Functional Medicine: A New Model of Medicine

Functional Medicine is a new and emerging science-based model of medicine that approaches the body from a ‘systems biology’ perspective. It understands that the organs and organ systems of the body work together in synchronicity to maintain health (homeostasis) and have tremendous influence over each other in subtle but complex interrelationships. An imbalance in any of these systems can lead to health problems or disease.

Functional Medicine is science-based medicine, not “alternative” medicine. It incorporates the most recent scientific literature of physiological and pathological processes into its model of clinical care. While our understanding of the human body is always advancing and evolving, there are always advances in the literature of human biology, particularly neurology, endocrinology and immunology and genetics pointing to a new way of looking at and understanding health and the maintenance of health and our risk of developing disease.  A Functional Medicine practitioner must stay informed of the most current literature, be a critical thinker and analyst of new information and be willing to challenge beliefs and current dogma in medicine.

The focus of the Functional Medicine practitioner is on identifying physiologic mechanisms based on patterns that exist in the body which ultimately manifest as the patient’s signs and symptoms and managing these underlying mechanisms, rather than overly focusing on the symptoms, as the pharmaceutical model tends to do.  This is accomplished through specialized interpretation of laboratory testing, (blood, urine, stool and saliva) and various health assessment questionnaires.  Once these patterns are identified, various diet, lifestyle and nutritional recommendations are made and natural/nutritional medicine is used to correct these imbalances. The ultimate objective is to strive for self-regulation so that health can be achieved and maintained. In the preventative model, we look carefully for signs of imbalance or early-stage disease states and work to bringing back balance before it progresses to late-stage or chronic disease.

Principles of Functional Medicine

Functional medicine is a personalized, science-based field of health care that is that deals with primary prevention and underlying causes instead of symptoms for chronic disease. It is a grounded in the following principles:

  1. Biochemical individuality describes the importance of individual variations in metabolic function that derive from genetic and environmental differences among individuals.
  2. Patient-centered medicine emphasizes “patient care” rather than “disease care,” following Sir William Osler’s admonition that “It is more important to know what patient has the disease than to know what disease the patient has.”
  3. Dynamic balance of internal and external factors.
  4. Web-like interconections of physiological factors. An abundance of research now supports the view that the human body functions as an orchestrated network of interconnected systems, rather than individual systems functioning autonomously and without effect on each other. For example, we now know that immunological dysfunctions can promote cardiovascular disease, that dietary imbalances can cause hormonal disturbances, and that environmental exposures can precipitate neurologic syndromes such as Parkinson’s disease.
  5. Health as a positive vitality and not merely the absence of disease.
  6. Promotion of organ reserve as the means to enhance health span.

Common Mechanisms that Lead to Chronic Disease

Functional medicine is anchored by an examination of the core clinical imbalances that underlie various disease conditions:

  1. Hormonal and neurotransmitter imbalances
  2. Oxidation-reduction imbalances and mitochondropathy
  3. Detoxification and biotransformational imbalances
  4. Immune imbalances
  5. Inflammatory imbalances
  6. Digestive, absorptive, and microbiological imbalances
  7. Structural imbalances from cellular membrane function to the musculoskeletal system

The other distinguishing characteristic of Functional Medicine is the use of scientifically-validated natural substances (herbs, botanicals, vitamins, minerals, acupuncture and homeopathic remedies) to address these underlying conditions, rather than man-made synthetic chemicals. These are natural substances that the body can easily assimilate and utilize with minimal toxic effects. In most cases, these are very safe and non-toxic substances that can be consumed long-term with little or no risk of adverse effects. For complex chronic conditions, these are the options of choice, since many of these patients suffer from problems of hepatic overload and detoxification issues already. The modern pharmaceutical model will have the patient believe the more complex and varied symptoms a patient presents with, the more medications that are required. While in actuality, according to the most up-to-date research on the human body, simple and easily-corrected health problems can lead to a wide variety of symptoms and signs, as in vitamin B12 deficiency, for example, which can lead to anemia, dementia, cognitive decline, depression, cardiovascular disease, learning disorders, autism, autoimmune disease, cancer and infertility.

Chronic Disease: Prevalent in Modern Society

Due to our diet, poor eating habits, reliance on overly processed commercial foods and fast food, most of us suffer from nutritional deficiencies. In addition to this, we tend to have sedentary lifestyles, excessive long-term (chronic) stress, poor sleeping habits and exposure to environmental chemicals and toxins on a daily basis. It is no wonder we often suffer from multiple bodily systems being affected simultaneously. In fact, we rarely see single isolated imbalances in the body that do not have an effect on other organs or organ systems. We see patients presenting with complex conditions which ultimately result in a “diagnosis” given such as diabetes, migraine headaches, obesity, fibromyalgia, chronic fatigue, and autoimmune diseases such as SLE (lupus), inflammatory bowel disease (ie: Crohn’s or inflammatory bowel disease), rheumatoid arthritis or Hashimoto’s hypothyroidism. Each of these diseases affects multiple organs and organ systems simultaneously. These conditions linger and usually worsen over time unless the underlying mechanisms of these conditions are addressed.

Chronic conditions are more difficult to manage, but not impossible to manage. These conditions require more perseverance and patience on both the part of the practitioner and patient. One of the reasons why these can conditions can be difficult to manage is due to the fact that multiple organ systems are being affected. It is often challenging to determine which imbalances are the most important health issues that must be addressed in order to make progress towards better health. This is often one of the most important and challenging tasks of the Functional Medicine practitioner. Additionally, we often need to make lifestyle changes, including diet, exercise and stress management in order to bring about significant change. We often have patients avoid certain foods that we feel may be triggering their symptoms and causing an allergic or immune response, particularly those foods which are associated with common food allergies, such as wheat or dairy products. This is especially important in many inflammatory conditions and all autoimmune disease.

Current conventional healthcare, while very effective for acute conditions and life-threatening emergencies, is often not well-suited to address these complex conditions affecting multiple systems since most drugs are developed to target very specific and well-defined biochemical pathways. Instead of focusing on the underlying mechanisms, pharmaceuticals are directed toward specific biochemical pathways involved in the signs and symptoms of the patient (ie: high cholesterol, high blood pressure, acid reflux, etc.) by blocking, down-regulating or inhibiting specific enzymes involved in these pathways and therefore, not only do patients often require multiple medications for multiple symptoms, but usually have to continue these medications indefinitely with no endpoint since the underlying causes are rarely addressed.  As people get older, they are prescribed more and more medications when they visit their doctor which put the patient at risk of various side-effects.

“29% of elderly aged 57 to 85 used at least 5 prescription medications concurrently” JAMA, Dec. 24/31, 2008

Functional Medicine takes a comprehensive approach to the road to wellness, incorporating key nutrients and lifestyle change as part of a more whole-body approach to these complex chronic conditions we often see.  For many health conditions, this is a more sensible and often more effective and long-lasting approach as well.