Functional Medicine is the future of medicine. It is a holistic, patient-centered, collaborative team approach to healthcare. Recognizing that each patient is a unique individual, it applies that patient-centered approach to an understanding of the complex relationships among the organ systems of the body. It does not see the body’s systems as being isolated from each other, but rather focuses on what connects those systems. In other words, the inter-relationships between various pathways are explored in order to find the underlying cause of symptom patterns in patients with chronic illness. This is very different than the conventional approach of making a diagnosis and then treating the patient based on that diagnosis.
The foundation of Functional Medicine is built upon a healthy diet, lifestyle, and environment, which is where all Functional Medicine practitioners begin their clinical investigation and treatment. It is evidence-based and uses the latest in diagnostic testing. It is this system of healthcare that will help the world defeat the worst health crisis it has ever faced, the growing epidemic of Chronic Illness.
Changes in civilization over the past number of millennia have improved the human condition in many ways. Common causes of death in times past from problems including severe physical injury, infectious disease, and mortality in childbirth have decreased drastically. Throughout much of the industrialized world, people now enjoy a state of relative comfort, with 70-degree climate control – 24/7/365, access to food at will, a light at any time of the day or night, not to mention indoor plumbing. Most people appreciate the luxuries of modern life. However, these changes have led to one major problem with dire consequences, a mismatch between our genetics and the environment in which we live.
Let’s compare the timeline of human existence on earth to a football field. The first 299 feet would represent our Hunter-Gatherer ancestry. The remaining one foot, the last 10,000 years of civilization, with only a fraction of an inch representing the time since the industrial age. The invention of agriculture within the last 10,000 years, particularly as it pertains to growing and consuming grains, exposed something new to the genes of our species. This exposure was not without consequences. That change pales in comparison, however, to the changes that have taken place since the industrial revolution.
Our Hunter-Gatherer ancestors got up with the sunrise, walked an average of 8 miles per day while hunting and foraging, and typically completed their tasks by noon. After that, they often participated in social activities, dancing, ceremonies, and storytelling. When the sun set, they would sleep until the next sunrise. Their diet consisted of local indigenous game, vegetation, berries, nuts, and seeds. There were times of feast and times of famine. It is this Paleolithic lifestyle that programmed our genetics over millions of years. Exposing our ancient genetic code to the modern lifestyle causes alterations in gene expression (function) that will for many, eventually manifest as a Chronic Illness.
GENETICS & EPIGENETICS
To understand the basic principles and philosophy of Functional Medicine, you will need to know a little bit about human genetics. The human genome is the complete assembly of DNA that makes each of us unique. DNA holds the instructions for building the proteins necessary to carry out all of the functions of our cells. Scientists once thought that mapping the human genome would give us all of the answers we needed to fight the battle against Chronic Illness. However, it was soon apparent that the genome did not call all of the shots. There was something else directing the genome and changing its function. This finding led to the discovery of the aptly named epigenome (epi- above) since its control is above that of the genes.
The epigenome is made up of complex chemical compounds that tell the genome what to do. These compounds attach to the DNA and turn some genes on and turn others off. The epigenome doesn’t change the DNA sequence; it changes genomic expression (function). In other words, it changes the set of instructions that the genes give to their respective cells. Although our genes are the same as those of our ancient ancestors, our epigenome tends to be vastly different due primarily to three things: Diet, Lifestyle, and Environment.
The differences in modern environmental and lifestyle factors from those of our ancestors, expose us to physiological and emotional stresses that create chemical responses within our bodies. These chemical responses then lead to changes in the epigenome. Most often, these changes then lead to the development of Chronic Disease. Scientists today agree that it is the environment over genetics that causes up to 90% of all chronic physical and mental illnesses. The good news here is that if we can change our genetic expression for the worse, we can also change it for the better.
According to the Centers for Disease Control, chronic diseases are responsible for seven out of every ten deaths in the United States. Six in ten Americans now suffer from a chronic illness, and four in ten have multiple chronic conditions. More than 2 million people die each year from chronic diseases in the U.S. alone. Over half of adults take at least one prescription medication, and 40% of our elderly population take more than five medications. The rate of chronic disease in kids more than doubled between 1994 and 2006, and for the first time in history, the expected lifespan of children is less than that of their parents.
Out of the $3.5 trillion that the U.S. spends on healthcare each year, 90% goes towards treating Chronic Disease and mental health conditions. This amount of money equates to 1/4 of the nation’s Gross Domestic Product. Financial experts predict that if healthcare spending continues to rise at its current pace, the United States will be insolvent (bankrupt) by 2035.
CONVENTIONAL -VS- FUNCTIONAL MEDICINE
Conventional medicine looks to identify a disease or syndrome by making a diagnosis. Then it treats the patient based on that diagnosis. Ten individuals diagnosed with Rheumatoid Arthritis under Conventional Medicine will almost certainly receive the same treatment and advice. That is because the protocols used for treatment in Conventional Medicine are based on that specific diagnosis.
The treatment will typically either involve suppressing symptoms (i.e., medications for migraine headaches) or suppressing the disease process (i.e., medication for hypertension or immune-suppressing drugs for Rheumatoid Arthritis). Conventional Medicine does not look for the cause of, or to support the prevention of disease. It is typically not enacted until a disease diagnosis has been made. Often at this point, a significant amount of damage has been done.
The main tools used for treatment in Conventional Medicine are drugs and surgery. The value of these tools can not be overstated. In conditions involving acute infection and significant physical trauma, medications and surgeries are most likely the required treatment. Within the Functional Medicine paradigm, these are thought of as critical short term or ‘Rescue’ interventions. These tools may be necessary when treating chronic illnesses, but are approached conservatively, and never without also addressing underlying imbalances and lifestyle factors.
Negative side-effects of treatment common
Patients treated as diagnostic groups, not individuals
Significant long-term expense
Focus on symptom suppression
Focus on early disease detection
Functional Medicine seeks to identify the underlying cause of a condition. It treats the individual, not the diagnosis. Ten people under Functional Medicine care diagnosed with Rheumatoid Arthritis may receive ten different approaches to treatment. The reason the method of treatment may differ for each patient is that, although the outward manifestation of their pathology is ‘Rheumatoid Arthritis,’ the underlying cause of that condition is a product of that specific individual’s genetics, environment (current and past), and lifestyle.
Genetics will always play a part in the equation. However, environment and lifestyle play a much more significant role. For one individual the greater cause of their illness could be a food intolerance, for another – a gut infection, for another – heavy metal toxicity, for another – nutritional imbalances, for another – a mold/biotoxin illness, and yet for another – stress, which can negatively impact every aspect of human physiology.
Functional Medicine doesn’t aim to suppress symptoms; it seeks to correct the functional imbalances that have caused those symptoms in the first place. Symptom improvement is a natural “side effect” of correcting those imbalances. Functional Medicine commonly utilizes nutritional therapy, herbal medicine, supplements, lifestyle modifications, stress management, and detoxification. However, in the Functional Medicine model of care, conventional methods are also utilized when deemed necessary in the treatment of that individual patient.
A side-effect of treatment is improvement in health and symptoms
Focus on treating the root cause
Focus on prevention
THE FUTURE OF MEDICINE
Our current conventional medical system is outdated. Patients are all unique and different, and their treatments should be based on that uniqueness. The days where the patient with a complex chronic illness is herded through a 15-minute office visit and given three new prescriptions need to end. These patients often need a great deal of health, lifestyle, nutritional, and stress management education and guidance. Functional medicine provides office visits of sufficient length that allow the clinician adequate time to get to know the patient and understand their problems. It also provides ongoing health coaching visits to guide and support the patient through their unique process.
The takeaway here is that up to 90% of the Chronic Disease that is plaguing the citizens of the world today is preventable and reversible. This epidemic continues to grow at an exponential rate, and it doesn’t have to. Functional Medicine practitioners already know what to do to turn these problems around. Ongoing suffering is no longer necessary.
Functional Medicine doesn’t treat diseases. It works, side by side, with individuals, using the most advanced, evidence-based diagnostic methods to determine the actual underlying cause of a health problem and to create a personalized treatment plan focused on the patient’s goals.