What is Functional Medicine?
Functional medicine is commonly referred to as root cause medicine, identifying the underlying cause, the reasons for a person’s health challenge.
Functional medicine is going back to the roots of medicine, it is going back to the science of physiology and biochemistry, which are the one common denominator and common thread that joins all the healing arts and schools of medicine.
The Primary Premise of Functional Medicine
Function = Health
Improve function => improve health.
How Did We Lose Our Roots?
How did we lose our roots and how did conventional medicine deviate so far off the course?
Dr. Grisanti gives the example of a conference he attended where MDs were excited to be learning functional medicine, saying they were so frustrated with just treating patients with prescriptions, they knew there had to be a better way
They understood that that is not why they went to medical school, they went to medical school to help people get well. It is not that they were against medicines but there obviously had to be other reasons why a person continued to be sick and they were tired of consistently writing scripts every 3 months for the same problem over and over again.
The whole emphasis of functional medicine is to focus on the patient and not necessarily on the xyz-named disease. Let’s treat the patient with the disease and not the disease. Focus on what has led to the development of the disease.
Iceberg Analogy for Named Diseases
He gives the example of the tip of the iceberg showing above the water, but the largest part of the iceberg being below the surface of the water.
The tip of the iceberg: what you see at the tip of the iceberg are the named diseases such as diabetes, arthritis, fibromyalgia, autoimmune disease, heart disease.
But below the surface: is where you find some of the possible underlying causes of a person’s disease entity. It could indeed be: An inflammatory imbalance, Hormonal imbalance, Mitochondrial imbalance, Toxic chemical exposure, Digestive issues, Toxic emotions, Structural imbalances
- We evaluate WHY do they have the high blood pressure?
- We do our due diligence: history, examination, run the appropriate testing and here is what we found in many cases – patients may have some deficiencies, maybe potassium / magnesium deficiencies. The patient may have a heavy metal toxicity such as a cadmium toxicity which many times can be responsible for elevated blood pressure.
- What I’ve seen in my office over and over and over again are patients that come in on medications, we start identifying the underlying causes and lo and behold guess what the blood pressure starts to naturally drop down lower and lower.
He explains that what lies beneath the surface can be the most significant contributing factors to a disease, but if the doctor is just looking at the tip of the iceberg then the patient cannot receive the highest level of health improvement.
It is identifying these underlying issues, which indeed are many times the primary contributing factors to these named diseases.
So You Think Your Docs Are Testing You?
**My personal views on this: Of course most doctors believe they are giving tests and looking under the surface, but an important point here is the advanced functional medicine laboratories such as Genova and Cyrex are offering advanced extra testing looking for more underlying causes and using different markers for chronic illnesses and they go way beyond the current standard medical care which is missing underlying causes and often not even looking for them... In some ways it is like the annual NCT or MOT for your car, there is a basic test that says you are roadworthy, however many important things are not on that test, then when something major happens to the engine you don't fall back on the fact 'well it passed the NCT/MOT', because you know that was a certain minimal basic range of tests - basic tests however - However, your doctors don't seem to know how basic their tests are and go on to apply that basic set of tests to your entire health scenario.
Which is why ‘healthy people’ suddenly come down with cancer or some life threatening disease ‘out of the blue’!
No such thing as ‘suddenly’ or ‘out of the blue’! They simply weren’t looking at what was going on the whole time, the regular doctors and hospital consultants just look at the tip of the iceberg and think they are going all the way down but no, not at all.
Most major illnesses have been growing over a decade before they manifest to something they can show on their regular hospital tests. Of course this means many people could be preventing the horrors of certain emergency treatments for cancer and heart bypass, etc.
For the record, these advanced functional medicine laboratories have been around 20-30 years, so there’s a bit of an issue that the general public have not been made aware and doctors still view this as ‘optional’ training. In my own case I’m sure if they’d used even the most basic functional medicine testing that I would not have had an adverse reaction to an anesthetic which nearly claimed my life, as I had told the doctors I thought I wasn’t suitable and had allergies but ‘nothing that officially rang a bell for them’ as they weren’t looking too closely as physiology and biochemistry.
Dr. Grisanti says of the current medical philosophy:
Applying emergency medicine thinking to long chronic health problems has failed to produce positive clinical outcomes. If someone is suffering with a heart attack, a gunshot wound, pneumonia, you absolutely want a quick thinking doctor – that is acute care. Understand that acute care treatments so often do not succeed in helping those patients with chronic problems.
You can’t take the same thinking process of an acute medical management and apply those same thinking principles to long term chronic health problems such as diabetes, autoimmune disease, heart disease.
That is why you are seeing a large number of traditional physicians moving into the realm of functional medicine.
Two-Pronged Healing Approach
When we think of functional medicine there is a two-pronged healing approach.
- Number one is we identify what needs to be added to the body to nudge a person’s physiology back to an optimal state.
- And the second component is remove anything that is blocking or impeding the physiology and biochemistry from working effectively.
Your body is always striving towards a state of health.
You simply need to investigate what is lacking and what is blocking the physiology and biochemistry. The things needed by the body to function at its best may be missing or something may be standing in the way.
It is really that simple but not always that easy. It takes the doctor who is more like a Sherlock Holmes and a CSI agent to turn a chronic health problem around.
It could be amino acids, fatty acids, omega 3s, omega 6s, omega 9s, vitamins, minerals, enzymes, exercise, oxygen, water, it could be getting enough sleep…
All these are essential that need to be added, and these need to be investigated to find out if the person indeed needs these or is lacking these.
Next we have what possibly could be impeding or standing in the way of a person’s body not achieving optimal functions? Well there’s a number of things, it could be:
- Microbial pathogens
- Bacterial pathogens
- Mold, fungal
- Environmental toxins, such as benzene, xylene, PCBs, pesticides
- Heavy metal toxins, lead, mercury, aluminum, cadmium
- Emotional poisons – anger, worry, frustration, jealousy, etc
- Structural/Neurological stress – nerve interference
- Medication reactions and side effects
- Toxic stress – family, work, financial, marital issues
- Food sensitivities – gluten, dairy, wheat issues
- Glycemic imbalance – not having a proper ratio of carbohydrates to proteins
- Bioenergetic interference – we’ve all heard of acupuncture and meridians
So the next question is how do we determine that, how do we determine what needs to be added and what needs to be removed in order to allow the body to achieve a higher level of function?
- First and foremost it is a comprehensive history. That is part of what you will be doing, when you are filling out the history you will see how comprehensive it is. 90% of a clinical diagnosis is a history, no physician will argue with that.
- Second is a physical examination, both the traditional physical exam as well as a functional exam.
- Next is laboratory testing:
–> Blood testing | Urine testing | Salivary testing | Stool testing
Who Offers These Tests?
There are a growing number of advanced functional labs that offer innovative advanced testing to zero in, to carefully identify some of the underlying issues which are contributing to xyz disease. Examples include Genova, Cyrex, Metametrix, DoctorsData, to name but a few.
Manipulating Physiology – Conventional vs Functional Medicine
Conventional medicine’s primary focus is to treat the symptoms. If the patient stops the medicine especially for chronic problems, emphasis chronic problems, most of the medication or intervention for chronic problems is to reduce the symptoms. If a patient stops the medicine the symptoms will return.
Functional medicine’s approach is different: instead of masking the problem, the power of functional medicine is finding the root cause. That is where it shines in helping return optimal physiology and biochemistry.
Functional Medicine Uses Medications as Supports Only…
- The doctors who practice functional medicine still use medication but the difference is that the medication is used to nudge the physiology and biochemistry back to an optimal state while at the same time carefully monitoring the patient through testing to determine when the physiology has reached an optimal state.
Functional Medicine Vs Conventional Medicine in Clinical Practice
Dr. Grisanti proceeds to give some examples for a greater appreciation of exactly how functional medicine works in a clinical practice, with examples of high blood pressure, acid reflux, sinusitis.
Example #1: A patient with high blood pressure
Conventional Medicine: The patient may be on 1, 2, maybe 3 medications – an ACE inhibitor, a beta blocker, they may be on a calcium channel blocker, on a diuretic, and the primary emphasis is to lower that blood pressure, which is fine if the patient’s blood pressure is significantly elevated you definitely a physician who can prescribe the right medication to make sure you don’t get a stroke.
Functional Medicine: but here is where it is different with functional medicine:
- We evaluate WHY do they have the high blood pressure?
- We do our due diligence: history, examination, run the appropriate testing and here is what we found in many cases:
1. Patients may have some deficiencies, maybe potassium / magnesium deficiencies.
2.The patient may have a heavy metal toxicity such as a cadmium toxicity which many times can be responsible for elevated blood pressure.
What I’ve seen in my office over and over and over again are patients that come in on medications, we start identifying the underlying causes and low and behold guess what the blood pressure starts to naturally drop down lower and lower.
Because we have identified the underlying problem the patient can then, working with their physician, gradually get off the medications.
Example #2: Sinusitis / Chronic Sinus Infections
Conventional Medicine: Patients with sinusitis, chronic sinus issues, they are on antihistamines, on steroidal medications – remember applying acute management to a chronic problem.
Functional Medicine: We evaluate the patient:
- The patient may have some GI problems which contribute to the sinusitis.
- We’ve had patients with fungal infections which has led to the sinusitis.
We eradicate and treat the underlying cause, the sinus problem gets better, the patient doesn’t need the medication because the underlying root cause has been treated.
Example #3: GERD / Acid Reflux
Conventional Medicine: the patient with acid reflux, sometimes called GERD gastrointestinal reflux disease, is on Nexium or Prilosec.
Functional Medicine: We evaluate the patient, I’ve seen patients with these particular problems have H. pylori which is a bacterial infection. We get the patient appropriately treated, eradicate the H. pylori, the acid reflux improves.
Back to Conventional Medicine’s Original Roots
Dr. Grisanti quotes Dr. William Osler, introducing him as:
Dr. Sir William Osler was the most influential physician in history. The first professor of medicine in Johns Hopkins University. He was published extensively and built an international reputation as an astute clinician.
- He was quoted as saying, it is much more important to know what sort of patient has the disease than what sort of disease a patient has.
- He was also quoted saying, if you listen carefully to your patient they will tell you the diagnosis.
- And one of the most impactful quotes was this: the good physician treats the disease, the great physician treats the patient who has the disease.
Back to Basics Healthcare
So in summary, functional medicine is basically getting back to the basics of healthcare, to root cause medicine. You’ve heard me say it over and over and over again but:-
Its focus is in the identification of the underlying root causes of why a person is sick to begin with.
*If you’d like the full pdf transcript to the video What is Functional Medicine by Dr. Ron Grisanti then email me at this address: firstname.lastname@example.org
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