Functional Medicine: A Renewal of Healthcare
The doctor of the future will give no medicine, but will instruct his patient in the care of the human frame, in diet and in the cause and prevention of prevention of disease.”
When Thomas Edison spoke those words, more than 100 years ago, healthcare was nowhere near as advanced as it is today. There have been remarkable strides forward in medicine. We have capabilities in the care of the critically ill, lifesaving surgeries, and emergency medical techniques which weren’t even dreamt about back then.
When you think of modern healthcare, chances are you think about diseases such as diabetes or high blood pressure. You think about the symptoms you may be experiencing and what they mean. You probably think about what tests will be done to find out what’s wrong and which medications will be used to treat you. If these topics are what come to mind when you see the word “healthcare”, you aren’t alone. As a society, we’ve been trained to believe that the best way to stay healthy is to get some medicine to treat our ailments. If we have a symptom, take something to get rid of it. As long as we feel good, we’re healthy.
But “Healthcare” is probably the wrong word for much of the modern practice of medicine. “Disease Care” may be a more accurate term. After all, we don’t tend to worry about our health until it is suffering. And even then, we don’t pay much attention to the reasons why we’re sick, but rather concentrate on treating the symptoms of the illness. Medications, while often useful in the management of disease, usually only treat the consequences of disease. Other than some notable exceptions, such as antibiotics, medications don’t actually “cure” anything. Insulin is necessary for many diabetics to control high blood sugars, but does not cure diabetes. Blood pressure medications will lower your blood pressure, but they don’t cure hypertension. Antidepressants will improve your mood, but don’t cure depression.
“Functional Medicine addresses the underlying causes of diseases, using a team approach to engage both patient and practitioner in a therapeutic partnership.”
Unfortunately, this way of thinking has gotten us into trouble. Among developed nations, the United States has among the worst rates of maternal and perinatal death, heart attack deaths, and deaths from nutritional deficiencies. Our lack of attention to health, but rather our focus on disease, has led to a population that is sicker than most countries in our “peer group” (i.e., industrialized nations).
Throughout my conventional medical training, I was taught how to identify and treat symptoms and disease. While lifestyle and nutritional changes were often discussed, the mainstay of therapy was medication. And this is how I practiced for the first 8 years after training. Find the disease or symptom, and then find the medication that treats it. In women’s healthcare, where I have dedicated my career, irregular bleeding is treated with birth control pills, PMS is treated with antidepressants, osteoporosis is treated with bisphosphonates (i.e., Fosamax®). Many patients feel better with this approach. But, for many of them, while this takes care of their symptoms, it does not always solve the underlying problem. Even worse, the medications intended to treat symptoms often come with side effects. While we were treating one problem, we were unintentionally causing another.
Increasingly, more and more of my patients were becoming unhappy that their underlying problems were not going away. And, to tell you the truth, I became dissatisfied that we were not returning our patients to good health, but rather treating and managing their diseases. I simply did not see the logic in this.
In my article on Aging in A Modern World, I talk a little bit about Functional Medicine, and how it relates to healthy aging. After attending college, medical school, four years of training, and several years of practicing medicine, I went back to school to study Functional Medicine, and began to apply the concepts I learned to my practice of Obstetrics & Gynecology. Rather than covering up the symptoms or chasing diseases with medicines, Functional Medicine addresses the underlying causes of diseases, using a team approach to engage both patient and practitioner in a therapeutic partnership. We were taught to focus on health management, not disease management. For example, it makes much more sense to address the nutritional and hormone deficiencies that may be responsible for a disease, to assist our bodies in repairing natural processes which are no longer functioning well, rather than to add a prescription of chemicals (“medicine”) to cover up the symptoms.
What is it about Functional Medicine that makes it such an improvement over the conventional medical approach? And how does a Functional Ob/Gyn apply this knowledge to Women’s Health? Here are several important ways Functional Medicine differs from traditional medical practice and why it is better for women’s health:
- We look at underlying dysfunctions (i.e., Why are you sick?)
Have you ever wondered why you get sick? In my traditional medical training, I was originally taught that it was usually enough to figure out that somebody has a given disease, and then to treat it. Diagnose hypothyroidism, and give Synthroid®. Diagnose depression, and give Prozac®. Diagnose osteoporosis, and give Fosamax®.
But the questions that really should be asked are – Why do I now have thyroid problems? Why am I suffering from depression? Why are my bones weak? It is now my professional opinion as a Functional Medical Doctor that it isn’t enough to treat the disease, because it doesn’t address the underlying cause. And if you don’t treat the cause, the disease will persist even if we reduce or eliminate its symptoms. All many medications do is mask the underlying conditions. Functional Medicine addresses, treats and tries to eliminate the underlying problems which lead to disease. Nutritional deficiencies, hormone imbalances, GI dysfunction – these are just some of the many important contributors to our health which are often overlooked by conventional medicine. To be really healthy, the underlying problems must be fixed.
“A holistic approach, rather than looking at a single organ system, is the best way to get healthy”
2. We look at the body as an integrated system
Rather than a bunch of organs piled together and separated into different specialties, Functional Medicine views the body as an integrated whole. All systems interact with each other. And if one isn’t functioning well, chances are there are several others malfunctioning too.
Nowhere is this concept more evident than in Women’s Health. Hormones – such as estrogen, testosterone, progesterone, and the thyroid – are considered part of the endocrine system. But the levels of these hormones, and how they interact with each other, affects almost every other system of the body. The brain, heart, gut, and skeletal systems, just to name a few, are greatly affected by hormone imbalance. So, it isn’t just the hot flashes, or PMS, or bleeding, that is the problem. When your hormones are out of whack, everything is affected. We could treat these conditions with “some meds”, but that misses the real villain, which in this case is hormone imbalance.
A holistic approach, rather than looking at a single organ system, is the best way to get healthy.
3. We look at labs differently
When you go to your doctor and have blood tests done, the lab report usually comes back with a numerical value for that test. Also included on the lab report is a “normal range” (sometimes called “reference range”) for that test. Whether you are at the upper limit of that range, or the lower limit of the range, you are still considered “normal”, so not much further attention is focused on the test results. The problem with this is that disease processes don’t start with lab values outside the range. Evidence of a medical condition starts with numbers trending in a certain direction. With greater focus on our lab results before they become “abnormal”, we can get ahead of the disease process and, in many instances, avoid it altogether.
Functional Medicine practitioners look at “optimal levels” rather than the normal ranges. A good example in Women’s Health is the thyroid. Thyroid disease doesn’t start when your hormone levels are abnormal – which is when most healthcare providers diagnose the problem. By that time, you already have full-blown disease. But levels of thyroid hormone that are trending downward are an indication that thyroid function is suffering. It is much more effective to treat abnormalities while, or even before, they develop, than it is to treat the problem once it has gotten bad.
Optimization vs. normalization. A vital distinction addressed by Functional Medicine.
4. We customize healthcare Every human being is unique.
We’ve all heard it, and most of us subscribe to this belief. But conventional healthcare doesn’t treat us this way. Once you are labeled with a disease, you get the same treatment, or set of treatments, as everybody else with that disease. This approach works for some. But much of the time, it fails.
Functional Medicine recognizes the individuality of each patient. For a given problem, no two people will have the same exact symptoms, respond the same way to medications, have the same side effects, or have the same rate of improvement. A program tailored to your unique needs is vital to achieving optimal health.
Practicing medicine this way provides me with the personal satisfaction of partnering with my patients to help improve and maintain their health. This, to me, is modern medicine at its best.
Are you looking to get truly healthy? Team up with a Functional Ob/Gyn to create a customized approach to health tailored to your unique needs. Call today to get started.