A Functional Medicine Approach to Complex Diseases
William S. Queale, MD, MHS
Erin Prokop, CRNP
Many people suffer from complex diseases. Complex diseases are chronic conditions that cause multiple symptoms and often defy diagnosis with conventional medicine. They reduce quality of life and can lead to significant disability. At Personal Healthcare Providers, we feel that understanding and treating complex diseases requires looking at the body as a whole system. In addition to providing comprehensive primary care services, we utilize a clinical model called Functional Medicine to treat complex diseases. Many people are unfamiliar with Functional Medicine, so we’d like to provide an explanation to enhance your understanding.
Functional medicine is an operating system for health promotion, disease prevention, and complex disease management. It is based on the science of systems biology. In Functional Medicine, the body is viewed as an interconnected “system of systems”. The goal is to identify disordered function in any of its component systems. Disorder in one system can negatively impact other systems through feedback loops. Disordered system function is often identified through an extensive health history and traditional laboratory testing. However, functional medicine also incorporates advanced diagnostic testing when appropriate.
The health history in Functional Medicine includes identifying Antecedents, Triggers, and Mediators (ATMs). Antecedents are predisposing factors that impact health, such as your unique genetic makeup. They can set the stage for illness. Triggers are activators. They are things that happen during one’s life, such as infection, trauma, or even the loss of a loved one. A trigger may precede an illness. Mediators are things that perpetuate a health problem or prevent the body from healing. This could be an ongoing stressor, such as an environmental toxin or unhealthy relationship. ATMs are plotted on a timeline to help gain a better clinical picture of a patient’s health concern.
Another tool used in Functional Medicine is the Functional Medicine Matrix. The Matrix is basically a “network diagram” that shows the connections between the body’s component systems. Data from the health history are mapped onto the matrix, which helps the provider visualize which systems are impacted the most. Having this matrix helps identify additional areas of the body that need support.
The primary treatments in Functional Medicine are lifestyle interventions. There are five general interventions that are used to build a solid foundation of health. These include exercise, nutrition, meditation, sleep, and social relationships. Often, simply by changing lifestyle patterns, we can restore normal function to various systems. Even making basic lifestyle changes can reduce the severity of disease and improve one’s sense of well-being significantly. In addition to general lifestyle recommendations, we will also use personalized nutrition supplementation when indicated to improve system function.
The Functional Medicine model is gaining wider acceptance in conventional medicine. Currently, it is being studied at the Cleveland Clinic Center for Functional Medicine. In fact, a retrospective study published in JAMA in October 2019 demonstrated a benefit to patient self-reported quality of life outcomes using the functional medicine model to address health concerns.1
Complex diseases cause a significant amount of suffering and even frustration, especially when they defy treatment with conventional medicine. We believe a systems-based approach, like Functional Medicine, offers the best hope for treating complex diseases and we are excited to offer it in our practice.
Bibliography
1. Beidelschies M, Alejandro-Rodriguez M, Ji X, Lapin B, Hanaway P, Rothberg MB. Association of the Functional Medicine Model of Care with Patient-Reported Health-Related Quality-of-Life Outcomes. JAMA Netw Open. 2019 Oct 2;2(10):e1914017. doi: 10.1001/jamanetworkopen.2019.14017. PMID: 31651966; PMCID: PMC6822085.