What is Functional Medicine? What do Functional Medicine Doctors do?
Treat the Root Cause, Not Just Symptoms.
In conventional medicine, a visit to the doctor’s office is generally centered around answering the question, “What does this patient have?” Once a diagnosis is determined, a treatment plan is developed based on the diagnosis. Functional Medicine practitioners focus on answering the question “Why does this patient have these symptoms?” Or in other words, “What is the root cause?”
“Functional Medicine determines how and why illness occurs and restores health by addressing the root causes of disease for each individual.
The Functional Medicine model is an individualized, patient-centered, science-based approach that empowers patients and practitioners to work together to address the underlying causes of disease and promote optimal wellness. It requires a detailed understanding of each patient’s genetic, biochemical, and lifestyle factors and leverages that data to direct personalized treatment plans that lead to improved patient outcomes.
By addressing root causes, rather than symptoms, practitioners become oriented to identifying the complexity of disease. They may find one condition has many different causes and, likewise, one cause may result in many different conditions. As a result, Functional Medicine treatment targets the specific manifestations of disease in each individual.” – The Institute for Functional Medicine
Assess the Environment & Lifestyle Factors Driving Disease
Getting to the root cause of a symptom or disease requires identifying systemic physiologic imbalances and an in-depth investigation of an individual’s environment and lifestyle. Despite what we used to think, our lifestyle and environment, not our genes, has the largest impact on our development of disease. Everyday our lifestyle and environment bathe our genes in information, and our genes respond accordingly producing either expressions of health or “dis-ease.” Thus, the job of the Functional Medicine practitioner is to look for imbalances occurring in the body and identify the areas of lifestyle and environment that are causing those imbalances.
Identify Imbalances in the Body
The following are the seven physiologic systems that Functional Medicine practitioners assess in order to identify imbalances in the body that are driving symptoms/disease.
- Assimilation: digestion, absorption, microbiota/GI, respiration
- Defense and repair: immune, inflammation, infection/microbiota
- Energy: energy regulation, mitochondrial function
- Biotransformation and elimination: toxicity, detoxification
- Transport: cardiovascular and lymphatic systems
- Communication: endocrine, neurotransmitters, immune messengers
- Structural integrity: subcellular membranes to musculoskeletal integrity
Having identified the predominant areas of imbalance for an individual, Functional Medicine practitioners then work collaboratively with the patient to investigate lifestyle and environmental factors that may be causing and/or exacerbating the problem. Dr. Mark Hyman outlines five causes of illness (environmental & lifestyle) that interact with genes to influence the 7 core physiological systems.
Address the 5 Causes of Illness
- Toxins (biologic, elemental, synthetic)
- Allergens (food, mold, dust, animal products, pollens, chemicals)
- Microbes (bacteria, yeast, parasites, worms, prions, etc)
- Stress (physical or psychological)
- Poor diet (standard American diet, or SAD)
What is unique about the Functional Medicine approach?
Functional Medicine practitioners utilize cutting-edge research to guide investigation of the root cause of symptoms and disease and fuse the best practices in conventional and “alternative” medicine to address the underlying physiological imbalances driving disease. Generally speaking, Functional Medicine practitioners spend more time with patients in order to understand the uniqueness of their history and lifestyle,
Provide Patient-Centered Care (instead of Disease-Centered)
Practitioners promote health as a positive vitality, beyond just the absence of disease. By listening to the patient and learning his/her story, the practitioner brings the patient into the discovery process and tailors treatments that address the individual’s unique needs. Functional Medicine practitioners realize that two people with the same symptoms or disease could have developed them from very different environmental causes, which is why it is absolutely necessary to understand the patient’s environment and tailor the treatment accordingly.
Use an Integrative, Science-Based Healthcare Approach
Functional Medicine practitioners look “upstream” to consider the complex web of interactions in the patient’s history, physiology, and lifestyle that can lead to illness. The unique genetic makeup of each patient is considered, along with both internal (mind, body, and spirit) and external (physical and social environment) factors that affect total functioning. The goal for the Functional Medicine practitioner is to identify potential causes of illness (toxins, allergens, microbes, stress and poor diet), rather than provide a conclusive “diagnosis” that has a prescribed pharmaceutical treatment. In Functional Medicine, a “diagnosis” is only just the beginning!
Fuse Best Medical Practices
Functional Medicine practitioners combine traditional Western medical practices with what is sometimes considered “alternative” or “integrative” medicine, creating a focus on restoring balance and prevention by addressing diet and nutrient status, inflammation, exercise and movement, stress, toxin exposures, genetic considerations, etc; use of both standard and specialty laboratory and diagnostic testing; and prescribed combinations of nutraceuticals, botanicals, therapeutic diets, detoxification programs, and/or stress-management techniques.
Functional Medicine vs. Conventional Medicine: How Functional Medicine is Different
Conventional medicine doctors primarily treat their patients with a drug-centered approach, and break the problem into individual components by treating each issue with a separate medication. This is perfect when it comes to acute issues like a broken leg or infectious disease, but not so much when it comes to the epidemic of chronic diseases such as obesity, cardiovascular disease, cancer, diabetes, arthritis, Crohn’s disease, autoimmune issues, etc. Functional Medicine considers all aspects of life including genetics, sleep quality, diet and nutrient status, exercise, environmental and toxin exposures, and stressors to identify the root cause(s) contributing to inflammation, hormonal imbalances, immune dysfunction, suboptimal detoxification, and alterations in our microbiomes, etc. And then we treat those imbalances, dysfunctions, and alterations accordingly.
A Comparison of the Approaches of Functional and Conventional Medicine
Below is an example of how conventional medicine would treat a case compared to how we would treat it with a functional medicine approach. The patient is a 56 year old male, struggling with high blood pressure, high cholesterol, heartburn, joint pain, and type 2 diabetes.
Conventional Medicine Approach |
Functional Medicine Approach |
| Prescribe blood-pressure medication: have been linked to an increased risk of cancer, back pain, and headaches | Evaluate and address stress, gut health, nutrient status, toxin exposures, sleep quality. High blood pressure is often the result of nutrient deficiencies, inflammation, and chronically elevated stress hormones. |
| Prescribe cholesterol medication: increases risk of type 2 diabetes and joint pain; only decreases risk for heart-attack by less than 2% | Evaluate and address gut health, phase 1 and 2 Detox pathways in the liver, nutrient deficiencies, toxic burden, stress hormones, and medicine that may be contributing to endocrine dysfunction. Suboptimal thyroid function is often a contributor to elevated cholesterol levels, as is inflammation, gut dysbiosis, and high toxic burdens. |
| Prescribe diabetes medication although insulin: can actually worsen type 2 diabetes in the long run | Evaluate and address gut health, detox pathways, nutrient deficiencies, inflammation, sleep quality, adrenal function and stress hormones, toxin exposures, etc. Diabetes is an inflammatory condition with many lifestyle and environmental mediators. |
| Suggest non-steroidal anti-inflammatories for joint pain such as ibuprofen: can damage the all-important gut lining and lead to bleeding ulcers, heart attacks, and strokes | Evaluate and address gut health and GI function, adrenal function, hormonal balance, etc. Encourage anti-inflammatory foods and supplementation. Consider possible food intolerances and have patient complete an Elimination and Reintroduction Diet. |
| Prescribe acid blockers for heartburn: this inhibits the stomach’s ability to make acid needed to digest food and resist harmful bacteria; long-term use is linked to osteoporosis and nutritional deficiencies | Monitor and maintain improvements: if heartburn does not clear up after a whole foods diet, integrate digestive enzymes, strategic probiotics, bone broth and other gut rejuvenation therapies. Consider having patient complete an Elimination and Reintroduction Diet. Eliminate alcohol and caffeine, address stress and sleep. |
| Taking all of these drugs together can cause adverse interactions or toxicities such as confusion, which can be misdiagnosed as Alzheimer’s in older patients | By avoiding the “pill for an ill” approach, our patients can avoid the long-term effects these medications eventually cause such as neuropathy, depression, heart disease, and thyroid disorders. Treating the root causes of symptoms and conditions can help patients avoid using medications that have many side effects. |
Functional Medicine Doctor vs. Naturopath
What is the difference between a Functional Medicine doctor and a Naturopath or Integrative doctor?
While conventional medicine often treats symptoms with a pill or procedure, naturopaths and other “natural,” “holistic” or “integrative” practitioners opt for more natural treatment alternatives. What’s important to note is that while the treatments may be more natural, the approach may still be “a pill for an ill,” except in place of a pharmaceutical the pill is a supplement, herb, essential oil, etc. In this way, the “natural” approach can still fall short as practitioners often continue to treat symptoms, not taking the time and diligence to uncover and address the underlying imbalance and root cause. A practitioner trained in Functional Medicine seeks out the underlying drivers of symptoms and disease and then fuses the best of both conventional and alternative medical research in order to address the cause.
How are Functional Medicine doctors trained?
Dr. Amy Beard at the 2018 IFM Annual Conference
Functional Medicine is an approach to treating disease and optimizing health, as opposed to a specialized area of focus like cardiology or gynecology. Many licensed health care professionals are eligible for becoming certified in a Functional Medicine approach: doctors, nurse practitioners, naturopaths, dietitians, acupuncturists, etc. Thus, a Functional Medicine practitioner’s scope of practice is based on what their license allows them to do. A certification in Functional Medicine simply means that the practitioner has been trained in using that approach with their current license and specialty. For this reason, it’s important to understand a practitioner’s license and how they have been trained in Functional Medicine.
While there are several practitioner training programs in Functional Medicine, the most respected and well-established is provided by the Institute for Functional Medicine. This certification program takes most practitioners about 1.5-2 years to complete. It requires the completion of seven courses (each with 15-30 hours of lectures), a case report and a written exam.
How to Find and Pick Good Functional Medicine Practitioner
So now you might be thinking, how do I find the best functional medicine doctor for me? Here’s what I recommend when looking for the right Functional Medicine practitioner…
- Check their medical background and license. As mentioned earlier, many licensed health care professionals are eligible to get certified in Functional Medicine. While a credible certification in Functional Medicine is excellent training, it’s equally important that you trust the initial medical training and license. You can read about Dr. Beard’s credentials, experience and personal Functional Medicine journey here.
- Make sure they are actually certified in Functional Medicine. As the popularity of this approach grows, more and more health care professionals are advertising Functional Medicine on their websites. Some even say they have been “trained in Functional Medicine” in their biography. My recommendation is to look for a practitioner that has completed the IFM certification. That ensures they have completed all content modules, passed the exam and are involved in continuing Functional Medicine education. You can find certified Functional Medicine practitioners on the IFM website here: https://www.ifm.org/find-a-practitioner/
- Look for a practice with health coaches and/or dietitians. Functional Medicine recommendations can be very comprehensive and require a lot of dietary and behavior changes. A well-designed practice will recognize that behavior change is a major component of patient success and provide consultations with supporting health care professionals like coaches and dietitians. You can read about our team here.
- I recommend finding someone with a conservative testing philosophy. Since Functional Medicine consultations and testing are not always covered by insurance, it can get expensive quickly. Some practitioners insist on doing comprehensive lab testing upfront, despite signs/symptoms that can (and likely should) be addressed with diet and lifestyle first. There’s definitely a place for advanced diagnostic testing in Functional Medicine, but I’ve found that I’m able to help many clients with minimal or no lab testing, so you’ll want to find a practitioner whose testing philosophy is balanced.
Functional Medicine is not a specialty, it’s an approach that works for everyone.
Functional Medicine is an approach that supports the unique expression of health and vitality for each individual and recognizes the mind and body as one, interconnected system. In this way, a Functional Medicine workup can be beneficial for everyone.
Our patients come to us from all walks of life—those suffering from chronic diseases, competitive athletes, young women, older men, children, and everyone in between. Functional Medicine clinicians spend a lot of time with their patients, listening to their histories and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and contribute to complex, chronic disease.
Will Functional Medicine work for my condition?
All symptoms and diseases have a cause(s). The Functional Medicine approach is designed to uncover and address the cause(s) of symptoms and disease for the given individual. This requires looking beyond signs and symptoms to identify the fundamental imbalances in the body and what might be causing those imbalances. For this reason, Functional Medicine can be beneficial to anyone suffering chronic symptoms, whatever the diagnosis. Remember, two people with the same diagnosis might have different causes; and two people with different diseases may have developed them from the same environmental trigger!
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