Functional Medicine: Science or Quackery?
Posted by Andrea Nakayama
I’m always surprised when I discover that some people think Functional Medicine is quackery. They may say there aren’t enough studies to back it up, that the evidence for its efficacy just isn’t there, or that it doesn’t have any sort of board certification.
Yet I beg to differ.
The History of Functional Medicine
Functional Medicine and Functional Nutrition are rooted in a kind of healthcare that:
- honors the truth that each patient is unique
- acknowledges the need for curiosity throughout the clinical process
- recognizes the need for systems thinking in assessments
- highlights the care in healthcare
In the late 1800s, Sir William Osler claimed that “It is more important to know what patient has the disease than to know what disease the patient has.” He insisted on teaching medicine outside of the classroom, taking it instead to the bedside. In fact, Osler wanted his epitaph to read, “He taught medical students at the bedside.”
Osler was not alone.
A Personalized Approach to Health
Throughout history, doctors and researchers have been heralded for their efforts to treat people who were suffering as the individuals they are—for their specific needs and the unique conditions that lead to their signs, symptoms and diagnoses. But somehow we continue to slip-slide back into misinformed cultural desires. Those desires are for the quick-fix (where one doesn’t exist), the band-aid approach (that masks the roots we actually need to uncover), or for the seductive theories that may be interesting to study in the classroom but hold little weight by the bedside.
No wonder there is a growing population of people suffering from chronic conditions not addressed by these types of approaches!
Functional Medicine has its basis in bioindividuality. This principle states that we are all biologically and genetically unique; that we are all impacted by myriad and diverse life experiences and exposures. Because of bioindividuality, each person needs different nutrients and therapies, in particular doses, in order to heal.
In other words, each patient is unique.
A Functional approach to health and healing considers how the unique parts within a person’s body, along with their unique history and their unique habits, interrelate and understands how these systems work together over time.
Functional Nutrition Rooted in Orthomolecular Medicine
“Ortho” means “normal.”
“Orthomolecular” is a term that was coined by Linus Pauling in 1968. It describes a method that uses nutrients and “normal” constituents of the body in optimal amounts as treatment and therapy. In other words, nutrients are introduced and utilized to fine-tune a person’s biology to improve function and preserve health.
Orthomolecular Medicine is one of the forerunners of a Functional approach. It fundamentally states that the basis for health is good nutrition, and that “good nutrition” is different for each of us because we all have unique nutritional needs.
Let’s consider an example: a study might conclude that eggs are good for brain health and development because of their high concentration of the nutrient choline. Yet for someone who’s taken several rounds of antibiotics in their childhood, like me , and developed an immune response to eggs as a result (as is true for me), eating eggs will not help, but instead harm my brain health—possibly contributing to systemic inflammation.
Therefore, I avoid eggs, even though I believe the egg to be a perfect whole food in and of itself.
In doing so, I take in less choline on a regular basis than people who have a daily omelet or hard-boiled egg for breakfast. So I, and others who steer clear of eggs for their own bioindividual reason(s), will have a greater need to address choline intake, making sure to get this important nutrient elsewhere.
Similarly, an MTHFR polymorphism can make it difficult to use the folate coming into the body through diet alone. Therefore someone with this gene mutation, if activated, would have a greater need to address their body’s needs for folate, and may even need to address how the body has grown accustomed to functioning without access to this much needed nutrient.
How Functional Nutrition Compliments Western Medicine
Take the topic of “anti-nutrients”, for example. An anti-nutrient is any “food” that requires more nutrients for the body to use it than the food itself supplies. Refined sugar is considered one such anti-nutrient. It supplies zero nutrients while requiring magnesium, zinc and B vitamins (to name a few) for its metabolism.
Anti-nutrients are a common cause of subclinical deficiencies, which refer to a deficiency in one or more essential nutrients that is not severe enough to cause obvious symptoms or clinical signs of deficiency, but is still significant enough to negatively impact health and well-being. These deficiencies often fly under the radar of Western medicine due to traditional lab tests (or at least traditional lab test interpretations).
And these upstream nutrient deficiencies can lead to downstream complications of the nervous system, the energy systems and, most particularly, the immune system.
Often unrecognized, these subclinical nutrient deficiencies can lead to clinical complications of the nervous system, the energy systems, and the immune system. This subclinical realm is sometimes referred to as “hidden-hunger.” With Functional Medicine (and Functional Nutrition in particular!) we can recognize and address “hidden hunger,” bringing about metabolic and physiological homeostasis to prevent clinical issues before they occur.
Far from quackery, Functional Medicine just makes good sense. It makes good medicine. And true to it’s name, it can help your practice function at its best.
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