I get asked very often about the way I work. My work is entirely based on the principles of functional medicine. Today I want to talk a little bit about the difference between conventional and functional medicine and how they would approach disease.
In conventional medicine, one of the biggest problems with it is that they mostly focus on symptoms of diseases. If you go to a doctor and you have a problem, you get a drug for this problem to just bring the symptoms down and there’s often little investigation into what is actually causing that problem.
In functional medicine, symptoms are important as they can give me clues as to what the underlying mechanisms might be that are contributing to the problem, but since I focus on the underlying mechanisms and causes and address those, the symptoms tend to resolve on their own, so I don’t have to worry about going after every symptom individually. I just address the root causes and the symptoms resolve.
So that’s the difference. Conventional medicine works from the outside in, and functional medicine tends to work from the inside out.
The core of all diseases starts with the interaction between our genes and the way that our genes express. There are certain genetic mutations in genes that can either guarantee that something is going to happen to us or make it more likely that we’re going to have a problem. An example would be, mutations in genes that are involved in detoxification don’t necessarily guarantee detoxification problems, but they increase the risk that you might detoxify poorly, especially if you are exposed to certain environmental factors.
Genetics account for 10% or less of disease and the remaining 90% is controlled by our lifestyle, by gene expression and how our genes interact with environmental factors.
This could be our parents’ health at the time of our conception, our mother’s health during pregnancy, and then things like our diet, our lifestyle, physical activity, stress, social status and environment, external environment, like the air that we breathe, the water we drink, chemicals that we’re exposed to, whether we live in an urban or rural environment, and then our internal environment, which would be our microbiome and our hormones and metabolic health, inflammation, oxidative damage, etc.
So, the first thing we investigate is our lifestyle, diet and possible do DNA testing if clients wish so. The second step would be finding underlying mechanisms and processes that lead to dysfunction. They could be things like gut bacterial imbalance, nutrient deficiency, hormone imbalance, chronic infections, etc. The third step would be looking into diseases, and these are things like rheumatoid arthritis or type 2 diabetes. And then the final investigation would be symptoms, such as abdominal pain, fatigue, skin rashes, whatever they may be.
Again, in conventional medicine often the outside of the circle is the focus, and in functional medicine, the inside of the circle is the starting place, and we move outward from there.
The key differences between the functional and conventional approach lie in the limitations of the conventional approach for dealing with chronic illness. Conventional medicine is great for emergency situations that require an immediate intervention, and that’s somewhere where conventional medicine really excels. But with a chronic illness, it’s never that simple, and there’s so much investigation that needs to be done to really get to the bottom of things, and the conventional system is just not set up in a way that makes that possible.
The core of this whole picture is diet and lifestyle and environment, that is always the starting place. It doesn’t make any sense to do anything else if you’re not addressing those things. You can try to do other things, but they’re not going to have a good effect if sleep, diet, stress management, and physical activity aren’t being properly addressed.
What factors lead to disease?
- Gut dysfunction – This includes a lot. It would include leaky gut; low stomach acid; poor digestive enzyme production and malabsorption; SIBO (small intestine bacterial overgrowth); parasites; fungal/candida overgrowth; other infections; and then definitely food intolerances.
- Nutrient imbalance, either deficiency or excess. Now, deficiency is a lot more common, and lots of people these days are deficient in things like vitamin A, D, C, E, B12, selenium, magnesium, and fibre. These nutrient deficiencies are widespread, and that’s very important because nutrients are what fuel our body and our basic metabolic processes.
- Toxicity or toxic overload is another primary mechanism. This can be caused by exposure to toxins like heavy metals or chemicals, phthalates, BPA in plastic etc., and mould or other toxins. Or it can be caused by poor detoxification capacity. So maybe the level of toxic exposure is minimal, but your ability to properly detoxify is low for any number of reasons, or you have a combination of both, which is the most likely scenario.
- Chronic infections and viruses.
- Hormone imbalance. This could include HPA axis dysregulation – adrenal fatigue; metabolic hormone disruption – hormones that regulate blood sugar; thyroid hormone imbalance; and then sex hormone imbalance both in men and women.
- Immune dysregulation, another big category because this includes not only autoimmunity or overactive immune system but also an underactive immune system; poor or weak immune function; inflammation, systemic inflammation and things like chronic inflammatory response syndrome, which is a toxin-related illness.
- And then the last one would be genetic mutations that can lead to problems with methylation, cellular energy production, mitochondrial function, etc.
Those are all of the things that need to be investigated and you can see why functional medicine is complex, and why it takes as long as it takes to address any chronic disease.