Being a Big Vision entrepreneur is a ride on an emotional roller coaster. My vision is of a connected world of personalized care for autoimmune patients that uses data and digital tools to reshape research, diagnosis, and clinical practice for autoimmune disease. This, of course, is outside today’s mainstream thinking, which sees a hundred different diseases, all separated by body part and medical specialty rather than looking at the underlying autoimmune dysfunction that unites them. It does not see that the aggregate, autoimmune diseases strike more people than heart disease and cancer combined!
Often, I wake up with all the motivation and innovations I could want. But as soon as I turn the corner, I’m shot down by possible sponsors, business collaborators, conference nominations, and more. On the days where it seems like no one cares about the invisible struggles of autoimmune patients, I sometimes panic, thinking I’m going to run out of time, energy, and money to move the needle on this big problem.
Still, there are good days when the roller coaster is more fun than scary. That happens when I meet like-minded individuals who encourage me to continue working to create new products and services that will help the millions afflicted with immune disorders now and in the future.
This was exactly how I felt when I interviewed Dr. Jeffrey Bland.
Reinforced and ready to go!
Dr. Bland, “the Father of Functional Medicine,” started the Institute of Functional Medicine in 1991 and the Personalized Lifestyle Medicine Institute in 2012. Having worked in the field of functional medicine for 40 years, Dr. Bland has been “hopeful that he would see a major health paradigm shift in his lifetime.” The beginnings of this shift, happening now, is one that could lead the way for better treatment and even prevention of chronic and autoimmune disease. As Dr. Bland says, “there is a global pandemic of chronic disease.”
Going beyond name and blame
Pinpointing the source of the problem of many patient struggles, Dr. Bland pointed out that,
“Our acute medical system has been good at learning more and more about less and less.” In other words, “we have lost the forest for the trees.”
The medical system needs to go beyond a disease-centric “name and blame,” where the diagnosis is determined by body part, and instead, move towards understanding the underlying causes—genetic, environmental, personal—that manifest as different autoimmune dysfunctions.
Finding a thought-ally in Dr. Bland, I asked about autoimmune disease and the importance of lifestyle modifications. He echoed my thoughts on how we must look at the underlying causes since autoimmune diseases can strike any part of the body, and we are only beginning to understand why and how specific body parts are affected. For example, rheumatoid arthritis, lupus, and psoriatic arthritis all attack the joints, but through different derangements of the immune response pathways—and we usually don’t know what set things off.
Changing the tides
Luckily, with “new biology that understands the relationship between diet and lifestyle,” integrative medicine approaches are beginning to receive more validation and could help us move from symptom management to treating underlying causes. We envision a future of chronic and autoimmune disease care that looks like the picture of collaboration below, where functional and conventional medicine are integrated into a team.
“The good news is that we are in a global transformative period,” the way we view autoimmune disease is changing. For chronic and autoimmune diseases, “pharmaceutical treatments aren’t working now” because they do not solve the underlying problem. “They only mask the symptoms and make it worse.” However, we can now look to new discoveries in research and technology that are beginning to explicate the lifestyle factors that affect our health, as well as building a systems biology approach to health.
The Disease Delusion
In Dr. Bland’s book, The Disease Delusion: Conquering the Causes of Chronic Illness for a Healthier, Longer, and Happier Life, he takes a systems biology approach to explaining how the body works and how to tease out the individual intricacies that fuel chronic diseases. He breaks health down into the following seven core physiological processes:
- Structure. Proper structural alignment of the musculoskeletal system is important.
- Cellular communications. It controls the inflammatory response which is influenced by genes, environmental toxins, diet, fitness levels, stress.
- Cellular transport. Defects in cellular transport of nutrients, hormones, neurotransmitters, and other cellular messengers can contribute to chronic disease.
- Energy production. Dependent upon proper intake of macronutrients (protein, lipids such as omega-3 fatty acids, carbohydrates), micronutrients (vitamins, minerals), and phytonutrients.
- Assimilation and elimination. The importance of the gut as an organ of immunity.
- Detoxification. How the body defends itself against exposure to toxins from the environment and metabolism.
- Defense. Processes that modulate the immune system with a focus on gene-environment interaction.
Applying this systems biology approach to the future of autoimmune disease, Dr. Bland points to the history of celiac disease.
“The history of Celiac disease may foreshadow our thinking about autoimmune disease. We used to think that Celiac was caused by an immune reaction to [one of] a family of proteins from grains isolated to the GI tract. Now, we know that Celiac disease can affect areas outside the gut—body, joints, brain—and there is an association between diet, lifestyle, and the immune system. Celiac thinking has evolved [as with the discovery of non-celiac gluten sensitivity] and this could be the same for autoimmunity.”
Encouraged by Dr. Bland’s Celiac analogy, I boldly asked and found that we agreed on my vision of an autoimmune consortium for multidisciplinary collaboration using advanced testing, big data analytics, and tools to develop a new evidence base that tackles how to best prevent and reverse autoimmune disease.
“Knowledge comes when we can figure out the best way to harness each person’s individual uniqueness.”
Dr. Bland is hopeful that, as a society, we will be able to harness our collective creativity and will to expand the toolkit for those with chronic autoimmune disease.
I am excited about a future where patients can choose the best from conventional and alternative medicine. From understanding our genetic codes to discovering what’s happening in our microbiomes, along with better insights into behavior change, I can see a future where we can begin to build an evidence base that supports and enables personalized care and eventually personalized prevention of chronic disease.
“When one door closes, another opens or you can open the closed door, that’s how doors work.”
This was first published on Dr. Bonnie 360° on 06/21/16.