With my recent visits to both the ER and the Doctor’s office, I’ve been thinking a lot about the deep-rooted problem of healthcare. I’m finding that the line between health and disease is very blurred.
As I communicate daily with you, mainly on Facebook, I recognize that there’s a big gap between health and disease.
So I thought I would clarify the Functional Medicine model today to help you shift your view from thinking disease management to creating health.
Current Healthcare Model
We have an epidemic of patients getting sicker and sicker and just this past year, the International Statistical Classification of Diseases and Related Health Problems, referred to as the ICD-9 codes, were updated to ICD-10.
This is a coding system used to name diseases to universally make it easier to diagnose, treat, and bill for us providers.
ICD-9 vs ICD-10 went from 12,000 diseases to 155,000 diseases.
It’s a crazy time as healthcare spending is out of control, when most of the diseases can be reversed or prevented by lifestyle intervention.
It’s a worldwide issue, and there will be a shortage of doctors as the number of people who are getting sick is increasing.
20 years ago, the obesity rate across the entire U.S. was under 20%. Today, the obesity rate is over 25 % across all states.
It used to be that back when I graduated from Graduate School in 2001, incidence of childhood diabetes was 1 in 10. Today, it’s 1 in 3.
I’m seeing more younger women in their teens for PCOS, IBS, and various autoimmune conditions like Lupus and Hashimoto’s.
As we become a global world and processed foods are being introduced into China and India, the incidence of diabetes in these two mega countries is exploding.
Disease vs Symptoms
Disease is nothing more than a list of symptoms, yet when we complain of symptoms, our medical system is quick to name it, tame, and blame it.
There’s a fundamental flaw in the way we treat disease. We are busy treating the symptoms rather than the cause.
For example, a symptom of diabetes is high blood sugar. The medical community blames the diabetes and provides medication for the symptom without asking what the underlying cause of the diabetes or uncontrolled blood sugar levels could be.
Doctors are quick to place patients on diabetic medications or insulin to manage blood sugar levels.
But did you know that those with the most intensive therapy to drive their blood sugar down were most likely to suffer heart attack or death?
We should be asking why is blood sugar elevated? Work on the diet and nutrient intake first, the variables that are obvious and common sense.
Insulin for diabetes increases inflammation, triglycerides, oxidative stress, and increased appetite, which leads to obesity and lowered HDL. These of which are classic causes of heart disease.
A classic example, Avandia, a diabetic medication, caused side effects that resulted in 200,000 deaths since 1999 from heart attacks.
In another study, 26,000 people were given statins to prevent heart disease, which resulted in 87% increase in type 2 diabetes.
And according to women’s health initiative, statins increase diabetes risk by 48%.
(Arch Intern Med. 2012 Jan 23; 172 (2): 144-52 )
We should stop mopping up the water from the floor, and rather, we should turn off the faucet.
Balance is Key
We should aim to achieve homeostasis and health rather than looking to diagnose and manage disease.
I hope that in the future, they include a nutritional curriculum in Medical Schools. It’s an absolute necessity as food is medicine.
At the end of the day, we all know that drugs don’t fix the root problem, only the symptoms.
Most often, with autoimmune or chronic diseases, we are looking at systemic dysfunction.
For example, all illnesses will result in mitochondrial dysfunction. We need our mitochondria to function at its best because this is how our cells have the ability to produce energy for our bodies. It’s how we use fuel.
But the medications interfere with metabolic pathways that enable our mitochondria to function to produce energy. When we end up with mitochondrial dysfunction, we will be fatigued, have muscle weakness, foggy brain, and may end up with depression.
It’s time to respect natural order. But in medicine, we tend to have a microscopic view of our human biology.
For example, if your bones hurt, you go to the bone doctor, your stomach hurts, the stomach doctor, nerve pain, nerve doctor, eye issues, eye doctor, heart issues, heart doctor.
But human biology is infinitely complex. We are a Complex Adaptive System, which is constantly changing daily.
Functional Medicine is a model to filter through information from you as the patient and think through problems, using the framework of biomedical system.
It is globally addressing YOU, as opposed to the disease.
This is because clearly, a disease manifests differently for every individual. So the important thing is to focus on the patient who has the disease, rather than treating the disease.
Functional medicine looks at the birds eye view of all your systems, and how they are personalized to YOU. It’s a shift from treating the organs to the organism.
We have a tsunami of chronic disease in our world today, and at the root, inflammation is responsible for our imbalance.
We also understand now that genes play a huge role in symptoms manifestation, however, we also understand that genes are influenced by the environment, including social and spiritual, microbiome, and nutrients.
Dr. Sidney Baker from the Institute of Functional Medicine eloquently described the tack rule:
You stand on one tack and if you get rid of that one tack, you’ll feel better. But if you’re standing on two tacks and take one out, it doesn’t makes you feel 50% better because you’ll still feel all the pain from that other tack.
There’s lots of different elements to multi systems involvement so there’s much more to the symptoms than meets the eye.
Masking it with medications causes unnecessary side effects which are often worse than the initial symptoms, so we need to be careful in how we disrupt our very own ecosystem.
Functional Medicine aims to differentially diagnose and understand the nature of the symptoms and then understand the underlying root cause.
Diseases are only a way of explaining symptoms.
Our bodies are like an ecological system that needs balance and adaptive processes, and if all we do is throw more toxins (medications and toxins in foods) into the body, our ecosystem doesn’t have a chance to survive.
We have to look at the BIG picture, and address the whole system.
Simply put, our approach is to:
- Remove what causes imbalance
- Provide what creates balance
Because we know that it’s all about balance.
Food is Medicine
Because every one of us consumes thousands of pounds of food each year, it’s helpful to look to food.
There’s no better medicine than food. However, we need to think about the quality of the foods we eat.
Rule of thumb is if God made it, then you can eat it. But if a factory made it, then it’s a no go.
Our foods are much more than calories, and not all calories are created equal.
Some man’s medicine may be another man’s poison, meaning that we have to be respectful of our individual differences.
That’s where we can help to fine tune what’s optimal for YOU.
Manage Disease vs Heal Disease
So we choose to look at the root cause and create balance by focusing on health.
Using the example of a tree, you can clearly see the tree roots are where the health of the tree is most important. The leaves and branches of the trees are an extension and a reflection of the health of the roots.
So it makes sense to focus on the ROOT and create balance first to decrease symptoms and improve function.
For example, depression is a name for symptoms, not a prozac deficiency.
Similarly, high cholesterol is not a statin deficiency.
We begin asking the hard questions and find where the root causes are to then calm the symptoms once and for all, by creating health.
In the case of depression, it can be a result of many different root causes. As I mentioned it’s not a Humira, Effexor, or a Prozac deficiency.
It may be a B12 deficiency due to acid blocker use.
Or it can be due to gluten sensitivity that overtaxed your immune system, causing you to develop Hashimoto’s, which resulted in low thyroid, which then caused depression.
Because we all know now that gluten is a common offender that can lead or exacerbate depression, RA, IBS, cancer, dementia, or Lupus.
You may think that not everyone will have gluten sensitivity, and you’d be correct. It’s in your genes that dictate your susceptibility, and certain antecedents, triggers, and perpetuating factors that are highly specific to you.
Depression may be from a Vitamin D deficiency because you don’t see the sun too much due to Lupus or Autoimmune, and that can cause depression.
Or it may be because you took antibiotics which changed your microbiome and caused you to have an imbalance, leading to depression.
Or maybe because you love sushi or fish and you had a mercury overdose, which resulted in depression from mercury toxicity.
It may be because you love sugar and processed foods, which cause a nutritional imbalance, leading to a deficiency.
Difference Between Integrative Medicine and Functional Medicine
Integrative Medicine is when you are using alternative therapies with conventional medicine. For example, you are open to using acupuncture and meditation, coupled with medications.
Functional Medicine, on the other hand, is a paradigm shift from the conventional medical systems of looking at disease management to health management.
Functional Medicine uses a new map and tools to get away from pathology to function.
It is not so much about the disease as much as it is about YOU.
Rather than thinking Silos of medicine, it’s about interconnections, patterns and understanding causes of your symptoms in order to find solutions using laws of nature to create balance and ultimately create health.
- Understanding the underlying causes of disease, such as:
- Coupled with gene expression
- Considering the system imbalances
We always ask the question, “Have you done everything for this patient? Have I been through? Did I cover everything?”
Two main questions that we ask are, “Does this person need to be rid of something (toxins, allergens, infections, poor diet, stress)?” and “Does this person have additional needs for optimal function (enzymes, coenzymes, nutrients, such as vitamins and minerals)?
Depending on our genome, we have different needs. It’s not so black and white.
In this way, we begin to Remove, Replenish, and Balance.
- Primary causes of disease: who/what do you need to get rid of?
- Toxic relationships
- Toxins (biologic, elemental, synthetic)
- Allergens (food, mold, dust, animal products, pollens, chemicals)
- Microbes (bacteria, ticks, yeast, parasites)
- Stress (physical, psychological)
- Poor diet (SAD: Standard American Diet)
- What do you need to thrive?
- Food (protein, fats, carbs, fiber)
- Vitamins, minerals, accessory or conditionally essential nutrients, hormones
- Light, water, air
- Love, community, connection
- Meaning, purpose
Functional medicine is not a test, treatment, or supplement.
It’s a new way of thinking
Focus on the patterns and inter-connections, on finding the causes that lead to the clinical imbalances, and learning how to create balance.
Power of Connection
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