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Functional Medicine
Functional medicine is personalized medicine that deals with primary prevention and underlying causes, instead of symptoms, for serious chronic disease. Jeffrey Bland, PhD, and Susan Bland founded the Institute for Functional Medicine (IFM) in 1992 (http://www.functionalmedicine.org). IFM is a nonprofit educational organization that provides continuing medical education for healthcare providers.

Functional medicine is an evolution in the practice of medicine that addresses the healthcare needs of the 21st century. By shifting the traditional disease-centered focus of medical practice to a more patient-centered approach, functional medicine addresses the whole person, not just an isolated set of symptoms. Functional medicine practitioners spend time with their patients, listening to their histories and evaluating the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease. In this way, functional medicine supports the unique expression of health and vitality for each individual.

The system of medicine practiced by most physicians is oriented toward acute care, the diagnosis and treatment of trauma or illness that is of short duration and in need of urgent care, such as appendicitis or a broken leg. Physicians apply specific, prescribed treatments such as drugs or surgery that aim to treat the immediate problem or symptom. Unfortunately, the acute-care approach to medicine lacks the proper methodology and tools for preventing and treating complex, chronic disease. In most cases, it does not take into account the unique genetic makeup of each individual or factors such as environmental exposures to toxins and the aspects of today’s lifestyle that have a direct influence on the rise in chronic disease in modern Western society. There’s a huge gap between research and the way doctors practice. The gap between emerging research in basic sciences and integration into medical practice is enormous—as long as 50 years—particularly in the area of complex, chronic illness. Functional medicine’s aim is to evaluate, assess, and carefully enfold emerging research in a practical, efficient, and safe manner.

Functional medicine involves understanding the origins, prevention, and treatment of complex, chronic disease. Most physicians are not adequately trained to assess the underlying causes of complex, chronic disease and to apply strategies such as nutrition, diet, and exercise to both treat and prevent these illnesses in their patients. Hallmarks of a functional medicine approach include:

Patient-centered care. The focus of functional medicine is on patient-centered care, promoting health as a positive vitality, beyond just the absence of disease. By listening to the patient and learning his or her story, the practitioner brings the patient into the discovery process and tailors treatments that address the individual’s unique needs.

An integrative, science-based healthcare approach. Functional medicine practitioners look “upstream” to consider the complex web of interactions in the patient’s history, physiology, and lifestyle that can lead to illness. The unique genetic makeup of each patient is considered, along with both internal (mind, body, and spirit) and external (physical and social environment) factors that affect total functioning.

Integrating best medical practices. Functional medicine integrates traditional Western medical practices with what are sometimes considered “alternative” or “integrative” medicine, creating a focus on prevention through nutrition, diet, and exercise; use of the latest laboratory testing and other diagnostic techniques; and prescribed combinations of drugs and/or botanical medicines, supplements, therapeutic diets, detoxification programs, or stress-management techniques.

The Functional Medicine Approach to Assessment
Functional medicine practitioners promote wellness by focusing on the fundamental underlying factors that influence every patient’s experience of health and disease. They assess the patient’s fundamental clinical imbalances through careful history taking, physical examination, and laboratory testing. The functional medicine practitioner will consider multiple factors, including:

Environmental inputs – The air you breathe and the water you drink, the particular diet you eat, the quality of the food available to you, your level of physical exercise, and toxic exposures or traumas you have experienced all affect your health.

Mind-body connections – Psychological, spiritual, and social factors all can have a profound influence on your health. Considering these areas helps the functional medicine practitioner see your health in the context of you as a whole person, not just your physical symptoms.

Genetic makeup – Although individual genes may make you more susceptible to some diseases, your DNA is not an unchanging blueprint for your life. Emerging research shows that your genes may be influenced by everything in your environment, as well as your experiences, attitudes, and beliefs. That means it is possible to change the way genes are activated and expressed.

Through assessment of these underlying causes and triggers of dysfunction, the functional medicine practitioner is able to understand how key processes are affected. These processes are related to larger functions, such as:

• how your body rids itself of toxins

• regulation of hormones and neurotransmitters

• immune system function

• inflammatory responses

• digestion and absorption of nutrients and the health of the digestive tract

• structural integrity

• psychological and spiritual equilibrium

• how you produce energy All of these processes are influenced by both environmental factors and your genetic makeup; when they are disturbed or imbalanced, they lead to symptoms, which can lead to disease if effective interventions are not applied.