What is Functional Medicine?
New approaches to health and wellness are becoming ever more relevant as chronic disease is burdening the world. 125 million Americans are burdened by chronic disease and 70-90% of mortality is greatly affected by modifiable lifestyle measures. In this way, chronic disease prevention and treatment is imperative. A paradigm shift has occurred as chronic disease does not follow the systems-based, conventional model which often aims to treat one single invader that causes one single disease with one single treatment. This is where Functional Medicine comes to play.
Functional medicine asks, “Why” as opposed to “What”.
It is patient-centered not disease-centered and requires a therapeutic partnership between the patient and practitioner.
It acknowledges the biochemical individuality of each patient as genes, SNPs, epigenetics, nutrigenomics, etc. all affect the development and presentation of disease symptoms.
It seeks to discover the root causes of disease and restore them while promoting positive vitality and organ reserve to enhance health.
It understands the complexity of disease and the web of interconnectedness between organ systems and imbalances.
It seeks to restore the balance between the internal and external body, mind and spirit.
What to Expect
Chronic disease requires a more thorough examination of a patient and often requires long-lasting, slow approaches towards healing. This examination is intensive and requires a strong, healing and therapeutic relationship between the patient and their doctor. In fact, in the initial functional medicine appointment, you may have already filled-out extensive paperwork discussing your signs and symptoms, diet and lifestyle, former drug and supplement use, history of disease, family history, exposures to toxins, environmental triggers, etc. This information can help guide a long, thorough discussion with the patient that results in a comprehensive timeline, detailing antecedents/triggers/mediators of disease and lifestyle factors.
The ATMs
Antecedents are the predisposing factors that may lead to a particular disease. They can include age, gender, family history, intrauterine history, genetics, former diseases, infections, abuse, trauma, etc.
Triggers are what provoked the disease and its symptoms. Triggers can often be interrelated to antecedents as a stressful event (trauma or abuse) could also be a single trigger, while infections, intestinal permeability, dysbiosis, medications, and/or toxins could also indicate a triggering moment. Triggers can be difficult and sensitive to explore with patients. You may be asked, “When do you think these symptoms began?” or “When was the last time you felt well?”
Mediators are psychosocial or biochemical mediators of the disease: something that perpetuates the condition. For instance, obesity, dysbiosis, intestinal permeability, poor belief about oneself and condition as well as inflammatory cytokines can all mediate illness.
Once antecedents, triggers and mediators are elicited from the patient and their story has been mapped onto the Functional Medicine timeline, a truly personalized discovery can begin.
The FM Matrix
The Functional Medicine matrix is used to map out the core clinical imbalances at play. These seven imbalances include assimilation, defense/repair, communication, transport, biotransformation and elimination, energy and structural integrity. Many of the patient’s ATMs and timeline indicators will overlap with various clinical imbalances.
You may have one clinical imbalance that is present in various disease states such as heightened stress levels which can lower gut integrity, increase inflammation, increase mitochondrial dysfunction, decrease proper hormone production, reduce detoxification pathways, etc.
You may also have various clinical imbalances that impact one disease. Chronic disease is ridden with complexity as each system interacts with each other. For instance, a patient with Type 2 diabetes may suffer with:
- Assimilation: nutrient malabsorption, vitamin deficiencies, low iron, low B12
- Defense/Repair: heightened inflammation
- Communication: hormone dysregulation, estrogen dominance
- Transport: dysglycemia
- Biotransformation and Elimination: increased toxicity from Standard American Diet, poor phase I/II pathways
- Energy: increased fatigue, exercise intolerance
- Structural Integrity: intestinal permeability, poor membrane integrity
We are at the crux of the evolution of medicine.
Instead of serving individuals with 15 minutes of cold, one-sided conversation, functional medicine breathes life into the healing process and helps to harness individuals with the tools and empowerment to sustain lifestyle changes. Medicine should involve rapport, effective communication, reflective listening and empathy. Functional medicine searches for the root causes of a patient’s illness which are intricately woven in their personal story. Functional medicine asks why (genetic, biochemical and lifestyle factors) and truly listens. When the imbalances are unearthed, restoration and healing can begin. Without exploring the individual, we cannot help support and heal the biochemically-unique person with a personalized protocol.
Happy healing! ♥