The standard medical approach is strongly rooted in finding a diagnosis, a label, to describe an underlying pathology or sometimes just a constellation of symptoms which seem to occur together (this is one definition of a “syndrome”). People would often think of a diagnosis as being “the cause” of their symptoms. In some situations this may well hold true, for example acute bacterial pneumonia is a diagnosis which quite clearly tells you you have an infection in your lungs due to a bacteria.

With most chronic diseases however, a diagnosis does not tell you the cause of your symptoms, it merely tells you what is usually the end observed consequence of a long chain of events leading to the abnormality it defines. Consequently, with relatively superficial diagnoses we end up with fairly superficial treatment strategies intervening too far downstream in the sequence of events causing the ultimate symptoms of the condition.

Let me explain this with an example. Hypothyroidism tells someone they have insufficient thyroid hormone going around their body. It explains why they are experiencing symptoms like weight gain, hair loss, cold intolerance or constipation. What this doesn’t explain is why their circulating thyroid hormone is low. Now some people may be lucky (or unlucky depending on your perspective) enough to get a bit more detail added to their diagnosis of hypothyroidism, like autoimmune hypothyroidism or Hashimoto’s disease. This particular diagnosis gives a little more detail in that it tells you your thyroid hormone is low because your immune system is damaging your thyroid gland limiting its ability to produce thyroid hormone. However the question now becomes, why is your immune system doing this, and why now? Again, the explanation standard medical practice will give is your immune system is just “overactive” and incorrectly recognising your own cells as foreign. But why?

You hopefully see where I am going with this. Standard medical practice would usually stop here and you would usually not get this next answer. You would be given replacement thyroxine hormone to be taken at a dose that managed to keep your blood levels within “normal” range (look out for another blog post talking about the problem with “normal ranges”).

Why keep asking, why?

Asking and answering a few extra layers of “why” is the real power in a functional medicine approach. Applying this to the above situation, we could answer the unanswered question by considering how a physiological imbalance in the gut like a “leaky gut” may be the first predisposing factor leading to your immune system to become overstimulated. We can also then ask why the leaky gut has occurred in the first place, and this is often linked to the nutritional inadequacies of a poor diet or perhaps even a dysfunctional gut microbiome.²

This approach often leads us much higher up the chain to treat and correct the driving force for the problem which then naturally improves the downstream markers of disease and symptoms.

Traditional medical diagnosis is organ based, which is why there are specialists for each organ or type of tissue in your body – cardiologists, hepatologists, gastroenterologists, rheumatologists, etc. Functional medicine is based on the understanding that the whole body is a complex interconnected system of physiological processes requiring balance, and imbalance in one part can and will affect one or more of the other parts. Looking at things this way we consider the core physiological processes that define human function and health, and using this we can understand and treat much better the imbalances that underlie chronic ill health.

The Functional Medicine systems biology model defines 7 core physiological processes of the body:

1. Assimilation – the process of breaking down what we eat, absorbing and using the nutrients for energy and metabolism
2. Biotransformation and Elimination – the process of detoxifying and removing compounds that the body does not need, largely controlled by the liver and kidneys
3. Defence and Repair – the function of your immune system in fighting external threats and infection but also regulating repair and restoration of our own cells
4. Communication – the function of the neuroendocrine system to send signals to maintain homeostasis of various physiological processes vital to health
5. Transport – the body’s cardiovascular and lymphatic systems are what transport important molecules throughout the body to their appropriate destination
6. Structural Integrity – this applies to all levels from cellular all the way up to the structure of your musculoskeletal system as a whole
7. Energy – the function of the mitochondria which are the master producers of essential energy for every process within the body

Functional medicine understands that all of the above are profoundly affected by myriad of lifestyle factors which most importantly are MODIFIABLE. This fact is empowering for us clinicians and for patients because it allows you to take control and optimise these factors to restore balance in the above physiological systems.

The soil in which the tree of health grows

If we think of our health and wellbeing as a tree, think of the modifiable lifestyle factors as the environment, or soil in which the tree grows. As shown in the image above, the key modifiable risk factors we can address are:

1. Nutrition
2. Exercise
3. Sleep
4. Stress
5. Social Connection and Relationships

The biochemical and physiological changes that occur due to inadequate optimisation of the above factors are often the biggest driver for chronic diseases and ill-health.

My functional medicine approach at Agami is to combine your symptoms with your story – getting to know you and understanding what has lead you to this point is key to determining where your imbalances lie. With this information, we then work with you to create an individualised plan to correct the imbalances found using a strategy that is most likely to work for you.

This will always include an in depth optimisation plan of the above modifiable risk factors, using a “food-first” approach alongside potentially pharmaceutical medications, supplements and/or botanicals. Occasionally extra testing can be helpful in helping to guide some of the above treatment plans, but in truth most of the benefits of this approach can be gained without the need for extra testing as the answers are most often found in your story.

I believe health is an endless journey and a way of living, not an end goal. It is my passion to help guide patients on their own journey.

Contact us at Agami to arrange a free initial 15 minute consultation to see how we can use a Functional Medicine model to help you to heal.

References:

1. Institute for Functional Medicine – ifm.org
2. Knezevic, J.; Starchl, C.; Tmava Berisha, A.; Amrein, K. Thyroid-Gut-Axis: How Does the Microbiota Influence Thyroid Function? Nutrients 2020, 12, 1769. https://doi.org/10.3390/nu12061769