“What is functional medicine and how do you figure out what in my history is important?”
This was a great question posed by my last patient on Friday as we started to delve back through his 50 year plus case history.
Functional medicine – what it is not
In order to answer ‘what is functional medicine?’ it is probably best to start with what it is not.
Functional medicine is not about treating your disease or your presenting problems. You are not your symptoms. Symptoms are merely clues that are whispering to us (sometimes very loudly) that we need to go back in time to understand what has bought you here. If you took your car to the garage with a red light flashing on the dashboard you would be somewhat disappointed if the mechanic simply disconnected the light and said “problem solved it doe not flash any more,” yet this is exactly what we do with our health every day.
- Baby feels unwell – out comes the Calpol
- Head aches – take an aspirin
- Acne – take a birth control pill
- Appendix pain – remove it
- Menopause symptoms – take hormones.
All of these symptoms and many more are red lights flashing on the dashboard and these are the whispers we want to listen to and ask why. They are all gifts which if we choose to unwrap them can lead us to a healthier and happier future.
It all starts with your case history
Whether I am working mechanically with muscles and joints or looking under the bonnet with a functional medicine approach, the journey begins with a thorough case history. Where did things start to unravel? What pushed you off centre and then how did life accumulate on top of this. I am looking for the root cause/causes of an inflammatory cascade which can then effect your hormones, pain, digestion, mood and immunity. If you have IBS, fibromyalgia or thyroid issues the process is always the same. Lets leave the diagnosis on the bench for a moment, get out a pen and paper and go back along your time line.
To give you a demo I am going to use myself as an example. Through each decade of my life I am going too explore 5 different categories:
- Illnesses: Infections, viruses, parasites, hospitalisations, and surgeries
- Stresses: Family, school, work, relationships
- Toxins: Heavy metals, moulds.
- Food sensitivities and recurring allergies
- Medications past and present: corticosteroids, antibiotics, etc what were they for and did they help?
- Straight out of the womb I did not want to breast feed (I was a little bugger even back then). Breast is indeed best as every baby is born with a leaky gut and it is the colostrum in mother’s milk that helps heal it ready for solids and the various infections that twill inevitably come our way as we get older.
- Repeated urinary tract infections and antibiotics (UTIs are often a sign of candida infections)
- Repeated antibiotics as a child for a suspected case of bacterial meningitis
- Mumps, Chicken pox and Measles
- Family stress as my parents divorced mixed in with the usual angsts of being a teenager
- The mandatory STD associated with university life and another course of antibiotics to get on top of it
- A fungal foot infection aged 18 that would just not shift
- I began dancing and training people so I began a 100 hour work week that lasted for over 3 years.
- I began to get acid reflux
- A touring lifestyle that involved late nights and poor diet as we lived out of hotels (and night clubs!)
- Oral thrush infection and white coated tongue
- Sore throats
- Multiple joint pain and consecutive injuries
- Chronic fatigue
- No longer able to get enough adrenalin in my body to get me up on stage and through a performance
- I had to retire from dancing
- Brain fog
- Gut issues: bloating and IBS symptoms
- A voyage of self discovery to get on top of things.
- The thought I would have to settle for just feeling older and this was the nature of being over 30
Tying my case history together
My presenting problem was chronic adrenal fatigue and discomfort that meant I could no longer do what I loved. Scouring through my timeline the first whispers were already there by the time I was 2 weeks old.
My gut never got a chance to heal and much of my mother’s gut microbiome (the bacteria that lives in harmony with us) never made it across (if you fancy a great read on the topic I would thoroughly recommend 10% human: How Your Body’s Microbes Hold the Key to Health and Happiness) A good dose of antibiotics made sure that any ‘good’ bacteria became collateral damage leaving what should have been a sterile small intestine with the starts of candida over growth. The signs of Candida overgrowth are urinary tract infections, thrush, fungal foot infections, brain fog and a white coated tongue – a clean sweep!
Candida overgrowth then affected my digestion by creating lesions in the gut wall (leaky gut) allowing undigested proteins to enter my blood stream causing inflammation and autoimmune responses. Add in high stress (physical and emotional) and I was the perfect storm for a catabolic stress response which broke down anything made from collagen (my predisposition to injuries and further gut wall break down).
My solution at the time was to increase my coffee intake and sugar intake to get me up in the morning and keep me going into the evening. My friendly Candida loved the added sugar it was being lovingly fed and the coffee further stressed my adrenals. The end result, my adrenals went on strike. In order to prioritise survival my adrenals sacrificed the production of sex hormones (inability to gain muscle plus the libido of a door mat) and they struggled to make cortisol causing uncontrolled inflammation, whole body joint pain and the inability to get the adrenalin needed to get me up on stage each night. What a mess.
What was the medical solution – corticosteroids and the chronic pain clinic to understand the complex nature of pain so that I could live with it in harmony. In other words: disconnect that flashing light! Still being the obstinate bugger who refused to breast feed aged 1 week I chose instead to look under the bonnet.
- You are not your disease
- You symptoms are whispers which you might want to listen to
- Those whispers are gifts
- Go back through your timeline paying attention to infections, stresses, toxins, food sensitivities and medications
- Figure out where your inflammatory cascade began.
Treat that root cause and watch the red flashing light go out on its own.