We have lost the ability to see the forest for the trees. Many of you may have multiple doctors and have likely observed how little communication takes place between these doctors. I think that sub-specialization within medicine is detracting from, and not augmenting our ability to be healthy. We can no longer just look at a single, isolated component of our physiology or our biochemistry in which to intervene.
It has never been this simple.
The second way that medicine has failed us is by reducing the practice of medicine to the treatment of a symptom. Human beings are far more complex than that. Decades of medical training has reduced patients to the “heart attack in room three,” the fibroid in pre-op, or the “kidney infection in room four.” This practice removes the symptom from the body, and the condition from the individual.
I want to teach you to start looking at it as a product of several different systems. Disease is less a singular event, less the proverbial “Occam’s razor” that hinges all on a single condition, answer or factor.
The future of medicine is realizing that a disease state is the constellation of deficiencies of several systems
These systems each contribute to varying degrees of cellular dysfunction when deficient, defective or unregulated. This cellular or metabolic dysfunction then presents as a symptom. Sometimes symptoms are the product of a single systems failure and more commonly symptoms arise from several misbehaving systems.
Symptoms are the basis of contemporary treatments. Allopathic medicine, taught in all medical schools in the country, is the practice of “relating to, or being a system of medicine that aims to combat disease by using remedies (as drugs or surgery) which produce effects that are different from or incompatible with those of the disease being treated” (Webster on-line). We are learning to only treat the symptoms, and the body is “cured.” Does it really indicate the body is fixed if one’s symptom is gone? I would contend that the body is not fixed, and the symptom is masked often at the expense of a trade-off in another system – a “side-effect.”
We have the capacity to identify, define and measure the components of the systems that are triggering the symptoms. Imagine dissipating the symptoms by repairing the body and returning the systems to a state of optimal function.
This is the concept of Functional Medicine.
I imagine this is probably a novel concept to any doctors reading this. It lends itself to an entirely new way of looking at our health. Instead of simply treating a symptom, what if we focused on the ability to identify, diagnose and then ultimately treat the abnormal systems? What if this treatment of systems relied on the healing power of nutrients, hormones and foods rather than expensive, side-effect prone drug therapies?
The environment carries many possible factors that can damage our health and diminish the quality of our lives. An infectious agent, autoimmune disorder, toxic environmental exposure or hormonal imbalance can all significantly influence our health and wellness.
The secret is that the end effects of all these disease-causing factors are mediated through the same biologic systems. In understanding and prioritizing these systems, we are able to make real and lasting changes to not only the symptoms, but to the function and health of the entire body.
With directed education, I believe we all have the ability to understand our basic physiology in states of both wellness and disease. The letters MD, DO or ND after our names isn’t required to understand, measure and modulate our state of health. In developing and understanding these concepts, we can approach our doctors with the correct language and perspectives required to make them a partner. And not an conspirator in our pursuit of genuine and complete health.
Let’s look at an example. Imagine Joan, a fifty-something woman who has been suffering recently with a variety of seemingly unrelated symptoms. She has been noticing some increasing fatigue and mild depression. She also has been noticing a change in her stool patterns, with a tendency towards firm, hard stools. In the past she often had a bowel movement twice a day, not every other day. Her libido is down, and she can’t seem to shake those extra pounds gathered around her waist.
She sees her primary care doc, who looks at some basic blood markers and tells her that she’s fine. Her blood count and chemistries are all normal, and her thyroid function (per measurement of TSH only) is mid-range. He sends her to a GI specialist who performs a colonoscopy. He tells her she’s fine and recommends an acid blocking medication as a door prize. Finally, the psychiatrist, the third referral, thinks she is depressed and prescribes an anti-depressant. Furthering a decrease in her libido. And if all of this wasn’t enough, her longstanding friend and hairdresser tells her that her hair is thinning. Her eyesight seems to be changing as well, so a visit with the eye doctor is on the schedule. What could be going on?
What is going on is a failure to examine her health as a function of different systems. I suspect that with Joan, if one were to closely examine and manage her thyroid system, many of her symptoms would likely improve. In her Functional Medicine provider’s office, she realizes that even with a mid-normal TSH, she has a free T3 in the lower tenth percentile of normal. With this constellation of symptoms, I would fully expect that all her symptoms would resolve by addressing this single system of thyroid function.
If I am able to create a sense of wonder, insight and potential in the mystery and capacity of the human body, I will consider these blogs a success. If reading these words compels you to take the subsequent steps towards your health (and the health of your subsequent generations), together we can begin to make a favorable impact on the way that health care is delivered in this country.
And guess what. In the end, we will all look and feel so much better.
Dr. Scott Resnick