Ep 45 Living Life Well Show: Traditional vs Functional Medicine & the testing difference
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[00:00:00] Welcome to the Living Life Well Show, the intersection of God's Word, today's science, and healthy living with common sense application, all based on the truth of the Word of God. I'm your host, Dr. Jon Skelton. Now let's get straight to the truth.
All right. Welcome back to the living life. Well, show today. I'm excited to talk about the differences. Between approaches in medicine between approaches to labs. So what we're going to be talking about today is the traditional medicine approach versus functional medicine approach, traditional or standard range lab work versus functional or optimal range lab work.
So let's go ahead and dive right in. So. Traditional medicine is how I was trained. Should traditional medicine [00:01:00] meant that I went through four years of medical school. Then three years of residency,
The first two years of medical school, we're really learning about the human body about how God made us about the physiology, about the anatomy, about what normal is.
That was the vast majority of the two years of medical school. Now we were also introduced to disease process. We were also introduced to how disease process may carry variations in the function of those organs that we had been studying for the year and a half or two years and medical school. Before really starting to see patients and how that disease process was manifested in symptoms was manifested in history, was manifested in physical exam findings and finally in laboratory findings.
And that is the [00:02:00] crux of medical education today. It is all about diagnosis. It is about getting to what label we can put on what someone's experiencing. So. If somebody is experiencing fatigue. And they are believing that they are having. Thyroid issues are seeing weight gain. They're seeing hair changes that would trigger a physician to check the thyroid.
Right. Well, once they check the thyroid, if it is deemed to be abnormal through that standard range, blood testing. Then, typically what is going to happen is you're going to be started on a medication. Most likely it's going to be levothyroxine and trade names may be Synthroid. You may see other names that are out there as well. Well, what that's doing is that is artificially supplying you with the thyroid hormone. [00:03:00] That appears to be deficient that the thyroid hormone produces.
When we check labs, we're checking a TSH and a T4 in traditional medicine. TSH is a signaling hormone that comes from the brain to signal the thyroid, to make T4.
And when that process isn't occurring in balance, that's when we diagnose thyroid disease, be it a graves' disease.
Be it Hashimoto's be it. Hypothyroidism, hyperthyroidism. Just really is dependent upon what we're seeing in those TSH and T4 values. Well, in traditional medicine, that's kind of where we stop. We stop right there and then we continue to add on, thyroid medication and, or other medications.
If we're looking at hyperthyroidism. And that's kind of where it ends. It kind of stops right there for, for [00:04:00] most patients. And once a year, once every six months occasionally some physicians will check it more often than that. They will check, say a thyroid lab every three months. And so. You go along, you're on your medication. If you're noticing improvement.
Great. If you're not noticing improvement well, Well, you're going to stick around there for a while. You're going to stick around there on that same dose for about three months, maybe even up to six months, unless you are then going to your physician and saying. Hey, I'm not getting the results. I thought this was going to increase my energy.
Allow me to also lose weight exercise now, but I'm not really experiencing any of that. And so we go along in this fashion. Where. If you are getting results in the timeframe that's expected. Great. If you're not, then you have to push.
You have to be your advocate. And really that is [00:05:00] a lot of the difference between traditional medicine, as well as functional medicine. Traditional medicine is about getting to a diagnosis. It is not about getting to the root cause. It is about determining whether you are in the normal range. Or abnormal range.
It is about physical diagnosis. And it neglects any other confounders that may be at play causing these manifestation of symptoms. And so we tend to want to automatically go to drugs and, or procedures in traditional medicine, because that's what we know. That's how we've been trained. We've been trained that if a person has hypothyroidism. They're going to be placed on. Leave a thyroxin they're going to be placed on thyroid hormone.
But again, we're not [00:06:00] getting to the root cause.
So in functional medicine, what we're going to do is we are going to diagnose with that is that is step one. We will diagnose, okay. What organ system and or systems are out of balance here, because what we see frequently with thyroid. It is not just thyroid that's out of balance thyroid when it stays out of balance long enough. It's going to cause issues with other organ systems within the body.
Be it the adrenals be it, the sex hormones. Be it even potentially your gut and vitamins.
So in functional medicine to really diagnose where the root cause is, we need to be much more comprehensive. We need to be comprehensive in the organ systems that we're testing. And we also need to check the other organ systems that can cause similar symptoms and not just focus on the one that we believe [00:07:00] that it might be.
And ding, ding, if that box is checked on, those labs were done. We check out that's the traditional medicine way functional medicine way is going to look at and see what other organ systems are potentially being affected. What other organ systems could have potentially led to this disruption that we're seeing. In the thyroid hormone, thru testing.
So. When we test in functional medicine, we want to be very exhaustive. We want to test the wide. Ranges of tests that are available to us, but we also want to look at what the causes could be. So any time I get somebody that on my intake forms, Score's very high with regards to thyroid. I also want to check for Mono be it a history of Mono or a history of reactivated Mono. [00:08:00]
I also want to check for antibodies. Antibodies frequently. It would be a diagnosis of Hashimoto's or an auto-immune condition causing thyroid disease. And so that's how we would diagnose that through antibody formation. Well, one of the main drivers of Hashimoto's and antibody formation. Could be previous infection and could be. Reactivated Mono.
And so we want to look at it thoroughly so that we can have a full spectrum of treatment to a minimize the impact to you on your body and B really promote healing in all its forms throughout your body. Not just the organ system that seems to be disrupted. Through the blood work, but through this reactivated virus that over time can cause disruption to multiple org, other organ systems.
If it goes undiagnosed or [00:09:00] unseen.
So the functional medicine approach is going to look at where all the potential disruptors are. Of the organ system that is manifesting the most symptoms. Be it. In this case, the thyroid. And so we're going to check widely, we're going to check multiple labs. We're going to check the antibodies.
We're going to check your free T4, your total T4, your free T3, total T3. We're going to check your iodine and selenium that are involved in that process of transforming T4 to the active form of T3. And then, like I said, we're gonna gonna check for other causes that could be creating this environment for this disruption of the thyroid performance. And so when we check labs, we're going to be very wide with that net. In addition, we're also going to be very narrow with the results.
So this brings me to standard range, lab work versus functional late range [00:10:00] lab work. So standard range lab works are based on standard deviations from the mean. Basically what that is assuming is that each standard range lab region may have variations. In what is quote normal? The reason they have these variations could be because of the way the particular test is, is being derived.
The result is being derived, but typically. What it is, it's that the population being tested to arrive at the standard ranges is either more sick or less sick than other populations. So let me give you an example of this. So. Looking at. Insulin. . Fasting insulin being one of the things that, that we check in functional medicine very often when [00:11:00] patients are having issues with fatigue or, or hunger or salt loss. Different things. Like this will, will drive us to checking. I fasting insulin. Well, when you look at standard range lab work, it is going to be anywhere from an average of two to 19 to currently in our west Texas region from lab Corp. The range is going to be from about two to about 25. Well, that's a pretty wide range.
Just looking at that. That's a 23 point. Range variable, essentially. What, how did they come up with that? Well, what they do is they essentially. Take a healthy population where someone that hasn't been diagnosed with diabetes. And then they have them. Draw blood, check those fasting levels. They determine what the mean is, or in the middle. And then they [00:12:00] calculate something called standard deviation. Standard deviation takes into account the wide breadth of all the results that they receive.
And it's a calculation that they determined that. Okay. We're going to say that 95% of these people are normal. So that would coincide to two standard deviations. Well, if everybody is really close, say everybody had an insulin level between five and, and say 10. Well, then that standard deviation is going to be much more narrow, right?
So if you have an insulin level of say three, you're definitely going to be outside of that center. Deviation. If you have an insulin level of 10. You may be outside that center deviation as well. The standard deviation is going to be either wider or smaller based upon the breadth of the scores that are [00:13:00] achieved.
So standard deviation is used in traditional lab work to determine what is quote normal for 95% of us. And when we believe that up to 94% of us have some sort of underlying metabolic issue. That's supposition just is. Quite. Frankly, it's just stupid. So to consider that you're going to try and include 95% of the population. Within this laboratory test and say that 95% of the population is going to be considered. Normal. That. It takes a huge giant leap. So you've made two assumptions here.
One you've made the assumption that, that all the people that are, that you're testing are without dysfunction of the organ [00:14:00] system that you're testing. That's number one. You're also assuming that average is the starting point. And when you look at average, as of the results as a starting point, And then develop your standard deviations off of that.
You're again, making a huge assumption that the information that you're gathering is actually accurate. Well, the difference between traditional medicine and functional medicine with regards to lab ranges is vast. So traditional medicine says that. You're you're. Levels are based upon your peers. Is essentially where traditional medicine goes.
Functional medicine says. Your results, whether normal or abnormal are based upon what is normal, good physiologic function of that organ system, not on what everybody else is [00:15:00] doing in society or how everybody else scores this. Isn't scoring yourself against everybody else. This is scoring yourself against what is best. And so when you take that approach, the Rangers are much different.
Let's take a fasting insulin, for example. So fasting insulin. We'll really be between two and five. Your pancreas, if you're fasting for eight hours or more, should not be fired up, it should not be secrete, ING, significant levels of insulin. If it is, that's an indication that you have insulin resistance, that you may have cortisol elevation that your. Organ systems are not functioning properly. And if you are way outside of this and you're outside of the normal range, then you have significant insulin resistance. Now you can have a little bit of variable within that when you're talking [00:16:00] about extremes of age, when you're talking about teenagers, when you're talking about the elderly you and newborns.
Those things are taken into consideration. And so when we take thyroid and we look at thyroid, so we see TSH typically is going to be anywhere from about one to about four and a half or five and a half on standard range lab work. It really appears that the optimal range for TSH is about one to three. Much more narrow.
So if you're at a TSH for your primary care physician may tell you, oh, this has nothing to do with your thyroid. Your thyroid is normal. This is not at all. Your, your symptoms that you're having or just in your head, it's not affecting your thyroid. Well, we know in functional medicine that you're outside of the optimal range.
Anytime you're outside of the optimal range. That organ system could [00:17:00] be leading to see this a lot with potassium as well. The optimal range for potassium is four to four and a half. The standard range for potassium is about three and a half to five and a half. Well, when your potassium is low, But low between three and a half and four, you may have symptoms of fatigue.
You may have muscle cramping. You may have muscle fasciculations or twitching even. And so when you're outside of these optimal ranges, you can have some symptoms. Now, when you're very close to the optimal range, typically your symptoms are going to be much less when you're well outside the standard range. Then, yes, you're definitely going to have symptoms.
Typically. They're going to be very significant. So. When we, when we test in functional medicine, we want to be comprehensive with that testing, but we also want to be very narrow with what [00:18:00] we are considering. Optimal or best. And so I hope that sheds a little light today on the difference between a traditional medicine approach and a functional medicine approach.
The functional medicine approach is. Going to really encompass diet and lifestyle, your mental health, because in a functional medicine approach, we know that a new diagnoses or just stress in general is going to affect your overall body function. It's going to affect your levels of neuro-transmitters your dopamine, your serotonin, your oxytocin.
It is going to affect your cortisol levels. Your nor epinephrin levels. Which in turn is going to affect your glucose levels and your pancreatic function. And so it's that overall approach that functional medicine takes to really look at the global health that is going on to really get to those root causes, [00:19:00] to not just hijack the body's normal routines. For function. And then set them back into quote, a state of no more symptoms. Because that's really what we're doing.
When we talk about adding pharmaceuticals in, we are really talking about managing symptoms as opposed to reversing disease or curing disease, blood [00:20:00] pressure.
That's it for this episode of the Living [00:21:00] Life Well Show. If you like what you've heard and want to learn more, or want to know how to put this into practice for yourself, go to livelifewellclinic.com. Until next time, this is Dr. Jon Skelton saying, go out and live the truth so you can live life well. The preceding is for entertainment and educational purposes only. It is not meant to be used to prevent, diagnose, treat, or cure any condition. The information contained in this show does not substitute the need for a qualified medical professional, nor is it meant to provide medical advice or services.
If you feel information presented in this show may apply to you, we recommend you seek out the help of a qualified medical professional who can evaluate and treat your specific concerns.
