The year is 1871 when an esteemed physician named Dr. Willoughby Wade wrote, “every symptom arises from the imperfect discharge of some function, hence it requires a slightly higher order of thought from that which is commonly in vogue in medicine.”
But it wasn’t until 1991 when a group of British Columbia physicians brought this idea to fruition. Thinking that they discovered something new (sorry Dr. Wade), these Canadian physicians hypothesized against conventional medicine—they theorized that the genetics individuals are born with are NOT the sole controller of health. Instead, our physical, metabolic, cognitive, and behavioral levels affect genes and predisposition to disease, organ and tissue function, cellular performance, and biochemical and energetic processes.
These physicians studied how traditional medical care (like cultural medicinal practices) converges to advanced scientific medical care to capture care for the entire person. From this, the principles and development of functional medicine was formed.
Principles of Functional Medicine
- Form and function are interconnected and interdependent.
- All aspects of life can be viewed through the lens of form and function.
- We live in a hologram of interconnectedness through homeodynamic relationships.
- The concept of functional systems is operative at every organizational level.
Understanding the Legitimacy Debate
Although functional medicine has a legitimate foundation, it doesn’t have the long history or mainstream backing that conventional medicine does. Because of this, people often question, “is functional medicine legit?’.
Yes it is!
But what does it really mean to be legit in healthcare?
How to Determine Healthcare Legitimacy
There are many ways to quantify legitimacy in healthcare: from the degree someone has, the organizational backings, and even the opinion of the government sometimes. Questioning legitimacy is valuable, it helps us ensure we’re getting the best care that is heavily scrutinized.
Healthcare Legitimacy Red Flags
The University of California, San Francisco, notes four red flags to look out for to ensure a healthcare practice is legitimate:
- Anonymity; no identification with who published a study or discovered a practice.
- Unaligned educational background; an individual or group with educational background that doesn’t align with the practice
- Claims of a “magic” or easy fix”; there is no magic fix!
- Using opinion instead of referencing studies; clinical studies are integral to the healthcare field. They give insight into whether a practice is actually making a difference (AKA statistically significant).
Federal Drug Administration
The Federal Drug Administration (FDA) is a regulatory body we look to to ensure the safety, efficacy, and security of drugs, biologics, medical devices, radiation products, cosmetics, and food. The FDA does approve many therapies used in functional medicine.
However, the FDA does not give approval for dietary supplements (vitamins, minerals, herbs), a common tool used in functional medicine. This fact leads some to wonder if functional medicine is legit.
But the reality is that the FDA doesn’t disapprove of these supplements. Instead, it has chosen to take a hands-off approach to not definitively say whether supplements are effective because of the mixed reviews. And when you think about it, it makes perfect sense for functional medicine to have this relationship! Functional medicine bases on the belief that there is no one-size-fits all solution and supplements are just that: supplemental.
So yes, FDA approval IS valuable; but there are things that the FDA just won’t touch.
The Science Behind Functional Medicine
The Cleveland Clinic Center of Functional Medicine reported that 20% health is determined by genes, and 80% is affected by lifestyle, physical, and social environment affects on our genes. Because of this, Functional Medicine practitioners utilize labs to determine current genetics.
Testing for:
- Organic acids
- Micronutrients
- Microbiome
- Food sensitivity
- Comprehensive thyroid
- Hormone and adrenal levels
- Environmental toxins
- Mycotoxin levels
- Allergies
- Genetics
Functional Medicine practitioners study and analyze this information beyond just whether a patient has a disease or not. They evaluate how these systems are interconnected and imbalances may affect other aspects of health. Once coming to these conclusions, Functional Medicine practitioners collaborate with patients for treatment modalities.
Exploring Functional Medicine Modalities
Functional medicine uses three types of modalities: personalized treatment plans, nutritional therapy, and lifestyle modification.
Functional Medicine Personalized Treatment Plans
Functional Medicine practitioners value the uniqueness of individuals and see that no person’s health is the same. Because of this philosophy, every patient has a personalized treatment plan that encapsulates their physical, emotional, and mental health. Some Functional Medicine clinics even have compounding pharmacies, where a prescription can be designed personally for a patient. The personalized modality is completely different from the conventional method of prescribing a generic medication to manage one aspect of patient health.
Functional Medicine Nutritional Therapy
Nutritional therapy, also known as the immunonutrition practice, is a cornerstone of Functional Medicine. Immunonutrition is defined as the potential to regulate the immune system by intervening with nutrients. Nutrients include vitamin A, C, D, E, folic acids, beta carotene, zinc, iron, and manganese.
Providers review nutrient levels from test results and encourage patients to rework their diet. This may mean eating more nutrient food sources or adding a supplement in more severe cases. Test results may also reveal allergies or sensitivities, which practitioners can work with patients on how to avoid those foods.
The nutrition support not only can alleviate chronic conditions, but it also has proven to prevent chronic illness, enhance cognition for dementia, improve outcomes for colorectal and GI oncological surgeries, shorter stays in the hospital, and fewer infectious complications. The risk of obesity, diabetes, hypertension, and cardiovascular disease are also related to these diet modifications.
Functional Medicine Lifestyle Modification
Lifestyle modification encapsulates Functional Medicine. Diet is just one modification, but there are plenty others!
Functional Medicine practitioners may recommend exercises that align with health improvements and patient ability. Another lifestyle modification may be auditing house toxins, which may show up in lab tests results. Practitioners may recommend air or water purifiers for eliminating toxins.
Finally, and most popularly known, Functional Medicine practitioners may recommend supplements. Supplements may be for nutrient deficiencies, heart function, brain function, sleep, or even libido health!
Addressing Chronic Conditions
Functional Medicine is especially known for the successful treatment of chronic conditions. The reason being that chronic conditions are unique to each individual and can affect an entire well-being, which aligns with Functional Medicine’s core principles.
Functional Medicine approaches chronic illness with intense understanding. Focusing on triggers, root causes, and improving symptoms on a deep level. Conventional medication may still be prescribed for chronic conditions, but Functional Medicine also includes lifestyle and diet changes with treatment.
Case Studies and Patient Experiences
There are many case studies comparing Functional Medicine vs conventional medicine for chronic conditions. Here are some highlights:
- A 10 year long study on individuals with type 2 diabetes showed that a Functional Medicine approach to lifestyle, diet, exercise, and behavioral health showed better symptom management and higher labor market outcomes.
- Another type 2 diabetes study revealed that a Functional Medicine approach improved medication response to SGLT-2 inhibitors and GLP-1 receptor agents, plus overall better outcomes.
- A study at the Cleveland Clinic revealed Functional Medicine practices statistically improved and physical health score for patients with inflammatory arthritis (compared to conventional medicine).
- Another study at the Cleveland Clinic revealed that Functional Medicine practices showed a decrease in high-sensitivity C-reactive protein and white blood cell count for patients with Hashimoto’s thyroiditis.
Evaluating Efficacy and Safety
Although Functional Medicine is a newer type of healthcare, it still has oversight, training, and certifications to legitimize it.
Training and Certification
Not just anyone can become a Functional Medicine practitioner. The Institute Functional Medicine (IFM) requires the following qualifications:
- MUST have a license in a primary specialty such as Medical Doctor, Dentist, Doctor of Osteopathy, Doctor of Chiropractic, Naturopathic Doctor, Nurse Practitioner, Physician Assistant, Registered Nurse, Registered Dietician, Acupuncturist, Pharmacist
- Must pass subject-matter health courses from IFM: Gastrointestinal, Detox, Immune, Hormone, Cardiometabolic, Energy.
- Must create a case report and take a written exam. Both are graded by IFM.
- Ongoing education as with any medical professional.
Regulatory Oversight
The Institute of Functional Medicine (IFM) is the leading institute for Functional Medicine, as the only one offering accreditation by the Accreditation Council for Continuing Medical Education (ACCME). IFM partners with renowned clinics like the Cleveland Clinic and top universities such as Dartmouth, Harvard, George Washington University and Yale. The FDA also has jurisdiction to disapprove any Functional Medicine practices.
Debunking Myths and Misconceptions
Myth: Functional Medicine is made up and not based on science
FACT: Functional medicine is based on science. The idea that Functional Medicine is a pseudoscience or made up is not based on facts, but rather a misunderstanding of what Functional Medicine is. Functional Medicine practitioners are required to have conventional training in primary care, and Functional Medicine accreditation is additional education.
Functional Medicine values genomics, body interconnectedness, root cause analysis, and lab testing. Even more, there have been numerous studies backing up Functional Medicine principles.
Myth: Functional Medicine is an anti-medication and anti-medical field.
FACT: Functional medicine practitioners can and will prescribe conventional medications if needed. However, functional medicine practitioners do not solely rely on conventional medicine.
Additionally, Functional Medicine is not an anti-medical field. All Functional Medicine practitioners have medical field degrees and training.
Myth: Functional Medicine is only about supplements.
Yes, supplements are an important part of some Functional Medicine treatments. However, no Functional Medicine practitioner will only recommend supplements without also considering other lifestyle changes.
Integrating Functional Medicine into Healthcare
Functional Medicine isn’t a crazy concept that exists on its own. In fact, many conventional practitioners and other healthcare modalities will collaborate with Functional Medicine practitioners!
Collaborative Care Model
The collaborative care model is one that treats patients with physical and mental health care into one office. Functional Medicine practitioners may work with psychiatrists, counselors, or case managers to benefit the patient inside and out.
Integrative Medicine Centers
Integrative medicine centers are clinics that include Functional Medicine and alternative therapies like acupuncture, aromatherapy, ozone therapy, red light therapy, and more. Patients can benefit from seeing their practitioner and also having specialized support from these centers.
Functional Medicine Practitioners + Conventional Medicine
Seeing a Functional Medicine provider doesn’t mean ditching your primary care physician or specialist. Many practitioners will encourage you to continue the relationship so both providers can work together for the best treatment plan.
Challenges and Limitations
Just as any facet of medicine, Functional Medicine is not exempt from challenges and limitations.
Affordability and Insurance Coverage
Especially since healthcare is already expensive, a huge criticism of Functional Medicine surrounds the affordability. Skeptics may wonder, “how is functional medicine not a scam if it’s so expensive?”
Functional Medicine’s legitimacy is not tied to the price tag. Unfortunately, insurance companies are not inclined to cover Functional Medicine. Functional Medicine’s principles of preventative care do not align with many insurance companies’ business interests.
With the lack of insurance coverage, patients see higher costs; especially since Functional Medicine frequents lab testing. Although studies have shown that investment in Functional Medicine can show long-term cost-effective outcomes, that isn’t a feasible investment for some.
However, some functional medicine is covered by certain insurance plans. For example, some providers can put together a superbill that may be covered by insurance depending on the agency. If you’re wondering about your affordability, contact your insurance agency directly.
Accessibility
Accessibility is another challenge that comes with the territory of Functional Medicine. Since conventional medicine is mainstream and Functional Medicine is not, some individuals have no access to Functional Medicine care. This is an unfortunate truth that will hopefully change as time goes on.
Lack of Standardization
Although Functional Medicine has been around for decades, the standardization isn’t as secure as conventional medicine. There are national accreditations, but no board-certifications per state. Also, the constant changes in the industry are moving fast! Functional Medicine is still getting its footing in mainstream medicine, so the lack of standardization only emphasizes the importance of patient informed consent and education.
Ethical Considerations
All healthcare professionals must take into account ethical considerations of treating patients, and Functional Medicine is no different.
Informed Consent
Informed consent refers to fully informing a patient about a treatment modality in order for full consent.
Functional Medicine practitioners are especially serious about informed consent since the patient journey is based on open communication and understanding someone wholly.
Patient Privacy and Confidentiality
ALL functional medicine patients are safeguarded against the same protections as conventional medicine, like HIPPA and the American Medical Association Code of Ethics which protects physical, informational, desicional, and associational privacy.
Professional Responsibility
Since functional medicine practitioners must be licensed in a primary specialty, they follow the standard of care rules that conventional doctors do.
However, since Functional Medicine practitioners practice differently, they follow the “Respectable Minority Rule”. This rule acknowledges that Functional Medicine practitioners operate differently, but still have a legitimate standard to live up to.
The Future of Functional Medicine
The future is bright for Functional Medicine. As technology advances and information spreads, there’s more interest in how our systems are interconnected.
For instance, there’s a movement for rejuvenating our epigenomic structure—meaning reversing our genes into a youthful state. This movement is a big step for Functional Medicine by validating that we can change our susceptibility to certain diseases. As technology allows us to analyze genes deeper, Functional Medicine will soar in mainstream integration.
Functional Medicine’s entrance into the mainstream arena may improve standardization, recognition, affordability, and accessibility.
Navigating the Landscape of Functional Medicine
Functional Medicine is not a pseudoscience. No Functional Medicine practitioner can practice without conventional medical training and additional accreditation. Harvard, Yale, Dartmouth, George Washington University, and the Cleveland Clinic have backed Functional Medicine and studies. Patients are showing positive changes in pain, inflammation, chronic illness, and outlook on life.
Instead of accepting a dire fate tied to genetics, Functional Medicine shows us that we can have hope about our health. We can take charge of our health, feel empowered, and be functional members of society. Our genetics we were born with aren’t everything, we can use science-backed treatment plans to modify them and live a healthy life.
As you move forward and decide whether Functional Medicine is for you, remember this quote from Medline, an official governmental body:
“Good health information doesn’t give you one treatment over another. It gives you balanced facts based on research”.
Consuming functional medicine information should always be informed and detailed, and your practitioner should always be receptive to questions, feedback, and constructive criticism about your treatment plan. If you ever meet a provider that is not living by these principles, that person is not accurately reflecting Functional Medicine.
Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9173848/
https://www.ucsfhealth.org/education/evaluating-health-information
https://www.ifm.org/news-insights/power-functional-nutrition-2/
https://medlineplus.gov/evaluatinghealthinformation.html
