What in the world is Functional Medicine?

Sometimes I feel like Chandler on Friends, where no one understands what I do for a living. During my first job out of Residency, I was fortunate to have a supervisor who believed in me and the way I practiced.

Early on in my career, frustrated with the bureaucracy and limitations of an insurance-based model, she empathized with me. I'll never forget, she said that I was “ahead of my time.”

Over the years, I've been tagged wonderful names by my patients, such as natural or holistic doctor. I remember one of my patients calling me her “crunchy doctor.” I remember her chuckling with surprise that I had never heard the term before. Out of curiosity, I googled it and here is the slang definition, “Having sensibilities of a counter-culture nature lover or hippie; derived from the concept of crunchy granola.”

Hmmm…I'm not sure what to make of that.

Even when my patients see Specialists, they almost always refer to me as a Naturopathic or alternative medicine doctor. I've always wondered what my patients say to them to make them assume I'm not an MD. Perhaps they just make that presumption. I don't know. It's just not common for an MD to be prescribing supplements instead of medications I suppose. It's never bothered me, as I consider it an equal honor to be called a Naturopath. Just please don't call me an “alternative medicine doctor.” [shiver] What does that really mean, anyway?

So, what better way to launch my first combo blog/vlog series. Let's talk about Functional Medicine! Let's bring this into the light! [In my mind, you’re all hooting and cheering in anticipation]

Originally while in Residency, I was in search of my passion. Having grown up with conservative Indian parents who migrated to the United States before I was born, I was always surrounded by the richness of the Indian culture which includes homeopathy, ayurveda, yoga, meditation. It’s in my blood. It's who I am. While I understand the conventional side of medicine, there are clearly large gaps in the system.

Conventional medicine is great for emergent and life-threatening issues. For that, it truly shines. For everything else… there's medication (whomp, whomp).  It quite often fails us when identifying disease processes early on and there's minimal to no approach to reversal.

I'll never forget a patient of mine from nearly 10 years ago. She's such a great example! An enlightening moment for both of us. So, this lovely patient of mine was newly diagnosed with Hashimoto's thyroid disease through my more extensive bloodwork. This is a process where your own immune system becomes confused and starts attacking your thyroid gland. The disease process can take up to 8 years to evolve before it negatively impacts thyroid hormone production. Our thyroid gland is critical to many functions in our body. If it's not working properly, you can expect a domino effect throughout. Fortunately, this patient had not reached this point and her thyroid was still able to do its job, but she was clearly not on a good path.

My functional mind was thrilled that we could implement lifestyle and nutritional changes to prevent her from progressing into full blown hypothyroidism (low thyroid function) mandating daily medication.

We chatted about lifestyle changes and methods to redirect and strengthen her immune system (the underlying trigger). She felt a little skeptical. I understood and encouraged her to seek out a second opinion from an Endocrinologist, as I'm all about patients making an informed decision. She came back to me and voiced extreme disappointment in that visit. While the Endocrinologist acknowledged the Hashimoto's automimmune process and subclinical state, he had nothing to offer her, and told her to come back when it had progressed to full-blown hypothyroidism. At that point, he would put her on medication.

Wait. What??

Did that just really happen?

I couldn't believe it!   Sure enough, it was even dictated in the consult note. How could any Physician be ok with that? I still don't understand. And to this day, most Endocrinologists I know have no interest in screening for autoimmunity as their management of the situation doesn't change. They simply wait for the inevitable, full-blown disease to take affect, then treat it with medication.

Over the years, I have identified and reversed many subclinical cases of Hashimoto's hypothyroidism beginning with foundational lifestyle and nutritional changes , then digging further to other potential underlying imbalances such as gut dysfunction, adrenal dysfunction, etc. You better believe I’m going to screen for autoimmunity.  This is one of the most prevalent autoimmune processes affecting women today, though it can also occur in men.  Additionally, if you have Hashimoto’s, you are more likely to develop other autoimmune diseases such as Insulin-dependent Diabetes, Celiac disease, Rheumatoid arthritis, etc. Every case is different and tailored specifically to the patient. Through our collaborative effort, it's a gratifying feeling for both patients and I to see this evolving disease process completely reverse itself. Ahhh. Never gets old.

What's shocking is that most patients who come to see me, who have had thyroid disease and been on medication for years, have absolutely no idea as to whether they have underlying autoimmunity. For me, as a Functional Medicine Physician, this is one of the first main distinctions that needs to be made. Is the thyroid disease autoimmune or non-autoimmune in nature? My approach and thought process is completely different for each.  It’s the big fork in the road. Makes sense, right? It should always make sense.

This is one small example of Functional Medicine in action. We’re always asking WHY. Why is this dysfunction in the body happening? How does it interconnect with other organ systems in the body? How do we systematically work to resolve it? It is science and evidence-based. Yes, we order more tests because we’re seeking to understand. It’s essential to connect the dots.

Although we still have a long way to go to spread the word on Functional Medicine, it’s definitely in demand and growth is rapidly accelerating. This pandemic only further highlights the need. Many medical schools and Residency Programs, such as the Cleveland Clinic and Loma Linda University, are integrating Functional Medicine into their Programs. Functional Medicine is becoming increasingly recognized as the only Specialty that truly addresses the underlying cause for complex, chronic disease which plagues the 21st Century.

One thing I know for sure is that the body has an amazing, innate ability to heal. It's truly incredible. I see this magic happen every day and there’s nothing more awe-striking and beautiful.  One thing I often tell my patients, is that our body tells us everything we need to know. We just need to listen.

As a Functional Medicine Physician, I have way more options in my toolbox to offer patients, aside from medication.  We strive to identify the underlying causes and contributors to disease in the body and fix it. I take a logical and systematic approach.  I present my patients with options, so that they can choose what works best for them.  We work together and that’s where the magic happens.  Functional Medicine, Holistic Medicine, Alternative Medicine [cringe].  Call it what you wish.  To me, it’s just good Medicine.