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Joanne Pizzino, MD, MPH, is board-certified in Preventive Medicine, and Diplomate-certified in Integrative Medicine. Dr. Pizzino is part of the Parsley Health team and has practiced Functional Medicine for over 20 years. Feel free to refer your friends and family. She is licensed to treat patients in 17 states. To see videos about Functional Medicine and brain function, type “Whole Health Solutions Cary” into your YouTube search engine.

Health Care Precision:
A Personalized Proactive
Partnership Gets Result

By Joanne Pizzino, MD, MPH
Medical Editor of Health&Healing

Dr. Pizzino

How do YOU feel? Does your body or mental state have a message for you? What signals are you receiving to clue you in for optimal health? Among the most important health habits is the ability to notice what makes you feel great, and when things are deviating from that powerful, life-affirming center. Are you a tough player, on your game, who can fight on through broken bones? Or are you a highly sensitive person, frequently distracted by puzzling irritations that seem to make no sense? Either way, partnering with a Functional Medicine physician can help you hone your mind and body to maximize your ability to be productive and follow your preferred pursuits.

Never before in history have humans had so much quality health care information literally available at their fingertips. And yet, this information overload of do-it-yourself, over-the-counter health care can be a source of confusion, frustration, and overwhelm in and of itself. Should I eat this food or that? Prepared this way or that? With these supplements or without? With water or a different beverage? And where do my medications fit in? Am I supposed to keep doing this exercise when I get sore or is that dangerous? What kind of lab test would get to the root cause? Do I need a device to monitor all these hidden indicators, or could the device itself cause harm?

While Dr. Google contains a wealth of information, which of it applies to you and your unique situation? Just because a celebrity says they had a miracle with something, does that mean it will work for you? If you put out your hard-earned cash for a gym membership, supplement, device, etc., will you be able to apply it to get the results you want? This is where personalization is precisely what is needed.

Detailed Health History

Science is an invaluable tool to help us make sense of big data. In particular, randomized controlled trials with large numbers of people make us feel safer to apply certain knowledge. But what about people in the real world who have variables that were not accounted for or answered by the science? Our real-world differences include genetics and epigenetics (how environment influences genes), taking medications, varying amounts of stress and sleep, and many more variations that can influence our outcomes.

This is why it is necessary to start with a detailed health history, which may need to go back to the womb. Did you know, for instance, that certain diseases such as asthma and multiple sclerosis are affected by whether or not you were delivered by caesarian section? Developing an ongoing partnership with a Functional Medicine physician who will take into account your unique timeline and environment is crucial not only for solving current issues, but also for preventing more serious problems.

Precision Laboratory Tests

Did you know there are literally tens of thousands of laboratory tests using blood, urine, stool, hair, etc.? A typical routine physical examination, or even admission to a hospital, might cover one or two dozen of these. The most common ones are designed to rule out acutely life-threatening conditions, such as severe anemia, blood glucose abnormalities, or kidney failure. But, when we are dealing with an ongoing condition, lasting months or longer, we want to think beyond surviving today to proactively optimizing conditions for your body to return to its innate ability to heal, as well as staying balanced to avoid chronic diseases.

Take the printed reference ranges that come with lab results, suggesting that you’re OK if your numbers fall between the high and low number. Rather than those conventional ranges, Functional Medicine uses “optimal” laboratory ranges. The printed reference range is based upon a standard 95 percent bell curve of the population. Unfortunately, not all of these people are actually healthy.

Instead, in Functional Medicine, we look at marathon runners and Olympic athletes, people who are optimally healthy. We look at their numbers, because this is what you want to be. To repair a serious condition such as diabetes, dementia, or cancer, close may not be good enough. Did you know, for instance, that a liver enzyme won’t even show up as elevated until 80 percent of your liver is affected? Using optimal ranges, by the time a lab test is “a little outside the range” we have important clues about where to look for root causes.

And what about tests that are not commonly ordered? Some of them—such as blood levels of nutrients or evidence of hidden infections—are available through standard labs and are often covered by insurance. It just requires a physician savvy enough to know which root causes are likely related to your unique situation to know which tests to order.

Others tests, such as specialty hormone tests or gastrointestinal function tests, require specialized laboratories and intensely detailed knowledge to understand how to interpret and treat. For instance, for a menstruating woman having suspected hormonal issues, don’t we need to know what is happening throughout the cycle, rather than just a one-day test that mostly measures non-available levels of the hormones? And is blood, saliva, or urine the best information? If your gut is not working, and the gross examination of a scope did not reveal tumors or life-threatening inflammation, wouldn’t it be helpful to know what is going on at the microscopic and molecular level? You betcha!

OTC Supplements

When it comes to nutrition and over-the-counter nutraceuticals, Dr. Google serves up more confusion than answers. Just because a certain diet works for someone else, does not mean it matches your unique genetics, your ability to assimilate, your environment, etc. Or could taking that supplement actually counteract your medication? I like to look at functional lab tests, which tell us whether that nutrient is actually working at the cellular level. When a patient asks “should I take this?” I try to answer with precision based upon their unique results. Similarly, when treating a common GI condition such as constipation, is this a result of digestive, immune, or toxin issues? Precision testing gets us specific answers to solve your problem, not just generic guideline recommendations for thousands of people.

While some physicians may balk at patients who bring information they have read elsewhere, I welcome patients who want to partner with a provider trained to evaluate the applicability of that information to their unique situation. This is the approach of a Functional Medicine physician. And, if I don’t know, I will find out so we can both learn something. Fine-tuning your approach by focusing on root causes is much more likely to get you the results you want.