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Noah Reed

Welcome back to the DUTCH podcast, where integrative medicine providers can expand their understanding of functional endocrinology and testing. And everyone, no matter who you are, can learn more about their body’s most complex communication system. I'm Noah Reed, Vice President of Sales and Marketing for the DUTCH test.

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Noah Reed

And coming up on this week's episode, we have the, “Godfather of functional medicine himself,” Dr. Jeff Bland, and he's going to take us through the evolution of the functional medicine industry. So, stay tuned with us for an insightful conversation between Mark Newman and Dr. Bland as they discuss where functional medicine got its start, where the industry is

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Noah Reed

headed, and how functional testing fits into the question. Dr. Jeff Bland is known worldwide as the, “Godfather of the Functional Medicine Movement.” Functional medicine represents his vision for a care model that is grounded in systems biology and informed by research.

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Noah Reed

His pioneering work has created the Personalized Lifestyle Medicine Institute, as well as the Institute for Functional Medicine­—the global leader in functional medicine education. Since 1991, hundreds of thousands of health care practitioners have participated in PLMI and IFM programs, and this collective knowledge has positively impacted the lives of patients all over the world.

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Noah Reed

We are honored to have Dr. Bland on the show with us today. So, let's dive right in.

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Mark Newman

Thanks to Dr. Bland for joining us today. This will be a fun conversation.

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Jeff Bland

Absolutely. I can't tell you how much I'm looking forward to this, Mark. There's a lot of history to cover and a lot of future to look forward to, so thank you.

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Mark Newman

Yeah, we you know, we're about to have all these conversations of this is called endocrine essentials. So we're talking testosterone and we're talking cortisol and all of this with various experts. And it all fits within the framework of functional medicine.

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Mark Newman

There are other terms you could probably use. I like that one and I haven't been in that world since its inception and you've been so influential throughout. I thought it would be great to just start our broader conversations with a specific conversation with you, just kind of looking at the history of how we got where we are

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Mark Newman

when it comes to a functional topic. So for us, we belong in the world of functional endocrinology. So we're, we're trying to look at hormones through the lens of functional medicine. That's the world I think about the most.

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Mark Newman

And then you I mean, the thing I always I always say about you, Dr. Bland, is I always consider myself an inch wide and a mile deep. I think most of the doctors that we work with are a mile wide because they have to think about so many different topics and they go as deep as they can.

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Mark Newman

So for me, I've intentionally kept my focus narrow so that I can go as deep as I can in this little world of functional endocrinology. And what I what I love about you is you have one of those special brains that's able to go wide and broad and also to go deep on so many different topics.

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Mark Newman

So we'll do a little bit of that today. So I'll tell you a few dates in the history of what I consider relevant to what I'm doing. And then I'm gonna have you build the functional medicine story around that.

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Mark Newman

So we are the most, we hope, comprehensive look at reproductive and adrenal hormones. So if I just picked cortisol as a story of like how where did functional medicine come from? That I think back to 1981 was the first development of the salivary cortisol assay, also the year that the unfortunate people got released from being hostages in

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Mark Newman

Iran. And that one always sticks out to me because it's one of the first times where you can see in the literature this use of salivary cortisol to paint a different picture for those people, then all of their quote unquote normal peers.

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Mark Newman

So that's back in ’81. Through the 1980s you get the development of urine testing, saliva testing. So, we have these functional tools starting to develop. In 2001, the book Adrenal Fatigue was written. I think the term was coined back in 1998.

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Mark Newman

We've since corrected our thinking about that, but that really gave some fuel to the fire of the utilization of functional testing as it relates to cortisol in 2006, you'll see well, if go back to 1998, you see the first salivary study with chronic fatigue in 2006, the cortisol metabolites in chronic fatigue.

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Mark Newman

So those are stories we talk about a lot. And then again, in 2001 adrenal fatigue, we started our lab in 2012. In 2015, Tom Williams wrote a book that really helped our industry narrow back in on, I think, taking those cortisol stories from a functional perspective and getting more truthful with what was actually happening and refining that

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Mark Newman

message. And then that leaves us where we are today. That's sort of my cortisol story is I think of it in my head and I've missed a lot of what's happened in functional medicine because for part of it I was in high school and having just witnessed all of it as you've had such an amazing view and

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Mark Newman

been so influential and it. So, that's a long set up for Dr. Bland to sort of tell us the story of where functional medicine sort of emerged from what some of the key like dates and things that happened in that and some of the key players.

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Mark Newman

And then we can talk about where this is headed. But I wanted you to just sort of set the stage of where this world of functional medicine came from.

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Jeff Bland

Well, thanks, Mark. And again, I think this is such a privilege to kind of muse with you on this extraordinarily important topic of functional endocrinology, because I believe it's one of the seminal opportunities for those people who come across this river from a histopathology based DRG, CPT code focused medicine into functional medicine to understand how endocrinology crosses that same bridge from a histopathology-based state of this is specific pathologies of endocrine disease to that of endocrine function as measured through these different analytes. So I think this is a really important topic for any clinician who is in this field to understand the origin of.

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Jeff Bland

So I would like to go back because I'm a little older than you, a little earlier then where you started your timeline because I think by taking a quick review of a little earlier timeline, it helps us to understand the acceleration of change that's occurring right now and why it's occurring and why functional endocrinology is a topic

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Jeff Bland

that will take us into the future with important ways of improving patient health and outcome. So I'm going to go back actually to the birth of the field of endocrinology, steroid biochemistry and Hans Selye who is kind of a swing

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Jeff Bland

Scientist between animal-based studies of the endocrinological system, which was kind of a new development back in the in the thirties and forties when he first started his work as a very young man. And then later into understanding as to how these different chicken-wire frame molecules, we call it sometimes the chicken wire diagrams that are related

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Jeff Bland

to the tetracyclic, triterpenoid family, the steroids, how they ultimately transition into regulating so much of animal function. And I want to emphasize that these molecules, these steroid molecules, which are polymers of isopentenol pyrophosphate as they get put together in this chicken-wire frame configuration are unique to animals.

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Jeff Bland

You don't find these in plants. Plants have certain kinds of plant steroids, but they're not of the same structure and therefore certainly not the same function exactly as these steroid molecules that are all derived ultimately out of cholesterol.

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Jeff Bland

And cholesterol is found uniquely in animals. It's not found in plants. So there's a separation between the signaling mechanisms in plants and the signaling mechanism in animals that travels through these unique molecules. And I think it's kind of interesting to note that when we think about everything that travels down through this this river and all the tributaries

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Jeff Bland

that come in, the steroid the steroid river or the endocrine River, that be it estrogen, progesterone, testosterone, aldosterone, they dehydrate beyond aspirin. And it's sulfate cortisol, cortisol, derivatives. All of these molecules ultimately somehow interrelate with this molecule. Cholesterol.

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Jeff Bland

It's always has appeared very interesting to me because people have often said, oh, cholesterol is you know, it's the scourge, it's a problem. It's it causes heart disease. It's a it's a bad molecule. Got a bad rap? Well, no, that's not true.

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Jeff Bland

Cholesterol is a very important molecule because it's the building block, not only of cellular membrane architecture that holds the glue that holds all cells together in mammalian cells. But it also is a precursor to all these various bioactive intermediates that separate the plant in the animal kingdom and give us regulatory advantage in how we manage stress and environmental perturbations in the animal model versus the plant model.

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Jeff Bland

So when I started thinking of what Selye did now going back to the thirties and forties in which he started to make this connection between the nascent early stage development of the chemistry of these steroid molecules and their effect at the functional level.

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Jeff Bland

He was really the first functional endocrinologist in my mind, so I just want to put that stake in the ground.

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Mark Newman

Right.

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Jeff Bland

And you recall that what he did. Is. And I only met him one time in my young years before he he passed away. But he was reputed to be just a brilliant thinker who was not the best animal handler.

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Jeff Bland

His laboratory and techniques were not that good, and the story was that he was doing studies on adrenal-ectomized rodents and then looking at the effect that it had when you took the adrenal glands out on their function.

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Jeff Bland

And because he was not the best guy at handle handling animals and those of us who have done any rodent studies know that they're not always compliant and like to be involved with being handled and touched. He was a little timorous about them and he would often drop them and there was a joke around his laboratory with

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Jeff Bland

his post-docs that they were always around with him chasing these animals around the lab floor that would get away from him. And what he found was, he made the observation that, the animals that had been adrenal ectomized often when he found them, eventually chased them down, they were dead versus the animals that were not adrenal ectomized

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Jeff Bland

when they got away were always spry and active. And so he thought, well, what, why have these animals that have had their adrenal glands taken out suddenly not able to survive when they've gotten loose and were chasing them around?

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Jeff Bland

Which led him to the metaphor from physics of stress like you would have on a bridge that had a certain load and when you exceeded the bridge’s load capacity the stress on the bridge could bring it down. And so he started to appropriate that concept that maybe these animals had lost their stress, resilience, just like a bridge

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Jeff Bland

that's kind of lost its abutments, could then be jeopardized in its strength. And so that led him then into really a whole series of studies that we're all aware of looking at what was the bioactive molecules that could be associated with that unique gland in the animal, which he later called the stress clan, the adrenal gland.

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Jeff Bland

And then, of course, it led into all sorts of histopathology work, looking at the three layers of the of the adrenal gland in cellular layers and how they had different functional abilities with regard to what they produced as their different steroid molecules, some producing glucocorticoid, some producing molecules that related more to androgen and estrogens.

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Jeff Bland

And so he and some producing molecules relate to blood pressure regulation like aldosterone. Right? So this was a very dramatic birthing of, I believe, the field of functional endocrinology. Now, clearly, what happens in medicine is it's evolved through what is called the kind of the triage system.

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Jeff Bland

So the first things that medicine picks up on are the lowest hanging fruits. Those are the places where there is such a discreet observational connection between a dysfunction of an organ tissue or a cell. Then it leads into a specific set of symptoms that can be discreetly tied together to call a disease.

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Jeff Bland

So now suddenly what we see is the observations of function. And these adrenal steroids that Selye was making was starting to be tied to specific low hanging fruit of diseases. And so the field of endocrine apathy really developed as a kind of way waystation for how functional endocrinology was going to evolve.

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Jeff Bland

But we got hung up on that level because it was much easier to measure endocrine apathy than it was to measure functional endocrinology.

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Mark Newman

It was in the same decade as Cushing's and Addison's sort of getting characterized for the first time in those that same things were. BULKLEY Right. Yeah.

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Jeff Bland

So now we've got really landing spots that you think are easily teachable. They're all agreed upon. You've got diagnostic criteria. It's not so confusing as function is on the intermediary states. And so the field grew up to be a pathology focus, just like virtually every subspecialty of medicine.

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Jeff Bland

I was going to say every subspecialty, but there might be an exception to the rule. But virtually every subspecialty grew up around pathology. Now, with that as a kind of a history. What happened? What happened was there were lots of individuals who were very intrigued with the symptoms that were associated with adrenal functional status that were not

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Jeff Bland

yet pathologic, but would not be considered to be highly resilient. It could be associated with certain degrees of dysfunction, and dysfunction could present itself into the phenotype, into the symptoms in very complex ways with different frequency, duration and intensity.

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Jeff Bland

So now we start to build up a question of, well, how do you measure the intermediary stages then before you get to acute pathology? And here is where you start saying, well, we need some analytic tools, analytical tools that will allow us to arrange a dynamic range of assessment so that we can look at different ranges of

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Jeff Bland

dysfunctions of these molecules or levels of these molecules and correlated with human phenotypes with with outcomes. And in here is probably where I came into the field and I came in really in the seventies as the clinical laboratory director of the Bellevue Redmond Medical Lab that was really servicing Dr. Lee Bowles, who was the first medical

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Jeff Bland

doctor in the in the Seattle northwest area, that was really focusing on nutritional assessment and what I guess we would later call integrative medicine, although I don't think at the time that term, I know it had not been invented yet. And so Lee Bowles decided he needed a laboratory in order to assess some of these these functional

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Jeff Bland

characteristics of which then I as a professor of biochemistry who had already been certified as a lab director. He and I teamed up and I became the lab director of the Bellevue Redmond Medical Lab. Interestingly enough, at that time, you know, obviously this now is the seventies.

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Jeff Bland

So to say the least, that was a little bit of a younger guy back then. And I had some younger colleagues, one of whom was working as a new medical doctor in the first kind of group practice of medicine in the United States—

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Jeff Bland

Group Health—whose name was Jonathan Wright and Jonathan Wright was a very bright guy. He had gotten his undergraduate degree from Harvard in anthropology. And and he was you can see always a reader of the literature and and a guy always asking questions.

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Mark Newman

Right. And now you're starting to tell that parallel story of, you know, just cortisol and then then the sex hormones of how, you know, hormone replacement therapy and some of those things evolved sort of in this parallel way of him being one of the early adopters of of kind of a functional way to approach the reproductive hormones

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Mark Newman

so that's that's interesting to see those stories merge.

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Jeff Bland

Yeah. And it was for me at the time because it turns out that the lab director that I had hired at the Bellevue Redmond medical lab was Raymond Soon and Raymond Soon then was cherry-picked by Jonathan Wright to come in and head his lab and develop these particular methodologies that that were being picked up

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Jeff Bland

by Jonathan by reading the literature and and saying, you know, we need some of these tests like the development of the estradiol test and the development of some of the other newer analytics that were associated with metabolites of of the steroid hormones.

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Jeff Bland

So the field started to grow up. This would be the by this time now the eighties and from that time forward, then we could get into discussions about other people joining in. Steve Barry had done an internship with Jonathan.

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Jeff Bland

Wright. And so Dr. Barry then went back to Asheville and partnered with Marty Lee to start the Great Smokies Diagnostic Lab. Andy Brawley, who is a recent graduate from University of Georgia, Georgia, on in biochemistry. He came to my seminars early on and he and his wife, Carolyn, decided they wanted to start a lab to do analysis

00:19:09:02 - 00:19:26:12

Jeff Bland

of these in these similar analytes so they a formed Meta Metrics. So the field started to grow up with the focus not on pathology but on function. This is well before we came up with the concept really of calling this functional medicine, which was 1989-1990.

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Jeff Bland

So that's how I kind of see the confluence of all of this emerging into this new body of knowledge. Yet now with functional medicine in the Institute of Functional Medicine, there are several hundred thousand individuals that have been touched by this concept and many different ways of approaching the assessment of function.

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Jeff Bland

How have developed and of course Precision Analytical has been one of the premier labs to really take this to another level of precision, accuracy and reproducibility.

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Mark Newman

When you talk about, you know, people often say in science you're sort of, you know, standing on the shoulders of, you know, whoever came before you or building off of their work. And, you know, all of those you know, the last two that you mentioned sort of now sit under the umbrella of Genova Diagnostics and so many

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Mark Newman

other players that came along in the eighties and nineties with, you know, diagnostics and ZRT and all and all of these groups, many of which filter back down to, you know, very few players. This really started, Jonathan, as an example of making these huge strides of creating, you know, sort of philosophical frameworks and then and then the

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Mark Newman

analytical tools that we needed to ask those questions. And and of course, there's also this parallel development of the types of mass spectrometers that we want to use and those types of things which which really lacked what we have today in terms of sensitivity and accuracy in some of those things.

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Mark Newman

And given that context, you know, that group of pioneers did like some amazing work in sort of setting the stage for that which is created, you know, a really amazing place for us to sort of work from and and to try to go into into new to new areas and to take this as sort of to another level.

00:21:08:16 - 00:21:11:07

Mark Newman

I want to ask you along the way.

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Jeff Bland

Just let me let me stop for a second here, because I think you said something really important. I think it's very easy, I think, to criticize where we've come from because it appears crude. And part of the fact the reason that is crude is that the analytical tools or the the tools in general that we had did

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Jeff Bland

not allow for some of the level of specificity that we have today. And, you know, we have quadrupole mass spec and we have GC/MS and we've got all these really remarkable tools that have micro miniaturized. And what used to take a whole laboratory floor for a machine now can be put on a lab bench.

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Jeff Bland

So, I think the harnessing of technology by people who are always striving for pursuit of excellence and evolving the model of which you're in a principle example of that is what's allowed this this field to to power itself up.

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Jeff Bland

Now, the problem for that and I don't want to even call it a problem, I want to call it a legacy, is that when you're emerging a field, you gain a certain level of what I guess is called a superficial understanding by those who don't really understand the history or understand what's going on, but are quick to

00:22:20:00 - 00:22:44:16

Jeff Bland

make judgments. So in the field of endocrinopathy there was a challenge and a criticism of this emerging of this field of functional endocrinology, because their criticism was we were overreading the data. That our data was not precise enough, not analytical, reproducible enough, not sensitive enough to make the conclusions that we were making.

00:22:44:16 - 00:23:07:04

Jeff Bland

And therefore it was the scatter-gram that we were really studying and not as scientific as their data, which was measuring pathology, which was actually easier to measure at this point. And so there is this legacy that somehow our field is imprecise and and nonscientific and their field of pathology is

00:23:08:02 - 00:23:26:13

Jeff Bland

cientific and precise and reproducible. I believe that in older times that probably does have some legitimacy. I don't believe that that any longer stands because of the emergence, as you pointed out, of of technologies that now allow us to measure things in these early stages at lower levels in much more accurate ways.

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Mark Newman

Yeah. One of the things I've I think I've appreciated about you over the years is I think there, um. There's a temptation when you're out ahead as a pioneer of, you know, it's sort of overstating it. But this sort of Messiah complex can can be, I think, tempting in that we find ourselves in a position, those that

00:23:47:06 - 00:24:07:19

Mark Newman

went before and really pioneered. There's like reverence. They're like from our market. And then there's the temptation to to not value the humility that's needed to approach those topics. And I think one of the things I approach I appreciate about you is I don't know that I've ever heard you say something with significantly more confidence than you

00:24:07:19 - 00:24:22:17

Mark Newman

can justify from what's available in the literature. Right? There are some of these things that are known that we can say with confidence, and there are some of these things that we have to hold pretty loosely. And then there are things that we used to say with with some measure of confidence that we say very differently today.

00:24:22:22 - 00:24:39:13

Mark Newman

And I was curious for you, having been through this sort of whole this whole evolution of do you have a good example from your past of something along the way that you thought to be true with a pretty high degree of certainty that as new information has come your way and as new analytical tools and and studies

00:24:39:13 - 00:24:48:16

Mark Newman

have been done, that has really reshaped your mind about what's true about a particular topic. What's the first example that comes to mind when I when I say that for you?

00:24:49:18 - 00:25:08:07

Jeff Bland

I think there are a number of them that I probably could cite, but the one probably that would be most dramatic going way back to the seventies for me was there was a period of time in the seventies where one of the principal tools that was being used for evaluating aspects of human health from a functional perspective

00:25:08:19 - 00:25:33:14

Jeff Bland

was atomic absorption analysis of trace minerals in hair. And, you know, I think that the intention at that time was a good intention. And the intention was to say that minerals were put in hair as a consequence of their availability within cellular systems to be deposited in hair, but also as a consequence of other factors that

00:25:33:14 - 00:25:56:07

Jeff Bland

lead to the growth of the hair protein and the growth of the hair follicles. So it had an endocrine connection to hair of follicular protein synthesis. And so there were there were people (of which I was one) who thought that we can glean a lot of kind of suggestive information about a person's endocrine system and their general

00:25:56:07 - 00:26:15:10

Jeff Bland

health status from a hair mineral analysis. And we did in our Bellevue Redmond Medical Labs a lot of hair mineral analysis. And there was a big, very successful commercial lab called Mineral Lab that was doing this in the seventies and early eighties for literally thousands of practitioners in the field.

00:26:15:22 - 00:26:36:19

Jeff Bland

And the interpretation of those hair mineral reports were much more than just looking at toxic burden of cadmium, lead, mercury, aluminum, but but actually looking at in nutritional elements and looking at ratios like zinc to copper ratio and, and reflecting on liver function or looking at sodium-potassium ratios and looking at adrenal function.

00:26:37:13 - 00:26:58:00

Jeff Bland

I think that our enthusiasm and maybe our zeal at that point was a little overly exaggerated in light of what we learned later about the variables that could influence those mineral levels. Not that there is not usefulness in hair trace mineral analysis, there is usefulness, but I think we overread its usefulness clinically back in the seventies and early eighties.

00:26:58:13 - 00:27:19:10

Mark Newman

Yeah, well, I think as you as you whoever or wherever you find your entry point into this world of functional medicine, and you you hear these broad sort of descriptions that are inspiring from someone like yourself and, and then and then along the way, you can buy into some of these concepts that do need to be refined and sometimes

00:27:19:10 - 00:27:40:12

Mark Newman

discarded along the way as we pursue, you know, truth as, as an industry. And I've certainly, I think experience that enough that that's been a big lesson for me is that to hold the things that we believe to be true with enough of a dose of humility and a and a critical eye that we can make progress

00:27:40:12 - 00:27:58:00

Mark Newman

but also (for us as a lab) the lesson that we've learned is, is that if we're if we're basing what we do on a on a claim and that claim is provable, then there needs to be some pressure put on our industry, whether it's nutraceuticals in our industry or lab testing in our industry, to take those claims

00:27:58:00 - 00:28:13:13

Mark Newman

that we're that are we're basing ultimately what people are basing treatment on and to continue to pursue sort of the articulation of that in the scientific literature so that we can get rid of the chaff and continue to refine this thing

00:28:13:13 - 00:28:36:01

Mark Newman

that is functional endocrinology, because part of the critique from allopathy, I would say, is fair in that some of these claims that we've sort of chased down have been lost upon, you know, us scrutinizing them. And so I hope that that continues to be sort of the the sort of approach that we all take as we, you know

00:28:36:02 - 00:28:42:05

Mark Newman

look forward to to where this field heads. Which leads me to want to ask you

00:28:42:12 - 00:29:09:03

Jeff Bland

I have a question to ask you. I think what you just stated was a very powerful philosophy that guides your leadership within your own company. And then the question is. What drives you to that particular type of perspective, knowing that now you've just laid onto yourself a higher level of responsibility?

00:29:09:21 - 00:29:27:17

Jeff Bland

And one might even say. A higher cost structure because now you're going to be obligated to do certain things that if you didn't have those questions, you wouldn't have to expend the money to find the answers. So what drives you and how do you make your decision?

00:29:27:17 - 00:29:52:04

Jeff Bland

How you want it to make your way in this field of functional endocrinology as a leader? Because I think. That whatever drove right here is the litmus test that separates. Those that are comfortable with the status quo versus those that are only comfortable if they see they're pursuing the next level of of understanding.

00:29:53:06 - 00:30:07:07

Mark Newman

Um, that's a good question. It's been an interesting evolution for me personally and then for us as a business. Um, you know, I've thought about how I see myself and how I see us and our role in this industry.

00:30:07:14 - 00:30:29:00

Mark Newman

And I would honestly, I would liken it to along the way, I've seen people do so many amazing things on an individual basis, right? Here's a person whose life has been profoundly changed by functional medicine, functional endocrinology, which is it ends up being a combination of a provider or a person, maybe like yourself that really knows their

00:30:29:00 - 00:30:43:08

Mark Newman

stuff, right? They know the interconnectedness of all these things so that they're able to enter into a conversation, to listen, to understand what's dysfunctional, and then to know enough about all these interdependent systems to have a solution that.

00:30:44:08 - 00:31:04:22

Mark Newman

Might lead to profound change in that person's life, which is currently dysfunctional. And for me, I love the tools that need to be available to those people. Like, that's where I, I think of. You know, like a good James Bond story is out to sort of save the world.

00:31:04:22 - 00:31:20:22

Mark Newman

And I think for us, I relate to that. The role of Q in that story of, you know, here's your superhero who wants to change someone's life. Like maybe we all want to be the superhero. But for me, that the role for us is to arm those people that are going to go out and change people's lives

00:31:21:06 - 00:31:33:14

Mark Newman

with a tool that really is it can be transformative. And I got frustrated with the limitations of those in our industry in that I sort of started in the urine world and oh my goodness, you can measure some really interesting things.

00:31:33:20 - 00:31:52:10

Mark Newman

But in that traditional carry your urine jug around all day. One, they won't do it, so then that's not very leverageable. And two, you don't have a picture of hormones that change throughout the day like cortisol. And then I drifted into the world of saliva testing where, you know, the prominent value there is that changing cortisol

00:31:52:10 - 00:32:11:04

Mark Newman

story throughout the day. But I've lost those rich metabolites that bring value to the story. That is sometimes the rock you need to uncover to see what the change agent is for that person. And then I and then there's some other, you know, parts of that about analytical preferences that are too nerdy to get into probably in

00:32:11:04 - 00:32:24:10

Mark Newman

any in any great degree. But so what we tried to do is build a tool that just brought more of that information to bear. So there's visibility on these systems at a deeper level, right? Reproductive hormones, adrenal hormones.

00:32:25:01 - 00:32:44:08

Mark Newman

And some of the things that sort of fill in that story has really been our obsession is to build the most comprehensive tool for adding to that story, so that if you're in search of the “why” of why that patient is dysfunctional, that just the likelihood of having the right solution goes up.

00:32:44:08 - 00:32:58:17

Mark Newman

And that's been I think one part of that story is just having the tool that's most useful in that sense. And then the other half of that, I think is my brain really kind of obsesses over truth and trying to figure out what's right and what's true.

00:32:58:17 - 00:33:17:08

Mark Newman

And our industry so interesting in that sense because we're out ahead of the curve on a lot of these topics about, you know, you've got this traditional medicine model and then you've got these pioneers who have pioneered these really fascinating topics that are really powerful for change in people's lives.

00:33:17:08 - 00:33:36:07

Mark Newman

But they're not they're not fully baked at this point. Right. There's there's this refining process that we're still in the middle of. And like I said before, you have to be willing to let go of the things that end up just being noise in this whole picture of what's going on with a patient to really hone in

00:33:36:07 - 00:33:53:14

Mark Newman

on the things that are meaningful and words that I've been using a lot real recently is meaningful differentiation. Like, that's the thing I want to bring to someone like yourself that's trying to figure out what's wrong with somebody so you can go find the right solution is if I can give meaningful differentiation on as many fronts that

00:33:53:14 - 00:34:06:12

Mark Newman

relate to for us, reproductive and adrenal hormone health. And then of course it's your job to fit in the thyroid story and the gut health story and maybe, you know, toxic exposure and mold and those types of things.

00:34:06:12 - 00:34:22:19

Mark Newman

But for that hormone story, we want to give a true, rich, deep, comprehensive story of where dysfunction potentially lies so that the provider can step into that story and you can see on an individual basis then profound change.

00:34:22:19 - 00:34:39:23

Mark Newman

And those are really the things that fuel our whole company is when you get that story of here's a patient who's been to 12 doctors, they don't know what's wrong. And then they go to that brilliant functional medicine provider and they're able to take a look at all of these things, which includes what we do with the

00:34:39:23 - 00:34:58:00

Mark Newman

DUTCH test. And it's and it, you know, is really instrumental in helping them understand the patient better and find those solutions. And then you see that change. And then even better, if you see the follow up testing to where you can actually see, you know, that they're actually changing hormonal production or metabolism or whatever.

00:34:58:00 - 00:35:06:03

Mark Newman

And it all makes sense and it all clicks those those are the things that I think really drive what we do as a company and for me as an individual.

00:35:07:16 - 00:35:27:19

Jeff Bland

Was beautifully said. And what you just did for me was you gave me a great gift. And that gift was, I think, for the first time in hearing you speak. I. Clearly understand what we've been trying to do in functional medicine for the past 30 plus years.

00:35:28:14 - 00:35:42:19

Jeff Bland

And I think now I can articulate it with a gift you just gave me in a way that I don't think I've ever done before. I think there are piece parts of this what I'm going to say in the next few minutes, but I don't think I've ever put it together in this kind of assembly.

00:35:43:02 - 00:35:46:07

Jeff Bland

So I'm going to test it on you right now. All right.

00:35:46:07 - 00:35:46:22

Mark Newman

Far away.

00:35:47:10 - 00:36:11:09

Jeff Bland

Here we go. So I introduce earlier in my history of Hans Selye this concept of endocrinology versus funder functional endocrinology. So let me go back and revisit that in light of what you just said. That if we were to ask in any organ and let's focus on the adrenal glands just here for an example, how much?

00:36:12:09 - 00:36:30:21

Jeff Bland

Capability that Glenn had to produce a specific substance. It could be cortisol or it could be aldosterone or could be DHEA or whatever. And we ask, what is the capability or maximal conditions for that plan to produce that substance?

00:36:32:10 - 00:36:56:00

Jeff Bland

And then what would be the example of that same gland in another person that was so injured that it was producing hardly any of that substance? So that would be considered the dynamic functional range. I'm giving it a name, the dynamic functional range of what that plan was able to do as measured through the production of that

00:36:56:00 - 00:36:58:08

Jeff Bland

substance. Am I okay, so far.

00:36:59:07 - 00:36:59:19

Mark Newman

Carry on.

00:37:00:06 - 00:37:27:03

Jeff Bland

Now I'm with you now. Now, let's say that the technology that's available to measure that dynamic range. Has an analytic range of specificity that doesn't totally overlap the dynamic range in dynamic functional range. In fact, maybe it only measures accurately the upper quadrant or upper tier of that dynamic functional range.

00:37:27:15 - 00:37:46:12

Jeff Bland

And that's all that we can measure in say accurately. With Reproducibility, which means that we're really focused in on just the latter stages of endocrinopathy. It's either completely absent or it's presented very high level. The intermediary range is lost in ambiguity.

00:37:47:08 - 00:38:14:10

Jeff Bland

Now we say, okay. Then if we don't have the ability to completely analyze. The dynamic functional range as accurately as we do the pathology range. Then what else do we do to try to bring light on this? And we say, well, we better develop a pattern recognition system that brings multiple points of information together that would provide

00:38:14:10 - 00:38:39:03

Jeff Bland

some degree of overlap and reinforcement for our hypothesis as to what's wrong with that patient relative to that gland or that substance. Now that in the functional medicine model we have tried to capture with what we call the functional medicine matrix, the matrix brings in all sorts of different information that converge to emerge in a potential answer

00:38:39:03 - 00:39:05:06

Jeff Bland

to the question, not relying on only one piece of data, but how they interrelate together to create the right story that is corresponding to that patient's presentation of symptoms and their state of health. So I think what has happened historically is (A) I don't believe most people understand what you just said as a fundamental differentiation between functional

00:39:05:06 - 00:39:24:20

Jeff Bland

medicine and histopathology based medicine. (B) those that do understand it don't understand the technical laboratory differentiation between those two, where some things are closer to the analytical range being overlapping with the full functional range and some not being as close.

00:39:25:05 - 00:39:45:13

Jeff Bland

And then (C) they don't understand how the Functional Medicine Matrix provides a tool that allows the emergence of a pattern that then can better define the intermediary dysfunction before you get the pathology upstream of the pathology and how is to be used.

00:39:45:13 - 00:40:03:15

Jeff Bland

But also the qualifications on it have to be used of uncertainty. All of those things to me come out of what you just said and give honor to you and others in our field that are chopping your way through the forest here with your machete.

00:40:04:03 - 00:40:08:06

Jeff Bland

The better able to understand how to define these things with precision.

00:40:08:21 - 00:40:24:19

Mark Newman

When I think I appreciate those words, I think. The other layer of that you're talking about, everything you've just said, I think, is with the assumption that those those numbers that we have are always what they appear to be.

00:40:25:00 - 00:40:40:22

Mark Newman

One of the things that I appreciate about, like the idea of comprehensive analysis in what we do, is that when I think about estrogen, I have like eight or ten of them, right? When I think about cortisol, I've got cortisol and I've got cortisone and I've got cortisol metabolites.

00:40:40:22 - 00:40:58:12

Mark Newman

And I think look at being able to look at some of those and try to answer some of those questions from so many different angles. Also allows us to move forward with a decently clear picture of the most complex cases when sometimes the analytical work might have some uncertainty as well.

00:40:58:16 - 00:41:17:17

Mark Newman

You know, when I see one particular estrogen that's elevated and the rest are normal, like I can question something and still have a pretty solid view of what's going on. I think of cortisol as being so much more clear to me when you have this vast amount of information about it that sort of, you know, you can

00:41:17:17 - 00:41:36:00

Mark Newman

look at any individual point. But then there's also this sort of collage that emerges of someone who's hypo cortisol or hyper cortisol based on this like sort of breadth of information that we have. That's the additional piece that I feel like for me as a I'm pretty cynical about most things in terms of my first question is

00:41:36:00 - 00:41:57:11

Mark Newman

really, really, is that is that really the story that's actually accurately portrayed here? I think with what with what we're trying to do, it's not only to to cover those the dynamic range and to differentiate between function and dysfunction and then between dysfunction and actual pathology, but also to be able to paint those stories in a comprehensive

00:41:57:11 - 00:42:17:00

Mark Newman

enough way that it allows the flexibility of when you see the anomalies that come up as well, that that's when it gets really difficult. And, you know, we put our heads together and scratch our heads with those clinicians and try to come up with a clear story when we're overlaying the clinical picture of all of this lab

00:42:17:00 - 00:42:29:09

Mark Newman

data and the clinical data to come up with the most confident story that we can so that our solutions are correct most often, because ultimately and maybe it's too cynical, but I think in medicine you're always guessing, right?

00:42:29:09 - 00:42:46:02

Mark Newman

Like you never really get to look under the hood at everything. You never get to look at the entire story. And that's what I love about testing that that really encompasses a lot of different markers is that story that emerges and the confidence that we're able to have with that.

00:42:46:02 - 00:43:05:11

Mark Newman

As we overlay the clinical picture, I think just for me is at a different level than it used to be when I was looking at one single marker that told a story about the estrogen that a patient was producing or whatever the marker might be, I think that like to me adds to that story that you're telling

00:43:05:12 - 00:43:20:04

Mark Newman

as well is just that comprehensive nature of trying to be confident in the story that we're telling about a particular individual to try to get the solution right so that we can induce, you know, profound change in in that one individual.

00:43:21:08 - 00:43:35:19

Jeff Bland

Here here. And I think what you just described is what I would call pattern recognition that you've got. Don't put all of your eggs in one basket. You don't make a functional decision based upon only one bit of information.

00:43:36:08 - 00:43:54:22

Jeff Bland

The more redundant information you have that converges to give a similar outcome of understanding, the better off you are and the confidence of your decision. And I think that what you just said is that you want each of those points on the curve to be very accurate and reproducible, but you want to assemble them in such a

00:43:54:22 - 00:44:01:21

Jeff Bland

way that your pattern shows a clear directional outcome that connects with the patient's history.

00:44:02:05 - 00:44:15:06

Mark Newman

Yeah, and that's why I think we've become so passionate about education as well, because, you know, this this thing that you do, this thing that that you've sort of birthed in functional medicine. You know, it's not paint by numbers.

00:44:15:23 - 00:44:28:09

Mark Newman

It's not simple. And it takes a high level of understanding, which is why it's great to have, you know, educators like yourselves and the people that we're going to be interviewing on these various topics, starting very basic and understanding the basics of things.

00:44:29:00 - 00:44:48:01

Mark Newman

But then, you know, there are multiple layers to that. And, you know, in peeling the onion of functional medicine, sometimes I feel like I'm still in the outside wrapper of the part you don't eat before we get into the depths of some of these things, because there, there there are so many things, which is what makes our

00:44:48:01 - 00:45:05:08

Mark Newman

industry fun, too, because there's there's not a shortage of things to learn about and to explore. And that's, I think, what makes the pursuit of that really rewarding. As the years go by and we get to keep sort of chasing down some of these storylines, then I appreciate you joining us today.

00:45:05:12 - 00:45:20:21

Mark Newman

It's always a pleasure to pick your brain a little bit and to get some historical context and hopefully to give us some inspiration of, you know, where this thing is headed as we look forward to where we're all headed as an industry.

00:45:20:21 - 00:45:34:04

Mark Newman

And so you've been an inspiration to me and I know very really supportive of of what we're trying to accomplish here. So I appreciate your time and your support and just the all the things that you've meant to to our to our industry as as we look forward.

00:45:35:02 - 00:45:52:17

Jeff Bland

Well, thanks, Mark. Let me just say one last thing to a comment you made, which I think is a really important maybe closing point, and that is that you commented about in the field concerns about competitiveness in that we tend to then be insular because we don't want to share stuff for fear it might be stolen or

00:45:53:15 - 00:46:14:15

Jeff Bland

that we won't get our full value. It is my belief that that's how really early stage new concepts develop. They develop around this protectionism of ownership and and kind of fearful that someone might steal as things grow up however.

00:46:14:21 - 00:46:34:18

Jeff Bland

And become. More potentially impactful. We should start moving from a psychology of deficiency to a psychology of abundance. Because there are literally millions, I would say tens of millions, maybe hundreds of millions of people that are dying to know what we know.

00:46:36:18 - 00:46:55:14

Jeff Bland

There. They would benefit so greatly in their health if we could get these points across the marketplaces infinitely large. Our ability to get to that marketplace is only limited by our own sense of self protectionism. We need to tell our story collaboratively, truthfully.

00:46:57:03 - 00:47:03:17

Jeff Bland

And the world will take advantage as we will, we have success in their outcomes.

00:47:04:02 - 00:47:16:21

Mark Newman

Well, I definitely agree. And the other thing that I know to be true is it takes at least dozens and maybe hundreds of us to absorb all the things that you know. So thanks for joining us. And we we really appreciate your time.

00:47:17:01 - 00:47:17:13

Mark Newman

Thanks, Jeff.

00:47:18:20 - 00:47:35:09

Noah Reed

Well, it's been great having you on the show, Dr. Bland discussing the history of functional medicine and functional endocrinology, and a big thank you to all of our listeners who joined us this week. Stay tuned for next week's episode with another very special guest, Dr. Tara Scott.

00:47:35:13 - 00:47:53:11

Noah Reed

Mark will be back in studio and we'll get to learn together about the female reproductive cycle. We would really appreciate it if you would like subscribe and share this podcast with all your friends and family. Or if you have any questions, please send them to podcast at DUTCH Test dot com.

00:47:53:18 - 00:47:57:05

Noah Reed

I'm Noah Reid. Thanks for joining us today. Until next time.