Chronic Disease - Are We Getting It All Wrong

Functional Medicine ~ Shifting the paradigm of chronic disease management

If you have been following my blog you are already aware of my internal struggle between the traditional health care system as we know it and the growing body of evidence that supports the connection between chronic disease, nutritional deficiencies and our toxic American diet.

It’s sounds so ridiculously simple.  I spent the equivalent of 12 years in various traditional health care training programs learning how to diagnose and treat disease, to finally come to the self-realization that  most of the chronic disease we encounter in our society is food-borne.  And that our food is medicine.  To be perfectly honest, it is much easier just to write a prescription. Frankly, that’s what many people want, the “magic pill” rather than to commit to making comprehensive lifestyle changes.  Despite this harsh reality, I have decided to take the leap of faith…..to be the drop of water that makes waves in the pond.…to stand with a growing team of health care professionals across the nation who share the same vision.

We are in the midst of an epidemic of chronic disease that threatens the health of our people and the economic well-being of our nation. Systems-based care and strong therapeutic partnerships are required to address the dysfunctions that arise when genetic susceptibility, environmental exposures, and unhealthy lifestyles intersect—as they do in varying ways for most people. Functional medicine is designed to meet just this challenge—to help practitioners and patients recognize, manage, and prevent the interconnected web of dysfunction that is at the foundation of chronic disease. Click for more information on the evidence for functional medicine, Institute of Functional Medicine, 2013.  

So many people come to my practice looking for answers.  Many young people with a  list of medications longer than most of  the  80 year olds in my practice.  Often they are passed from health care provider to provider who are merely applying band-aids to their gaping wounds.  Seen by the elite leaders in medical care, still no answers….still feeling like they can barely make it through the day.  Somehow they make it to my door step.  I have to admit that I was initially overwhelmed by the complexity of their illness.  Then it all started coming together.   Over the past 2 years I have been training in Functional Medicine through the Institute of Functional Medicine’s Certification Program.  Wait….so what is functional medicine and how is it different from alternative or integrative medicine?

“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.  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.  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”.   Dr. Mark Hyman, January, 2013.

From my perspective, one of the biggest strengths in FM model is the search for underlying triggers….looking for the WHY of medicine.  So many times we blame genetics on many of the chronic diseases we see.  While genetics is a small part of the picture, there are many key triggers for disease including our toxic American diet, food sensitivities such as gluten intolerance, environmental toxins, hidden infections and STRESS!  The best example I see every single day is Hashimotos thyroiditis.  From my traditional endocrinology background, Hashimotos is primarily treated with thyroid hormone…..again applying a band-aid to the wound.   Hashimotos is an immune mediated disease, thus, the key to managing Hashimotos is not only to support the immune system, but to figure out what is triggering the immune response .

The figure to the left represents the Functional Medicine tree.

So many times we are looking at what is above the surface and fail to recognize what lies below.

I believe that identifying the underlying triggers for a chronic condition is the missing link to essential to managing our exploding epidemic of chronic disease.