FM 1.0 was foundational—these domains emerged later as science advanced.
Dear Colleagues, Students, and Friends,
As we continue the evolution from Functional Medicine 1.0 toward Functional Medicine 2.0, it’s important to clarify something that often gets misunderstood:
FM 1.0 didn’t “miss” trauma, CDR, HRV, or circadian biology.
The science simply wasn’t available yet.
This distinction matters—because it reframes frustration as progress, not failure.
FM 1.0 Was Built on the Best Science of Its Time
When Functional Medicine 1.0 emerged in the 1990s, it was revolutionary.
It gave clinicians:
- systems biology instead of organ silos
- root-cause thinking instead of symptom suppression
- gut-centered models when the microbiome was barely understood
- detoxification frameworks long before environmental medicine was mainstream
- nutrition and lifestyle as primary therapeutic tools
At that time,
these were the frontiers of medicine.
But many of the domains clinicians now struggle with simply did not exist as mature sciences.
Why Trauma Physiology Wasn’t Part of FM 1.0
In the 1990s,
trauma was largely viewed as psychological—not physiological.
The idea that:
- trauma could imprint the nervous system
- autonomic tone could drive inflammation
- safety
vs. threat could alter immune function …had not yet entered clinical medicine.
- Polyvagal theory, trauma-informed physiology, and neuroimmune signaling all emerged decades later.
FM 1.0 wasn’t incomplete—it was early.
Why the Cell Danger Response (CDR) Wasn’t Included
The concept that mitochondria:
- sense environmental threat
- shift from energy production to defense
- regulate immune
signaling …was not understood when FM 1.0 was formed.
- CDR reframes chronic illness not as “broken pathways,” but as adaptive survival states.
This framework simply didn’t exist in early Functional Medicine.
Why HRV and Autonomic Regulation Were
Absent
Heart rate variability (HRV) was once a niche research metric, not a clinical tool.
Only in the last 10–15 years has HRV been recognized as:
- a window into autonomic balance
- a predictor of resilience and
recovery
- a driver of inflammatory control
FM 1.0 focused on biochemical correction—not nervous system regulation—because autonomic science had not matured.
Why Circadian Biology Wasn’t Central
Clock genes, metabolic timing, light-driven hormone signaling, and immune rhythms were not well understood until the 2000s.
Today we know:
- timing influences detoxification
- circadian misalignment drives insulin
resistance
- immune responses follow daily rhythms
But FM 1.0 predated circadian medicine as a clinical discipline.
The Real Issue Isn’t FM 1.0—It’s the Era We’re Practicing In
Modern clinicians are treating:
- trauma-encoded physiology
- post-viral syndromes
- autonomic instability
- mitochondrial defense states
- circadian
disruption
- immune systems locked in threat
Trying to solve these patterns using biochemical tools alone leads to:
- stalled cases
- detox
reactions
- supplement intolerance
- unexplained flares
Not because FM 1.0 failed—
but because we’re practicing in a new physiological era.
This Is Why FM 2.0 Exists
Functional Medicine 2.0 doesn’t replace FM 1.0.
It adds:
state-based physiology
signaling biology
regulation before repair
timing before intervention
FM 1.0 explains what to address.
FM 2.0 explains when and why it will work.
Together, they form a complete clinical model.
What Comes
Next
In the next PLC, we’ll begin breaking down:
- the specific scientific breakthroughs FM 1.0 never had access to
- how these discoveries change clinical decision-making
- and why modern
Functional Medicine must be taught as a continuum—not a replacement
This is not about abandoning the foundation.
It’s about finishing the structure.
P.S. If you missed yesterday’s bonus, download The Supplement Scope Trap—it shows exactly how boards evaluate intent, language, and documentation.
Prefer to Listen: Click
Here for a 9 Minute Audio on Supplement Legal Concerns
With respect for the foundation—and clarity for the future,
Dr. Ron Grisanti
Founder, Functional Medicine
University