Why Functional Medicine Makes Sense for ME/CFS
Like many other things you hear about outside the mainstream, functional medicine can be a fad, gimmick, and dogma. However, functional medicine can also be the best approach to complex chronic diseases like ME/CFS, fibromyalgia, and autoimmunity.
*The opinions herein may not represent authorities in the functional medicine community. But they do represent Dr. Craig’s own opinions regarding what functional medicine is and should be.
What is Functional Medicine?
Functional medicine aims to be medicine for the individual, not the disease itself. Patients are more complex than their disease or symptoms. Because of this, a more nuanced approach is required. The future of medicine lies in a personalized approach, and functional medicine practitioners are already on board.
At its core, functional medicine digs deep and asks why; it seeks to uncover the root causes of illness or the prime drivers, rather than simply treating the symptoms that have arisen. It does this by acknowledging that our various body systems do not operate independently but as an interconnected whole. Functional medicine provides new ways to discover unifying factors at the cellular and systems level that underlie organism-wide problems.
In contrast, the conventional medical approach tends to treat each system of the body independently, suggesting they have only a linear or simplistic relationship to one another. As patients, how many of us have experienced being referred to one specialist after the other - perhaps a neurologist and then an endocrinologist doctor for example - but do these specialists have the time or inclination to compare notes? These bodily systems interact; so who’s connecting the dots?
Stepping back and ‘thinking outside of the box’, often allows functional medicine practitioners to unearth complex, diverse and sometimes unusual causes of illness such as mold exposure or sensitivity to pesticides for example. Sadly, these causal or prime perpetrators of disease, are often unheard of or unrecognized within traditional medical practice.
“Good medicine is good science. It is inquiry driven and open to new paradigms ”
At this year’s Invest in ME conference in London (2019), ME/CFS veteran doctor and researcher Nancy Klimas presented these very aspects of integrated and functional medicine. She stated quite eloquently that these approaches are not pseudoscience, but get to the heart of what good medicine is all about---listening to and treating the patient. From her slides, she stated, “Good medicine is good science. It is inquiry-driven and open to new paradigms.” Indeed, Klimas’ Institute for Neuro Immune Medicine is comprised entirely of physicians trained in integrative and functional medicine.
Functional Medicine isn’t simply “alternative” medicine. While the details of these disciplines are often blurred, functional medicine should not be confused with older, outdated alternative methods. To compare, functional medicine embraces newer technologies, such as –omics, which includes the study of genomics (genes), proteomics (proteins), and metabolomics (metabolites which are the intermediary breakdown products of our body’s metabolism).
Functional medicine practitioners should be well versed in evaluating more complex date biometric data for further precision. Typically, these practitioners will also examine environmental and lifestyle factors that may be impacting the health of an individual, such as diet, air quality, allergen-load, chemical toxins etc.
When choosing treatments, functional medicine is not against traditional pharmaceuticals or surgical intervention. Some in the alternative medicine world have drawn a line in the sand, but ideally functional medicine is open-minded to all necessary approaches as long as they are evidenced-based and specific to the patient’s needs. Coming back to Klimas’ comments, integrative and functional medicine are simply good medicine.
What to Expect
In a conventional medicine setting, where the appointment time with a family doctor may be around 10 minutes per patient, an initial appointment with a functional medicine practitioner is likely to be anything up to an hour and a half in duration. This allows for an in-depth discussion, enabling the patient to feel listened to as they convey the bigger picture to their practitioner. As a patient, I have often found functional medicine practitioners to be willing to ‘walk-the-walk’ as well as ‘talk-the-talk’; often personally invested in their area of expertise and less likely to expect sacrifices from their patients that they wouldn’t be willing to make themselves.
“functional medicine practitioners... [are] often personally invested in their area of expertise and less likely to expect sacrifices from their patients that they wouldn’t be willing to make themselves.”
Undeniably, functional medicine and its treatment options, can be costly for the patient; not just in terms of financial outlay but also in terms of personal responsibility. Patients must be active participants in the process - often needing to demonstrate resourcefulness, self-control and resilience, especially when treatments are inconvenient or viewed with suspicion by others. But in return, the rewards can be dramatic…even life-changing.
Typical treatment options and advice from a functional medicine practitioner may include:
Nutritional medicine (non-prescription nutritional/herbal supplementation, tailored dietary strategies)
Pharmaceutical agents (a functional medicine doctor is likely to use a combination of conventional drug treatments used within mainstream medicine, as well as natural treatments/approaches depending on patient need). It is worth noting here that a functional medicine doctor may advise that a patient takes a drug that has been produced by compounding pharmacies either to produce a tailored dose that would typically not be available in mainstream medicine.
Measures to improve lifestyle factors (such as stress management, improving sleep, exercise, etc).
Measures to improve environmental factors (such as reducing the toxic/allergenic load within the home, improving home air quality, etc).
Functional Medicine for ME/CFS and the like…
All too often those with ME/CFS, or the like, are moved from specialist to specialist before a diagnosis is made. Once diagnosed, the person can then be shuffled through another rigmarole of experimental treatments.
Those with ME/CFS are exceptionally heterogeneous in their condition. Illness onset, degree of severity, and core symptoms vary wildly. Two people with a diagnosis of ME/CFS will likely require two different treatment approaches. Traditional medicine regrettably does not always consider this, and uses textbook treatments and cookie-cutter protocols. Be wary of practitioners who are rigid in their approach.
“Two people with a diagnosis of ME/CFS will likely require two different treatment approaches. Cookie-cutter and one-size-fit protocols won’t work for most.”
Demand the Best
You may invest a lot in functional medicine so ensure you get the best value. Thoroughly vet your potential practitioner. Where did they study? Are their credentials respectable or suspect? Are there disciplinary actions against them from their medical board? (You can Google this!) HERE and HERE
Most of all, are they truly interested in your case? As in any other situation, if you don’t build rapport with your practitioner, positive outcomes may be less likely. Above all, the patient should first be heard. If you don’t feel like your health concerns are being listened to, go elsewhere.
I also don’t believe practitioners should create false hopes or overstate what is possible. If it sounds too good to be true, it is. Most with chronic illness also deal with other conditions that are indeed treatable. With precise and personalized information about the patient, one can then devise standard and alternative treatment options that offer hope…
