5 Fundamental Principles
There are 5 fundamental principles or concepts that help navigate to the underlying causes of disease and that will help you achieve Balance. These concepts are the new roadmap in the landscape of health and disease and I will share them with you so you can apply them easily into your life. Once you wrap your mind around these principles you will begin see through a new prism. It is essential that one embrace these truths so as to experience the power of the Balance Protocol.
Biochemical Individuality Based on Genetic and Environmental Uniqueness
According to Balance Protocol perspective, patient centered care presumes that each person is a unique individual with a singular genetic structure. My purpose as a Functional Medicine practitioner is to elicit and understand my patients’ uniqueness, including their life experiences.
These experiences are the context of the complex processes where environment merges with their genetic inheritance. We have seen with great anticipation the progression of thinking and instrumentation that has brought us closer to describing the probabilities and possibilities inherent in our inherited DNA templates.
We have come to understand that our DNA does set boundaries on individual performance. However, as the deterministic model of genetics breaks down, research has demonstrated a plasticity to genetic induction not appreciated earlier.
Important to Balance Protocol practitioners is the idea that lifestyle translates into quantifiable effects on health through the energetics of our biochemistry and genetics. These effects can lead to disease. As we more fully understand the web-like relationships between environment and genetic responses, we can develop individual programs that reliably reflect the unique needs of our patients.
Person-Centered versus Disease-Centered
The individual—not the disease—is the target of treatment. The Balance Protocol views disease not as an enemy (not even as an independent reality) with which to grapple, but as a manifestation of the breakdown of mechanisms that maintain control, resilience, and balance. Dysfunction and disease are rarely organ-specific. Rather, they are an altered systemic physiological malfunction that requires an integrated model of therapeutic intervention.
The Balance Protocol focuses on the interaction between the person and his or her internal and external environment and the processes that can go awry in this relationship. Findings in molecular medicine research have caused a revolution based on the discovery that modifiers of gene expression are not only produced inside the body by different organs, they also exist as agents of change within the diet and environment.
The patient-centered biographic model is a key feature of Functional Medicine. An early spokesman for this concept was Leo Galland, MD, who wrote:
“Disease is a dynamic event in the life of an individual, determined by disharmonies, imbalances and pernicious influences. The goal of diagnosis is not to identify the disease entity, which has no independent reality, but to characterize the disharmonies of the particular case, so that they can be corrected.”
This approach to diagnosis emphasizes the functional pathogenesis of disease in individual patients. It may complement or replace the convention of differential diagnosis, in which diseases are treated as distinct entities existing independently of the patients they inhabit. Patient-centered diagnosis focuses on knowing the mediators, triggers, and antecedents of disease in each individual patient.
Dynamic Balance of Internal and External Factors
Important in the application of the Balance Protocol is the idea that lifestyle translates into quantifiable effects on health and disease through the energetics of our biochemistry and genetics. Different activities and emotions; such as eating, exercising or not exercising, joy, pain, and love, for example; are integral to inducing the dynamic mix of molecules that, through the masking and unmasking of chromosome sites, lead to the sum of experiences that our patients identify as their lives.
Environment modifies not only the expression of inducible genes but also post-translational cellular function. After the genes have been expressed and their message has been translated into the manufacture of protein and other cellular materials, the structure and function of these substances can be further altered as a consequence of processes such as oxidation or glycation. Both of these post-translational influences can further alter cellular function in such a way as to be associated with unhealthy aging.
The combination of the environmental effects on both gene expression and post-translational modification of cellular materials gives rise to symptoms of aging that are well recognized in clinical medicine.
For example, individuals who smoke heavily appear to age faster, and they have higher risk of age-related diseases such as cancer and heart disease.Individuals who consume excessive alcohol also appear to age more quickly, and they have increased risk to liver and heart-related problems. Individuals who consume poor quality diets that are excessive in calorie load and low in essential nutrients density, show the signs of over-consumptive under-nutrition with obesity, poor health patterns, and more prevalent age-related diseases.
These examples demonstrate how environment and lifestyle influence gene expression and post-translational modification of cellular function. Medicine has focused principally on the diagnosis of these diseases once they occur, and physicians have historically placed less emphasis on understanding genetic susceptibilities and gene expression modifiers.
Web-like Connections of Physiological Factors
People do not get sick from diseases, but rather diseases reflect a disruption in the dynamic balance between themselves and their environment. This understanding of a simply truth can really free one’s mind from the chain’s of disease diagnosis.
Fundamental to Functional Medicine is a profound awareness of web-like interactions among all systems. These interactions that have been artificially singularized by system of medicine we have today that is fixated on coming up with a diagnosis or some title we can blame complaints on.
The greatest crisis facing us is a crisis in the organization and accessibility of human knowledge. We own an enormous ‘encyclopedia’ which isn’t even arranged alphabetically. Our ‘file cards’ are spilled on the floor. The answers we want may be buried in the heap.
Three key notions, first articulated by Leo Galland, MD, help illustrate and organize the web-like thinking that is essential to the success of the application of the Balance Protocol.
The “Antecedents” (things that predispose) of our patients’ dysfunction rest within their biological terrain and genetic susceptibilities. The patient’s dynamic balance has constant perturbations that require adaptation. However, sometimes a force of change such as allergens, xenobiotics, drugs, endotoxins, and emotional stress are strong enough to create a dysfunctional response; these forces are referred to as “Triggers”. The patient’s response to a trigger consists of complex, web-like effects on the biologic system known as “Mediators”. For example, cytokines, prostanoids, leukotrienes, and lipid peroxides are mediators that cause an inflammatory response.
As futuristic as it may seem, the next step in diagnosis and treatment protocols can incorporate an assessment of the unique risk factors present by virtue of the patient’s DNA interacting with the end-products of his or her lifestyle, diet, environment, and thoughts.
For example, we know that the byproducts of tobacco smoke interact with cellular gene structures in the lungs to induce translational molecules. The presence or absence of these molecules affects the detoxifying function of patients’ liver cells. In turn, these cells arbitrate the development of breast cancer. The research regarding the polymorphic expression of inherited detoxification capabilities helps explain contradictions regarding the connection between smoking and breast cancer. The phenotypic expression of breast cancer is controlled by the genetic susceptibility of the patient experiencing the tobacco smoke, which helps define this susceptibility.
Health as a Positive Vitality—Not Merely the Absence of Disease
Today medicine is at a crossroads. Although medicine has successfully contributed to the development of the science of disease diagnosis and treatment during the past four decades, it has not been as successful in promoting healthy aging.
A majority of the aging population expects that they will never actually cease being active and will continue to engage in multiple activities, travel the world, meet exciting new challenges, and be available as catalysts for social change as they grow into their 70s and 80s. This is not a health as the absence of disease model, but rather health as a positive, achievable vitality model.
James Fries, MD (Stanford University Medical School researcher in the processes of aging) explains that much of the loss of function associated with disease among older individuals is a consequence of the progressive loss of “organ reserve.” When we are young, there is a reserve of organ function beyond that which is necessary for the baseline requirements of most organ systems.
As we age, however, we lose organ reserve; stresses that we could have once accommodated now exceed our resilience, which results in health crises. Fries emphasizes that organ reserve is related to biological age. As we lose organ reserve, our biological age increases, making us more susceptible to disease. But it does not have to be that way! We can modify how quickly we lose organ reserve and undergo biological aging through changes in lifestyle, environment, and nutrition. It is now recognized that 75 percent of our health and life expectancy after age 40 is modifiable on the basis of such choices.