According to the Institute for Functional Medicine, the world’s leading educational resource for both patients and practitioners, Functional Medicine involves understanding the etiology, prevention, and treatment of complex, chronic disease. It is an integrative, science-based healthcare approach that treats illness and promotes wellness by focusing assessment on the biochemically unique aspects of each patient, and then individually tailoring interventions to restore physiological, psychological and structural balance.
There are seven basic principles underlying the functional medicine approach:
1. Science-based medicine that connects the emerging research base to clinical practice.
2. Biochemical individuality. Each person is genetically and environmentally unique, which affects how she or he expresses both health and disease.
3. Patient-centered care (rather than disease-centered) means that the person is the focus of care, not the diagnosis.
4. Dynamic balance describes the ever-changing relationship between internal (mind, body and spirit) and external (physical and social environment) factors that affect total functioning.
5. Web-like interconnections among the body’s physiological processes also affect every aspect of a person’s functionality. Diabetes, for example, affects the heart and hormone systems (and is affected by them).
6. Health as a positive vitality. The functional medicine practitioner wants to know: Do you feel really well, full of vitality and zest for life?
7. Promotion of organ reserve. Your heart, lungs, glands, and everything in your body can achieve greater stamina, better recovery from illness, and a longer health span, not just a longer “life span.”
Using these principles, Functional Medicine practitioners focus on understanding the fundamental physiological processes, environmental inputs, and genetic predispositions that influence every patient’s experience of health and disease.
Environmental inputs include the quality air and water, the particular diet, quality of the food available, physical exercise, psycho-social factors, and toxic exposures or traumas a patient may have experienced.
Genetic predisposition is not an unavoidable outcome. Genes may be influenced by everything in the environment, plus a person’s experiences, attitudes and beliefs. That means it is possible to change the way genes are expressed (activated and experienced).
Fundamental physiological processes keep us alive. They involve cellular communication; energy transformation; replication, repair, and maintenance; waste elimination; protection/defense; and transport/circulation. These processes are influenced by environment and by genes. When they are disturbed or imbalanced, they lead to symptoms that can lead to disease if effective interventions are not applied.
Most imbalances in functionality can be addressed; some can be completely restored to optimum function and others can be improved substantially. Virtually every complex chronic disease is preceded by long-term disturbances in functionality that need to be identified and managed effectively — the earlier the better.
The Institute for Functional Medicine teaches practitioners how to assess a patient’s fundamental clinical imbalances through careful history-taking, physical examination, and laboratory testing. Course attendees are taught to evaluate:
Hormonal and neurotransmitter imbalances
Redox imbalances, including oxidative stress and mitochondriopathy
Detoxification, biotransformation and excretory imbalances
Digestive, absorptive and microbiological imbalances
Structural imbalances at the cellular and whole body levels
Nutritional and dietary imbalances
Mind/body imbalances, including stress
Once an assessment has been made, the Functional Medicine doctor examines a wide array of interventions and selects those with the most impact on underlying functionality. Changing how systems function can have a major impact on the patient’s health.
Lifestyle is an important factor. Research estimates that 70 to 90 percent of the risk of chronic disease is attributable to lifestyle. That means what you eat, how you exercise, what your spiritual practices are, how much stress you live with (and how you handle it) are all elements that must be addressed in a comprehensive approach. So the patient becomes an active partner with the
Functional Medicine practitioner. You may be asked to make dietary and activity changes that, when combined with nutrients targeted to specific functional needs, will allow you to really be in charge of improving your own health and changing the outcome of disease.
Functional Medicine practitioners represent all the major healthcare disciplines – there are doctors such as MDs, DOs, NDs and DCs with Functional Medicine training. Nurses, dietitians, nutritionists, acupuncturists and other disciplines are represented in the Functional Medicine community. Within the scope of practice of their own particular disciplines, Functional Medicine practitioners may also prescribe drugs, botanical medicines or other nutraceuticals. They may suggest a special diet, a detoxification protocol, physical medicine intervention, or a stress management procedure. The good news is that when you look at functionality, you uncover many different ways of attacking problems — you are not limited to the “drug of choice for condition X.”
The following quotations exemplify some of the points made above:
“…we have been able to identify modifiable behavioral factors, including specific aspects of diet, overweight, inactivity, and smoking that account for over 70 percent of stroke and colon cancer, over 80 percent of coronary heart disease, and over 90 percent of adult-onset diabetes.” [Willett, WC. Science, 2002:296, 695-697]
“…that a disease is complex or multifactorial does not imply that simple solutions cannot be found or that clinical advance following insight cannot be swift.” [Rees, J. Science, 2002; 296:698-701]
“Inherited genetic factors make a minor contribution to susceptibility to most types of neoplasms. This finding indicates that the environment has the principal role in causing sporadic cancer.” [Lichtenstein, P et al. NEJM, 2000; 343:2, 78-85]΄