Systems-Based Medicine Is Essential for Your Good Health By Dr. Kiran Grewal, M.D.


unctional Medicine utilizes a systems-based approach to treat illness. It avoids the silo approach

of conventional medicine where every subspecialty is isolated and compartmentalized. A func- tional medicine practitioner understands that the body is a complex ecosystem. Standard medical training is usually focused on disease and diagnosis rather than on health and homeostasis. When I en- tered medical school I thought I was going to learn everything I needed to learn from my training. However, aſter working in conventional medicine for some years I was leſt hopeless. My patients were not improving. I had a pill for every ill but no time to invest in prevention or lifestyle efforts. Americans pay more

Cardiology crinology

Organ System Diagnosis

enterology Gastro- Neurology

Immun- ology

Endo- Pulmonary Urology

may then result in fundamental imbalanc- es at the trunk (core) level. Tese imbal- ances eventually result in signs and symp- toms that are grouped into diagnosable constellations that we call disease, and are represented by the branches and leaves of the tree. Conventional medicine,

on the other hand, tends to look at the constellation of


symptoms first–that would be clipping the leaves. Oſten the diagnosis is associated with

Signs and Symptoms

Digestion, Absorption, Microbiota/GI, Respiration

Defense and Repair Immune system, Inflammatory processes, Infection and microbiota

Energy Energy regulation, Mitochondrial function

long-term treatments such as pre- scribing metformin for Diabetes — and that is the end of the story. Patients

The Fundamental Organizing Systems and Core Clinical Imbalances Assimilation

Biotransformation & Elimination Toxicity, Detoxification

Communication Endocrine, Neurotransmitters, Immune messengers, Cognition

Transport Cardiovascular, Lymphatic systems

Structural Integrity From the subcellular membranes to the musculoskeletal system

per capita for health care than residents of any other country, yet we have poor health outcomes, increasing obesity and an epidemic of metabolic conditions. And we have a worldwide tsunami of chronic disease coming our way. Tree billion people around the globe are overweight. In the U.S. one of every three Medicare dollars is spent on Type 2 Diabetes. It is projected that in the U.S. alone we will spend 47 trillion dollars over the next twenty years on preventable lifestyle diseases.

Mental, Emotional, Spiritual Influences

Antecedents, Triggers, and Mediators Genetic Predisposition

Sleep & Relaxation

Exercise/ Movement

Nutrition/ Hydration

Resilience Stress/

Relationships/ Networks


will continue the drugs; the physician will monitor for side effects and eventually escalate the treatment with a second or third drug. Tis approach neglects the more fundamental aspects of health that reside in the roots and the trunk of the tree. It treats all patients that present with similar

Experiences, Attitudes, Beliefs

symptoms the same and completely neglects both the inherent genetic dif-

Environmental Pollutants

organisms Micro- Personalizing LIfestyle and Environmental Factors

larly, if the tree is not healthy, the first place you should look for answers are those same foundational elements. In Functional Medicine, we apply the

What is a systems-based approach and how can it help solve the chronic disease conundrum? Te Functional Medicine Tree illustration (above) represents the core aspects of the Functional Medicine paradigm. In order to keep the tree healthy and flourishing you must support the most basic and essential elements first–the roots and the soil. Simi-

similar approach to our patients. Te most important factors, and the ones we exam- ine first when gathering information about the patient, are the foundational lifestyle factors; sleep, exercise, nutrition, stress levels, relationships and the genetic make- up of that individual. Tese are the roots and soil, which are in turn influenced by specific predisposing factors (antecedents), discrete events (triggers), and ongoing physiological processes (mediators), which

ferences and the myriad of underlying root causes of the condition. Te road map to 21st century wellness and effective health care

looks very different when the lens of Functional Medicine is applied to chronic non-communicable diseases. It is the one looking at the human body as an inter- connected web where all the systems are connected and affect each other. My hope for the future is that we become more holistic physicians and stop practicing in silos or subspecialties — that we assist each patient toward optimal whole body long- term health instead or treating symptoms without regard for the underlying root causes of those symptoms. Harkiran Grewal, M.D., can be reached

at 1003 High House Road Suite 103, Cary, NC 27513. Call 919-234-7169 or visit See ad on page 13.

August 2018 15

Functional Medicine Tree illustration courtesy The Institute for Functional Medicine

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