What is functional medicine?

Functional medicine is in my view a new term used to describe an old way of treating: herbalists have been treating patients ‘holistically’ i.e. treating the whole person and not the disease for centuries, and this is the core principle behind functional medicine.

The concept underlying functional medicine is that you examine and assess the overall health of the person rather than just looking at the illness or diagnosis and then devise a personalised treatment programme which will change over time as the patient’s health changes.  A practitioner of functional medicine will consider the physical, emotional and mental well being of the patient.  They will think about all the different organs and systems of the body and try to establish which are working well and which are not.  The practitioner considers what has made this particular person vulnerable to this particular condition and tries to address the root causes of illness and any other underlying imbalances or dysfunction in the body.  Most illnesses or health complaints have complex causes.  For example, the causes of a woman’s anxiety and depression are usually multi-factoral and may include: hormonal imbalance, poor liver function, food intolerances, stresses at home and/or work, poor food choices and her digestive health. By working with the patient to address all of these issues you can often bring about a permanent improvement in health.

Medical herbalists are fully trained in diagnosis and often the initial one hour consultation which involves detailed questioning of the patient about their health and lifestyle, together with physical examination (if appropriate) will give a clear picture of the patient’s underlying issues and a treatment programme may be designed.  This would normally involve herbal medicines, detailed nutrition and supplement advice and lifestyle/exercise guidance.

Sometimes further investigations are required to give more information.  Often I send patients back to their GP or consultant with a letter requesting or suggesting tests such as scans to see what is going on inside the body or blood tests e.g. for vitamin and mineral deficiencies, to check for diabetes, to look at thyroid function etc.

When is private testing appropriate?
However, sometimes tests which are not readily available on the NHS are needed to give a more detailed insight into a patient’s health.  The knowledge gleaned from these tests can then be used to ensure treatment is targeted correctly giving the patient the best possible chance of bringing their body back into balance and optimising function.  I generally use Genova Diagnostics Uk or Biolab for testing.  If I think a patient would benefit from private testing we talk this through in the consultation and then the patient orders the appropriate test kit which is sent out to them from the lab.  Once they have completed the test and returned it to the lab (usually by courier) the results are sent to me and I can go through them with the patient at their next appointment.

A wide range of different tests are available, please see the testing companies’ websites for more details.  Below I have just listed a few links to the tests I use most frequently.

Adrenal stress profile – this test measures cortisol and DHEA via four saliva samples taken over twenty four hours.  Cortisol and DHEA play an important role in our ability to manage stress, sleep well, our energy levels and our ability to regulate our blood sugar levels.

Comprehensive digestive stool analysis with parasitology – this test is very helpful for assessing the state of the digestive system in detail and finding out if parasites or harmful bacteria are part of the problem.

Rhythm plus – to get a detailed look at a woman’s hormone fluctuations throughout the month and assess her testosterone levels.

ONE Optimal Nutritional Evaluation – this test is involves giving a first morning urine sample for analysis.  This comprehensive test gives detailed information on which nutrients a patient maybe deficient in, about gut health and absorption, energy production and much more.

The DUTCH TestDUTCH test stands for Dried Urine Complete Hormone Test.  This is an incredibly useful test which may help patients to find out the root causes of their hormone imbalances.  The test measures 35 different hormones and their metabolites including oestrogen, progesterone, testosterone, cortisone, cortisol,  DHEA-S, and melatonin.  It also measures six organic acids in the urine to give information on levels of vitamin B12 and vitamin B6, gluthathione (a powerful antioxidant), dopamine, epinephrine and norepinephrine (aka adrenaline and noradrenaline) and serotonin levels in the body.  

The test is often used by patients with conditions such as polycystic ovarian syndrome (PCOS), menopause and peri-menopause, pre-menstrual syndrome (PMS), pre-menstrual dysphoric disorder (PMDD), fibroids, low libido, fatigue, low mood or mood swings, sleep disorders or prostate problems.  It can also be useful to measure hormone levels in women taking HRT who are trying to find the right dosage regime for them.   

The test is easy to complete. It involves collecting urine samples on special filter papers which are then sent back to the laboratory for analysis.  Typically results come back in a little over fourteen working days.  I usually use Regenerus Labs for this test.