Sandra Ishkanes is a Functional Medicine specialist. She takes a whole-body approach to healthcare, combining nutrition, lifestyle and cutting-edge medical testing.
Find out if it’s right for you.
Currently in conventional medicine there’s a doctor for every part of your body, and drugs to suppress symptoms. But we are not a collection of independent organs divided up by medical specialties for the convenience of doctors.
The human body is an interconnected whole within a larger environment which responds to environmental triggers such as food sensitivities, infections, stress, poor sleep, toxic environmental overload, and hidden chronic infections. These triggers interact with DNA to produce symptoms such as type 2 diabetes, chronic pain, infertility, thyroid disease, digestive disorders, and many more. Which symptoms develop thus depends on the individual: your specific DNA, the environment you inhabit and the lifestyle choices you make.
Functional medicine provides a framework in which all these variables are taken into account. Hence functional medicine focuses on the promotion of health, rather than the management of disease. It is an approach which addresses you as a whole person - your genetics, your environment and your lifestyle - not just your isolated set of symptoms.
Instead of asking, “Which drug matches up with this disease?” Functional Medicine asks the vital questions that very few conventional doctors ask: “Why do you have this problem in the first place?” and “Why has function been lost?” and “What can we do to restore function?” In other words, Functional Medicine looks to find the root cause or mechanism involved with any loss of function, which ultimately reveals why a set of symptoms is there in the first place, or why the person has a particular disease label.
Meet our hypothetical patient.
In his 50s, he is struggling with high blood pressure, high cholesterol, heartburn, joint pain, and type 2 diabetes – an all-too-typical list of issues. So, how would he fare at a typical conventional doctor’s office versus a functional-medicine doctor’s office? Here are some key differences.
When it comes to acute trauma, like a broken leg, or infectious diseases, such as malaria, conventional medicine is incomparable. Not so when it comes to the epidemic of chronic disease. “The structure of medical-school curriculum hasn’t changed in more than half a century,” says the American Medical Association’s James Madara, MD. “Caring for this new population requires an entirely different mindset.” Confronted with our hypothetical patient’s set of symptoms, many conventional docs would certainly consider lifestyle-based solutions. But their primary treatment would most likely be a drug-centered approach, breaking the larger problem into individual components and treating each issue with a separate medication. This strategy is accepted and supported by health-insurance and pharmaceutical companies.
Routinely prescribed for even mild problems, blood-pressure meds have been linked to an increased risk of cancer, back pain, and headaches.
Research shows that statin medications decrease heart-attack risk by less than two percent and can have serious side effects, including increased risk of type 2 diabetes and joint pain.
Insulin can worsen type 2 diabetes in the long run. One drug, Avandia, has been linked to heart disease.
Non-steroidal anti-inflammatories (NSAIDs) for joint pain.
NSAIDs, such as ibuprofen, can damage the all-important gut lining and lead to bleeding ulcers, heart attacks, and strokes.
These drugs, often prescribed for heartburn, work by impeding the stomach’s ability to make acid. But the body needs stomach acid to digest food and keep harmful bacteria at bay. Long-term use of acid blockers is linked to osteoporosis and nutritional deficiencies. Taken together, this potent cocktail of drugs can cause adverse interactions, and toxicities are possible. One common side effect is confusion, which in an older patient is often misdiagnosed as Alzheimer’s.
The typical functional medicine practitioner would recognise that the combination of high blood pressure, high cholesterol, weight gain, type 2 diabetes, and heartburn all share a single root cause: metabolic syndrome, one of the most common causes of heart attacks today. After taking an extensive health history, the functional medicine practitioner would likely order laboratory analysis to create a personalised framework for diagnosis and support. Clearly, the course of action depends on what the testing turns up, but here are a few ways a functional medicine practitioner might support our patient.
The major cause of metabolic syndrome is excess sugar and refined carbohydrates in the diet. The average person consuming a standard British diet consumes about 150 pounds of sugar a year. Simply eliminating the excess sugar, starting with sodas and fruit juices, will often fix half of these problems.
Run thyroid tests.
A low thyroid level in men and women is a sign of hormonal disturbance that contributes to metabolic syndrome. Functional medicine pracitioners use a series of tests (not just the one or two ordered by conventional doctors) and note even minor abnormalities.
The long-term solution is a nutrition-rich whole-foods diet high in magnesium and potassium, which lowers blood pressure naturally.
Incorporate more light and movement.
Sunshine, for vitamin D, and exercise are both instrumental in bone strength, weight loss, and cardiovascular health. As the weight comes off, the arthritis pain disappears and much of what has been blamed on arthritis, which is often muscle pain, also improves with hormonal and nutritional support.
Monitor and maintain improvements.
Heartburn often clears up when excess weight comes off, but if it continues, the functional medicine practitioner might recommend a plant-based digestive enzyme with meals. Type 2 diabetes, too, usually clears up as hormones stabilise, diet improves, and weight normalises. Same with high cholesterol. By getting out of the chronic-disease loop early, the patient avoids the long-term effects these problems eventually cause, including nerve pain and cardiovascular disease. As our hypothetical patient ages, he maintains his healthy lifestyle and continues to feel like he is in his 40s or 50s, with a clear mind, a healthy cardiovascular system, and a low risk of cancer and osteoporosis.
Root causes: Address the engine, not the engine light. If the engine light of your car comes on, do cover it up with a sticking plaster or do you investigate under the hood?
Functional medicine is not about giving you a drug or even a nutrient for a symptom, but instead investigating why you have that symptom and working on that instead. For example, suppose 10 different people have the same complaint, whether it is depression, fatigue, digestive problems, or persistent skin rashes. Each of those 10 people can have the same symptom, but for 10 very different reasons. An overgrowth of gut bacteria may be causing depression in one person, while it is a gluten intolerance in another. Fatigue can be the result of low blood sugar in one person, and autoimmune B12 anemia disease in another.
Until you understand why you are suffering from a health problem, chasing after medications or therapies can keep landing you at dead ends. Functional medicine relies on published, peer-reviewed science to help us understand how the body works and where breakdowns occur. Lab tests, questionnaires, in-office exams, and a discussion about your case history help the functional medicine practitioner learn where the root cause lies
Although different people can have the same symptom for different reasons, functional medicine often finds common root causes. Some of them are:
Food intolerances, especially to gluten and dairy
Low blood sugar
High blood sugar (insulin resistance, or pre-diabetes)
Intestinal bacterial and yeast overgrowths
Autoimmunity (when the immune system attacks and destroys body tissue)
Addressing one or all of these factors, depending on the person, can relieve not only the symptom that brought you to the clinic, but a number of other symptoms as well.
The body is a highly complex web in which all systems and parts are related. The body does not have specialties in the way medicine does. The digestive system — or any other system in the body — does not function independently of the rest of the body. For instance, if autoimmune disease is destroying the thyroid gland, it’s not just the thyroid you address, but also the immune system. If the gallbladder is acting up, addressing a gluten intolerance and chronic inflammation can sometimes prevent gallbladder surgery.
Functional medicine aims to reverse or stop the progression of disease. It’s also about feeling as good as you should feel, so you can enjoy and make the most of your life.