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Show Description
In this episode of Foundations and Functions, Dr. C.J. Pabla and Dr. Jason Amich dive into the groundbreaking Four Point Hormone Panel—a tool they've developed to bring clarity and insight to women struggling with unexplained hormonal symptoms. Drawing from personal experiences and years of clinical practice, the doctors explain how traditional hormone testing often fails to account for the natural fluctuations in female physiology. By testing key hormones four times throughout the menstrual cycle, they’re able to map a more accurate picture of what's really happening in the body—and finally validate what so many women have been told to ignore: "Everything's normal" doesn't always mean everything's okay.
Dr. Amich and Dr. Pabla break down the science behind the panel and share how it's transforming the way they help patients address symptoms like anxiety, depression, infertility, and fatigue. From hormone behavior to root causes like thyroid dysfunction, PCOS, and even environmental toxins, this episode is packed with eye-opening insights into how functional medicine can restore balance and well-being. Whether you’ve been dismissed by traditional care or you’re simply curious about a deeper approach to hormonal health, this episode will help you ask better questions—and understand your body like never before.
Disclaimer:
The information provided in this podcast is for educational and informational purposes only and is not intended as medical advice. The content is not a substitute for professional medical care, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.
If you would like more detailed medical information, please contact Integrative Medicine through their website at https://integrativemla.com/
Show Transcription
3 0:00Welcome to Foundations and Functions weekly podcast, where we return to when medicine actually made you better. Now here's Dr. Jason Amick and Dr. C.J.
6 0:14Pabla.
2 0:16This is Dr. C.J. Pabla with Dr. Jason Amick. Welcome to our Foundations and Functions podcast. Today we're going to be talking about the Four Point Hormone Panel and kind of like why we decided to do the Four Point Hormone Panel. So I'm going to pass it on to my partner, Dr. Amick. Why don't you tell us kind of how you came up with this concept and how it really has
2 0:40helped our patients?
1 0:41Dr. Amick Morse Yeah, thanks so much. So, you know, one of the things that I say pretty frequently is, you know, I'm a girl dad, and constantly in my life, you know, I've been faced with situations, you know, with my daughters and my wife, and I just think, wow, dudes don't put up with that.
1 0:58You know, a dude would never go through that the way you guys do that. And so, you know, in seeing a lot of our patients, female patients who come in really frustrated, and they hear kind of the same thing, like, well, you know, I haven't felt well, I haven't felt well, and my doctor just tells me everything is normal. My labs are normal, my hormones are normal, but I don't feel well. And you know, I kind of thought about that for a while, and it occurred to me, biologically, dudes
1 1:30are dumb. I mean, from a biological perspective, our hormones are really pretty basic. You're 10 years old, you're 12 years old, boom, you hit puberty, your testosterone spikes, kind of hangs out there. Yeah, maybe in your late 30s and 40s, your testosterone may waver a little bit,
1 1:47but female physiology, their hormones change daily. Daily, and it's a cycle that they go through every single month. And so, one of the things that I thought of was, what does normal mean when you talk about an estrogen level? So we know the range of estrogen can be, depending on where you are in your cycle, 4 to 400,
1 2:14generally speaking. And that's a huge range. And so I applied that and I thought, well, gosh, 71 is normal. But is it always 71? Is 71 the highest that you get? Is 71 the lowest that you get?
1 2:32And so, yeah, I mean, it would be great to, as scientists and as nerds that we are, to get as many data points as possible. But it's really hard to get people to come in and get blood drawn every day for 28, 32 days.
5 2:46Right.
1 2:47So really we work with our lab. We've got a great relationship with our lab that keeps a lot of costs down for patients who pay out of pocket. And so we're able to actually put together this panel that includes an estrogen level, progesterone level, luteinizing hormone, follicle stimulating hormone, prolactin, and testosterone.
1 3:07And we can actually sample that on a patient four different times during their menstrual cycle for really low cost. And what that does for us is it allows us to graph that. Now it took me some time. I had to go back and remember my Excel and logarithmic functions to put all that on a graph. But really, it was eye-opening.
1 3:28I remember when you and I first looked through that graph and went, wow, this is kind of out of a textbook. We know how the hormones are supposed to fluctuate throughout the different – the luteal phase, for example. We know kind of where estrogen should be in relation to progesterone. And so we've been able to take that graph and really give patients a lot of data and
1 3:53help them make it make sense. And so there are patients that we've definitely sat across from and said, you know what, right, all of your lab values are within the normal range. But the behavior of these hormones are not normal. And so, validating that, I think, means a lot to a lot of patients that say, you know what, you're right, you don't feel well.
1 4:14You're not crazy. There's nothing wrong with you. You're not broken. You just have some physiology that's off and that manifests in emotions, anxiety, depression, sometimes infertility even. And so using that data set and what we know about physiology helps us really paint the picture for our patients and put them on the right track, know what questions to
1 4:39ask. And then sometimes that means going back to their OBGYN or going back to their primary care doctor and saying, hey, here's this graph. And I know in my experience, most of those providers have never seen a graph like that.
4 4:52Yeah.
1 4:53The current insurance model just would never allow a primary care doctor using insurance to order the same five or six labs four times in a month. Right. You know, and cover those costs. to order the same five or six labs four times in a month, you know, and cover those costs. So we're able to do that, and because of that, we can provide a lot of insight into, you know, what's happening with someone's hormones.
1 5:17And so from there, you know, some of those patients may choose to see us from a functional medicine perspective, right, where, you know, they see you, and we start kind of digging down that root cause path of why is that? choose to see us from a functional medicine perspective, right, where they see you and we start kind of digging down that root cause path of why is that? Why is your progesterone flat?
1 5:31So that may indicate you're not ovulating. Well, why would that be? So then we can kind of talk about some of the reasons that someone may have hormone
2 5:43dysfunction. Dr. Darrell Bock Yeah, polycystic ovarian syndrome. You could have thyroid dysfunction. So those can affect high androgens. Elevated prolactin can suppress ovulation. So there's several root causes that we can look up and kind of try to determine, like, why are you not ovulating?
2 6:04And you know, how many times have you had people come in and said, well, I have my hormones checked and I'm like, okay, where were you in your cycle? Like, I don't know. And I said, well, then this data makes no sense because your hormones change so much throughout your cycle. And so I think just helping women know that there's not a linear response to your hormones throughout all 28 days. They change.
2 6:25And I think that's kind of like their aha moment. They're like, oh, okay, now that makes sense to me. And then that's why we're looking at four data points so we can follow this curve. So yeah, I think the four-point panel has really helped a lot of our women kind of understand what's going on throughout their cycle and their responses to their hormones.
1 6:45Darrell Bock And then we take that lens and we broaden that lens because, again, we go back to where do some of these hormones come from? What are the foundations of these hormones? And so, again, we go in and we look at gut health. We look at toxin load. We look at chronic viral infections.
1 7:01And we really kind of figure out, oh, it may not be PCOS, it may not be a thyroid, it may be something going on with your environment. It could be a heavy metal toxicity, it could, mold exposure, we talk about that a lot. A lot of these things can affect your physiology in lots of different ways.
1 7:19So that's kind of where we started down the path with these four-point hormone panels. And man, it's one of my favorite things to do with patients and helping them really gather good quality data that really helps explain their physiology. So if you are someone who thinks, gosh, I just don't feel well, I want to get my hormones checked, the questions to ask are are what hormones are you getting checked?
1 7:46When are you getting them checked? Maybe a good option would be to come to our office and let's do a four-point hormone panel and just take a look at how your hormones are behaving, not necessarily what their level is because one of the things I explain to people too, it seems like no one really kind of knows what a normal estrogen level should be. That's going to be different person to person.
1 8:08So it's about the behavior though. So hopefully that helped make it make sense. And thanks for listening today to our Foundations and Functions podcast with Dr. Pabla and Dr.
3 8:21Amy. The information provided in this podcast is for educational and information purposes only and is not intended as medical advice. The content is not a substitute for professional medical care, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider
3 8:38with any questions you may have regarding a medical condition. If you would like more detailed information, please contact Dr. Amick or Dr. Pabla at Integrative Medicine through their website at please contact Dr. Amick or Dr. Pabla at Integrative Medicine through their website at integrativemla.com
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Show Description
Foundations and Functions is a weekly podcast hosted by Dr. C.J. Pabla and Dr. Jason Amich that challenges the current medical model by returning to the core of what medicine was meant to do—make people better. Drawing from their extensive experience in emergency medicine, critical care, and integrative health, Dr. Pabla and Dr. Amich dig into the foundational principles of human physiology and the root causes of chronic illness. Whether it's unraveling the mystery behind hypertension, uncovering hidden mold toxicity, or connecting seemingly unrelated symptoms to gut health, each episode offers insightful, real-world discussions grounded in science and practical clinical experience.
Designed for patients who feel unheard or stuck in a system of short visits and fragmented care, the podcast is a deep dive into personalized medicine that values time, thoroughness, and education. Dr. Pabla and Dr. Amich believe true healing happens when we make sense of the body's signals, ask the right questions, and have the freedom to connect the dots. Through compelling cases and thoughtful analysis, Foundations and Functions offers hope, understanding, and a roadmap for anyone looking to reclaim their health by addressing what truly matters at the root.
Disclaimer:
The information provided in this podcast is for educational and informational purposes only and is not intended as medical advice. The content is not a substitute for professional medical care, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.
If you would like more detailed medical information, please contact Integrative Medicine through their website at https://integrativemla.com/
Show transcription:
3 0:00Welcome to Foundations and Functions weekly podcast, where we return to when medicine actually made you better. Now, here's Dr. Jason Amick and Dr. C.J.
8 0:14Pabla.
2 0:16Welcome to Foundations and Functions with Dr. C.J. Pabla and Dr. Jason Amick. Dr. Pabla, why the name, foundations and functions?
1 0:25Well, kind of like the foundation of a house, right? It starts from the ground up. The foundation is not strong, the house is not strong. So just like in science, foundational things like the structure of a protein, you change the structure, its function changes, right? So that's kind of what we wanted to get through in the podcast is, these are very important concepts, and we want to kind of weave this concept through all of our podcasts.
2 0:57Darrell Bock And it speaks a little bit to how we think and talk every day in terms of, you know, patient conditions, patient issues, is, you know, we understand that the foundation of homeostasis and the normal physiology people are supposed to have. And so getting back to, you know, fundamental foundational clinical science, clinical medicine, and understanding how what we do every day affects the function of our body.
2 1:25So when you have symptoms, it's letting you know that there's something off with maybe the function. And so we can tie that into the foundations. What are the root causes? What are the basic principles of physiology that we can apply to help people get better?
2 1:43And so, one of the goals that we have, and we always say is do we want to
1 1:50return to when medicine made you feel better.
2 1:53So talk, tell me about that. Talk about that. What does that mean to you when you when you
1 1:57say we want to return to when medicine made you better? You know, when somebody presents to our office, instead of just kind of looking at, you know, the basic symptoms and consider maybe, you know, medicine for short term, which initially may help stabilize symptoms, we want to kind of work upstream, right? We want to get to that root cause. For example, if you come in for hypertension, maybe you need an antihypertensive medicine to stabilize that.
1 2:25But what are the reversible causes of hypertension? Sleep apnea, hypercortisol, multiple other things that we can look at. So obviously addressing weight, lifestyle, caffeine toxicity, right? So foundational stuff is really working upstream and really trying to address those root causes. And I think this is one thing that, you know, I think we do well in our practice. We spend enough time. And I think that's the key is really spending that time
1 2:57with a patient unraveling the mystery.
2 2:59Yeah. And I think we both have a lot of experience in medicine, in emergency medicine, critical care, hospital administration. And I think some of this, for me, helps remind us that the American health system that we currently have really doesn't do a great job of actually healing people. It used to be, used to be focused on that quite a bit and I think now when we look at all the statistics and data, despite the fact that we spend a tremendous amount
2 3:33of money on healthcare compared to any other first world country, we have some of the worst outcomes, infant mortality, maternal mortality, diabetes, obesity, heart disease, all these things. And no doubt, we do a phenomenal job with acute care, trauma, strokes, heart attacks, best in the world hands down. But actually making people better or what do you always say about type 2 diabetes? The best way to treat type 2 diabetes is?
1 4:04Dr. Darrell Bock's don't get it.
2 4:05Don't get type 2 diabetes. So we can get to that level of returning to when medicine focused on, not necessarily just even preventative care, but avoidance care. How do we keep you from getting a disease anyway? So with that in mind, let's talk a little bit about who our target audience is.
2 4:29When we do this podcast, because we talk a lot amongst ourselves, and we do a tremendous amount of education with our patients, what's something that you could point to to say, look, this is who we want to reach?
1 4:41This is our target audience. Well, I mean, I think that's a broad range. I mean, men and women, you know, children. I think, you know, our target audience is people that might have had chronic issues that aren't being addressed necessarily. Not just, you know, talking about preventative care, but, you know, maybe they've gone to multiple providers and they have this mysterious illness, and, you know, the 15-minute to 20-minute medical model isn't working because they have multiple symptoms and no one's connecting the dots, you know.
1 5:17They might see a different specialist for each one of these symptoms or each one of these disease processes, and no one, unfortunately, is connecting the dots. And that's kind of like what we see. So you know, obviously, we do do acute care medicine, we do some urgent care in the office, and we love doing that.
1 5:34But really addressing those people that have gone to multiple different providers, and you know, haven't really, no one's really addressed their root cause. I guess that's kind of the general audience we really appeal to quite a bit.
2 5:49Yeah, and I think two things that come to mind. One of those patients that come in, like I've had, for example, high blood pressure for the last 15 years. I'm about to start my fourth blood pressure medicine, but no one can help me figure out why I have this
2 6:04or what I need this for. And then I think the other side of it that sets us apart is that audience, you know, that patient, that medical consumer. You know, like you said, you know, 9 to 11, 9 to 15 minutes, that's the average time that you spend face-to-face with a provider in the United States.
2 6:20And you know, one of the things you always say is you can't solve complex problems, you know, in 10, 15 minutes. Dr. John Alder Reid Right. Dr. John Alder Reid You need more time to really dig into that. And so I think, you know, this will be a whole other podcast someday, but from a, you know, even an insurance model, you know, I think the fact that is looking at that, you know, they're paying out of pocket and going, what am I getting for this? What did I just pay for in that office visit?
2 6:50So I think that's a big chunk of drive for patients who come see us because they want their questions heard, they want answers, and they want to feel like that there was a value in this visit that they just had with us.
1 7:06So, right. Well, I think the other big thing is we limit the complexity by seeing, you know, much less patients and knowing them in depth, you know, getting all their data, reviewing their data well before seeing the patient and not, you know, having to see 30 to 40 patients a day, which is driven by unfortunately insurance issues. And so we have the freedom to really spend that time.
1 7:31And I think that's where the, a lot of our patients get resolution of their symptoms because we finally connect the dots. And you know, that can take an hour. That can take two hours, you know what I mean?
7 7:45Dr. Darrell Bock Yeah.
1 7:45Dr. Robert Pulsner But I don't think, no matter how intelligent of a physician you are, I don't think 15 minutes is going to solve that problem.
2 7:52Dr. Darrell Bock Yeah. And I think one of the things that sets us apart is this concept that we carry around with making it make sense. Even today, we had a patient that we were just spitballing about, like this is their lab value, doesn't seem to make sense with their symptoms, so where else should we be looking? What else can we be doing to help them? And just kind of throwing out a neurological basis,
2 8:18an endocrine basis, what are all the possible reasons that this person could be having the symptoms, but at the end of the day, how do we help the patient understand the symptoms they're having, why they're having them, and what the next best steps are for them? So yeah, we definitely spend a lot of time with patients. Education is very key for us because again, we just love treating every patient like a
2 8:39research case.
6 8:40Yeah.
1 8:41Yeah. You know, and then also having access to, you know, other biotech companies that can really help us dig into the mystery. Like sometimes the mystery is you have multiple symptoms and no one bothered asking the patient, oh, by the way, do you have water damage in your home? Oh, by the way, do you have mold in your home?
1 9:00You know, mold toxicity is one of those mysterious illnesses that can cause multiple symptoms. And so really then helping not only educate the patient, but then demonstrating to the patient, yes, you have mycotoxins because we've done the appropriate test. So I think that's the other thing that we figured out over the years in our practices, who's our go-to to help us figure out some of these mysteries. And I think that takes time to find the companies that are going to give you valid information
1 9:30so you can share that with the patients. And that's important, not only to help the patient, but then they can actually see, oh yes, my mycotoxins are very elevated. And yes, this correlates, maybe not not causation but correlates and is
2 9:46resulting in some of your symptoms. And digging through those symptoms you know you know near and dear to my heart is gut health and and gut dysbiosis and so one of things I share with patients is sometimes you have these 12, 15, 17 random symptoms that don't I call them just white noise and you know if we can tie that back to your gut health we can get your gut healthy, sometimes we can reduce those symptoms or even eliminate those symptoms completely.
2 10:11Now what's left are the two or three symptoms that are really at the heart of your discomfort and issue.
5 10:18So...
1 10:19Yeah. I use the term dust settles a lot with the patients. I said, you know, you're coming in pretty ill, multiple symptoms. Let's walk you, you know, to 30 to 40 percent better. See what symptoms peel away because, A, you know, we address your gut issues first, and then, you know, when these symptoms go away, then we can follow the other symptoms, you
1 10:40know. So we're really big on looking at that. Patients can be overwhelmed. Well, how am I going to get better when I have 20 different symptoms? Well, that's for us to try to focus on those core symptoms first and address that core issue first. And then, you know, they come back a couple months and they feel really great and they say, but I still have insomnia and I still might have some fatigue, but hey, these are gone now. Okay, well, now we have another subset of core symptoms that we're going to look at
1 11:06to address those issues.
4 11:07Dr. Darrell Bock Yeah.
2 11:08So I think it's a great introduction, and hopefully we've given you a little bit of insight of how we think we can get better medicine through foundations and functions. So ultimately, again, we just want to return to when medicine made you better. Thanks for spending time with us today. Thanks for listening to our podcast. There are going to be a lot more coming. And so please stay tuned. And we'll talk to you soon.
3 11:36The information provided in this podcast is for educational and information purposes only and is not intended as medical advice. The content is not a substitute for professional medical care, diagnosis, or treatment. Always seek the advice of a qualified health care provider with any questions you may have regarding a medical condition. If you would like more detailed information,
3 11:58please contact Dr. Amick or Dr. Pabla at Integrative Medicine through their website at Integrative Medicine through their website at integrativemla.com.
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Patient Coordinator Rachel Phillips gives an overview of the personalized approach to discovering the root cause of illnesses.
We use an integrated clinical approach to combine functional and traditional medicine to go further and identify the root cause of our patients’ problems. Functional medicine addresses the full range of physical, emotional, mental, social, spiritual and environmental factors that influence a person’s health. We often see clients with chronic issues who haven’t been getting better with traditional treatments.
Unique to Integrative Medicine, Laser and Aesthetics in Carmel, our providers will create individualized whole body health, 360-degree plans based on genetic testing, functional/integrative lab assessments, nutrient deficiency testing and your patient history. Often we spend over two hours with you during your initial visit, asking questions and actively listening.
Here is what you can expect as a new patient: Patient schedules an initial appointment and completes preliminary questionnaires. Our doctors review and research your history and records prior to meeting you. On your first visit, you will have a full exam with Dr. Pabla and further discuss concerns. You receive a custom action plan and review it with Dr. Amich to implement. We continue to meet every 2 months to treat the root cause of your medical conditions.Learn more about our approach Integrativemla.com/
Disclaimer:
The information provided in this podcast is for educational and informational purposes only and is not intended as medical advice. The content is not a substitute for professional medical care, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.
If you would like more detailed medical information, please contact Integrative Medicine through their website at https://integrativemla.com/
Show Transcript
Welcome to Better Medicine, a return to when medicine made you feel better. Now, here's patient coordinator, Rachel Phillips. Welcome to Better Medicine, where we return to when medicine actually made you better. We are looking to deep dive into the root cause of health issues and explore how our personalized approach can help you achieve better health. I'm your host, Rachel, and today we're going to talk about something that affects so many people but is often misunderstood. It's the connection between gut health, hormones, and your overall well-being. Have you ever wondered why you don't feel quite like yourself? Why no matter what you do, your health issues just aren't improving? Well, there's a good chance you might be missing a key piece of the puzzle, and that's where we come in. At Integrative Medicine, Laser, and Aesthetics, our doctors specialize in root cause analysis, a way of looking at your health that focuses on identifying and addressing the underlining factors contributing to your symptoms, not just masking them. It's a powerful way to get to the bottom of what's truly going on inside your body. Let me introduce you to Dr. Amick and Dr. Pablo, our top specialists who are transforming the way we look at health. Dr. Amick is an expert in gut health and hormone balancement. You may not know this, but your gut health and your hormones are connected. Issues like bloating, digestion discomfort, fatigued, or even skin problem could be linked to imbalances in your gut and your hormones. Dr. Emick is dedicated to helping you understand and treat these underlying causes, leading to a healthier and more vibrant you. And then there's Dr. Pabla. When you see Dr. Pabla, he doesn't rush through your appointment. He takes his time, sometimes up to two hours long. He studies your symptoms, understanding your health history, and gets to the root cause of your health issues. Whether you're dealing with fatigued, persistent pain, or unexplained weight gain or loss, Dr. Pabla is committed to digging deeper to figure out what's really going on in your body. And if future testing is needed, he will order any diagnostic testing or screening to ensure nothing is overlooked. Did you know that we offer a full functional medicine blood panel right here in our office? Right after your visit with the doctor, you can get it done. That's right! No need to go to an outside lab anymore. Everything is handled in-house, making it quicker and easier to get the answers that you need. If you're a woman struggling with hormonal imbalances, you'll be especially interested in what we offer. Our 4-point, 6-point, and 8-point hormone panels are designed to help uncover issues with everything from infertility to your monthly cycle. If your hormones are out of balance, you may be experiencing fatigued, mood swings, weight changes, or even difficulty getting pregnant. Our comprehensive hormone panel gives us valuable insight into what's really happening and helps us develop a personalized treatment plan just for you. We believe that health is more than just treating the symptoms. It's about understanding the entire picture. We are the top practice here in Indiana that can order specialty testing to find food sensitivity, mycotoxin testing. So how does the process work? Well, it's easier than ever to get started. Here's how to connect with us. Just give us a call or schedule online. Our friendly front desk team is here to assist you. We are here to help you find the best time that works for you. Once your appointment is scheduled, you'll receive an email with all the important details about your visit. This includes any preparation you might need and a link to sign up for our online patient portal. Did you know that once you set up the patient portal, you can send us lab panels, medical records, or any other important information you'd like Dr. Pabla and Dr. Amick to review? It's a great way to save time and ensure that your doctor has all the information that he needs before your appointment for your best care. We believe putting our patients first, and that means ensuring your experience is as smooth as possible. By using our online patient portal, you'll help us create a more personalized and effective care plan that is tailored to your needs. Whether you're dealing with chronic conditions, want to improve your overall well-being, or you just want to explore a more natural approach to health, Dr. Pabla and Dr. Amick is here to guide you every step of the way. Their extensive experience at Integrative Medicine allows them to combine traditional treatments with advanced therapies, giving you the best of both worlds. So what are you waiting for? Take the first step towards a healthier, more balanced life today. Call us now or go online to schedule your appointment with Dr. Pabla or Dr. Amey, our top leading doctors at Integrative Medicine, Laser, Laser Anesthetics. Thanks for listening. My name is Rachel top leading doctors at Integrative Medicine, Laser, Laser Anesthetics. Thanks for listening. My name is Rachel and this is Better Medicine.
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When looking for answers to your health problems, it can feel as if you’re on your own. Your health and happiness are our top priorities. We’re here to help you identify the source of your problems and get you back on track to feeling healthier and happier. Functional medicine, IV infusions, and functional aesthetics are just some of the methods we utilize to get to the bottom of your health issues and help you get back to feeling your best. Whether you live in Carmel, Zionsville, Indianapolis, or the surrounding areas, we are here to help.
Disclaimer:
The information provided in this podcast is for educational and informational purposes only and is not intended as medical advice. The content is not a substitute for professional medical care, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.
If you would like more detailed medical information, please contact Integrative Medicine through their website at https://integrativemla.com/
Show Transcript
Welcome to Better Medicine, a return to when medicine made you feel better. Now, here's Dr. Jason Amick and Dr. CJ Pabla. Hello, this is Dr. CJ Pabla. This is Dr. Jason Amick. Welcome to Better Medicine. This is our first podcast. We're excited to do this, to start this endeavor, to share kind of our thoughts, our philosophy, and a lot about our practice, and to talk about things that are relevant and important to people every day. So one of our big philosophies at our practice is returning to when medicine actually made you better. And that has so much to do with our integrative approach to medicine and healthcare in general. So, Dr. Pawa, tell us a little bit about why you started the practice, how you developed functional integrative medicine mindset. I practiced emergency medicine for 18 years and this is where Dr. Amick and I kind of connected, but, uh, we'd see a lot of chronic stuff in the emergency department. Not necessarily acute stuff. Uh, women that had gut problems, multiple CT scans, and, uh, no one can really find what's wrong. We could tell them what it's not, but what was it? Right. So I started thinking about like, why are so many chronic stuff in this country just handled with just medication. So that was kind of the philosophy, could we work upstream and find root causes to these problems if we dug a little bit deeper. So that's kind of the philosophy behind that practice. We're not anti-medicine. I think medicines are great for stabilizing symptoms and getting people kind of stabilized, but you know, we kind of look at it as a band-aid. And then, you know, what can we do to work upstream? So that's kind of my philosophy and Dr. Amick's philosophy, and we know the gut is linked to many things. Dr. Amick can kind of speak about that, but so that's kind of why I decided to get out of emergency medicine and deal more on the chronic side and look at more root causes for patients. I think we both had some personal experiences we can talk about, but I you know, I can remember a long time ago we work in the ER. We would have patients come in with sometimes pages, two, three pages of medicines. I can remember even back then kind of thinking to myself that, gosh, you would think that if medicine solved problems, the more medicines you were on, the healthier you would be. And it was never the case. The more medicines they were on, the worse off they were. So I know early on, we started kind of questioning our training and the standard medical model, you know, 20 years ago, kind of going, nah, does this really kind of make sense? And so, you know, from my perspective, you know, I kind of stumbled into integrated functional medicine just through, you know, lots of different experiences that I had, including some hospital administration roles and really getting to see what happens behind the scenes, you know, how the insurance model affects healthcare, how it drives clinical decisions in healthcare organizations, looking at different types of healthcare models, you know, from emergency medicine care, under MTALA and all those things, all the way to cardiac and cardiovascular care, you know, acutely and chronically, you know, in those two areas, I would say in a lot of areas, the United States, we surpass every other country with our acute care model when it comes to trauma, cardiovascular, you know, heart attacks, strokes, you know, when, when an insult occurs to people, we, we are bar none the top of the world in managing those. Yeah. But when it comes to preventing those things, we really, it's sad and embarrassing how terrible we really rank against other countries, even some of the countries that aren't necessarily considered first world countries. So, from that perspective, I kind of, you know, really took into account, okay, so what else is out there? And that's kind of why I stumbled into functional medicine, integrated medicine, and really understood, going into it, that this is an approach where you start with basic physiology, basic biochemistry. Like, how do we actually make people better? You and I talk a lot about the systems biology approach, right, the whole body is connected. So you don't have a liver problem, you've got a body problem that manifesting in the liver, that sort of thing. So that was kind of my experience. And then also understanding the healthcare model today, I think as a lot of people are acutely aware, isn't really about making you bad at it. So that's kind of where I came from. And I think you had some personal first-hand experience maybe with some back injury or back pain. And so tell us about that a little bit. Yeah, so, you know, like Dr. Amick said, chronic care, we basically manage symptoms and do we actually get patients better? You know, I snowboarded for many years and was having a lot of chronic low back pain and, you know, went the traditional medicine route, did an MRI, which is important to look for structural issues, saw a back surgeon and really wasn't getting any better until I saw a doctor that did myofascial release and that made a world of difference. So you know, getting that done, getting look at muscles that were inactivated, that weren't functioning right, made a big difference in my pain management and I was able to get back into working out and being healthy. So, you know, besides my personal journey, you know, I realized that, you know, what can we do to affect change? And, you know, as a physician, I really didn't know a lot about nutrition, right? So, you know, you study a little bit of it in medical school and I realized that the countries that do it well, the core is changing the way you eat, you know, eating not only so what does it mean to eat healthy and we can get into that down the road but you know, eating not only, so what does it mean to eat healthy and we can get into that down the road, but you know, really eating whole foods and avoiding foods that tend to be inflammatory and you know, and it's harder and harder to eat healthy. And so, that's kind of our take on it, you know, really establishing a core of, you know, good foods, some proper supplementation, and then really focusing on gut health. Yeah, and you know, I've said for a long time, I continue to say, and I think the two worst things we say in medicine and healthcare is, eat better and exercise. Yeah. Because no one really knows what any of that means. Right. And so, we have to take a really broad look at, what does it mean to eat better. Well, it's not just, you know, removing processed food and things that are bad for you, but it's also understanding how your body reacts to the foods you are putting in your mouth. Because again, from a systems biology approach, I mean, every single organism on this planet, and you can take a good hour and watch some really good TV programs about nature, and what you learn from just watching, whether it's a butterfly or a snail or a Capuchin monkey or whatever, you know, they're intimately tied to their environment and what they eat How they eat and what's available to them and that's something that you know from a biological perspective. We've gotten away from yeah and so there's absolutely a recourse when you're eating processed foods and chemicals and things that just aren't natural to your biology, and that has some long-term effects. So we see a lot of things in our practice, and we manage a lot of that, not just, you know, from a food and nutrition perspective, but a lot of chronic diseases. We talk a lot in here about inflammation, inflammatory processes. We do a lot of disease management for patients. And I think one of the things that sets us apart from a lot of other practices is our deep understanding of the physiology, but also our ability to explain physiology to our patients and educate them. Yeah. And you know, emergency medicine gives you a broad perspective on a lot of different pathology because, you know, as a ER doctor, you might see trauma in one room and then you got a heart attack in another room and you got ortho in another room so it gives us a broad perspective and also in graduate school I studied a lot of physiology and biochemistry and really I think the battle is won when you look at the cellular level you know how does toxins how does inflammation affect the cellular level? And, you know, we spend a lot of time on Dr. Emick on whiteboards, kind of nerding out and, you know, drawing formulas and looking at organic molecules and looking at different pathways that are interrupted by inflammation or interrupted by, you know, toxins in our environment. And so, I think, you know, this is not just some pseudoscience. This is actually science at its best, I believe, where you really have to understand the pathways. For example, B vitamins, I mean, what are they? Well, they're cofactors. They make enzymes more efficient. Minerals, they make enzymes more efficient. So, when people tend to say, well, vitamins and minerals,, do they really impact you? Well, reactions in the body slow down when you don't have the cofactors. And a slowed down reaction could develop symptoms, which ultimately could develop disease. So, you know, I think that's kind of our philosophy. We really like to research our patients and impart change. And this is where the philosophy comes in, is working upstream, looking at root causes. You know, you come in with hypertension. Has anybody looked at sleep apnea? Has anybody looked at other secondary reversible causes? And we try to do that. So we're not just gonna stop your antihypertensive because that would be not healthy. But if we can impart change and do the other things, then maybe we can wean you off the antihypertensive. Yeah. So, you know, returning to basic fundamental physiology and biochemistry. Returning to basic physiology and biochemistry means, you know, not being afraid to revert back to the basics, you know, and again, we keep saying, we tell people, we're not anti-medicine, but, you know, understanding things like vitamin D and what does vitamin D do to your body and all the things, remember, vitamin D can be, it can act like an enzyme, it can act like a hormone, it should act like a vitamin, it's kind of a multiplayer. And so a lot of times when we see patients that have issues, we want to know, hey, what's your vitamin D? No one has ever checked their vitamin D level, right? They're on a bunch of different medicines or gels or creams or shots for this, that, or the other, and we look and their vitamin D is in the tank. And so, you know, we say, gosh, if we fix those things, maybe you don't need to be on five medicines, Right. Um, you know, maybe you just need one, one low dose daily medicine that is actually helpful to you. Right. Uh, because remember the, the rule of polypharmacy, once you get above three medicines, I think everything else is interacting with each other and causing more problems. So, uh, again, I think that's where we really latch on the idea of getting back to when medicine and not just medicine pills, but medicine care, medicine health, actually makes you better and gives you a longer health life. Exactly. How long do you live well? That's what we're trying to shoot for, improving your quality of life. Going back to the vitamin D, low vitamin D can cause mood disorders. So you're on antidepressant, but maybe once we correct your vitamin D, you could get off the antidepressant or the antidepressant becomes more effective. I think a lot of people in the end can relate to that because everyone realizes they feel better about July, August, when the sun is out and they're happy, they're outside, they're feeling better. But just not understanding how that, that, that vitamin D actually plays a big part of all year long throughout our whole healthcare. Yeah. So, I mean, that's kind of our philosophy is, you know, really digging in and really trying to find root causes to help you. So this was kind of our beginning podcast. It's going to be a little clunky. So thanks for sticking in there with us and being patient. We're going to perfect our sound and our mode as best we can, but really, we just want to share who we are and what we do, and if that is helpful to anyone, that's God's work, and it's really what we're about. So thanks for listening. There's going to be so much more coming over the next few weeks and months, and we look forward to doing this for a long time. Yeah, absolutely. And don't hesitate to reach out to us and say, hey, can you talk about vitamin D metabolism? Can you talk about gut health? And we're more than happy to look out there. And what are people searching? What are people interested in, and we're more than happy to talk on that subject matter. All right. So, again, thanks so much for spending time with us today, giving us your time and your attention for better health. attention for better health. So, thanks again, and we'll sign off.
