Functional Medicine: thinking of your body as a factory
In our holistic medical practice we are increasingly looking into metabolic disturbances that often have far reaching and unpredictable consequences on health and wellbeing. Given increasingly sophisticated technology, we can pull away the curtain that then reveals blockages in normal body functions.
One analogy I use is to imagine a manufacturing facility that makes a lot of different products of amazing abilities. One of the surprising features of this facility is the relatively simple supply chain. It can make widgets that are used in lots of different products and these widgets only require a limited number of raw materials.
This is not a bad comparison to our own metabolic machinery where the “products” are the complex biochemicals of our metabolism that allow us to move about, think, plan, build, relate, eat, process nutrients, eliminate toxins and engage in meaningful work and relationships – sometimes even loving and joyful ones.
But sometimes this production facility has a partial breakdown in one of the assembly lines and our job as functional medicine physicians is to figure out where the breakdown is, figure out its cause or causes and then set about to repair.
This is fascinating process that requires some detective work – based on symptoms that lead to choosing specific diagnostic tests not usually performed in the setting of mainstream medicine. These tests will often pinpoint the exact spot in the production pipeline where the system is hung up.
In our human production factory, instead of using robots, we have enzymes. These enzymes take a “piece” (biochemical) and with the assistance of some cofactors 
transform the piece into the next stage of the process (another biochemical). The enzyme often comes in a variety of types based on genetic variation, so some people’s robots are inherently fast and effective and in others, not so much. Believe it or not, there can be problems when some enzymes are super-efficient.
So that part is pretty much the baseline state of our factories and because there is so much genetic variability we see a lot of variability in people! With regard to illness, we see some factories that are at risk for some diseases and other factories at risk for others. So what tips us one way or another in the evolution of illness – that is, a breakdown in factory production? It has to do with the things that effect those robots other than the genetics and they fall into one of two groups – one group that makes the robot worse and one group that makes the robot better.
Let’s talk about the group of things that makes things better – that make the enzymes work more effectively – even often able to overcome some bad coding in the genes. These are nutrients – most often vitamins and minerals and the cool thing about the current state of knowledge is we know what nutrients are good for which enzymes = so if we can identify which enzyme is not doing well, we can recommend some nutrients that may help.
The other side of the coin is much more complex, and we know little about the specifics. The category of things that tend to slow down or sometime shut down the production facility are toxins. Toxicology is the ultimate multifactorial problem – there are now so many manmade toxins and more being produced each year that the scientists that work in this area just can’t keep up and since the toxins influence each other’s toxicities for each new toxin we must theoretically understand how that one interacts with all the others. This is just not feasible since the incentives (and resources) to understand pale in comparison to the incentives to invent new ones.
So as we work with individuals to help their “factories” to become healthy again, much of our work can focus on helping increase specific nutrients to support the enzymes that are impaired. Because of the decreasing nutrient levels in food, this usually requires supplements. But when we try and decrease the effect of toxins, our work is more complex. The number one rule in toxicology is eliminating or reducing exposure. So helping our patients understand how to do this is important but time consuming since there are so many ways we can be exposed. There are also steps that can be taken to facilitate the body’s ability to clear toxins. These are often difficult areas to convince our patients to pay attention to because we have so few specifics about how it all works. But it is clear from a number of research studies that general efforts to reduce exposure and increase elimination will pay off in greater health and longevity.
To your Health.
Dr. Michael Sharp