If you want to help people who just aren’t getting better with the traditional methods they’ve already tried, then there’s a distinction you need to know: Pathological vs Functional.
Pathology relates to the study of the causes and impacts of a disease state or condition. Pathological is a term we use to describe a set of conditions—signs, symptoms, and relevant lab markers that relate to that disease state. If someone has high pathological serum levels of Thyroid Stimulating Hormone (TSH), HA1c, or iron, then they may be diagnosed with hypothyroidism, diabetes, or hemochromatosis respectively.
In each of these instances the pathological range means that the number falls outside of the realm that the particular lab recognizes as ‘normal’. It falls into the territory where it would be recognized as part of the pathology of the diagnosable condition.
And yet, someone could have ‘normal’ levels of one of those same lab markers (or any other) according to a pathological interpretation, but still be showing signs that relate to an imbalance.
That TSH is an easy marker to help us understand this concept. That’s because it’s slowly but surely better understood and appreciated that we cannot only look at the marker of a hormone produced by the pituitary gland in the brain (that TSH) to tell us everything we need to know about the function of the gland (the thyroid) that must supply the actual hormones needed by every cell throughout the body. In this case those hormones are thyroxine (T4) and triiodothyronine (T3).
In addition, it may behoove us, in our effort to help individuals who are suffering and not getting better, to narrow the range. This allows us to look at healthcare through a preventive lens and address imbalances before they reach the tipping point. If the leg of a chair is wobbly, we’d be best served to fix it before it breaks under the weight of the body!
Many people don’t feel well because they’re walking around with subclinical deficiencies in certain nutrients, or levels of biological compounds (blood cells, hormones, microbial factors and even oxygen or pH levels). Their imbalances aren’t pathological, but they aren’t optimal either.
These subclinical deficiencies often fly under the radar in Western medicine and traditional lab tests (or at least traditional lab test interpretations!) That means that just because a patient was tested, doesn’t mean they aren’t deficient. Just because the red ‘L’ (for low) or ‘H’ (for high) didn’t show up to catch the lab interpreter’s eye, doesn’t mean clinical interpretation and intervention isn’t necessary. And just because a patient does not have a diagnosable disease does not mean that they’re OK, that their pain, suffering or health challenges are all in their head, or that they shouldn’t receive help to allow them to feel better.
This is where you come in.
As someone who works with diet and lifestyle modification, you can play a unique role, and fill an important GAP in healthcare. One that addresses Functional levels of nutrients and biological compounds.
Most of the time, you don’t even need to read labs to do this. You can understand what the body needs most (I call this Tier 1 work), bring those factors in first, and take it from there. Tier 1 work alone can often address many of these imbalances!
Functional levels are more than simply not disease levels. Functional levels are optimal. They’re the levels we want for our clients because they nourish, create resiliency, and can even bring someone out of a disease state.
I like to use the analogy of a radio dial. Pathological levels mean that the station (of health) is not coming in at all. You’re getting zero signal or at most a very weak one. Working Functionally, on the other hand, means we’re fine-tuning the dial. The station is coming in, but the sound is fuzzy.
If you’ve ever listened to a fuzzy radio station, you know how it takes all your concentration just to make out what the person is saying. This happens in your body too. When the body is functional, it doesn’t need to work as hard to do what needs to be done, day in and day out.
After all, it’s functional!
As I said above, the place to start with every client is what I call Tier 1 work. These are the Non-Negotiables for that individual. They’re the foods (to add and subtract), nutrients, and habits that you have determined are most critical for that particular person. These Non-Negotiables often include sleep, exercise, community, and the removal of inflammatory foods.
Addressing these Non-Negotiables alone begins to fine-tune that dial. And they can be determined and implemented before we need to gather (or wait for the gathering) of information from lab results.
When you understand what’s going on in the body of your client, there is so much you can do with diet and lifestyle modification to help your clients create positive, lasting change.
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Functional nutritionist and educator Andrea Nakayama (FNLP, MSN, CNC, CNE, CHHC) is leading patients and practitioners around the world in a revolution to reclaim ownership over our own health. Her passion for food as personalized medicine was born from the loss of her young husband to a brain tumor in 2002. She’s now regularly consulted as the nutrition expert for the toughest clinical cases in the practices of many world-renowned doctors, and trains a thousand practitioners online each year in her methodologies at Functional Nutrition Lab. Learn more about Andrea here.