Being a functional medicine practitioner, I hear this daily from my patients.
They have had small issues that have grown to larger issues involving more systems and then finally to a stage where they are having multiple issues and they know something is wrong even though all of their lab tests are “normal.” They often hear “I know you are not crazy” or “you may just have depression”, which implies to them that what they are feeling is all in their mind or why would they even bring those issues up.
After a period of time, many of these patients actually do believe it is all in their head and reside to the fact that this is just the way their life will be. Others, will be put on to anti depressants and other medications chasing their symptoms around like a cat does a mouse without any lasting results. The sad truth is that the healthcare model today is based on acute care and not on chronic care and disease.
When we look at the fact that our body is a chemical masterpiece with many factors having to work together all in harmony we start to see where the problems begin. The fact that most US medical schools (86/121, 71%) fail to provide the recommended minimum 25 hours of nutrition (1). That is not very comforting seeing that what we eat, absorb and are able to use affects every system in our body.
That is one of the issues with the current medical model that needs desperate repair. A 2013 report on the state of US health in JAMA, identified dietary factors as the single most significant risk factor for disability and premature death (2).The Lyon Mediterranean Diet Heart Study, published in 1999, showed a 72% reduction in cardiovascular events attributed to diet (an effect approximately twice that of most statin trials). A whole foods, plant-based diet low in refined carbohydrates and animal products has been proven to reverse coronary heart disease and confer potent protection against type 2 diabetes and cancer (3).
Ok, back to the “normal” studies. The current acute care model looks at symptoms, gives it a diagnosis and then a treatment. The problem with that model is that we are not separate components, we are one machine. What affects one system affects the next. While tests for other systems may be in the normal range, a low normal or a high normal finding can show that certain systems are moving into dysfunction and further testing may be necessary.
When our water temperature in our cars rise the check engine light does not turn on. It is only when the car is overheating that the light turns on and you are stuck at the side of the road. The reality is that the car had been overheating and there was an issue that was causing it to overheat but the warning light or “abnormal test result” had not shown up quite yet.
With chronic disease issues, there are often many simmering issues that can be seen and addressed before the issue becomes severe. The problem is that the chronically ill do not always have 1 huge issue but many smaller ones that together cause them to have their symptoms and later disease.
If a test is normal from levels of 20 to 200, and you are at 20 or 200 do you think there might be something going on? At 201 and 19 you have an issue but not at 20 or 200. I don’t know about you, but i have a problem with that reasoning. Yet, I hear it daily from my patients. The other growing issue with these “normal” values is that they are based off of normal ranges for 95% of their “healthy”customers. As our nation continues to become less healthy, those ranges will ultimately change as well.
The functional approach looks at lab values differently, as stated above, as well as the entire disease process. Dr. Mark Hyman, the Director the Cleveland Clinic Center for Functional Medicine, explained functional medicine best by stating that “ Functional medicine addresses the underlying causes of disease, using a systems-oriented approach and engaging both patient and practitioner in a therapeutic partnership. By shifting the traditional disease-centered focus of practice to a more patient-centered approach, functional medicine addresses the whole person, not just an isolated set of symptoms. Functional medicine practitioners spend time with their patients, listening to their histories and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease. In this way, functional medicine supports the unique expression of health and vitality for each individual.”
Michael Bartell, D.C., is a certified functional medicine practitioner and has a Masters of Science Degree in Human Nutrition and Functional Medicine from Western States University and practices in North Bend, OR.
1. Kelly M. Adams, W. Scott Butsch, and Martin Kohlmeier, “The State of Nutrition Education at US Medical Schools,” Journal of Biomedical Education, vol. 2015, Article ID 357627, 7 pages, 2015. doi:10.1155/2015/357627
2. US Burden of Disease Collaborators. The State of US Health, 1990-2010: Burden of Diseases, Injuries, and Risk Factors. JAMA. 2013;310(6):591-606. doi:10.1001/jama.2013.13805.
3. Devries, S., Dalen, J. E., Eisenberg, D. M., Maizes, V., Ornish, D., Prasad, A., . . . Willett, W. (2014). A Deficiency of Nutrition Education in Medical Training. The American Journal of Medicine, 127(9), 804-806. doi:10.1016/j.amjmed.2014.04.003