drug approval process tends to exaggerate effectiveness of drugs while understating adverse effects. The fact that natural treatments are often utilized in a functional medicine (FM) approach that have not been sub- jected to the kind of controlled clinical trials typical of FDA approved drugs leads to one of the objections often raised by professionals who are not familiar with the evidence base underlying the principles of FM. As a practitioner within the tradi- tional medical paradigm for over 30 years, as well as spending 11 years in academic pediatrics, I shared this skepticism myself until plunging into the FM model in recent years. To my great surprise, the science underlying the major tenets of FM is vastly more extensive and complex than that upon which conventional approaches and pharmaceutical agents are based. Thirty hours of formal CME (continuing medical education) training under the auspices of the Institute for Functional Medicine and the North Carolina Integra- tive Medical Society, along with extensive reading in the functional medicine litera- ture, revealed to me what proved to be an astounding depth and complexity of basic biochemistry upon which these practices are based.


An example of the complexity of the science undergirding functional medicine is the biochemical pathways underlying neurotransmitter function and numerous other fundamental biochemical entities responsible for normal functioning at the


cell level. The following diagram is, be- lieve it or not, just a small piece of the big picture of cellular biochemical pathways – although an important one relating to areas of biochemical function where dys- function, weakness, or other variances in gene function are involved. These are in- volved in what is known as the “methyla- tion pathway” from a diagram by genetics researcher Amy Yasko:


dysfunction, neurological disease (includ- ing MS, Parkinson’s and Alzheimer’s), cancer, and autism. These mutations often act in concert with environmental and/or infectious agents to lead to these disease entities. Most chronic disease today in- volves the intersection among genetic weaknesses, infectious agents (parasites, bacteria, fungi, and viruses), and environ- mental toxins. Correction or compensation


Each colored capsule shaped object


in the diagram represents a genetic muta- tion or variant within the methylation pathway and can be influenced by spe- cific nutrients or supplements. As Dr. Yasko explains, genetic weaknesses, or mutations, in this pathway increases the risk for a number of conditions such as diabetes, cardiovascular disease, thyroid


for these genetic factors in the oversimpli- fied manner described above can impact the expression of the latter. This phenom- enon is commonly referred to as nutrige- nomics – the effect of nutrients upon ge- netic expression. This is part of the bigger picture of “epigenetics” which refers to the significant impact upon gene expression by environmental factors. Genes cannot


Robinhood Integrative Health Bruce Lantelme, MD


Weston “Wiggy” Saunders, MD Bose Ravenel, MD


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• Bioidentical Hormone Replacement Therapy • Adrenal & Thyroid problems • Breast Health • Perimenopause / Menopause


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