I spent three days last week at a blood chemistry seminar down in the Bay Area. I thought when I signed up for the seminar that it would be rather dry – just lots of pathologies revealed by tiny variations in numbers from your blood chemistry after you go to a lab and have blood drawn. The going to a lab and having your blood drawn part has not changed, but the usual stuff they taught us in school has taken on a whole new spin, the Functional Medicine spin.
Traditional medicine has focused forever on saving you from immediate death. It is very rescue oriented. Much like firemen, modern/ traditional medicine waits until you have an overt disease condition that might kill you, then, like firemen waiting until a fire breaks out, they jump in and try to save you. From this orientation, lab blood work has historically only been interested in blood chemistry values that indicate that you are in serious trouble and need some sort of intervention. Other than cholesterol and blood sugar, no attempt has been made to try to use lab work to anticipate health imbalances and recommend lifestyle changes to avoid serious diseases.
Well the reality is all of the hundreds of blood chemistry values have their usual normal versus pathological values and they have functional ranges that define health. Lets use blood sugar to illustrate this idea. The “normal” range for blood sugar is 65 to 100, with the levels above 125 meaning a person now has the disease of diabetes. Until a few years ago the numbers between 100 and 125 were sort of ignored. Then preventative medicine woke up and realized that 100 to 125 is actually telling us that a person is pre-diabetic and needs to change their diet immediately. Functional medicine knows through lots of studies that the healthy range for blood sugar is actually 85 to 100. People that have blood sugar between 65 and 85 are actually underfeeding their energy system and will have decreased mental and physical functioning.
So part of my three day weekend was getting used to looking at blood chemistry in terms of optimal numbers, functional ranges that are still considered healthy, but may be less than optimal, the wider lab normal ranges that are not really about health at all – just not into overt disease, and finally serious disease numbers.
The bigger and more interesting subject of the extended weekend was looking at how these various lab values affect and relate to each other to indicate the health of the body. When something starts to go awry in the body, it almost always affects several organs and systems. Each organ and system has blood chemistry numbers that tell us how they are doing. But by looking at the pattern of which organs and systems are being affected, we can begin to figure out what the actual cause is behind the ill health, not just what organ needs emergency intervention. This is the real beauty of functional medicine; the ability to figure out the real cause behind poor health. A single lab value might tell you that your liver is inflamed, but it tells you nothing about why it is inflamed. Is the problem alcohol, a virus, sugar, hormones, environmental toxins, stress, what? Most lab values shift out of range because tissue destruction is occurring and chemicals from the broken down cells are spilling into the blood where they can be measured. There is always a normal “healthy” level of these chemicals in the blood because a certain number of cells die naturally every day and are replaced with younger cells. When too many die and spill their chemicals, we
know there is a problem because the chemical levels go up in the blood.
Here is an example of how patterns of lab values tell us a story – low total protein levels tell us there is a problem with protein digestion. Low globulin levels tell us the liver is not working well. And low electrolyte levels tell us there is a kidney issue. But if you find all three together it usually means there is a leaky gut issue causing all of these. The individual items tell us the problems, but not the cause of the problems. This is exactly the primary complaint most everyone has about modern medicine – it treats the symptoms and not the cause. When I was in Chiropractic school, we were taught the medical way of reading blood work in order to pass the state boards to get our license. No one taught us how all these things relate to each other to help us find the root cause of the problems the patient has.
Other interesting facts missed in traditional medical interpretation of lab values is with things like reading a cholesterol panel. Everyone is taught that your total cholesterol should be below something – the exact number seems to get lower every year. When I was in school that number was 240 because all the studies showed there was no increase in heart attacks tied to cholesterol levels until those levels went above 240. Strangely that number started going lower once they invented the drug Lipitor to lower cholesterol. Its almost as though someone is regularly creating more customers for statin drugs, like Lipitor, by simply changing the “normal” number for cholesterol. I have even heard that some doctors are telling patients there is no number low enough for cholesterol, and they want patients to get lower than 100. This is actually insane because any level lower than 130 is highly associated with suicide. This is because your body makes cholesterol into all your brain neurotransmitters and hormones. Below 130 your brain starts failing from lack of neurotransmitters. Women who go on super low fat diets drop their cholesterol levels to the point that they can’t make their hormones, so their periods stop and they can’t get pregnant.
The really new piece I picked up this last weekend was about HDL – the good cholesterol. Patients have told me their doctors have told them that their total cholesterol was up a bit, but that it was ok because their good HDL cholesterol levels were raised and that would protect them. Everything has a sweet spot, a Goldilocks just right level and HDL is no exception. High levels of HDL are now known to be a red flag for autoimmune disease. Not only is the high HDL level not protecting them, but is actually saying they are brewing up some serious trouble.
These are some highlights that stuck out in my mind from the seminar, but the shear volume of information will take me some time to digest. Practitioners in the room that had been used to this stuff for years were still being caught up on stuff they did not know. This is especially true with information concerning autoimmune and gut issues, as these areas are evolving so rapidly right now. Unfortunately this is because these diseases are actually getting more and more common. Fifty years ago less than one person in a thousand had any kind of autoimmune issues. Now they are becoming one of the most common cause underlying disease states in this country. For instance, fifty years ago almost no one ever had Hashimoto’s thyroid – the autoimmune form of thyroid disease. Now 95% of thyroid cases are Hashimoto’s disease.
The reason behind why autoimmune and gut issues are becoming an epidemic has to do with toxic chemical exposure, bad diet, stress, drug use, and lifestyle choices that are not working for us. This seems to be primarily an American issue, as the rest of the world is not seeing these tremendous increases in these conditions. Hooray for us?
I just thought I would share some of the new stuff developing in the world of Functional Medicine.