August 12, 2024 • 12 mins
In this episode, Dr. Paul Anderson clarifies the distinction between diseases and functional health issues, helping you understand how each impacts your health and well-being. He covers:
- Defining Disease: Explanation of what constitutes a disease, including its diagnosis, pathology, and how it typically involves structural changes in the body, such as infections, cancers, and chronic conditions like diabetes.
- Understanding Functional Health Issues: Overview of functional health issues, which may not have a clear-cut diagnosis but involve imbalances or dysfunctions in the body’s systems, such as chronic fatigue, hormonal imbalances, and digestive issues.
- How They Differ: Key differences between diseases and functional health issues, including how they are identified, treated, and managed.
- Diagnosis and Testing: Discussion on the diagnostic processes for both diseases and functional health issues, including the use of lab tests, imaging, and symptom analysis.
- Treatment Approaches: Comparison of treatment strategies:
- Disease Treatment: Typically involves targeted therapies like medications, surgery, or other medical interventions aimed at eradicating or managing the disease.
- Functional Health Treatment: Often focuses on holistic approaches, including diet, lifestyle changes, stress management, and natural therapies to restore balance and improve overall function.
- Integrative Approaches: How to combine conventional medical treatments with functional medicine principles to address both disease and functional health issues comprehensively.
- Case Studies: Real-life examples of how patients with either diseases or functional health issues have been treated and managed successfully.
- Empowering Health Choices: Advice on how to navigate healthcare options, understand your own health better, and make informed decisions about treatment and lifestyle.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome back to medicine health. I'm doctor Paul and this
is doctor pro Tips. The next one is what is
the difference between a pathologic disease state and then what
we in more modern times might consider a functional disorder.
And I think this is a really important distinction to
(00:23):
make because it especially the more doctors you get involved
in your life, and sometimes with complex chronic illness and
cancer and other things, you may have a whole lot
of healthcare providers all playing in the same field, and
so sometimes there is a distinction in what might be
(00:45):
being worked on between a disease which is going to
be fairly simple to define, and then something that is
maybe pre disease prevention oriented or a functional problem which
is maybe partly pathology and partly non pathologic. So what
(01:07):
does all that mean? Well, one way to think about
it is diseases are things that we've identified in the
science of pathology and pathophysiology. We know generally why they occur.
We certainly know what happens to the cells or the
(01:28):
body when we have that disease. You know, in modern
times we have codes for these diseases, and we usually
have some sort of diagnostic and therapeutic algorithm. It says, well,
if we're looking at this disease, here's how we diagnose it.
And if it's diagnosed and that truly is your disease state,
(01:49):
then here's the options for treatment that are available. So
it's pretty linear, it's pretty straightforward. A dysfunction or a
functional problem can be anything along a pretty long road. Now.
One way to think of it is a functional problem
can be a non disease state because it's it's actually
(02:10):
a precursor to the disease state. So, for example, you've
probably heard of people who are diagnosed with, you know,
pre diabetes. Well, what your healthcare provider is really saying
is you have the you know, all of the factors
that go together to make let's say type two diabetes
(02:32):
and an adult, but your lab values haven't reached the
critical point where we're going to call it type two diabetes.
We're going to say you pre diabetes. This is an
excellent time to do a lot of preventive things. And
we've had a lot of people, you know, who are
diagnosed as having pre diabetic conditions, which really means your
body's already on the way there, it's just not so
(02:53):
bad off, and they were able to change their diet
and exercise and all that and they never became full blown,
you know, type two diabetic for example. So that's an
idea of a preventive or a functional problem. Now some
of these things, now I was mentioned coding and all
of that, and that's usually what you know, gets it
(03:16):
paid for on your insurance. Some of these pre states
or these these preventive states now actually have diagnostic criterion entities.
Another one that we see a lot of is early
diagnosis of macular degeneration degenerative eye condition. That's quite common,
and it used to be not commented on or not
(03:38):
diagnosed very early. It was until you start to have
vision loss. And now they are doing a much more
aggressive job of diagnosing people younger. And what they will
tell them it's kind of like the diabetes story. Well
it's not it's not fully you know, changing your vision's
not doing these things, but it's it's in your future
(04:01):
and so you don't really qualify for the drugs that
we would normally give somebody with that or whatever. It's
just a really good time because it's a precursor disorder
to look into things that would be preventive for that
and again our practice, we work with people who have
early stage or pre MacLaine degeneration and we look at
a large number of other factors that may feed into
(04:24):
that and help them to either forest all or slow
down the onset of the actual disease state. Now, another
thing that happens is a little more complicated than that
is I mentioned that some functional problems have a component
(04:45):
of disease to them, And usually what that means is
the component is at a lower level, and so it
might be diagnosed or it might not be diagnosed, but
because it's at a lower level, it doesn't look like
a big part of the problem. But what I would
sort of describe to patients is you could have a
(05:05):
lot of symptoms from a disease, and let's say that disease,
you know, is a stack of quarters that's you know,
three inches tall, so it's pretty much above the radar.
The labs are going to be weird, and you're going
to need treatment. There. What if you had three one
(05:27):
inch stacks of quarters, so you had three different body
systems that were all a little deranged, a little abnormal,
but not fully pathologic or maybe a little bit maybe not,
you'd still have the same amount of problems, they just
wouldn't be sticking up above above the radar. So a
lot of the screening tests, etc. Might not test or
(05:51):
check those things. And that's a really important thing to
keep in mind too. So in a lot of our
chronically ill patient, sometimes in our recovering cancer patient many times,
and people that aren't getting you know, they go to
their doctor and they don't feel well. Doctor says, well,
your labs look fine, so you know, let's just keep
an eye on you. A lot of those types of
(06:12):
cases are these cases where they're a little more complex
or there might be little, you know, little baby level pathologies,
but there's a bunch of them going on. And in
the primary care acute medicine model, we're not always taught
to look for more than one thing. So for example,
you know, you might be feeling tired and fatigue and
(06:33):
they check you for anemia, They look at your liver
and kidney functions, they take a look at your thyroid function.
Everything looks okay, you're not profoundly a knee make, your
thyroid's not that bad, et cetera. And will what will
happen a lot of times is in that person will
continue to feel bad, and they'll say, well, these things
(06:54):
look good. Then what you have to do is take
a step back and say, well, haven't we looked looked
at Could there be other hormonal influences that are creating
my fatigue? Could I have a sleep disorder, you know,
obstructive sleep app or something. Could I have other biological
things going on they're all feeding in and so then
(07:16):
in that case, what you would wind up with would be,
you know, maybe a little bit of a thyroid issue
and a little bit of another thing and some sleep disorder. Whatever.
The point is that it's more of a functional collage
of a problem giving you these symptoms of maybe fatigue
(07:36):
or sleep disorder or something, and that functional collage has
to be dealt with, but it can't be dealt with
with the same intensity that one big disease does. So
this is where a lot of times things like the
functional medicine approach or nature pathic medicine or integrative medicine
(07:57):
kind of shines in these areas where there's not one big,
shining disease state. There's a lot of little things that
are wrong, and you can look at them functionally and
try and number one, do what you can to make
them go away or minimize them. And if you work
on all of the parts that might be contributing to
you not feeling well, then you can feel better with
(08:20):
a lot of times less medicine and not wait till
you do get you know, a big thyroid problem or
a profound anemio or you know whatever other sort of
pathology that you're looking at. Now, as we sort of
wrap up here in a minute or two, I want
to talk about real quickly that a lot of times
(08:45):
the idea of a functional problem is not you know,
going to be a totally new idea to most of
your healthcare providers. But if they don't do that sort
of approach to medicine, it's it's going to be sort
of well, yeah, I guess you know that can't exist.
So sometimes looking at it and discussing it as more
(09:06):
of a preventive approach, so you know, I don't I'm
still having my symptoms, but I obviously these labs you
did look pretty good to you. What are other things
that I could explore, you know, that might be non
pathological or sub threshold And sometimes you know, they'll be
(09:26):
really great with that and they'll give you ideas, and
sometimes they'll say, well, you know, usually when it comes
to these things, will we refer you to you know, X,
y Z practitioner because they do the you know, functional approach,
or they do whatever. And that's getting to be a
little bit more common. It's not, you know, completely common,
but it's getting to be a little bit more common
(09:48):
as you go around. Now. You do still have some
healthcare providers that I'll say, well, it's you know, functional
medicines a bunch of crap, or functional problems don't exist,
or you know whatever, and it's that's really more of
a worldview and a perspective issue than anything else. One
(10:09):
of the things that you do want to keep in mind, though,
is that if you're not getting the help that you
need from the provider that you know you're dealing with
for most of the things, and maybe they have referred
you to a specialist and the specialist said the same thing.
Look your thought right, it's fine, We're not going to
do anything about it. In those cases, if you're still
(10:29):
carrying around a lot of symptoms and you're not recovering,
or like I say, we see this a lot with
our recovering cancer patients or they're trying to recover after
chemol surgery or something, and it's just, you know, it's
it's not the you know, the purpose of the medical
oncology folks or the surgeons to give a ton of
(10:50):
advice about just healing and getting over things, et cetera.
They'll give you some. So then the next thing is
can you seek out information and or help healthcare practitioners
who are trained to look at this sort of bigger picture,
more functional approach, and they can fill in that piece
for you. So it doesn't mean that you have to
get rid of your other doctor or doctors or your
(11:13):
healthcare providers, but it might just be that you need
somebody to take a step back and take a broader look,
more of a three to sixty look. So all in all,
work with your providers. There is a difference between a
disease state and a pathology and a preventive state or
(11:33):
a precursor state or what we're calling maybe a functional illness,
And a lot of times your primary care is going
to be really focused on disease state and they're not
going to verge because they don't have time and they
don't have a lot of other things going on. Verge
out into these functional areas or preventive areas beyond a
little bit of preventive stuff they already do. So again,
(11:54):
if you're more in the functional state and they've told
you your labs or your imaging looks fine, not going
to die great, but I still feel horrible. Either ask
for a referral or look around for people who do
integrative medicine, nature, pathic medicine, functional medicine. Make sure that
they're duly licensed and qualified and able to do what
(12:16):
they're supposed to do. But you can get help in
the area of functional and preventive medicine. All right, Well,
we're out of time for this one. Please like, share,
and subscribe, check us out on CTR radio and the
YouTube channel, and then we're on all the pod burners.
I'll see in the next one.
Welcome back to medicine health. I'm doctor Paul and this
is doctor pro Tips. The next one is what is
the difference between a pathologic disease state and then what
we in more modern times might consider a functional disorder.
And I think this is a really important distinction to
(00:23):
make because it especially the more doctors you get involved
in your life, and sometimes with complex chronic illness and
cancer and other things, you may have a whole lot
of healthcare providers all playing in the same field, and
so sometimes there is a distinction in what might be
(00:45):
being worked on between a disease which is going to
be fairly simple to define, and then something that is
maybe pre disease prevention oriented or a functional problem which
is maybe partly pathology and partly non pathologic. So what
(01:07):
does all that mean? Well, one way to think about
it is diseases are things that we've identified in the
science of pathology and pathophysiology. We know generally why they occur.
We certainly know what happens to the cells or the
(01:28):
body when we have that disease. You know, in modern
times we have codes for these diseases, and we usually
have some sort of diagnostic and therapeutic algorithm. It says, well,
if we're looking at this disease, here's how we diagnose it.
And if it's diagnosed and that truly is your disease state,
(01:49):
then here's the options for treatment that are available. So
it's pretty linear, it's pretty straightforward. A dysfunction or a
functional problem can be anything along a pretty long road. Now.
One way to think of it is a functional problem
can be a non disease state because it's it's actually
(02:10):
a precursor to the disease state. So, for example, you've
probably heard of people who are diagnosed with, you know,
pre diabetes. Well, what your healthcare provider is really saying
is you have the you know, all of the factors
that go together to make let's say type two diabetes
(02:32):
and an adult, but your lab values haven't reached the
critical point where we're going to call it type two diabetes.
We're going to say you pre diabetes. This is an
excellent time to do a lot of preventive things. And
we've had a lot of people, you know, who are
diagnosed as having pre diabetic conditions, which really means your
body's already on the way there, it's just not so
(02:53):
bad off, and they were able to change their diet
and exercise and all that and they never became full blown,
you know, type two diabetic for example. So that's an
idea of a preventive or a functional problem. Now some
of these things, now I was mentioned coding and all
of that, and that's usually what you know, gets it
(03:16):
paid for on your insurance. Some of these pre states
or these these preventive states now actually have diagnostic criterion entities.
Another one that we see a lot of is early
diagnosis of macular degeneration degenerative eye condition. That's quite common,
and it used to be not commented on or not
(03:38):
diagnosed very early. It was until you start to have
vision loss. And now they are doing a much more
aggressive job of diagnosing people younger. And what they will
tell them it's kind of like the diabetes story. Well
it's not it's not fully you know, changing your vision's
not doing these things, but it's it's in your future
(04:01):
and so you don't really qualify for the drugs that
we would normally give somebody with that or whatever. It's
just a really good time because it's a precursor disorder
to look into things that would be preventive for that
and again our practice, we work with people who have
early stage or pre MacLaine degeneration and we look at
a large number of other factors that may feed into
(04:24):
that and help them to either forest all or slow
down the onset of the actual disease state. Now, another
thing that happens is a little more complicated than that
is I mentioned that some functional problems have a component
(04:45):
of disease to them, And usually what that means is
the component is at a lower level, and so it
might be diagnosed or it might not be diagnosed, but
because it's at a lower level, it doesn't look like
a big part of the problem. But what I would
sort of describe to patients is you could have a
(05:05):
lot of symptoms from a disease, and let's say that disease,
you know, is a stack of quarters that's you know,
three inches tall, so it's pretty much above the radar.
The labs are going to be weird, and you're going
to need treatment. There. What if you had three one
(05:27):
inch stacks of quarters, so you had three different body
systems that were all a little deranged, a little abnormal,
but not fully pathologic or maybe a little bit maybe not,
you'd still have the same amount of problems, they just
wouldn't be sticking up above above the radar. So a
lot of the screening tests, etc. Might not test or
(05:51):
check those things. And that's a really important thing to
keep in mind too. So in a lot of our
chronically ill patient, sometimes in our recovering cancer patient many times,
and people that aren't getting you know, they go to
their doctor and they don't feel well. Doctor says, well,
your labs look fine, so you know, let's just keep
an eye on you. A lot of those types of
(06:12):
cases are these cases where they're a little more complex
or there might be little, you know, little baby level pathologies,
but there's a bunch of them going on. And in
the primary care acute medicine model, we're not always taught
to look for more than one thing. So for example,
you know, you might be feeling tired and fatigue and
(06:33):
they check you for anemia, They look at your liver
and kidney functions, they take a look at your thyroid function.
Everything looks okay, you're not profoundly a knee make, your
thyroid's not that bad, et cetera. And will what will
happen a lot of times is in that person will
continue to feel bad, and they'll say, well, these things
(06:54):
look good. Then what you have to do is take
a step back and say, well, haven't we looked looked
at Could there be other hormonal influences that are creating
my fatigue? Could I have a sleep disorder, you know,
obstructive sleep app or something. Could I have other biological
things going on they're all feeding in and so then
(07:16):
in that case, what you would wind up with would be,
you know, maybe a little bit of a thyroid issue
and a little bit of another thing and some sleep disorder. Whatever.
The point is that it's more of a functional collage
of a problem giving you these symptoms of maybe fatigue
(07:36):
or sleep disorder or something, and that functional collage has
to be dealt with, but it can't be dealt with
with the same intensity that one big disease does. So
this is where a lot of times things like the
functional medicine approach or nature pathic medicine or integrative medicine
(07:57):
kind of shines in these areas where there's not one big,
shining disease state. There's a lot of little things that
are wrong, and you can look at them functionally and
try and number one, do what you can to make
them go away or minimize them. And if you work
on all of the parts that might be contributing to
you not feeling well, then you can feel better with
(08:20):
a lot of times less medicine and not wait till
you do get you know, a big thyroid problem or
a profound anemio or you know whatever other sort of
pathology that you're looking at. Now, as we sort of
wrap up here in a minute or two, I want
to talk about real quickly that a lot of times
(08:45):
the idea of a functional problem is not you know,
going to be a totally new idea to most of
your healthcare providers. But if they don't do that sort
of approach to medicine, it's it's going to be sort
of well, yeah, I guess you know that can't exist.
So sometimes looking at it and discussing it as more
(09:06):
of a preventive approach, so you know, I don't I'm
still having my symptoms, but I obviously these labs you
did look pretty good to you. What are other things
that I could explore, you know, that might be non
pathological or sub threshold And sometimes you know, they'll be
(09:26):
really great with that and they'll give you ideas, and
sometimes they'll say, well, you know, usually when it comes
to these things, will we refer you to you know, X,
y Z practitioner because they do the you know, functional approach,
or they do whatever. And that's getting to be a
little bit more common. It's not, you know, completely common,
but it's getting to be a little bit more common
(09:48):
as you go around. Now. You do still have some
healthcare providers that I'll say, well, it's you know, functional
medicines a bunch of crap, or functional problems don't exist,
or you know whatever, and it's that's really more of
a worldview and a perspective issue than anything else. One
(10:09):
of the things that you do want to keep in mind, though,
is that if you're not getting the help that you
need from the provider that you know you're dealing with
for most of the things, and maybe they have referred
you to a specialist and the specialist said the same thing.
Look your thought right, it's fine, We're not going to
do anything about it. In those cases, if you're still
(10:29):
carrying around a lot of symptoms and you're not recovering,
or like I say, we see this a lot with
our recovering cancer patients or they're trying to recover after
chemol surgery or something, and it's just, you know, it's
it's not the you know, the purpose of the medical
oncology folks or the surgeons to give a ton of
(10:50):
advice about just healing and getting over things, et cetera.
They'll give you some. So then the next thing is
can you seek out information and or help healthcare practitioners
who are trained to look at this sort of bigger picture,
more functional approach, and they can fill in that piece
for you. So it doesn't mean that you have to
get rid of your other doctor or doctors or your
(11:13):
healthcare providers, but it might just be that you need
somebody to take a step back and take a broader look,
more of a three to sixty look. So all in all,
work with your providers. There is a difference between a
disease state and a pathology and a preventive state or
(11:33):
a precursor state or what we're calling maybe a functional illness,
And a lot of times your primary care is going
to be really focused on disease state and they're not
going to verge because they don't have time and they
don't have a lot of other things going on. Verge
out into these functional areas or preventive areas beyond a
little bit of preventive stuff they already do. So again,
(11:54):
if you're more in the functional state and they've told
you your labs or your imaging looks fine, not going
to die great, but I still feel horrible. Either ask
for a referral or look around for people who do
integrative medicine, nature, pathic medicine, functional medicine. Make sure that
they're duly licensed and qualified and able to do what
(12:16):
they're supposed to do. But you can get help in
the area of functional and preventive medicine. All right, Well,
we're out of time for this one. Please like, share,
and subscribe, check us out on CTR radio and the
YouTube channel, and then we're on all the pod burners.
I'll see in the next one.
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