effective disease-modifying therapies (DMTs). They greatly reduce new lesions and relapses and can substantially slow disease progression. There are also highly effective treatments for many systemic autoimmune diseases that cause neurological or psychiatric symptoms such as pain, fatigue, anxiety, or depression. I often urge patients with a heavier disease burden or more disability to take a highly effective DMT to stabilize their disease while we work on their environmental factors.

A functional medicine practitioner has more training in the environmental and lifestyle factors that drive autoimmune disease. The modifiable lifestyle factors include:

• Nutrition
• Exercise and movement
• Sleep
• Stress-reducing practices
• Social connection and emotional resilience
• Spiritual and religious practices

Other environmental factors include gut health (your ability to digest and absorb nutrients), toxin body burden, mitochondrial health, and the mix of microbes in your mouth and bowels. A functional medicine practitioner can help you evaluate these factors and then improve them.

I have trained health practitioners in how I approach MS and autoimmune disease. You can search for one near you in the Wahls Protocol® Health Practitioner Directory.

You Can Do Both

You can take an FDA-approved DMT to treat autoimmunity and use a functional medicine approach to address your environment and lifestyle. Many neurologists and autoimmune specialists simply do not have time in a short visit to talk through the environmental factors that contribute to disease activity.

I have lived on both sides of this, as a physician-researcher and as a patient. I was diagnosed with MS in 2000, and by 2003 I had secondary progressive disease. I underwent chemotherapy to try to slow the disease and still declined, and I spent four years in a tilt-recline wheelchair. In the fall of 2007, I began the program that became the Wahls Protocol®. In three months my fatigue was gone, and in six months I was walking without a cane. That is why I believe so strongly in doing both.

Nutrition for a healthier brain

Hopefully your specialist and primary care team are talking with you about nutrition. But they may not be giving you concrete steps. Here are two additions and one reduction to discuss with your family. For most people, additions and swaps are easier than eliminations.

Eat more non-starchy vegetables and berries.

 I recommend working toward nine cups of vegetables and fruit a day: three cups leafy greens, three cups sulfur-rich (cabbage family, onion family, mushrooms), and three cups deeply colored. Pigments are markers for polyphenols. Your gut bacteria break polyphenols down into smaller compounds that cross into the bloodstream and support the chemistry of life.^(1,2) Diets rich in colorful vegetables and fruits are anti-inflammatory and provide excellent support for a wide range of autoimmune conditions.⁽³⁾

Swap flour-based foods for starchy vegetables.

Replace cereals, breads, and pasta with potatoes, sweet potatoes, yams, squash, and beets, especially pigmented varieties, which are higher in polyphenols. This one swap will significantly improve your nutrition.

Again, look for deeply pigmented options (like purple potatoes). The deeper the color, the richer it is in antioxidants.

Reduce ultra-processed foods.

That means sugar-sweetened beverages and flour-based cereals, breads, and pastas. Eating more ultra-processed food is linked to higher rates of obesity,⁽⁴⁾ prediabetes and diabetes,⁽⁵⁾ and high blood pressure,⁽⁶⁾ all of which are linked to a more aggressive autoimmune disease course. It is also linked to more cognitive decline,⁽⁷⁾ more mental health problems,⁽⁸⁾ and more severe MS.⁽⁹⁾ For all these reasons, I advise my patients to eliminate sugar-sweetened beverages and replace flour-based products with starchy vegetables.

What Your Specialist May Not Know About Vitamins D and K

Your neurologist has likely told you that vitamin D matters in MS, and the evidence has grown stronger since I first wrote this post. In the D-Lay MS trial, published in 2025, 316 people with a first MS-like episode took either 100,000 IU of vitamin D3 every two weeks or a placebo for two years. Disease activity (a relapse or new MRI lesions) occurred in 60% of the vitamin D group versus 74% of the placebo group, and new enhancing lesions were cut roughly in half.⁽¹⁰⁾ Relapse rates and disability did not differ between the groups. By contrast, a 2024 meta-analysis found that adding vitamin D3 to DMTs in established relapsing MS did not significantly change relapses, disability, or lesions.⁽¹¹⁾ Lower vitamin D levels are also linked to greater disability in MS.⁽¹²⁾

My read is that vitamin D appears to matter most early, and that it is a powerful partner to, not a replacement for, your DMT. The dose in D-Lay MS was high and given under medical supervision, so do not copy it on your own.

What your specialist may not know is that vitamin D is best taken with vitamin K2. Vitamin K2 helps direct calcium into bone,^(13,14) supports tooth mineralization,⁽¹⁵⁾ and in animal studies enhances remyelination.⁽¹⁶⁾ Blood levels of vitamin K2 are also much lower in people with MS than in healthy controls.⁽¹⁷⁾ For all these reasons, I advise my MS and autoimmune patients to take vitamin D and vitamin K2 together. I also suggest enough sunlight to tan without burning.

Why Targeted Supplements May Help

It takes more nutrients to repair damage to the brain, spinal cord, and cranial nerves than to maintain a healthy brain. Your cells must clear out damaged proteins and structures, then make new proteins and rebuild. Improving your diet comes first: eliminate the empty calories of added sugar and white flour. Targeted supplements can then help ensure your immune cells and brain cells have the nutrients they need to do the work of rebuilding a better brain. That is certainly my goal for myself.

Fish oil

Supplemental fish oil has been studied extensively in MS. Several studies link omega-3 supplementation with fewer relapses and lower inflammatory markers, though results across trials are mixed.⁽¹⁸⁾ In psoriasis, fish oil reduced the severity of plaques and inflammatory markers.⁽¹⁹⁾ In rheumatoid arthritis, it was associated with less pain⁽²⁰⁾ and lower inflammatory markers.⁽²¹⁾

Acetyl-L-Carnitine and Alpha-Lipoic Acid

People with MS who have more fatigue have lower carnitine levels.⁽²²⁾ In aging rats, giving acetyl-L-carnitine with alpha-lipoic acid improved mitochondrial function and reduced oxidative stress.⁽²³⁾ This matters because your brain is about 2% of your body weight yet uses about 20% of your body’s energy.⁽²⁴⁾ Helping mitochondria make more adenosine triphosphate (ATP), the energy molecule our cells use to drive the chemistry of life, can be very helpful for people with brain-related symptoms. That is what I mean by minding your mitochondria.

Coenzyme Q

Coenzyme Q is a key part of the machinery that makes ATP in the mitochondria.⁽²⁵⁾ In a randomized trial in people with MS, 500 mg a day of coenzyme Q10 for 12 weeks improved fatigue and depression scores compared with placebo,⁽²⁶⁾ and another trial found it lowered inflammatory markers.⁽²⁷⁾ In fibromyalgia and rheumatoid arthritis, coenzyme Q10 has been linked to less pain and lower inflammatory markers.⁽²⁸⁾

N-Acetylcysteine (NAC)

N-acetylcysteine (NAC) is a sulfur-containing amino acid that your body uses to make glutathione, one of its most important antioxidants. It has been studied as an add-on therapy for neurological disorders including MS, mild cognitive impairment, Parkinson’s disease, and Alzheimer’s disease.⁽²⁹⁾ It is also used as an add-on for anxiety and depression,⁽³⁰⁾ which are common in people with MS. In a trial in people with MS, NAC reduced anxiety, depression, and markers of oxidative stress.⁽³¹⁾

Phosphatidylserine

Phosphatidylserine is one of the fats that make up cell membranes, including the myelin sheath that insulates the wiring between brain cells. Its content in our membranes declines with age, which is why it is often recommended for people with neurological conditions^.(32,33)

Broccoli Seed Extract

Broccoli seeds are rich in glucoraphanin, which the body converts into sulforaphane. Sulforaphane switches on the Nrf2 pathway, which lowers inflammation and boosts detoxification.⁽³⁴⁾ It has been studied as an add-on therapy for anxiety, depression, and cognitive impairment,⁽³⁴⁾ and, mostly in early and animal studies, for Parkinson’s disease, Alzheimer’s disease, and MS.⁽³⁵⁾

Next Steps for You

Food First

• Eliminate added sugar and white flour-based foods. They are stripped of nutrients and feed the wrong microbes.
• Work toward nine cups of vegetables and fruit a day.
• Swap breads, pasta, and cereals for starchy vegetables such as sweet potatoes, squash, and beets.
• Eat omega-3 rich fish and grass finished meats. Have protein with every meal.
• Improve your nutrition at a pace you and your family can manage.

Targeted Supplements for Brain and Immune Support

These are the three supplements I recommend most often to my MS and autoimmune patients. For people who are healthy and want to thrive to 100 and beyond, these same three are terrific for longevity.

• Brain Protect combines acetyl-L-carnitine, alpha-lipoic acid, coenzyme Q10, N-acetylcysteine, phosphatidylserine, and broccoli seed extract in one formula. It is a convenient way to get the six nutrients for brain health I reviewed in this post.
• D3K2 5000iu provides 5,000 IU of vitamin D3 and 180 mcg of vitamin K2 (as MK-7). I advise my patients to check their vitamin D level and adjust their dose to bring it into the upper half of the reference range.
• MindFuel Omega provides 900 mg of EPA and DHA in one small softgel. Doses studied in clinical trials range from 1 to 4 grams of fish oil a day. Work with your medical team to find the dose that is right for you.

I have included all three, along with a multivitamin/multimineral and magnesium, in the Wahls Protocol® Memory Support Kit. If you prefer to take nutrients individually, I also offer NAC and Ultra CoQ10.

Build Your Team

• Keep working with your neurologist or specialist, and understand how your DMT fits into your plan.
• Find a functional medicine practitioner through the Wahls Protocol® Health Practitioner Directory.
• Move every day, and ask for a physical therapy consult to design a program that fits your body.
• Do this alongside your medical team, not instead of them.

Closing Thoughts

It is not either-or. You can follow your conventional specialist’s treatment plan and work with a functional medicine practitioner on your diet, lifestyle, and environment. Improve your nutrition step by step, and add targeted supplements to help your cells do the chemistry of life and rebuild a healthier brain.
It is my goal to thrive to 120 and beyond. I hope that is your goal as well.

New to The Wahls Protocol® Supplements? Subscribe and save with 5% OFF your first order, and get 10% OFF each order thereafter! Shop Now

Citations

1. Cardona F, Andrés-Lacueva C, Tulipani S, Tinahones FJ, Queipo-Ortuño MI. Benefits of polyphenols on gut microbiota and implications in human health. J Nutr Biochem. 2013;24(8):1415-22.
2. La Rosa G, Lonardo MS, Cacciapuoti N, et al. Dietary polyphenols, microbiome, and multiple sclerosis: from molecular anti-inflammatory and neuroprotective mechanisms to clinical evidence. Int J Mol Sci. 2023;24(8).
3. Khan H, Sureda A, Belwal T, et al. Polyphenols in the treatment of autoimmune diseases. Autoimmun Rev. 2019;18(7):647-57.
4. Moradi S, Entezari MH, Mohammadi H, et al. Ultra-processed food consumption and adult obesity risk: a systematic review and dose-response meta-analysis. Crit Rev Food Sci Nutr. 2023;63(2):249-60.
5. Moradi S, Hojjati Kermani MA, Bagheri R, et al. Ultra-processed food consumption and adult diabetes risk: a systematic review and dose-response meta-analysis. Nutrients. 2021;13(12).
6. Wang M, Du X, Huang W, Xu Y. Ultra-processed foods consumption increases the risk of hypertension in adults: a systematic review and meta-analysis. Am J Hypertens. 2022;35(10):892-901.
7. Henney AE, Gillespie CS, Alam U, Hydes TJ, Mackay CE, Cuthbertson DJ. High intake of ultra-processed food is associated with dementia in adults: a systematic review and meta-analysis of observational studies. J Neurol. 2024;271(1):198-210.
8. Mazloomi SN, Talebi S, Mehrabani S, et al. The association of ultra-processed food consumption with adult mental health disorders: a systematic review and dose-response meta-analysis of 260,385 participants. Nutr Neurosci. 2023;26(10):913-31.
9. Guglielmetti M, Grosso G, Ferraris C, et al. Ultra-processed foods consumption is associated with multiple sclerosis severity. Front Neurol. 2023;14:1086720.
10. Thouvenot E, Laplaud D, Lebrun-Frenay C, et al. High-dose vitamin D in clinically isolated syndrome typical of multiple sclerosis: the D-Lay MS randomized clinical trial. JAMA. 2025;333(16):1413-22.
11. Mahler JV, Solti M, Apostolos-Pereira SL, Adoni T, Silva GD, Callegaro D. Vitamin D3 as an add-on treatment for multiple sclerosis: a systematic review and meta-analysis of randomized controlled trials. Mult Scler Relat Disord. 2024;82:105433.
12. Moosazadeh M, Nabinezhad-Male F, Afshari M, et al. Vitamin D status and disability among patients with multiple sclerosis: a systematic review and meta-analysis. AIMS Neurosci. 2021;8(2):239-53.
13. Maresz K. Proper calcium use: vitamin K2 as a promoter of bone and cardiovascular health. Integr Med (Encinitas). 2015;14(1):34-9.
14. Mandatori D, Pelusi L, Schiavone V, Pipino C, Di Pietro N, Pandolfi A. The dual role of vitamin K2 in “bone-vascular crosstalk”: opposite effects on bone loss and vascular calcification. Nutrients. 2021;13(4).
15. Southward K. A hypothetical role for vitamin K2 in the endocrine and exocrine aspects of dental caries. Med Hypotheses. 2015;84(3):276-80.
16. Popescu DC, Huang H, Singhal NK, et al. Vitamin K enhances the production of brain sulfatides during remyelination. PLoS One. 2018;13(8):e0203057.
17. Lasemi R, Kundi M, Moghadam NB, Moshammer H, Hainfellner JA. Vitamin K2 in multiple sclerosis patients. Wien Klin Wochenschr. 2018;130(9-10):307-13.
18. AlAmmar WA, Albeesh FH, Ibrahim LM, Algindan YY, Yamani LZ, Khattab RY. Effect of omega-3 fatty acids and fish oil supplementation on multiple sclerosis: a systematic review. Nutr Neurosci. 2021;24(7):569-79.
19. Chen X, Hong S, Sun X, et al. Efficacy of fish oil and its components in the management of psoriasis: a systematic review of 18 randomized controlled trials. Nutr Rev. 2020;78(10):827-40.
20. Senftleber NK, Nielsen SM, Andersen JR, et al. Marine oil supplements for arthritis pain: a systematic review and meta-analysis of randomized trials. Nutrients. 2017;9(1).
21. Gioxari A, Kaliora AC, Marantidou F, Panagiotakos DP. Intake of omega-3 polyunsaturated fatty acids in patients with rheumatoid arthritis: a systematic review and meta-analysis. Nutrition. 2018;45:114-24.e4.
22. Harirchian MH, Babaie S, Keshtkaran N, Bitarafan S. The association of serum carnitine levels with severity of fatigue in patients with multiple sclerosis: a pilot study. Curr J Neurol. 2023;22(1):30-4.
23. Hagen TM, Liu J, Lykkesfeldt J, et al. Feeding acetyl-L-carnitine and lipoic acid to old rats significantly improves metabolic function while decreasing oxidative stress. Proc Natl Acad Sci U S A. 2002;99(4):1870-5.
24. Raichle ME, Gusnard DA. Appraising the brain’s energy budget. Proc Natl Acad Sci U S A. 2002;99(16):10237-9.
25. Pradhan N, Singh C, Singh A. Coenzyme Q10 a mitochondrial restorer for various brain disorders. Naunyn Schmiedebergs Arch Pharmacol. 2021;394(11):2197-222.
26. Sanoobar M, Dehghan P, Khalili M, Azimi A, Seifar F. Coenzyme Q10 as a treatment for fatigue and depression in multiple sclerosis patients: a double blind randomized clinical trial. Nutr Neurosci. 2016;19(3):138-43.
27. Sanoobar M, Eghtesadi S, Azimi A, et al. Coenzyme Q10 supplementation ameliorates inflammatory markers in patients with multiple sclerosis: a double blind, placebo, controlled randomized clinical trial. Nutr Neurosci. 2015;18(4):169-76.
28. Freire de Carvalho J, Skare T. Coenzyme Q10 supplementation in rheumatic diseases: a systematic review. Clin Nutr ESPEN. 2024;59:63-9.
29. Bavarsad Shahripour R, Harrigan MR, Alexandrov AV. N-acetylcysteine (NAC) in neurological disorders: mechanisms of action and therapeutic opportunities. Brain Behav. 2014;4(2):108-22.
30. Minarini A, Ferrari S, Galletti M, et al. N-acetylcysteine in the treatment of psychiatric disorders: current status and future prospects. Expert Opin Drug Metab Toxicol. 2017;13(3):279-92.
31. Khalatbari Mohseni G, Hosseini SA, Majdinasab N, Cheraghian B. Effects of N-acetylcysteine on oxidative stress biomarkers, depression, and anxiety symptoms in patients with multiple sclerosis. Neuropsychopharmacol Rep. 2023;43(3):382-90.
32. Ma X, Li X, Wang W, Zhang M, Yang B, Miao Z. Phosphatidylserine, inflammation, and central nervous system diseases. Front Aging Neurosci. 2022;14:975176.
33. Nogueira-de-Almeida CA, Zotarelli-Filho IJ, Nogueira-de-Almeida ME, Souza CG, Kemp VL, Ramos WS. Neuronutrients and central nervous system: a systematic review. Cent Nerv Syst Agents Med Chem. 2023;23(1):1-12.
34. Zheng W, Li X, Zhang T, Wang J. Biological mechanisms and clinical efficacy of sulforaphane for mental disorders. Gen Psychiatr. 2022;35(2):e100700.
35. Schepici G, Bramanti P, Mazzon E. Efficacy of sulforaphane in neurodegenerative diseases. Int J Mol Sci. 2020;21(22).