Standby for a bit of a rant! Over the past 2-3 years, I have become increasingly worried/annoyed/frustrated by the way so-called ‘natural medicine’ is going. Ooer. Deep for a Wednesday afternoon!
More and more, I am finding myself saying things like: ‘do the simple stuff first and only get complicated if you have to’. Or, I hear the result of a really complex test and treatment ‘journey’ from someone and end up thinking: ‘yes, the liver needed support; it shouldn’t have taken all that to get to that pretty obvious answer, someone should have picked that much earlier!’ or something like that. I confess I have been doing some chuntering 😉
In essence, I think the emphasis has become much too complex, too medical; we are becoming like mini doctors offering plug-the-deficiency, influence-the-pathway sort of solutions to physiological illness, using supplements like medicines a bit too much and being influenced by some supplement companies who are acting not dis-similarly to Big Pharma ‘educating’ doctors to build sales. Not all of them, but there is a definite feel of it in the air and I think we need to become more aware of it.
It’s actually made me think quite carefully about what the Purehealth philosophy is and what I do next and I thought I might share the whys and wherefores with you!
Complex functional approaches
We have been experiencing a major shift over the last few years, not least with the growth of ‘functional medicine’ from the US. I have been an IFM member for several years and have been watching it build, including the massive growth of US websites and news articles propounding the FM approach and I confess my head has been in my hands at the hundreds of Summits being put out. I can’t say I’m entirely happy about it. Ooer. Controversial, but bear with me!
I’m not saying that functional medicine is wrong or bad or anything like that and I love the way people can get really useful information now where it used to be so hard before. I do also believe the movement is doing a lot to raise the science-base of natural medicine approaches in mainstream, which is fabulous, and it is giving a lot of insight into complex cases when it is needed.
BUT, I am saying functional medicine is not the whole story in natural medicine – and the complexity involved is confusing an awful lot of people – including practitioners! – hence I think the reason for me keep saying: ‘you’re getting too complicated, slow down and let’s look at the obvious’!
Some of you I know are shouting at me now, and I’m sorry about that, but I am not the only person saying this, it turns out. Phew.
Are we turning into pharmacologists?
As I say: my feeling, in a nutshell, is that we are getting far too ‘medical’ for want of a better word, using tests to identify things that may or may not make any difference in the end to a person getting better, using supplements like mainstream meds to upregulate or downregulate genes and body pathways etc.
I have studiously refused to get pulled in by genetic testing, by so-called personalised medicine, to full blown functional medicine. I got to the stage at the end of last year where I felt I either had to book myself onto a functional medicine course to learn more, or give up. My knowledge of all these pathways just wasn’t up to scratch. I couldn’t see how personalised medicine really helped unless you did a very specific diet and used single nutrients for each person, which is pretty untenable in real life practice, not least because of the cost. More chuntering.
Then I realised I have 25 years’ experience in natural medicine, most people have got well doing as I’ve asked, and this FM and genetic stuff has only been around a very short time. People were getting on well fine before it. I started to think about it and realised many people are simply missing out a whole raft of obvious stuff and diving straight into complexity, which can’t be right. Obviously, I can only say how I am seeing it, but I talk to a LOT of people and have definitely seen a shift in the last year especially. People are lost with it, to be honest, and I feel lost with it, let alone them!
My feeling is that it can indeed be important to do the complex biochemical stuff but not before you have done the obvious and far simpler elements of healing an illness first, for long enough and done well enough. Try telling that to someone who has already committed a lot of time, effort and money into a complex testing and treatment regimen; it doesn’t go down well when I suggest we go back to the basics and make sure we have covered them. There is an element of more complexity in illnesses nowadays, I am aware of that, but that may actually be partly because we are not covering the basics well enough like absorption, elimination, detoxification, inflammation etc, which I think are actually needed even more if anything nowadays.
It’s not good for business but I am also finding myself saying: ‘are you sure you need that test?’ more. ‘Is it going to help, really, in the treatment scheme of things?’ Many of the newer tests are so complicated and overwhelming. I find, much of the time, I am helping people pull out the priorities and trying to say this or that specific marker shouldn’t be taken out of context. They confuse people – and practitioners – more a lot of the time. There is a case for them sometimes, obviously, if you are looking for something specific and know what to look for, but a lot of people write to me and say ‘eh?’ and off we go with a really complex hunt…and, truthfully, it usually comes back to one of the basics like absorption, dysbiosis, nutrient imbalance etc. I quite miss the days of gut and adrenal tests lol. I offer the complex tests because people ask for them. Maybe I shouldn’t. Eek.
Not just me saying it, it turns out…
Anyway, I’ve been feeling like this for some time – and wondering what to say, whether to say it or just to ignore my instincts. You know I can’t do that by now ;).
So, this weekend, I was reading my usual journals and came across two pieces in IHCAN (previously CAM Magazine) for practitioners where experts I have known in the industry for many years were saying the exact same thing! (John Stirling, who founded Biolab amongst many other accolades, Patrick Holford, who coined the term ‘nutritional therapist’ and Simon Martin, the editor). I’ve followed all of them since the early 80s and respect what they have to say as they usually have their finger on the natural medicine pulse. To say I whooped and punched the air with relief is an understatement! I’ll let you have that image…. 😉
The magazine sparked the debate by changing their name from CAM (Complementary and Alternative Medicine) to Integrative Healthcare and Applied Nutrition. To illustrate my point, I paraphrase some of the points made in the articles for you and give you some direct quotes, so you can see what I mean:
It’s all in the name..
In my strapline for Purehealthclinic, I say ‘complementary and alternative medicine’. That was very deliberate at the time 20 years ago as I didn’t believe we should be called complementary, the recognised term at the time, and should be seen as a credible alternative to when mainstream medicine wasn’t getting it right for someone.
Holford asks: Complementary or alternative to what anyway? To a system of mainstream medicine that doesn’t want us, understand us and doesn’t work (evidenced by the huge increase in chronic illness which is what most CAM professionals deal with).
Functional medicine, is that the right term? We are all functional – a dentist, a doctor, a surgeon, a nutritionist, an osteopath – we are all working with the function of the body so it doesn’t truly describe what we do. FM has become:
heavily biochemical, pathway-based and not inclusive of the whole gamut of alternative approaches”.
In general, “We have become “too mechanistic, symptom-oriented,” acting like doctors prescribing meds. There is “too much focus on isolated specific biochemical factors upregulating and downregulating genes and pathways.” We are ignoring the underlying causes and contributing factors. “I do wonder whether practitioners are drowning in a sea of complex information that doesn’t add that much.” “There is too much functional testing and mega-dosing of nutrients.” ” The answer is not in higher doses of supplements trying to push pathways.” Some of these tests give results that can be ‘meaningless and are often overwhelming” that many practitioners are ill-equipped to deal with. Many supplement companies are acting like Big Pharma and spending huge amounts on educating practitioners, putting a lot of effort into convincing them of their worth. Not all, but some certainly. “There is too much substituting supplements for conventional medicines.”
Ooh. They weren’t dissing FM in general, of course, FM is very useful. What they – and I – am saying is that it is not the be all and end all and, I believe, in a lot of cases this emphasis is very confusing and we are starting to act like the very mainstream medicine we became ‘alternative’ from all that time ago!
We are spending our time on symptoms and what has gone wrong physiologically with the body, chasing down rabbit holes which, when we get there, often confuse the picture even more. We are simply getting too far away from the basic tenets of good health which, as I have seen from my time in natural medicine, gets most people well. You do those first and then – only if you need to – search and delve deeper.
Everyone says they know that, of course, but in practice I see it is not happening like it used to. No matter what anyone came into clinic with, I used to put almost everyone on digestive and absorptive support, a liver and gut cleanse (the Gut Plan now), remove common allergens and often give homeopathic, herbal or nutrition support for something specific.
I can honestly say I rarely had anyone who didn’t come back after that first 3 months feeling a ton better.
After that, we got specific with anything left and with what may have been triggering illness in the first place. It worked. For example, we used to talk through lifestyle, stress, emotional health, refer for physical therapy, energetic therapy (acupuncture, Bowen etc), hypnotherapy, counselling, foot therapy, holistic dentists etc – all of whom we made sure worked with us in the clinic (apart from the dentist – I don’t think drilling noises would be very relaxing for a natural healthcare centre!).
The emphasis was on supporting the body so that it developed more healing and corrective ability and removing any obstacles to that – whatever that might be. We didn’t chase any pathways.
Nowadays, it is much more likely that I try to suggest that but the person is fixated on something that have learned about a pathway – often thyroid, methylation, iron status, hormones etc – or they have had results of a gene test and are working on manipulating a SNiP. That’s all fine and great that we have such sophisticated patients now. BUT, when I dig to see if they have done the obvious first – most often are they absorbing the nutrients properly, have they supported the gut and liver, considered how their emotional past is affecting them physically etc – I get blank looks. We are looking for quick fixes much more often – supplements as drugs? Life is just busy and I would most likely be doing the same! The trouble is that our system of natural medicine is playing into that, I think, a bit too much.
This, I think, is the influence of the way natural medicine has gone and why it is bugging me! It means people have missed out simpler steps and are spending time, money and suffering on things that probably are not necessary. Not all the time, obviously. Sometimes there is much need to dig and do the complex stuff, but I think the emphasis has become warped in far too many cases I am seeing. People no longer believe me about the simpler stuff so much lol!
I am ranting here a bit, aren’t I? I know, but it is important.
Time to simplify…
There is a gradual movement, I think, back to simpler times. The term integrative medicine and integral medicine is being bounded about now. These reflect the fact that we should be incorporating a much more ‘holistic’ approach in clinical practice again – it is coming back around.
“We need to broaden and go beyond nutrition and functional medicine to truly resolve a person’s health issues.”
Many clinics would say they do that already. But do they? We were guilty of the same thing in Purehealth. We had all those different allied therapists all practicing from our clinic but we rarely did any formal case conferencing. I was always sad about that. Maybe I should have set it up better. I did do it with my own patients – which was most of them! – because I acted as a conduit and driver to their therapy through the clinic, reviewing them regularly, referring them to the various people and having conversations about what was needed from each one etc.
Sadly, I think I am beyond setting all that up again in any physical sense, but I have got some ideas about how to pull together some of these strands virtually and offer the simpler steps for people to do – and hopefully, as before, solve the majority of issues thus avoiding the need for complexity unless needed.
The Return of Sparkle…
Does anyone remember my Sparkle Programme? I taught the 12 week programme as the basis for turning your health around and as an illness prevention scheme for years in local colleges and for the NHS and companies. It covered many of the key themes that crop up in most illnesses.
I used to send people off with homework for the week – such as find anything in your cupboards that mentions trans fats and throw it out (remember: this was in the 90s when no-one really knew the issues about trans fats!) or find a piece of music, lay down once a day and try to follow one instrument only when you listen (a form of meditation). We did a full elimination and detox during the 12 weeks, tons of questionnaires and self-analysis and even field trips to the local supermarket! And, we had some wonderful success stories from it. The groups themselves became very close and that was part of the healing.
Here’s just one feedback I was sent at the end of one of them:
I have made dramatic changes… My symptoms have reduced from MAJOR to almost negligible as has my need for and dependence on medication. I feel more alive than I have for years and therefore more positive. I look forward to further improvements and to continuing to follow Micki’s advice.
Lump in throat.
We did have fun and I quite miss teaching them. Of course, Sparkle is a bit dated now, but I am thinking I may now bring that right up to date with current thinking and research and re-establish it so that people can do a simpler health programme from home, with group peer and 1:1 support and whatever else is needed. Who knows, we might even do some physical classes or even weekend retreats!
Anyway, the purpose of this (very long!) rant is to say that I feel validated in my ‘feeling bugged’ ness, that we have missed a simpler part out somewhere and I am going to do something about it.
Purehealth Philosophy of Medicine
So, now seems a good time to reaffirm what I mean by natural medicine at Purehealth. I have no idea what term we now use and don’t think it matters that much because it seems whatever term we come up with eventually gets dissed and turned into ‘woo woo’!
I actually think ‘holistic’ is the best term we ever had but it is not seen as sciencey-enough. I think Naturopathic, Holistic, Integrative Person-Centred Medicine is about right lol! I shall have to work on that…!
For me, anyway, this is Purehealth’s philosophy just so you know – and writing it down helped me to stop feeling insecure, bugged and more confident!
Holistic, Integrative, Person-Centred Medicine (HIP!) ????
All types of medicine are valid and respected for what they can bring to the table. From conventional meds, diagnostics and surgery to physical therapies (massage, physio, osteopathy etc), energetic therapies (Bowen, acupuncture, reiki, homeopathy), cognitive and behavioural/belief therapies (CBT, counselling, psychotherapy, hypno, neuroplasticity brain retraining etc), emotional health therapies (hypnotherapy, EFT, EMDR, WHEE, trauma therapy, art therapy, sound therapy, journalling), spiritual therapy (deepening connections, community support, meditation etc), biochemical medicine (nutritional therapy, functional medicine, cellular medicine, anti-inflammatory medicine, herbal medicine), exercise (walking, yoga, Qi Gong etc), social and cultural elements and much more besides – those are just the ones that came to mind. The point is knowing about them and when to use them.
Open-minded about approaches, but critical at the same time, not just accepting anything – due diligence and all that.
Preventative medicine is hugely important – get it right early and prevent the need for deeper treatment. This includes pre-conceptual care and childhood emotional health.
Supportive therapy is paramount. The body knows how to heal, we just have to identify and remove obstacles to it and do what we can to remind it how. Everything is designed to get that body into a healing state and help encourage it along.
Get the basics right. You are what your digest, absorb and eliminate first and foremost. The key body systems need to be supported to take the pressure off the body and give it energy to heal. The point is not to give it too much stress and even more to do.
Emotional health is a big part of therapy. There is too much research – and evidence clinically now – that past and present emotional stress is a major cause of (very real) physical symptoms and conditions and prevents the body from healing.
The patient and practitioner are partners in the healing process. It’s a (hopefully!) beneficial, respectful and mutually-supportive relationship. Self-enquiry, self-development and debate is a good thing! No one person or therapy has all the answers; collaboration and synergy make us stronger.
OK, so there you have it. I apologise for ranting and if you don’t agree with me. I am simply saying things are getting a bit too complex for my liking out there and I am going to try and return to a simpler approach for those who need it – which is about 80% of cases I see. We want to stop the illnesses becoming complex such as autoimmune, hyper-sensitive to stuff, chronic fatigue etc, and also to ward off the growing epidemics of anxiety disorders, diabetes and heart disease, so that will be my focus for now. I personally don’t want to be a clinician chasing down really complex stuff; I’d rather stop it in its tracks before it gets that far!
Of course, part of bringing it smack up to date will be to incorporate all we have learned in TGF and the Healing world over the past few years.
Next week, we’ll have the release of the new Healing Plan, which will target chronic illnesses triggered and exacerbated by emotional stress and trauma: a huge issue that very few people are even aware of, let alone doing anything about. It is a very big part of preventing and treating chronic illness so will form one of the modules of The Return of Sparkle course, or whatever I call it as that sounds a bit sinister!
Thanks for listening. I feel better now and I shall go and get on with creating it all 🙂