About Functional Medicine
Functional Medicine is a systems biology-based approach that addresses the underlying causes of diseases
Introduction to Functional Medicine
Functional medicine is a systems biology–based approach that focuses on identifying and addressing the root causes and contributors of disease.
Each symptom and diagnosis can be the result of more than one cause. Likewise, a cause such as a chronic inflammatory response may lead to a number of different diagnoses and symptoms, depending on the patient’s individual biochemical make-up, environment and vulnerabilities.
Only treatments that address the right underlying contributors and causes will have lasting benefit beyond symptom suppression.
Functional Medicine uses advanced testing of blood, urine, stool and saliva to investigate the causes and contributors to illness and restore health by addressing these underlying factors that conventional tests from both GPs and specialists miss.
It can involve using detailed genetic, biochemical, biomarker, microbiome and toxin exposure diagnostics used to further personalize treatment and improve patient outcomes, especially when conventional drugs only approaches have failed.
Addressing Chronic Illnesses and Neurodevelopmental Disorders
It can help in cases where a diagnosis is often a final common pathway, such as with depression and chronic fatigue spectrum illnesses as well as fibromyalgia and other poorly understood medical symptoms.
In neurodevelopmental disorders such as ADHD and ASD, although there is not a ‘cure’ for these conditions, functional medicine approaches and addressing microbiome issues can have a dramatic effect on behavioral symptoms and improve functioning significantly.
Using these tests can help target treatments to make them more effective and remove the ‘guesswork’ of what may work best for a specific person.
Functional medicine biomarkers can also in some cases, be used to track treatment progress and efficacy along with clinical measurements in cases of complex chronic illness where many factors are at play.
Exploring the Microbiome & Brain-Gut-Immune Health
One aspect of functional medicine testing and treatment involves an in-depth investigation of the microbiome environment, factors that influence the brain-gut-immune axis and issues in this system.
We now know that the health of our gut microbiome has a direct effect on brain health, behavior, mood, energy levels and immune system function.
When there is an imbalance in the gut, this can contribute to a wide variety of symptoms ‘outside’ of the gut, ranging from mood and anxiety problems, behavioral disturbances, chronic fatigue and brain fog, autoimmunity, problems clearing viral infections and even neurodegenerative changes.
This is because gut bacteria and other microbes such as yeasts, moulds and protozoa produce chemicals that can change our neurotransmitter production, having a direct effect on brain and energy function.
Some of these changes that we can see from detailed stool and urine panels looking at the gut microbiome as well as the chemicals produced by bugs that colonize the gut include:
- Overgrowth of pathogenic bacteria
- methanogen overgrowth
- fungal species overgrowth
- reduced intestinal barrier function
- markers of micro-inflammation and/or immune suppression
- chronic opportunistic infections
A core component of functional medicine is personalized therapeutic diets.
Therapeutic diets are not one-size fits all, but combined with looking at biomarkers and a thorough understanding of each patient’s illness, it is possible to use personalized nutritional interventions to address root causes and contributors of illness.
It is likely that food alone approaches are not enough in many complex chronic illnesses. However, without implementing a therapeutic diet, it is hard to get the longer lasting changes in many cases.
Specific types of diets can influence and improve symptoms such as fatigue, pain, inflammation and mood, working on multiple inflammation pathways, neuro-immune modulation, gut-brain axis and microbiome function and others.
However, each person is different and while some people may respond very well to say a ketogenic diet, others will not improve or even worsen on the same diet, even if they both have the same ‘diagnosis.’
Below are some examples of therapeutic diets used within functional medicine.
Ketogenic diets including variations such as: plant based keto diet, cyclical ketogenic diet and modified (keto-lite) diets. These consist of high healthy fat low carbohydrate diets with moderate (not high) protein and specific anti-inflammatory foods. They can be plant based or include animal sources depending on the patient.
Detoxification Support Diets
This is part of a doctor-led detoxification protocol and provides maximal amounts of nutritional components needed for phase 1 and 2 detoxification, excretion of toxins from the gastrointestinal tract and is appropriate for patients where environmental exposures may be playing a role in their illness
Gut Reset Therapeutic Diet
This is step-wise diet with 3 different phases that focuses on decreasing fungal and bacterial overgrowth in the gut and then subsequently, repairing the gut lining to decrease intestinal permeability, microinflammation and restore the gut microbiome balance.
Mitochondria Support Diet
This diet focuses on optimizing mitochondrial health and function, to improve energy utilization in the brain and body. It involves eating an anti-inflammatory, antioxidant rich diet low on the glycemic index, avoiding gluten and minimizing grains in general. There are different versions of this diet that include lower carbohydrate options to produce some ketones, which are also mitochondrial protective
Low Histamine Diets
This diet reduces foods that are high in histamine or ‘liberate’ histamine and then builds the diet backup as a gut restoration protocol and histamine intolerance program is undertaken to expand the diet once again. It is used for patients suffering with MCAS and histamine intolerance symptoms, which is also common in EDS.
Low Glutamate Diets
This is a diet low in ‘free glutamate’ which can be neurotoxic and ‘immonexcitatory’ in certain people, especially those with neurodiversity, ASD, ADHD, OCD and sensory processing disorder. This type of diet can help rebalance glutamate vs. GABA levels in the brain to create a calming and focusing effect. There is a list of high glutamate foods to reduce, the top ones being gluten, casein, MSG and additives like guar and xanthan gums as well as carrageenan to name a few.
Some people may be able to tolerate some higher glutamate whole foods so this diet is normally further personalized using a partial elimination diet approach. Balancing blood sugar with low glycemic index eating is also a component of this diet since wild swings in blood sugar can also trigger the body to release more glutamine too. A low glutamate diet can have a very significant positive impact on behavior, mood and anxiety levels in neurodiverse people.
These are targeted towards identifying food triggers,reducing inflammation and symptoms and then by following a gut restoration and leaky gut repair protocol, slowly introducing foods back into the diet in a specific way to minimize reactions
The Core Diet
This is a basic starting point for everyone. It involves dramatically reducing processed foods, added sugars, artificial preservatives and sweeteners and eating a low GI mediterranean style diet rich in healthy fats from cold pressed oils, plants and small fish as well as small amounts of healthy animal protein if desired from organic free range sources. As part of this core diet, reducing gluten is recommended due to the highly processed nature of gluten containing grains.
Intermittent Fasting and Its Benefits
These are eating plans that involve a daily eating ‘window’ and then a period of fasting. The length of the fasting period can vary depending on the individual case. These diets are often combined with another therapeutic diet to customize the program further to each individual. Benefits of using this approach can include improvements in energy, mood, gut function and metabolism.
Prescribed Nutraceutical & Supplement Combinations
Another aspect of functional medicine is targeted prescribed combinations of nutraceuticals and high potency supplements. These are chosen based on a combination of personal biomarkers and symptoms.
In some cases such as mitochondrial support, detoxification pathway augmentation and in rebalancing the microbiome, specific supplements are needed to achieve successful treatment outcomes. For example, if you have genetic differences called snps that impair certain energy or detoxification pathways, food alone is generally not enough to reverse symptoms.
Likewise with dysbiosis and leaky gut, a specific Remove, Repair and Restore protocol using specific probiotic strains, high potency botanicals and supplements such as slow release glutamine, short chain fatty acids and others depending on the individual are needed to support the gut back to optimal microbiome balance and overall functioning.
Diet Alone isn’t Enough to Address Chronic Illness Symptoms
Even if following a so-called ‘perfect’ diet, if you have a medical issue, prescribed supplements are often necessary at least in the short term.
Many doctors, although well-meaning, incorrectly inform patients that supplements are not needed as long as you eat a varied diet. This is simply not the case when you are being treated for a chronic illness.
This well meaning but incorrect advice stems from the fact that in standard medical school curriculum, there is an average of often a single day in many years of training on nutrition alone and non pharmaceutical therapeutic nutraceuticals are not discussed at all, despite a large body of evidence.
Integrative and functional medicine doctors take years of additional training in these areas after core medical training as part of their speciality.
To utilize natural compounds such as botanicals, minerals and other nutraceuticals therapeutically, meaning to target a specific underlying issue, the amounts you need to get a response are normally many times that which you can get from the diet alone.
Optimizing Supplement Regimens for More Effective Treatment Outcomes
Supplement regimens are often changed over a period of months with a functional medicine doctor depending on treatment progression, changes in biomarkers and symptoms to try to slowly reduce the reliance on supplements over time while still maintaining treatment gains.
To optimize supplements, they should be chosen based on biomarkers not just on symptoms or blanket indications, since everyone’s biochemistry and microbiome are unique.
A common issue is that navigating supplements on your own is confusing and costly. Many high street supplements do not have sufficient potencies or the right combination of ingredients to be effective for clinical issues.
Another issue is that with botanical supplements, the right part of the plant, extraction technique and vehicle for absorption is extremely important for the active ingredients to have any effect, and most botanicals should be used in combination with synergistic other herbal preparations rather than on their own like single pharmaceutical drug agents.
Many high street supplements are also contaminated and untested for quality. This is often why patients arrive for their first appointment with entire bags of partially used supplements they are unsure made any difference to their condition.
Functional medicine is a methodology that allows the root cause of illness to be identified and the development of treatment plans incorporating personalised therapeutic diets and personalised supplement regimens alongside medications, setting the right conditions for clinical improvement and progress on your healing journey.