Functional Medicine

What is functional medicine?

Functional medicine is a treatment approach created by Dr. Jeffrey Bland, who has a background in biochemistry and nutrition. He founded the Institute for Functional Medicine with his wife, Susan Bland, to teach healthcare practitioners the method he developed for treating and preventing chronic disease.

Functional medicine is a form of alternative treatment. It typically involves a mix of treatments which are not necessarily evidence-based. This means that some treatments offered in functional medicine are not proven by research to be effective. Functional medicine remains a controversial and debated topic among healthcare professionals.

What can functional medicine help with?

Functional medicine was developed to treat and prevent chronic disease. Supporters of functional medicine say that it can help with a wide range of complaints relating to the gastrointestinal system, immune system, and other chronic diseases such as diabetes.

Does functional medicine work?

Research is currently scarce and does not enable a conclusion that functional medicine is effective. Its use - in the absence of evidence of its efficacy - has been criticized by many in the medical community.

Additionally, The American Academy of Family Physicians (AAFP) currently states that it

“…does not deem it appropriate to learn how to practice functional medicine or implement related techniques…” (1)

That said, a number of clinical trials are underway, such as those run by the Cleveland Clinic.

What does functional medicine involve?

The aim of functional medicine is to identify and address the underlying cause of disease, rather than treating symptoms.

The underlying causes of disease are thought to vary according to individual factors like genes, environment and lifestyle. The best-fitting personal treatment is selected on the basis of the unique underlying causes for each person.

Practitioners build a strong relationship with patients before taking a comprehensive history. Tests and lab services, which might include genetic testing, help to assess the underlying causes. The assessment method described by the Cleveland Clinic also involves appointments with a dietitian and health coach.

The individual treatment plan may include a combination of lifestyle changes, medicine, supplements, and other tools.

Some critics note that it’s hard to find information about exactly what functional medicine does involve. This makes it more challenging to evaluate.

Frequency and length of functional medicine treatment

There is no set length or frequency of treatment in functional medicine. If you choose to pursue functional medicine, the length and frequency of treatment depend on your individual circumstances and the problems you are experiencing.

What happens in a typical functional medicine session

According to the Institute for Functional Medicine, a session might involve the following:

  1. Information gathering: The practitioner builds a strong relationship with you, asks questions, gives questionnaires, performs assessments and physical examinations to understand the problem. You’ll be asked questions about your lifestyle, diet, exercise, mental health, trauma, spiritual health, social support, and other factors in addition to your medical history.
  2. Organizing information: Information is often organized using a timeline and matrix tool. This helps develop an individualized and comprehensive history, and determine factors underlying the problem.
  3. Confirming the information: The practitioner re-tells your story in their own words, going through the information to confirm it is accurate. You might explore the effects of lifestyle factors, goals, triggers, pre-disposing or perpetuating factors. This step might also include identifying imbalances in physiological systems.
  4. Order and prioritization: The step is based on the result of the above conversation. Your perspective and preferences are taken into account in deciding the next steps.
  5. Initiate: Further assessments, education or treatment are initiated based on the prior steps. This might also include referrals to other healthcare providers. You might learn about mindful eating, nutrition, or the relaxation response. Treatment may also involve making changes to your lifestyle, learning about stress management, and taking nutritional supplements or medication.
  6. Track: The practitioner works with you to track the effectiveness of treatments and assess progress at each session.

What to look for in a functional medicine practitioner

Keep in mind that there is not currently a strong evidence base to support the efficacy of functional medicine, so it’s good to be cautious. If you do decide that you’d like to learn more about functional medicine, consider the following:

  • Talk to a licensed physician: This ensures that they have completed the appropriate level of education to practice medicine.
  • Make sure you feel comfortable with them: Given that functional medicine practitioners emphasize the importance of the relationship, prioritize the potential for developing a strong working relationship.
  • Ask questions before you make a decision: Ask for a preliminary phone call so that you can ask the practitioner:
  • About their qualifications and training
  • About their experience providing functional medicine to other patients
  • What the outcomes were for these other patients
  • About their experience treating people with concerns similar to your own
  • What functional medicine treatment will be like
  • What kinds of treatment this might involve for you
  • What the evidence is to support that this treatment is safe and effective
  • Whether they work with other healthcare practitioners
  • What the costs will be

It’s a good idea to speak to a few different practitioners, including those who offer different treatments, before making your mind up.

Sources and references