We used to live in a time when women died in childbirth and children died of smallpox. We died of infectious diseases. That was, until the antibiotic was invented, a drug which treated a single cause of illness - the microbe. This was one of the most important turning points in medical history, it changed everything, most importantly the life expectancy of the human race.
Today, we are no longer dying from infectious diseases. We are dying, but perhaps more importantly, suffering, from chronic diseases. Often we suffer for decades, even lifetimes, before we die. Perhaps we have back or joint pain that means we can’t sleep, breathing issues which mean we struggle to get up the stairs, fatigue that stops us from being able to work, mood disorders that mean we have a hard time socialising, or fertility issues that lead to us never having the family we dream of. Perhaps it’s all of the above.
The issue of today is less about life expectancy, but life quality.
Heart disease, cancer, diabetes, asthma, autoimmune diseases, depression, dementia and many more chronic health concerns cause endless suffering and drain our economy. A 2011 study by the World Economic Forum predicted that the cost of chronic illness worldwide will be more than $47 trillion by 2030 and despite the $billions spent on bringing new drugs to market every year, the global incidence of these chronic diseases is rising, not falling.
Why? What we are doing is not working…
"Our current healthcare model is geared towards curing a contagious illness that derives from a single cause or remediating an acute injury or medical event like a heart attack or stroke. Unfortunately, this pill-for-every-ill system is in no way suited to addressing the chronic illnesses that are today’s health reality" Dr Jeffrey Bland, The Disease Delusion
Before we get into why this is the case, let me start by saying if I were in a car accident or any other situation requiring acute care, there is no place I’d rather be than with the brilliant medical professionals in my local hospital. Recently I was in need of emergency treatment and I am so thankful for the care I received, I credit them completely with helping me to survive a serious and scary situation. Our doctors, nurses and healthcare assistants do an exceptional job for which we should all be very grateful. But, our system is simply not able to address the epidemic of chronic disease, and here’s why…
Why does our current system not work for chronic disease?
Firstly let’s look at what drugs do. Our medical system tried to apply the same logic of antibiotic
—> kills microbe —> cures disease, to the development of drugs for chronic disease. The problem is that these conditions tend not to come from a single cause, they have multiple causes. So what did we think the next best thing to do was? Develop a drug to solve the primary symptom of that disease, such as pain or inflammation.
Now, clearly drugs which manage the dominant symptoms of a person’s suffering can be helpful, but let’s be clear, the underlying disease hasn’t gone anywhere. Instead, the condition tends to persist or recur. "The outcome of the treatment isn’t a return to good health but rather increasing disability and diminished quality of life" Dr Jeffrey Bland
Because the medical system seeks to find one cause to explain one disease and treat it via one drug, all too often, we end up being prescribed multiple drugs to manage multiple symptoms. In someone with rheumatoid arthritis, they might be prescribed something for the pain, something for the inflammation, something for sleep and an anti-depressant for good measure, because unsurprisingly, they are feeling low. Then say this person develops diabetes and heart disease because their pain has caused a sedentary lifestyle…the drugs just multiply and often, they are prescribed for the rest of their lives.
Worryingly, a drugs safety testing is carried out on the assumption that they are used short term, which raises the question - do we really understand the effects of using them long term, as so many of us are?
Well, we know that adverse events from drugs are the fourth leading cause of death in the United States (1). We also know that every single drug comes with a long list of side effects. Doctors make an educated decision based on ‘benefit vs risk’. Meaning that if a drug manages your pain, it’s worth the side effects. But I’m not so sure patients truly understand the side effects in their bodies…Let’s look at a few examples:
Anti-inflammatory drugs such as ibuprofen, may* improve arthritis symptoms, but long term use can lead to gastric bleeding, heart attack and stroke (2), (5)
Statins such as atorvastatin may* lower the risk of heart disease, but long term use may also lead to an increased risk of diabetes, cognitive impairment and muscle pain (3), (5)
Steroids such as prednisolone may* reduce inflammation associated with autoimmune disease, but long term use can lead to an increased risk of infections, high blood pressure and mood issues (4), (5)
Proton pump inhibitors such as omeprazole may* reduce the symptoms of acid reflux, but long term use also increases the risk of nutrient deficiency and the many chronic diseases associated with this (5), (6), (7)
As well as a healthcare model built largely on using drugs for management not cure, we put medical professionals into silos. If we go back to that theory that there is one cause for one disease, it makes sense for doctors to specialise in one narrow area of the body where that one cause could come from right? Once again, the problem is that chronic conditions do not come from one cause, and importantly, each system in the body is talking to one another continuously.
We know that a drug which improves one system in the body can have an adverse effect on another system and we know people frequently present with symptoms across multiple different systems at the same time. Depression and IBS, anxiety and hormone imbalance, suppressed immunity and joint pain, the list goes on…
So wouldn’t it make sense to look at each person as a whole? To see, for example, how the brain’s neurotransmitters affect the gut microbiome which affect hormone balance which affect fertility?
Unfortunately, I see clients time and again, who are seeing 2 or 3 different specialists for different symptoms, who do not tend to work with each other, but each prescribe a drug or two… and yet the patient goes on suffering.
Is Functional Medicine the answer?
I agree with Dr Mark Hyman when he says:
"Functional medicine is a cataclysmic shift in our view of biology. There are moments of awakening in science that are not incremental but transformational - Columbus proving the earth was round, Galileo showing us the earth was not the centre of the universe, Darwin explaining that species evolved and didn’t arise fixed in their current form and Einstein shattering notions of time and space. Functional medicine is a paradigm shift of equal magnitude and significance"
It all starts with our understanding of how we become ‘diseased’. For a long time we believed that our genetic code determined our destiny. If your parents and grandparents had cancer, you were doomed to get it too and there wasn’t much you could do about it.
The breakthrough discovery which underpins functional medicine is that our health is not determined by our genes in the way we once thought, in fact we now know that our health is largely within our control, or in other words: our nature is very much influenced by our nurture.
We have The Human Genome Project - considered one of the greatest scientific feats in history - to thank for this knowledge. It was this project which found the answers to why we can share 96% of our genes with chimpanzees, but they don’t get chronic diseases as we do, and why identical twins with the same DNA, can have very different health outcomes. It found that human gene expression is influenced by our environment, diet and lifestyle and it is highly individual. (8)
So when we apply this to issues such as diabetes or depression, we can see that there are a family of genes which may lead to a susceptibility, but whether a person does indeed become diabetic or depressed, depends on environmental factors which can vary widely from one person to the next. This brings into focus the importance of just how individual we all are. No one drug, diet or lifestyle practice works for us all - we are far too unique for that.
So, the Human Genome Project (and many other studies into lifestyle medicine (9,10)) has taught us that we are not hardwired for disease and we can change our genetic expression for the better. It has also taught us that we are incredibly unique and healthcare has to be personalised for each of us to reach our optimum quality of life. These are the core principles upon which functional medicine is based.
The Core Principles of Functional Medicine
1. We have agency over our health.
Our environment changes our genetic expression**, so it is mainly the environment we live in and the choices we make, which determine whether we will get ill.
The great challenge we face is understanding what a healthy environment is. The norm today is to live in a way which harms us - most of us are sedentary, chronically stressed and exposed to more toxic chemicals and inflammatory foods than ever before. These are the things which switch on disease promoting genes, but functional medicine gives us the framework for finding the environment which promotes health in each of us.
2. Healthcare has to be personalised to our unique make-up
We have 3 million gene variants and a planetary level population of microbes which reside in our guts, affecting every system in our body. Because of this individuality, each of us is more influenced by some things in our environment than others and our own history is what determines much of this.
What was going on for your mum when she was pregnant with you? What was your childhood environment like? How many antibiotics have you taken over the years? What beliefs have affected your food choices? What health procedures and drugs have you had over the years?
Unlike in conventional medicine, where unfortunately, doctors have 10 minutes or less with their patients, in functional medicine, we are able to take the time to truly understand how you have got to where you are.
3. We have to unravel the root causes of disease to create lasting health
Has trauma in childhood put your nervous system into a state of hyper vigilance and led to chronic IBS and anxiety?
Have inflammatory foods and stress led to chronically high blood sugar and diabetes?
Have toxins and nutrient deficiencies led to an overactive immune system and autoimmune disease?
Does your genetic make-up require nutrient intervention to prevent osteoperosis?
Has gut imbalance led to hormone imbalance and polycystic ovarian syndrome?
In functional medicine we find each of your root causes and we connect the dots between them. Then we help you unravel them, so you can get well and stay well.
4. We need to be in the optimal blood ranges to be well
Researchers estimate that it takes between 4 and 10 years for many chronic diseases to become diagnosable. This means that we can spend a very long time in the so-called 'healthy' blood ranges, while that disease state is brewing.
Blood glucose can progressively increase for years before a diabetes diagnosis is made, antibodies can creep up for years before an autoimmune diagnosis, hormones can be imbalanced for years before problems with fertility are found....
The truth is that you can have a number of sub-optimal blood markers for a long time before anyone tells you there is a problem. In functional medicine, we find these sub optimal issues and then we help you to get into the optimal ranges.
I believe that Functional Medicine truly is the paradigm shift we need to heal from an epidemic of chronic disease, to take pressure off a crippled medical system and our brilliant doctors, nurses and healthcare assistants who are pushed to their limits under the current model. It is the change we need to shift our collective thinking into a preventative mindset, so that one day, our conventional medical system can focus on acute care, as it should be doing.
Time and again, I have seen people heal from chronic gut issues such as IBS and Chrohn’s, metabolic conditions such as diabetes, autoimmune conditions such as thyroiditis and rheumatoid arthritis, mental conditions such as depression and anxiety and hormone conditions such as polycystic ovarian syndrome.
When we unravel the root causes of disease and find the environment that allows our body to heal and thrive, we create health for the long term. So if you or someone you know is struggling to get answers for your health conditions, taking multiple drugs but not feeling any better, or just dealing with perpetual and debilitating symptoms, please reach out. My team and I would love to chat about how we could help you.
Footnotes
*Drugs may not work on as many people as you might imagine. It’s why the president of genetics at Glaxo Smith Kline (one of the world’s leading drugs developers) said ‘Most prescription medicines do not work on most people. The vast majority of drugs - more than 90% - only work on 30-50% of the people’ (8)
**Just 2% of diseases come from a single faulty gene and they include Huntingdon’s and Cystic Fibrosis, approx. 5% of cancers and heart disease can be attributed to heredity (11, 12)
References
7) Mind Over Meds, 2017, Dr Andrew Weil
8) The Disease Delusion, 2014, Dr Jeffrey Bland
11) Mind Over Medicine, 2013, Lissa Rankin