The Heart and Hope of Functional Medicine

by Melodie on June 9, 2010

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Here’s a scenario that has played out more than once for me:

A specialist I’m seeing for the first time enters the exam room where I wait and, after a greeting, begins asking about my health history. He asks what has brought me to his office, and reviews my cancers, medications, family history and symptoms.

He notices on the sheet I’ve filled out that I am on various food supplements and some compounded medications.

“Those are prescribed by my primary physician,” I tell him. “She’s a specialist in functional medicine.”

The pen stops, poised in mid-air as he looks up at me. An eyebrow arches upward, quizzical.

“What is functional medicine?”

I wish I had time during a quick doctor’s appointment to explain what functional medicine is, how it has dramatically altered my own health, and why, as a wellness coach, I think it is an important option for people I work with to consider.

It’s why recently, I happily agreed to tell my own story for an article on functional medicine in Radish Magazine (read it here).

And it’s why I’m devoting a whole blog article to the subject.

You may not have heard of this type of medicine because, as a cohesive area of practice, it’s been developing for just 30-some years. This is not a unique body of knowledge, but combines research from a variety of disciplines into effective ways of understanding and promoting wellness and healing. Jeffrey Bland, Ph.D., considered to be the leading figure in functional medicine’s development, is a nutritional biochemist and one of the founders of the well-regarded Bastyr University which trains providers of natural medicine. In 1991, he and his wife, Susan Bland, founded the Institute for Functional Medicine to educate practitioners in this form of integrative health care.

So what is functional medicine (FM)?

It’s science-based, individualized medicine that focuses on the prevention of chronic diseases and their underlying causes, and it emphasizes these primary principles:

1. Functional medicine is patient-centered.

FM practitioners provide patient care rather than disease care. Sir William Osler, an early leader in medicine, said, “It is more important to know what patient has the disease than to know what disease the patient has.”

I can tell you what a relief it is to sit across from a doctor who considers her patients partners in their total health care. You are not a passive patient who is having procedures and tests done to you; you are an active participant.

In conversation with a FM practitioner, it’s not unusual to hear the questions, “What do you think? Does that resonate with you?” There’s an understanding that the patient has an intuitive and long-standing knowledge of his or her health, lifestyle, beliefs and intuition that are critical to the doctor’s understanding of the situation at hand.

2. Functional medicine recognizes the individuality of each person.

One of the premises of FM is that everyone has a unique biochemical makeup determined by genetics and environmental influences. There are important differences in metabolic function that affect how a person’s health evolves and how diseases may develop.

With this understanding, a FM doctor will not use a cookie-cutter approach with patients. Instead of saying, “This drug works best in your type of cancer,” he may suggest, “Let’s do a lab test to find out how your liver will process this drug.” Instead of insisting, “Everyone over the age of 50 needs 400 IU of vitamin D daily” or “You’re getting enough sunlight; you don’t need vitamin D supplements,” he will more likely say, “Let’s see what your vitamin D level is to determine whether you would benefit from a supplement or not.”

3. Functional medicine understands that the body’s functions are interconnected.

A large body of research now underscores the view that the body is a network of systems that all affect each other. For example, if you have an immune disease, it can affect your heart health. If you eat specific foods, hormonal imbalances may result. Exposure of the skin or lungs to certain environmental toxins can lead to cancer in remote organs.

A conventionally trained doctor will treat a patient’s repeated sinus infections with steroids and ever stronger antibiotics. A doctor skilled in FM will not just consider these infections a nasal problem, but will look at the patient’s diet, environmental exposures, activity level, immune system and hormone function, among other considerations, to determine how to overcome the repeated infections.

4. Functional medicine integrates science-based research from a variety of fields.

For many decades, research into holistic healing models, the genetic basis for disease, botanical and nutritional medicine, and many other areas was ignored. It’s encouraging now to see a surge in peer-reviewed, scientific research on a wider range of approaches to wellness. Functional medicine draws on this body of research to integrate a variety of methods of disease prevention, diagnosis and treatment.

5. Functional medicine emphasizes prevention of disease.

Anyone who has struggled with cancer and the after-effects of treatment can understand the importance of prevention. It’s much better to avoid a serious condition in the first place, rather than to try to treat it once it has presented itself.

FM practitioners understand that the seeds of many serious diseases like cancer, heart disease and diabetes are planted long before the diseases manifest themselves in symptoms. If you come to a FM doctor wanting to prevent cancer or to avoid further relapses and secondary cancers, she will likely look at genetic markers that predispose you to these diseases and determine how to prevent those genes from expressing themselves. She may recommend lab tests to determine how your liver and cells process antioxidants and other cancer-fighting substances, what food intolerances may be preventing your body from absorbing cancer-fighting foods, or what hormonal imbalances may be promoting disease development. She will consider emotional stressors that may be draining your body of energy. At the heart of each of these actions is prevention.

6. Functional medicine addresses core clinical imbalances that promote disease.

When a disease shows up as a tumor or high blood-sugar or shortness of breath, functional medicine views this as a malfunction in the body caused by some imbalance. Imbalances can occur in areas such as how the cells divide, how the body detoxifies substances, how digestion and absorption take place, how the body’s muscles and bones provide structural support, how the person views her life’s experiences, or how the immune system functions.

The hope that functional medicine provides lies in its ability to determine and treat these imbalances before symptoms even begin, and to reverse many of the effects of disease after it has developed. This may be done by a combination of drugs, botanical medicines, nutritional supplements, therapeutic diets, detoxification programs, and counseling on lifestyle, exercise, or stress-management techniques.

You may be drawn to this kind of holistic health care, but wonder where to find a pracititioner who uses this approach. There are doctors who integrate many of these practices but don’t label themselves functional-medicine specialists. If you want to find someone specifically trained in this area, check out the practitioner database at the Institute for Functional Medicine website where you can search by location or qualification.

Just as in any field of medicine, you’ll find practitioners with a wide range of educational backgrounds, personalities and experience. There are MDs, DOs, nurse practitioners, naturopathic physicians and chiropractors all practicing functional medicine.

Use the practitioner database, personal recommendations and/or a web search to narrow down your possibilities to several practitioners. I suggest calling their offices and asking a few questions relating to the areas most important to you. This can help you hone your choice of provider to someone whose philosophies most closely match your own.

Do you think functional medicine has something to offer you? If so, what steps will you take to find a practitioner who will work as a partner with you?

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1 Nancy Quarantotto June 9, 2010 at 2:40 pm

Thank you for this article. As a Mom of five who just this weekend was with my otherwise healthy 22 yr. old in the ER and hospital who was diagnosed as having a blood clot in his arm, I am definitely doing more and more to learn about Functional Medicine, though I didn’t know this was it’s name. Finding out what is behind the symptoms seems to me a crucial step in overall health care, one that for all too long has been overlooked. Thank you Melodie! I have no idea what steps to take to locate a doctor who calls themselves a Functional Medicine doctor but I’ll be checking out the internet and seeing what I can find out. I’ve heard of a doc in town who may be one…we’ll see.

2 Melodie June 10, 2010 at 10:00 pm

It’s great to have skilled ER doctors when you need them, but it’s also good that you are looking beyond the emergent problem to “what caused it.” To find a practitioner trained in functional medicine, go to the Institute for Functional Medicine website (www.functionalmedicine.org) and click on “Find a FM Practitioner.” There you can search by zip code, state or city in the U.S. or in other countries. All the best!

3 vitamin d3 benefits December 24, 2010 at 9:49 pm

On the topic of Vitamin D I’ve learned it plays an important role in the body which is required for the absorption and maintenance of calcium. Having the required amount of calcium in the body enables the maintenance of the appropriate structure within the bones, teeth and proper functioning of the nervous system. This is the major reason why we require the proper amounts of vitamin D in our body. Vitamin D belongs to a group of fat-soluble vitamins. This means you need to transport the fats.

4 vitamin d3 benefits December 24, 2010 at 11:08 pm

Vitamin D acts as an agent that prevents and cures diseases such as rickets and osteomalacia. Rickets is a bone disease usually found in children because of poor vitamin D IU levels. If the same deficiency occurs in the case of the adults, then the condition is called osteomalacia.

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