Everything You Should Know About Functional Medicine
Doctors explain what sets functional medicine apart from conventional medicine, plus who can benefit most from the functional approach.
Natural remedies and alternative medicine are nothing new, but they're definitely becoming more popular. A couple decades ago, people might have thought acupuncture, cupping, and aromatherapy were a little kooky, but increasingly, people are trying them-and seeing results. Now, there's a surge in interest in functional medicine, a way of thinking about health that's pretty different from what your current doctor may practice. (BTW, here are seven essential oils with serious health benefits.)
What is functional medicine?
Functional medicine is exactly what it sounds like: It focuses on how your body functions and is practiced by all kinds of doctors, from M.D.s and D.O.s to chiropractors and naturopaths. "It views us all as being different; genetically and biochemically unique," says Polina Karmazin, M.D., an integrative physician in Vorhees, NJ, who specializes in acupuncture and holistic pain management.
There's no one-size-fits-all treatment in functional medicine, so instead of immediately going for the most common treatments for a particular set of symptoms, practitioners will always take an in-depth look at the bigger picture of your health before recommending a treatment. "Functional medicine practitioners spend 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 complex, chronic disease," says Dr. Karmazin.
How does functional medicine treat disease?
Functional medicine doctors use a wide variety of testing to decide which kinds of treatments they might use, from traditional blood, urine, and stool tests to saliva DNA tests. When you visit one, they'll spend time with you deciding which tests are appropriate (if any), and they'll ask you plenty of detailed questions about your health and medical history.
Once your doctor decides on a treatment protocol, it's not very likely that it will involve filling a prescription-even if you see a doctor who can prescribe medicine, like an M.D. or a D.O. who specializes in functional medicine. "Nutrient therapy, hormone replacement, IV vitamins, and personalized lifestyle modifications are areas that may be targeted to improve patient outcomes," notes Taz Bhatia, M.D., or "Dr. Taz", author of Super Woman Rx, a functional medicine physician based in Atlanta.
While there are some similarities between the treatments conventional and functional medicine doctors recommend (reducing stress, exercising more, and eating healthy), there are some important differences. "Functional medicine utilizes several treatments that are rarely recommended by your standard physician," explains Josh Axe, D.N.M., D.C., C.N.S., author of Eat Dirt and cofounder of Ancient Nutrition. "These include dietary supplements (including essential oils), acupuncture, hyperbaric chamber, chelation therapy, lifestyle changes, stress-relieving practices such as yoga or chiropractic care, exercise, detox regimens, and more."
Not all of these methods of treatment are fully research-backed (although yoga, exercise, and healthy eating certainly are), but there's an understandable rationale for trying alternative methods. "While research is limited on some treatments, these options are often chosen because of a large wealth of anecdotal evidence that supports potential benefits," says Dr. Axe. "Add to that the fact that many of them come with little to no risk of side effects, and it's not hard to see why these doctors aim to steer clear of prescription medications when less risky options may be available." Overall, functional medicine aims to reduce a patient's reliance on medication. (If nothing else, this anti-Rx stance is an argument for helping to put an end to the opioid epidemic in America.)
You can also expect to take a close look at your diet. Your doc will usually recommend dietary changes to both treat issues you're having now and to prevent other health issues down the road. "We know that food is medicine," says Dr. Axe. "There's no better defense against the development of disease than to feed your body life-giving, inflammation-reducing, and oxidative stress–eliminating foods."
It's true that what you eat affects your gut, and the health of your microbiome (the microorganisms living in your gut) has been linked to a number of conditions, from breast cancer to heart disease. This is also one of the main reasons antibiotics aren't a popular method of treatment in functional medicine. Even though they're sometimes necessary, they're known to mess with your microbiome. (Heads up: Your skin has a microbiome too. Here's everything you need to know about it.)
Who is functional medicine right for?
Functional medicine doctors say that everyone can benefit from their approach, and this is especially true if you're interested in disease prevention or treating something chronic. "Our society is experiencing a sharp increase in the number of people who suffer from complex, chronic diseases, such as diabetes, heart disease, mental illness, and autoimmune disorders like rheumatoid arthritis," says Dr. Karmazin. "The functional medicine approach is more effective at getting to the root cause of these conditions than conventional medicine."
Dr. Axe agrees, saying that functional medicine can especially help with autoimmune disease, as well as hormone-related issues like PCOS. "Many of today's diseases are rooted in diet and nutrition and start in the gut," he says. "Most autoimmune diseases start with leaky gut and chronic inflammation."
While there is quite a bit of evidence that this is true, not all conventional medicine physicians agree. In fact, some conventional physicians are decidedly not on board with the functional medicine philosophy or the methods it uses. Like any other science, conventional medicine *does* have shortcomings, according to Stuart Spitalnic, M.D., an emergency medicine physician in Newport, RI and assistant clinical professor of emergency medicine at Brown University. The problem, he says, is that sometimes people are a little too willing to take advantage of the placebo effect when trying to fill the void left by traditional medicine's shortcomings. While not all conventional medicine physicians feel this way, it is not an uncommon view among those who have been traditionally trained in medicine.
But here's the bottom line as functional medicine physicians see it: "Drugs can't create health in the absence of healthy dietary and lifestyle choices," says Dr. Karmazin.
Is it a replacement for conventional medicine?
You might be wondering whether you need to see both a functional doctor and a conventional doctor to have all your bases covered. The answer? It depends. "In most cases, the two types of medicine are a direct replacement for one another," says Dr. Axe. "Either you're going to use conventional medicine or you'll use functional medicine." It is possible for the two approaches to overlap, though. "There are some doctors who take a more integrative approach and will typically use more natural remedies until they feel certain medications are necessary for short periods of time," he adds.
Srini Pillay, M.D., a Harvard psychiatrist and author of Tinker Dabble Doodle Try: Unlock the Power of The Unfocused Mind, is one such physician. "In my opinion, both conventional medicine and functional medicine offer advantages. Any patient seeing either type of doctor should seek a referral from the other type of doctor in order to understand how each approach might pertain to them," he suggests.
Dr. Pillay notes that one of his patients recently developed Parkinson's, and since neither he nor his neurologist (both conventional physicians) were experts in dietary modifications for this condition, they recommended he see a functional medicine physician for more information in this area. That doesn't necessarily mean, however, that it was recommended this patient stop taking medication for his condition.
Dr. Pillay also advises asking questions about any treatments recommended by either type of doctor, although many of these questions are particularly relevant to non-research-backed treatments. "For different conditions, there are different levels of evidence for both conventional and functional medicine. Ask both types of doctors, 'What level of evidence is there that this type of treatment works?' he suggests. It may also be helpful to ask how many patients like you they've treated and what kind of success they have personally had with the treatment they're recommending. Lastly, always ask about side effects, even if they've recommended something fairly standard like seeing a chiropractor, a certain type of massage, or even antibiotics (from a conventional physician, of course), just to be sure you have all the information.
Still, experts say any urgent medical issue should be treated by conventional medicine. "I think any acute condition-surgery, trauma, worsening infection-needs a conventional approach, although integrative and functional medicine can be supportive," says Dr. Bhatia. In other words, functional medicine may help you deal with prevention, ongoing illnesses, and even the aftermath of more serious medical events, but if you're having a heart attack, please head to the hospital.