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HEALTH CONCERN? BioHealth Health Concerns

Functional Medicine: The Basics

Contributing Author: Ross, Steven D.C, F.A.S.B.E, D.A.A.P.M.

Ross StevenDr. Steven Ross, President and Co-Founder of The Institute For Integrative Medicine. The IFIM is an evidence based educational institution focusing on teaching the integrative practitioner the evidence based medicine, business, marketing acumen and personal development needed to succeed in their practices. Dr. Ross has been practicing Integrative and Functional Diagnostic Medicine since 1982. He maintains an active practice in the southern California while consulting with patients and doctors worldwide. He is the author of Curing the Cause and Preventing Disease; a guide not only for patients seeking a new and scientific method of treatment but, also for health care professionals interested in incorporating evidence based treatment plans in helping their patients achieve optimum health without the use of dangerous drugs.

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Functional Medicine (AKA Functional Diagnostics, or Functional Diagnostic Medicine) combines traditional health care of years gone by with modern science. It focuses on improving physical, mental, and emotional function. Functional Medicine sees disease not as an enemy, but as an opportunity for change and growth. Older systems of medicine believed that the body was self-regulating and that disease occurred when this self-regulation was disrupted. In more contemporary terms, we speak of feedback loops. When these feedback mechanisms get stuck or disrupted, imbalances and disharmony occur. We call this being “sick.” The aim of Functional  Medicine is to help your body come back into dynamic alignment.

Functional Medicine focuses not on endpoint or pathological states, but on the dynamic processes that underlie and precede them. While acknowledging the existence of pathology as well as a need to understand it, Functional Medicine focuses on the underlying processes and seeks a path of therapy that engages these underlying events. Functional Medicine is used in combination with contemporary medicine for the best possible approach.

Functional Medicine is holistic rather than specialized. It approaches the body as web-like and holographic. Contemporary medicine compartmentalizes the body into specialties: liver doctors, heart doctors, mind doctors, etc. Functional Medicine considers all systems to be linked and explores patterns between organ systems. Some of the many diverse fields that contribute to Functional Medicine include genetics, herbal medicine, nutrition, and environmental toxicology, and endocrinology, natural medicine of all types including chiropractic, gastroenterology, psychology, and immunology.

Functional Medicine Is:

  • Patient centered
  • Based on each person’s unique needs
  • Helps balance your biochemistry
  • Integrates physical, mental, and emotional
  • Encourages you to take an active role in your program
  • Interested in outcomes rather than controlling symptoms

Patient Centered Care

Today, people want medical care that compliments their lifestyle and values. Many people are turning to complimentary medicine because they feel listened to, cared for, and treated as a whole person.

Functional Medicine looks at how you are “doing” and “feeling.” You won’t be told, “It’s all in your head.” Functional Medicine is interested in you—your life, your well-being, what you eat, your work environment, your relationships and communication with others, how you relax and play, your hobbies, what medications you’ve taken, how well your digestive system functions, and what chemicals you’ve been exposed to. Your total lifestyle helps create a picture of, and understanding, who you really are. Hearing about your life and significant clues and information can be found to really help you feel better. You can change the way you feel!

Rather than naming a specific disease, Functional Medicine looks to find the underlying causes. The Functional approach takes you and your lifestyle into the practice of medicine. It looks at you in context of your life and choices. Your treatment program will reflect your needs.

Who can benefit from this approach?

Many people today have complex health problems that don’t fit into simple categories, and involve inflammatory responses, or immune, nervous, digestive, energy, and/or cardiovascular systems. These people are best helped by a functional approach. Typical patients include people with chronic fatigue syndrome, auto-immune illness, fibromyalgia, fatigue of unknown origin, and digestive complaints. Often, these people have been to many physicians without results. Functional Medicine is also for people interested in true preventive health care. They want to take an active role in their own well-being and that of their family. These people seek out Functional  Medicine practitioners to act as guides for their continued good health.

Common Categories of Functional Imbalance

Oxidative Stress
Nutritional Imbalances
Intestinal Dysfunction
Impaired Detoxification
Endocrine Imbalance
Immune/Inflammatory Imbalances

How does Functional Diagnostic Medicine differ from Conventional Medicine?

In a Functional Diagnostic Medicine, the approach is that the absence of disease is NOT health. Functional Diagnostic Medicine is concerned with finding out how you function—on a physical, mental, emotional, and spiritual level. Optimal wellness is the ultimate goal.

In Conventional Medicine, making a diagnosis is often the endpoint of therapy. Just treat the symptoms and send the patient home. Functional Diagnostic Medicine looks deeper to find the cause. Pain, discomfort, or reoccurring health complaints is our body’s way of trying to get us to pay attention. Rather than taking pain medication each time we get a headache or backache, perhaps we ought to ask why we are experiencing the pain.

Functional Diagnostic Medicine looks to see if you are missing something you may need—perhaps you have special needs for vitamins, minerals, probiotics, or amino acids. It also looks to see if you have something you don’t need, such as environmental contaminants, heavy metals, bacteria, fungus, and/or parasites. The answer may be simple or complex. For example, if you are depressed, perhaps an antidepressant would help you feel better. But, wouldn’t you really like to explore why you are depressed? Could it be a neurotransmitter problem? Or a relationship problem? Could you be reacting negatively to food you are eating? Or could it be the load of heavy metals or toxic chemicals you’ve accumulated? This approach obviously takes more work than just writing a prescription for an antidepressant, but it gives a much more satisfying answer.

Contemporary medicine talks about “prevention.” However, pap smears, cholesterol and blood pressure screening, and cancer testing are all tests for early detection of disease, not prevention of disease. Functional Diagnostic Medicine is concerned with real prevention of disease. By paying attention to small problems, you can often prevent large ones. We seek to help you be able to do more of the things you want to for longer in life and to increase your “health span.”

Functional Diagnostic Medicine

Conventional Medicine

  1. Health Orientation
  2. Patient Centered
  3. Biochemical Individuality
  4. Holistic
  5. Cost Effective
  6. Looks at deep causes of illness
  7. Preventive Medicine
  1. High Touch/High Tech
  1. Disease Orientation
  2. Doctor Centered
  3. Everyone treated the same
  4. Specialized
  5. Cost Prohibitive
  6. Diagnoses Illnesses/Names them
  7. Early Detection of Disease is called Preventive Medicine
  1. High Tech

Examples of How Functional and Conventional Therapies Differ

Irritable Bowel Syndrome

Functional Diagnostic Medicine
Will look at food sensitivities; possible fungal, parasitic, and/or bacterial infections; Looks at digestive function

Conventional Medicine
Eat bran. Learn to live with it, and stress reduction

Migraine Headaches

Functional Diagnostic Medicine
Will look at hormone balance; food sensitivities; stress reduction techniques; herbs such as feverfew

Conventional Medicine
Medication and rest


Functional Diagnostic Medicine
Will look at exercise patterns, food sensitivities, digestive function. Will use nutrients to help rebuild cartilage. Will do a metabolic cleansing regime and alkalizing diet to help remove calcification in the joints.

Conventional Medicine
Medication and physical therapy or rest


Functional Diagnostic Medicine
Will look at counseling, use of nutritional supplements, dietary modification, and exercise programs

Conventional Medicine
Medication and Counseling

Biochemical individuality
Roger Williams, MD, coined the term “biochemical individuality.” Just as each of us has a unique face, fingerprint, and personality, our biochemistry is also unique. A wide variety of “normal” values are found. For example, research has found that some babies require four times the vitamin B6 as others, and ranges of serum amino acids in healthy young men varied fourfold on average. Looking for your unique biochemical needs provides a foundation for Functional Diagnostic Medicine.

4-R approach

This is the basis of Functional Diagnostic Medicine and provides the basic functional treatment philosophy. Although simple in concept, it is an effective approach for resolving difficult and undefined illness. The 4 Rs are Remove, Reinnoculate, Replace, and Repair.

Remove refers to the elimination of anything that may be in our body or diet that contributes to poor health. This can include foods, pesticides, food additives, unwanted bacteria, fungi, and parasites.

Reinnoculate involves the use of probiotic supplements containing lactobacillus acidophilus, bifidobacteria, and other friendly flora. These bacteria repel harmful microbes, and have antitumor effects. They are easily disrupted by antibiotics and the stress of contemporary living.

Replace refers to the addition of supplements to support digestive function and may include digestive enzymes, bile salts, and/or HCl.

Repair refers to the nutritional support that helps quickly regenerate and heal the body.

Your relationship with your doctor

In Functional Diagnostic Medicine, your relationship with your doctor is different. It is an equal partnership, and built on teamwork. It makes for a rewarding relationship for both parties. Functional Diagnostic Medicine asks us to pay attention to our bodies and our biology rather than our sociology. It asks us to be in partnership with our physician, to use our doctors as advisors and explorers on our journey of life.

Your relationship with your doctor will be a partnership. Your physician will be your advisor in your life journey. You may find that he or she spends more time with you. You may fill out extensive questionnaires about your medical history, work history, diet, exercise patterns, stress level, hobbies, use of supplements and medication, and home and work environment. A program will be developed specific to you and your individual needs and lifestyle.

What is expected of you? You will be expected to make changes in the way you eat, think, feel, and experience life. You are an important part of this process and your role is primary. You are asked to participate fully in the process. The benefits are tremendous and you will see effects ripple out into your relationships with yourself and others.

You may be asked to make changes in food choices, eating patterns, take nutritional, homeopathic or herbal supplements, exercise, go through a detoxification program, meditate, see a counselor about life issues, join a support group, have massages or other body work, sit under colored lights, or any one of many other modalities. You probably will be asked to participate in testing, some of which you will do at home. Some may involve laboratory testing, while others may involve testing the pH of your urine or taking your basal body temperature.

What are the benefits of a Holistic approach?

By looking at each person as an entire being, whole person patterns can be seen. Often, people go to see a variety of specialists—one for heart problems, another for gynecological problems, an internist for general needs, and so on. For example, a man went to see a cardiologist because he experienced heart palpitations. The cardiologist put him on heart medication. He saw his internist because he had tremendous leg cramping, and was put on a muscle relaxant. And, his psychiatrist put him on an antidepressant for anxiety. The same man saw a Functional Diagnostic Medicine physician who immediately noticed that all of these symptoms could be the result of a lack of magnesium. Magnesium and other supportive nutrients were given to him, and he was able to discontinue all other medications.

Better health now

Most of us have a reoccurring health problem that can be alleviated or corrected through Functional Diagnostic Medicine. Many of us just learn to live with a variety of small to large health problems and to limit our lives accordingly. Often, people with irritable bowel syndrome stay home because they are unsure of their bowels. Many women with migraines don’t schedule anything during certain parts of their menstrual cycle. And people with arthritis just give up moving in certain ways or doing certain things because they can’t. We have been told to just accept our limitations. Physicians working with Functional Diagnostic Medicine are realistic about the possible limitations, but optimistic about helping you feel really well again.

Increased life and health span

Our goal isn’t necessarily for you to live longer, although you just might. Many people have experienced a decline in health for the last several decades. Yet, we all know people who lived happily and healthily until the last few months or year of life and then quietly passed of “old age.” The goal of Functional Diagnostic Medicine is to improve overall health throughout life and especially in old age. A recent study from the University of California at Stanford showed that people who began paying attention to preventive health care in mid life—stopped smoking, exercised, and made dietary changes—had fewer hospitalizations, surgeries, took fewer medications, and lived longer than people who didn’t.

What types of lab tests may be used?

Evaluating organ “function” versus organ “pathology” is one of the principles of Functional Diagnostic Medicine. Many labs have developed a number of assessment tools that allow practitioners to understand a patient’s functional status. Because these tests are fairly new, many physicians are unfamiliar with their use. These tests compliment the usual testing that physicians use and can detect problems long before more traditional tests find anything amiss. Tests may examine blood, hair, stool, urine, breath, and/or saliva. Common tests check for your nutritional status, digestive function, food and environmental allergies, amino acid balance, energy metabolism function, hormones balance, and more. With this approach, no specific disease is being looked for; rather, your doctor is looking to determine why your body is out of balance.

For example, food allergy testing can be used in a wide variety of instances. Some common ones include children with learning or behavior problems, and people with migraines, skin problems, depression, digestive complaints, and foggy thinking. Hair analysis may be used if exposure to heavy metals or malabsorption of minerals is suspected. Innovative saliva testing can measure your levels of hormones such as DHEA, progesterone, testosterone, and estrogens. Stool testing is used to measure overall digestive function, whether you’ve got enough good bacteria in your gut, and whether you have bacteria, fungus, or parasites that interfere with good health.