Functional Medicine – In the practice of medicine, healing depends not only on doing the right things, but doing them in the right order.
Illness is never simply one discrete process or dysfunction. It is a bundle of the patients’ whole life, their genetics, early inﬂuences, environment, diet, lifestyle, habits, travel, relationships, beliefs and how those inﬂuences are layered and woven to create the thing we call disease. Rooting out the original cause from the downstream eﬀects is the essential task of the healing process. Our job is to determine how the illness is layered or woven into a client’s story and their biology.
Doing the right thing in the wrong order will often result in failure or worsening of the illness. Finding the one medication or surgical procedure, or the right herb or alternative modality to treat a “disease” may fail even though it is the right thing to do if it’s done in the wrong order.
Though human biology is inﬁnitely complex, there are some principles and well-traveled routes to healing that are straightforward and accessible for healing.
As We Begin-First Task – Functional Medicine
Our ﬁrst task in the patient-practitioner relationship is to seek the cause(s) of the symptoms/illness presented. Thankfully, there are a limited number of root causes for all illnesses. 6 root causes to consider:
We must become experts in identifying and treating these underlying causes.
The Second Task – Functional Medicine
Identify the 9 ingredients needed for optimal functioning
- Real food and nutrients come through our food
- Speaking your truth/self expression
- Healthy environment, air, light etc
- Meaning and purpose
We must become experts in assessing the deﬁciency of these ingredients and helping provide the necessary conditions for thriving.
The presence of any of the 6 root causes and the absence of any of the 9 essential ingredients creates an imbalance in the basic biologic web-like systems and processes of the body to include:
- Energy/mitochondrial /cell health
- Structural bone/muscle balance
Any imbalances in any one or combination of these systems result in the manifestation of symptoms and illnesses. With this map and process of thinking, the name of your disease becomes increasingly meaningless.
The trick lies in having a place to start and understanding how to unreel the layers of dysfunction and in what order. Fortunately, the body knows how to heal if we remove the impediments and provide the proper conditions in the right order. This takes time, patience, and persistence.
What’s the Right Order – Functional Medicine
These steps are listed in order of priority for peeling the onion of chronic illness. Sometimes we will do multiple things at once like start hormone therapy along with immediate dietary changes and treatments to heal the gut. Healing is a process.
And not always linear. It is more like tailoring-,making adjustments each step along the way until we get it right.
Steps we follow:
- Start with food
- Identify and remove food allergens/sensitivities
- Fix the gut
- Optimize nutrient status
- Balance hormones
- Enhance detoxiﬁcation
- Support energy metabolism
- Mind body balance
- Look for hidden infections
- Gut and hormones and implement a mind practice self-love, breath, work on sleep.
- Optimize Detoxiﬁcation -gentle detox homeopathic, IV glutathione
- HM, lipids, mold etc
- Blocks or other special testing
- proper fatty acid composition high levels of healthy omega 3 vs omega 6 low in saturated fats and no trans fats.
- high phytonutrient density high level of phytonutrients and antioxidants
- healthy protein – lean, healthy plant-based or pasture raised animal products.
- High micronutrient density contains high amounts of vitamins/minerals
- Low allergenic burden to minimize the toxic burden of food/no added hormones/pesticides/antibiotics or other ﬁllers
- Healthy PH balance provides the proper balance between acid/alkaline
- Healthy salt-potassium ratio
- High ﬁber content to help slow the insulin response and optimize digestion
Remove Food Allergens and Sensitivities
Delayed food sensitivities are among the most potent triggers for chronic symptoms and an inﬂamed immune system. A trial of an elimination diet for 2-3 weeks with systematic food reintroduction is a powerful therapeutic and diagnostic tool. The closer you follow this, the faster the answers can be found. Other times eliminating the most common triggers gluten and dairy can be suﬃcient
Fix the Gut
Health starts in the gut and contains about 60% of our immune system. Identifying and treating the causes of gut dysfunction like leaky gut, delayed food allergies, SIBO, yeast overgrowth, parasites and other pathogens are vital.
Optimize Nutrient Status
Nutrient deﬁciencies aﬀect up to 92% of Americans. The most common deﬁciencies are magnesium, zinc, vitamin D, methylation supporters like B6, folic acid, and B12 and omega 3 fatty acids. Depending on testing, other deﬁciencies may be found and treated
Hormones and neurotransmitters is rampant because of dietary inﬂuences endocrine disrupters or petrochemicals and heavy metals along with chronic stress.
The delicate balance of hormones is essential for health and understanding the factors that cause disruption and restore balance is essential. Of the many hormones, four categories are the most important hierarchy of hormones
- Cortisol and stress response
- Insulin resistance
- Thyroid dysfunction
- Sex hormone dysfunction
These are addressed through diet, exercise, stress management, bio dental hormones nutrient supplements and herbal therapies are commonly used.
Detoxiﬁcation is one of the most important and metabolically demanding functions of our physiology and one that health professionals learn little about. The toxic burden of 2.9 billion pounds of petrochemical toxins and 6 million pounds of mercury unloaded into our environment every year has put undue stress on our capacity for detoxiﬁcation.
Identifying heavy metal toxicity particularly mercury and lead is important to treat chronic illness.
HM can be tested at the ﬁrst visit but does not usually treat this until 3-6 months after the ﬁrst visit after we have normalized your digestion, immune function, hormones and nutritional status as much as possible. Then we can safely begin the detox process of heavy metals.
Supporting Energy Metabolism
The end result of many nutritional, toxic, allergic, infectious and dietary insults is an injury to the mitochondria unchecked oxidative stress and the loss of energy and ultimately cell death.
We assess mitochondrial dysfunction using organic acid analysis and common supportive tools including phospholipids, essential fatty acids, acetyl l carnitine, CoQ10, ribose, magnesium/potassium aspartate, arginine, resveratrol, alpha lipoic acid, NADH, B vitamins, NAC among others.
Finding meaning and connection in the context of illness and within life, relationships and beliefs are an essential pillar of the healing process. We support clients to develop skills in self-care and nourishment and stress management such as exercise, yoga, meditation, or other ways. Learning to deeply relax, let go of worry and build trust in life and the healing process is a necessary ingredient for becoming well.
Look for Hidden Infections
If we ﬁnd clients don’t respond fully to the treatment of the basic systems outlined or if there is elevated hs CRP that is not decreasing, testing for hidden infections often identiﬁes unsuspected triggers with dental issues being primary. Mold is another common culprit.
The Right Order Of Things
Despite the exceedingly complex world of systems biology and medicine, the way into the web of dysfunction and healing is actually quite simple and eﬀective for most clients. The puzzle is not so diﬃcult if we start with food, address food allergens, ﬁx the gut, optimize nutrient status, balance hormones, enhance detoxiﬁcation, support energy metabolism teach self-care and nourishment of the mind and soul and if we get stuck dig around for hidden bugs.
It is based on a clear framework for understanding the impediments for optimal function, and the necessary conditions for thriving and an understanding of the essential physiologic systems that are at the root of more than 12,000 diﬀerent “diseases” that indeed are only the eﬀects of these causes.
Keeping in mind the right order of things will get us from eﬀect to cause, from illness to health.