Dr Nikita Grover joined us last year as an integrated practitioner combining her 30 years conventional medical experience with functional medicine. We are delighted that our patients can benefit from her skills and knowledge. We shine a light on Dr Grover and her work at Harpal Clinic below.
I’ve been a GP for 25 years and have seen conventional medicine provide many benefits for patients in treating severe and acute disease. However, increasingly, I became aware that conventional medicine often didn’t have the answers to why my patients were experiencing symptoms or why their chronic diseases were not improving, despite having the best available scientific evidence and best pharmaceuticals at my disposal. Patients were also keen to know what they could do to improve their health without medication, and conventional medicine was often unable to provide the answers.
Functional medicine acknowledges that disease and wellness are not black and white but on a spectrum of degrees of health. Although individual symptoms may not always indicate disease, they can indicate a change in the function of our biological systems, whether that relates to the digestive or endocrine systems, how energy is produced or metabolic function.
Functional medicine provides a framework to deal with any patient, irrespective of symptom or diagnosis, enabling them to be placed at the centre of a process of exploration which is respectful of their complexity and individuality. It allows them time to be heard and properly evaluated. It acknowledges that the human body has an incredible capacity to heal itself, when provided with what it is missing, or by removing causative agents.
Functional medicine allows us to first do good, with no or minimal harm, as opposed to either doing nothing, because there is an absence of evidence, or treating with pharmaceuticals and accepting their significant harms, with often questionable benefit.
The other thing that attracted me to functional medicine was that it was just as helpful in a person who was well and wished to optimise their health as for someone with symptoms. Hence it enables true prevention of disease and helps everyone achieve their best health.
Chronic disease is lifestyle driven. It doesn’t just happen because of one thing. It is the result of a process of accumulation of environmental insults over time, the collective sum of our lifetime exposures, from how we arrived in the world, our development in the first three years of life, emotional or physical trauma, viral infections, what we eat, chemical exposures, and more. All those exposures have a bearing on why we are the way we are. These are the root causes. By identifying and quantifying the imbalances in the body, and how they’ve impacted our biological functions, we can correct them. Usually, this involves addressing a wide number of areas and making small changes in each of them. It’s that aggregation of marginal gains that can make a huge difference to one’s health trajectory.
Unexplained symptoms are a huge problem – a modern problem. The first thing we do at Harpal Clinic is give patients time. Consultations are 45-90 minutes long which allows me to really hear my patients’ concerns and understand what their exposures have been, what their predispositions are (be it genetic, family, emotional, physical), and to assess the mediators and perpetuators of their symptoms.
Conventional blood results are interpreted through the lens of optimal health, and then precision diagnostics are offered. This is personalised diagnostic testing with novel biomarkers that are looking for changes in biochemical or physiological functions of the body’s systems, be that of their gut, detoxification systems, hormones, immune function, checking whether they’ve got enough nutrients on board or how they’re using energy. Biological function is a tangled web of complexity and if one area is out of balance, this can impinge on other areas of functioning. Nutrigenomic testing is also offered where we’re not looking for ‘big picture’ genetic problems, but changes in function that patients can modify through diet and lifestyle changes.
Patients are provided with a scientific explanation that connects their symptoms with the changes in their underlying physiology or biochemistry. Then we explore the resources they’ve got at their disposal, using them as levers to restore health. The obvious things include what, how, when they eat; activity, sleep hygiene; nutrients; hormones; what their gut function is like; psychosocial and spiritual networks (if they have a faith, who supports them at home), and psychological modalities. All are supremely important.
We travel with our patients through their health journey, providing them with the support and hope they need. We recognise that even though every story is complex, there is usually always something we can offer.
For me, that initial consultation, where, very often, we’re the first professional to have acknowledged and validated the patient’s concerns and we begin establishing a connection between the patient and doctor – that’s special. Then, working together to harness the plethora of ideas and recommendations that arise empowers patients to regain agency over their health. Every single patient has a unique story which evokes curiosity and interest. What I love about my job as an integrative practitioner, is that I have all the resources available to me from both functional and conventional medicine to help me craft bespoke solutions together with the patient.