What is Functional Medicine?
“Prevention is better than cure”. This is what I was told by one of my lecturers when I first started medical school 23 years ago. This statement has always resonated with me throughout my career as a doctor. However, with workload and individual pressures, it can be easy for doctors to lose sight of this principle.
In many ways, it can be said that modern medicine may have lost sight of the importance of prevention or the causes of disease and can be seen as mostly managing the symptoms of it. Functional Medicine aims to address this. Functional Medicine uses a systems-based model of comprehensive care and primary prevention for complex, chronic illness and is grounded in science:
- evidence about common underlying mechanisms and pathways of disease as well as
- evidence about the contributions of environmental and lifestyle factors to disease.
It is a new way to practice medicine that doesn’t fall into the “conventional” nor “alternative” categories and it combines best elements of both. Functional Medicine is along the lines of, and complements the goals of, traditional General Practice. However, the main aim is to address and treat the root causes of chronic disease and illness.
This should be the future of medicine.
Functional medicine is:
- A holistic, science-based approach. Treats the body as it is – as a whole. A complex network of interconnected systems. The digestive, cardiovascular or other bodily systems do not work in isolation. They have a complex, dynamic relationship between themselves and the environment e.g the recently discovered links between the digestive system and heart disease. Functional medicine recognises this.
- Patient-centered. Treatments are highly customised to each patient’s needs. Treat the person, not the disease and this is a shift away from the current diseased focus practice.
- Investigative. Using highly specialised and advanced diagnostic tests, which can help diagnose symptoms by detecting and addressing the root cause disease.
- Is validated by research and many doctors worldwide. The Cleveland Clinic, one of the top US hospitals (U.S. News & World Report’s “2018-19 Best Hospitals”), has recently opened a multi-million dollar centre for Functional Medicine.
The Root Causes Of Many Health Issues That Functional Medicine addresses:
- Improper Sleeping
- Poor Diet
- Immune Imbalances
- Negative Thought Patterns
- Lack of Regular Exercise
- Digestive Problems
- Toxin Exposure
Conventional medicine and functional medicine
The goal of Functional Medicine is to help people achieve health better outcomes and stay healthier for longer. The purpose is to treat the person as a whole, and not just the disease, with a highly customised treatment plan. We must remember that all drugs can have potentially harmful side effects. Rather than giving somebody with a rash some cream for it, we would be searching and treating the underlying cause of the rash instead, rather than just suppressing the symptoms of it. The current medical system has room to better at working on disease prevention or reversibility.
I am not anti-conventional medicine – I work in an excellent service providing outstanding acute care to patients. However, there are some things that Functional medicine may be better at treating. The acute care approach may not work well for investigating chronic medical problems.
Functional Medicine is also not a replacement for traditional General Practice. It involves a more thorough exploration into what General Practice is and has always been. Like traditional General Practice doctor, a Functional Medicine doctor scutinises the many and complex interactions between genetic, lifestyle, and environmental factors, which of course can have a huge influence long-term health and the development chronic disease. Functional medicine methods always start with the elemental and core lifestyle factors, such as:
Functional Medicine uses evidence-based approaches to overall health and, depending on an individual’s needs, might include some of the following:
- Simple lifestyle changes, such as regular exercise and better sleep.
- Testing for hormone imbalances, digestive health and nutritional deficiencies.
- Assessing family medical history and using Functional Medicine as a means of prevention.
- Strengthening the body’s normal healing abilities rather than just attacking symptoms or disease.
- Eating whole foods instead of unhealthy processed foods.
The methodologies taught in Functional Medicine are all concentrated around efficacy and safety, with a solid foundation in peer-reviewed publications. A major tenet of Functional Medicine is that by using science, clinical experience, and a profound understanding of the impact on the patient, to address the root causes of chronic disease, which can be identified and then targeted. The aim is then to institute interventions that remediate those causes earlier and hopefully more effectively. In fact, Functional Medicine depends on and uses evidence-based medicine as it was originally intended to be employed; using the best evidence available, in conjunction with the expertise of the physician, and along with the specific motivations and preferences of the patient. These are all in line with the core values of traditional General Practice.
The truth is that your doctor may not be in the best position to ask for detailed advice on exercise, diet, sleep, mental or physical wellbeing. Most traditional doctors are not trained thoroughly enough in these disciplines to apply personalised strategies on nutrition, diet, and exercise to both treat and prevent these illnesses in their patients, or to assess the underlying causes of complex, chronic diseases. The correct answers to some of these issues are also very uncertain even for the experts in the respective non-medical fields. Low fat vs high fat diets, high protein and low carb diets, high intensity training vs low intensity steady state exercise for cardiovascular health? Many doctors may not be appraised well enough of the arguments behind these discussions, let alone the answers.
How should maintaining and disseminating health be best achieved? Deferring some of this knowledge acquisition and dissemination to other experts already occurs. Strength and conditioning coaches know far more about injury prevention, muscle strength, and cardiovascular health. It’s hard to supersede a sleep experts’ knowledge and insight into the importance of rest. Nutritionists understand better than most the impact that diet can have on the digestive system and health. This should be accepted, embraced, and promoted by health services to ensure better preventative medicine.
Or perhaps another way is to develop a new breed of doctor, a Functional Medicine doctor, a specialist in health who can concentrate on function, rather than malfunction and disease, with a combination of:
- occupational health,
- promoting mental attitudes
- Stress reduction strategies,
- and sleep medicine.
Using advanced lab tests, they would not just treat disease, but promote health. This could be delivered anywhere, outside of hospitals or GP surgeries. Concentrating on this function may reduce the burden on the NHS. As the number of patients with difficult to define, complex, chronic conditions continues to rise, our current system is struggling to meet this demand (1). Functional medicine aims to work alongside it to reduce this burden and make you as healthy as you can be – to be the best you can be.
My Credentials in Functional Medicine
I have undergone an extensive Functional Medicine Certification programme, with over 1000 hours of training at the Kresser Institute, run by Chris Kresser M.S., L.Ac, who is the co-director of the California Center for Functional Medicine and founder of Kresser Institute. He is the creator of ChrisKresser.com, and the New York Times best selling author of The Paleo Cure. He is one of the most respected clinicians and educators in the fields of Functional Medicine and ancestral health, and has trained over 1,000 practitioners around the world in Paleo principles and Functional Medicine. His ADAPT programme is one of the first and only training programmes to fully integrate functional medicine with the better questions and new insights of an ancestral, evolutionary perspective. I am also a member of the Institute of Functional Medicine (IFM). As a hospital Consultant and a Functional Medicine practitioner, I have learnt how to effectively combine my knowledge and skill to treat of a range of health issues, by integrating and applying functional medicine in clinical practice.
What I can achieve is to create a focus on wellbeing and disease prevention through nutrition, diet, and exercise. This is along with the use of the most cutting edge laboratory tests and other diagnostic techniques, along with a combination of drugs and/or botanical medicines, supplements, therapeutic diets, detoxification programs, and stress-management techniques.
I believe that Functional Medicine, in association with aspects of conventional medicine, could be the future and the best way to restore the balance of health in favour of the patient. After all, the patients were the reason why I got into medicine in the first place.
What conditions has Functional Medicine worked for?
Diseases and Health Issues Treated or Improved Through Functional Medicine:
- Eczema / Psoriasis
- Hashimoto’s thyroid disease
- Inflammatory Bowel Disease
- Rheumatoid arthritis
- High Cholesterol
- Type II Diabetes
Chronic Pain / Fibromyalgia
- Heavy metal / Chemical / Mould toxicity
- Food intolerances / allergies
- Acid reflux
- Coeliac’s disease
- Intestinal permeability / leaky gut
- Irritable Bowel Syndrome
- Small Intestinal Bacterial Overgrowth
- Weight management / Obesity
- Sex hormones
Psychological & Neurological
- Brain Fog