Functional Medicine and Genomics
In an interview format, Dr. C.E. Gant outlines his practice philosophy in Integrative and Functional Medicine.
Interviewer: Dr. C.E. Gant received his BS in Chemistry from Hampden-Sydney College in 1971 and his MD from the University of Virginia Medical School in 1975 taking additional doctorate courses in biomedical engineering and computer modeling. During his subsequent post-graduate, residency trainings in family practice and psychiatry, Dr. Gant became increasingly concerned with the threat of prescription, psychotropic drug use, abuse and irresponsible prescribing practices, which along with alcohol, tobacco and illicit drugs, propels psychotropic chemical abuse to the leading cause of death, disability, violence and social disintegration in the world, with tobacco alone killing nearly 500,000 Americans and over 5 million human beings worldwide per year. The threat of chemical abuse worsened by prescription drug abuse has since accelerated to astonishing current levels and Dr. Gant believes it now threatens the sustainability of modern civilization.
Dr. Gant engaged in various modalities of psychotherapy and meditation to find his own personal solutions to life’s challenges and he went on to become an expert in reconstructive and mindfulness-based psychotherapies which has been applied extensively in his medical practice for almost 4 decades. As a psychiatric consultant in the early 1980s, he achieved a 50% reduction in antidepressant, antipsychotic and sedative medications while treating a large, chronic, mentally ill, outpatient population and he published these results in 1984 in his PhD thesis in psychology entitled A Neurophysiological Model of the Transformational Psychologies. This thesis proposes a physiological (physical) model by which the brain changes as an individual psychologically moves away from mental distress towards self-realization or self-actualization and how that could be proven with physiological brain scanning technologies.
A Neurophysiological Model of the Transformational Psychologies took a look at the physiological research into brain function available 30 years ago which could be used to unify the seemingly divergent psychotherapies and spiritual paths, such as RET (rational emotive therapy), gestalt therapy, meditation, prayer, transpersonal psychology, family therapy and others. Dr. Gant predicted over 3 decades ago that all of these mindfulness-based methodologies must obviously be radically altering brain physiology especially in the frontal lobes of the brain, and that brain imagery technologies should at some time in the future be capable of proving these changes. Dr. Gant is delighted to have lived to see his predictions come true and witness the astonishing findings in PET or positron emission tomography as well as the FMRI or functional magnetic resonance imagery studies of mindfulness meditators.
Dr. Gant has practiced Functional and Integrative Medicine, and Reconstructive and Mindfulness-based Psychotherapy for over 36 years, and in the last decade has added Genomics. While in private practice and while serving in medical directorships and consultancies to many clinics and hospitals in the Central New York area over the years, Dr. Gant instituted and perfected various integrative treatment regimens. These included nutritional therapies, detoxification and neurotransmitter repair. Also, infections such as candida, Lyme disease, hormonal and metabolic rebalancing and mindfulness-based, reconstructive psychotherapies. All of this was to support the recoveries of his patients from all kinds of common, chronic medical and psychiatric disorders.
Dr. Gant has developed innovative treatments for many kinds of common medical disorders such as cancer and cardiovascular and autoimmune diseases, but a significant portion of his work has focused on natural, drug-free treatments for brain disorders, such as AD/HD, depression and other mood disorders, autism, and addiction to prescription drugs, tobacco, alcohol, and illicit substances. His work spanning most of four decades is summarized in various studies, years of national continuing-education-approved lecture tours and publications such as his books: 1) “ADD and ADHD: Complementary/Alternative Medicine Solutions,” 2) “End Your Addiction Now”, 3) “End Nicotine Addiction Now,” 4) “Attentional Disintegration of Hurt and Distress Therapies,” and 5) “Basic Concepts in Integrative, Complementary and Alternative Medicine.”
Dr. Gant is the Chief Medical Officer and teaches at The Academy of Functional Medicine and Genomics. He is also an instructor in functional medicine and genomics at Huntington College of Health Sciences, which is the first distance-learning, nutrition college accredited by the Accrediting Commission of the Distance Education and Training Council (DETC), listed by the U.S. Department of Education as a nationally recognized accrediting agency.
In addition to teaching, Dr. Gant currently practices functional medicine, predictive genomics, mindfulness-based psychotherapy and neurofeedback in Washington, DC at the National Integrative Health Associates.
Also, the culmination of his life’s work is being published in a multi-DVD series entitled “The Grand Unified Theory of Mind Body Function”.
Q: Dr. Gant, what is your Practice Philosophy?
A: My practice philosophy is holistic and based on optimizing the seamless continuum of the biological, psychological, social and spiritual dimensions of my patient’s lives and health. I combine the clinical tools of Functional Medicine and Genomics with Neurofeedback and Mindfulness-based Cognitive Therapies to help my patients reverse or modify their unique impediments to optimal mental, physical and spiritual function. I assist them in making rational, effective, cost-conscious and sustainable interventions.
Q: What is functional medicine?
A: Although modern medicine, dentistry and psychology has made astonishing advances in the treatment of acute healthcare problems, increasingly, healthcare consumers suffer from chronic diseases, such as heart disease, arthritis, diabetes, cancer, addictions, depression, anxiety and auto-immune diseases. Modern medicine, dentistry and psychology often have few answers for such chronic problems. Amassed scientific studies strongly suggest that certain nutritional, allergic, metabolic, toxicological, infectious, immune, energetic, hormonal, neurotransmitter and genetic risk factors are causing or are seriously exacerbating chronic medical and psychiatric problems.
Functional Medicine offers a wide array of specialized diagnostic technologies, testing of the blood, saliva, hair, stool and urine, to uncover the root causes of chronic medical and psychiatric disorders, allowing us to move beyond merely palliative drug therapies and begin to entertain the notion that we can actually cure or at least reverse the symptoms associated with “incurable” chronic medical and psychiatric disorders. Typically I will order between 300 and 500 separate, laboratory, diagnostic tests to get to the root causes of my patient’s problems.
Q: This all sounds so rational. Why aren’t more doctors and healthcare professionals practicing medicine in this way?
A: There are many possible ways to answer this question, but the one that makes the most sense to me has to do with a historical context and the definition of the term diagnosis, the foundation of what good medicine is all about. In order to practice good medicine and know what treatment to provide, a healthcare professional must first of all make a valid diagnosis. A definition of the term “diagnosis” is somewhat confusing and misleading in most dictionaries. The reason for this is that the term diagnosis is defined in two very different ways. Therefore if an agreement does not exist as to which of the two meanings of the term diagnosis we are talking about, how is good medicine supposed to be practiced?
Q: What are the 2 definitions?
A: A diagnosis could be defined as a name or a label of a condition, illness, syndrome, disease or disorder, which describes the appearance of a cluster of symptoms. A diagnosis could also be defined in a second and completely different way, as a description of the cause of the symptoms or the condition, illness, syndrome, disease or disorder. At first glance this may seem trivial, but the implications are far-reaching, and understanding the difference between these two definitions could determine the extent of disability, suffering and longevity for the listeners, their loved ones and ultimately for every human being on the planet.
Q: That’s kind of abstract, so give an example of what you mean.
A: OK, consider Pneumonia, which has been diagnosed for thousands of years as a disease characterized by the symptoms of fever, chills, cough, sputum production, chest pain and extreme fatigue. Note that this kind of diagnosis simply describes the appearance of a cluster of symptoms and does not describe the cause of the symptoms. As the biological sciences advanced, pneumonia was eventually proven to be caused by germs, and this allowed clinicians to invoke the second definition of the term diagnosis and define its cause. Pneumonia came to be known not simply as pneumonia, but as pneumococcal pneumonia or streptococcal pneumonia, depending on which micro-organism was found to be the causative agent.
Q: So the first definition, a label given to a constellation of symptoms, is relatively prescientific and that the second definition, a description of the cause, is more scientific.
A: Yes, and once we are able to describe the cause, in this example, a diagnosis of the germ causing pneumonia, we can design treatments such as antibiotics that target the cause and actually cure the condition. On the other hand, if we don’t know the cause, or are unwilling or lack the knowledge as to how to determine the cause, and only describe pneumonia as a cluster of symptoms which appears to be this disease, we don’t have the luxury of prescribing a targeted cure such as an antibiotic, and we are left with guessing as to its cause or prescribing palliative rather than curative treatments. Palliative treatments merely make a patient more comfortable or cover up symptoms and don’t address the root cause of the problem or cure the condition, illness, syndrome, disease or disorder.
Q: But wouldn’t this then lead to another question like why did the germ get into the patient in the first place?
A: Exactly, or what factors caused the patient’s immunity to be depressed allowing the germ to have a window of opportunity to infect the patient? Was the patient emotionally stressed, or was their diet deficient in vitamin C and zinc which could have resulted in a weakened immune system less capable of fending off infections? If they were deficient in zinc, what caused that? Thus, we can follow a timeline into the past to diagnose more and more fundamental causes of the pneumonia or any condition, illness, syndrome, disease or disorder.
Q: This reminds me of a game my kids would play, where they ask why, and if I gave them an answer, they’d ask why about that, on and on until I would just ask them to stop asking questions.
A: Now we can get to the definition of Functional Medicine, which is a healing art practiced with a heightened sense of intellectual and scientific curiosity compelling its practitioners to discover the root, science-based causes or risk factors underlying conditions, illnesses, syndromes, diseases or disorders.
Q: I have heard about risk factors and cardiovascular disease.
A: Risk factors have been known for some time to cause cardiovascular disease and many chronic medical and psychiatric disorders, but they were generally thought to be useful as a preventative measures, but not as treatment of already existing medical and psychiatric disorders. In other words, lowering one’s cholesterol and triglycerides, cutting or eliminating nicotine abuse, normalizing blood pressure and keeping blood sugar levels low, were all considered to be modifiable risk factors in the prevention of cardiovascular disease. But recent evidence suggests that these risk factors are much more than that; modification of risk factors has now been shown to reverse cardiovascular disease once it is established.
Q: I get the feeling that functional medicine practitioners are going to keep asking deeper questions about the cause of these.
A: That’s right. Currently science has advanced some and the diagnosis of heart disease is usually accompanied by a list of risk factors analysis hypercholesterolemia, hypertension, tobacco abuse and diabetes. However, a functional medicine practitioner might not be content to end the search there and simply medicate such a patient with statins or antihypertensive and anti-diabetic medications and nicotine gum. Having the scientific and intellectual curiosity to look deeper, they might ask; “What causes the addiction to nicotine, and the high cholesterol, blood pressure and blood sugars?” Do more fundamental risk factors or causalities exist which can cause nicotine dependence, hypercholesterolemia, hypertension and diabetes, which then causes heart disease?
Q: And the answer is yes.
A: Of course. Well done studies have defined dozens of other cardiovascular risk factors, as well as dozens of deeper risk factors which cause the more superficial risk factors of elevated blood fats, blood sugar and blood pressure and nicotine abuse. Like a child asking why that, then why that, then why that, a functional medicine practitioner keeps asking questions about risk factors which cause other risk factors which cause conditions, illnesses, syndromes, diseases or disorders which their patients suffer from.
Q: Why does the medical community seem disinterested in such an in-depth risk factor analysis, and how can obviously dedicated, compassionate healthcare practitioners not want to determine these fundamental risk factors which cause their patient’s to suffer and die?
A: Even a better way to ask this question is, exactly which risk factor that is causing one’s patient to be sick would a practitioner not want to know about? The answer for me is none; I want to do a thorough risk factor analysis and determine as many causal risk factors as possible, and I typically order 300-500 distinct laboratory tests on each patient in a deep search for the underlying answers. I am not content to label any patient with a prescientific diagnoses which merely describes the appearance of a condition, illness, syndrome, disease or disorder. I must know the risk factors causing other risk factor or causing the symptoms. For instance, I may diagnose a patient as having bipolar disorder, but I also know that an in-depth risk factor analysis will reveal one or more of the 40 to 50 causalities of bipolar disorder.
Q: What happens when a risk factor is found on diagnostic testing which has not been correlated through any competent scientific studies to be related to your patient’s symptoms or superficial diagnostic label?
A: The famous saying that “the absence of evidence is not necessarily evidence of absence” comes into play here. In other words, just because a certain nutritional, toxicological, metabolic, hormonal or genetic abnormality revealed through diagnostic testing has not been correlated in scientific studies to a patient’s symptoms or to their older, pre-scientific, diagnostic designations, that does not necessarily mean that science will not march on and find that such abnormalities possess a causative link.
Q: So you assume that any abnormality might have such a correlation and be a causative risk factor of your patient’s problems?
A: Should I wait for the science to someday reveal that correlation which would then somehow justify the assumption that a certain risk factor should be addressed? No, because my patients are suffering today, and if an in-depth risk factor analysis reveals certain nutritional, toxicological, metabolic, hormonal or genetic abnormalities, I must assume that it is relevant regardless of the scientific evidence at hand as to its importance.
Q: So what separates conventional doctors from functional medicine practitioners is simply that they have more of a scientific curiosity about determining the underlying, root, science-based, or I suppose you’d call it, “someday-to-be-proven-science based, risk factors.”
A: That’s right. Functional medicine practitioners tend to diagnose from a causative, science-based perspective, the 2nd definition of the term diagnosis, rather than from a descriptive perspective which is the older, pre-scientific meaning of the term diagnosis. Functional medicine practitioners therefore can come closer to a targeted “cure” of problems instead of simply palliatively managing the symptoms with medication and other stop-gap treatments. This is what is so exciting about functional medicine. It promises to completely revamp the way healthcare practitioners diagnose and treat chronic medical and psychiatric disorders.
Q: Let’s move on to genomics. I thought that our genes are hardwired and can’t be changed.
A: That’s correct, our genes can’t be changed, but their expression can be. Any change in status, an added stressor, a shift in nutrition, an infection or the sudden appearance of a toxin causes all of the cells in our body to adapt, by going into their DNA library and pulling out new copies of DNA to make new proteins to adapt to the change. Some of the old DNA and RNA that was being used to make protein and enzymes may get put away. So any change, especially chronic sustainable changes, causes our cells to change its genetic expression.
Q: Does this mean that all healthcare practitioners, regardless of what they do or whether they are aware of it or not, is to change genetic expression?
A: And we are fond of using the term, optimize genetic expression, because we all have a certain genetic code which can have its expression spruced up. Everyone has hundreds to thousands of genetic quirks called polymorphisms, which makes us all so delightfully unique. We can test for many of the polymorphisms, especially the ones which can interfere with optimal genetic expression.
Q: So what quirky genes or polymorphisms do you test for.
A: First of all, they have to be important ones. Why test for a gene which doesn’t potentially do bad things. Secondly we test for polymorphisms which are common – why test for a rare quirky gene. And finally, we test for polymorphisms which we can change the expression of – why test for a polymorphisms which you can’t do anything about anyway.
Q: So you test for genetic quirks which are common, important and modifiable, and then what?
A: We can recommend focused lifestyle changes, nutritional supplements and detoxification which controlled studies have suggested can modify the expression of these genes to then improve and potentially optimize genetic expression.