Lab Assessment in Chronic Illness: A Functional Medicine Approach
This topic is one I hold in high regard as medicine commonly grapples with an inability to provide an actionable diagnosis for the rising number of chronically ill people in the US. The CDC currently lists 6 in ten adults as having a chronic disease and 4 in ten adults as having two or more chronic conditions. This number is predicted to rise in the years to come; likely due in part to increasing levels of environmental toxicity, worsening nutrition and lack of physical activity. Other recognized contributors include chronic or stealth infections, breakdown of immune function, increasing amounts of electro-smog or EMF exposure, poor gastrointestinal health and unhealthy living conditions amongst others. In these situations, the real challenge is determining the head domino in a cascade and understanding how to begin the process of rebuilding one’s health.
Medicine as it currently operates is designed to treat disease not to restore health. This, fundamentally, is the pitfall and reason behind our inability to treat chronic illness and fully embrace preventative care. We have more or less abandoned the need for individualized therapy in favor of treatment algorithms (“standard of care”) with pharmaceutical medications and the glory of saving a life after catastrophe occurs. While necessary in emergency medicine and surgical care, this mechanistic approach forgoes the concept that the whole is in fact greater than the sum of the parts and treating symptoms will never eliminate the cause(s) of a slow decline found in chronic illness. If I were a conspiracy theorist, I might even consider how much this medical approach contributes to the overall economy by driving dollars toward a lifetime of increasing medical management.
The good news is that there are well trained practitioners such as Naturopathic Physicians (the original functional medical specialistS) that diagnose and treat based on the principle of vitalism. They recognize that to achieve health, you must treat all aspects of an individual and that health is dependent on a healthy lifestyle and on the health of the internal and external environment. This concept is studied extensively by all medical students in physiology and biochemistry and understood as fundamental to the normal homeostatic process of all living organisms. Unfortunately, this same concept is typically put aside when students move on to learn pathology and the various specialties found in clinical sciences (i.e. urology, cardiology, neurology, etc). Yet, up to the very point of death, maintaining homeostasis is the primary driving force in all living organisms that allows for the regulation and adjustment of cellular function in order to achieve a state of constant and consistent health. Ignoring this fundamental principle is a denial of basic science.
In this same regard, lab testing, while not distinctly black and white, can be thought of as more geared to either assessing disease or measuring health. Standard lab testing is more focused on determining what is wrong rather than measuring what isn’t right, and, while this may seem like the same statement, there are key differences. The former approach will tell you that your liver is inflamed, you have an autoimmune disease named “X” or your cholesterol is too high. The later establishes that you have elevated levels of an organic solvent such as an insecticide or disruptive heavy metal levels causing liver toxicity. Or, you have an overgrowth of a bad type of bacteria in your gut or you got an infection that lead to an autoimmune response due to the principle of “molecular mimicry”. Or, your cholesterol is too high because you have poor diet, genetic susceptibility or impaired bile flow. The first example provides justification for anti-inflammatory medication, immune suppressive drugs and statin therapy; while, the second gives you a measurable route to recovery through detoxification, targeted immunotherapy and lifestyle changes with the support of natural medicines such as vitamins, minerals, herbs and other physiotherapy approaches.
Too numerous to provide a thorough review, some of the many functional medical tests available include: Organic Acid Testing, Comprehensive Stool Analysis, assessment of numerous immune and autoimmune markers, epigenetic analysis, mold toxin and solvent testing, bacterial and protozoal metagenomic testing, cardiovascular risk assessment, heavy metal challenge, intestinal antigenic permeability screening, food sensitivity antibody screening and neurotransmitter metabolite analysis. Finding a skilled and knowledgeable physician who spends the needed time in a medical appointment to determine appropriate testing is the first step in unraveling the mystery of how to treat a chronic illness or a persistent functional problem like chronic fatigue, fibromyalgia, recurrent headaches or irritable bowel syndrome.