Teri was in her late 40s when she first came to my functional medicine practice. For years she has struggled with fatigue, insomnia, weight gain, anxiety and joint pain. Because of recurrent indigestion, Teri generally felt better when she didn’t eat. She tried many types of diets: paleo, vegetarian, low carb—with little success and found the information available contradictory and confusing. She had been seen by several physicians. In addition to her primary care doctor, she was evaluated by a gastroenterologist, gynecologist and rheumatologist, but did not receive any specific answers. She rejected the antidepressant medication that was offered. She was frustrated.
How might functional medicine be different? Can it help Teri?
Attention to Prevention
Conventional medicine tends to be disease and symptom focused most often using pharmaceuticals and procedures. Different body systems (head/neck, digestive, reproductive, etc.) are treated by specialists. Practicing in conventional medicine for 25 years, I saw the advantage of deep expertise that comes with specialization. But I also witnessed the disadvantages that stemmed from fragmentation. Conventional medicine is great at addressing many types of illness. For example, with trauma, acute cardiac events or even some types of cancer, our high-tech health care can be amazing. However, there is minimal attention to prevention and when patients have more vague chronic symptoms that don’t fit neatly into our “diagnostic paradigms,” conventional medicine falters.
Functional medicine uses a patient-centered holistic approach recognizing that everything is interconnected. It more often employs natural modalities that support the body’s innate ability to heal. Beyond seeking ways to minimize symptoms, there is a focus on uncovering root causes. Functional medicine proactively seeks ways to help individuals reach their greatest health potential and wellbeing. We take time to go broad and deep to learn our patient’s story.
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With Teri, testing disclosed systemic inflammation and some nutrient gaps. Her gut microbiome (bacteria and yeast that live in our intestines) was imbalanced with overgrowth of certain bacteria that can be inflammatory. She was entering into menopause and had hormonal imbalances. Sleep disturbance, anxiety, weight loss resistance and joint pain can all be related to these underlying imbalances.
Together, we created an individualized plan to optimize her gut health and balance hormones. We used supplements to help support nutrients. Over time, Teri has instituted several lifestyle changes including a sustainable plant-forward clean diet, a daily meditation practice and improved sleep habits. Today Teri has much more energy and is calm. Her joint pain is gone and she is sleeping much better. Her renewed energy has helped fuel regular exercise. She is delighted with the eight pounds she has dropped.
While there are marked philosophical differences in approach to health between conventional and Functional Medicine, they can be complementary. Both are important and serve a purpose. Unfortunately, while many professionals in the Functional Medicine space recognize and respect aspects of conventional care, those in the conventional care space often regard Functional Medicine with skepticism and sometimes disdain. The term “alternative medicine,” often applied to Functional Medicine, tends to imply lack of validity or science. In fairness, there is a spectrum of practitioners that hang “functional medicine” signs, some perhaps deserving the “woo-woo” designation. Yet in my experience, my traditionally trained Functional Medicine physician colleagues are all about science and seek evidence when it can be found.
It is distressing that our healthcare constructs and payor systems have yet to recognize the true value of the approaches used in Functional Medicine. Insurance rarely covers the cost of such in-depth, time intensive and individualized care plans. While the successful and credible Cleveland Clinic’s Functional Medicine Center suggests that inroads are slowly being made, it seems unlikely that a similar holistic approach will be widespread within our entrenched healthcare systems any time soon. My hope is that small Functional Medicine practices that are taking root around mainstream medicine will flourish regardless, fueled by the desires of healthcare professionals and the needs of patients like Teri.
Perhaps then Functional Medicine is an alternative?
I find that every patient’s story offers a fascinating approach to healing and I look forward to sharing my learning and experiences with you through this column.
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