What is Functional Medicine?

The following guest post was written by Dr. Ron Grisanti, a board certified chiropractic orthopedist with a master’s degree in nutritional science from the University of Bridgeport. You can read more of Dr. Grisanti’s posts at www.FunctionalMedicineUniversity.com and www.Clinical-Rounds.com.

It’s a science-based, natural way to become healthy again

Functional Medicine is patient-centered medical healing at its best. Instead of looking at and treating health problems as isolated diseases, it treats individuals who may have bodily symptoms, imbalances and dysfunctions.

As the following graphic of an iceberg shows, a named disease such as diabetes, cancer, or fibromyalgia might be visible above the surface, but according to Functional Medicine, the cause lies in the altered physiology below the surface. Almost always, the cause of the disease and its symptoms is an underlying dysfunction and/or an imbalance of bodily systems.

If health care treats just the tip of the iceberg, it rarely leads to long-term relief and vibrancy. Identifying and treating the underlying root cause or causes, as Functional Medicine does, has a much better chance to successfully resolve a patient’s health challenge.

Using scientific principles, advanced diagnostic testing and treatments other than drugs or surgery, Functional Medicine restores balance in the body’s primary physiological processes. The goal: the patient’s lifelong optimal health.

How Functional Medicine Heals a Key Health Care Gap

Today’s health care system is in trouble because it applies a medical management model that works well for acute health problems to chronic health problems, where it is much less successful.

If you have a heart attack, accident, or sudden lung infection such as pneumonia, you certainly want a quick-thinking doctor to use all the quick-acting resources of modern medicine, such as life-saving technology, surgery and antibiotics. We are all grateful about such interventions.

However, jumping in with drugs, surgery and other acute care treatments too often does not succeed in helping those with chronic, debilitating ailments, such as diabetes, heart disease or arthritis. Another approach is needed.

The Two-Pronged Healing Approach to Functional Medicine

To battle chronic health conditions, Functional Medicine uses two scientifically grounded principles:

1. Add what’s lacking in the body to nudge its physiology back to a state of optimal functioning.
2. Remove anything that impedes the body from moving toward this optimal state of physiology.

Plainly put, your body naturally wants to be healthy. But things needed by the body to function at its best might be missing, or something might be standing in the way of its best functioning. Functional Medicine first identifies the factors responsible for the malfunctioning. Then it deals with those factors in a way appropriate to the patient’s particular situation.

Very often Functional Medicine practitioners use advanced laboratory testing to identify the root cause or causes of the patient’s health problem. Old-fashioned medical diagnosis helps too, in the form of listening carefully to the patient’s history of symptoms and asking questions about his or her activities and lifestyle.

For treatment, Functional Medicine practitioners use a combination of natural agents (supplements, herbs, nutraceuticals and homeopathics), nutritional and lifestyle changes, spiritual/emotional counseling, and pharmaceuticals, if necessary to prod a patient’s physiology back to an optimal state. In addition, educating the patient about their condition empowers them to take charge of their own health, ultimately leading to greater success in treatment.

Treating Symptoms Versus Treating the Person

In the dominant health care model today, medication is used to get rid of people’s symptoms. If the patient stops taking the medication, symptoms generally return.

Functional Medicine approaches health problems differently. Instead of masking the problem, it aims at restoring the body’s natural functioning. Although Functional Medicine practitioners may prescribe pharmaceuticals, they are used to gently nudge the patient’s physiology in a positive direction so the patient will no longer need them.

For example, conventional doctors would normally prescribe pharmaceuticals like Prilosec, Prevacid or Aciphex to treat acid reflux or heartburn. When the patient stops taking such drugs, the heartburn symptoms come back. In contrast, a Functional Medicine practitioner might find that a patient’s acid reflux is caused by Helicobacter pylori bacteria. Eradicating the Helicobacter pylori might very well lead to the end of heartburn symptoms, permanently.

It’s also important to note that in Functional Medicine, treatment for similar symptoms might vary tremendously for different patients, according to their medical history and results of laboratory tests. Factors that can come into play in producing the same symptoms include toxic chemicals, pathogenic bacteria, parasites, chronic viral pathogens, emotional poisons like anger, greed or envy, and structural factors such as tumors or cysts.

The Roots of Functional Medicine

You may be surprised to learn that Functional Medicine isn’t new. It actually represents a return to the roots of modern scientific medicine, captured in this statement by Sir William Osler, one of the first professors at Johns Hopkins University School of Medicine and later its Physician-in-Chief: “The good physician treats the disease; the great physician treats the patient who has the disease.”

Another important saying by Osler is “If you listen carefully to the patient, they will tell you the diagnosis.” This encapsulates the importance placed in Functional Medicine on taking a thorough history from the patient.

Your Experience of Functional Medicine

We have titled this web site, “Your Medical Detective,” because patients often feel their Functional Medicine practitioner is leaving no stone unturned in their relentless research to pinpoint the causes of a particular patient’s symptoms.

When you consult a Functional Medicine practitioner, the first step is always your history. Practitioners are trained on how to unravel and make sense of a complicated story. Often clues in the story lead to the identification of key imbalances.

The next set of clues comes from a comprehensive physical examination, which includes many nearly forgotten examination procedures used by famous diagnosticians (both living and long gone), such as chapman reflex points, ankle brachial reflex and nail inspection.

The final set of clues comes from advanced laboratory testing. Innovative, cutting-edge lab tests help the practitioner look deeply into a patient’s physiology to identify how it has been compromised and how physiological balance can be restored.

After diagnosis and treatment, a Functional Medicine patient can expect his or her symptoms to diminish in severity, with a renewed sense of well-being and significant increase in health and vitality.

While there is no substitute for face-to-face treatment from a trained Functional Medicine practitioner, this site educates you on the Functional Medicine perspective and on the kinds of clues and treatments that may be key to restoring you to optimal health.

 

 

From the Doctor’s Desk: How Do I Detoxify? Detoxification Part 3

First of all, take a few minutes to read through my two previous posts: Detoxification Part 1 and  Detoxification Part 2. Part 3 of our detoxification series begins with a little chemistry lesson. Are you ready? Here we go. Let’s get down to the nuts and bolts of detoxification in the liver. By learning how the detoxification process works, we can learn the steps we need to take to detoxify.

As I mentioned in my earlier post, there are two basic parts to liver detoxification: Phase I and Phase II (this reminds me of Thing 1 and Thing II from the Dr. Seuss book I read to my kids).

Phase I Detoxification.

Phase 1 detoxification involves the cytochrome P450 system. Phase I detoxification involves oxidation, reduction, and hydrolysis. Phase I detoxification is always active and is very redundant.  What do I mean by redundant? There are a handful of enzymes in the CYP450 family that are utilized by over 200,000 substrates for oxidation, reduction and hydrolysis. In other words, many different chemicals or substrates will use the same CYP450 enzyme. A great picture of the redundancy is seen by clicking here.

Of note is the the CYP1A2 enzyme. This particular enzyme is responsible for metabolism of 40-50% of the drugs that we take. Do you remember the statistic from my earlier post? A leading cause of death is drug-to-drug interactions. Approximately 100,000 Americans die each year from adverse reactions to medications. If we are taking too many medications, then there is not enough CYP1A2 enzyme to adequately metabolize the drugs in the system leading to drug-to-drug interactions.

Let me give you some perspective. Drug interactions cause twice as many deaths as car accidents. And furthermore, hospital costs due to drug interactions have been estimated at between $1 and $4 billion annually. One of the big topics in the healthcare debate is controlling health care costs. Reducing deaths due to drug interactions looks like a good place to start, doesn’t it?

It doesn’t stop there. Phase I detoxification requires many cofactors: niacin, magnesium, copper, zinc, vitamin C, vitamins B2, B3, B6, B12, folic acid, and flavonoids. As you can see, vitamins are extremely important in the detox process. Without them, our bodies don’t work well. One more tidbit on vitamins — many causes of vitamin deficiencies today are the prescription medications we take — a double whammy!

Phase II Detoxification.

Phase II detoxification leads to further modification of the products of Phase I detoxification.  Large water-soluble molecules are added to the toxins through several different processes: glutathione conjugation, amino acid conjugation, methylation, sulfation, acetylation, and glucoronidation. In layman’s terms, after phase II modification, the body is able to eliminate the inactivated toxins via the bowels and/or bladder.

In summary, Phase I and Phase II enzymes are the power houses that detoxify our bodies of our daily toxin load. They are very dependent on vitamins, minerals, and energy. The many prescriptions we take lead to major drug interactions and vitamin depletions which interfere with our body’s ability to detoxify. Thus, if we are malnourished (typical American diet of fast food) and lack key vitamins and nutrients, then our body cannot adequately detoxify.  If we cannot detoxify, then we become inflamed. If we become inflamed, we develop disease.

So what next?  A shoe isn’t one-size-fits-all. And neither is detoxification. Assessment of your individual detoxification system and the build-up of toxins within your body will allow us to develop a customized detoxification process to fit your individual needs. Not only will we live healthier, disease-free lives through detoxification, but we will also save money! It all starts with a call. Make an appointment at Seasons join us on the path to wellness. Renew yourself.

From The Doctor’s Desk: Who Needs To Detoxify? Detoxification Part 2

Ever wonder if you need to detoxify? My first recommendation is look at and listen to your body.  The body will tell you if it is in trouble or imbalanced.  How? Physical signs or symptoms are our bodies’ message that all is not right. Here’s how to know if you bodies’ signs and symptoms are saying that you might be suffering from toxic build up. Here are some symptoms of toxin buildup.

• Headaches
• Muscle aches and pains
• Fatigue
• Asthma
• Allergies
• Skin disorders
• Chronic infections
• Altered mood
• Altered cognition
• Weight gain
• Altered stress tolerance
• Altered libido
• Infertility

Where do toxins in our bodies come from? Remember the quote from last week’s post? “For the first time in the history of the world, every human being is now subjected to contact with dangerous chemicals, from the moment of conception until death.  In the less than two decades of their use, the synthetic pesticides have been so thoroughly distributed throughout the animate and inanimate world that they occur virtually everywhere.”  — Rachel Carson from her book Silent Spring, published 1962.

Toxins are everywhere. The sources can range from toxins like Dioxins to prescription medication.  Adverse reactions to prescription drugs have been ranked as the 4^th to 6^th leading cause of death in the US according to the Journal of American Medical Association. This amounts to over 100,000 deaths per year.  The cause of adverse drug reactions is an overloaded pathway in Phase I of detoxification (CYP3A4), the pathway that detoxifies over 50% of all drugs in your system. The costs associated with adverse drug reactions has been estimated at up to $4 billion. With the rising costs of health care, treating the cause of these adverse drug reactions in addition to decreasing prescription drugs are two excellent ways to prevent complications and lower costs.

The most dangerous sources of toxins are environmental. Organochlorine pesticides, industrial chemicals, and unintended chemical byproducts surround us everyday and expose us to unwanted toxins. Widespread production of  pesticides began less than 80 years ago. Recently, the EPA estimated that more than 4 billion pounds of chemicals were released into the grounds natural water sources in the year 2000. In addition to pesticides and chemicals, the average American eats, unknowingly I might add, 124 pounds of additives per year. Frightening to think of it, isn’t it? And over 2.5 billion pounds of pesticides are used on crop lands, forests, lawns, and fields. The unfortunate fact is this: we live in a toxic world.

How can you decrease your daily exposure to toxins? Here are some great ways.

1. Avoid processed foods
2. Avoid fats
3. Avoid tap water — use filtered water
4. Avoid excess caffeine
5. Avoid excess alcohol
6. NO tobacco
7. Limit chronic medicine, if possible
8. Daily exercise
9. Avoid exposure in your workplace
10. Avoid living near industrial plants
11. Avoid liver dysfunction
12. Avoid kidney problems
13. Avoid intestinal dysfunction

The first ten suggestions are steps you and I can take every day to decrease our toxin exposure. But the last three require a bigger step: detoxification. By detoxifying your body, the liver, kidney, and intestines can operate more efficiently and effectively.

So, the question is not who needs detoxification, but who does NOT need detoxification?  The answer? EVERYONE will benefit from a periodic detoxification program.

From the Doctor’s Desk: The Sludge Pool of Toxins–Detoxification Part 1

“For the first time in the history of the world, every human being is now subjected to contact with dangerous chemicals, from the moment of conception until death.  In the less than two decades of their use, the synthetic pesticides have been so thoroughly distributed throughout the animate and inanimate world that they occur virtually everywhere.”

While this quote sounds like a line from a recent news report, it is actually an excerpt from Rachel Carson’s book Silent Spring published in 1962.

Detoxification seems to be a buzz word these days. Just google detoxification. You will find everything from water detoxification to colon cleanses.

So what is detoxification? The official definition of detoxification is this: the chemical changes of a xenobiotic, a phytochemical or an endogenous (one your own body makes) compound that renders it less toxic and ready to be excreted.  In layman’s terms, detoxification is the way our body protects us from things that we take in that could damage our body.

The ideal situation is toxins in and toxins out, right? If the body is working as designed, then it should be toxins in and toxins out. And how does the body get toxins out? There are many organs that detoxify.  The skin (through sweating), kidneys (through urination), but the liver is the most important detox organ.  The liver detoxification mechanism involves 2 main processes: Phase I and Phase II detoxification.

Phase I detoxification involves the cytochrome P-450 system in the liver. This is the first line of defense against all toxins.  Toxins are tagged and altered for further detoxification, which then occurs in Phase II.  Any break down in this process will result in increased toxin load on the body.  We will talk more in-depth about the detoxification process in my next two posts.

We are what we eat, drink, breath, and touch. But did you ever think that we are what we don’t eliminate? Without elimination of the toxic chemicals we take in and produce every day, our bodies swim in a sludge pool of toxins.

This increased toxic load on the body leads to  inflammation, the balance between pro-inflammatory and anti-inflammatory substances. The balance between Omega 6, a pro-inflammatory subtance, and Omega 3, an anti-inflammatory substance, is the perfect example.

It is the chronic imbalance of  pro-inflammatory substances that then leads to disease.

Shouldn’t the aim of all health care be to prevent inflammation and, therefore, disease? It is in fact, one of the main focuses of the Seasons approach to health and wellness.

In my next two posts, I will cover what detoxification is, who needs detoxification, and how one detoxifies.