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UNDERSTANDING FUNCTIONAL MEDICINE By Elizabeth Lipski, PhD, CCN

UNCTIONAL MEDICINE COM - contribute to Functional Medicine are: genetics, bines the ancient traditional health herbal medicine, nutrition, environmental toxicol- beliefs of primitive peoples with the ogy, endocrinology, natural medicine of all types, F bene ts of modern science. It is an gastroenterology, psychology, and immunology. emerging eld which focuses upon improvement of physical, mental, (spiritual?) and emotional Functional Medicine function. Functional Medicine sees disease, not as an enemy, but as an opportunity for change • Is Patient Centered and growth. In older systems of medicine it was • Is based on each person’s unique needs believed that the body was self-regulating and • Helps balance your biochemistry that disease occurred when this self-regulation • Integrates physical, mental and emotional became disrupted. In more contemporary terms • Uses Challenge tests rather than diagnostic tests we speak of feedback loops. When these feed- • Encourages you to take an active role in your back mechanisms get stuck or disrupted, imbal- program ances and disharmony occur. We call this being • Is interested in outcomes rather than controlling “sick”. The aim of functional medicine is to help symptoms your body to come back into dynamic alignment. • Is used by all disciplines of medicine: medical, naturopathic, chiropractic, osteopathic, den- Functional medicine focuses not on endpoint or tistry, nutrition, etc. pathological state, but on the dynamic processes which underlie and precede it. While acknowl- Patient Centered Care edging the existence of pathology as well as a need to understand it, functional medicine fo- Today people want to seek medical care that cuses on the underlying processes and seeks a compliments with their own lifestyle and values. path of therapy which engages these underlying Many people are turning to complimentary medi- events. Functional Medicine is used in combina- cine because they feel listened to, cared for, and tion with contemporary medicine for the best are treated as a whole person. possible approach. Functional Medicine looks at how you are “do- Functional Medicine is holistic rather than spe- ing” and “feeling”. You won’t be told “It’s all in cialized. It approaches the body as web-like and your head.” Functional Medicine is interested in holographic. Contemporary Medicine compart- you—your life, your well-being, what you eat, mentalizes the body into specialties: liver doc- your work environment, your relationships and tors, heart doctors, mind doctors, etc. In Func- communication with others, how you relax and tional Medicine, all systems are known to be play, your hobbies, what medications you’ve linked and patterns between organ systems are taken, how well your digestive system functions, explored. Some of the many diverse elds which and what chemicals you’ve been exposed to. www.innovativehealing.com © Elizabeth Lipski, Ph.D., CCN Innovative Healing Page 2

Your total lifestyle helps create a picture of By • Intestinal Dysfunction understanding who you really are and hearing • Impaired Detoxifi cation about your life, signifi cant clues and information • Immune/Infl ammatory Imbalances can be found to really help you feel better. You • Endocrine Imbalances can change the way you feel! How does Functional Medicine differ from Rather than naming a specifi c disease, Functional Conventional Medicine? Medicine looks to fi nd the underlying causes. The Functional approach takes you and your lifestyle In a Functional Medicine approach the absence in to the practice of medicine. It looks at you in of disease is NOT health. FM is concerned with context of your life and choices. Your treatment fi nding out how you function—on a physical, program will refl ect your needs. mental, emotional, and spiritual level. Optimal wellness is the ultimate goal. Quote: “I don’t treat migraines; I treat people with migraines. Each person who has migraines In conventional medicine making a diagnosis is requires their own unique treatment plan.” Latifa often the endpoint of therapy. Just treat the symp- Amdur, Licensed Acupuncturist. toms and send the patient home. FM looks deeper to fi nd the cause. When we have pain, discomfort, Who Can Benefi t from this approach? or reoccurring health complaints, it is our body’s way of trying to get us to pay attention. Rather Many people today have health problems that than taking a pain medication each time we get a don’t fi t into simple categories. Often people headache, or backache perhaps we ought to ask have complex health problems involving infl am- why we are experiencing the pain. matory responses, immune, nervous, digestive, energy, and/or cardiovascular systems. These FM looks to see if you are missing something you people are best helped by a functional approach. may need—perhaps you have special needs for Typical patients include people with: Chronic vitamins, minerals, probiotics or amino acids. It fatigue syndrome, auto-immune illness, fi bro- also looks to see if you have something you don’t myalgia, fatigue of unknown origin, and diges- need such as environmental contaminants, heavy tive complaints. Often these people have been to metals, bacteria, fungus, and/or parasites. The many physicians without results. answer may be simple or complex. For example, if you are depressed, perhaps an anti-depressant FM is also for people who are interested in true would help you to feel better. But wouldn’t you preventive health care. They want to take an ac- really like to explore why you are depressed? tive role in their own well-being and that of their Could it be a neurotransmitter problem? Or a family. These people seek out FM practitioners to relationship problem? Could you be reacting act as guides for their continued good health. negatively to food you are eating? Or could it be the load of heavy metals or toxic chemicals Common Categories of Functional Imbalance you’ve accumulated? This approach obviously takes more work than just writing a prescription • Oxidative Stress for an antidepressant, but it gives a much more • Nutritional Imbalances satisfying answer. www.innovativehealing.com © Elizabeth Lipski, Ph.D., CCN Innovative Healing Page 3

How Functional and Conventional Therapeutics Differ The Tack Theory: Conventional Functional Medicine Medicine

“1)If you are sitting on a tack it takes a lot of aspirin Will look at: food sensitivi- Eat bran. Irritable to make you feel good; 2) if you are sitting on two ties; possible fungal, parasitic, Learn to live Bowel tacks, removing just one does not result in a 50% and/or bacterial infections; with it, and Syndrome improvement.” Look at digestive function stress reduction Will look at: hormone balance; Detoxifi cation & Healing, Keats Publishing, Sidney Migraine food sensitivities; stress reduc- Medication and Baker. MD Headaches tion techniques; herbs such as rest feverfew Will look at: exercise patterns, Contemporary medicine talks about “prevention”. food sensitivities, digestive But pap smears, cholesterol and blood pressure function. Will use nutrients to Medication and screening, and cancer testing are all tests for early Arthritis help rebuild cartilage. Will do physical therapy metabolic cleansing regime and or rest detection of disease, not prevention of disease. alkalizing diet to help remove Functional medicine is concerned with real pre- calcifi cation in the joints. vention of disease. By paying attention to small Will look at: Counseling, use of nutritional supplements, Medication and problems, you can often prevent large ones. We Depression dietary modifi cation, exercise Counseling seek to help you be able to do more of the things programs. you want to for longer in life and to increase your “healthspan”. men varied fourfold on average. Looking for your unique biochemical needs provides a foundation Functional Medicine Conventional Medicine for Functional Medicine. Health Oriented Disease Orientation Patient Centered Doctor Centered 4-R approach Biochemical Individuality Everyone treated the same Holistic Specialized One of the underlying bases of Functional Medi- Cost Effective Cost Prohibitive cine is the 4-R approach. This approach provides Looks at deep causes of illness Diagnoses Illness /Names them the basic functional treatment philosophy. Al- Preventive Medicine Early Detection of Disease is though simple in concept, it provides an effective called Preventive Medicine approach for resolving diffi cult and undefi ned High Touch/High Tech High Tech illness. The 4 R’s:

Biochemical individuality • Remove refers to the elimination of anything that may be in our body or diet which contrib- Earlier this century Roger Williams, MD coined utes to poor health. This can include foods, the term “biochemical individuality”. Just as each pesticides, food additives, unwanted bacteria, of us have a unique face, fi ngerprint and per- fungi, and parasites. sonality, our biochemistry is also unique. There is a wide variety of “normal” values found. For • Reinnoculation involves the use of probiotic example, research has found that some babies supplements containing lactobacillus acidophi- require four times the vitamin B6 as others, and lus, bifi dobacteria, and other friendly fl ora. ranges of serum amino acids in healthy young These bacteria manufacture vitamins, repel www.innovativehealing.com © Elizabeth Lipski, Ph.D., CCN Innovative Healing Page 4

harmful microbes, and have anti-tumor effects. you eat, think, feel, and experience life. You are They are easily disrupted by use of antibiotics an important part of this process and your role is and the stress of contemporary living. primary. You are asked to participate in the pro- cess fully. The benefi ts are tremendous and you • Replace refers to the addition of supplements will see effects ripple out into your relationships to support digestive function and may include: with yourself and others. digestive enzymes, bile salts, and/or HCl. You may be asked to: make changes in food • Repair refers to the nutritional support that choices, eating patterns, take nutritional, ho- helps quickly regenerate and heal the body. meopathic or herbal supplements, exercise, go (Kara: In the 4-R materials this refers only to through a detoxifi cation program, meditate, see a GI mucosa? Seems better to me to broaden the counselor about life issues, join a support group, concept to the whole body, what do you think?) have massages or other body-work, sit under col- ored lights, or any one of many other modalities. Your Relationship with your Physician You probably will be asked to participate in test- ing, some of which you will do at home. Some Your relationship with your doctor is different. It may involve laboratory testing, while others may is an equal partnership, teamwork. It makes for a involve testing the pH of your urine or taking rewarding partnership for both parties. Functional your basal body temperature. Medicine asks us to pay attention to our bod- ies and our biology, rather than our sociology. It “If we accept that the human body is an energy- asks us to be in partnership with our physician, to driven, energy-sensitive system, that is in dynamic use our doctors as advisors and explorers on our interaction with all of its surroundings, then illness journey of life. may be seen as communication from some level to a level of conscious awareness. Once awareness occurs, it allows a person to begin a process of Functional medicine takes you and your lifestyle understanding the infl uences that collectively led to into the practice of medicine. It looks at you in the illness. Illness in this context may be seen as a context of your life and choices. Your relation- vehicle for transformation.” ship with your doctor will be one of a partner- ship. Your physician and medical staff will be Functional Medicine: An Integrative Approach your advisors in your life journey. You may fi nd to Health Care, Jeffrey Bland, PhD., Buck Levin that they spend more time with you. You may fi ll Ph.d, R.D., and Michael A. Schmidt, D.C. 1997 out extensive questionnaires, about your medi- cal history, work history, diet, exercise patterns, stress level, hobbies, use of supplements and What are the benefi ts of a Holistic approach? medication, and home and work environment. A program will be developed which will be specifi c By looking at each person as an entire being, to you and your individual needs and lifestyle. whole person patterns can be seen. Often people go to see a variety of specialists—one for heart What is Expected of You? problems, another for gynecological problems, an internist for their general needs, and so on. You will be expected to make changes in the way For example, there was a man who went to see a www.innovativehealing.com © Elizabeth Lipski, Ph.D., CCN Innovative Healing Page 5

cardiologist because he experienced heart palpita- attention to preventive health care in mid-life— tions. The cardiologist put him on heart medica- stopped smoking, exercised, and made dietary tion. He saw his internist because he had a tre- changes—had fewer hospitalizations, surgeries, mendous amount of leg cramping, and was put on took fewer medications, and lived longer than a muscle relaxant. And his psychiatrist put him on people who didn’t. an anti-depressant for anxiety. The same man saw a functional medicine physician who immediately What Types of Lab Tests may be Used? noticed that all of these symptoms could be due to a lack of magnesium. Magnesium and other Evaluating organ “function” versus organ “pa- supportive nutrients were given and the man was thology” is one of the principles of functional able to discontinue all other medications. medicine. Many labs have developed a number of assessment tools that allow practitioners to Better health Now understand a patient’s functional status. Because these tests are fairly new, many physicans are Most of us have a reoccurring health problem that unfamiliar with their use. These tests compli- can be alleviated or corrected through functional ment the usual testing that physicians use and can medicine. Many of us just learn to live with a detect problems long before more traditional tests variety of small to large health problems and to fi nd anything amiss. Tests may examine blood, limit our lives accordingly. Often people with hair, stool, urine, breath, and/or saliva. Common irritable bowel syndrome stay home because they tests check for your nutritional status, digestive are unsure of their bowels. Many women with function, food and environmental allergies, amino migraines, don’t schedule anything during certain acid balance, energy metabolism function, hor- parts of their menstrual cycle. And people with mones balance, and more. With this approach no arthritis just give up moving in certain ways or specifi c disease is being looked for, rather your doing certain things because they can’t. We have doctor is looking to determine why your body is been told to just accept our limitations. Physi- out of balance. cians working with functional medicine are real- istic about the possible limitations, but optimistic For example, food allergy testing can be used in about helping you get feel really well again. a wide variety of instances. Some common ones include: children with learning or behavior prob- Increased Healthspan! lems, people with migraines, skin problems, de- pression, digestive complaints, and fuzzy think- Our goal isn’t necessarily for you to live longer, ing. Hair analysis would be used if exposure to although you just might. Many people experience heavy metals was suspected or if malabsorption a decline in health for the last several decades. of minerals was suspected. Innovative saliva test- Yet we all know people who lived happily and ing can measure your levels of hormones such as healthily until the last few months or year of life DHEA, progesterone, testosterone, and estrogens. and the quietly passed of “old age.” The goal of Stool testing is used to measure overall digestive functional medicine is to improve overall health function, whether you’ve got enough good bacte- throughout life and especially in old age. A ria in your gut, and if you have bacteria, fungus, recent study from the University of California at or parasites which interfere with good health. Stanford showed that people who began paying www.innovativehealing.com © Elizabeth Lipski, Ph.D., CCN Innovative Healing Page 6

These tests are well-researched and most of them are reimbursed by insurance companies. It is wise to ask your physician and/or staff about reim- bursement before you proceed with testing. Some tests may need to be paid for out-of pocket.

Common Lab Tests

• Stool testing for digestive function • Blood testing for food allergies & sensitivities • Urine testing for intestinal permeability / leaky gut • Hair analysis for mineral levels • Blood testing for vitamin status • Saliva testing for hormone status • Urine or Blood for amino acid levels • Testing for energy cycle metabolites

Want to know more? Suggested Reading

• 20 Day Rejuvenation Diet Program, Jeff Bland

• 7-Day Detoxifi cation Miracle, Peter Bennett, ND, Stephen Barrie, ND

• Digestive Wellness, Elizabeth Lipski, PhD, CCN

• Tired or Toxic, Sherry Rogers, MD

• Power Healing, Leo Galland, MD

© Elizabeth Lipski, PhD, CCN

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