From childhood, we have been taught various meanings of the word ‘health’. A common theme among various definitions of health is that most of these interpretations are incomplete. For example, the Oxford Dictionary defines ‘health’ as a state of being free from illness and injury. But, over time, the medical community has recognized the incompleteness of such an approach and has started to take a more comprehensive and holistic view of ‘health’. In fact, the WHO defined health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. The evolution of functional medicine is the outcome of this increased understanding of human health.
The word ‘health’ is derived from the Old English word ‘hal’, which refers to ‘something being whole or complete in itself.’ Functional medicine is based on this principle of ‘wholeness’. It treats the human body as an integrated and comprehensive unit while focussing on the mental, emotional, and spiritual well-being of the person. We will discuss the philosophy of functional medicine in detail to understand how it aims to restore the human health to a state of vitality.
The Institute for Functional Medicine defines functional medicine as a systems biology-based approach that focuses on identifying and addressing the root cause of disease. Each symptom or differential diagnosis may be one of many contributing to an individual’s illness. In other words, functional medicine restores health by identifying the clinical imbalances in various functions being performed in the body. The main physiological functions performed by the body are:
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Assimilation (respiration, digestion, absorption, and gastrointestinal microbiome)
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Defense and Repair (infection, inflammation, and Immune System)
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Energy (energy regulation and mitochondrial function)
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Biotransformation and Elimination (toxicity and detoxification)
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Structural Integrity (from subcellular membranes to musculoskeletal structure)
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Communication (endocrine system, neurotransmitters, and immune messengers)
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Transport (cardiovascular system, lymphatic system)
According to functional medicine, the body is an integrated unit and any unhealthy state is a result of imbalances in the critical bodily functions mentioned above. The principle of wholeness can be further understood by the following aims of functional medicine:
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Mental well-being (cognitive function and perceptual patterns)
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Emotional well-being (regulation of emotions)
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Spiritual well-being (meaning and purpose in life)
Principles of Functional Medicine
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Treating the patient, not the symptoms
The patients are at the centre of the functional medicine philosophy, not their symptoms. The goal is to identify the root cause behind those symptoms and rectify it to restore the patients’ health. On treating the root cause, the related symptoms will gradually vanish as a result.
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Personalised treatment
Functional medicine model recognizes the uniqueness of every individual. For example, two different individuals may have similar symptoms but the remedies to their problems may vary. The medication and treatment are based on an individual’s lifestyle, life experiences, fitness levels, prevailing health conditions, and diet. The solution is personally tailored to the individual’s conditions, rather than being a standardised and fixed-solution approach. The practice of compounded medicine, where the medication is personalised to an individual, is preferred to the conventional practice of the same medication for different individuals.
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Promoting organ reserve
Organ reserve refers to an organ’s ability to successfully return to its original physiological state following repeated episodes of stress. In short, it is an emphasis on the body’s ability to heal itself over time. Functional medicine recognizes the healing capacity of the body and aims to aid the body in its recovery by providing proper nutrition and lifestyle inputs.
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A science-based, integrative method
Functional medicine model follows a science-based approach that recognizes the various interactions that occur inside the body as well as the external factors affecting it. The goal is to modify the various biological processes ‘upstream’ to regulate the production of various harmful end-products in the body, rather than suppressing the effects of those end-products. For example, instead of using Non-Steroidal Anti-Inflammatory Drugs such as Ibuprofen that block the last step in the production of inflammatory mediators, functional medicine aims to reduce the upregulation of such inflammatory mediators.
Further, the body and mind are not viewed as two separate units. Rather, they are viewed as a part of an integrated whole. Body and mind have a deep inter-relationship and understanding and modifying those relationships are critical to the practice of functional medicine.
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Gene-Environment relationship
A majority of chronic diseases are caused by interactions of an individual’s genes with the environment around them. The environment affects the human body at the cellular level and can affect key processes such as energy production and nutrient regulation. Therefore, understanding the role of environment and genetics forms an important part of functional medicine.
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Multi-dimensional treatment approach
Treatment using functional medicine combines the strengths of various methods to create a solution ideally suitable to a patient. For example, this may include the involvement of integrative medicine which involves changes in nutritional and exercise habits of individuals to restore their health. Further, meditation, yoga, and spiritual development may play a key role in restoring vitality. Stress management, sleep quality, and diet also makes up an important aspect of functional medicine.
Treatment Process of Functional Medicine
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In the first step, the functional medicine doctor establishes a therapeutic relationship with the patient by collecting basic information about the patient and listening to the problems faced by the patient at the present time.
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Then, the functional medicine doctor enquires about the patient’s medical history from birth till the present time. The goal is to identify the history of the symptoms, the factors that initiated those symptoms (antecedents), perpetuated those symptoms (mediators), and the events that can trigger such symptoms.
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The role of lifestyle factors is also given consideration while understanding a patient's health history. Lifestyle factors include sleep, relaxation, stress, nutrition, exercise, and relationships.
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Next, on the basis of the information gathered above, the clinical imbalances in the physiological systems of the body are identified. Some of the medical tests related to inflammation, immunity, hormones, neurotransmitters, gut and digestive health, detoxification, and energy production in the body may be requested by the functional medicine practitioner to provide a comprehensive assessment of a patient's health.
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A final assessment is made by the doctor keeping in mind the physical, mental and spiritual health of the patient. The doctor informs the patient about the treatment process and the various components in it. The patient may also be referred to nutritional specialists and other healthcare providers to aid in the treatment process.
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The progress of the patient is tracked over time to personally tailor the treatment according to the patient and make modifications, if required, to the recovery program.
Hence, the field of functional medicine provides a novel method of healing chronic diseases (such as thyroid problems) and medical conditions that are understood very little. It would not be surprising if conventional medicine makes way for functional medicine over time, especially as our understanding of the human body is increasing and the world is facing new health challenges.
