One of the big buzzwords in health care these days is “functional medicine.” And, perhaps like you, for years I had no idea what it meant.
When I first heard about it, during my days writing for the now-shuttered WellWire, people tried to explain: “It’s what you do as a naturopathic doctor,” they said. Which completely didn’t answer the question. Fine, so it’s in my repertoire. Lots of things are in my repertoire. Which thing is it? No one ever answered the question to my satisfaction.
Then a few months ago, listening to a CD on natural health, it finally clicked: It’s catching the difference between not being sick (pathology) and actually feeling well (function.)
whole-person medicine
In principle, functional medicine is defined as looking at a patient’s whole picture, including the physical, emotional and social levels. That means finding the underlying causes of disease and treating the whole person — two of the six foundational principles of naturopathic medicine.
In practice, much of what’s called functional medicine relates to lab tests. Some of these are specialty tests, often looking at hormones, digestive function, nutritional status, food intolerances and toxic burden.
But viewed through a naturopathic or “functional” lens, we can get a lot out of the most basic blood work you’re used to getting from your doctors.
basic labs
These usually include, at a very minimum:
- a complete blood count which looks at markers for anemia, immunity, clotting ability;
- a metabolic panel, which looks at markers for blood sugar, liver and kidney function; and
- a lipid (cholesterol) panel.
The way I explain functional lab interpretation to patients in the office is this: When you’re outside the pathological range, that means you’re sick. When you’re inside my narrower functional range, you’re well. If you’re between the two, we can work to reverse negative processes and prevent disease. (In my office this explanation is accompanied by hand gestures.)
Traditionally, these tests tell you little unless you’re overtly sick. Unless your iron or B vitamins are low enough that you have anemia, unless your blood sugar is so high you have diabetes, most doctors will just say you’re fine.
naturopathic interpretation
In the hands of a naturopath, these simple, basic tests offer insights into a much broader range of conditions.
We can catch issues like insulin resistance (which can become diabetes) and anemia early — before things gets bad enough that you have symptoms.
Comparing some electrolytes tells us how your body responds to stress. Patterns of less-than-optimal parameters provide clues about digestive function, heavy-metal burdens and inflammation.
Functional medicine also shows up as an approach to subclinical disease. Patients often come in with a persistent health complaint for which other doctors can find no overt, objective cause.
On classic example is someone coming in feeling sluggish and cold and who has a hard time losing weight. If their labs are not outside the pathological range, they’re probably told they just needs to eat right and exercise more. Looking through a functional-medicine lens, we may see that their thyroid isn’t quite as efficient as it should be. When we treat the cause of the malaise they feel better and have fewer of the health risks associated with long-term hypothyroidism.
knowledge is power
I treat people, not lab values. But I also believe that knowledge is power — it’s the second of my 5 Pillars of Natural Medicine and the second step on The Journey with nearly every patient. The insights we get from basic and specialty tests can offer important guides to care.
After your labs we’ll have a whole session devoted to review your results in depth. You’ll know exactly what every test means, what your specific numbers say about your health and how to make changes to feel better.
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