What Is Functional and Integrative Medicine?

There are many of us nutrition professionals now aligning ourselves with Integrative Medicine. I consider myself in this group. Maybe you are asking yourself what exactly this is and most importantly, does it really matter?

To answer that question, let's first address the area of conventional medicine. For some time now modern medicine has sought to treat the presenting symptoms. This might mean treating a fever or a cough, for example, or addressing pain or other discomforts. Sometimes this approach is entirely appropriate, however more often this approach misses the underlying cause and the person is never completely restored to health. Think of lingering health conditions such as acid reflux, chronic fatigue, and headaches, just to name a few. Drugs are often prescribed and the patient is sent on her way, but the symptoms persist if the drugs are discontinued.

Additionally, there is very little discussion with the patient as to how their condition came about. Unfortunately, and not the fault of our doctors, there is limited time available to spend with patients and so remedies must be delivered quickly. Without more in-depth dialogue there is little chance the practitioner even has the opportunity to see below the surface of what is really going on.

From a dietetic perspective, a conventional approach to diet intervention would be something like prescribing the same diet to everyone with the same disease. Everyone with heart disease would get guidance on the exact same heart healthy diet, for example, with no consideration given to their culture, preferences, cooking ability, or genetics. Similarly a person seeking to lose weight would be advised on the same general diet as another without consideration given to what they've tried in the past or an understanding of what foods work or don't work for them. These would be examples of conventional approaches.

Now let's flip to the functional side. Functional practitioners are looking less at masking symptoms and more at how the body is functioning as a whole. They are attempting to uncover where the body is malfunctioning and how can we restore it to its normal, healthy state. Symptoms are just clues to lead us towards the underlying cause.

In addition to symptomatic clues and obviously a physical exam, if appropriate, functional medicine practitioners are also looking in-depth at a person's unique health history to find more clues as to how and why the body is not functioning as it should. This means sitting down with someone for a significant length of time (often 45 min to an hour) and asking a series of pertinent questions to paint a picture of the person before them. What might seem off-topic to the patient is often valuable information to the practitioner, as random side notes about vacations, new pets, change of jobs, or significant loss can give further clues into a person's current state of health. These are topics rarely discussed in the conventional model.

Additionally, if necessary, laboratory tests can be conducted to give further insight into treatment options. These might include not only standard blood work but also food allergy tests, digestive stool testing, hormone testing, etc.

The goal then, after this information is obtained, is to determine how to best gently nudge the body back into an optimum state. Pharmaceutical options are a last resort as we know these only mask symptoms and leave the original condition unresolved. Potential nutrient deficiencies are often addressed, exercise recommendations may be made, and stress reduction techniques might be employed as well. Some may go further and prescribe other treatment modalities such as massage, acupuncture or chiropractic care to complement their recommendations. Once initiated these treatment plans often need time. Patients do not develop chronic health conditions in a day or even a week. Likewise these treatments need weeks if not month to restore the body to proper function and balance.

So how does this model work for the dietitian? Thankfully, we already have the immense fortune of being able to sit down with someone for a good hour or more to delve into health and diet history. This gives us a solid place to start when it comes to tailored diet advice. While we are not credentialed to prescribe or "treat" per say, this time allows us to get a full picture, both past and present, of what clients are dealing with; therefore we can devise and educate on an appropriate diet strategy. Often we suggest helpful supplements as well, especially where nutrient deficiencies are apparent. We can also advise on exercise and stress and provide additional referrals when needed.

While both modalities have their place, consider looking into functional medicine, especially if you have chronic conditions that the standard medical model is not effectively addressing. Remember, more medications is not necessarily the answer and in fact can lead to yet more symptoms that require more drugs. Believe me, I have clients in these predicaments and it's a slippery slope.

So consider seeing a naturopath, a functional dietitian like myself or other holistic care providers for a more thorough look into your condition; or even consider it for another opinion. It just may be the nudge your body needs to finally heal and restore.