More than half of Australians and Americans are suffering from chronic health conditions, with the trend worsening. Functional medicine is the answer; modern healthcare reimagined. In this definitive guide to functional medicine, we’ll cover what functional medicine is, how it works, and why it’s the solution to the chronic disease crisis.
Functional medicine is a comprehensive, evidence-based approach to healthcare that is personalised to each individual. It combines the holistic approach to health seen in traditional and alternative healthcare approaches with a modern understanding of biology, disease processes, testing, and medications to deliver effective health outcomes.
The functional medicine approach involves deep and broad investigation that considers a person’s whole health picture: diet and lifestyle factors, supported by comprehensive testing. It provides a unique roadmap for recovery for each person, with an emphasis on building long-term resilience.
It is now well understood that chronic diseases are caused by largely modifiable elements such as diet, lifestyle and environmental factors that switch on genes and promote disease. Functional medicine focuses not only on disease resolution, but prevention by reducing known risk factors that promote disease.
Functional medicine also recognises that health and disease are on a spectrum, and many conditions can be prevented, reversed, or put into remission. A functional medicine practitioner is trained to look for signs of dysfunction, a state that occurs before a condition fully manifests, and can recommend treatments to improve health and prevent disease, rather than relying on medications that mask symptoms.
This approach to chronic disease management can not only halt or reverse disease - it can also improve long-term health. Functional medicine is well placed to play a crucial role in influencing the trend of rapidly declining health and the growing burden on the healthcare system, which is predicted to worsen as the population ages.
Patient Izabella found herself visiting the doctor frequently after receiving her Hashimoto's diagnosis. She saw an endocrinologist to manage her thyroid hormone prescriptions, and a gastroenterologist for IBS-type symptoms such as diarrhoea and bloating. Izabella felt frustrated by the long wait times for specialist appointments, which often felt rushed. The prescription-based approach seemed to offer little in the way of dietary or lifestyle advice to manage her various complaints. Feeling alone and disempowered, Izabella felt caught up in a system where she didn't feel heard or valued as a person.
Izabella is not alone. Studies have revealed that many patients feel they are receiving suboptimal care, in a fragmented system that is poorly coordinated, leaving gaps in their care that lead to poor health outcomes.
Patients are looking for better evidence-based support for chronic conditions, being engaged more in their care that has a focus on prevention and health, with improved coordination and follow-ups to ensure continuity of their care. This is precisely what functional medicine sets out to achieve.
Functional medicine can help people with chronic health conditions, including autoimmunity, neurological conditions, hormonal disorders, cardiovascular conditions, digestive issues, and skin disorders. It can also be used in acute settings such as viral infections like COVID-19.
Some health concerns elude diagnosis, yet with an in-depth understanding of human biology and pathophysiology, can be helped by following signs, symptoms and using clinical tools like functional testing to pinpoint and address potential root causes of dysfunction.
The many chronic diseases or health challenges that functional medicine can help with include:
People with seemingly unrelated symptoms that don’t fit neatly into a specific category or condition can also benefit from the functional medicine approach. A perfect example is Izabella, who had bloating and diarrhoea, as well as thyroid and autoimmune issues, which we often see in our clinic.
Many people in this situation are confused by which practitioner or specialist they need to see. With the functional medicine approach, practitioners can help by taking a 360° view of their health to determine what’s going on their body, and why. In many cases, while symptoms can seem disparate and unconnected, often the same causes or contributing factors are at play, and through a thorough understanding of the interconnectedness of systems in the human body, symptoms that seem disconnected suddenly make sense.
Other people who benefit from functional medicine are those in good health who want to prevent disease, extend their lives, or optimise their health now, such as elite athletes, biohackers, high-performance seekers, and optimal health enthusiasts.
So you might be wondering - how is functional medicine actually practiced? Functional medicine is a framework, and because functional medicine practitioners include doctors, naturopaths, chiropractors and even nurses, the way functional medicine is practiced will vary depending on what type of practitioner you see. However, all practitioners of functional medicine follow certain principles while working with patients to help them recover their health. Let’s take a closer look.
Functional medicine takes a detective-like approach to solving patient cases. It requires thinking about all the possible things that could be causing a person’s symptoms, then figuring out a way to explore and rule out each possibility. In our clinic, our practitioners create a timeline of a patient’s medical history, and map out their health picture including possible root causes and contributing factors. From there, they create a plan that they continually refine as they rule out causes until they hone in on what’s really going on with a patient.
This deep detective work takes time, incessant curiosity, and skill. To do this effectively, practitioners need to have a deep understanding of biology, biochemistry, and pathophysiology (disease conditions). This allows them to think creatively about potential solutions for each unique case.
Imagine caring for a tree: if the leaves went brown and spotty, you could paint them green to make them look better, or even cut them off. The symptoms will be gone, however, without having addressed the underlying problem, they will return. This is akin to using medications for rapid relief and symptom suppression. The symptoms might disappear for a while, however the underlying problem still exists, while the treatments themselves can often lead to further problems.
Consider the management of high cholesterol. Statins reduce cholesterol by inhibiting an enzyme used in its production. The same enzyme is also required to produce CoQ10, a critical antioxidant and cofactor involved in energy production - so synthesis of CoQ10 is reduced which can lead to side effects like fatigue and muscular pain, and an increased risk of developing diabetes mellitus.
Meanwhile, most heart attack patients have normal levels of LDL cholesterol, and new insights show that high cholesterol is often a symptom of other imbalances in the body, such as metabolic syndrome, intestinal hyperpermeability, changes in thyroid function, stress, underlying viral infections or toxin exposure.
Functional medicine asks not just ‘what is the best drug or intervention for rapid relief of this disease?’, but also ‘why did it occur, and what needs to be resolved in order for a return to health?’.
The health of a tree is dependent on the environment it lives in (soil, access to sun, water etc.). In the same way, human health is determined by ‘the exposome’: factors like nutrition, stress, pollution, exercise, relationships, and sleep. For a tree, the problem might be a lack of sun, or excess water. For a person with a chronic disease or other chronic health issue, it might be poor nutrition, stress or heavy metal toxicity. By addressing these factors, health can be restored, and longevity maximised.
Functional medicine practitioners look for the root causes of illness. They do this by looking for:
This is why a thorough case taking is the first step in the investigative process. No stone should be left unturned, as even a minor clue can be the key to putting a person’s health puzzle together.
Functional medicine is a ‘systems biology’ approach to medicine that looks at the body as a whole rather than focusing solely on isolated body parts or systems. While specialist knowledge is a valuable part of detective work, disease states and chronic disease management can be complex, involving many different biological systems. By taking a holistic view of the body, functional medicine practitioners can provide more comprehensive and individualised care to patients.
One of the most well-known examples of the interconnectivity of body systems is the psycho-neuro-endocrine-immune (PNEI) system. The nervous, endocrine and immune systems have been identified as a super system, which can be influenced by psychological factors, highlighting the detrimental impact that stress can have on the body. In autoimmune conditions like Rheumatoid Arthritis and Lupus, psychosocial stressors, for example, may impact the nervous system and lead to high levels of inflammatory immune cells called cytokines, pro-inflammatory hormones, and downregulation of anti-inflammatory hormones.
The body is interconnected, with systems working together directly or indirectly to keep the body in homeostasis - a dynamic adaptability in response to the internal and external environment.
In the case of an autoimmune condition, rather than simply seeing the immune system as the issue, a functional medicine practitioner will look to assess the health of other systems such as the nervous system or digestive system, depending on a patient’s health picture, to determine the cause.
|System||Other system interactions|
|Digestive||Cardiovascular, muscular, nervous, endocrine, detoxification, urinary, immune|
|Cardiovascular||Respiratory, digestive, lymphatic, immune, nervous, endocrine, detoxification|
|Immune||Cardiovascular, lymphatic, nervous, skeletal, skin, digestive|
|Endocrine (hormones)||Nervous, cardiovascular, reproductive, skeletal, immune|
|Detoxification||Skin, respiratory, digestive, cardiovascular, urinary, lymphatic|
|Urinary||Digestive, cardiovascular, endocrine, detoxification|
|Reproductive||Endocrine, nervous, digestive, immune|
|Respiratory||Cardiovascular, detoxification, nervous, muscular|
|Skeletal||Muscular, cardiovascular, immune, respiratory|
|Muscular||Nervous, skeletal, digestive, respiratory, cardiovascular|
|Lymphatic||Immune, cardiovascular, skeletal/muscular|
|Skin||Digestive, detoxification, nervous,endocrine, immune, lymphatic|
Because of the complexity of the body, the functional medicine approach recognises that there is rarely a sole cause of a chronic disease state. As seen in the example below, there are many factors contributing to diabetes mellitus (type 2 diabetes) such as inflammation, hormones, genetics, epigenetics, diet, exercise and mood disorders.
On the flip side, many conditions can be caused by one imbalance. For example, chronic inflammation is a cause or driver of many - if not all - chronic health conditions, notably including heart disease, depression, arthritis, cancer and obesity.
This is why personalised care is a key approach of functional medicine.
Taking all of this into consideration is the reason why functional medicine is a deeply personalised approach. Rather than applying one protocol to many patients with the same health problem, functional medicine practitioners take the time to learn about each individual's diet, lifestyle and health history (including family history) in order to develop a truly tailor-made treatment plan that matches their biochemical individuality. It’s about solving a person’s health puzzle rather than solving a condition.
By combining their clinical expertise with the latest evidence in the scientific literature and their patient's health narrative, functional medicine practitioners are able to create a strategy that is unique to each person. This approach always considers 'what will be right for this patient?' and, as such, patients not only discover how to get their health back, but also how to live in alignment with what their body needs to be healthy.
This means that two people with the same diagnosis will likely get a completely different treatment plan that targets the root causes and drivers of their condition.
For example, two people with the same autoimmune condition can have entirely different contributing factors and root causes, requiring distinctly different treatments.
With chronic diseases predicted to rise across the globe, and with hospital systems already overwhelmed by mostly preventable conditions, functional medicine is perfectly placed to solve the healthcare crisis, given its role not only in disease resolution, but prevention through education and empowerment.
Highly individualised care involves a substantial amount of time and effort from both clinicians and patients, and until functional medicine receives the recognition and subsidy it deserves, the testing and treatment can be expensive.
As the saying goes, an ounce of prevention is worth a pound of cure. And the benefits of investing in an approach that can prevent or reverse a condition and improve quality of life, seem certainly worthwhile. Yet, the adoption of the functional medicine approach requires a complete paradigm shift by the medical industry, to recognise that getting to the root cause of a chronic disease is more economical than managing that disease over the long-term.
Watch Mark Hyman’s TEDMED talk on why functional medicine is the future of medicine
Functional medicine is here, and perfectly placed to care for patients' health based on the latest clinical research and insights. So if you’re after a personalised, collaborative, and supportive approach to solving your health problems, functional medicine is your best bet right now. Not only will it cost you less money in the long run, you’ll also live a higher quality, longer life. And you can’t put a price on that.
Browse our FAQs by category below.
Yes, functional medicine is evidence based, and the evidence base for functional medicine is constantly growing, as more and more studies are published on the functional medicine approach with a range of health concerns such as COVID, neurodegenerative conditions, cardiometabolic conditions such as diabetes, atrial fibrillation, arthritis, digestive health concerns like SIBO and a range of gut, skin, heart, hormonal and mood conditions.
A functional medicine practitioner is a healthcare professional who has undertaken training in the functional medicine approach, and is certified as a functional medicine practitioner. They specialise in the prevention and treatment of chronic disease through personalised care, and have a broad knowledge of disease processes, health, natural remedies and lifestyle medicine. Many different health professionals can train in the functional medicine approach, from doctors to nurses, naturopaths, and chiropractors.
A functional medicine practitioner uses a systems biology approach to understand how the body works in order to solve health issue. They focus on finding and addressing the root cause of illness, rather than simply treating symptoms.
Functional medicine practitioners take a holistic approach to health care, considering all aspects of a person’s life that may be contributing to their illness. They work with patients to develop personalised treatment plans that may include diet and lifestyle changes, nutritional supplements, and other natural therapies.
A naturopath can be a doctor, which is typical in the United States, however in Australia, naturopaths are typically not doctors, and training levels can vary, from having a Bachelors of Science to Diplomas. There are however functional medicine trained naturopaths, like the functional medicine practitioners at our clinic.
The difference between a functional medicine doctor and a functional medicine naturopath in Australia is that a doctor can prescribe medications and order blood work, often covered by Medicare, whereas a naturopath prescribes natural medicines like nutrients and herbs, and can organise functional testing, however any prescription medication or standard blood pathology testing is managed with a patient’s doctor by working in an integrated way. Functional medicine doctors may focus more or less on a conventional approach to your health issue, depending on their training and preferences, whereas a naturopath will focus solely on natural approaches to your health.
If you’re a GP or naturopath and want to be a functional medicine practitioner, find out how to become a functional medicine practitioner here.
Integrative medicine is similar to functional medicine in some ways, however there are some distinct differences. Integrative medicine is more about a team of health practitioners supporting a patient in an integrated way - for example, a doctor working with a dietitian - to help a patient improve their health. However, they may still be working in a conventional way rather than looking at addressing a person holistically and seeking to find and treat the root cause of a health condition.
Functional medicine practitioners can work in an integrated way, and often do, working alongside psychologists, endocrinologists, neurologists and other specialist practitioners to bring resolution to health issues.
It is likely that a functional medicine doctor is a GP, however this is not always the case. For example, an endocrinologist could decide to train in functional medicine, and even though they’d technically be a functional medicine doctor, they’re likely to be working in an endocrinology clinic versus a general practice where you’d go to see a GP.
Integrative medicine is where healthcare providers work in an integrative way, for example, a doctor and dietitian working together to help improve their patient's overall health. However, they may still use conventional methods rather than taking a holistic approach, and looking for the root cause of a condition. This might mean that a patient makes some improvement, however may not fully resolve their health issue if there is an underlying root cause or contributing factor that hasn’t been investigated and addressed.
Functional medicine practitioners usually take an integrated approach as well, partnering with specialists like psychologists, endocrinologists, neurologists etc. to resolve issues. The difference is that functional medicine practitioners focus on identifying and treating the underlying causes of disease so that lasting positive health outcomes can be achieved.
At this stage, functional medicine isn’t covered by Medicare in Australia. However, a few private health insurers offer some rebates associated with other modalities that practitioners tend to be qualified for, such as naturopathy or nutrition. Speak to your health insurer for more information.
Find out how the practitioners at Melbourne Functional Medicine would approach your health issues and support you back to the healthiest version of you.