Dear Colleague,
Open Enrollment for Functional Medicine University is now open (January 19, 2026).
Today I want to
start with the most universal problem I see in modern clinical practice—especially in complex, chronic cases:
Guessing.
Not ignorance. Not lack of intelligence.
But the quiet, ongoing uncertainty of:
“What do I do first?”
“What do I hold back?”
“Am I about to make this patient more
reactive?”
“Why did this work last time but fail this time?”
If you’re newer to functional medicine, guessing feels like drowning.
If you’re experienced, guessing feels like unnecessary risk.
Most clinicians don’t struggle because they don’t know enough.
They struggle because they don’t have decision rules under complexity.
FMU was built to end that.
A GI case that illustrates exactly what I mean
A 45-year-old patient with chronic GI symptoms:
- alternating diarrhea and constipation
- urgency, bloating, and food reactions
- fatigue that worsened with
every flare
- increasing sensitivity to supplements
They were not “new.” They were already doing functional medicine.
They had completed:
- multiple stool tests (more than one
lab, more than one time)
- antimicrobial rotations
- gut repair phases
- elimination diets
- probiotics, prebiotics, postbiotics
Each round helped briefly.
Then the symptoms returned—often with more reactivity than before.
At this stage, most clinicians feel something that’s hard to say out loud:
“I’m doing a lot… but I’m not confident it’s the right next
move.”
And that’s where guessing starts.
The reflex most training reinforces
When GI symptoms persist, the reflex is:
- look deeper in the gut
- find a missed organism
- rotate the protocol
- intensify the intervention
It’s logical. It’s well-intended. It’s also the point where many cases become unstable.
Because escalating treatment
in a system that isn’t ready doesn’t create healing.
It creates flares, intolerance, and churn.
The FMU pause (this is the decision point)
FMU’s first move was not another test or another protocol.
FMU asked one question:
“Is this system biologically ready for repair?”
That question instantly changes the case.
Because this patient also had:
- worsening fatigue after treatments
- escalating supplement intolerance
- stress-triggered flares more than food-triggered flares
- poor recovery between
interventions
Those findings are not “gut problems.”
They are readiness problems.
And if you miss readiness, you will keep treating downstream expression and wondering why it won’t hold.
The sequencing decision (this is where guessing ends)
FMU treated this as secondary GI dysfunction.
Meaning:
the gut was the expression
not the origin
So FMU deliberately:
- delayed additional antimicrobial and aggressive gut repair strategies
- deprioritized “dysbiosis chasing”
- stopped rotating interventions simply to “try something else”
And instead stabilized the conditions that allow healing.
Not because we were doing less.
Because we were finally doing things in order.
What we
explicitly did not do (and why)
FMU did not:
- stack more supplements
- further restrict the diet
- “clean up the gut again”
- chase a
new organism
Because this patient didn’t need more force.
They needed more sequencing.
Restraint wasn’t hesitation.
Restraint was clinical judgment.
What changed
As stability returned upstream:
- food tolerance expanded
- urgency softened
- bowel patterns stabilized
- gut-directed work finally held when reintroduced
And here’s the point I want you to notice:
Nothing “magical” was
added.
The order changed.
And with that, the clinician stopped guessing.
They finally knew what to do
first.
That is what FMU installs
FMU is not a course.
It is a Clinical Operating System designed to replace
guessing with:
- decision rules
- sequencing clarity
- readiness gating
- and a structured method that produces more predictable outcomes in complex patients
Enrollment is now open (and closes January 26).
✅ Enroll now
With respect,
Ron Grisanti, D.C., D.A.C.B.N., D.A.B.C.O., M.S., DIANM, CFMP
Founder, Functional Medicine University®
P.S. Tomorrow I’ll share an immune/autoimmune case where the turning point wasn’t another intervention—it was knowing what to
delay, and why. If you’ve ever worried about making a complex patient worse, don’t miss it.
P.S.S: Enrollment closes January 26. If this way of thinking resonates, don’t wait.
