What Is Functional Medicine?

Functional medicine has become the latest craze in the health and wellness space. But what exactly does it mean? What is functional medicine, and how is it different from the conventional medicine we all know? Does it actually work, or is it all woo-woo and crystal healing?

I’ll admit that before I started this journey, I was skeptical of another approach to medicine besides the one I was taught. I thought that the only “real doctors” were the ones who went down the traditional road like I did: four years of medical school to get an MD; four or more years of residency to specialize, and THEN you could be a “real doctor.” I’d never considered any other approach to medicine.

Until I began to see some holes in conventional medicine.

Over the years I’ve been in private practice, my patients were showing up to the operating room sicker and sicker, with more decompensated chronic diseases. In fact, six out of ten adults have one or more chronic disease, and 88% are metabolically unhealthy. If conventional medicine is so effective, wouldn’t we all be getting healthier over time? That’s not what was happening at my hospitals.

So that’s when I began to look around for another approach that could actually help prevent people from needing medical care in the first place. The bias of conventional medicine is to “name it, blame it, tame it.” In other words, it tells you what disease you have and what drugs to take to treat your symptoms, but we often do very little to treat the underlying cause of why you got sick to begin with.

Now don’t get me wrong, I think conventional medicine is fabulous for what we call “acute care.” In other words, if you are having a heart attack or get hit by a truck or need surgery, that’s not the time to call a functional medicine doctor. But for chronic, preventable diseases, I do think functional medicine is an underutilized gem, and I’m happy to see is getting more traction. Let me explain it to you.

Functional medicine is different in a few specific ways. First, conventional medicine separates the body into independent silos. If you have a problem with your brain, you see a neurologist. Kidneys? A nephrologist. Diabetes? Endocrinologist. Mood? Psychiatrist. And so on. By contrast, functional medicine recognizes the interconnection between these systems and treats a patient’s individual dynamics. A whole host of different symptoms could have one root cause. And one symptom could have many underlying causes, and both external and internal factors matter. The goal is to figure out what a patient needs less of (and eliminate the bad stuff), and what a patient needs more of (and put in the good stuff).

So here’s what you can expect if you go to see a functional medicine doctor. First and foremost, they will make you tell your story. The timeline is one of the most important elements of a patient’s history because it shows the spectrum between when you felt well and when you felt poorly, and it can often identify risk factors for a disease as well as certain circumstances that have triggered your symptoms. “Antecedents” is the functional medicine term for things that predispose you to illness, such as family history, trauma, and antibiotic use. “Triggers” are things that provoke your symptoms, such as toxins, a surgery, infection. And “mediators” are factors that contribute to making the disease worse or better, such as psychosocial stress or biochemical exposures.

Once the story is clear, a functional medicine doctor will identify the processes that might be contributing to your symptoms. Do you have a problem with defense and repair, such as infections, autoimmunity or inflammation? Or communication, such as an issue with hormones or neurotransmitters? The goal is to find out what is out of balance and restore it.

Lifestyle factors, of course, are the basis of functional medicine, not drugs, like conventional medicine. How you sleep, eat, and exercise affects your health significantly, as does the stress in your life and your relationships.  “Food is medicine” is a central functional medicine tenet, and given that only 28% of medical schools have a formal nutrition curriculum and that the average medical student receives less than 20 hours of nutritional instruction, I think conventional medicine is ill-equipped to answer the question of “what should I eat.”

To summarize, functional medicine seeks to identify and treat the root causes of a disease, viewing the body as one integrated system. It takes into account both internal and external factors of an individual’s unique circumstances, and seeks to restore and maintain health through nutrition, exercise, stress reduction and sleep to set a foundation of wellness. This is not to say that functional medicine doesn’t use drugs, but it’s typically not the first-line of treatment. In most cases, the ultimate goal would be to eliminate the need for drugs to begin with.

If you’d like to learn more about functional medicine, I’ve taken courses through the Institute of Functional Medicine. For patients, a well-known functional medicine practice that is widely available throughout the United States is called Parsley Health.

What is your experience with functional medicine, either as a practitioner or as a patient? Do you have any questions about it? Let me know in the comments!