What is Functional Medicine?
Functional medicine is a way of thinking about medicine. Practiced by doctors and other licensed health professionals, functional medicine is a cutting-edge approach that aims to change how medicine works by changing what questions physicians ask. The goal of functional medicine is to help you feel better by digging deeper.
Most of us are familiar with the standard approach to medicine. If you feel sick, your doctor asks you about your symptoms, makes a diagnosis, and prescribes a treatment to make those symptoms go away. Hopefully, you feel better, but whatever is causing those symptoms is often left unaddressed.
A functional medicine doctor wants to tackle the root causes. Those who practice functional medicine recognize that wellness isn't just about suppressing symptoms, but identifying and healing fundamental dysfunctions within our bodies that may be making us sick. Functional medicine is a bigger picture way of looking at healing: one that wants to help you recover from disease, not just manage it.
In doing so, functional medicine practitioners use a wide toolkit of healing techniques, including nutrition, herbs, medications and lifestyle changes. They also make an effort to really get to know their patients, as truly understanding each person's health history is a key part of treatment.
In many ways, functional medicine is similar to other holistic healing approaches, such as integrative or naturopathic medicine. Doctors who practice in any of these traditions share many of the same perspectives on how best to help you become well. However, some holistic doctors, like naturopathic physicians, are trained differently from traditional MDs. By contrast, many functional medicine leaders are MDs, and seek to reform and modernize conventional Western medicine from the inside.
Jeffrey Bland, PhD, a functional medicine pioneer and co-founder of the Institute for Functional Medicine, describes functional medicine as "less focused on what to call a particular health condition, and more on what is actually causing that condition. Diagnosis is important, he notes, but it doesn't get at what is really creating the problem".
A functional medicine doctor can treat you for anything and , like other holistic health professionals, is often especially good at working with chronic, complex conditions. Such conditions are usually the result of the deep, systemic dysfunctions in your health that functional medicine is well-equipped to uncover and work with.
Dr. Bland gives the example of diabetes to illustrate this point. "People who have been diagnosed with type 2 diabetes are normally all treated with the same few drugs. But a functional medicine doctor understands that no two people are exactly alike: 100 different people with diabetes have 100 different variations on how they became diabetic. Functional medicine designs a treatment approach around each person's unique health history and life circumstances".
This can be very effective.
How does functional medicine work?
Functional medicine doctors want to offer you better outcomes than more traditional Western medicine can sometimes provide. They do this by really getting to know your specific health history: exploring all the stress points in your body and life and how they could be coming together to make you sick. This systemic perspective is at the heart of functional medicine. Like other holistic doctors, they also typically work with a wide range of treatment tools, drawing from evidence-informed practices both timeless and modern.
History and philosophy
Functional medicine was first developed by Dr. Bland and his wife Susan Bland, MD, who co-founded the Institute for Functional Medicine in 1991. Working within the larger holistic health tradition, the two sought to combine the latest scientific research with healing approaches like nutrition that had largely been ignored by many other doctors. Their goal was to revolutionize the overall practice of medicine.
In Dr. Bland's own words, "Eventually, functional medicine won't be called functional medicine. It will just be considered good medicine".
Perhaps the key to the functional medicine approach is the systemic perspective. Medicine today is typically divided into specialities: orthopedics, cardiology, neurology, gastroenterology. This means that doctors practicing within these specific areas often have a truly impressive grasp of how their specific part of the body works, but may not be trained to focus on how that part fits into the body as a whole. They are taught to see deeply, but not always broadly.
This makes treating chronic, complex health conditions really difficult, because they almost always involve the relationship between several parts of the body, as well as a range of emotional and lifestyle factors. How your organs affect each other, and how your mind, feelings, relationships, and choices affect your body all matter when it comes to unraveling disease.
Functional medicine recognizes that seeing you and your body as a cohesive whole is essential to healing. That's why functional medicine doctors are more interested in root causes than symptoms and diagnosis. The symptoms are a red flag that lets you know something is wrong, but simply treating them usually doesn't fix what's actually going on. Figuring out how your body system is struggling and how to support it often does.
Dr. Bland notes that, "Functional medicine moves away from organ-centric to systemic thinking. It isn't so much what you do as how you think about it".
Science
The overall philosophy of functional medicine is grounded in the scientific study of systems biology. A substantial body of case reports validates the effectiveness of this approach. Larger-scale studies are also currently underway.
When treating their patients, functional medicine doctors and other practitioners use evidence-based and evidence-informed treatment techniques, in keeping with the best practices of their professions. However, functional medicine doctors tend to also use healing modalities that fall outside the canon of traditional Western medicine. These are supported by evidence, but not necessarily by the sort of double-blind clinical trials that are common in evaluating many conventional medical practices.
In addition, functional medicine's emphasis on seeing how each patient is unique means that different patients with similar symptoms may receive different treatments. Genetic testing - understanding your distinct genetic makeup and how that influences your health - is an important part of this. Functional medicine is not one size fits all, but interested in finding what works specifically for you.
Method
A functional medicine doctor typically starts by sitting with you and talking about your health history. This process can be quite extensive'it is not uncommon for a first appointment to last upwards of 90 minutes. The doctor wants to understand as much about you as they can, in order to tailor a treatment plan that will specifically address exactly what is going on with you and your body.
Follow-up appointments are usually briefer, and aim to assess and adjust your treatment plan as needed. Your doctor may also refer you to allied health professionals such as a nutritionist, acupuncturist, psychotherapist, or massage therapist.
The Institute for Functional Medicine recommends that functional medicine practitioners explore and address several key areas with their patients, including physiological imbalances, mental, emotional and spiritual health, and the patient's life story. If you have lifestyle factors that are affecting your health including: sleep, stress, relationships, exercise and nutrition, a functional medicine doctor will work with you to make positive changes in those areas as well. Functional medicine also often makes extensive use of detailed laboratory testing, in order to better understand what is going on inside your body.
When it comes to which specific treatments doctors prefer, Dr. Bland notes that, "functional medicine is fairly agnostic." In other words, functional medicine doctors don't necessarily emphasize one type of treatment over another: herbal supplements over dietary changes, for example, but go with whatever fits within their overall systemic, holistic perspective. Dr. Bland also makes that clear functional medicine practitioners want to "start with the least invasive treatments possible, and only use the heavy artillery when really needed".
What are the benefits of functional medicine?
Functional medicine is an effective, practical way of approaching health care. A functional medicine doctor can treat anything any other doctor can, but through a systemic, root-cause focused lens. Functional medicine doctors want to get to the bottom of what is going on, and help you heal from the ground up.
Some of the specific benefits of functional medicine include:
Working with complex, chronic health conditions
The treatment of complex, chronic health conditions is where medicine often runs into trouble. However, functional medicine doctors are well-suited to deal with gut disorders, autoimmune diseases, chronic pain, heart disease, obesity, cancer, depression and other ongoing conditions that seem to have no easy answers. By looking at how all the areas of your life are affecting your health, and using extensive testing to explore the exact conditions inside your body, functional medicine physicians can get a clear picture of what's going on and what needs to be addressed in order to help you feel better. Many people find that a functional medicine approach can help them not only experience relief from a chronic health condition, but actually reverse or heal the condition entirely.
Supporting wellness
You don't have to be sick to see a functional medicine doctor. In fact, a functional medicine doctor can help support your general well-being, offering guidance on nutrition, supplements and other steps you can take to sustain or boost your wellness. This can improve your physical and mental performance, help you age with greater ease, and otherwise enjoy your body.
Personalized treatment
Functional medicine treatments are tailored to your specific health needs. Functional medicine doctors make substantial use of laboratory testing - such as blood tests, stool samples and genetic assessments - to learn more about your individual physiological makeup. Your treatment plan is then designed to correct any deficiencies this testing helps identify.
Minimizing side effects
As Dr. Bland notes, functional medicine doctors seek to treat you using the gentlest possible approach. This means that you may be able to heal or feel better without experiencing a host of unpleasant side effects. It's not a guarantee, but it's certainly a goal. Indeed, many of the most common functional medicine treatments, such as improving your nutrition or level of fitness, have no negative side effects at all.
Healing the whole you
Wellness isn't just about having the right blood pressure readings and cholesterol levels, but feeling at ease in your own skin. Because functional medicine understands the impact that all aspects of your life can have on your health, your doctor is motivated to help treat the whole you. They can help you explore how not just your physical, but your emotional, mental and spiritual health can be improved.
Emphasis on doctor-patient relationship
A strong relationship between you and your doctor is considered essential to functional medicine. Your doctor wants to take the time to get to know you so they can better understand how to help you. This pays off: numerous studies show that the doctor-patient relationship is an important part of what helps people heal.
Safety and side effects
Many medical treatments carry some risk. However, functional medicine physicians and other practicing health professionals typically address any health condition starting with the mildest interventions possible. Because functional medicine practitioners frequently use nutrition, lifestyle, and herbal medicine as well as pharmaceuticals and surgical procedures, they can often help their patients avoid the risks associated with the latter forms of treatment.
References:
About Functional Medicine
Dr Mark Hyman
Functional Medicine Matrix
Institute for Functional Medicine
Selected Studies:
Form Follows Function: A Functional Medicine Overview
Patrick Hanaway, MD
The Permanente Journal, 2016
Refractory Depression, Fatigue, Irritable Bowel Syndrome, and Chronic Pain: A Functional Medicine Case Report
Gregory Plotnikoff, MD, MTS, FACP & Melissa Barber, MSc
The Permanente Journal, 2016
