What is Functional Medicine?

I’m Dr. Joe Mather MD, MPH&TM. I’m a board certified Family Practice Physician who specializes in Functional Medicine.

During my last year of residency I realized that all the tools I was being taught in conventional medicine simply wasn’t enough to help patients struggling with chronic disease. That realization started me on a journey to discover if there were other ways that I could help my patients feel better.

One of the approaches I found was Functional Medicine. The more that I learned and brought to my patients the better they got. I had found a new perspective and different tools that finally let me help patients that I previously thought were uncurable. I saw patients with chronic fatigue regain their energy, patients with Crohn’s Disease go into remission without medication, and symptoms of all sorts resolve. I even saw patients reverse cognitive decline and seizure disorders disappear.

I’ve noticed increasing confusion about what Functional Medicine actually is, which is to be expected given the sudden overwhelming number of podcasts, supplements, treatments, books, labs and seminars all with a different perspective!

So what is Functional Medicine?

Functional Medicine is the idea that disease can be improved or resolved by treating its underlying cause.

Forget all the talk about bio-individuality, genetics and diets. Ignore the podcasts discussing all the new conditions your doctor has missed, the specialty labs telling you why their test is the best, and doctors selling you supplements on youtube.

Functional Medicine is a way of thinking and addressing the problem of illness. It isn’t the use of a particular lab test, or being open to supplements instead of medications, it’s working with a patient on a different level as compared to many of our conventional medicine colleagues.

Instead of simply quieting symptoms with medications, we ask “Why is this particular patient sick, and how can we fix it?” While we Functional Medicine doctors use a variety of remedies and methods, what we have in common is a desire to get to the cause of the issue, because we have learned that addressing a problem at it’s cause is simply the most effective way to help them heal.

This sounds revolutionary only because our current healthcare system is mostly set up to throw prescriptions at symptoms but treating the reason why someone is sick isn’t a miracle, it’s common sense.

After all, this is what we expect all of our professionals to do. You’d be justifiably upset if your plumber showed up and instead of fixing your leak, just told you to put a bucket under the sink, or your mechanic wasn’t sure why your car was making that noise, but recommended that you simply turn up the radio.

Why Do You Practice Functional Medicine?

It works! I’ve been able to help patients recover from diseases that baffle other doctors. Most doctors go to medical school because we want to help people feel better, and thinking in terms of root cause is the most straightforward way to help patients.

I created this list below by thinking of some of the conditions in my practice that have either resolved or improved when their cause was addressed.

I hope you’ll begin to appreciate the huge variety of symptoms that can be improved by this approach as well as begin to see how many different tools are available to a well trained Physician.

Examples of Treating Root Causes

• Resolution of IBS symptoms by treating SIBO with antibiotics or herbal treatments. 

• Resolution of type 2 diabetes using fasting and ketogenic diets.

• Resolution of high cholesterol using weight loss surgery, or with a plant based diet.

• Resolution of rosacea by fixing SIBO

• Resolution of high blood pressure by diagnosing and treating sleep apnea.

• Resolution in fatigue by treating iron deficiency .

• Resolution of neuropathy by treating B12 deficiencies.

• Resolution of Hashimoto’s Thyroiditis by treating GI dysbiosis.

  Resolution of Dermatitis Herpetiformis with a gluten free diet.

• Improvement of chronic constipation using abdominal massage.

• Resolution of depression and treating elevated blood lead levels.

If I had a dollar for every patient with IBS who was told by their GI doctor that it didn’t matter what diet they ate or who recommended a cookie cutter approach of “colonoscopy, fiber, then antidepressant,” then I’d be sitting on a beach instead of writing this article. (For the record, the vast majority of patients with IBS have easily identifiable problems and feel better once those areas are addressed.)

On a weekly basis, my patients tell me how other doctors dismissed their complaints by suggested they were just stressed, or who told them their symptoms were all in their head.

Patients who have been suffering for years deserves a comprehensive, practical approach. You deserve to be heard and taken seriously. You deserve a doctor who is equally comfortable with lifestyle medicine and prescription management. This is what Functional Medicine does best.

Because of all the reasons I believe that Functional Medicine is the future of medicine, but only if it can address some of the growing problems in the field.

Problems in Functional Medicine

The first problem is that no one agrees on what the root causes are.

The truth is that if you presented the same case to five different Functional Medicine doctors, you would get five different perspectives on what is wrong (along with five different opinions on how to fix it - but that’s a story for another day). Some of this is because different doctors tend to treat different groups of people who have different illnesses, but it goes deeper than that.

You see, most don’t understand that there is no regulation of how to become a Functional Medicine practitioner. After all, Functional Medicine is more of a philosophy than a formal set of tests and treatments. Because basically anyone can set up shop and say that they practice Functional Medicine lots of different people have entered the field: that trainer at your gym, the person from church who sells essential oils, your health coach or nutritionist, all the way to traditionally trained MDs from a variety of specialties and backgrounds.

While this diversity of thought has been good in a lot of ways, it has led to a lot of confusion on what Functional Medicine is and what it can do. For example, many think that Functional Medicine is simply the use of a particular unconventional lab test, some that it is the treatment of a specific condition like SIBO, while others think that it is a matter of what treatments the practitioner offers.

This leads to my final point.

Not all Functional Medicine offices are equally helpful, and some harm patients.

As I mentioned above, there are tons of different approaches to Functional Medicine. In my former role as Medical Director of a Functional Medicine clinic that treated patients worldwide, I got an inside look at how a lot of Functional Medicine offices work. It’s not always pretty.

In my current practice, I help many patients who have seen a half dozen doctors or more and are still sick. There are problems in the field that need to be openly discussed.

I want to describe both some red flags that I’ve observed in the field so that you can avoid some of the practices that hurt patients, and also provide some tips so that you can find and work with a responsible practitioner.

Harmful Practices in Functional Medicine

• When a doctor orders tests before meeting a patient. Unfortunately, it is a common practice in many offices to require a bunch of expensive tests to be completed before the doctor will accept you as a patient. The doctors who do this have generally marked up the cost of the test and make a steady profit by ordering more testing. This is a HUGE problem, because not only does this waste your time and money, when doctors order a bunch of tests at once, it leads to a high chance of returning a false positive - sending you and your doctor chasing problems that are not real.

• It is a red flag if your practitioner aggressively pushes supplements. It is my experience that around 30% of a typical Functional Medicine doctor’s income comes from supplement sales. This frequently leads to a situation where the doctor can not act in your best interest due to financial bias. One clue that your practitioner might not be thinking things through is if their solution for every complaint or symptom you have is yet another supplement.

• Worry if your provider recommends multiple treatments all at the same time, because this leads to unnecessary treatment and wastes your time. Unfortunately this leads to a situation where these docs rarely learn what is or isn’t helping their patients - too many go their entire career without figuring this out. Think about it like this - if I give you three treatments - A, B & C, and you feel better how would I know which one helped? If you feel worse, how do we know which treatment is to blame? Perhaps two are helpful, and one is not.

• Finally, take caution if your doctor seems overly dogmatic, especially if you feel they have already decided what is wrong with you before you enter their office. Some doctors have become attached to certain ideas or causes that cloud their judgment. If your doctor is constantly blaming one thing (gluten, MTHFR, glyphosate, thyroid dysfunction …) as the cause for all health problems then you should start looking for someone who is more open minded and is able to take a broader approach. You do not want to be railroaded into a diagnosis or problem that you don’t have simply because the doctor is interested in a particular topic. A sign this might be happening is if you tell them a treatment isn’t working and their immediate response is to say you aren’t doing it enough or the right way.

  
  
  

Signs of a Helpful Functional Medicine Practitioner

• It’s a good sign if your doctor starts with fixing lifestyle issues then reevaluates your symptoms. The truth is that most chronic diseases are caused at least in part by lifestyle imbalances, and if these are not fixed then it becomes very difficult or impossible to help your patient heal.

• Look for a doctor who is more interested in your symptoms than your lab tests. Your symptoms and experience are always more important than numbers on a piece of paper!

• You should feel your doctor didn’t rush to judgment. One sign that they are actively listening to you is if they are asking pertinent questions about your case.

• Bonus points if your doctor is an expert at helping fix gut health. The beauty about fixing the gut is that many other systems in the body get better as the gut function improves.

• Your doctor reevaluates treatments if you aren’t getting better.

• Your doctor is happy. The truth is that Functional Medicine is incredibly fun. I get to think about all sorts of things, and frequently get to put on a detective hat to figure out why someone is sick, and how to get them better. It is never boring!