Category Archives: 3. Functional Medicine FAQ

The Truth Behind the “Everyone Is Different” Mantra

If you’ve hung around the internet-based support groups and forums (either general or for a specific disorder) long enough, you might get lucky and see a practitioner pop up every once in a while with a gem….followed by the disclaimer: “Everyone is different.”  Many patients in my office ask me how long it might take them to get better; someone next to me in the grocery store might ask me what they can take for their Candida, Mercury toxicity, or a general detox plan.  Or a colleague calls me to ask what they can do for a patient with a mysterious symptom.  To which I reply with my own: “Everyone is different.”

What’s with that?  Is “Everyone is Different” a simple cop-out?  An office ploy to obtain more patients or clients?

Maybe it is for some practitioners, but I can only speak for myself and how I practice.  When it comes out of my mouth, “everyone is different” really means just that.

The skeptics out there scoff and say, “well, that’s just a ploy.  There can’t be that much variation between human beings.  After all, we share 96% of our DNA with cats, which is only a 4% variability; how can humans vary so much?”

The easy answer is…three factors.  1) Predisposing Factors, 2) Triggering Factors, and 3) Perpetuating factors.

1.  Predisposing Factors

That starts with genetics.  You’ve probably heard the term “genetic predisposition”, usually in reference to a disease or condition.  Our genes vary a lot!  For example, 30% of the population has a genetically-predisposed reactivity to gluten.  About 40-50% of the population has a methylation (detox pathway) defect.  Do you have estrogen dominance symptoms, or are you one of the estimated 50-80% of the women out there with uterine fibroids?  Then you may be among the 50% of the population that metabolizes estrogen differently in the liver, turning it into a very powerful, too-active form of the hormone.  When I order a genetic screening of someone’s detoxification ability, about 25% of the markers are abnormal, indicating mutated genes…in every.  Single.  Person.

It’s not just genes, either.  We vary in our physical structure as well.  Ten percent of the population is missing the retinaculum, a strip of tissue that goes across the inside of the wrist.  An estimated 40% were born *without* a psoas (pronounced “so-azz” major muscle.  Wow!

Let’s consider development, the first factor being prenatal care.  Parents whose children were planned are much more likely to have sought prenatal care, including prenatal vitamins with extra folate and other nutrients vital for proper fetal growth.  At the very least, they have (hopefully) stopped smoking or drinking.   A mother who doesn’t realize she’s pregnant (and may not until the third or even fifth month!) may not have taken any of these precautions.

2. Triggering Factors

Triggering Factors (or “triggers”) involve events or physical/chemical/emotional assaults that set something in motion, usually the development of a chronic disorder.  These usually occur after birth (although they can indeed begin in the womb), and can happen at any time of life, even in the elderly.

The birth process itself can change things.  A traumatic or emergency delivery, or a situation in which the baby was deprived of (or otherwise low on) oxygen can present lasting problems.  If the baby was born vaginally, this bodes much better for the development of the “good”/helpful bacteria that live in the GI tract; in fact, it’s an important point of establishment.  Those born by Cesarean section by-pass that opportunity.  The same goes for breastfeeding versus a soy or cow’s milk formula; the first three days of breast milk production isn’t the milk protein at all, but rather, colostrum, which is absolutely vital to a healthy immune system and (once again) the establishment of good intestinal bacteria.

Immediately after birth, a baby is born with 287 different toxic chemicals and metabolites in the blood. The urinary studies are even worse: of over 3,000 metabolites found in the urine, 2,200 were toxic and unnatural.  According to current research, it’s estimated that a lady sheds 60% of the stored toxins from her adipose tissue (fat cells) during pregnancy.  These do indeed cross into the umbilical cord.  If this lady lives on a rural ranch, her toxic exposures will be different than for someone who lives in a city, across from the cement plant (which releases ambient Mercury into the air).

As a newborn, if a baby was separated from his or her mother (mom was in the military or otherwise absent), this can actually intensify the brain-adrenal stress response, creating changes that last through life.  If the baby is vaccinated immediately, the immune system fails to develop properly (it is not developed well enough to know how to handle a vaccine properly until at least six months of age; vaccinating beforehand simply confuses the immune system, not to mention the doses of Mercury, propylene glycol/antifreeze, and formaldehyde that have been reported in vaccines).  Again, the same goes for breastfeeding – six months is the minimum for a healthy immune system; 12 months is ideal; I’m happy with anywhere in between.

Then, one must ask, what is this person’s early life like?  Do the parents fight?  Did the family move a lot?  Is the house clean and sanitary?  (Is it *too* clean and sanitary?)  Did the neighbors treat their lawn with chemicals or commercial fertilizers?  Is there an unknown growth of black mold in the vents?  Is there an unknown termite infestation releasing naphthalene (a toxic chemical) into the air?  What about diet?  Some brands of commercial baby food contain MSG!  That does not promote a healthy gut; in fact, it causes a Leaky Gut.  And what about baby clothes?  Many of today’s baby products (such as clothes, blankets, etc) have been treated with flame-retardant chemicals, which sounds good in theory, but in reality are quite toxic.  These chemicals release fumes into the air and through the skin that end up in the baby’s blood, threatening vulnerable developing tissues (like the brain and reproductive system, especially).

When the child gets sick, is he or she automatically given antibiotics?  During a seasonal cold or flu, it’s good to know that dairy and sugar create additional mucus and prolong the illness.  Eliminating these foods from the diet, at least during that time (and regardless of allergy) will help ease the symptoms and duration of a cold or flu.  Antibiotics, however, will not.  What they *will* do is kill off healthy bacteria.  There’s a place for antibiotics–to take care of an immediate problem before it becomes worse, while then taking the time to figure out why it happened.  A healthy immune system only gets a seasonal cold once or twice per year and in some people, every two years.

In light of the above, consider all of the “forks in the road” that each of us has faced.  We’ve had incredibly different combinations of predisposing and triggering factors influencing us from before birth!

You get the idea.  Most of my sickest patients had been subjected to long-standing family dysfunction or other emotional traumas growing up.  Many others were just fine until they got caught up in a bad relationship or moved to a particular house in which, undisclosed to them, was a black mold or cockroach infestation.  For others, it was a job change, in which the new job was extremely stressful, with a steep learning curve.  And for still others, all was well until a college spring break trip abroad, during which they contracted a stomach bug that ended up being an ulcer-causing bacteria; this created a hole between their intestinal tube and their bloodstream, and from there they went on to form severe reactions to several major foods.  Which brings us to…

3. Perpetuating Factors

These are factors that, once a condition or dysfunction has been set in motion, play a major part in keeping it going/making it worse.  These factors provide additional–often daily–assaults to the system, progressing the condition.  Prime examples include unrealized food intolerance, a dysfunctional marriage, fibromyalgia, harsh medication, environmental chemical exposures, processed foods, MSG intake, genetic abnormalities (such as the estrogen metabolism example mentioned early on), a manipulative sibling, an aging parent, chronic injuries from a car accident, migraines, birth control pills, a chronic unknown intestinal or dental infection, a special needs family member, death of a loved one, an old sports injury, *additional* food allergies (that develop long after the first few), and so much more.

Alcohol intake or prescription medications will change one’s nutrient status, and with that, one’s entire function.  The same holds true for one who is under chronic stress or chronic pain from an old injury.  Someone who harbors emotional traumas that have not been resolved through quality counseling may do “everything right” in terms of their care plan, and their symptoms may not budge.  Thus, it’s crucial that your doctor asks a lot of probing questions, scrutinizes every inch of a detailed health and personal history, gathers information about medications you’re taking, and recommends a comprehensive diagnostic lab workup.  (Hint: A blood cell count and an adrenal stress test are *not* a comprehensive workup!  At least not when you have a long list of mysterious symptoms and nothing you’ve tried has provided lasting relief.)

(The Unwritten #4: The Gameplan)

Each of us is a fingerprint–we look the same, but no two of us are exactly alike.  I see this variation very plainly when I receive lab test results on my patients.  I must carry three or four different versions of, for example, an intestinal healing formula, because a patient with a sulfur-loving bacteria growing in their intestine wouldn’t respond to the version that contains MSM, a sulfur-derived natural compound.  Others have an aloe allergy, so they wouldn’t handle the one with aloe very well.  Some need a more basic formula, while others need one with more anti-inflammatory ingredients.  Some peoples’ immune systems need turning up, while others’ systems need calming down.

Another good example involves thyroid disorders.  There are about 22 different patterns of thyroid dysfunction.  Healthy levels of specific brain chemicals are needed in order to stimulate TSH, the thyroid-stimulating hormone.  The thyroid gland must be open to receiving that TSH signal.  Then it must have enough raw nutrients (minerals and proteins) to make thyroid hormones.  The catch is, most of the thyroid hormone that the thyroid gland makes is inactive.  This hormone must be activated elsewhere.  If you suffer hidden, sneaky, chronic inflammation, you won’t activate thyroid hormones properly.  Thus, your thyroid tests can be “normal” and you still feel like a textbook hypothyroid case.

Some people need Iodine to improve their thyroid function, while for others, that can be an unpleasant–and risky–idea.  Some people need immune boosting (or calming) support in order for their thyroid symptoms to improve.  And still others need to tone down their adrenal stress before they’ll feel normal in thyroid terms again.  Sex hormone dominance can also mimic low thyroid function.  There’s no one magic bullet for “hypothyroid”.  For some people it might be a stomach cell-rejuvenating formula so that they can break down protein again in order to make their thyroid hormone backbone.  For others, it might be an adrenal modulating formula so that excess stress hormones stop interfering with thyroid hormones.  And so on…

The good news is, the technology is out there–and it’s now reliable, widely-available, and cost-effective!  It is now possible to sniff out these underlying causes, and rule some out while ruling others in.  This allows us to very specifically hone in on what the underlying cause of *your* particular problem is.  This also allows us to say, “well, it isn’t that, so we don’t even have to go down that road; let’s focus our efforts over here instead.”  The diagnostic approach becomes smarter.  The treatment or care approach becomes more targeted.  People heal more completely.  They even heal faster…

….even if:     “Everyone Is Different”

🙂

Advertisements

“My lab tests are normal” (…or are they?)

Cindy* sits across my small round table during our first visit together.  She has hit a brick wall.  Last week, she submitted to my office her intake forms and previous medical records, which consist of lab test after lab test.  These are isolated individual tests, taken on different days (or even months), never all at the same time.  Some of the tests are repeated several times.

Cindy shrugs, throwing her hands in the air.  “I don’t know what to do.  They look at me like I’m crazy.  They tell me my labs are normal.  And yet–well, you’ve seen my questionnaires.  I’m a mess!”

So her lab tests were “normal”, eh?  Let’s see about that….

First, let’s talk about the blood test process.  After the doctor or nurse takes your blood, they send it to a lab, telling that lab to run various tests on it.  The lab analyzes the blood sample and determines the results of the tests ordered.  These test results are reported back to the doctor in the form of a number.  Some of those numbers are familiar–for example, a cholesterol of 183, triglycerides of 132, or a blood sugar/blood glucose of 94.  If you have a thyroid issue, you may also know your TSH level.  The lab will compare your number results with what is called a “reference range” – a “normal” range.

Next, it’s important to understand what “normal” means.  The conventional medical system only recognizes two states of health: either you have a disease or you don’t.  If they can’t establish the presence of a disease, the doctor tells you you’re “normal” or “fine”.

The problem is, the regular definition of “normal” (and the “normal range” used by the labs to determine whether you’re sick or not) isn’t based on good health or healthy function.  It’s based on that “normal range” we talked about earlier.  How are those ranges determined?

By statistics.  The large national lab companies are responsible for setting their own reference ranges.  To do this, they compile the test results of the samples submitted, established an average, and compare the results to the corresponding patients. Every so often, as the general health of the population shifts and the average number values change, these laboratories will adjust their average ranges accordingly.

Look around you; 60% of the population is overweight and 20% of the population has developed diabetes.  About 73% of the population is taking at least one medication.  Cholesterol problems, hormone imbalances, and digestive issues abound.  Alzheimer’s Disease and autoimmune disorders are skyrocketing.

Do you really want to be compared to those around you?
Do you really want your “normal” range to be based on those people?

Also, it’s important to understand that these labs do this on a regional basis.  This means that a patient in South Carolina and a patient in Utah may have the same fasting blood sugar levels, but get labeled “normal” in South Carolina, while the lab in Utah would “flag” the result as abnormal.  The South Carolina patient’s doctor would tell that patient he or she is “fine”, while the Utah patient’s doctor will make recommendations for preventing diabetes.

One huge problem is that in gathering these statistics, labs fail to take prescription drugs into account when establishing normal ranges.  Medications, by definition, artificially manipulate the body’s function, altering its chemistry.  Because of this, it’s important to consider their effects when determining what’s “normal” and what’s not and yet, this is not done.  As a result, people undergoing thyroid testing get lumped in with people taking thyroid medications, and people undergoing a blood sugar screening get lumped in with those taking insulin.

Do you want to be lumped in with people taking loads of medications?  Do you think that these “normal” ranges can be fully trusted?

Now…when most doctors get these results back, they scan them, looking for abnormal results.  If any test result falls out of range, the lab highlights it, usually in bold, stating “high” or “low” off to the side.  Most doctors, lacking the time to fully investigate these results, quickly scan each line item.  Anything not flagged in “pathological” (disease) range is passed over without a second thought.

So, back to Cindy.  When she hands me the printouts from her previous lab tests, I, too, scan for the lab’s flags.  However, that’s just the tip of the iceberg; I usually find many more abnormal results that lie outside of healthy range, but not yet far enough advanced for the lab to flag the result as “abnormal”.  It’s not that I run different tests, it’s that I use “functional ranges”, which are much tighter and designed for healthy function.

For example, a good healthy functional range for fasting blood sugar is about 85-100.  The lab’s established reference range is often 65-110. If Cindy has a fasting blood sugar of 77 , she begins to lose optimal function, and yet most doctors will tell her she’s “fine” because the lab won’t highlight her result as “abnormal” until she reaches 64.  By the time her blood sugar falls that far, she has lost a lot of function!  She probably started feeling dizzy and lightheaded around 79.

Is Cindy hypoglycemic at 77?  Nope, she’s what we call “functionally hypoglycemic”, because she falls below the lower functional blood sugar limit of 85.  When she gets to 64, we can officially call it true hypoglycemia.  But why wait until then?  Someone with blood sugar in the 70s can certainly have hypoglycemic symptoms and can still benefit from a blood sugar stabilizing plan.

That’s what Functional Medicine is all about, folks: good function.  It’s about catching health issues early, identifying breakdowns in proper function before they become established diseases.

Of course, once they do, it’s not impossible to turn it around.  But if you’ve got a train starting to travel in the wrong direction, picking up speed second by second, isn’t it easier to get it stopped and turned around before it reaches full speed?  True health works exactly the same way. 🙂

*real patient, but not her real name

Does my health insurance cover Functional Medicine?

That’s a great question.  In fact, that’s one of the first and most common questions people ask.  This is understandable; after all, chances are you’re paying good money for your premiums, not to mention deductibles and co-pays.  Your employer has no doubt touted the benefits of each plan, which seems generous at the time.

So where does Functional Medicine fit in?  The short answer is, I recommend that you first carefully review your policy, checking for any reference to “preventive” services, or possibly “nutritional counseling”.  When in doubt, it’s best call your insurance company directly and ask them if any of these types of service are covered under your plan.

To understand the long answer, we must first make an introductory foray into the world of so-called “health” insurance.  The first thing that you should know about health insurance is that the term is a misnomer; your health insurance company (be it Blue Cross Blue Shield, Aetna, Cigna, Humana, or worse, United Healthcare) has not made your health their top priority.  How can this be?

Well, let’s do a little research (I love research).  Quick Google searches show that the first Blue Cross plan was introduced in 1939.  Humana was founded in 1961.  United Healthcare is the new kid on the block, formed in 1977.  And the elder of the insurance companies?  Aetna has been around since 1853.

Since insurance companies are private corporations, this may go without saying, but it’s worth highlighting here: in order to survive, health insurance companies must turn a profit.  This is true of any company, family/household, or individual.  You must make more than you spend.  By definition, this means that they must take in (revenue) more than they pay out (expenses).  This means that their customers (that’s you) must pay more in premiums (as well as deductibles and co-pays) than they pay back out on your behalf (in the form of benefits, or covered services).

Functional Medicine itself requires the doctor to spend an enormous amount of energy behind the scenes between your appointments.  This time spent on your behalf includes deeply interpreting lab results and putting them together, attempting to find the underlying common cause or causes of the problem.  This may also take research and review of the newest published studies as they come hot off the presses.  No other healthcare discipline goes this far or invests this amount of time on each patient.

Since these doctors only have so many hours in a day, they’d rather devote that time to your case, (researching and reviewing your case, preparing information and treatment plans, and answering your questions), than wrangling with insurance bureaucrats, none of whom have any medical training themselves and thus lack the understanding that Functional Medicine doctors have.  Most Functional Medicine doctors would love to provide the convenience and assistance of filing insurance for their patients, but with the time and energy constraints, they find that they can’t do both well.  The bad news is, they don’t file your insurance for you and they furnish you with the receipt to submit instead.  The good news, though, is the most important: they’re not bound by their arbitrary rules, and their time can be spent where it counts–devoted to YOU.

So, about that receipt I just mentioned… Yes, most Functional Medicine doctors will provide a descriptive receipt upon request.  Depending on your insurance company, they may accept that receipt and perhaps reimburse you for part of the out-of-pocket investment you made.  I can never guarantee this, as insurance companies are like water, always changing and tough to get a firm grasp of.  Sometimes they will want codes, and this is where things get sticky…

The codes the insurance company likes to have essentially reduce you to a Dewey Decimal-like system of numbers.  Every established disease (official diagnosis) has a 4- or 5-digit number, in the form of “123.45”.  Each recognized type of treatment has a 5-digit code, too, in the form of 12345.  Although the two numbering systems are different, each recognized disease corresponds with its appropriate avenues of treatment, and vice versa.

So what’s the problem?  The difficulty arises in that these coding systems are old and outdated.  They fail to consider dysfunction (i.e. breakdowns in healthy functions or processes, the earliest signs of disease) and they also usually neglect to include contemporary health issues.  In other words, there is a language barrier between Functional Medicine and health insurance, especially considering that health insurance is actually structured around–and oriented toward–conventional medicine, which intervenes only when the dysfunction has advanced for years to decades, resulting in a blatantly recognizable, established disease condition.

The common scenario is this: you start to feel that something’s not quite right.  You visit your conventional/regular doctor, who runs the blood tests and, after scanning them quickly, says “everything is normal”.  You know that it’s not, but now they’re hinting that it’s all in your head.  Meanwhile, your health does slide further and further away from healthy ranges, toward the outlying borders of “normal” and eventually it does cross into “abnormal” territory.  This may be years later, and by then it may or may not be too late to effectively use natural methods.  But the insurance company now has a number it can assign you, a little numeric box it can neatly put you into.  They’re happy, they’ve been satisfied.  But what about you?

That’s where Functional Medicine comes in, and hopefully you’ll be able to see a Functionally-oriented doctor before you reach the disease point.  With any luck, your insurance company will cover at least part of the tab.  If they do, look at it as a secondary bonus, and if they don’t, simply consider it part of the cost of living.  After all, when owning a vehicle, we understand that if we don’t invest in maintenance, the car breaks down and stops working.  We must pay for regular oil changes, state-mandated vehicle inspections, license plate tags/stickers, brake pads (which are actually designed to wear out!), tires, and many more.  Why give your body any less?  Make your health your top priority, even if it’s not your insurance company’s.  Why?  Because you only have one body, and it only treats you as well as you have treated it.  We’re a product of the decisions we have made every day.  Up until now, people have relied on their insurance coverage for any kind of medical care.  But if we want a different result, we may have to consider a different approach…whether an out-of-touch insurance company thinks it’s medically necessary or not 🙂

How to find a good Functional Medicine doctor, Part 2

In my most recent post, I started laying out some guidelines I use to help people find a good Functional Medicine practitioner.  To sum things up so far…

The most important aspects of a good Functional Medicine practitioner include holding a doctor license of some kind (doctors of all kinds receive similar training where it counts in Functional Medicine – all receive extensive Anatomy, Physiology, Endocrinology, Biochemistry, Embryology, Histology, Cytology, Biology, Lab Diagnosis, and more).  Doctors of all kinds can order and interpret diagnostic lab testing in nearly all states, whether he or she is an MD, DC, or DO.  There are indeed MDs and DOs who practice exclusively Functional Medicine without using medications at all, and there are indeed DCs (Doctors of Chiropractic) who practice exclusively Functional Medicine without ever doing a single spinal manipulation or physical rehab therapy session.

So now, let’s move on to a few more guidelines that can help separate the “men from the boys”, so to speak, and maximize your chances of finding a good practitioner that meets your needs.  Here are a few more important clues to look for:

Guideline #4: Look for mentions of diagnostic lab testing, when surfing the web or calling around.  Some websites will mention some of the tests the doctor will order.  Look for standard lab work such as CBC (Complete Blood Cell Count), CMP (Metabolic Panel), immune profiles, antibody testing, and thyroid panels.  Look for specialty testing such as salivary testing, hormone testing, digestive analysis, or stool testing.  Shy away from anyone who says they can test your neurotransmitters by analyzing your urine; those tests are NOT reliable, diagnostic, or accepted.  In fact, they have been disproven.  Shy away from anyone using muscle testing instead of lab testing.  A combo of muscle and lab testing is OK, but I would personally ignore any “diagnosis” or assessment given by muscle testing alone.

Guideline #5: When surfing the web (or calling the clinics), look for (or ask about) the depth of the paperwork.  They should put a lot of stock in the intake forms.  They should want to know your life story in terms of your physical, mental, and emotional health.  They should want to know ALL KINDS of things about you, as far as your lifestyle, your travel history, your birth, childhood, adolescence, adulthood, and more.  If what is posted on the web is very basic and there is no mention of additional paperwork to come, I would call the clinic and ask what kinds of questions and information the doctor wants to know.  Doctors practicing real Functional Medicine want to ask a lot of questions, and their receptionist should be able to tell you that.  Proper healthcare begins with an extensive gathering of information, and it’s not uncommon to see intake packets of 20 to 50 pages or more.

Guideline #6: Some Functional Medicine doctors list their preferred supplement companies online.  Word to the wise: many supplements, notably Standard Process, will inadvertently make their patients’ conditions worse, especially any autoimmune condition, because they contain wheat products.  Another word to the wise: Many supplements are either multi-level marketing companies (such as Juice Plus or some glutathione supplements), or they are affiliated with cults such as Scientology.  A Scientology-affiliated company can still make excellent products, but upon asking myself the question of whether or not I wanted to contribute financially to that type of organization, the answer was no.

Guideline #7: If they mention multi-level marketing companies (think Mona Vie acai berry juice, Juice Plus whole food supplements, Kangen water, or Nikken magnet products to name a few), I would personally shy away.  MLM products are generally fads that produce little to no results.  Some truly are good (such as the pH-based water); however, they tend to be overpriced and you may face some high-pressure sales tactics.  Many claim to have undergone testing or research, but typically the testing is useless because it is done in-house, and not by an objective, standard third party.  Thus, there’s a vested interest, which renders the scientific validity questionable at best.

Now…I’ll bring these next few things up because you’ll probably come across it in your research and if you’re like I was, you’ll wonder about the following:

  • Many Functional Medicine doctors do sell supplements in their practice.  Yes, this is ethical, as long as when they recommend a supplement, it is for a reason that benefits YOU, and it’s something YOU actually need.  Again, beware MLM supplements.  Google for a list of MLM companies; you may need to check several sources, as many MLM companies are newer and may not be on older lists.  Chances are if you see the product/supplement advertised on someone’s car/SUV, it’s an MLM.
  • Many Functional Medicine doctors do not file insurance.  (This topic alone will probably be discussed separately in the future.)  This is because insurance takes a lot of time and effort that the doctor would rather devote to your case instead of wrangling with bureaucrats.  Coverage for these types of services will depend on the policy you chose; doctors don’t know anything about the literally tens of thousands of policies out there.  Also, even if your insurance policy does not cover this type of care, that doesn’t mean it’s not valid or necessary.  Health insurance companies do not care about your health; they’re trying to minimize costs, even at your long-term expense.
  • Functional Medicine doctors should have no problem openly communicating with conventional medical doctors.  If they seem shifty about this, think twice.
  • Some Functional Medicine doctors may charge a fee to analyze your paperwork and review your records and history.  This is perfectly normal and legitimate.

This is by no means an extensive list – there are always other indications of a quality practitioner, as well as pitfalls to watch out for.  I’ll try to cover additional items as they arise.  For now, however, you should be armed with a little more information to begin your search.  Of course, the best bet is to ask around; although not many people are seeing a Functional Medicine doctor (yet!) you never know who may know someone. 🙂

How to find a good Functional Medicine doctor, Part 1

I administer several forums, most notably a group on the social networking site Facebook called “Functional Medicine“.  To find it, simply enter “functional medicine” in the search box and select the “Group” (not the “Interest” – that’s different).  One of the most common questions I encounter both on- and offline is, “I need a good Functional Medicine doctor.  How do I find one?”

The short answer is, sometimes it takes a little digging and reading between the lines.  Sometimes it doesn’t.

The long answer is, there are several ways to find a good doctor who practices real, genuine Functional Medicine.

To get started, please see my two posts on what Functional Medicine is not, Part 1 and Part 2.  This will weed out a lot of the fat.  It’s important to keep in mind that each Functional Medicine clinician will practice slightly differently; however, a few basics should be consistent.

Guideline #1: The practitioner really should be a doctor of some kind, or perhaps a nurse practitioner–maybe.  I would not visit an acupuncturist, massage therapist, physical therapist, pharmacist, nurse, midwife, or non-doctor clinical nutritionist for this type of care.  Not only can many of them not legally order or interpret diagnostic testing, they also many times lack the depth of foundational information that doctors receive.  I also would not visit any unlicensed practitioner for Functional Medicine, such as a holistic health counselor, wellness coach, or, depending on the state, naturopath.

Beyond that, however, the type of doctor does not matter.  Whether he or she is an MD, DO, DC, or, (depending on your state!) ND, a good Functional Medicine doctor will practice much like another.  A good Functional Medicine MD (medical doctor)  will practice just as well as a Functional Medicine DC (Doctor of Chiropractic) and vice versa.  It’s nearly impossible to tell the difference other than the initials behind their names.

Guideline #2: The practitioner should be from the United States, or possibly Canada.  It’s possible to find good Functional Medicine practitioners elsewhere*, but the quality of education could be questionable and there may be a lack of standard.  Although Functional Medicine in North America is largely unregulated, true Functional Medicine doctors generally do a decent job of regulating themselves and raising the bar of quality for themselves, constantly striving to complete more training, stay on top of current research, and invest in elective training, conferences, and symposiums, both domestically and abroad.

Many Functional Medicine doctors here in the States will care for patients/clients outside of their state or even country, via telephone, fax, email, regular mail, or Skype.  Often, the distance between doctor/consultant and patient/client is not important at all.  Some doctors require that their patients make the trip to the office or clinic at least once; others don’t have this requirement.

Guideline #3: When searching for a good Functional Medicine doctor, the web could very well be your best tool.  Look for those who specifically mention Functional Medicine.  Look for some who list their CV (curriculum vitae, a professional type of resume) online, including where they went to school, their areas of focused study, and their continuing education beyond school.  Many will list the post-doctoral classes they’ve taken.  Look for information; if the website is scanty and it barely offers any information, move on.  Now, not every site will be filled to the brim with information like Mercola or Mark Hyman, but it should be more than a single page with hardly any information. If it strikes you as cheesy or high-pressure sales-like, with lots of bold or red text, or yellow highlighted text, they may be a good doctor, but move them down your list.

More to come!  Stay tuned…

*If you live outside the United States and you need Functional Medicine care but a trip to the US is out of the question at this time, please email me through our website (just scroll all the way to the bottom and click “Email Us”) and I will send you a list of members of a reputable organization I’m personally familiar with – although it is based here in the US, it is truly international.