by Dr. Miles Nichols and Nicola Schuler, CNTP, MNT
What is Functional Medicine and Should you Consider it together with Conventional Medicine?
There is a lot of frustration with conventional medicine these days. Obesity, diabetes, cancer, heart disease, autoimmune diseases and other chronic conditions are all on the rise.
6 in 10 Americans have at least 1 chronic disease (defined by the CDC as cancer, heart disease, lung disease, stroke, Alzheimer’s, diabetes, kidney disease) (1).
4 in 10 Americans have 2 or more chronic diseases (1).
Trends show an overall increase in chronic diseases: Chronic diseases are responsible for seven out of 10 deaths in the US, killing more than 1.7 million Americans each year; and more than 75% of the $2 trillion spent on public and private healthcare in 2005 went toward chronic diseases (2).
90% of the 3.3 $ trillion annual health care expenditures are for chronic and mental health conditions (3).
A recent Milken Institute analysis determined that treatment of the seven most common chronic diseases coupled with productivity losses will cost the U.S. economy more than $1 trillion dollars annually (2).
Heart disease and stroke are the leading killer: One third of all deaths are due to heart disease or stroke every year. These diseases cost the health care system $199 billion per year and cause $131 billion in lost productivity on the job (3).
Cancer is the second leading cause of death: Each year more than 1.6 million people are diagnosed with cancer, and almost 600,000 die from it. The cost of cancer care continues to rise and is expected to reach almost $174 billion by 2020 (3).
Diabetes is the seventh leading cause of death in the U.S. in 2015 (4): Diagnoses of type 2 diabetes increased from 0.93% in 1958 (5) to 9.4% of the U.S. population in 2015 (4). More than 30 million Americans have diabetes, and another 84 million adults in the United States have pre-diabetes, which puts them at risk for type 2 diabetes (3). Diabetes can cause heart disease, kidney failure, and blindness, and costs the US health care system and employers $237 billion every year (3).
The overall prevalence of obesity was 39.8% of the population in 2015-2016 (6). Obesity affects 1 in 3 adults and almost 1 in 5 children (3). Over 25% of all Americans aged 17 to 24 years are too heavy to join the military (3). Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer. These are some of the leading causes of preventable, premature death (6). The estimated annual medical cost of obesity in the United States is $147 billion per year (3).
Arthritis is a leading cause of work disability in the United States (3): Arthritis affects 1 in 4 adults or 54.4 million adults in the United States (3). It one of the most common chronic conditions and is a common cause of chronic pain. The total cost of arthritis and related conditions was about $304 billion in 2013. Of this amount, nearly $140 billion was for direct medical costs and $164 billion was for indirect costs associated with lost earnings (3).
Alzheimer’s disease is the sixth leading cause of death among all adults and the fifth leading cause for those aged 65 or older (3). It is an irreversible, progressive brain disease that affects about 5.7 million Americans (3). In 2010, the costs of treating Alzheimer’s disease were estimated to fall between $159 billion and $215 billion (3). By 2040, these costs are projected to jump to between $379 billion and $500 billion annually (3).
About 20% of Americans suffer from autoimmune diseases (7) and the incidence of autoimmune conditions are rising.
Common autoimmune diseases are rheumatoid arthritis, Hashimoto’s, Grave’s, lupus, celiac disease, MS, IBD (Crohn’s disease or ulcerative colitis), Type 1 diabetes and approx. 100 others. Autoimmune diseases are among the top ten causes of death in girls and women under 65 years (8).
Between 2001 and 2009, the incidence of type 1 diabetes increased by 23%, according to The American Diabetes Association (9).
The incidence of celiac disease is on the rise. Until the 1970s the estimated prevalence of celiac disease was 0.03%. The current estimated prevalence is 1% in the USA (10).
The incidence of RA appears to be rising: This rise in RA followed a period of 4 decades of declining incidence and appears to be limited to women (11).
Diagnoses of IBD (Crohn’s disease or ulcerative colitis) has risen to 1.3% of US adults in 2015, up from 0.9% in 1999 (12). IBD seems to be increasing in children, according to a 12-year study showing the incidence rate doubling in the period 1991–2002 (8).
Most of these chronic health problems have been getting dramatically worse over the past couple of decades and are only going to continue to get worse if effective treatment is not found…and soon. As most of these chronic diseases can be prevented and/or resolved through lifestyle and targeted natural supplements, they are primarily caused by diet and the way Americans live. Many chronic diseases are not inevitable and can be prevented with better diet & lifestyle. They can possibly be reversed with a more appropriate approach to treatment.
Conventional medicine is great at treating acute and crisis issues. For example, in 1900 the top causes of death were from infectious disease (typhoid, tuberculosis, and pneumonia). Today none of those are even in the top 10 causes of death. However, when it comes to treating chronic diseases, Conventional Medicine tends to only offer drugs to manage symptoms, but nothing to resolve root causes. Conventional medicine uses medicine designed for acute conditions for these chronic diseases.
In the midst of this depressing scenario, Functional Medicine emerges as a solution. Functional Medicine truly shines in its ability to work with chronic disease. The rest of this article defines what Functional Medicine is and how it strives for optimal health.
Functional Medicine defined:
Functional Medicine or FM aims to look for and address the root causes of disease. The body is one integrated system. Segregating specialties by organs / systems misses the boat on the researched interconnected impacts between different systems in the body. FM treats the whole system at the root cause level, not just the symptoms at the single organ / system level.
In FM, your doctor or practitioner will spend time with you to assess your case. This is often very difficult to do in the 10-15 minute consultation conventional doctors provide.
FM is not attempting to match your symptoms to a pharmaceutical drug. Rather, it aims to find the underlying root causes and address these causes. For example, a conventional medicine doctor may diagnose hypertension (high blood pressure) and prescribe an anti-hypertensive drug (to lower blood pressure). In most cases there will be little discussed around the root causes of high blood pressure. Perhaps in some cases there will be a vague mention of exercise and possibly a comment about lowering salt intake, but no thorough testing for specific root issues.
In FM, a thorough investigation into the root cause for high blood pressure will ensue. There may be testing around cortisol levels (an adrenal hormone related to stress), gut issues, toxic burden, a thorough dietary assessment, and an investigation into nutrients like potassium (potassium deficiency is one commonly missed root cause of high blood pressure). After the comprehensive assessment, the functional medicine doctor will typically meet with the client for 30-60 minutes and review the findings of the lab work and other assessments about possible root causes. The FM doctor will then prescribe a thorough treatment plan including a prescription of natural supplements like vitamins, minerals, and herbs, plus some specific nutrition and lifestyle changes. In the Living Love clinic, this is then followed up by support from a functional health coach to implement the plan in a step-by-step process with thorough explanations and answers to questions. This allows for the client to understand why they are doing what they are doing, how to overcome challenges that present themselves along the way, and support for tweaking / honing / refining the plan along the way as needed to keep moving towards desired results.
There is more than one root cause in most cases. Addressing the root causes are typically done through natural modalities such as supplement prescriptions including vitamins, minerals, and herbs, diet and nutrition, and lifestyle modifications using exercise, meditation, stress management and other tools. FM may use pharmaceutical drugs but this is not the first reflex. Drugs are typically used in the lowest dose for the shortest time while getting to the root causes and resolving them.
Dr. Mark Hyman, MD, calls FM ‘the future of conventional medicine’.
Principles of FM:
- Find the root causes. There can be a variety of issues in a complex case. Why is someone suffering from a particular symptom? Get to the underlying reasons for why the symptom or symptoms exist and address those underlying root causes. This may be due to:
- Chronic inflammation (but what is causing the chronic inflammation?)
- Nutritional deficiencies (B12, iron, folate, zinc, glycine, potassium, etc.)
- Toxicity (mold, toxins from Lyme, other biotoxins, metals, chemicals, etc.)
- Chronic infections (Lyme, Epstein-Barr Virus, or other viral, bacterial, fungal, etc.)
- A poor diet of inflammatory foods
- Stress and/ or psychological or emotional issues that can be improved with lifestyle changes
- A lack of movement or even excessive or the wrong types of exercise for the individual
- Gut issues like infection, overgrowth, dysbiosis or other, etc.
- These issues or root causes need to be untangled to really get to the crux of the problem. Then an approach to resolve the root causes can be taken to make the patient well again.
- Test don’t guess. FM uses extensive advanced lab testing to find out what the root causes are. In FM, specific lab testing is used looking at blood, stool, urine and occasionally breath samples. Many of these tests are not used in conventional medicine. Using advanced lab testing helps your FM practitioner to get the full picture to assess what the root causes are. Without testing, a practitioner is forced to make guesses about your health that may or may not be correct.
- Prevention is key. FM seeks to be preventative. There are often signs of a problem lurking years before a person is diagnosed with a disease. We can see antibodies in blood tests years before an autoimmune condition is diagnosed. We can see type 2 diabetes coming if the right blood glucose and insulin tests are examined. Rather than focusing on disease, functional medicine focuses on optimal function. This means that in addition to getting well when chronic disease is present, there is also a focus on longevity, increasing vitality and energy, and not just feeling okay but instead feeling great. There is also a focus on sustaining and maintaining wellness once achieved. Strategies are implemented to help prevent recurrence of issues that had been present in the past.
- FM is very science-based. It draws upon the latest research to understand how the body functions. This is why lab testing is frequently used so that your FM practitioner can see what is happening rather than making assumptions. Peer-reviewed studies are regularly reviewed by the greater functional medicine community and it does not take the 15-20 years that it sometimes takes for research to become integrated in conventional medicine. Instead, research is applied to clinical practice shortly after being published and that means innovative and new interventions are being utilized quickly.
- Health is not just a lack of disease but is rather, a state of optimal vitality. Many of the conditions that society thinks are due to aging can actually be improved or eradicated with a FM approach. Declining health in later years is not a given. A preventative FM approach can improve how a person ages. The last 10 years of a person’s life are important to the functional medicine practitioner. The FM doctor will be thinking about not only how to feel good now, but also how to stay well enough into old age to play with grandchildren, travel the world, and enjoy retirement to its fullest.
When to turn to FM:
- FM is ideal for complex cases in which people have seen many doctors but are still ill
- FM is great when there are unexplained or unresolved issues that conventional medicine has been unable to identify and/or resolve
- FM can help to improve and even reverse chronic lifestyle diseases like diabetes and pre-diabetes, and obesity
- FM can help reverse root causes for immune dysfunction (autoimmune diseases), gut issues (IBS, Crohn’s, Ulcerative Colitis, Small Intestinal Bacterial Overgrowth [SIBO], etc.), hormone imbalance (without the need to take hormone replacement in many cases), chronic infections like Lyme disease, toxic burden like mold toxin illness (also call Chronic Inflammatory Response Syndrome or CIRS), and many more because the root causes of nearly every chronic illness are similar.
- FM is for anyone who wants to prevent health problems before they become debilitating, or even appear
- FM is for everyone who wants to experience optimal health and enjoy life to the fullest! Just because some people feel good now doesn’t mean you can’t feel even better. Longevity, vibrant vitality, unshakeable happiness, and an inspired sense of purpose are all areas of focus for a more holistic kind of functional medicine.
If you or someone you know is interested in learning more about functional medicine, please click here to schedule a complimentary 15-minute phone consultation and/or call or text 720-722-1143 and/or email firstname.lastname@example.org . We will help you learn more about taking the next steps in a more functional and holistic care model. We work with people who do not live locally so feel free to contact us regardless of where you live. We look forward to playing a part in your health and happiness!
- Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion. November 19, 2018. About Chronic Diseases. https://www.cdc.gov/chronicdisease/about/index.htm. Accessed February 12, 2019.
- Raghupathi, W. and Raghupath, Vi. 2018. An Empirical Study of Chronic Diseases in the United States: A Visual Analytics Approach to Public Health. Int J Environ Res Public Health. doi: 10.3390/ijerph15030431
- Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion. February 11, 2019. Health and Economic Costs of Chronic Diseases. https://www.cdc.gov/chronicdisease/about/costs/index.htm. Accessed February 12, 2019.
- Centers for Disease Control and Prevention. CDC Newsroom. July 18, 2017. New CDC report: More than 100 million Americans have diabetes or prediabetes. https://www.cdc.gov/media/releases/2017/p0718-diabetes-report.html. Accessed February 12, 2019.
- Centers for Disease Control and Prevention. CDC’s Division of Diabetes Translation. April 2017. Long-term Trends in Diabetes. https://www.cdc.gov/diabetes/statistics/slides/long_term_trends.pdf. Accessed February 12, 2019.
- Centers for Disease Control and Prevention. August 13, 2018. Adult Obesity Facts. https://www.cdc.gov/obesity/data/adult.html. Accessed February 12, 2019.
- American Autoimmune Related Diseases Association Inc. April 29, 2017. How many Americans have an autoimmune disease? https://www.aarda.org/knowledge-base/many-americans-autoimmune-disease/. Accessed February 12, 2019
- Tincture. Jan 29, 2016. An Invisible Epidemic – When your body attacks itself – Autoimmune Disease. https://tincture.io/an-invisible-epidemic-when-your-body-attacks-itself-autoimmune-disease-5738b699de12. Accessed February 11, 2019.
- Medical News Today. June 22, 2012. Autoimmune Disease Rates Increasing. https://www.medicalnewstoday.com/articles/246960.php. Accessed Feb 10, 2019.
- Medical News Today. February 2019. The Spectrum of Celiac Disease: Epidemiology, Clinical Aspects and Treatment. https://www.medscape.com/viewarticle/720681_2. Accessed February 12, 2019.
- Myasoedova E, MD PhD, Crowson C. S., MS, Kremers H. M., MD MSc, Therneau T. M., PhD, and Gabriel S.E., MD MSc. 2011. Is the incidence of rheumatoid arthritis rising? Results from Olmsted County, Minnesota, 1955-2007. Arthritis Rheum. doi: 10.1002/art.27425
- Centers for Disease Control and Prevention. November 14, 2018. Inflammatory Bowel Disease (IBD). Data and Statistics. https://www.cdc.gov/ibd/data-statistics.htm. Accessed February 11, 2019.