Good afternoon.
Thank you to the chair of the committee and to my MP, Dr. James Lunney, for inviting me to present.
As you know, there's an urgent need for health care reform in Canada. I believe the solution is to introduce and implement functional medicine in health care professions' curricula and practices throughout Canada.
Functional medicine addresses the underlying causes of disease using a systems-oriented approach and engages both patient and practitioner in a therapeutic partnership.
You have the cover page of “21st Century Medicine”, which is a white paper published a couple of years ago on how functional medicine could take our health care forward.
Functional medicine offers a powerful new operating system and clinical model for assessment, treatment, and prevention of chronic disease. It incorporates the latest in genetic science, systems biology, and the understanding of how environmental and lifestyle factors influence the emergence and progression of disease. It enables physicians and other health professionals to practise proactive, predictive, and personalized medicine.
The slide with the picture of the three-legged stool illustrates the importance of the three components of functional medicine: the patient’s complete story, looking at modifiable lifestyle factors, and a systems biology matrix framework.
The next slide goes over the seven organizing systems where core clinical imbalances are developed, such as, assimilation, defence and repair, energy, and biotransformation.
On the next slide the three core tools are the matrix, the timeline, and a GoTo It heuristic. What this provides the practitioner is a way of critical thinking when presented with complex cases.
The next slide is the functional medicine matrix, with a column “The Patient’s Story Retold” on the left, with antecedents, triggering events, and mediators. On the bottom is a section detailing fundamental lifestyle factors. In the centre is the mental, emotional, and spiritual components of the person, surrounded by the core clinical imbalances.
The next slide looks at the timeline from preconception to current concerns.
Then there is the GoTo It heuristic that helps the practitioner gather, organize, retell the story, and initiate a care plan.
The next slide is a picture of a dense jungle. That's how we often feel when we have these complex cases sitting before us and have to sort all of this out.
We know there are many famous detectives in the world, such as Detective Adrian Monk, Inspector Clouseau, Sherlock Holmes, and then the most famous of all, the medical detective, “Dr. Fxn L. MeD”.
I'll end this presentation with a case study of a woman with severe pain and gasping. This is a woman I met a few years ago. She is a 45-year-old businesswoman who had just got her M.B.A. She had a one-year history of episodic vomiting, diarrhea, abdominal pain, non-throbbing headaches, night sweats, red eyes, and severe muscle and joint pain, especially in the wrists and ankles. She also had intermittent shortness of breath with gasping episodes. You can see what I mean about being in a jungle and having to sort all this out. She had had several ER admissions, and most of her symptoms cleared up within several months.
She had evidence of fluid in her lungs at one of those admissions. Her joints were transiently swollen, and her C-reactive protein level was extremely high, at 211. That's the best marker we have for inflammatory disorder.
She had seen five specialists, including a rheumatologist, who thought she had inflammatory arthritis of unknown origin. She'd seen an ophthalmologist, as well as an allergist, and nobody came up with a diagnosis.
When I was taking her history, there was a key question I asked her: Did anything unusual happen to her just before becoming ill each time? She said, “Yes, one to two days before becoming ill, I sprayed my trees and shrubs with malathion”, which is a potent pesticide and herbicide. Examining her, I found her blood pressure was low, her skin was dry, her finger tips were cracked, the membranes of her nose were quite swollen, and her wrists and ankles were warm to touch.
Her lab work showed that she had iron deficiency anaemia, her C-reactive protein inflammatory marker had come down to 38 and it should be under 5, and her vitamin D level was quite low. I also ordered genomic studies to see how she was designed for detoxification and I found that in her phase I detoxification pathways, two of them had genetic mutations. Then in her phase II pathways, she had a complete absence of the most important pathway for getting metals and chemicals out of the system, called glutathione. This is specific to liver and kidneys.
I went on line to the Agency for Toxic Substances and Disease Registry and found the toxicologic profile for malathion and discovered that it is metabolized through the glutathione pathway, the pathway she was missing, and she had every symptom described in that profile.
The therapeutic intervention was to change her diet and put her on a medical food product to support her detox, probiotics, pharmaceutical-grade fish oil, a good dose of vitamin D, high dose of curcumin, which comes from the spice turmeric, the most potent anti-inflammatory compound on earth, and oral glutathione, and I told her to avoid further exposure to chemicals.
The outcomes at the four-week follow-up showed that her wrist and ankle pain and swelling had improved by 95%. Her arm muscles had regained strength. Her night sweats and GI symptoms had all resolved. Her sinuses were clearer than they had been in year. She had only occasional headaches now, and she was back to work.
The second-last page is cost comparisons. We look at the conventional approach and we see she had had numerous trips to the ER, eight days in hospital, five specialist consults, numerous blood tests and imaging studies, numerous medications, and no diagnosis, with prolonged disability. In the functional medicine approach, she had no ER visits, only two office visits, no specialists, and few blood tests. I had ordered the genomic study on detoxification and comprehensive stool study and arrived at the correct diagnosis. She experienced rapid recovery, was back to work in a month, and regained a thriving life.
I do believe that the answer to our health care problem in Canada is the introduction and implementation of functional medicine in the health care profession's curricula and practice throughout Canada.
Thank you very much.