About Functional Medicine
What is Functional Medicine?
Functional medicine model of care is a personalized approach aiming to restore optimal body function, reverse illness and promote health. It involves a whole new way of understanding, assessing, preventing, and treating chronic diseases. It integrates a variety of science-based approaches to find and treat underlying imbalances in how the body’s systems are functioning. Practitioners focus on what’s unique about a patient and try to understand how genetics, environment, and lifestyle interact with the body’s systems to create dysfunction. Treatments are then tailored to change and restore optimal body systems function.
How is Functional Medicine different from Conventional Medicine?
Functional medicine is based on the understanding how the body’s systems are linked together and how their function is influenced by both the environment and genetics. Conventional medicine, in contrast, is based on compartmentalization into specialties. The conventional specialties are centered mainly on the body’s different organ systems (cardiology, endocrinology, neurology, etc.). As Dr. Mark Hyman, an outspoken leader in functional medicine says, this conventional medical paradigm is based on “artificial divisions that are really an artifact of medical history.”
Functional Medicine recognizes the body’s interconnectedness. Functional medicine breaks apart the artificial divisions and instead bases its view of health and disease on the reality that the body is really one integrated, whole system. For years now, researchers have been identifying and studying the underlying fundamental problems—like inflammation, oxidative stress, toxicity, or energy problems in the mitochondria—that are occurring across medical specialties and are basis for most of chronic diseases. While these phenomena are well-recognized by researchers and even some conventional physicians, they are not being incorporated into the conventional medical model and its guidelines. Functional medicine is the bridge that connects these and other fundamental imbalances in the body’s systems to chronic symptoms and diseases.
The primary conventional approach to treating disease is to suppress the symptoms of the disease. For instance, if arthritis is triggering inflammation and pain, the solution is to block the body’s inflammatory response with anti-inflammatory drugs. If atherosclerosis is clogging important arteries, the solution is to surgically bypass the blocked arteries. If PMS is causing breast tenderness, depression, and other premenstrual symptoms, the solution is to suppress the normal monthly cycle using birth control pills.
Functional Medicine seeks to understand “Why?” and address the cause. Functional medicine seeks to understand why these symptoms are happening in the first place. That knowledge is then used to change the triggers of illness—to address the fundamental causes of chronic disease. Things like toxins, infections, allergens, stress, and poor diet are all examples of drivers of a chronic disease. Within the functional medicine model exists a unique methodology for identifying and addressing these underlying triggers. The treatments are based on treating the cause, which may be quite different for two people with the same disease. They involve providing the raw materials that create health (adding what’s missing) and removing the impediments to health (taking away what’s causing harm).
Who practices Functional Medicine and how are they trained?
Functional medicine is not limited to medical doctors but may be studied and practiced by any type of licensed healthcare provider including NDs, DO, nurse practitioners, acupuncturists, nutritionists, and chiropractors and health coaches.
The world leader in teaching functional medicine to healthcare practitioners is the Institute for Functional Medicine. This educational institute offers many programs, including an official certification program, to teach practitioners how to assess, treat, prevent, and manage patients with chronic disease. In order to take courses in functional medicine through the Institute, healthcare practitioners must be a graduate of an accredited medical, osteopathic, chiropractic, naturopathic, homeopathic, nursing, dietetics, acupuncture, pharmacy, physiotherapy or nutritional therapy program. The Institute is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Institute has also begun training medical students and faculty in academic medicine, nutrition, and residency programs and at least 18 academic institutions are introducing functional medicine into their curriculum.
Key conditions treated by Functional Medicine practitioners
Any chronic health issue in children or adults can be treated using a functional medicine approach. Whether you have already been diagnosed with a chronic disease or are still struggling to figure out what is causing your symptoms, a functional medicine practitioner can help. Examples of chronic conditions functional medicine practitioners may treat, depending on their training and focus, include:
- Chronic symptoms of all types including fatigue, sleep problems, pain, weight issues, headaches, nasal congestion and allergies, skin rashes, poor memory and concentration, frequent colds, constipation
- Gastrointestinal disorders like IBS, Crohn’s and ulcerative colitis, and GERD
- Hormonal disorders like hypothyroidism and Grave’s disease
- Autoimmune disorders like rheumatoid arthritis and lupus
- Metabolic diseases like diabetes, prediabetes, and metabolic syndrome
- Cardiovascular diseases like high cholesterol, heart disease, hypertension, and atherosclerosis
- Women’s health issues like PMS, infertility, menopausal symptoms, PCOS, endometriosis, fibroids, and pelvic pain
- Men’s health issues like prostate enlargement, erectile dysfunction, and low testosterone
- Mood disorders like depression and anxiety
- Neurological disorders like dementia, Parkinson’s, migraines, and autism
What does a working with a Functional Medicine practitioner entail?
Functional medicine practitioners generally spend much more time with their patients than practitioners in the conventional medical system. Patients are usually interviewed at length and fill out questionnaires on a variety of topics. Laboratory tests of many types, including some less conventional tests, are typically recommended to help determine which key biological processes are functioning normally and which are not. All the collected information helps the functional medicine practitioner determine the underlying imbalances and influences that have contributed to the development of a disease or dysfunction. Patients are expected to work with a collaborative team of providers (such as functionally-trained doctors, nutritionists and health coaches) and participate in multiple educational group visits/events.
Key therapies used by Functional Medicine practitioners
The functional medicine approach to treatment is focused on ameliorating dysfunctions in physiology and biochemistry that have resulted from interactions between an individual’s genes, environment, and lifestyle. The goal of treatment is to maximize functionality at all levels of body, mind, and spirit. Treatments are individualized and personalized in order to address each person’s unique genetics, diet, nutrition, environmental exposures, stress, exercise, and psychological and spiritual needs.
Therapies and treatment used by functional medicine practitioners will vary depending on the practitioner’s training and scope of practice in his or her state. Generally, therapies include tools from both conventional and integrative medicine and are based on clinical scientific research. Treatments may include combinations of nutritional supplements, herbal medicines, drugs, diets, detoxification programs, exercise, physical therapy, bodywork, acupuncture, spinal manipulation, counseling, and stress-management techniques.
The patient is always an active partner in whatever therapy is used and takes the leading role in changing his or her health. Multiple types of comprehensive therapies are typically recommended since the goal is not just to alleviate symptoms but to reestablish balance and functionality and to restore health and wellness for years to come.
Who can benefit from Functional Medicine?
Here are some examples of reasons why patients may choose to engage in Functional Medicine:
- They are healthy but wish to optimize their current good level of functioning. They wish to learn about themselves through advanced testing to look at their genomics, hormones, toxins, gut microbiome and potentially detect imbalances that could affect their health (and their children’s health) down the road.
- They wish to prepare their bodies (both women and men) to have a healthy baby and start the process well before pregnancy begins.
- They are looking to prevent a certain disease based on family history and/or genetics.
- They have a symptom(s) that has been fully worked-up using the conventional model, but they still have no diagnosis or explanation.
- They have been diagnosed with a disease but want to get to the root cause of their disease and try to reverse it, not just manage its symptoms.
- They have been diagnosed with a disease and a medication was recommended which they do not tolerate, or which they choose not to take.
- They have been diagnosed with a disease for which there is no treatment in conventional medicine.
Is Functional Medicine’s effectiveness scientifically proven?
- The evidence to support the functional medicine model of care has been published in multiple case reports.
- There is abundance of peer-reviewed evidence for functional medicine based on specific interventions used by the functional model including nutrition, lifestyle, or medications and dietary supplements.
- A recent study published in a prestigious conventional Journal of the American Medical Association [JAMA Network Open. 2019; 2(10):e1914017] collected data from patients using systematic validated measures and compared outcomes of patients receiving care through the Center for Functional Medicine at Cleveland Clinic vs patients receiving primary care at Family Health Centers in Cleveland area. In this study, the functional medicine model of care was significantly associated with improved longitudinal PROMIS GPH scores in patients at 6 months, and these improvements remained significant for up to 12 months. Patients seen at the Center for Functional Medicine were more likely to experience a clinically meaningful change in their PROMIS GPH scores at 6 months, which were less likely to decrease over time. Comparing PROMIS GPH scores with those from the Family Health Center, patients seen at the Center for Functional Medicine experienced a significant longitudinal benefit for up to 12 months. (PROMIS provides a measure of patients’ global physical and mental health that can be monitored over time, measuring factors like fatigue, physical function, pain, gastrointestinal issues and emotional well-being).