Practising ‘Good Medicine’?

Our article today is a conversation between Amanda Williams, Managing Director of Cytoplan and Dr Rangan Chatterjee who, post qualification, worked as a hospital doctor for 6 years and has spent the last 7 years working in General Practice around Manchester. His passion is to get to the root cause of problems rather than to just treat symptoms. He specialises in gut health and the immune system, and these areas plus nutrition typically form the core of his new patient consultation and treatment.

As a result of this approach Dr Chatterjee has developed a ‘nutrition based’ methodology when engaging with his patients; this he simply terms “practicing good medicine”. Some would perhaps also associate this approach with the increasingly popular term of ‘functional medicine’.

With a desire “to cure rather than suppress symptoms” Dr Chatterjee continues to attend conferences around the world to stay up to date with the latest medical research and nutritional science. He continues to work as a NHS GP but also has a private practice where he see patients for 60-90 minutes at a time and aims to get to the root cause of his patients’ symptoms.

He is currently lined up to present a prime-time health documentary gracing our TVs later this year.

His passion for medicine and caring for his patients whilst practicing as a doctor shone through in our conversation. More particularly whilst being infected and inspired by such passion we were left wondering if he has been trialling the future of a nutrition based medicinal approach that could be widely adopted by NHS doctors? As he says “Nutrition is my starting point when it comes to seeing patients – without fail. Otherwise you may only be managing symptoms that could potentially be helped by making different dietary choices.”

Gut Health

My conversation with Dr Chatterjee starts with gut health, which for him is not only a health field he specialises in, but a passion too.

“I treat a lot of people with gut related issues, indeed it is an area of general health I will review with pretty much all my patients even if it’s not the reason they have come to see me. The health of the gut and its immune system is a fundamental factor for me to assess with every patient. Why? The gut and immune system are intimately related in their interactions and if they are not performing as they should then this can negatively influence the overall health of the person.

Time after time I see that a focus on improving the functionality of the gut and its immune system translates to improvements in the rest of the body.”

So, we can see how important good gut health is in respect of our overall immune health and Dr Chatterjee continues to clarify the topic for us.

“Unfortunately the modern western diet means that many of us are eating calorie dense, nutrient poor meals. This can have a negative impact on the ecology and balance of the gut microbiome (the ecosystem of bacteria and other micro-organisms that live in harmony inside the gastrointestinal tract). In addition other factors such as stress and alcohol, as well as prescription medications can contribute to this imbalance. This alteration of balance in the gut flora can have multiple knock on effects for ones overall health, and we need to help bring equilibrium back to this critical area.”

“Nutrition Is My Starting Point”

Worryingly for him is also the high number of children who present with health problems related to nutritional shortfalls. “A lack of education is at the heart of this issue for me as well as the current food landscape that exists” he states. “If you go to a supermarket these days, it can be very hard, without some form of nutritional training, to try and determine what is healthy food and what is not.

Many people make poor decisions on what they eat and this is often under the assumption that this is the only option available on a limited budget. We need the educational support to show them that eating a healthy, nutritionally replete meal need not cost any more.

Nutrition is my starting point when it comes to seeing patients – without fail. Improvements in the diet and nutrition of most people I see are much needed and getting this fundamental basic right is a key starting point to improving their overall long-term health. I truly believe that if you do not address these fundamentals then all you are doing is just ‘managing the symptoms’ of the ailments that are presenting. Most people really do want to know what is causing their health problems, and to resolve these for the long-term.”

Dr Chatterjee returns to this theme of “treating symptoms rather than seeking solutions to the causes of illnesses” a number of times during our conversation, particularly in relation to the way the NHS and GPs are designed to function; and more on this later in the article. And this raises the themes of time and personalisation.

“Every individual is biochemically unique and thus needs a personalised approach to restore optimum health.”

Nutrigenomics

This leads on to us talking about the emerging sciences of Nutrigenomics and Epigenetics, two topics we at Cytoplan are very keen to discuss. Dr Chatterjee comments:

“The sciences of Nutrigenomics and Epigenetics are certainly ‘hot’ topics in medical circles worldwide. However I feel at the moment this field is a potential minefield in terms of patient care. And this is because we are still in the early stages of the ‘learning curve’ in these fields. So research is regularly providing new and exciting revelations, but I think at this moment in time it’s hard to easily translate much of this into better patient care.

I would like to see a lot more research in this and related fields before I use it in patient care more regularly. But it’s very pertinent that the Institute of Functional Medicine in the United States has its annual conference this May and the focus is very much on the sciences of Nutrigenomics, Epigenetics etc. I am booked to attend and look forward to hearing about the latest research at that stage.”

My conversation with Dr Chatterjee has certainly got me excited on this topic and after we finish our chat I take a look at the Institute of Functional Medicine website for the conference details. It is appropriately titled ‘The “Omics” Revolution: Nature and Nurture’ and I have reprinted part of their overview text (below) as it is so fascinating:

“The evidence that almost all disease results from the interaction of genes with the environment is now extremely convincing. The emerging science continues to confirm that, in the overwhelming majority of cases, genes don’t actually cause disease; rather, they influence a person’s susceptibility to disease. It’s not nature vs. nurture, but nature and nurture. Our genetic heritage (or genotype) is still unchangeable (at least for now), but how those genes behave is very much affected by the environment in which we bathe them (our phenotype).”

The Institute of Functional Medicine

Continuing the discussion on the Institute of Functional Medicine (IFM), and Dr Chatterjee has just returned from the IFM in the States where he attended a Gastrointestinal Conference. He comments:

“I have realised that for many years I have effectively been practicing functional medicine without actually knowing its official name! This has felt rather intuitive to me. However, this approach has been from an ongoing, self educational basis, as my training as a doctor did not provide the requisite skills for this type of patient approach.

Several years ago I looked extensively at appropriate training and education facilities based worldwide and ultimately opted on the IFM route. Why? they provide a huge amount of research to support all of their philosophy and training. And the fact that it is run and taught by medical practitioners was a key decision maker for me too. The IFM approach also resonated with me as the philosophy was that of doctors finding solutions to patients ill health, rather than treating the symptom – and this is a mantra I very much believe and adopt.

Life as a GP

Again the passion really comes through in my conversation with Dr Chatterjee. It is clearly a huge commitment, both in terms of time as well as resources, to continue to keep abreast of new developments with the IFM in the United States. But back to his life as a GP in Manchester and working in the NHS:

“It’s no secret that the life of a GP can be very hectic. On some days, I can see as many as 50 patients in one day! This means that you only have a few minutes to see each patient. Is this the best way to provide good care? Clearly not. The NHS vision talks a lot about preventative medicine but I would argue that in 7-10 minutes, it is simply not possible to empower patients with the lifestyle and nutritional education that they may require to improve their health for the long term.”

This belief led to Dr.Chatterjee reducing his NHS hours and opening up a private practice, which is now thriving as his reputation continues to grow both nationally and internationally. This private option allows him to see people who want, and are receptive to, an individualised approach to their health. When it comes to this approach – of more patient time, and a nutrition and lifestyle based consultation – this is surely where the future lies for us all?

Practising ‘Good Medicine’?

But what would you call this approach to health care? ‘Functional Medicine’ is a term that has recently become popular to describe a methodology very much like that used by Dr Chatterjee, and is certainly applicable. You could also suggest ‘science based medicine’, or even an ‘integrated medicine’ approach. But for him (if some kind of label is needed) it is simply “practising ‘good medicine’”.

And so many times he has seen that even basic nutritional advice and lifestyle changes requested of patients can make dramatic improvements to their overall health; as he notes:

“A prime example is diabetes where the conventional belief is that diabetes is not reversible. Patients are routinely placed on drugs for this condition, a lot of the time without a specific, focussed trial of lifestyle intervention. Yet repeatedly I have seen that with individually targeted nutritional interventions, it is possible to improve and even reverse the condition in many patients.

The bulk of my medical school training with respect to diet and lifestyle can essentially be summarised as “Eat less fat and take more exercise!” I really do not think that we, as doctors, are given adequate training in nutrition and lifestyle to help the rising tide of chronic disease that we are facing. Diabetes, Heart Disease, Stroke, Dementia and even Cancer are fundamentally conditions that are driven by lifestyle choices. If doctors are not trained adequately in these areas, I think we are really going to struggle at reversing the prevalence of these conditions.”

Patient Empowerment

As our talk draws to a close I ask Dr Chatterjee how his changed working life is going, specifically in relation to his private practice but also the TV work.

“I remain focussed on my NHS work as a GP and my patients. However my own private practice gives my working week real balance, although my new TV commitments are making it harder to juggle everything effectively.

I feel that with more time with patients, I can really practice medicine the way I would like to and really get to the root cause of my patients’ problems.

I like to think that my practical experience to-date (almost 14 years practicing medicine) combined with a nutrition based approach, gives the patient knowledge, empowerment and confidence to make the lifestyle changes that can be necessary to bring about optimal health.”


Dr Rangan Chatterjee qualified from Edinburgh University Medical School in 2001 and has been practising medicine ever since. He has completed Membership for the Royal College of Physicians as well as Membership for the Royal College of General Practitioners. Initially, he worked as a hospital doctor for 6 years and has spent the last 7 years working in General Practice. Rangan also holds a BSc Honours Degree in Immunology and is a member of the Institute of Functional Medicine in the United States where he has undergone extensive training. You can find out more about him on his website: Dr Chatterjee


Dr Rangan ChatterjeeDr Chatterjee was in conversation with Amanda Williams, Managing Director of Cytoplan. As she comments “I want to thank Dr Chatterjee so much for sharing some of his time with us for this fascinating article. Fortunately this is the first of a number of health articles by Dr Chatterjee that will be published on this blog in the coming months. If you have any particular health topics you are keen on him to cover do please let me know. And as always we encourage people to leave feedback to this article by using the ‘leave a reply’ option below”.

If you have any questions regarding this article, any of the health topics raised, or any other health matters please do contact me (Amanda) by phone or email at any time.

Amanda Williams, Cytoplan Ltd
amanda@cytoplan.co.uk
01684 310099

RELEVANT LINKS:

The Institute for Functional Medicine

Cytoplan Blog:
Nutrigenomics – Where nutrition meets genetics
We are what we eat? We are also what our mother ate at the time of conception
Our Genes throughout life – the importance of dietary components and Nutrition
Methylation: energy for life and living!


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19 thoughts on “Practising ‘Good Medicine’?

  1. Hi,

    I would be interested in his views on the best treatment for shrinking large (10cm plus) uterine fibroids.

    Thanks

    Julie

    1. Dear Julie,

      Fibroids are usually caused by inappropriate hormonal drive, oestrogen and to a lesser extent insulin, being common factors to investigate. Treatment would involve addressing these underlying causes. Some patients get a good response from digestive enzymes taken in between meals on an empty stomach.

      Kind regards

  2. A breath of fresh air! At last a GP with vision to change the treatment of symptoms.
    Dr Chatterjee should be educating all GPs to use this practice. Empowerment with knowledge and responsibility for our own health. Great article.

  3. What nutritional advice can you offer to alleviate or eliminate Burning Mouth syndrome? I have suffered this condition for 5 years. I have been seen and advised by ENT doctors, taken Zinc and vitamin B supplements, been unable to find any changes to my diet that helps, all to no avail. I get this painful and aggravating condition every other day. It builds up in the evening. I also get a very unpleasant tasting mouth every morning with flehm which clears shortly after I wake up.

    1. Dear Jane,

      Thank you so much for your question. What an unpleasant ailment burning mouth syndrome is. From a nutritional point of view burning mouth can be caused by a shortage of folate (the b-vitamin folic acid), vitamin B12, and sometimes a shortage of iron. So all of these nutrients plus vitamin B6 in the form of ‘P5P’ may be of benefit. I should also note that we only recommend the methylfolate form of folic acid when supplementing.

      However “oral dysaesthesia” as it is known can have a number of different causes. It can also be caused by other factors such as food allergies, or disease conditions such as erythema migrans, ulcers, lichen planus and candida.
      Some prescription drugs also predispose. As the cause can be multifactorial I always like to get a full case history and full information to identify the most likely cause and hence give appropriate remedial recommendations to address the cause. In the meantime if you want to take a good multivitamin and mineral supplement including the mentioned nutrients and also use Aloe Vera inner leaf gel as a mouth wash throughout the day that will help the symptoms.

      If you would like a health questionnaire for a full assessment please do request that. This service is free of charge, but I usually prefer to get full history and details before recommending. So do please contact me directly – amanda@cytoplan.co.uk. More details (and the form) regarding the health questionnaire can be found on our website – http://www.cytoplan.co.uk/Health-Questionnaire/.

      Very best wishes, I do hope to hear from you. Amanda x

    2. Very hard to say without further information but sounds like your gut may need thorough investigation. There may be underlying factors such as residual infections, toxins etc. that may be stopping your dietary changes and nutritional supplementation from making a noticeable change in your symptomatology.

  4. thank you so much for your blog and Im so happy to see that more Doctors are embracing nutrition into their practice. Ive been a naturopath/nutritionist for almost 30 years and its been so hard with our medical practitioners totally against this thought process, but gradually they are seeing that the so called non-reversible illnesses can be reversed with good nutrition , I would now like them to also look into naturopathic techniques, as this is also a huge part of the picture.
    thank you Amanda

  5. I have consulted complementary practitioners for many years, who have advocated this approach to healing. Getting to the core of the problem is vital and this is something the NHS would be wise to address. In the long term it would cost less to do so. Well done Dr Chatterjee for leading the way.

  6. If only all GPs were this enlightened – what a difference it would make to the health of their patients! Looking forward to reading more of his articles & to seeing him on TV.

  7. its refreshing to hear someone wants to prevent rather rather than just cure, what would you suggest for immune system every time my gran so get a cold or cough i get it and seem to have a constant cold he`s 2 yrs old and it seems like i`ve had it since he was born .regards joe

    1. Thanks Joe. There are many nutrients that can boost the immune system but a 3-5 day course of high strength Vitamin D (5000-10,000IU per day) can be very helpful, especially if you feel viral symptoms coming on.

    2. Dear Joe,

      Thank you for your feedback on the article. In regards to supporting the immune system I would typically suggest a suitable multi-vitamin and mineral formulation such as our Foundation Formula 1. In addition a supplement specifically for immune support such as ‘Immunovite’ that comprises Beta 1-3, 1-6 Glucan, Selenium and Zinc.

      This should help in respect of ‘protection’ from the infections your grandson gets. In addition a diet high in fruit and vegetables is very important. If you are in the UK and without the suitable supplements I can send you some samples to get you going.

      Alternately you can contact me directly to discuss this further. Or complete our free health questionnaire for a full assessment – this service is free of charge. You can email me at amanda@cytoplan.co.uk should you wish. You can have a look at the two products I mentioned, and the health questionnaire with the links below:

      http://www.cytoplan.co.uk/Immunovite-Beta-1-3-1-6-Glucan-3211/
      http://www.cytoplan.co.uk/Foundation-Formula-4107/
      http://www.cytoplan.co.uk/Health-Questionnaire/

      Kind regards, Amanda

    1. Dear Marion,

      Margarine is rarely healthy as most contains hydrogenated or trans fats which are inflammatory and disruptive to membrane integrity. But I do notice some suppliers are changing this and now using oils plus lecithin (instead of hydrogenated/trans fats, which is an improvement depending on what other ingredients are contained within the product.

      Butter in small quantities is ok. It contains conjugated linoleic acid which is beneficial to health and pretty much the only source of this nutrient. I would advise salt free organic butter in small quantities as being the best option.

      There are also alternatives such as coconut oil which is solid at room temperature and has health advantages and olive oil spreads. The key is to look at the totality of ingredients, the level of salt and any other flavourings and organic status and make your choice based on that and your taste preference.

      Do contact me directly if you would like further information. Best wishes and thank you for the interest in our blog. Amanda (amanda@cytoplan.co.uk)

  8. Isn’t it wonderful to find a GP treating patients’ health problems by treating the cause and not the symptoms! The Gut Health and Immune system ! This is how it should be, should have been, if we are to help the nation to be healthy, to help stop draining the NHS and be more effective in treating patients. From a Registered Nurse turned to Complementary Health, 20 years ago, its very frustrating to see patients having to pay privately in order to get better! Well done Dr Chatterjee, we salute you! Looking forward to more articles and TV from you. Keep up the good work, its time more doctors & nurses need to be trained differently! Thankyou Amanda for this brilliant article!

  9. REF: IMPROVED GUT HEALTH

    Apologies to the person who posted a question about gut health. In the process of updating our blog late last week you email address was lost. Your question is posted below with our answer. We do hope you get to see it.

    The Question:
    “I am interested in hearing more about how I can improve gut health. I already take pre and pro biotic supplements in pill form but surely the bacteria are destroyed by stomach acid. Are there other foods I should be eating more of or avoiding to aid the bacteria and encourage its own replication?”

    The Answer:

    Many thanks for your question.

    Strains used in probiotics from good companies will be acid and bile resistant. But not withstanding it is still advisable to ingest probiotics about 2 hours after eating when the stomach Hcl will be at its lowest.

    Prebiotics such as from root vegetables and fermented foods will encourage the growth and reproduction of one’s own native strains so these are highly beneficial.

    I am not sure whether you suffer from any specific digestive ailments such as IBS? We have a number of articles on the blog regarding gut health, live native bacteria (formerly termed probiotic) and diet – I have provided the links to each blog category below.

    In order to advise you further I would need a better overview of your general health. You are very welcome to contact me directly if you wish to discuss this further. Otherwise you can complete our health questionnaire (which is free and confidential) for a full assessment please do request that. This service is free of charge, but I usually prefer to get full history and details before recommending.

    More details (and the form) regarding the health questionnaire can be found on our website – http://www.cytoplan.co.uk/Health-Questionnaire/.

    Best regards. Amanda x
    amanda@cytoplan.co.uk

    https://blog.cytoplan.co.uk/category/ailments/digestive-disorders/
    https://blog.cytoplan.co.uk/category/the-paleo-diet/
    https://blog.cytoplan.co.uk/category/probiotics-and-prebiotics/

  10. Hi, my son has suffered with extreme excema for 7 years he is 9 now. I have tried lots of different creams and use potent steriods. He is suffering so much with it at times I’m changing his bedding everyday as it’s full of dead skin. His diet is good he eats lots of fruit drinks lots of water but still his skin is so dry and sufferers with a lot of infections. As he’s getting older it’s becoming a mental thing and how he feels about himself, it’s heartbreaking.

    1. Hi Nusreen,

      So sorry to hear about your sons condition. The best way to approach this is to fill out a health questionnaire for us? This will supply us with dietary and lifestyle information so that we can look at what the underlying causes may be. Please do get in touch via e-mail (amanda@cytoplan.co.uk) if you would like me to send you one. This is a free service of course.

      All the best,
      Amanda

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