What is Functional Medicine?

(Note: This blog post was written by Carl Paige, MD, independent health care practitioner at Medical Transformation Center. Dr. Paige will speak on a panel at the KHC June Community Forum, “Obesity Fatigue.” This post first appeared on the Medical Transformation Center website.) 

Throughout the twentieth century and the beginning of the twenty-first, medical care in the western world has often revolved around attributing symptoms to a single disease and prescribing medication or more serious interventions to eliminate those symptoms. While modern advancements have allowed humans to transcend many pathogens, they have also created a new way of living that results in many of the chronic diseases experienced by those in industrialized nations. Daily life is fraught with stress and pollution. Most lead sedentary lives and consume too much food with little nutritional value. Personally, I grew weary of what seemed to be a never-ending cycle of writing prescriptions and then seeing the same patients a few months later needing help with side-effects or different manifestations of the same root cause.

Functional medicine offered me an alternate approach. It seeks to prevent disease by understanding the effects an individual’s genes and lifestyle have on health and the power of deficiencies to fuel illness and vulnerability to it. Instead of fixating on “what” the disease is, functional medicine asks “why” it is manifesting. Physicians that choose to practice in this way employ a variety of tests for genetic markers and chemical imbalances or deficiencies. They look for disorder in these core areas:

  • Immune surveillance
  • The inflammatory process
  • Digestion, absorption and barrier integrity
  • Detoxification and biotransformation
  • Oxidation and reduction
  • Hormone and neurotransmitter regulation
  • Psychological and spiritual equilibrium
  • Structural integrity

These doctors seek to use diet, exercise, supplementation and lifestyle changes when applicable, and defer to medication as a last resort. Their methods are rooted in evidence-based medicine, placing high importance on randomized controlled clinical trials. They understand and take advantage of cutting-edge discoveries from the latest research in biochemistry, physiology, immunology and nutrition. Such innovations are revealing the ways in which diseases originate at the molecular level and are influenced by the interaction of genes and the environment.

One of these breakthroughs is the discovery of Single Nucleotide Polymorphisms (SNP), often called “snips.” DNA is made up of individual nucleotides that, when taken in groups, provide the directions for the body. They are akin to the letters that make up a word, and those words comprise the book that is the human genome. When an SNP is present, a person has two different letters serving the same function in a word. For instance, should the word be hop or hip in the sentence: I broke my ? Which version of the gene is expressed depends on environmental factors. “Snips” are the most common genetic anomaly in humans. Many are benign, while others can make one more susceptible to disorders. They can change the actions of chemicals in the body, like those that bind to various vitamins and nutrients, just as the choice of hop or hip would change the above sentence, one even rendering it meaningless. By pinpointing these SNPs, a physician employing functional medicine could determine genetic inability to process essential nutrients, which can predispose a patient to certain symptoms and illnesses. He can then treat this, consequently eliminating or reducing the bothersome side effects. This approach allows the patient to truly heal instead of just masking or mitigating presenting symptoms with a drug. By administering a series of tests tailored to the individual patient’s symptoms, the functional medicine practitioner can identify biomarkers for health and disease.

Functional medicine has several key tenets that a physician seeks to apply when using this approach. They are:

  • An understanding of the biochemical individuality of each human being, based on the concepts of genetic and environmental uniqueness
  • Awareness of the evidence that supports a patient-centered rather than a disease-centered approach to treatment
  • Search for a dynamic balance among the internal and external body, mind, and spirit
  • Interconnections of internal physiological factors
  • Identification of health as a positive vitality, not merely the absence of disease, and emphasizing those factors that encourage the enhancement of a vigorous physiology
  • Promotion of organ reserve as the means to enhance the health span, not just the life span, of each patient
  • Taken from The Institute of Functional Medicine(Institute of Functional Medicine)

From these principles and using the information retrieved from tests and a detailed medical history and lifestyle questionnaire, the physician creates an individualized therapy plan to suit that particular patient’s needs, symptoms and lifestyle. These usually seek to eliminate triggers and ameliorate mediators (like age, sleep, hygiene and social interaction) and antecedents (factors that predispose an individual to illness). In the process, a higher level of health and function is obtained.