My path to Personalised and Integrative Medicine
Dr Nina Fuller-Shavel, Integrative Medicine Doctor
Hi, I’m Dr Nina, an Integrative Medicine doctor with a special interest in Precision Health. I believe that our current healthcare system with its best intentions and its hard-working men and women is unfortunately poorly equipped to deal with the overwhelming tide of chronic disease and we need to find a better way.
To understand why I feel the way I do, I will give you a bit of background. I was born in Europe and was lucky enough to have an upbringing that had nature at its core. I spent most of my summers running around a beautiful pine forest, my grandmother used to grow most of her food and often used local herbal remedies to self-manage minor conditions in the family. Food was seasonal, fostering a deep connection to the earth that fed us. Food was also all about love and family, and movement was ingrained in us as the way to live.
I moved to the UK at 15 by myself, going to boarding school, where I couldn’t really recognise the food. The joke was that I ate tuna salads for dinner every night for a year, and I still can’t stand tinned tuna to this day. Later on, during my university degree in Natural Sciences at the University of Cambridge, I got interested in nutrition to support my long distance running, and this sparked my appetite for more knowledge in this area, although I was unable to pursue it further at the time. When I left university, I started working in medical education but over time a combination of long working hours and a high-stress environment really affected my health, resulting in profound fatigue. In my search for ways to support my recovery, I dived deep into nutrition and lifestyle and trained further as a nutritional therapist at the Institute of Optimum Nutrition in London. During that degree, I gained my first proper introduction to Functional Medicine, which is the model within which I have practiced ever since.
Learning more about nutrition and lifestyle and seeing the huge benefits for me and my nutrition clients further fuelled my passion to help people regain and maintain their health and wellbeing. I felt that my science and nutrition studies were not the full story, and I really wanted to learn more about pathology and the clinical aspects of healthcare. I also wished to combine lifestyle approaches with conventional medicine within an integrated approach in the future, so I went on to do the Cambridge Graduate Course in Medicine, winning the Henry Roy Dean Prize for Pathology during my studies.
Sadly, the stress of a hospital doctor’s job with its erratic hours and the physical and emotional impact of caring for very sick people in an understaffed NHS, combined with the demands of raising my young daughter, took a huge toll on my wellbeing. I initially struggled with depression, followed by being diagnosed with an aggressive primary breast cancer. Something had to change! I was pushing myself too hard to fit into the conventional model that worked neither for me, nor for my patients for whom I was putting in the long hours yet not making enough of a true long-term difference, and this had to stop.
Ever since I trained in nutrition, my vision was to combine lifestyle and other therapeutic modalities alongside conventional medicine in an integrative and cohesive approach but this was the time to really practice this approach. I got through a gruelling six months of chemotherapy and two operations by throwing the book at it – nutrition, exercise, yoga, meditation, acupuncture, herbal medicine and psychology. My surgeons and my oncologist (to whom I would be forever grateful) were amazed at my progress and I was lucky enough to come out of the other end of that year in remission.
During that time, I also set up my own practice in Winchester (Synthesis Nutrition) and started doing what I truly loved and what inspired me every day – using the power of Functional Medicie to transform lives, including many complex cases that found no relief elsewhere. I got my Certified Functional Medicine Practitioner status through further study with IFM (Institute of Functional Medicine), qualified as a health coach with FMCA and completed a two-year Diploma in Integrative Medicine to further my knowledge and understanding. Later on I also became a registered yoga and mindfulness teacher and undergone training in herbal medicine. I love continuing to expand my knowledge through my own studies, such as studying for a yoga therapy certification and TCM (Traditional Chinese Medicine), as well as through collaborating with wonderful practitioners from different disciplines who are passionate about evidence-informed high quality care.
Following the completion of my cancer treatment, I went back to the NHS part-time for a while but decided not to continue with being an NHS doctor. This was for the sake of my own health (night shifts and cancer are not a great mix) and because I felt that I had a calling to do something different. My big frustration when I started working in the NHS was the way that chronic disease is treated is largely symptom-driven with more and more drugs being thrown at more and more symptoms. This approach does not truly acknowledge or tackle the underlying causes in the person’s life and disempowers them, fostering reliance on pharmaceuticals for everything. Primary disease prevention is also left to the bottom of the pile. Additionally, I could see people falling through gaps everywhere where the system was failing patients with complex disease with no one to truly integrate care (a GP with the best will in the world cannot do this in 10 minutes!) Finally, due to the huge demand on services, despite doing their very best the NHS front line staff can struggle to give the most valuable gift one can give another person who is vulnerable and sick – time. There is no easy solution to the issue of time but I feel that with more preventative care, enthusiastic and knowledgeable use of lifestyle medicine as a core approach and empowering the person to take a more active role in their healthcare, this can shift over time.
The ‘something different’ that I left the NHS to do is what you will see at Synthesis Clinic, my vision for ‘extra-primary’ healthcare for chronic disease. At the clinic, we aim to leverage the power of Functional Medicine as a root cause-based approach to disease. We look at your whole health timeline to understand your story and disease triggers. We examine your symptom pattern and your lifestyle (nutrition, sleep, stress, activity and relationships) in detail to understand which physiological systems are out of balance and what we can do to rebalance them to uproot disease. This is not ‘a pill for every ill’ approach and it is not a quick fix but it truly changes lives. It also gives you back the power to manage your own health going forward, once you are back on track. Within this personalised approach, we work as your partners, providing knowledge, expertise and support every step of the way, with the understanding that change is hard but it has to come from you. With the willingness to change your lifestyle and address the root causes of dysfunction and disease, comes true transformation and the gains are truly worth it, as many of our patients can attest.
So, Functional Medicine is the working lens with which we view disease at the clinic, and we then go further to tackle the root causes relevant to the individual with an expanded toolkit of Integrative Medicine. This is a combination of conventional medicine, lifestyle approaches (nutrition, sleep, stress management, activity), psychological therapies that address mental, emotional and spiritual aspects of disease, allied health professions (e.g. physiotherapy), and evidence-informed complementary healthcare (e.g. acupuncture). We are now also looking broader into precision health approaches, which aim to produce deeply personalised health plans based on real-time monitoring with a 360 degree view from genes to your exposome, including big data-driven work.
I am lucky enough to have gathered an amazing team of passionate, dedicated and knowledgeable healthcare practitioners who share my vision. Every Wednesday we meet as as an MDT (multidisciplinary team) to discuss the our patients’ needs together, working to create plans that are designed to achieve health outcomes in the best way possible. We will also always aim to communicate and work with NHS care (with the person’s consent) because we believe that’s what true integrative healthcare is about – teamwork and connection for the maximum benefit of the person at the centre of it all – you!
© Dr Nina Fuller-Shavel 2019-2022
Listen to our podcast episode about Synthesis Clinic, Precision Health and Integrative Medicine here.
About the author
Dr Nina Fuller-Shavel has studied Natural Sciences and Medicine at the University of Cambridge and has recently obtained an MSc in Precision Cancer Medicine from the University of Oxford with distinction. She is an Integrative Medicine and Precision Health doctor, a Fellow of the College of Medicine and BANT (British Association for Nutrition and LIfestyle Medicine) and the Director of the award-winning Synthesis Clinic. Alongside her scientific and medical training and over a decade’s experience in integrative health, Dr Nina Fuller-Shavel holds multiple qualifications in nutrition, integrative medicine, functional medicine (IFMCP), health coaching (FMCA), herbal medicine, TCM (Traditional Chinese Medicine), yoga, mindfulness and other therapeutic approaches.