Dear Colleague,

Yesterday I talked about guessing—and how FMU replaces it with sequencing clarity.

Today I want to address the fear that usually follows once guessing stops.

It’s the one most experienced clinicians feel but rarely say out loud:

“What if I’m making this patient worse by acting too early?”

This fear doesn’t come from lack of knowledge.

It comes from responsibility.

Experienced clinicians don’t fear not knowing.

They fear causing harm through well-intended action—especially when escalation quietly becomes 'more"care" without clearer rules for timing and tolerance. (Overtreatment risk: Ooi et al.)

FMU was built with that fear in mind.

An immune case that explains why

A patient with a long-standing autoimmune condition:

persistent inflammation
fluctuating symptoms
periods of improvement followed by flares
increasing sensitivity to treatments over time

This patient had already done “everything right.”

They had:

cleaned up their diet
addressed the gut
supported detoxification
used immune-modulating strategies
optimized nutrients

Markers would improve.

Symptoms would follow—briefly.

Then the flares returned.

Often stronger.

The default interpretation

Most training frames this situation as:

“The immune system is overactive and needs stronger control.”

So clinicians escalate:
immune modulation
anti-inflammatory strategies
more precise targeting
additional layers of support

Each step feels justified.

And yet, with every escalation, tolerance shrinks.

This is where clinicians begin to worry:

“Why is doing more making things worse?”

The FMU reframe (this is the turning point)

FMU asked a different question:

“Is this immune system actually unsafe—or is it compensating?” (Allostasis framework: McEwen)

If it’s unsafe, you suppress. If it’s compensating, you stabilize.

That distinction matters.

Because in this case, the immune system was not misbehaving.

It was protecting a system that was not yet stable enough to downshift.

The flares weren’t failure. They were signals. (Disease tolerance model: Medzhitov et al.)

The sequencing decision

Instead of escalating immune intervention, FMU did something counterintuitive:

We stopped doing things.

Not neglect—prioritization. We kept the basics and removed what the system couldn’t tolerate.

Not everything—but the things that required tolerance the system didn’t yet have.

FMU deliberately:

paused immune-directed escalation
delayed additional modulation strategies
deprioritized suppressive and stimulating inputs

And focused on restoring biological safety and readiness.

Meaning: sleep, blood sugar stability, nervous system downshift, and reducing total treatment load until tolerance returns.

This wasn’t passivity.

It was clinical restraint.

What we explicitly did not do

This is important.

FMU did not:

intensify immune suppression
rotate immune strategies
chase inflammatory markers
“push” the system to comply

Because pushing a system that doesn’t feel safe doesn’t create regulation.

It creates defense. (Sympathetic–immune signaling: Pongratz & Straub)

What changed

As readiness returned:

flares became less frequent
recovery between flares improved
symptom swings softened
tolerance slowly expanded

The immune system didn’t need to be “controlled.”

It needed the conditions to stand down on its own.

Why this matters to you

FMU teaches something most training never names:

Restraint is a clinical skill.

Knowing:

when not to intervene
when to delay
when stability must come first

is what prevents:

patient flares
treatment intolerance
clinician burnout

This is how FMU protects both patients and practitioners.

Enrollment remains open (and closes January 26)

If you’ve ever worried that acting too early might be causing harm—and wished you had clearer rules for when to wait—FMU was built for you.

If this message described cases you’re currently managing, FMU will give you the rules for what to stabilize first—and what to delay.

✅ 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 a hormone/fatigue case where labs looked “treated,” but the patient wasn’t better—until sequencing shifted from optimization to capacity.

References (full citations)
• Ooi K, et al. The Pitfalls of Overtreatment: Why More Care is not Necessarily Beneficial. Cureus. 2020. https://pmc.ncbi.nlm.nih.gov/articles/PMC7747436/
• McEwen BS. Stress, adaptation, and disease: allostasis and allostatic load. Ann N Y Acad Sci. 1998;840:33–44. https://pubmed.ncbi.nlm.nih.gov/9629234/
• Medzhitov R, Schneider DS, Soares MP. Disease tolerance as a defense strategy. Science. 2012;335:936–941. https://pubmed.ncbi.nlm.nih.gov/22363001/
• Pongratz G, Straub RH. The sympathetic nervous response in inflammation. Arthritis Res Ther. 2014. https://pubmed.ncbi.nlm.nih.gov/25789375/