Proverbially 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.
The purpose of this blog is to teach you to look at your health 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 in the realization that a disease state is the constellation of deficiencies of several systems. When deficient, defective or unregulated, these systems each contribute to varying degrees of cellular dysfunction. This cellular or metabolic dysfunction then presents as a symptom. Sometimes symptoms are the product of a single systems failure; more commonly symptoms arise from a number of errant 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 only to treat the symptoms; in doing so they go away, and the body is “cured.” But if one’s symptom is gone, does it really indicate that the body is fixed? I would contend that the body is not fixed, and that the symptom is only masked—often at the expense of a trade-off in another system, a ‘side-effect.’ And we go off into the medicinal Ponzi scheme, “borrowing from Peter to pay Paul” with our health.
We have the capacity to identify, define, and measure the components of the systems that are precipitating the symptoms. Imagine dissipating the symptoms by repairing the body, returning the systems to a state of optimal function. This is the concept of Functional Medicine.
I imagine that this is probably a novel concept to any doctors reading this, as it lends itself to an entirely new way of looking at our health. What if, instead of simply treating a symptom, we focused on the ability to identify, diagnose and then ultimately treat the abnormal systems? And what if this treatment of a systems relied not on expensive, side-effect prone drug therapies, but on the healing power of nutrients, hormones and foods?
There are many possible insults in the environment 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 of 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.
I believe that we all have the ability to understand our basic physiology in states of both wellness and disease with directed education. One need not have the letters MD, DO or ND after our names to understand, measure and modulate our state of health. In developing an 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, and has been noticing a change in her stool patterns, with a tendency towards firm, hard stools. In the past she never had bowel problems, and 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 that have 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, tells her that she’s fine, and recommends an acid blocking medication as a door prize. Finally the psychiatrist, the third referral, thinks that she is depressed, and prescribes an anti-depressant, which decreases her libido even more. And if all of this wasn’t enough, she has her longstanding friend and hairdresser tell 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 in spite of 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 of her symptoms would resolve by addressing this single system of thyroid function.
If I am able to engender in the reader 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 the 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
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