What is Functional Medicine?

A person who is functioning well on every level is a person who is in good health. Our well-being is dependent on the harmonious interaction of our physical, biochemical, emotional, and spiritual elements. Disorders in any one of these will, sooner or later, drag the others down with it. But this process may not become evident for months or even years until disease symptoms express themselves.

Many people, however, are unwell in ways that do not constitute a distinct disease. They may complain of fatigue, headaches, aches and pains, or digestive troubles. These problems are caused by disturbance in the functions of the body. The symptoms of disease are only an end point of these disturbances. Functional Medicine tries to address the underlying imbalances rather than simply treating the symptoms of disease when they occur.

This is not a new idea; naturopaths, herbalists, and homeopaths, have, for generations, practised a system of medicine that centres on the individuality of the patient rather than his or her disease. In recent years, a strong functional medicine movement has grown up in the USA to bring together such practitioners with like-minded physicians who have become aware of the limitations of mainstream medicine’s dependence on expensive and potentially poisonous drugs and surgical procedures. The term ‘Functional Medicine’ was coined in 1993 to describe the integrated medicine of the future. Physicians of all persuasions from conventional and complementary medicine now meet and share expertise as members of the Institute for Functional Medicine - www.functionalmedicine.org

Functional Medicine is based on the recognition that ill health is the result of a three stage interaction of antecedents, mediators, and triggers:

    Antecedents are predisposing factors such as genetic make-up.
    Mediators are the environmental factors that create biochemical or structural imbalances, such as food or work-related stresses.
    Triggers are the precipitating factors which superimpose on the influence of the other two to initiate a phase of ill health.

Functional Medicine in action

A good example is chronic bronchitis, a condition which afflicts many people in temperate climates. The antecedents might be a family history of respiratory problems. The mediators would be poor nutrition, weakening the immune system, and excessive catarrh-forming foods, such as milk products or, perhaps, a smoking habit. Given such a background attacks might be triggered by exposure to cold or damp conditions or an acute infection, such as the common cold.

The approach of functional medicine to such a disorder is to use both new and established treatments aimed at strengthening the immune system (nutritional, herbal), toning lung function (herbal or homeopathic medicine), and assisting the mechanics of breathing by manipulation and related procedures (osteopathy, massage, lymphatic drainage techniques). It may also embrace the correction of energetic imbalances by the use of acupuncture.

Diagnosis

Functional Medicine diagnosis is geared very much to the individuality of the patient. While conventional blood tests are fairly sharply delineated as to what is health and what is disease, functional medicine pays more attention to the borderline values, which might be more significant where a patient has other compromising symptoms. For example, a patient is not generally considered to be suffering from hypothyroidism unless the level of thyroxine (T4), the thyroid hormone, is below about 10 micrograms. But if the T4 is around 12 to15 micrograms in a patient with symptoms of tiredness, chilliness, dry skin, weight gain, or hair loss we would consider thyroid function to be insufficient and in need of nutritional or herbal support.

Apart from interpreting blood tests, such as thyroid hormone levels, more critically, we now have a wide range of other tests that enable us to determine much more about how your body is working under normal conditions. These include measurements of liver detoxification functions, tests for fermentation by yeasts in the digestive system, adrenal stress index, and tests for permeability of the intestines. All these enable the functional medicine physician to add to the very thorough case history and examination which is usually made and to develop a program that creates better health for the patient no matter what the level of disease or distress may be.

In the words of the Institute for Functional Medicine the ‘functional medicine model produces a unique approach to healthcare and focuses on achieving health through optimising physiological function’.

R. Newman Turner, ND


Further reading:
Institute For Functional Medicine