Why is functional medicine being incorporated into practice at The Chiro Hub?

Think about the last time you visited your GP. What was the reason for your visit? Did you have acute symptoms that required management or were you were home from work run-down and ill and felt forced or obligated to produce a medical certificate for work? Do you rely on your doctor to assess your health status on a regular basis? Have you established a good rapport with them and trust that they are taking care of your health needs in the long term? Many GPs tend to wait for impending doom before taking restorative action, rather than direct their focus on preventative measures of health.

Most doctors will generally only intervene with a treatment plan of care if examination results (bloods, urinalysis, salivary) fall completely outside the population norms, mostly disregarding results that are at the edges of normal ranges, allowing the potential for a decline in health if not actively considered. Even then, advice is limited to temporary solutions rather than a broader outlook of addressing specific lifestyle factors. Generally, a GP’s scope lies within an acute disease or pathology model. A very small minority of patients who present to a chiropractor are categorized within this small group. However, health is not merely the ‘absence of disease’, unfortunately the most prolific philosophy of our current medical system. Our clients are experiencing unresolved symptoms that are not entirely biomechanical in nature and yet not classified as extreme to the point of requiring urgent medical attention.

When there is chronic recurrence of musculoskeletal pain and health conditions that are not alleviated by manual therapy, regardless of what type of treatment is employed (chiropractic, physiotherapy, massage, osteo), we need to consider the complex web of interactions in the patient’s history, physiology, diet, and lifestyle that can lead to illness.

Functional pathology testing is often used to identify underlying factors contributing to symptoms. We are looking beyond simply the absence of disease and focusing on the unique expression of the biochemical and neurochemical aspects of each patient. This evolution in The Chiro Hub practice reinforces the broader goal of restoring health to the nervous, immune, endocrine, cardiovascular and other regulatory systems of the body, taking into account the complex, dynamic systems nature of an individual. Understanding the unique internal relationships between body systems, when combined with chiropractic care, allows us to further facilitate natural self-regulation of our clients.

Bioregulatory systems medicine (BrSM) proposes that a more robust and effective solution for disease complexity should optimize the homeostatic systems of an individual as well as their interactions across many levels of biological organization. Underpinning this is a holistic understanding of the human body as a multi-scale, multi-level regulatory network, which covers the entire concept map.

The complexity of a systems approach challenges common reductionist thinking, and paves the way for medicine that works with rather than against the inherent interconnectivity of biological organization.

The whole is greater than the sum of its parts!

The current and prevailing linear model of intervention can be linked to increasing rates of iatrogenesis, unnecessary or poorly targeted diagnostics, and multiple practitioner consultations. This collectively contributes to escalating healthcare costs and inefficiencies in treatment.

Many doctors’ general advice would be to rest and go home, and where pain or inflammation is concerned, will prescribe opioids, anti-inflammatories or as reported recently in ABC news, a drug called Lyrica, used for depression and anxiety and now ranked as the top prescribed medication for pain on the PBS which is creating a public furore. Figures from the Federal Government show more that 4.1 million subsidised scripts for Lyrica (Pregabalin) were written in Australia last financial year at a cost of $113 million to taxpayers. Is this the best we can do when it comes to preventative health? Is this all that can be expected with the limited time constraints of a GP in the real life demands of a regular practice? With most practices being 15-20 years behind the current research as well as limited acknowledgement of the link between the gut, brain, nervous, endocrine and immune systems, it is no wonder that a shotgun approach is used to address a set of individual symptoms, rather than satisfactorily appraising the reasons for these system links to be biologically behaving in a certain way.

As mentioned, conventional medicine operates in a very logical, isolated, linear systems model. i.e. if your vitamin D score is low, the logic is to thereby supplement with vitamin D rather than assessing why Vitamin D is compromised from an interrelated, functional, co-dependant approach. Perhaps many people relate to this simplistic reasoning and are easily coerced into the ‘story’ they are given. The danger of this however, is that there is a greater incidence of inducing an iatrogenic effect in the patient by operating within this linear paradigm, with serious long-term consequences of health decline.

Another example involves the continually updated perspective on cholesterol and its relationship to insulin resistance and heart disease. A conventional general practice strategy would be to simply look at measures of high-density lipoproteins (HDL) and low-density lipoproteins (LDL) and ensure that these are sufficiently interpreted within a ‘normal’ range (see figure 1 below). On closer inspection, however, with a more detailed analysis using a functional approach, it is apparent that the LDL sub-fractional measures may present a more sinister result that would have otherwise been ignored. Sadly, this advanced scrutiny clashes with a deeply entrenched conventional ideology, hence the exponential rise of disease, regardless of advances in medicine and functional knowledge. We need to look beyond statin therapy, especially with the growing body of evidence-based preventative treatments for atherosclerosis.

Figure 1: ‘Normal Cholesterol’

At The Chiro Hub, we believe that the patient’s interest is also OUR interest and PRIORITY and we would be doing them a disservice if we did not offer a more rounded model of investigative treatment options.

Functional Medicine offers a powerful new operating system and clinical model for assessment, treatment, and prevention of chronic disease to replace the previously mentioned outdated and ineffective acute-care model carried forward from the 20th century. It incorporates the latest in biome research advances, genetic science, systems biology, and the understanding of how environmental and lifestyle factors influence the emergence and manifestations of disease. In this way, incorporating laboratory testing into our practice enables us as health professionals to practice proactive, predictive, personalized medicine and empowers our clients to take a more active, responsible role in their own health.

We begin this process by utilizing detailed questionnaires that are targeted at addressing the many systems involved in sub-optimal health by pinpointing specific symptoms. Added to this, results from in-depth clinic examinations (neurological and musculoskeletal, orthopaedic) that cannot be adequately treated with a chiropractic or physiotherapy scope alone are taken into consideration and used to formulate a distinct plan of action. We then synthesise the most relevant lab testing that coincides with your current state of physical and mental health, symptomatology and examination findings. The ability to deliver this more precisely integrated form of therapy is not merely the result of many intense years of study to understand the processes, It is also reliant on the skill and mind of the clinician, whereby the extracted data can be mapped into an organised, actionable plan. Please note however, that the time frame of this plan is never a quick fix solution, but requires an active client/practitioner dedicated plan carried out with respect to the aggregated process.

The addition of these lab testing services at The Chiro Hub, signifies hope for many of our clients that have experienced unresponsiveness to multi-modal treatments, ‘practitioner-hopping,’ chronic recurrence of symptoms and continuous ‘flare-ups’, even with the most gentle of manual therapy care!

This is an opportunity for our clients to uncover the multiple drivers in their symptoms and/or pain chronicity, knowing they have thoroughly been guided through all possible scenarios with the utmost professionalism and regard for their highest health wishes.

Below are only a few of the hundreds of possible tests to choose from, that may be employed in your consultation:

From respected Australian functional laboratory Nutripath:

  • Adrenal & Neurotransmitters Profile – a saliva test that measures DHEAs, Cortisol (6-8am, noon, 4pm, 8pm)
and a urine test to measure Serotonin, GABA, Dopamine, Noradrenaline, Adrenaline, Glutamate, ratios
  • Cardiovascular Profile – Comprehensive 2 – this measures Cholesterol, Triglycerides, HDL, LDL, ratios, Fasting Glucose, Homocysteine, Apolipoproteins A & B, Lipoprotein (a), Fibrinogen, hsCRP AND LIPOSCREEN LDL subfractions (x7)
  • AA : EPA Ratio – AA (arachidonic acid), EPA (eicosapentaenoic acid)

From renowned world-leading Cyrex Laboratory in the United States:

  • Neurological Autoimmune Reactivity Screen – Expanded, including testing for:
Myelin Basic Protein IgG + IgA Combined
Myelin Basic Protein IgM
Asialoganglioside IgG + IgA Combined
Asialoganglioside IgM
Alpha + Beta Tubulin IgG + IgA Combined
Alpha + Beta Tubulin IgM
Cerebellar IgG + IgA Combined
Cerebellar IgM
Synapsin IgG + IgA Combined
Synapsin IgM
  • Blood Brain Barrier Permeability, testing for:
Blood Brain Barrier Protein IgG + IgA combined
Blood Brain Barrier Protein IgM

One major concern about functional testing is the seemingly high cost of some of the comprehensive laboratory studies that are employed and yet not covered by our health care system. Whilst it would seem that a conventional approach would be more economical, a lifetime of treating ongoing symptoms is actually more costly. By unveiling a host of indicators through targeted questioning and diagnostic tools and determining links in the manifestations that arise, a short-term investment in targeted laboratory examinations makes much more sense!

So it is easy to see how and why bioregulatory systems medicine is the way of the future. You can rest assured that as a practice, The Chiro Hub’s objective is to guide you into this ultimately progressive field, with your highest health interests in mind. Our plethora of care ensures that all aspects of your health are taken into account, as well as providing a real and measurable understanding of what you are experiencing. You deserve clarity when it comes to caring for yourself! Why continue with disjointed care from a number of health professionals when all the linkages can be made within one destination?

Start completing your health puzzle now and book in for a consultation with Dr Yazbek here.

References:

  1. https://www.abc.net.au/news/2020-02-18/lyrica-pbs-drug-linked-to-depression-anxiety/11921882?sf230281900=1&fbclid=IwAR1yFQQA9K-BefKZJutmsXF9MhHlBc0_f-ds0n010tm4KP2fbmeqmL2AjVY
  2. Goldman AW, Burmeister Y, Cesnulevicius K, Herbert M, Kane M, Lescheid D, McCaffrey T, Schultz M, Seilheimer B, Smit A, St. Laurent G III and Berman B (2015) Bioregulatory systems medicine: an innovative approach to integrating the science of molecular networks, inflammation, and systems biology with the patient’s autoregulatory capacity? Front. Physiol. 6:225. doi: 10.3389/fphys.2015.00225
  3. Wong, ND, Toth, PP, Amsterdam, EA, American Society for Preventative Cardiology (2019) Most important advances in preventive cardiology during this past decade: Viewpoint from the American Society for Preventive Cardiology, Trends Cardiovascular Medicine, Dec 6. pii: S1050-1738(19)30163-X

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