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


F THE FUNCTIONAL MEDICINE TREE


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


Hepatology


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


Trauma


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 www.grewalcenter.com. See ad on page 13.


August 2018 15


Functional Medicine Tree illustration courtesy The Institute for Functional Medicine


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