Physiology Matters!

Fernando Bernall, DOM, AP Medicine

I have coined the term Physiology Based Medicine® to reflect the direction my practice is heading. It is my conviction that all issues pertaining to our health have their root at the physiology that animates our cells. I’ll explain.

As practitioners of holistic medicine, we often say that we treat the body as a whole. In other words, we don’t treat a migraine, or diabetes, hepatitis, etc.,. We talk about treating the “whole person”. And this is true. However, we need to understand that there are levels of organization within our bodies that make up the “whole”. Thus, the human organism is made up of organ systems. These systems have organs that work together in an effort to keep equilibrium or harmony within that system. For example, our vascular system consists of the heart, the blood vessels, and the blood. All three of these components need to work together in a healthy state in order for the cardiovascular system to properly operate. This applies to all the various systems in our bodies. But for now, let’s stay with the cardiovascular system as model for the rest of the body.

Each one of the cardiovascular system is made up of tissues. Yes, including the blood. In fact, the blood is often referred to as “specialized connective tissue”1https://www.exphem.org/article/S0301-472X(10)00148-7/fulltext. Tissues are made up of cells. And the cells are the smallest working unit in our organs.

There around 200 different types of cells in the human body2https://www.ncbi.nlm.nih.gov/books/NBK554382/. Each type has a specific function.

By way of analogy, cells are like miniature cities with many components inside of them called organelles. Like a city, each cell, (with a few exceptions such as red blood cells, hair cells, nails and some skin cells) has a command center where all the codes reside similar to city hall where code enforcement and rules are found. In the cell this is called the nucleus and the code is in our DNA. Like a city, there is a power plant where energy is made. This organelle is called the mitochondria3https://www.nature.com/scitable/topicpage/mitochondria-14053590/.

The cell also has a Department of Public Works, Solid Waste Division, that takes our garbage and waste. These organelles are called lysosomes, peroxisomes, and proteasomes. They have several functions including the removal of toxins and other waste components within the cells. There are factories where proteins are made called ribosomes and quality control methods in place to ensure proper manufacturing4https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4853245/.

I could go on with the analogy but by now I think you get the idea. The cell has many functions within itself and outside itself. Proper functioning of the cell is important for the overall health of the tissues they collectively make such as connective tissue, vascular tissue, muscle tissue and so on. Think of the tissue as the county within which the cities -cells- are located.

In order for cells to properly function, they need resources from outside to properly be able to meet the needs of its inhabitants, the organelles. These resources are obtained from food, oxygen, water, supplements, etc.,.5https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6020734/. When the cell’s needs are met, the tissues are healthy, the organs function properly, the organ systems are in harmony and the overall organism, the human, is in a state of vibrant health.

Therefore, the health of an individual is dependent on the health of his/her cells. And all the functioning of the millions of cells in our bodies through dozens of metabolic pathways, is collectively called “physiology”6https://en.wikipedia.org/wiki/Physiology

I’ve stated all of the above, so that you understand why there’s a shift in my practice. For years, as health care providers we have focused on the treatment of individual disorders: diabetes, hypertension, atherosclerosis, fibromyalgia, cancer, and the list goes on. But all of these and other conditions that affect the human body ultimately leave their footprint on, or “jumped” from our cells. The physiology of the cell has been altered. Either by genetic variables, or exogenous input from lifestyle, medications, toxins, trauma, nutrition, etc., etc.,. The list is endless.

As I do more research, it becomes clear to me that my focus in my attempts to help my patients should be directed at the physiology that affects the cells. To have a more thorough understanding of the metabolic needs that each type of cell requires for proper functioning or physiology by way of nutrition, oxygen essential amino acids, fatty acids, hydration and so on.

My studies in physiology, has piqued my interest into the subjects of pathology, immunology,  and pharmacology. All of these branches of medicine directly point to the functional physiology of our cells. Pathology, informs us of the causes and effects of disease7https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7150310/. Immunology, is the study of the immune system and is a very important branch of the medical and biological sciences8https://aacijournal.biomedcentral.com/articles/10.1186/1710-1492-7-S1-S1. Pharmacology aims to remediate or redirect the course of disease by restoring, or altering our physiology through prescription drugs9https://pubmed.ncbi.nlm.nih.gov/20230758/.

Reading about these subjects, has given me a little more clarity on the role physiology plays in the instant-to-instant state of our being. Of course, as in the past, that which seemed clear yesterday, could seem muddy today and unrecognizable tomorrow. In other words, that which was true yesterday may not be true today. And as nature allows us to look into her intricate inner workings, that which we think as true today, may well be false tomorrow. Humility is a quality nature requires if we are to learn from her. Just the thought that trillions of physiological processes have taken place within the minutes since I wrote these words and the time you read them, is mind boggling. Physiology Matters – physiology rules!

How is this affecting the way I practice today? I don’t really know. But, there has been a paradigm shift in my thinking. I’m inclined to think that this is what is needed within myself and with those who trust me with their health care – a change in thinking – perhaps starting with our thoughts and their effect on our physiology10https://www.psychologytoday.com/us/blog/in-the-face-adversity/201207/thoughts-neurotransmitters-body-mind-connection.

In our day to day practice, patients present with this or that condition with a diagnosis of this or that disease or syndrome. It is easy to become sidetracked by the titles of these conditions and miss the mark: the cells’ function. Restoring proper cell function. Supporting the physiology. Optimizing the metabolic pathways. The rest will take care of itself.

Again, I don’t know to where this will lead.  But I will stay on this journey and bring you up to date when I know.

Fernando Bernall, AP

Saint Augustine, FL

 

References

References
1 https://www.exphem.org/article/S0301-472X(10)00148-7/fulltext
2 https://www.ncbi.nlm.nih.gov/books/NBK554382/
3 https://www.nature.com/scitable/topicpage/mitochondria-14053590/
4 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4853245/
5 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6020734/
6 https://en.wikipedia.org/wiki/Physiology
7 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7150310/
8 https://aacijournal.biomedcentral.com/articles/10.1186/1710-1492-7-S1-S1
9 https://pubmed.ncbi.nlm.nih.gov/20230758/
10 https://www.psychologytoday.com/us/blog/in-the-face-adversity/201207/thoughts-neurotransmitters-body-mind-connection