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Functional Medicine
by Kim Webster, MD

The last twenty years have brought dramatic changes to the way medicine is practiced. Patients act more appropriately as assertive consumers and doctors have incorporated alternatives such as acupuncture and herbs into their bag of tricks. The very conservative New England Journal of Medicine even published an article in late 1998 on the 72% decrease in colon cancer seen in those using multivitamins for 15 years.

Unfortunately my experience has been that the majority of MD's still view supplements as a waste of money. There is, however, one newly emerging specialty that believes otherwise and this is the practice of functional medicine. Coined by Jeff Bland, Ph.D. this term refers to a shift in perceptive that views symptoms as clues that a biochemical dysfunction is occurring in the body and that the most effective and safe way to treat such symptoms is to give the body optimal nutrients, remove harmful toxins (chemical as well as mental/spiritual), detoxify and allow the complex restorative mechanisms of the human body to function optimally. This is in contrast to using a chemical medication that is foreign to the body and that may have significant side effects.

A good example of the difference between mainstream allopaths and practitioners of functional medicine is osteoarthritis. This is a wear and tear breakdown of cartilage with resulting joint pain that affects most people eventually. I was taught to treat such a condition with anti-inflamatory drugs such as Motrin or Aleve. These are effective for pain relief but result in about two thousand deaths per year from gastrointestinal bleeding. They're OK for symptoms but very bad for the stomach lining.

The functional medicine approach is to view the symptoms of joint pain not as something to be masked with a chemical but as a clue that all is not well in the joint space and the surrounding tissue. I would thus use a combination of glucosamine (a chemical found naturally in the body that may increase joint fluids), chondroitin sulfate, and MSM in addition to nonweight bearing range of motion exercises and strength training for the surrounding muscles. These aren't treatments that I use just because they are natural. I choose to use them because double blind, placebo controlled studies have consistently shown that these therapies are effective and much safer than anti-inflammatory medications.

The functional medicine perspective is useful for most symptoms, but it is especially helpful with chronic fatigue, irritable bowel, and weight loss, as traditional medicine has no effective tools for these conditions. From this biochemical perspective one would first attempt to remove as many unnecessary chemicals from one's environment. This would include filtering water, buying certified organic food, and avoiding toxic household cleaners. A detoxification process might then be useful.

I think most people mistakenly believe that the liver detoxifies by breaking down molecules when it actually works by adding molecules to the toxin to produce a nontoxic substance that is then excreted in the stool or urine. Your liver thus needs a fair amount of things like glutathione to add to toxins to neutralize them. If you run out of glutathione you're in trouble. That's why I don't recommend fasting for detoxification. It's a great way to determine if you have food sensitivities but you need to feed your liver well for it to work optimally.

The next step would be to optimize carbohydrate, protein, fat, vitamins, minerals, phytoneutrients, and hormones, if necessary. This is all done within the context of a progressively healthier lifestyle that incorporates balance between activity and rest, exercise, and the benefits from prayer and meditation that have been documented in a variety of recent studies.

Functional medicine acknowledges that we are each biochemically and experientially unique and that optimal health and vitality is not just the absence of disease but is the result of optimal environment, nutrition, and lifestyle leading to maximized function of our body.