Dear Colleague,

If you’ve worked with complex chronic illness for any length of time, you’ve seen this pattern:

You build a solid plan.

The patient improves.

Then progress stalls… or symptoms flare… or tolerance collapses.

And you’re left thinking:

“What am I missing?”

Let me name this as clearly as possible:

This is often not a protocol problem.

It’s a readiness + sequencing problem.

In your hardest cases, the body may not be in a repair state.

And if the body is in defense, even the right protocol becomes stress.

Clinicians describe it in the exact phrases I hear all the time:

• “This case is reactive to everything.”
• “Detox backfires every time.”
• “Gut-first makes them worse.”
• “They improve for two weeks, then relapse.”
• “They have zero tolerance bandwidth.”

That pattern is not a personal failure.

It’s physiology.

This is where FMU’s Tier 0 mindset changes everything:

Traditional functional medicine training often starts with systems protocols—gut, hormones, immune, detox.

Tier 0 starts one step earlier: is the body in defense or repair?

Get the state right first—confirm the body is in a repair state before escalating protocols—and sequencing becomes clear; then systems work predictably instead of backfiring.

This is what separates protocols from mastery: the ability to sequence care safely in complex, reactive patients.

Tomorrow, I’ll give you a clean, practical “aha” that reframes the whole field:

FMU teaches systems—and the operating system beneath systems: readiness first, sequencing second, and clinical decision logic that tells you what to do first, what to delay, and why.

And if you want the full context behind this evolution, you can read it here: