When I started this series on Functional Medicine, David Gorski suggested looking at Mark Hyman’s web page, which I had seen months before, but thought did not reveal much. That was a wrong. It shows a lot, and I suggest bloggers et al review it.
So I decided on a fourth “functional medicine” (FM) installment, in search of what it FM really is. On the Mark Hyman web page and in his Public TV monolog fund-raiser, Hyman follows a seven point outline of what he believes Fuctional Medicine (“FM”) is. If one follows the 7 “keys” as he writes, optimum health, “ultra-wellness” happens. Here are the points:
- Environmental inputs
- Gut & digestive health
- Energy/Mitochondria/Oxidative Stress
- Mind body
Here is a brief excerpt from the environment section.
It is like the health of the soil. To have healthy plants you must have soil with the right amount of organic matter, the right pH balance, the right amount of nutrients as well as water and light and air.
We are the same – we need to have a healthy soil or terrain in order to be healthy.
In fact, Lois Pasteur on his deathbed realized this – and it is the terrain, NOT the germ, that is the most important determinant of health.
This explains why giving zinc to malnourished children in the third world can reduce death from infections by over 75% – it doesn’t stop exposure to the bugs, but zinc boosts immunity, helping the children stay healthy.
So by believing in this “germ theory” of disease, medicine has ignored one of the most important scientific ideas of the last century – that our health is determined by the interaction of our genes and our environment.
Hyman errs in two general categories. First, he misleads through literature. I reviewed the last five review abstracts on Pubmed and found reference only to increased limited infection susceptibility in children with zinc deficiency. Zinc intake follows generally protein intake. Supplementation studies in people with normal zinc levels and normal dietary intake were scarce. Supplement studies in children seemed limited to children in third world countries with borderline intakes and effects were limited to certain conditions, not all infections, and not all at the 75 percent level. In one review, Bhutta concluded, “The existing literature provides evidence of a beneficial effect of therapeutic zinc supplementation in the reduction of the duration of acute and persistent diarrhea. However, evidence for its impact on pneumonia, malaria, and tuberculosis in children under 5 years of age is insufficient and needs further evaluation.” (Bhutta ZA., et al. Food Nutr Bull. 2009 Mar;30(1 Suppl):S41-59)
Hyman gave no reference for his statement.
Yet there may be a role for supplementation in infants and young children whose intake is low in meats and Zn rich vegetables. Most human Zn intake comes from animal products, paralleling B12 – critters being micronutrient nutrient rich sources – and although critters do depend on plant intake, which depends on soil content, the serial processes concentrate micronutrients for human intake. Kids can’t always be depended on to “balance” their intake. However, there is hardly a clinical need for supplementation in modern societies like North Americans, which some readers might infer from Hyman’s statement. .
Second, Hyman erroneously claims that our standard way of looking at disease: that one “gets” a disease or “catches” an infection is wrong. The correct way to see disease according to Hyman is to recognize that the above mechanisms are operating and interacting constantly, and that exposure and “imbalances” cause what we see as disease.
The problem with Hyman’s FM accusation against medicine’s conceptual formation of diseases is that we already incorporate such things as systematic interactions, and have for 100 years or more (internal milieu, etc.,) certainly since discovery of hormones and their feedback mechanisms, and the multiple functions of organs. Even deeper understanding followed the unraveling and understanding of cell membrane and nuclear receptors, intra- and inter-cellular signaling mechanisms, cytokines, hormones, and the genetic controls and external effects on all of them. Hyman makes one think that modern medicine knows little of normal and dysfunctional mechanisms, even though the newest biological drug are based on those same concepts. It’s just another “CAM” type straw man argument against “The System,” which somehow they construct as wrong, incomplete, reductionist, insensitive, and what have you.
He also believes our classification of disease by symptoms and signs is wrong: that diseases should be classified by what is out of balance among the seven [or more?] conditions; that disease exists when something is wrong with the functions or interactions of the contents of the seven points.
But medicine already classifies diseases according to other criteria
such as hereditary, infectious, neoplastic, degenerative, etc. Or, described by organ systems – endocrine, nervous system, etc., as taught in medical schools for 100 years. When the mechanisms are not known, we describe the disorder as a syndrome – a recognized deviation of symptoms and signs. When the mechanisms are discovered, we use more physiological rather than descriptive definitions. Somehow this order of progressive knowledge encoded in classification escaped Mark Hyman’s medical learning curve.
In order for medicine to accept Hyman’s New Order of diseases, the proponents must come up with both the proof and the reasons exchanging what we already know for what he proposes. So far, that evidence does not qualify.
Hyman’s principles apply more appropriately to the “functional” conditions we call phantom diseases – chronic fatigue, chemical sensitivities, fibromyalgia, neurasthenia, some irritable bowel, and other depression-generated, somatiform disorders, plus those for which there exist only behavioral definitions: ADD, autism-like syndromes, etc. Most of these conditions do not respond to specific therapies, but their human hosts tend to seek and respond to off-beat fringe, cultic methods and remedies and infomercials. Sufferers and victims ally with non-specific, often pseudoscientific methods and therapists and that appeal to imagination, creative imagery, and sympathetic magic.
FM: tailored for dysfunctional and unhappy people.
For the reeally curious, if one has not seen Hyman’s infomercial, here is a series of statements from a few segments as shown on public television. See how many you agree with.
- “Sugar is poison. Sugar addiction causes insulin resistance and depression 100 percent reversible by diet.”
- “Thyroid disorders occur in 1/5 females and 1/10 males. All people need free-T3 & free-T4 tests and absolute T3, T4 levels.”
- “Cornavirus (?) occurs in 1/3 people in the brain, causes brain swelling and depression. Also autism patients have “swollen brains.” “Treat the swelling and autism goes away.”
- “Depression, and irritable bowel (IBS,) etc. mean the body is out of balance.”
Interval: Host Greg Sherwood states that following Hyman’s advice can “make incredible changes.” The UltraLife Solution is a revolutionary change in how we lead our lives. It’s medicine of the future.
Next segment: In FM we think about the root causes. FM gets to the roots of all chronic disease. We find out how to connect the roots of 20 different diseases. In one case, I simply removed gluten (wheat product) from the diet and added vitamin D and all her diseases disappeared: IBS, CFS, depression, ADD, and dementia.
(Point 4.) Fixing your digestion: Half the brain is in the head, the other half in the gut. The brain and the gut have to talk to each other. Serotonin is half in the gut, half in the nervous system. A bloated inflamed gut produces a bloated, inflamed brain. Half of our immunity is in the gut. Absorbed toxins from diet get into the circulation and then to the brain. The liver gets overloaded [with toxins] and they then get to the brain. One patient with obsessive-compulsive disorder (OCD) loved carbohydrates – she was intoxicated from bugs in the gut, got drunk from their secretions sky high levels of yeast with overgrowth in the gut. I gave antibiotics followed by pro-biotics. Bad bacteria had overtaken the good bacteria. [This is the core theory of candidiasis, another of the many erroneously named of the somatiform disorders. WS]
Toxins are everywhere. So, reduce exposure and protect your brain. 80,000 lb. of lead and 6 million pounds mercury are released /yr – a total of 6 billion lb toxic chemicals. [This could be at least partially true – but the effects? WS] 600,000 babies have toxic levels of mercury. 3,000 chemicals exist around the home. One answer is to increase glutathione [an anti-oxidant in tissues].
The seven keys to ultra-mind: The major problem is mercury poisoning. In one instance we removed mercury fillings, increased the glutathione. We removed other metals, gave vitamins.
Boost energy metabolism. How to get the energy back: take CoQ10.
Calming the mind:
- Stem cells are made/stimulated through the vagus nerve.
- FM is “a new kind of medicine.”
- For 250 you can get 2 books, 8 CDs 7 audio CDs
- We talk about health, not disease.
An ad referred to treatments available through:
- Immunolaboratories, and
- The right food tst.com.
I’d serve you all better by referring you to two web sites:
- Hyman’s own site, DrHyman.com, which is worth exploring superficially to get a sense of how FM operates, or how his mind does.
- Then take in a thoughtful column in Salon magazine by Robert Burton, MD, from just 4 months ago.
Robert Burton is a neurologist and novelist. Except for the example I recorded above, I don’t want to repeat what a competent critic already has written. Look also at the Mark Hyman response and the 50+ letters that followed. Hyman’s response is a cornucopia of “alt/comp/Integ-med” nonsense jargon, false accusations, and unsupported claims. Note also the preponderance of letters favored Dr. Burton’s critique and were highly critical of Hyman and of KQED for using such infomercials. SBM and Harriet Hall’s post on Amen were mentioned in the letter exchanges.
So with this entry I finally see what FM really is – a non-scientific, ineffective, jingoistic, cultic approach to dysfunctional somatiform, non-disease conditions.
FM: Non-treatments for non-disease