What is Functional Medicine?

The health of a human being can be scaled into a three parts:  Sub-optimal health, “Normal” health, and Optimal health.

Let’s look at each of these categories individually to define what they might look like:

Sub-optimal health

Sub-optimal health presents itself in a couple different ways:

Acute illness (Ex. A broken leg, the flu, bacterial sinus infection, a pulled muscle, etc.)

If you suffer from an acute illness, you would likely visit your primary care physician, who would recommend a variety of short term treatments such as bed rest to antibiotics to ice baths to pain killers. As the name describes, these illnesses are ‘acute,’ meaning they start rather suddenly and are temporary in nature. Typical flu symptoms, for example, may last 7–10 days. 

Chronic illness (Ex. high blood pressure, high cholesterol, diabetes, Cancer, Asthma, Multiple sclerosis, etc.)

These illness typically require months or years to develop and treatment often serves to mitigate, control, or mange the illness rather than cure it.

Normal Health

If you are what society deems as an individual with “normal” health, it means you do not suffer from any chronic or acute illnesses. This is your average, every day sense of good health.

Optimal Health

Some days, we are just feel our absolute best. These are the days, where we get everything on our to do list done. We are focused, energetic and enthusiastic. We feel motivated and connected to those around us. These are the days in which it feels like it's your birthday (even though it's not). On these days, nothing can touch you. The normal, annoyances of your day no longer seem to matter. everywhere you look, there is nothing but sunshine, rainbows and daisies. A butterfly might even land on your nose and give you a kiss!

What if you could feel like this everyday?

Almost all of modern medicine deals with the space between "sub-optimal health" and "normal health." You get a cold, and you go to the pharmacy to get some cough medicine. Your cholesterol is sub-optimal and your doctor prescribes you cholesterol medication in an attempt to moves you a little closer back to the "normal" range. As I mentioned in my last post, this way of doing things is failing us as it is rapidly moving our health in the wrong direction.

1 in 2 Americans has a chronic disease, and 1 in 4 has multiple chronic diseases. 27 percent of kids now have a chronic disease, up from just 13 percent in 1994. 1 in 5 Americans struggles to pay medical bills, and 3 in 5 bankruptcies are due to medical expenses. 50 million Americans have an autoimmune disease. Almost a third of adults take two or more drugs.

Functional medicine (FM), on the other hand, deals with the space between "normal health" and "optimal health." What if my health is below normal? FM seeks to optimize the various underlying systems of the body. When you focus on optimizing the interconnected systems of the body, various chronic illnesses tend to resolve themselves. Patients that are on 200+ units of insulin are cured of their insulin resistance in a matter of weeks! Stubborn weight tends to melt off, blood pressure reverts back to normal levels, and you start seeing sunshine and rainbows again everywhere you go! :)

"Functional medicine focuses on promoting health rather than treating disease and managing symptoms."

How does Functional Medicine work?

FM takes a biology based, systems approach to developing a treatment protocol. To explain this more clearly, I will contrast it with the way things are typically done in modern medicine. Suppose You have difficulty breathing and are experiencing some mild discomfort in your chest. You go to the your primary doctor, who refers you to a pulmonologist. Your pulmonologist sees that you have an issue with your right lung, so he refers you to the right lung specialist, who prescribes you treatments that act specifically on the right lung.

Obviously, this is hyperbole, but demonstrates the point nonetheless. Modern medicine, tends to zoom in on a particular area of the body, ignoring the whole picture. The reality is that the body is a system of interconnected networks, none of which act independently. A disfunction in one system, take the gut for example, can very well cause a disturbance in the lungs. However, your right lung specialist is highly unlikely to order lab tests to assess gut function.

FM, on the other hand, treats the body as an interconnected whole and seeks to optimize the function of the individual systems so that the health of the human being can be enhanced. In short, FM focuses on promoting health rather than treating disease and managing symptoms.

Though this varies slightly between schools of thought in the FM community, the interconnected systems of the body are generally enumerated as follows:

1. Gastrointestinal Health

2. Detoxification

3. Immunity

4. Hormones

5. Cardiometabolic

6. Energy/Cellular Dysfunction

7. Hypothalamic pituitary adrenal (HPA) axis

Treatment protocols will generally be organized in the following order of priority:

1. Fix diet, lifestyle, and environmental exposure to toxic chemicals. The overwhelming majority of chronic disease can be fixed by optimizing these alone.

2. Correct nutrient imbalances, gut issues, and rebalance the HPA Axis (the body's stress response system)

3. Correct cellular dysfunction, toxic burden, hormone imbalance, immune dysregulation, and chronic infections.

4. Correct any unresolved issues with disease specific natural therapies.

"Functional medicine focuses on optimizing health instead of the conventional approach of managing disease and suppressing symptoms."

What are the differences Between Functional Medicine and Conventional Medicine?

Image courtesy of Kresser Institute, www.KresserInstitute.com

The major difference between conventional medicine and FM is best demonstrated with the above diagram. Conventional medicine tends to start from the outside and work in whereas FM starts from the inside of the circle and works out in regards to developing a treatment plan.

The exposome is the sum total of all inputs given to your body. Primarily, this includes inputs from nutrition, lifestyle, and environment. The exposome which you expose your body to determines the mechanisms and various biochemical pathways that are triggered in your body. If the inputs are adverse to the optimal function of your body, then the activated biochemical pathways can then manifest as a disease which will present as a various signs and symptoms in your body.

For example. Let's suppose you have a low level food intolerance to gluten that you are unaware of. You consume a slice of pizza for lunch. Some undetected permeability in the lining of your gut causes the gluten molecules to escape the gut and enter into the rest of your body. Your body then detects the gluten molecule as a foreign body and launches an immune response. The gluten triggers various biochemical pathways, that leads to low level chronic inflammation, which in your case presents itself as swelling, inflammation, and stiffness in the fingers, arms, legs and wrists. You also experience fever and chills, especially upon waking up in the morning.

FM will look at this situation and focus on treating the underlying cause of the arthritis by healing the gut and by altering the exposome by testing for and then reducing or eliminating gluten in the diet. This would, in turn, would eliminate the various inflammatory mechanisms being triggered and significantly reduce or eliminate the symptoms of the disease.

Conventional medicine, on the other hand, would typically focus on treating the symptoms and "managing" the disease rather than fixing the underlying problem. You would probably be placed on anti-inflammatory medication to reduce the pain and, if the symptoms were severe enough, you would be placed on expensive immune modulating medication that might ameliorate the symptoms temporarily, but will not effectively treat the disease and restore health to the patient.

In summary, functional medicine focuses on optimizing health instead of the conventional approach of managing disease and suppressing symptoms. Overall, Functional medicine is...

Investigative in that it treats symptoms by finding it's root cause rather than seeking to suppress them.

Holistic because it treats the the body as an interconnected whole.

Safer because common treatments used in functional medicine have fewer side effects, risks, or complications.

Patient centered in that it aims to treat the patient and not the disease.

Integrative because it combines the best of allopathic and alternative treatments.

Preventative in that it seeks to treat the disease before it occurs as opposed to conventional medicine, which tends to be more reactive.

Does this approach work? In an analysis of 4200 patients treated at the Cleveland Clinic Center for Functional Medicine (CCCFM), when comparing data from patients treated with conventional care at Cleveland Clinic, patients treated at Center for Functional Medicine experience greater clinical improvements and lower healthcare costs in both mental and physical health.

To find out more about functional medicine, visit: www.doctorram.co

In health,

Dr. Ram, Pharm.D.

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