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WHAT KIND OF DOCTOR are you?”
It’s one of the most common questions I get when I lecture or travel.
People want to know: Am I an alternative doctor, an integrative doctor, a holistic doctor, a natural doctor?
I’m none of the above!
In fact, I trained as a family doctor because I was interested in everything and wanted to learn every part of medicine. I couldn’t see how the body could be separated into specialties. I just could not imagine that somehow all the symptoms people had were unrelated.
So I kept searching for a different approach.
I became interested in nutrition and diet as a way of helping improve the health of my patients and studied Chinese medicine, herbs, and alternative methods of healing.
But many of these methods fell short.
They are all part of what is called Green Medicine. Green Medicine uses an herb or drug or alternative treatment to treat a disease, as we understand it, in conventional medicine.
For example, using feverfew to treat migraines, or saw palmetto to treat an enlarged prostate, or glucosamine to treat arthritis, or St. John’s wort to treat depression can all be considered Green Medicine.
While these treatments might be less toxic and even effective in some people, they still don’t help us to understand and treat the individual, not the disease.
Finally, I discovered the type of medicine that I wanted to practice.
It’s called Functional Medicine, or Systems Medicine. And I believe that it’s the future of medicine. It is an entirely new GPS navigational system in the world of health and illness.
How is Functional Medicine different than alternative, integrative, or even conventional medicine?
First, let’s define the differences between all these different labels and types of medicine.
Alternative medicine includes ancient traditions and new techniques, such as Traditional Chinese Medicine, Ayurveda, homeopathy, herbal medicine, and newer health techniques such as chiropractic, energy medicine, and even orthomolecular medicine.
All of these systems can have great benefit in treating chronic disease. And these alternative modalities are often effective and complementary to other therapies.
In fact, the way they view health and disease is similar to that of Functional Medicine. Like Functional Medicine, many of these other types of medicine take into account web-like relationships between all aspects of a person’s health. That’s especially true for Traditional Chinese Medicine.
I have written about the similarity between Traditional Chinese medical theory and Functional Medicine.
While one uses ancient metaphors to look at patterns through the pulse, tongue, and energy of the body, the other looks at natural patterns in biology.
You see, the next step in the evolution of medicine requires us to deeply question the foundations of conventional reductionistic medicine, which focuses on naming diseases.
But Functional Medicine goes a step farther. It uses the latest scientific understanding about how our genetics, environment, and lifestyle interact as a whole system to diagnose and treat diseases based on patterns of imbalance and dysfunction — without treating the disease specifically.
Functional Medicine treats the person who has the disease, not the disease that the person has!
But what about integrative medicine?
Well, integrative medicine purports that we must integrate the alternative modalities I’ve mentioned into conventional medicine so that patients have the opportunity to receive all these modalities when appropriate. It means in part that patients can get acupuncture or herbs along with their drugs or surgery, for example.
This movement is now being taught in a growing number of medical schools and hospitals throughout the country, has been pioneered by the great visionary physician Dr. Andrew Weil, and is a good step forward in the evolution of medicine.
However, while integrative medicine still uses the basic ideas of conventional medicine as a base, Functional Medicine questions these ideas. You see, the next step in the evolution of medicine requires us to deeply question the foundations of conventional reductionistic medicine, which focuses on naming diseases. This foundation is useful — sometimes.
It allows physicians to name a disease and then find the drug or treatment for that disease. It works well for dramatic and sudden or acute diseases such as trauma, infection, and emergencies. Unfortunately, it fails miserably in the care of the chronic diseases that affect 125 million Americans.
Those conditions include allergic, digestive, hormonal, neurologic, and metabolic problems — which most of us suffer from on a daily basis. Thankfully, the advance of scientific understanding of biology has provided an opportunity for an entirely new way of approaching diseases based on systems thinking.
This new approach is called Functional Medicine.
So what exactly is Functional Medicine?
First, it is deeply science-based. It has emerged from new discoveries in what we call systems biology — the understanding of the deep interconnections of the basic systems of the body. Systems biology is so important that it’s a key part of the agenda of the National Institutes of Health (NIH) and their New Roadmap Initiative.
The director the NIH, Dr. Elias Zerhouni, is attempting to completely reorganize scientific research and knowledge around systems biology and is spending hundreds of millions of dollars toward this effort.
And that’s not all.
Entire new organizations, such as the Institute for Systems Biology (ISB), have been established to bring these discoveries to the consumer. Dr. Leroy Hood, the founder of the ISB, is a Nobel prize-winning biologist who has devoted his work to exploring this radical and paradigm-shifting notion.
“Studying the interaction and interplay of many levels of biological information, systems biology will enable us to not only cure complex disease but to predict an individual’s health and extend the human body’s natural lifespan by preventing diseases. The new era of predictive, preventive and personalized medicine– made possible by application of systems biology — represents a profound shift in the practice of medicine and will reach into many corners of our lives.”
That’s because, in systems biology, NAMING diseases becomes increasingly meaningless as we understand the inner workings and function of our cells and biological systems within the context of our entire organism. You see, disease occurs because of the body’s attempt to correct underlying imbalances. It is the body’s best attempt to deal with a difficult set of circumstances.
Doctors who practice Functional Medicine believe that health depends on your constitution, which is partly genetic, and partly determined by your lifestyle and environment. Your constitution can also be called your “biological terrain.” This determines your resilience and capacity for self-repair and healing.
In fact, Functional Medicine is founded a number of key principles.
First — we are all different and genetically and biochemically unique and have to be treated as such.
Second — everything that happens within us is connected in a complicated network or web of relationships. Understanding those relationships allows us to see deep into the functioning of the body.
Third — your body has the capacity for self-regulation, which expresses itself through a dynamic balance of all your body systems.
Fourth — we have the capacity to enhance and optimize our organ reserve and prevent nearly all the disease of aging.
And last but not least — health is not just the absence of disease, but a state of profound and resilient positive vitality.
This new medicine is personalized. It treats the individual, not diseases. And it supports the normal healing mechanisms of the body, rather then attacking disease directly.
But what does this mean for you?
Well, it means that an infection or cancer requires a weakened immune system to take root.
It means that imbalances in your intestinal tract’s bacteria flora trigger inflammation throughout your body and can lead to autoimmune diseases and arthritis. And it means that deficiencies in folate and vitamin B12 prevent your body from producing the neurotransmitters that help to balance your mood. When you have health problems like these, you have a choice. You can choose the drug-heavy treatments of conventional medicine.
Or you can help heal your body with Functional Medicine.
So you can either take antibiotics or use toxic chemotherapy drugs to attack the infection or cancer, or you can discover how and why your immune system is not protecting you.
You can take powerful anti-inflammatory drugs for autoimmune diseases or you can change your diet and feed the healthy bacteria the fiber they love, and even help to “re-plant” new healthy bacteria back in your gut.
You can take an antidepressant for depression or you can take folate and vitamins B12 and B6 to help your neurotransmitters, including serotonin, function better.
I think the choice is clear!
So what’s an appointment with a doctor of Functional Medicine like?
First, rather than diseases, I investigate systems. These are the new systems to consider when analyzing patterns of imbalance or dysfunction that give rise to symptoms. These are the new concepts that can help us to solve the puzzle of complex chronic diseases.
* Your immune system * Your detoxification system * Your hormonal and neurotransmitter system * Your energy production system * Your acid-base system * Your redox system (the balance of oxidants and antioxidants in your body) * Your structural system * Your mind-body/body-mind system * Your nutritional balance
All these systems form my roadmap — my new GPS system that prevents me from getting lost in the sea of diseases.
During our appointment, I ask many questions about every aspect of your genetics, lifestyle, medical history, environment, beliefs, and attitudes. These deeply influence these systems and provide clues to the source and cure of the imbalances.
Then I investigate the landscape, your “biological terrain.”
I try to find out the nutritional imbalances you have, the toxins you are exposed to, whether you have hidden infections, which allergens affect you, what types of stress you’re under — in other words, I learn what things are pushing you off balance.
Next, I work persistently to discover those things (often with the use of specialized testing) and help you eliminate them or get rid of them.
Simply put, you cannot heal if you don’t deal with the cause of your imbalance or symptoms. Sure, you can treat the symptoms, but you’re not getting at the root of your problems.
One of my teachers likes to say, “If you are standing on a tack, it takes a lot of aspirin to feel better.”
The treatment, of course, is to take out the tack – not take more aspirin!
So if you have high cholesterol, you can take all the Lipitor you want, but if you eat cheeseburgers and fries and drink a Coke every night for dinner and don’t exercise, you won’t get much benefit.
You’ve got to treat the CAUSE of your problem!
Let’s get back to our appointment. After I’ve identified that cause of your imbalance, I look at what you might be missing that you need to thrive. To know what’s missing, you have to know what makes you thrive — and what it means to be healthy.
Health is the ability to maintain resiliency and balance and to respond effectively to life’s challenges, whether these challenges are germs, toxins, allergens, stresses, or poor food choices.
So how can you stay healthy and resilient?
Actually, it’s quite simple.
You need to learn what makes you run and make sure you provide it to yourself. You have to learn what works for you and doesn’t. And you must learn what makes you thrive and what depletes your health and life force. Sounds easy, but it isn’t always.
Here are the things we all need to thrive.
* A live, fresh, whole foods diet (ideally organic), comprised of predominately plant proteins, unrefined and whole fiber, phytonutrient-rich carbohydrates, and essential fats
* Adequate clean water (6 to 8 glasses a day)
* Optimal cellular levels of all essential vitamins and minerals (which may differ from person to person)
* Optimal levels of “non-essential” nutrients that become essential with disease, age, and stress
* Movement and play
* Clean air and deep breathing
* Optimal sleep — at least 7 to 9 hours for most people
* Deep and profound relaxation, which activates the vagus nerve — the relaxation nerve that heals and promotes longevity and renewal and even helps promote the development of our own stem cells
* Rhythm — regular patterns of waking, sleeping, eating, and activity
* Love and community
That’s it — really!
The trick is identifying YOUR particular needs and the right balance for you.
How can you get and stay healthy?
For 80 percent of people, simply getting what you need to thrive will lead to robust good health. For those other 20 percent who are still sick, medical guidance is necessary.
With Functional Medicine, your physician can pinpoint exactly what is pushing you off balance and exactly what you need and in what amounts to repair and heal.
Unfortunately, Functional Medicine is so different that only a few dedicated practitioners currently practice it.
But that doesn’t mean that your physician can’t learn more about it.
Here are some resources for you and physician to get more information:
* The Textbook of Functional Medicine http://www.functionalmedicine.org/ifm_ecommerce/ProductDetails.aspx?ProductID=133
* A training course for your physician called “Applying Functional Medicine in Clinical Practice,” which is given twice a year
* A few scientific articles that I have written about this topic, including “Paradigm Shift” (http://www.drhyman.com/pdf/paradigm_shift.pdf), and “Finding the Right Medicine” (http://www.drhyman.com/pdf/skillfull_means.pdf)
I hope I’ve inspired you — and your doctor — to learn more about Functional Medicine. After all, it is the future of medicine!
Now I’d like to hear from you…
Have you had an appointment with a Functional Medicine doctor? How was if different from a conventional physician’s visit?
Does your physician use any of the techniques I’ve described here? If so, which ones?
Have your tried approaching your doctor about learning more about Functional Medicine? How did he or she react?
Do you have any suggestions for how we can work together to move the medical establishment from its limited conventional approach to the more comprehensive and effective functional medicine approach?
To your good health,
Mark Hyman, MD
Welcome to the new Alternative in 21st Century HealthCare
Exciting New Field of Medicine called Functional Medicine
Dr. Jan Venter recently attended a six-day intensive continuing medical education course offered by The Institute for Functional Medicine (IFM), located in Gig Harbor, Washington. Applying Functional Medicine in Clinical Practice (AFMCP) addresses one of the key issues in healthcare practice today – improving the management of complex, chronic disease. IFM programs utilize the emerging research base to identify effective interventions and to train physicians and other providers to integrate those approaches for the benefit of their patients.
Dr. Venter is also currently enrolled in a 3 year Functional Medicine Certification program.
The training Dr. Venter completed involves understanding the etiology, prevention, and treatment of complex, chronic disease. It is an integrative, science-based healthcare approach that treats illness and promotes wellness by focusing assessment on the biochemically unique aspects of each patient, and then individually tailoring interventions to restore physiological, psychological and structural balance.
“…we have been able to identify modifiable behavioral factors, including specific aspects of diet, overweight, inactivity, and smoking that account for over 70% of stroke and colon cancer, over 80% of coronary heart disease, and over 90% of adult-onset diabetes.” [Willett, WC. Science, 2002:296, 695-697]
Working in partnership with a trained functional medicine provider, patients make dietary and activity changes that, when combined with nutrients targeted to specific functional needs, allow them to really be in charge of improving their own health and changing the outcome of disease.
Within the scope of practice of their own particular disciplines, functional medicine practitioners may also prescribe drugs or botanical medicines or other nutraceuticals; they may suggest a detoxification protocol, a physical medicine intervention, or a stress-management procedure. The good news is: when you look at functionality, you uncover many different ways of attacking problems — you are not limited to the “drug of choice for condition X.”
More information about IFM courses is available at www.functionalmedicine.org or by calling 800-228-0622.