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Going Beyond Integrative Care to "Functional Medicine"

Pervasive in modern society, stress permeates the human experience. Its complexity mirrors that of the human make-up and of the world around us, explained Ronald P. Ciccone, MD, director of Lourdes Integrative Family Medicine at the fifth annual Explorations in Integrative Medicine symposium, presented by the Lourdes Wellness Center and Lourdes Health System in March 2009.

“Stress is everywhere. We can’t get away from it,” said Dr. Ciccone. And, its solutions are multifaceted-addressing personal, environmental and genetic factors.

In his keynote address, “The Full Spectrum of Stress”, Dr. Ciccone outlined the myriad effects of stress and the range of alternative therapies available for it. He laid out the challenge for clinicians in caring for stress-related conditions: To conduct functional medicine-a brand of integrative medicine that focuses on addressing causes rather than symptoms and that looks at family history, nutrition, metabolism and other interconnected systems simultaneously.

Integrative medicine seeks to combine the best ideas and practices of mainstream and alternative medicine into effective treatments that will be in the best interests of patients and that aim to stimulate the body’s own natural healing potentials. It neither rejects mainstream medicine nor embraces alternative practices uncritically. It strives for optimal health and prevention-V and considers a person’s biochemical individuality.
— Ronald P. Ciccone, MD
Inclusiveness Essential

Using stress as an example of the breadth of interplay of factors and therapies that affect health, Dr. Ciccone suggested, “We should be cautious about the term ‘alternative medicine’ because it suggests two opposing camps of medicine, when in fact alternative and mainstream medicine are highly overlapping and synergistic.”

Putting these two schools together to achieve integrative medicine with a functional approach means understanding the likelihood of a given individual developing a particular disease or imbalance in a particular environment. One of a panel of experts addressing this year’s program theme, “Integrative Approaches to Managing Stress,” Dr. Ciccone added, “I like to refer to alternative providers as ‘healthcare extenders,’ partly because they are often more aware of the need to look at physical and emotional systems at all levels and to emphasize prevention.”

The Set Up: Genes + Exposures

Dr. Ciccone noted that just as one disease can have many causes, so one cause can precipitate many diseases. Stress is a primary example of a factor with disseminated effects, but one that, conversely, can have its own physical basis as well.

“Just reaching for a magic-bullet treatment for the end-manifestation of stress is like putting a Band-Aid on a much bigger problem,” he explained, citing the importance of the recent book by Mark Hyman (see sidebar), which looks at the effect of basic biology and wellness on our mind.

Dr. Ciccone referenced the importance of two areas:

  • Genes and the environment: Particularly, nutrition has a cell-signaling affect influencing the expression of genes. Thus, the importance of what is and isn’t in food. Traces of pesticide have a neurotoxic impact, even as traces of essential, naturally occurring minerals may be absent. The blood-brain and gastrointestinal barriers to unhealthy nutrition are weaker in some individuals. In discussing biomarkers for stress and mood susceptibility, Dr. Ciccone cited the work of Coriell Institute (see sidebar) in Camden.
  • Neurotransmitters: Exposures and diet also influence cytokines, which are “conductors of the orchestra of transmitters and hormones in the body.” Dr.Ciccone pointed out that, “Neurons don’t connect, they signal.” Not only can drugs deplete the neurochemicals needed for signaling, but stress and medications can overburden production and release of these transmitters. With the duress that constant, short-term stress places on the adrenal gland, the body can also go into cortisol deficiency or can develop conditions such as hypertension. Dr. Ciccone mentioned the utility of Ansar testing and the RESPeRATE device (see sidebar) for addressing such phenomena.

To care for stress-related conditions, clinicians must address the causes rather than symptoms, focusing on family, medical and personal history, as well as nutrition and other interconnected systems, according to Ronald Ciccone, MD.

The Accidental Psychiatrist

Reviewing the complexity of healing, Dr. Ciccone discussed quantum analysis and fractals, referencing these unifying, particle- and sub-particle level frameworks as a way to understand the fundamental systems that are the basis for health and disease. “With an appreciation of these constructs, we see that wellness goes far beyond linear, Newtownian, cause-effect physics and takes into account the energy from the total environment around us,” he explained, citing acupuncture as an example of a therapy that intervenes along the body’s meridians of energy.

“A working sense of the intricate nature of wellness helps us explain, for instance, the potency of placebos, an effect in which something is working therapeutically but we just don’t always understand what,” he elaborated. “For example, we didn’t understand why running gave a sense of well-being until we discovered brain endorphins.”

Maintaining that healthcare knowledge often runs well ahead of healthcare practice, he noted the significant obligation on the part of clinicians to use and discuss integrative interventions that have a good safety record, especially in addressing stress or stress-related conditions.

To learn more about Lourdes Integrative Family Medicine, call 856-869-3126.

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