Functional medicine is a systems biology–based approach that focuses on identifying and addressing the root cause of disease. Each symptom or differential diagnosis may be one of many contributing to an individual’s illness. There can be subclinical signs and symptoms of dysfunction that don’t add up to a recognized established diagnosis in traditional western medicine. For example, lab values for a patient may be in the normal range, yet symptoms indicating dysfunction are present. The body will do all it can to maintain normal blood levels for minerals, hormones, electrolytes, proteins, and other components of the blood. When something is out of normal range on a blood test, it signifies a problem that has been there a while. The body has broken down so much that it cannot even hold blood values in the normal range. Functional medicine recognizes problems before a person reaches that point; and even if it is after that point is reached, there are several methods to be applied that can help.
The main component of most disease is inflammation. How does it occur? There are few heavy hitters when it comes to inflammation: Food sensitivities, infectious pathogens, and exposure to toxins.
Food Sensitivities: These are immune reactions to specific proteins and sugars that are contained in food. It is not as sever as a food “allergy” where anaphylactic shock results, but instead an inflammatory response that may or may not be obvious to the person. For example, wheat has a couple proteins in it called gluten and gliadin. In a person with leaky gut, these proteins slide through the gaps in the gut lining. The body sees these as foreign invaders similar to that of a bacteria or virus and attacks it while making antibodies in the process. With chronic eating of wheat and exposure to these proteins comes chronic inflammation in the gut and throughout the body. A common symptom is joint stiffness, pain, and sometimes swelling.
Pathogens: These comprise of bacteria, viruses, fungus, yeast, and molds. There are several ways for these to enter the gut and create inflammatory reactions. One is inadequate stomach acid due to stress, advanced age, or both. Stomach acid is critical in disinfecting the food we eat. If pathogens make it through to the intestines, the dark, moist, and warm environment is perfect for proliferation of yeast and fungus. One example is Candida. If candida is allowed to grow in the gut, it creates toxins that attack the gut lining and make it “leaky.” In treating this type of pathogen, it is important to kill the bad bacteria while replacing the good bacteria; as well as change the diet. Yeast and fungus love sugar and alcohol and diet modification is critical in treating this condition.
Toxins: Everything from our food, cleaning supplies, household goods, furniture, carpet, auto interiors, fumes from the gas pump, heavy metals, and water/air toxins are a burden on our systems. Detoxification systems in the body have never been so in demand in the history of man. Without good detoxification, these poisons accumulate in the body and if present long enough, will cause chronic issues. For example, heavy metals have been shown to cause neurological damage and degeneration. Glyphosphate has been shown several times over to be carcinogenic and is banned in most European countries; yet now it can be found in the most remote mountain stream.
All of these components combined with leaky gut (increased gut permeability) cause specific unexpressed genes to become active. This “perfect storm” can lead to autoimmune conditions that seem impossible to overcome. Hashimotos thyroiditis, psoriasis, rheumatoid arthritis, Lupus, and other conditions can develop. These genes have “on/off” switches which are mostly activated by components in the food we eat. So diet modification is a huge component in “putting the fire out” and reducing chronic inflammation. This field of study is referred to as “Epigentics” or “Nutrigenomics.”
The field of “Functional Medicine” has expanded dramatically over the last decade. It is becoming more clear that the body’s physiology and its response in dealing and recovering from the stresses of the 21st century is a critical player in chronic disease.
Although western medicine is very good at saving lives in emergency situations with drugs and surgery, it is limited in its long term solutions for chronic conditions and overall health. Medical students receive an average of 19.6 hrs of nutrition training during their arduous study in medical school (AAMC.org); yet their hours of study in pharmaceuticals are much higher in actual classes and during clinic rotations. Dependent on the interests of the doctor, they may study nutrition post-grad and on their own, whereby they are much more versed it the area, however, it is a small minority of the medical profession.
I use labs to help with the diagnosis of several issues. Organic Acids Test measures metabolites in the urine that can describe the situation in the gut. Molds, fungus, yeasts like Candida all release toxins that are excreted in the urine and these can be measured. Also used are saliva tests for adrenal and reproductive hormones. These test have several samples taken throughout the day (adrenal) or throughout a menstral cycle. Having several samples can give us much more information of the status of hormones throughout a normal cycle. A blood test or a single saliva sample is a snapshot in time and can be helpful, but it lacks the detail of the changes in hormones during the cycle. Some of these labs may be covered by insurance depending on the policy.