Biological terrain: what is it and how does it make functional medicine better?

Functional medicine is synonymous with root cause medicine.  It touts addressing the underlying causes rather than just treating the symptoms.  It is an approach that considers the whole person, addressing lifestyle, stress, nutrition, and tailoring personalized treatment plans.

Root cause medicine suggests that multiple causes contribute to a single disease, and that many diseases can stem from a single underlying cause.  Take, for example, a gluten allergy or sensitivity.  It can be the cause of an inflammatory barrage on multiple systems, creating symptoms of joint pain, brain fog, depression, and skin issues like dermatitis.

On the other side of the coin, having just one symptom (such as inflammation) can cause multiple diseases like diabetes, Alzheimer’s, chronic fatigue, obesity, heart disease, anxiety, hypertension, or autoimmunity.

While this is a necessary approach for today’s troubling health issues, practitioners often miss the forest for the trees.  They forget to take a crucial step back and keep a broader perspective.  For instance, the root cause may be a food allergy, nutrient deficiency, leaky gut, or hormonal imbalance, but the roots are only responding to their surrounding conditions.  Therefore, ill-health and diseases are not the result of our body failing us.  Our health is the result of our body doing what it was created to do, given the conditions it is in. 

Simply, our body is doing the best it can with what it has.

Yes, the simile of your health being like a tree is true.  The leaves, fruit, and branches of a tree are only as healthy as the roots.  But roots need healthy soil.  The “soil” of the body is called the biological terrain.

What is the biological terrain?

Terrain is the term that refers to ALL the features of a landscape.  When considering the forest and the tree when it comes to health, the roots are just one aspect of the terrain.

Just like trees in the forest, the flowers in the garden, and the crops in the field depend on good soil to make for a healthy plant, the same goes for the cells and microbes of our body.

The biological terrain supports the cells and tissues that make us up.  It is a gel-like matrix that everything is nestled in and nourished by.  All 100 trillion of our cells depend upon it, and the entirety of the microbiome (the community of bacteria in and on our body) cannot live without it.  A healthy terrain not only takes care of our cells and our microbes but also supports a vibrant relationship between us and our microbiome.

Why is the biological terrain important?

The recognition of the importance of the biological terrain goes all the way back to Hippocrates and his thought that it is our bodies’ internal terrain that is responsible for the expression of diseases versus optimal health.  However, more recently in scientific history, the debate between germ theory and terrain theory, beginning in the mid-1800s, is where modern healthcare took a significant step towards sick care.

Louis Pasteur, with his germ theory of disease, stated that germs create illness.  Therefore, kill the bug and restore health.  Contrary to that, terrain theory was developed by colleagues of Pasteur, Antoine Bechamp and Claude Bernard.  This theory states that the expression of illness and our susceptibility to microbes are the result of our internal conditions.  Therefore, the bug is nothing, and the biological terrain is everything. 

Unfortunately, Pasteur’s theory won out, and it played a major role in healthcare transforming into a multibillion-dollar biotechnical business chasing after a pill for every ill.

But terrain theory was never fully stifled, suppressed, or snuffed out.  It is worth noting that neither of these two theories has yet to ascend to the scientific glory of being called a law.  However, the massive (and growing) body of research on the microbiome sweeps the shaky legs out from under the germ theory.  Absolutely, microbes and the infectious response created in the body need to be addressed.  But, so does the biological terrain that surrounds them.

The host of microbes, viruses, fungi, and parasites in our terrain are supposed to be there, and they have a purpose.  However, when we harbor unfavorable conditions, our biological terrain shifts, and so does our health.

 Terrain-shifting conditions toward illness and disease:

·      low nutrients

·      high toxins

·      stagnant drainage

·      pH imbalance

·      low oxygen  

·      mental, emotional, and spiritual stress

 Therefore, change the conditions, change the outcome.

Beyond the root cause

As with most things, it is easy to oversimplify healing and overlook the big picture.  The root cause approach has now made its way onto the lips of most natural healthcare practitioners and is at the risk of becoming cliché. 

Addressing the root cause is not simply substituting supplements and natural remedies for pharmaceuticals.  This is akin to trying to paint the brown leaves of an unhealthy tree with natural paint instead of toxic paint.   

Both doctors and patients have the tendency to lean towards a quick fix.  Just because a remedy or therapy is natural doesn’t mean it is what the body needs. 

Sure, depression may have the root causes of omega-3 deficiency, antibiotic use, vitamin D deficiency, low thyroid function, and pre-diabetes.  If these conditions are in your body, there’s a good chance you’ll feel terrible and likely be depressed.  But you cannot dump fertilizer on the soil and expect the problem to go away. 

Questions are the answer

Patients are asking plenty of questions these days.  Sick and tired of being sick and tired, patients have become advocates for themselves because the healthcare system is not serving them the way it should be. 

Overwhelmed by the gap between what patients are struggling with and the limitations of their training, practitioners feel the mounting tension and strain of providing care.   

Practitioners must remember that they are just one “why” question away from opening up the patient’s case.  Why are they deficient in omega-3s?  Why are they deficient in vitamin D?  Why do they or why did they need an antibiotic?  Curiosity is such an under-utilized clinical tool.   

Patients don’t need smarter doctors.  They need a doctor who can partner with them, sit with the problem long enough, and ask enough of the right questions to figure out more than just the root cause.  Patients need to be heard, seen, and met where they are at.  This is how to uncover the needs of the biological terrain and how to foster a therapeutic relationship to produce a unique strategy that fits the patient.  This is the key to better understanding the biological terrain and what the patient needs. 

Every symptom is the body’s way of communicating to both the patient and practitioner.  The patient’s story (the context for their symptoms) is just as important as their history (the details of their symptoms).  Symptoms and stories offer valuable clues to an ailing biological terrain.  Patterns emerge, dots connect, and lightbulbs go off when a practitioner turns off “fix-it mode” and assesses the terrain through empathy, compassion, patience, curiosity, humility, and wisdom.

Everything God created is complex.  Complex systems need simple solutions when there are problems.  Instead, humans have the fabulous capacity to add complication.  We try to solve problems through complicated means.  We even have a bias towards complicated answers.  Meaning, the more complicated the solution is, the better it must be.  Pills, biohacking, and fancy gadgets only cover up the symptoms.

What we need is simplicity.  Patient and practitioner must seek to remove the obstacles in the body’s way to restore health.  Right now, in this moment, your body is doing the best it can with what it has to work with.  Our biological terrain is adapting to the environment we are in.  We’ll never know the half of how everything works, but we don’t have to know it all.  We just have to know how to work with the body.

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