The core principles of Functional Medicine from the Institute of Functional Medicine have a great deal in common with the principles of Naturopathic Medicine. These principles are set out below to demonstrate how the Functional Testing used at the Plymouth Naturopathic Clinic integrates with all aspects of treatment we provide.  And for a perfect 20 minute introduction follow this link to a TEDMED talk on the future of medicine

Functional medicine has long been guided by six core principles:

 An understanding of the biochemical individuality of each human being based on the concepts of genetic and environmental uniqueness

  • Awareness of the evidence that supports a patient-centered rather than a disease-centered approach to treatment
  • Search for a dynamic balance among the internal and external body, mind, and spirit
  • Familiarity with the web-like interconnections of internal physiological factors
  • Identification of health as a positive vitality not merely the absence of disease emphasizing those factors that encourage the enhancement of a vigorous physiology
  • Promotion of organ reserve as the means to enhance the health span, not just the life span, of each patient

 A patient-centered approach refers to health care that is respectful of and responsive to individualpatient preferences, needs, and values, and that ensures that patient values guide all clinical decisions.

Patient-centered care is at the center of what is called the therapeutic partnership, the relationship that forms between a patient and clinician that empowers the patient to take ownership of their own healing. The power of the therapeutic partnership comes from the idea that patients who are active participants in the development of their therapeutic plan feel more in control of their own well-being and are more likely to make sustained lifestyle changes to improve their health.

Functional Testing

Conventional medical testing—like conventional medicine—addresses acute, advanced illnesses that have already manifested themselves. As a result, vague and undiagnosed symptoms may go on for months—or even years—before a chronic condition fully develops. 

Conventional testing and evaluation does not take into account the many individual factors that lead to disease. Diet, stress, and lifestyle are rarely discussed or evaluated—or even considered relevant in making a diagnosis. 

The truth is that every person has a unique biochemistry based on many factors, such as genetics, diet, environmental exposure to chemicals and metals, lifestyle, and psychological as well as physical stress. Functional testing helps identify your unique biochemical makeup and the potential for degenerative disease, in order to prevent it from happening in the first place. 

While a standard medical test may reveal that “everything is within the normal range”—because there truly is no existing pathology—functional testing identifies the many physiological precursors that lead to chronic conditions and degenerative diseases.

It’s important to note that functional testing is only one part of a comprehensive health and wellness assessment performed by an experienced healthcare professional. A thorough evaluation of the results by your healthcare professional is crucial in designing a detailed, individualized map for disease prevention and/or recovery.

Furthermore, functional testing does not usually lead to a “quick medical fix.” It requires you to work closely with your practitioner to resolve the identified problems which may have been present for a long time. Sticking to the plan you develop with your practitioner is crucial to the success of a well-designed map for recovery and good health. 

 

Functional Blood Chemistry Analysis:

an introduction to understanding a functional approach to your health.

normalrange

Has your doctor reported that all of your blood tests are fine or normal, but you still have symptoms and don’t feel well?

Would you like to take proactive steps towards better health and wellness?

 

 

​If you answered yes to these questions then a functional analysis of your Blood Biochemistry and Full Blood Count may be a good first step.

Using a standard blood test may help to more fully understand some of the chronic health challenges you could be facing.

Following the blood test we will analyse the results in a functional way.  We can analyse bloods taken here at the clinic or from results gained from your GP or other labs or clinicians.

So how is this functional analysis different?

It is all down to understanding the differences in, and implications of, the pathological (disease) range (given on standard lab reports), subclinical range and optimal range.

The pathological range is used to diagnose disease.

The subclinical range is used to assess risk for disease before the disease develops. You may be expereinceing some of the symptoms of the disease when your blood results are in this subclinical range.

 

 

Pathological

Subclinical

Optimal

Subclinical

Pathological

                                   [--------------------------------------------Normal range-----------------------------------------------------]

  [------------------------------------------------------------------------Total range---------------------------------------------------------------------------------]

 

When the test results are out of normal range, it usually indicates a potential for pathology or disease. The lab will flag up these numbers so they stand out (either in red, with a * or by adding a comment) so you can easily see results in the pathological range. Even so these pathological results can still be interpreted as normal by some clinicians.

A functional analysis also looks at the values that fall between pathological ranges, those that are considered sub-clinical; these may indicate the beginning stages of disease or dysfunction. These subclinical results may indicate that something is not as good as it should be; or they can be a sign of a developing condition that is not bad enough to treat medically…at least not yet. These subclinical results, on interpretation, often appear to relate to the symptoms that the patient is suffering from.
 
Most GPs only remark on the pathological ranges and do not address the sub-clinical findings.

However, both sets of ranges are valid and useful. It is important to know when to use each and how they can be used together, linking up seemingly different results to provide a functional understanding of the patient; i.e how the results relate to your physical and occasional psychological functioning.

The goal is to identify developing (subclinical) problems and prevent them from manifesting into a serious medical condition. This may help us on our path to true health and a better quality life.

Patients often remark that their GP has said that the results are “normal”. Rarely, in our experience, are the labs normal from a functional perspective. We think that it is important to look at the suboptimal ranges so you are not considered “normal” or “healthy”, when you are not feeling normal or healthy.  

So why don't most health care providers embrace the use of subclinical range?

A lot of health care providers think that care should be provided when disease is present. This view is generally formed from conventional medical training which ignores the philosophies of preventative functional medicine and nutrition. Allopathic medical training teaches doctors to evaluate blood chemistry in comparison to ranges that determine pathology. If pathology is not present, the patient is considered “healthy”.

The main difference between health care providers who embrace or reject functional ranges basically comes down to the definition of health. Some healthcare providers define “health” as the absence of disease, and therefore if you are not diseased then you must be “healthy.” Other healthcare providers define “health” as being free of disease but also having adequate energy levels, healthy digestion, ideal physiological and psychological function, etc. Dorland’s Medical Dictionary defines health as: “A state of optimal physical, mental, and social well-being, and not merely the absence of disease and infirmity”.

So we use the functional range when evaluating our patients. We take a step back and look at the whole person, not just a diagnostic label.  We don’t look at things in isolation. When we see shifts out of the optimal range we are going to analyse that in conjunction with a detailed history and physical examination.

Glancing down at a lab report and saying everything is “normal” because all the values fall within the “pathological reference range” often does not relate to how the patient feels and that’s why the cartoon above speaks a thousand words.



Identifying Recurrent Health Issues 
Functional testing can help identify many conditions and fall into Five main categories; Gastrointestinal (Gut), Immunology (Immunity), Nutritional, Metabolic (Energy) and Endocrine (Hormonal).

Specific test include but are not limited to the following more specific areas and from a functional and Naturopathic point of view many conditions overlap in their indication for certain symptoms and presentations: 
Digestive dysfunctions such as Nutrient Malabsorption, Leaky Gut Syndrome, Chronic Constipation, Diarrhoea, and Irritable Bowel Syndrome, Helicobacter pylori and Candida overgrowth

  • Intestinal parasites
  • Food intolerances, sensitivities and allergies
  • Nutritional deficiencies
  • Vitamin D3 profile, Iron status, B12 and folate status
  • Cardiovascular health markers. Cholesterol levels
  • Hormone imbalances, such as those that occur in Premenstrual Syndrome, and Menopause
  • Male hormone levels
  • Metabolic dysfunctions, such as Syndrome X, diabetes and thyroid function
  • Heavy Metal Toxicity
  • Autoimmune disorders, such as Fibromyalgia, Lupus, and Chronic Fatigue Syndrome
  • Causes of chronic pain
  • Chemical sensitivities
  • Sleep disorders, such as Insomnia as a result of Circadian Rhythm Disorder and Seasonal Affective Disorder
  • Immune disorders
  • Endocrine disorders such as Adrenal Fatigue Syndrome.


The Plymouth Naturopathic Clinic uses five laboratories: Genova Diagnostics EuropeThe Doctors LaboratoryArmin labs, My DNA health and Biolabs all with labs in the UK

These companies are market leaders in their field and make functional testing easy and efficient for the patient and your practitioner.

Most commonly either blood, saliva, urine or stool samples are required for most of the tests ordered at the Plymouth Naturopathic Clinic.  The clinic is able to offer a phlebotomy service for these tests where the samples do not require centrifuging.  A charge is made for this service.  This is a fixed cost and will be explained prior to any tests being ordered.

Each test comes with all the requirements and equipment to carry out the sampling.  Some of the tests are relatively complex but with careful planning and guidance from your practitioner they are very patient-friendly.  The functional tests allow a greater understanding of any underlying condition, enhancing and refining the consultative and treatment process.


Sources:

1) “What is Functional Medicine?” Institute of Functional Medicine 
http://www.functionalmedicine.org/about/whatis.asp