The Downfall Of Functional Medicine

Functional medicine is amazing.

Functional medicine combines the best of both alternative and allopathic medicine.

Functional medicine can help uncover the root cause of your illness.

Functional medicine treats you like the unique individual you are.

But functional medicine has a glaring flaw…

Perhaps it’s not so much functional medicine that’s flawed but the doctors that practice it – myself included. Functional medicine practitioners are information junkies. They run lab tests for everything.

Some of my colleagues run tens of thousands of dollars in laboratory testing before they even treat a patient. Functional medicine practitioners love data. Love it!

But with too much data, you can become blind to what’s in front of you. You can start treating lab values and not people. Information overload can see you mix up which are symptoms and which are causes.

Functional medicine isn’t a panacea. At least not the way it’s currently practiced.

The book of medicine needs an update

Learning that there were invisible microbes that brought about illness was a revelation. This discovery forever changed medicine. And we haven’t looked back.

Even today, the practice of medicine is about identifying what’s making you sick and altering it. Sometimes we kill it; like in the instances of bacterial infections. Other times we take it out; like when your gallbladder is misbehaving. Sometimes we repair it; like when you fracture a bone.

While this mode of thought serves us well in the context of acute illness, it’s really not at all the way to treat chronic illness. Chronic illness is nothing like acute illness.

In acute illness treating the symptom results in treating the disease/illness. 

In chronic illness, the crux of the issue has to do with the body’s response to an injury/illness/infection etc. Treating symptoms will not remedy the disease. 

Chronic illness has little to do with the injury/illness/infection that originally caused the symptoms. Take chronic fatigue syndrome as an example. Sometimes CFS gets triggered by the Epstein-Barr Virus (EBV). So practitioners go in with their anti-viral medications hoping that this will treat the fatigue.

But it doesn’t. The fatigue remains. Even after numerous cycles of anti-virals.

Why?

Because an illness like chronic fatigue has to do with the body’s inappropriate response to an infection. Not the infection itself.

Functional medicine is a step in the right direction, but it still finds itself following the original book of medicine. Identify the cause of symptoms and treat them. Even functional medicine neglects to consider that the body’s response to illness is the crux of the issue.

I’ll give you some more examples of what I mean in the next section!

What do lab values really mean?

If labs analyzing your thyroid function come back low, what do you do?

Take supplements or medications to increase your thyroid function.

If labs analyzing your cortisol levels come back high, what do you do?

Take supplements or medications to lower your cortisol.

Regardless of whether your doctor is functional or allopathic, she probably approaches your illness in this manner. If something’s low, increase it. If something’s high, decrease it.

This is the downfall of functional medicine. 

Your body does not work in binary sequences like a computer. There are more answers than 0 or 1. A lot of the illnesses you experience are not nearly a simple low level here or excess there.

The better question to ask is why.

Why is your thyroid under-functioning?

Why is your body producing so much cortisol?

Just because a lab value of yours is low or high does not mean its bad or wrong. At times, it does. But often, there’s a lot more to the story. This is a story that functional medicine gets wrong a lot of the time.

Remember, if you’re dealing with chronic illness, the main issue is the way your body is responding to the illness. It’s not about identifying a hidden infection – something functional medicine loves to do!

So, lab tests don’t matter?

No, lab tests matter. They matter a great deal. But they need to be interpreted with context at the top of mind.

I like to think of my job as a functional medicine practitioner as looking for patterns. I’m looking for patterns within a patient’s labs, within his presenting complaints, within his family history, within his job/industry, etc.

Just because you find a lab marker out of range on your patient does not mean you need to treat it. A lot of lab values (many of which we have no idea of) will go out of range in given conditions. These should be considered epi-phenomenon. Not causal forces.

When you run ten thousand dollars worth of labs, you have ten thousand dollars worth of markers that you need to balance. You can find all sorts of interesting things – SIBO, candida, parasites, an immune response to Lyme, a previous Epstein-Barr infection, thyroid antibodies, blood sugar imbalances, etc.

Which ones really matter? 

Which is causing disease?

Which ones will rebalance on their own? 

How do you know what you think you know is true? 

The downfall of functional medicine is treating all abnormal lab values. When this happens, you’ll find yourself on dozens of supplements/medications. You have no idea what is working and what isn’t. Neither does your practitioner 😉

The downfall of functional medicine is neglecting to remember that chronic illness has to do with the body’s response to illness. Chronic illness is not as simple as balancing lab values. To get out of chronic illness, you cannot simply reverse the pathway that got you there. Healing from chronic illness requires the creation of an entirely new pathway.

What happens when your illness doesn’t fit in the functional medicine framework?

Functional medicine is a step in a much-needed direction for medicine. The allopathic medical model saw your digestive system separate from your muscular system, separate from your reproductive system, separate from your nervous system. That’s why you’ve got medical specialists for each body system.

Functional medicine came in and went, hey, these systems don’t function independently from each other. Each is intertwined with the next. Do something to one system and you’ll affect another.

This was a great advancement in practice. Docs started seeing the effects the brain had on the gut. And the effects the gut had on the brain.

But there’s still a downfall to functional medicine. That being that the way out of illness is by simply reversing the steps that got you there. This works for acute illness only. It will not fly for chronic disease.

What sort of illnesses does functional medicine struggle to manage?

All practitioners become challenged when illness affects multiple body systems at the same time. This is when you approach the edge of functional medicine’s knowledgebase.

Patients, this the chronic fatigue, fibromyalgia, multiple chemical sensitivites crowd that never gets better.

Practitioners, this is the adrenal fatigue, food sensitivity, IBS crowd that never gets better.

Complex and chronic illnesses don’t limit themselves to affecting one area of the body. That’s why patients dealing with these illnesses often have fatigue, brain fog, GI issues, muscle aches/pain, headaches, and more; all happening concurrently. Remember, you can’t get out of these types of illnesses by simply reversing the steps that got you there!

There’s another level of functional medicine needed to treat these complex cases. Welcome to functional medicine v2.0.

Functional medicine v2.0 

When you or your patient’s symptoms don’t fit in the conventional medical paradigm, you get a useless diagnosis like chronic fatigue syndrome or fibromyalgia. Your doc gives you a prescription for an antidepressant and tells you to start exercising.

Not helpful!

Functional medicine is better. But it’s still not there. Instead of an antidepressant and exercise prescription, you remove inflammatory foods, heal the leaky gut, start meditation and gratitude practice. Maybe you also take some supplements like CoQ10 and d-Ribose. These are all great strategies. But they never seem to actually solve the problem. At least not fully.

When you or your patient’s symptoms don’t fit in the functional medicine paradigm, you get strange labels like adrenal fatigue or gut-brain axis abnormalities.

What to do when your condition can’t be explained by either medical paradigm?

It’s time for medicine to adapt. We need to shift our thinking from the original book of medicine. In the context of chronic illness, we need to stop looking for and treating what originally caused the illness. Instead, we need to focus all of our effort on understanding why the body is responding the way it is and how we can support the body to step away from illness and towards health.

No matter how many lab tests you run or how many markers you balance, you won’t fix chronic illness unless you rectify the body’s inappropriate response. Treating symptoms won’t remedy the disease.

Functional medicine needs to move beyond the fancy lab tests and focus on writing a new book of medicine. A book that views chronic illness as the separate entity that it is. Only then will we avoid the downfall of functional medicine.

Now, I want to hear from you!

How did functional medicine impact your health?

Leave your answers in the comments section below!