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. And history has my back!
Functional Medicine and Functional Nutrition have their roots in a legacy of efforts to return to a kind of healthcare that:
- honors the truth that each patient is unique
- acknowledges the need for curiosity throughout the clinical process
- recognizes that we need to embrace systems thinking in our assessments
- and 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.
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, pure and simple (and obvious, in my opinion). This is the principle stating that we are all biologically and genetically unique, and we’re 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, pay heed, as one size never fits all.
A Functional approach always honors bioindividuality.
A Functional approach always considers that the constituent parts—within the person’s body, their history, and their life habits—interrelate, and understands how these systems work together over time.
“Ortho” means “normal.”
“Orthomolecular” is a term that was coined by Linus Pauling back in 1968. It describes a method that uses nutrients and “normal” constituents of the body in optimal amounts as treatment and therapy. This means that nutrients—likely specific ones and in specific doses—are introduced and utilized to fine-tune the 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 different needs for nutrients.
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 many of us did), 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 so doing, 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 reasons) will have a greater need to address my choline intake. I need to pay attention and make sure I’m getting this important nutrient elsewhere.
Similarly, a MTHFR polymorphism makes it difficult to use the folate coming into the body through diet alone. Therefore someone with this gene mutation 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.
We can also look at an orthomolecular approach as it applies to anti-nutrients.
An anti-nutrient is any “food” that requires more nutrients for the body to use it than the food itself supplies. Refined sugar is one such anti-nutrient. It supplies zero nutrients while requiring magnesium, zinc and B vitamins (to name a few) for its metabolism.
So do you think that a person who is or has consumed a lot of sugar or alcohol in their life might have some subclinical deficiencies in these vitamins and minerals due to the nutrients that they’re unknowingly robbing from their very own bodies? You bet!
There are many people walking around with subclinical deficiencies in certain nutrients. If you’re working with clients, you’re likely to encounter them! These subclinical deficiencies often fly under the radar in Western medicine and traditional lab tests (or at least traditional lab test interpretations!) That means that just because a patient was tested, doesn’t mean they aren’t deficient.
And these upstream nutrient deficiencies can lead to downstream complications of the nervous system, the energy systems and, most particularly, the immune system.
Here’s a Functional sequence of what happens when there is a nutrient deficiency in the body:
- First, nutrients are depleted from the body’s tissues
- This lack of nutrients in the tissues then impacts the body’s overall enzyme activity
- This leads to a physiological injury, where immunity and function are affected
- If that depletion continues, a classical or pathological deficiency can manifest
- Finally, if not addressed, the pathology can result in permanent injury to tissues and organs or even death
As you can see, while a subclinical deficiency may seem minor, we have the opportunity to catch them with optimal nutrition as early as possible.
This subclinical realm is also sometimes referred to as “hidden-hunger.” Taking an orthomolecular or Functional approach tells us that we can address this “hidden hunger” with normal nutrients to bring about metabolic and physiological homeostasis and prevent downstream issues before they occur.
Far from quackery, Functional Medicine and Functional Nutrition just make good sense. And true to their names, they make your practice function well!
When you know how to take a Functional approach, nutrients matter and food is medicine.
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