| Functional Medicine Functional medicine is a clinical approach employed by physicians of various disciplines with the goal of maximizing health and overall performance of the human body. It is concerned with maximizing potential, not simply improving health, not simply treating disease. It represents the newest and most innovative and in-depth multidisciplinary and multidimensional approach to optimal health (wellness). Functional medicine has been defined as follows: "Functional medicine is the field of health care that employs assessment and early intervention to improve physiological, emotional/cognitive, and physical function."
More recently, the definition of Functional Medicine has been updated to the following: "Functional Medicine is a science-based healthcare approach that assesses and treats underlying causes of illness through individually tailored therapies to restore health and improve function." 
This science-based approach to assessing, treating, and preventing a wide range of health conditions was a major breakthrough since it allowed, for the first time, the ability to assess for subtle variations in physiologic function that were previously invisible. Assessing function of enzymes: An example of a functional assessment is assessing blood levels of homocysteine, a toxic amino acid produced in the body as a result of genetic defects (inability to utilize the vitamin folic acid) or nutritional deficiencies (especially folic acid). People with higher levels of homocysteine have increased risk for cardiovascular disease, dementia, osteoporosis, and certain cancers. By assessing levels of homocysteine in the blood, we are now able to identify which people have either subtle nutritional deficiencies or genetic defects in folic acid metabolism. More importantly, we are able to intervene at an earlier age before the onset of disease so that people can be much healthier for a longer period of time. This is considered a functional assessment because we are able to focus in on a specific metabolic-enzymatic function* and make necessary corrections before the development of disease.
*methylenetetrahydrofolate reductase Assessing function of organs: Another example is assessment of intestinal permeability or so-called "leaky gut." The functional assessment for this condition is to assess the "permeability" or "leakiness" of the intestinal wall to test sugars. The greater the absorption of the sugars, the greater the leakiness, and the greater the probability of recurrent disease for patients with bowel disease, such as Crohn's disease. By identifying this alteration in function which occurs before the return of the disease, we are able to implement a treatment plan to help the patient avoid a return of the disease. "The [intestinal permeability] test identifies Crohn's disease patients in apparent remission, but with a high risk of clinical relapse, better than clinical and biochemical indices. Different treatment strategies might be suggested for this subgroup of patients." Intestinal permeability test as a predictor of clinical course in Crohn's disease. Am J Gastroenterol 1999 Oct;94(10):2956-60
Functional Medicine is complex and does not lend itself to a "quick overview." Not a concrete object which can be seen and described, Functional Medicine is more of an abstract concept framed by certain approaches, assessments and interventions which are multidimensional and interrelated. Its interventions are almost always indirect, yet it generally provides the shortest route from illness to wellness. More than any other type of medicine, Functional Medicine allows for an exquisitely tailored patient-centered approach to improving health, and achieving and maintaining wellness. "...a functional medicine approach would insist that alleviation of symptoms and prevention of illness are not sufficient goals in the practice of medicine. Medical goals must also include support of vitality and wellness in the patient's overall life experience."
Functional medicine has now merged with clinical genetics to produce a new field of healthcare: Genomic Medicine. Many of the earlier functional assessments were based at least in part upon detecting the end-products of faulty metabolism that results from gene-environment mismatches. Now, we are able to test for the genes themselves. |
