Functional Medicine Explained: Experiencing the Difference

You can find plenty of information on the web about functional medicine — websites, blogs, videos, podcasts, and more. In fact, I’ve even written about it myself (please see The Difference between Traditional Doctoring and Functional Healthcare here on my website).

But based on my 20-plus years of experience as a functional medicine practitioner, it dawns on me that some potential patients may not fully understand or appreciate the advantages of functional medicine until they experience the difference for themselves.

The patients who describe the most dramatic epiphanies say they reached a dead end on the path through conventional medicine just before discovering functional medicine. They arrive at my office only after having “tried everything.” They are frustrated and they say I was the last house on the block in their search for a solution to their health issues.

Even their doctors were losing patience — and patients — because nothing in their many years of conventional medical training offers them any insight as to what’s going on or how to treat it. As a result, these patients often are led to believe that “it’s all in their head” or that the best they can hope for is the ability to manage their symptoms.

Patients say their first encounter with a functional medicine doctor resulted in a session with someone who not only listens to them but understands and empathizes with them. These health practitioners can describe what’s going on in their patients’ bodies and in their lives and how corrections can be made. They begin to feel a huge burden lifted as their frustration is replaced with understanding and hope.

In this blog post, I explore some of the attributes of the practice of functional medicine that make it so different from conventional medicine. And despite my obvious bias, I will attempt to do so from a patient’s perspective.

Time and attention

One of the big differences you’ll notice when you visit a functional medicine practice is that your doctor spends far more time getting to know you instead of focusing solely on your illness. Yes, you visit a doctor for relief from suffering, but your illness is the product of what’s going on inside your body and in your environment. We want to know what the root causes of that dysfunction are, so we can begin to address them.

And that requires a long conversation.

Suppose for a minute, that you seek advice from your conventional doctor for indigestion. The doctor prescribes medication to treat the indigestion — typically a medication that reduces the production of stomach acid. In contrast, a functional medicine doctor wants to know when you started to experience symptoms, what your diet looks like, whether you’ve been treated with antibiotics in the past, whether you’re sensitive to certain foods, the quality of your sleep, and more.

As a functional medicine practitioner, I want to know why you’re experiencing indigestion before I offer any treatment recommendations. It’s possible that the lining of your gut is damaged, or you have an imbalance of microorganisms living in your gut. Perhaps you have a food intolerance or sensitivity, or maybe you’re under constant stress. Each of these conditions would require a significantly different treatment approach than that offered by conventional medicine.

Every doctor is going to review your medical history and previous treatments to gain insight and get up to speed on what has been tried in the past. When you see a functional medicine practitioner, you can expect the following differences:

• Your doctor will know a great deal about you already after reviewing your Functional Medicine Analysis— the detailed questionnaire you fill out and submit prior to your initial consultation. Your Functional Medicine Analysis helps your doctor understand the context of your visit, nutritional status, environmental triggers, hormone balance, digestive health, and emotional state, to name a few key areas to be explored.
• Your functional medicine doctor is likely to spend, on average, one hour with you during your initial consultation. This is far more than the usually 15 to 20 minutes you get with a conventional primary care physician or specialist. And it’s a fair amount of time for you to get to know your provider and for your provider to get to know you.

What’s the importance of time?

Most of the patients I see are dealing with unresolved chronic health conditions. They’ve had many previous doctor visits, often with multiple doctors. The time we spend together gives me the opportunity to begin to develop an understanding of what’s going on, what might be missing, and what to focus on first.

A recent patient told me that she felt emotionally relieved by our visit because, in her words, “I have been to many doctors in the last two years trying to figure out what was going on with me. I have not been feeling well at all, and the doctors just kept saying that I was fine, and it was all emotional. Nobody was looking at the whole picture. I finally feel heard! I wanted someone to look at things more holistically.”

This was a breakthrough moment for the patient and for me as her doctor. I discovered through her Functional Medicine Analysis that she had poor digestion that was related to both diet and several environmental factors of which she was unaware. I felt at ease during our consultation and felt no need to rush her because I had set the appropriate amount of time for her visit and because I already felt confident that I could help her.

I knew there was an emotional component, which is almost always the case. She was feeling anxious and exhausted, but why? Why was she so anxious? Why was she having to struggle to gain control of her mental health? The gut and the brain are interconnected; there is even a medical term for it — the gut-brain axis. Each depends on the other for optimal health and function. Diet and poor gut health contribute to anxiety. This connection was overlooked in her previous consultations.

Over the course of our hour-long consultation, it became clear to me that there were a variety of physical factors that all tied into the anxiety and fatigue she was experiencing. She needed a holistic approach that addressed not only her anxiety and fatigue but also, and perhaps more importantly, the underlying biological and physiological factors responsible for how she was feeling.

Another contributing factor was the frustration that her previous doctors were feeling due to their inability to help. Their frustration led the patient to believe that there was no physical explanation, which inadvertently added to her psychological and emotion suffering.

Testing

Functional medicine practitioners follow the guideline of “Test, don’t guess.” We don’t diagnose by prescription — trying different treatments and then pretending to know what the problem was just because our patient experienced some degree of temporary relief.

Your functional medicine healthcare provider is likely to suspect the root cause of what’s ailing you based on your Functional Medicine Analysis but will then gather additional information through lab tests and diagnostics. Lab tests may check the blood for vitamin deficiencies, genetic abnormalities, and food sensitivities; check the stool for GI imbalances or dysfunction; test the urine for signs of metabolic dysfunction; swab for yeast overgrowth; and conduct other diagnostics that may be needed to develop a comprehensive diagnosis and personalized treatment plan. Many of these tests are covered by insurance while others may need to be paid for out of pocket. Your functional medicine provider can educate you on what the best testing options are for your concerns and budget.

In my experience, choosing the right tests can make all the difference, not only in developing an effective treatment plan, but also in saving patients time and money. I have seen patients who have been over-tested and under-tested. In either scenario, if the providers had spent more time understanding the patient, they may have opted for more targeted testing or alternative tests that would have provided better answers in less time and for less money.

For example, I have seen patients who had all the symptoms of hypothyroid but were not diagnosed as having the condition because their lab tests showed normal levels of thyroid hormones. However, they never had a sonogram of their thyroid. One glance at their sonogram was enough to tell that their thyroid was inflamed.

I also have patients who have been to gastroenterologists but have never had a stool test, even after they failed to respond to conventional treatments. Nobody can tell what’s going on in the gut without looking at what’s in it. A simple stool test often contains all the answers.

Thinking outside the box

Conventional medical doctors are well intentioned and well trained, but their perspective is limited by the scope of their education. They are taught primarily how to diagnose disease and then treat it with medication, surgery, and other interventions, such as chemotherapy and radiation. Medical schools focus far less on preventing illness and restoring health. As a result, when you visit a conventional medical doctor, you’re likely to leave the office with a diagnosis and a prescription — usually for a medication that’s designed to alleviate symptoms, not to address the root cause of your illness.

When you see your primary care physician or are referred to a specialist with symptoms that don’t fit inside their diagnostic box or that fail to show up on their limited testing and diagnostics, you get shuffled from one doctor to the next and from one medication to another. Over time, you may come to realize that your doctors have run out of options. Worse, you may begin to feel that you’re the problem.

In many cases you just need someone who can think outside the box and who can discover the keys to your success in partnership with you. After years of chronic problems, it’s just not realistic to expect a magic pill or a quick fix.

I have found that some of my most complex cases involve mold illness, Lyme disease, or chronic stress. Over years, a body burdened by a toxin, infection, or stress, can develop many imbalances within the digestive tract, immune system, nervous system, and endocrine system.

Effective treatment often requires a layered approach involving several systems of the body, along with treatment that restores health at the cellular level — providing cells with the nutrients they need for optimal health and function. A layered approach may involve addressing viral infections that lie dormant (such as with Lyme disease), mold remediation (if you live or work in a water-damaged building), stress management, dietary modifications and nutritional supplements, sleep optimization, and more. Treatment for chronic conditions is rarely in the form of one or more prescription medications. Working with your provider toward a common goal is the key.

I have rarely heard of a conventional doctor who focuses on restoring health and fitness, building resilience, or lessening a patient’s reliance on antibiotics, acid reducers, or other medications that simply act as bandages to cover a problem. More frequently, I see doctors layering on prescription medications, often prescribing medications to treat the problems caused by previously prescribed medications.

Don’t get stuck, like many patients and doctors, on the paradigm of one problem, one treatment, one cure. The complexity of the human body and mind far exceed the simplicity of conventional medical diagnoses and treatments.

The good news is that you don’t need a cure to be healed. You won’t get healthy merely by eliminating illnesses, but you can eliminate illnesses by improving your health one step, one layer at a time until you find that your quality of life has drastically improved.

Searching for the ultimate cure for a chronic health condition is a noble ideal, and often increases our knowledge and insight, But the most effective and lasting approach is usually the one that makes the most sense — optimizing one’s health and fitness.

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About the Author: Dr. Matt Lewis, D.C., DACBN, CFMP®, specializes in diagnosing and treating the underlying causes of the symptoms related to chronic and unexplained illness through nutrition, lifestyle, chiropractic, and other natural approaches to whole-health healing in Tampa, Fla. Dr. Lewis has 20 years of experience practicing nutritional and holistic medicine. He earned his B.S. in Biology from Shenandoah University, his Doctorate in Chiropractic from Life University, his Diplomate status in Clinical Nutrition from the American Clinical Board of Nutrition, his CFMP® from Functional Medicine University, and his certification as a Digestive Health Specialist (DHS) through the Food Enzyme Institute. Dr. Lewis’ passion for health and wellness stems from his own personal experience. With a family history of autoimmune conditions and diabetes, and his own lab tests showing his genetic susceptibility to Hashimoto’s thyroiditis (autoimmune thyroid), he has learned how to restore his own health and vigor to prevent the onset of these and other illnesses and live an incredibly active life. Through this process, he acquired a deeper understanding of health and wellness, which he now offers his patients in Tampa.