NG: The book encapsulates so many colossal changes in our thinking. When comparing it to the conventional reductionistic perspective, it seems like it represents nothing less than a revolution.
It is a revolution of similar magnitude to what we saw when it was recognized that infection could cause disease, which was a little over 100 years ago. That completely transformed our view of health and disease. At the turn of the last century people were thinking there were humors, hot and cold, warm and moist - these things were causing illness – they didn’t really know the origin of infectious diseases, and we had 1 out of every 3 children die postpartum, and 1 out of 6 women who had children ended up with some form of sepsis as a consequence of infection.
Once those particular discoveries were made, it increased life expectancy by almost 20 years, by just applying these concepts of “bugs cause disease, let’s keep hygiene and sanitation.” And then antibiotics, and then immunization.
We are undergoing the same kind of transformative discovery today, not about infectious disease, but around these chronic complex diseases. I believe we will have another huge bump in life expectancy as we implement these concepts. We’ll reduce the burden of unnecessary disease. Our health span will improve.
This will be a distributive healthcare system versus a top down system based on specialty medicine. It is going to become a variety of collaborators that have certain expertise in exercise, stress management, diet, botanicals, various types of physical medicine. All of these disciplines will work together collaboratively to develop a personalized system that delivers to the person what they’re going to have to do to manage their health.
NG: It seems like many so-called “CAM” practitioners are still caught up to varying degrees in protocols for specific disease states. Even though they are much better at treating the “person” rather than just the disease, the conceptual shift still needs to penetrate further into awareness.
JB: I think that’s beautifully insightful. What happens in “CAM” –and by the way I’m not being critical, I’m just making an observation having been in CAM for thirty plus years-- is it’s a kind of “green medicine.” Its concept is: “Well, drugs are toxic so let’s use a plant or a nutrient that’s less toxic.” But we’re going to use the same strategy, we are still going to look at the disease, and we’re going to treat the cause of the disease with a safer intervention, versus saying, “What, really, is a disease?”
A disease is a product of a mismatch been that person’s genes and their environment, so let’s look at the cause and not the effect. The disease and what we call it is not important. What’s important is how the person got the dysfunction that produces the disability that they are later going to call the disease. So let’s focus upstream at the cause. When we do that, then we are obligated to say, what’s the genetic strength and weakness of the person? What are they doing in their daily life, and what are they exposed to? These become the therapeutic tools, so it’s not just treating a symptom with a green medicine.
NG: Moving to features of systems biology, and features of complex adaptive systems, there is the concept of “hormesis”--how small things can make big changes to an entire system. You mention this in the book. Is this similar to chaos theory?
JB: I would say yes and no. Chaos theory is a little related to a tipping point with a small perturbation of the system that then creates a disruption of the system. But that small thing can also cause an aggregation in, or harmonic entrainment of the system too, right where it is the organizing factor. So rather than always being a disorganizing factor it (a small change) can also be an organizing factor. So hormesis can either be a positive or a negative on the stability of the system. When we think of BPA (the toxin, bisphenol A), it could have a negative hormetic effect, because it can cause disruption to the system. But ginger could have a positive hermetic effect causing the system to stabilize itself.
NG: In complex adaptive systems, “tipping points” can be very relevant. I notice with my CFS patients that they can be taking numerous multifactorial approaches over many months, and the analogy is like those old balancing scales: each treatment may take off one weight from one side of the scales, but the scales wont go back into balance until the very last weight is removed.
JB: This is what Dr Sidney Baker calls his “tacks” rule: if you’re sitting on two tacks and you take one out, do you get a 50% reduction in your pain? Of the course the answer is, no. You have to take both tacks out before you feel the difference. This is one of the fundamental principles of functional medicine and we’ve talking about this for 25 years.
NG: I think many patients give up too soon on treatments because they haven’t understood this – and it is vital for practitioners to understand if they want to retain patients.
JB: What people need to understand is that when a system is perturbed, it will then move to a new state of function that is stable. It is a stable disturbed system, meaning the person has symptoms. The body is over here saying, “OK, I’m stable, I’m going to be like this for years, and you’re going to know about it right?” Then as you restore the function of that system by changing the variables, you get to the hundredth monkey, that one that triggers a new state function and now it jumps almost like a quantum effect to its original resting healthy state. But you had to actually change the system to such an extent that a system that was, say, homeostatic to diabetes becomes homeostatic to normoglycemia.
NG: Changing subjects a bit, let’s talk about nutrigenomics and the revolution in genetic testing. The company 23andMe continues to impact the public because of the low-cost of its tests. Although the FDA has banned 23andMe from offering health risk analysis reports, consumers can still order their raw genome data, and now other websites are offering analyses.
JB: Yes, absolutely. You know, the government can’t legislate against this. There will be no government in the world that can legislate against this revolution that’s happening with genetic typing, and its relationship with health and disease. Trying to prevent people getting access to their genetic data is like trying to legislate against the internet.