Functional Medicine and Me: The Diagnostic Phase

San Francisco Exploratorium: Swinging Apes

Are you satisfied with your annual medical physical? Do you hear “that’s normal,” “everything looks fine,” from your doctor without any details after the standard blood tests and blood pressure results are presented? Does she focus on the specific symptom you’ve described without considering your overall health, nutrition, and life style? Do you even know what is the basis for “normal” or “standard” within the US population: is it the fit and healthy adult, the slightly overweight person who walks occasionally, or the sedentary obese person?

I was intrigued after reading several recent books (for example, “Why We Run,” by Bernd Heinrich, “Older, Stronger, Faster,” by Margaret Webb, “Your Personal Paleo Code,” by Chris Kresser, and “Brain Maker: The Power of Gut Microbes to Heal and Protect Your Brain—For Life,” by David Perlmutter) that focus on evolutionary anthropology, and the hunter-gatherers’ physical movement, agility and diet as the basis for considering new approaches to health, fitness and wellness. The key factors driving these ideas are an understanding of the basics of the human body, going back to the core principles of human health, and stripping away much of what we consider today as appropriate diet. Much of this consideration falls under the umbrella “functional medicine.”

Functional medicine was a term instituted in the early 1990s by Dr. Jeffrey Bland. It’s a patient-centered approach to health care guided by certain core principles, i.e., an understanding of the biochemical individuality of each patient (e.g., genome, epigenetics (how an individual’s DNA is expressed), environment, and disease symptoms) and awareness of the evidence that supports a patient-centered rather than a disease-centered approach to treatment. [https://www.functionalmedicine.org]

The Cleveland Clinic Center for Functional Medicine physicians “spend time with their patients, listening to their histories, mapping their personal timeline, and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex chronic diseases.” The goal is to diagnose the root cause of illness and tackle it to eliminate or prevent disease, without over-prescribing pharmaceuticals, performing unnecessary hospital admissions or surgeries, or relying on life-long medical interventions to improve health outcomes. [http://my.clevelandclinic.org/services/center-for-functional-medicine]

Although I often considered the fact that both my maternal and paternal ancestors lived very long lives, this approach reiterates the fallacy that genetics is the basis for our health, our longevity or being prone to certain diseases. In fact, how our genes express themselves (“epigenetics”) is likely a better indicator of our health. Focusing on my body as a whole system will likely improve the management and prevention of chronic disease. We are in the infancy of significant evolutionary biology and revolutionary focus on health care: chronic inflammation, food sensitivities, the link between the microbiome and the brain, the intersection between poor diet and lack of exercise/movement, crippling chronic, expensive, life-long conditions, the rising incidence of autism and other developmental diseases, the list is endless. This information is overwhelming at a macro-level but maybe manageable at an individual level.

After decades of “great” to “excellent” comments from my doctors (yes, my “good” cholesterol number is twice what is considered acceptable and my “bad” cholesterol registers far below levels of any concern, but are these scores even relevant?), I decided to take control of my health by scheduling an appointment with a functional medicine practitioner.

I don’t have any specific health issues of which I’m aware, but a few squiggly matters that I decided should be considered in a new light, i.e., long-term insomnia, chronic hamstring injuries (originally a tear at the attachment point, but after more than five years of physical therapy, massage therapy, autologous blood injections as well as plasma rich injections, core strength training, change in diet, it’s still bothersome), and post-menopausal hormone replacement therapy. My husband instituted a mostly-Paleo diet a few years ago and, although I have more of a sweet tooth than he does, I’ve generally followed it, too. I suppose our diet is ultimately a low-carb, low-grain/no legume combination, with the focus on vegetables, nuts, eggs, berries, Greek yoghurt, hard cheeses, chicken and fish, almond butter, cocoanut and/or almond milk, and dark chocolate (in small doses).

 My personal foray into functional medicine began at the California Center for Functional Medicine and includes three steps: an initial consultation to determine what, if any, are my health issues or concerns, an abundance of diagnostic tests (with an astounding breadth and depth of information for the doctor to discern, including SIBO (small intestine bacterial overgrowth), comprehensive hormone profile (assess my daily cortisol rhythm and cortisol metabolites to assess my stress response), testing for wheat/gluten reactivity and autoimmunity, a comprehensive blood panel, and a dysbiosis evaluation (the balance or imbalance of the microbiology of the gut)), and finally, an in-person debriefing of the test results and, if necessary, steps to take to remedy any noted issues. [http://ccfmed.com]

The process is not simple or for the faint-hearted (lots of blood drawn and with small veins like mine, ugly bruises on both arms; eating specific foods or fasting before certain of the tests; and following a 30-day Paleo Reset diet before my case review). It will take approximately three months from my initial consultation to the hour-long session to discuss test results and see where I fall on the functional health spectrum and what, if any, improvements I need to make to ensure, as much as I can, better health and fitness.

I have completed all the diagnostic tests and have started the Paleo Reset diet. Although the change in my diet will likely not be as drastic as for some people, eliminating cheese, yoghurt, oatmeal, and chocolate will take concentration!

 I do not anticipate major issues being found, but believe my greatest concern is from a nutritional perspective. I likely do not eat enough calories for optimal health and may need to focus on the panoply of nutrients that are critical to fighting inflammation and maintaining good gut health. Even though I am only a subject of one, understanding this “new science” and health approach is fascinating. Stay tuned!