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Welcome to the website for Jim Chialtas, L.Ac., and Laurel Acupuncture Clinic of Functional Medicine, located in San Diego.

Click on the tabs above to learn more about what Functional Medicine is, and about many of the health concerns I specialize in. Or scroll down for my blog. You might find it helpful to use the labels in the lower right column to find topics that interest you.

In addition to seeing clients privately in my clinic, I also offer many of the same services remotely to US residents. Please feel free to contact me to set up a consultation or appointment. Thank you!

10/14/11

“My doctor said that everything looked normal…”

The title of this article is a mantra that I hear repeated over and over again in my clinic which unfortunately more times than not has little merit whatsoever. My patients generally come to me because they either do not want to go to a Medical Doctor for their concerns, or they have been there many times only to have been turned away with the statement that “everything is normal.” “I am sorry that you are not feeling well. Perhaps it is all in your head,” says the good doctor. Why is this? Why are people being turned away time and time again with legitimate health care problems? The focus of this article is to explain just that. My goal is to help you understand how these blood tests are put together and why they can be so misleading. And even more than that, how they can be used as a tool to sell more pharmaceutical drugs.

The first thing that you need to understand when getting a blood test done is the way that a doctor determines if you are sick or not. You will get the blood drawn, they will run the tests on it and you will be given a report (usually only if you ask for a copy) that will detail all of your personal values for each test. These values will be compared against a reference range usually on the right of the report. So for example if you get tested for a fasting blood sugar (seen on the report as “glucose”) you may come back with a value of 78 with the corresponding reference range of 65 - 99. This means that you fit nicely within the reference ranges for this test and the doctor would tell you that everything is normal. “But why doctor am I feeling so tired and jittery throughout my day?” “I don’t know miss… It could be stress. I am seeing a lot of stress in here these days… The economy and all.”

So what went wrong? This woman’s symptoms seem to point to a low blood sugar state, but the report says it is normal. This leads me to my next point. It is very important to understand that the reference ranges that the mainstream medical world uses are designed around an average of all the people who go into hospitals and clinics in a particular geographical area. So these are generally sick and injured people, or even people taking medications which can alter a blood test. These reference ranges are not meant for generally healthy people. In order for a person to be considered “hypoglycemic” or low blood sugar by a doctor their fasting glucose would need to be below 65. If this is the case, you are probably already in one of their hospital beds, not walking around town popping into the clinic for a check up. I can tell you that in my clinical experience, people with fasting blood sugars below 85 begin to feel the symptoms of hypoglycemia. These people are considered “Reactive Hypoglycemia” patients, and it is more common than you know.

I use both the mainstream reference ranges called “Laboratory Ranges,” along with a wellness based model called, “Functional Ranges,” when I work up a blood chemistry panel. The Functional Ranges will be tighter and allow the practitioner to see more clearly, and much earlier, the various mechanisms of disharmony going on before it becomes something more serious. This way of looking at blood chemistry is called “Functional Blood Chemistry,” and it is where I choose to specialize. Waiting for things to progress to full blown pathology is a mistake that mainstream medicine makes every day 100% of the time. It simply is an illness/injury based medicine. Wellness, as much as the Kaiser commercials want you to believe, is not in their repertoire.

If I can now take this one step further… There is one particular marker on a blood test that stands alone from the others. It is your total cholesterol. If you really look into the most current medical literature on the subject, total cholesterol by itself is not a good indicator for heart disease risk. According to the Centers for Disease Control, approximately 50% of the people who die of vascular disease die with normal or even low total cholesterol! The other 50% have elevated cholesterol. But if you follow what has happened with the Laboratory ranges for this marker you will see that it has consistently gotten lower and lower over time. So if total cholesterol isn’t the true culprit for heart disease then why make the lab range lower? In my opinion, the answer lies in pharmaceutical sales. A doctor will diagnose a Statin class of medication when the total cholesterol is elevated beyond their reference range. So if you can lower the level of what is considered “elevated,” you can prescribe more medication to a greater number of people in the society. This has been done without supportive data or an obvious need besides drug sales. And since doing so and getting more people on these medications the death toll has not improved. So I ask you where is the merit here? I said that this marker stands alone because while all of the other makers on a blood chemistry report have gotten worse over time meaning that they are easier and easier to fit into, total cholesterol is the only one that has gotten harder to fit into. I for one find it rather fishy to say the least especially when Statin medications are among the most prescribed medications world wide and heart disease is still the #1 killer.

So to recap here for you:
• Laboratory Ranges are used by the mainstream medical establishment and are based upon illness and injury. These ranges are taken from an average of a local population who go into hospitals and clinics. There is no absolute consistency between labs on these ranges.
• Functional Ranges are based upon a wellness based system and allows the practitioner to be able to identify mechanisms going on in that patient well before the mainstream will recognize them. Looking at blood this way allows for the practitioner to treat symptoms or medical problems earlier before they reach more serious conditions or when the doctor can’t see them. It will also allow for the practitioner to find mechanisms which are seemingly unrelated at first glance but can actually be contributing factors to other more serious conditions. Blood sugar is a great example of such a marker. It can produce symptoms of its own if out of range Functionally speaking, as well as work as a driving force for other more serious things such as autoimmune disease and hormonal imbalance.

So there you have it. Not all blood work-ups are the same. The next time your doctor gives you the “All Clear,” on your blood test, perhaps it is worth a second opinion. Us Functional Blood Chemistry folks can pick up on some very important things that will routinely go unnoticed in the doctor’s office. My goal is to catch things early so that you don’t end up in the doctor’s office in the first place!