Joe Pizzorno, ND, Applies Clinical Pathophysiology
Harnessing Artificial Intelligence and Functional Pathophysiology to Improve Clinical Practice
IFM has a long history with Joseph Pizzorno, ND—as a Board member (and also Board chair for several years), as a contributor to developing the FM model (and occasional speaker), and as a decades-long friend and colleague to many IFMers. As the founding president of Bastyr University, Pizzorno has been at the forefront of the movement to create a more integrated healthcare system—one that includes all licensed providers and acknowledges the contributions of many different disciplines. For nearly 40 years, he has devoted his considerable intellect and energy to using the evidence base to devise new solutions to the challenge of preventing disease and creating health. Two of his latest projects are of particular interest to Functional Medicine practitioners.
SaluGenecists (SG) Advanced Corporate Wellness
SaluGenecists, Inc. has created a sophisticated artificial intelligence system (SaluGenie™) that focuses on identifying the underlying biochemistry behind patients’ problems. In an ideal world, says Pizzorno, everyone would have access to certified Functional Medicine practitioners and would be well educated in the nutritional, lifestyle, and environmental influences on health. In reality, of course, comparatively few have either the access to experts or the expansive knowledge base to keep a continuous, comprehensive grasp on the major elements in our environment and lifestyle choices that will lead us toward health or disease over a lifetime.
As Western medicine moves toward a more personalized approach to prevention and treatment, there is a concomitant movement toward the correction of underlying dysfunctions rather than the treatment of symptoms. Both systems and individuals need tools to help us accomplish this huge transformation. SaluGenecists is addressing the demand for knowledge delivery systems that combine an evidence-based expert understanding of integrative health with advanced technological platforms.
For more than five years, the SG system has been deployed in corporate settings, where employees are provided with personalized guidance on how to improve their health and where data have been collected and analyzed on about 20,000 people. From the SG website:
SaluGenecists' Natural Health Smart Tools ("Smart Tools") have been developed with the understanding that a considerable improvement in health and corresponding decrease in disease burden, accompanied by a concomitant savings in cost, can be accomplished by personalized health improvement advice based on a person's unique needs and biochemical individuality.
These Smart Tools are natural health expert systems that use artificial intelligence to identify each individual's most important underlying physiological dysfunctions and the steps necessary to remedy them. This is accomplished using rigorous probabilistic reasoning based upon authoritative, evidence-based, peer-reviewed research. The Smart Tools promote restoration of function through the use of inexpensive agents that strengthen the body, while also emphasizing personal education and self-care.
Our system design enables us to focus on a limited number of initial questions, the answers to which provide smart branching to increasingly targeted, differentiating questions. Working through a list of 50-100 questions (out of a database projected at over 20,000) yields advice personalized to a depth never before available. By answering this individualized series of "smart questions," the user triggers the system to create a map of his or her unique metabolic and functional needs, ranked by probability and their potential impact on health.
That personalized guidance in the corporate wellness programs produces for each individual a report on the:
- three actions in the individual’s life that are having the most positive impact on health;
- three actions in the individual’s life that are having the most negative impact on health; and
- the three most important actions the individual can take to improve his/her health.
This very specific, individualized information is used to enhance the possibility of behavioral change by focusing attention on a few things that will have the strongest impact on disease risk. What do the data show from the almost 3,000 employees for whom they have 3 years of data? Some very exciting results:
- Risk reduction for all individuals for a significant number of major diseases:
- Heart attack
- Lung Cancer
- Alzheimer’s disease
- 46% risk reduction in the number of high-risk individuals
- Positive behavioral change (see graphics below)
- Increased exercise
- Increased sleep
- Decreased stress
- Improved diet (greater emphasis on fruits, vegetables, whole grains)
- Improved blood pressure, cholesterol levels
In Pizzorno’s words, this system is a game-changer; it is innovative, effective, and cost-effective based on Functional Medicine concepts and priorities. When used by physicians in practice (a professional model and a consumer model are both available), it can help them identify the areas of greatest leverage for improving their patients’ health. When used by employers, it can reduce the cost of care (for self-insured employers) or the cost of insurance through decreased utilization.
Clinical Pathophysiology: A Functional Perspective (Mind Publishing, 2012)
This new book (co-authored by Pizzorno and Joseph Katzinger, ND), focuses on pathophysiology from the perspective of helping practitioners (and health professions students) think about patients differently from the current disease model of illness. It provides the connective tissue that links basic sciences with clinical applications. From the Introduction:
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Although thousands of diseases have been named, the overwhelming majority of these diseases owe their origin to a relatively few underlying causes [e.g., inflammation]. The actual symptoms or diseases a person manifests are determined by the constellation of genetic, psychological, dietary, lifestyle, and environmental factors. The role of the advanced physician is to identify these underlying causes rather than focus only on symptom alleviation or disease treatment.
Our goal for this Clinical Guide is to focus on key methods of assessment to identify underlying core factors that are responsible for disease, along with effective interventions using natural medicines and patient monitoring to provide a truly individualized approach. To reach this goal, we have reviewed thousands of research articles and extracted the most current, relevant information for practicing clinicians, and organized it by physiological systems.
Chapter contents (abbreviated):
| 1—A Cellular Approach to Health|| 7—Immune Function|
- External Environment
- Cell Membranes And Messaging
- Intracellular pH
- Mitochondrial Function/Energy Production
- Assessment of Cellular Function
- Mitochondrial Optimization Strategies
- Innate Immunity
- Adaptive Immunity
- Causes of Immune Dysfunction
|2—Digestive Health ||8—Endocrine Balance|
- Underlying Digestive Physiology
- Gut Flora
- GI Dysfunction
- Pancreatic insufficiency
- Increased intestinal permeability
- Food allergy/intolerance
3—Advanced Detoxification Support
- Clinical Consequences of Toxin Exposure
- How Toxins Cause Damage
- Types of Toxin Exposure—Exogenous and Endogenous
- Reproductive Endocrinology
- Causes of Excessive Degeneration
- Reactive oxygen species (ROS)
- Advanced glycation end-products (AGEs)
- Mitochondrial DNA
- Neurological Degeneration
|4—The Spectrum of Insulin Resistance|| 10—Cardiovascular Disease|
- Metabolic Syndrome
- Types 1 & 2 Diabetes Mellitus
5—A Comprehensive Approach to Inflammation
- Physiology of Acute Inflammation
- Para-inflammation/Meta-inflammation and Cellular Stress
- Cellular/Organelle Stress
- Contributors to Inflammation
- Inhibitions of Inflammation
- Resolution/Inadequate Quenching
- Endothelial dysfunction
- Nitric oxide availability
- Insulin resistance and obesity
- Other risk/contributing factors
|6—Stress, Anxiety, and Insomnia|
- HPA Axis and the General Theory of Adaption
- HPA Dysregulation
- Genetic Predisposition and Early Life Experiences
- Depression and Anxiety
The book is selling well, and the feedback has been excellent. A Clinical Guide has long been needed and, happily, one is now available. IFM is delighted to see this very useful addition to the Functional Medicine literature. Download this article in PDF format