Understanding Functional Medicine
By Elizabeth Lipski, PhD, CCN

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Functional Medicine combines the ancient traditional health beliefs of primitive peoples with the benefits of modern science. It is an emerging field which focuses upon improvement of physical, mental, (spiritual?) and emotional function. Functional Medicine sees disease, not as an enemy, but as an opportunity for change and growth. In older systems of medicine it was believed that the body was self-regulating and that disease occurred when this self-regulation became disrupted. In more contemporary terms we speak of feedback loops. When these feedback mechanisms get stuck or disrupted, imbalances and disharmony occur. We call this being “sick”. The aim of functional medicine is to help your body to come back into dynamic alignment.

Functional medicine focuses not on endpoint or pathological state, but on the dynamic processes which underlie and precede it. While acknowledging the existence of pathology as well as a need to understand it, functional medicine focuses on the underlying processes and seeks a path of therapy which engages these underlying events. Functional Medicine is used in combination with contemporary medicine for the best possible approach.

Functional Medicine is holistic rather than specialized. It approaches the body as web-like and holographic. Contemporary Medicine compartmentalizes the body into specialties: liver doctors, heart doctors, mind doctors, etc. In Functional Medicine, all systems are known to be linked and patterns between organ systems are explored. Some of the many diverse fields which contribute to Functional Medicine are: genetics, herbal medicine, nutrition, environmental toxicology, endocrinology, natural medicine of all types, gastroenterology, psychology, and immunology.

Functional Medicine

  • Is Patient Centered
  • Is based on each person’s unique needs
  • Helps balance your biochemistry
  • Integrates physical, mental and emotional
  • Uses Challenge tests rather than diagnostic tests
  • Encourages you to take an active role in your program
  • Is interested in outcomes rather than controlling symptoms
  • Is used by all disciplines of medicine: medical, naturopathic, chiropractic, osteopathic, dentistry, nutrition, etc.


Patient Centered Care


Today people want to seek medical care that compliments with their own lifestyle and values. Many people are turning to complimentary medicine because they feel listened to, cared for, and are treated as a whole person.

Functional Medicine looks at how you are “doing” and “feeling”. You won’t be told “It’s all in your head.” Functional Medicine is interested in you—your life, your well-being, what you eat, your work environment, your relationships and communication with others, how you relax and play, your hobbies, what medications you’ve taken, how well your digestive system functions, and what chemicals you’ve been exposed to. Your total lifestyle helps create a picture of you. By understanding who you really are and hearing about your life, significant clues and information can be found to really help you feel better. You can change the way you feel!

Rather than naming a specific disease, Functional Medicine looks to find the underlying causes. The Functional approach takes you and your lifestyle in to the practice of medicine. It looks at you in context of your life and choices. Your treatment program will reflect your needs.

I don’t treat migraines; I treat people with migraines. Each person who has migraines requires their own unique treatment plan.
- Latifa Amdur, Licensed Acupuncturist.

Who Can Benefit from this approach?

Many people today have health problems that don’t fit into simple categories. Often people have complex health problems involving inflammatory responses, immune, nervous, digestive, energy, and/or cardiovascular systems. These people are best helped by a functional approach. Typical patients include people with: Chronic fatigue syndrome, auto-immune illness, fibromyalgia, fatigue of unknown origin, and digestive complaints. Often these people have been to many physicians without results.

FM is also for people who are interested in true preventive health care. They want to take an active role in their own well-being and that of their family. These people seek out FM practitioners to act as guides for their continued good health.

Common Categories of Functional Imbalance

  • Oxidative Stress
  • Nutritional Imbalances
  • Intestinal Dysfunction
  • Impaired Detoxification
  • Immune/Inflammatory Imbalances
  • Endocrine Imbalances

How does Functional Medicine differ from Conventional Medicine?

In a Functional Medicine approach the absence of disease is NOT health. FM is concerned with finding out how you function—on a physical, mental, emotional, and spiritual level. Optimal wellness is the ultimate goal.

In conventional medicine making a diagnosis is often the endpoint of therapy. Just treat the symptoms and send the patient home. FM looks deeper to find the cause. When we have pain, discomfort, or reoccurring health complaints, it is our body’s way of trying to get us to pay attention. Rather than taking a pain medication each time we get a headache, or backache perhaps we ought to ask why we are experiencing the pain.

FM looks to see if you are missing something you may need—perhaps you have special needs for vitamins, minerals, probiotics or amino acids. It also looks to see if you have something you don’t need such as environmental contaminants, heavy metals, bacteria, fungus, and/or parasites. The answer may be simple or complex. For example, if you are depressed, perhaps an anti-depressant would help you to feel better. But wouldn’t you really like to explore why you are depressed? Could it be a neurotransmitter problem? Or a relationship problem? Could you be reacting negatively to food you are eating? Or could it be the load of heavy metals or toxic chemicals you’ve accumulated? This approach obviously takes more work than just writing a prescription for an antidepressant, but it gives a much more satisfying answer.

The Tack Theory:

1) If you are sitting on a tack it takes a lot of aspirin to make you feel good
2) if you are sitting on two tacks, removing just one does not result in a 50% improvement.

Detoxification & Healing, Keats Publishing, Sidney Baker. MD

Contemporary medicine talks about “prevention”. But pap smears, cholesterol and blood pressure screening, and cancer testing are all tests for early detection of disease, not prevention of disease. Functional medicine is concerned with real prevention of disease. By paying attention to small problems, you can often prevent large ones. We seek to help you be able to do more of the things you want to for longer in life and to increase your “health span”.

Functional Medicine

Conventional Medicine
Health Orientation
Disease Orientation
Patient Centered
Doctor Centered
Biochemical Individuality
Everyone treated the same
Holistic
Specialized
Cost Effective
Cost Prohibitive
Looks at deep causes of illness
Diagnoses Illnesses/Names them
Preventive Medicine
Early Detection of Disease is called
Preventive Medicine
High Touch/High Tech
High Tech


How Functional and Conventional Therapeutics Differ


Functional Medicine

Conventional Medicine
Irritable Bowel Syndrome Will look at: food sensitivities; possible fungal, parasitic, and/or bacterial infections;
Look at digestive function
Eat bran.
Learn to live with it, and stress reduction
Migraine Headaches Will look at: hormone balance; food sensitivities; stress reduction techniques; herbs such as feverfew Medication and rest
Arthritis Will look at: exercise patterns, food sensitivities, digestive function. Will use nutrients to help rebuild cartilage. Will do metabolic cleansing regime and alkalizing diet to help remove calcification in the joints. Medication and physical therapy or rest
Depression Will look at: Counseling, use of nutritional supplements, dietary modification, exercise programs. Medication and Counseling

Biochemical individuality

Earlier this century Roger Williams, MD coined the term “biochemical individuality”. Just as each of us have a unique face, fingerprint and personality, our biochemistry is also unique. There is a wide variety of “normal” values found. For example, research has found that some babies require four times the vitamin B6 as others, and ranges of serum amino acids in healthy young men varied fourfold on average. Looking for your unique biochemical needs provides a foundation for Functional Medicine.

4-R approach

One of the underlying bases of Functional Medicine is the 4-R approach. This approach provides the basic functional treatment philosophy. Although simple in concept, it provides an effective approach for resolving difficult and undefined illness. The 4 R’s:

  • Remove refers to the elimination of anything that may be in our body or diet which contributes to poor health. This can include foods, pesticides, food additives, unwanted bacteria, fungi, and parasites.
  • Reinnoculation involves the use of probiotic supplements containing lactobacillus acidophilus, bifidobacteria, and other friendly flora. These bacteria manufacture vitamins, repel harmful microbes, and have anti-tumor effects. They are easily disrupted by use of antibiotics and the stress of contemporary living.
  • Replace refers to the addition of supplements to support digestive function and may include: digestive enzymes, bile salts, and/or HCl.
  • Repair refers to the nutritional support that helps quickly regenerate and heal the body.

Your Relationship with your Physician

Your relationship with your doctor is different. It is an equal partnership, teamwork. It makes for a rewarding partnership for both parties. Functional Medicine asks us to pay attention to our bodies and our biology, rather than our sociology. It asks us to be in partnership with our physician, to use our doctors as advisors and explorers on our journey of life.

Functional medicine takes you and your lifestyle into the practice of medicine. It looks at you in context of your life and choices. Your relationship with your doctor will be one of a partnership. Your physician and medical staff will be your advisors in your life journey. You may find that they spend more time with you. You may fill out extensive questionnaires, about your medical history, work history, diet, exercise patterns, stress level, hobbies, use of supplements and medication, and home and work environment. A program will be developed which will be specific to you and your individual needs and lifestyle.

What is Expected of You?

You will be expected to make changes in the way you eat, think, feel, and experience life. You are an important part of this process and your role is primary. You are asked to participate in the process fully. The benefits are tremendous and you will see effects ripple out into your relationships with yourself and others.

You may be asked to: make changes in food choices, eating patterns, take nutritional, homeopathic or herbal supplements, exercise, go through a detoxification program, meditate, see a counselor about life issues, join a support group, have massages or other body-work, sit under colored lights, or any one of many other modalities. You probably will be asked to participate in testing, some of which you will do at home. Some may involve laboratory testing, while others may involve testing the pH of your urine or taking your basal body temperature.

“If we accept that the human body is an energy-driven, energy-sensitive system, that is in dynamic interaction with all of its surroundings, then illness may be seen as communication from some level to a level of conscious awareness. Once awareness occurs, it allows a person to begin a process of understanding the influences that collectively led to the illness. Illness in this context may be seen as a vehicle for transformation.”

Functional Medicine: An Integrative Approach to Health Care
Jeffrey Bland, PhD., Buck Levin Ph.d, R.D.,
Michael A. Schmidt, D.C. 1997

What are the benefits of a Holistic approach?

By looking at each person as an entire being, whole person patterns can be seen. Often people go to see a variety of specialists—one for heart problems, another for gynecological problems, an internist for their general needs, and so on. For example, there was a man who went to see a cardiologist because he experienced heart palpitations. The cardiologist put him on heart medication. He saw his internist because he had a tremendous amount of leg cramping, and was put on a muscle relaxant. And his psychiatrist put him on an anti-depressant for anxiety. The same man saw a functional medicine physician who immediately noticed that all of these symptoms could be due to a lack of magnesium. Magnesium and other supportive nutrients were given and the man was able to discontinue all other medications.

Better health Now

Most of us have a reoccurring health problem that can be alleviated or corrected through functional medicine. Many of us just learn to live with a variety of small to large health problems and to limit our lives accordingly. Often people with irritable bowel syndrome stay home because they are unsure of their bowels. Many women with migraines, don’t schedule anything during certain parts of their menstrual cycle. And people with arthritis just give up moving in certain ways or doing certain things because they can’t. We have been told to just accept our limitations. Physicians working with functional medicine are realistic about the possible limitations, but optimistic about helping you get feel really well again.

Increased Health span!

Our goal isn’t necessarily for you to live longer, although you just might. Many people experience a decline in health for the last several decades. Yet we all know people who lived happily and healthily until the last few months or year of life and the quietly passed of “old age.” The goal of functional medicine is to improve overall health throughout life and especially in old age. A recent study from the University of California at Stanford showed that people who began paying attention to preventive health care in mid-life—stopped smoking, exercised, and made dietary changes—had fewer hospitalizations, surgeries, took fewer medications, and lived longer than people who didn’t.

What Types of Lab Tests may be Used?

Evaluating organ "function" versus organ "pathology" is one of the principles of functional medicine. Many labs have developed a number of assessment tools that allow practitioners to understand a patient's functional status. Because these tests are fairly new, many physicans are unfamiliar with their use. These tests compliment the usual testing that physicians use and can detect problems long before more traditional tests find anything amiss. Tests may examine blood, hair, stool, urine, breath, and/or saliva. Common tests check for your nutritional status, digestive function, food and environmental allergies, amino acid balance, energy metabolism function, hormones balance, and more. With this approach no specific disease is being looked for, rather your doctor is looking to determine why your body is out of balance.

For example, food allergy testing can be used in a wide variety of instances. Some common ones include: children with learning or behavior problems, people with migraines, skin problems, depression, digestive complaints, and fuzzy thinking. Hair analysis would be used if exposure to heavy metals was suspected or if malabsorption of minerals was suspected. Innovative saliva testing can measure your levels of hormones such as DHEA, progesterone, testosterone, and estrogens. Stool testing is used to measure overall digestive function, whether you’ve got enough good bacteria in your gut, and if you have bacteria, fungus, or parasites which interfere with good health.

These tests are well-researched and most of them are reimbursed by insurance companies. It is wise to ask your physician and/or staff about reimbursement before you proceed with testing. Some tests may need to be paid for out-of pocket.

Common Lab Tests

  • Stool testing for digestive function
  • Blood testing for food allergies & sensitivities
  • Urine testing for intestinal permeability/leaky gut
  • Hair analysis for mineral levels
  • Blood testing for vitamin status
  • Saliva testing for hormone status
  • Urine or Blood for amino acid levels
  • Testing for energy cycle metabolites

Want to know more? Suggested Reading

  • 20 Day Rejuvenation Diet Program, Jeff Bland
  • 7-Day Detoxification Miracle, Peter Bennett, ND, Stephen Barrie, ND
  • Digestive Wellness, Elizabeth Lipski, PhD, CCN
  • Tired or Toxic, Sherry Rogers, MD
  • Power Healing, Leo Galland, MD

© Elizabeth Lipski, PhD, CCN

 

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