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Jan 24, 2019

Does Functional Medicine Really Work?

by Dr. Dan Kalish

Is Functional Medicine Real? - Criticism & Review

I’m a skeptical person by nature. I still, after 25 years of practicing question functional medicine, wonder every day does functional medicine really work? Which is awesome because it means every day I’m shocked, amazed and surprised by my patients that heal so dramatically from so many conditions in what seems like record time. Functional medicine criticism is well deserved, I myself question what I do, maybe the word critique is better, in any case posing the question is functional medicine legitimate, every day, for me keeps me on my toes.

Then on the other side of the equation I think how is functional medicine NOT legitimate. It’s as real as nature is real. It’s as important as the entire healing process is important because I believe functional medicine is in a sense a resurrected form of more ancient times when healing was based on what the patient did, NOT on what the doctors did. Let me explain.

Ok, so let’s address this head on, does functional medicine work. If it does work, how does it work, why does it work, is it just hocus pocus, is it just a bunch of doctors that couldn’t cut it in the world of “real medicine”, if it’s so great why doesn’t it become part of the curriculum at every medical school? Why does my “real doctor” not believe in it, why don’t we see articles every day in the New York Times and USA Today talking about it? Can something so fringe be legitimate?

These questions take us on a path less traveled. On a journey to pharmaceutical company marketing meetings and medical school curriculum planning groups. From insurance carriers bottom lines to the entire entrenched and multi billion dollar health care industry, and it is an “industry” like the auto “industry” or oil “industry” with all that that implies. I’m not one to promote conspiracy theories and I think most of us are trying the best we can to do the right thing most of the time but really, the entire concept of HUMAN BEINGS HEALING has been stomped on so hard at this point in modern American history as to be unrecognizable. But the healing process is undeterred by our personal opinions and current obsession on medications as a cure all.

How Do We Heal

The real question behind the question of whether functional medicine works is can human beings heal? I would say yes, it’s pretty obvious we have incredible healing capacity. If you cut your finger with a kitchen knife, the wound will heal, starting when you take a drug? Starting when you have a surgery? NO. Your body starts healing instantly, as soon as the cut occurs your platelets start to change, your white blood cells rush in to prevent infection, a rather dramatic orchestra of events occurs without any intervention on anyone’s part.

Functional medicine plays to this strength of humans. We are a part of nature and as such we heal in the same way a plant grows with adequate water and light. It just happens. Do you have to give a plant a drug to grow well? No. Just water, light, good soil, plant takes off. We are exactly the same. We are, first and foremost, a part of nature. For us it’s food, exercise, sleep, meditation/prayer and some really good quality human to human interaction and we heal.

Our modern drug oriented approach to resolving chronic health problems is on the ropes. We make ourselves sick with diseases like heart disease, cancer and diabetes simply by eating the wrong foods, not exercising and having high environmental toxin exposure levels and then try to solve our way out of this dilemma using ever more toxic medications and surgeries. It would be like me using jet fuel in my car and then constantly having the engine rebuilt to deal with the fact I was using the wrong kind of gas? How crazy can we be? How many engine rebuilds would you do before you started to question the type of fuel you were putting into your tank?

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Reversing Heart Disease, Cancer & Diabetes 

Functional medicine says, hey, wait a minute, maybe we can reverse and prevent heart disease, cancer and diabetes by, spoiler alert- making simple lifestyle changes including diet, exercise, sleep and human connections. This is the foundational premise of functional medicine. Since we are making ourselves sick because of behavior patterns and we can work our way out of it by stopping the harmful behavioral patterns. Does that seem like something we could question? To me it’s pretty much common sense.

Now because everyone knows they should eat better, exercise more, get more sleep and meditate and yet no one does this, functional medicine has developed a second arm or wing. Call it the scientific branch of our field, vs. the coaching branch. We focus on lab based assessments to determine how to get people out of the hole they have dug for themselves. I see functional medicine labs for hormones, GI, detox, neurotransmitters, nutrient levels and so on primarily as a means to get patients oriented as to the extent of their problem and to figure out how to get them feeling good enough so that they can implement the lifestyle changes that will resolve their issues.

One common trap we functional medicine doctors fall into is “treating the lab, not the patient.” Meaning it’s easy to forget when you are caught up reading some really cool labs that we need to primarily address lifestyle issues or people won’t improve over the long term. I always apply my airport test. Which is, now that you ask, a test question I ask myself on every new patient. “If I run into this patient ten years from now what will they remember about me?” The airport test is based on yup running into patients after ten years and having a patient say to their husband, “Hey, honey, this is Dr. Kalish, he’s the one that taught me about gluten when I had that thyroid problem.” Not, “Hey that’s Dr. Kalish he’s the one that got me addicted to antidepressant medications when I really had a Vitamin D deficiency and thyroid problem because I was eating gluten!”

The airport test makes me want my patients to primarily remember that it’s the lifestyle changes that – Change Lives. Not the supplements. The supplements are Supplemental, they are supplements not “permanents”. In functional medicine we change lives BECAUSE we change lifestyle factors, the supplements and lab work merely facilitate this process of behavioral change.

What Really Heals Us

To elucidate further, for example, most of my patients want to sleep more but they can’t! They can’t fall asleep or they wake up throughout the night. So we run a series of tests, calm down their adrenals and improve their melatonin levels based on lab work and suddenly they can sleep. It’s a miracle. It works every time pretty much. Then, WHAT HEALS THEM IS THE SLEEP, not the supplements.

Another example, most of my patients crave sweets and over eat sugar and carbs. We run a bunch of tests and use supplements as indicated based on the labs to stabilize blood sugar and clear up yeast overgrowth and then suddenly, pretty much every time, the sugar cravings are gone. It’s a miracle. Then, WHAT HEALS THEM IS ALL THE VEGETABLES THEY START TO EAT. The rush of antioxidants from vegetables can repair blood vessels, reduce cancer cell growth and even, yes there is research on this, reverse diabetes. Just ask Dean Ornish about the heart disease cures he’s performed, Dr. Colin Campbell about his research on cancer and diet and I’ve seen Diana Schwarzbein reverse diabetes more times than I can count. It’s all real. It’s not even that difficult.

We all know exercise works better than antidepressants for those that are depressed, exercise helps prevent memory loss and neurological problems and exercise restores mitochondrial function leading to fat burning and weight loss. That’s pretty clear, as they say “studies show…” but getting people to exercise? Most of my patients are too tired to exercise, so again, we order some functional medicine lab tests, fix their thyroid, get their mitochondrial energy pathways restored and boom, they have the energy to exercise. It works, pretty much every time. It’s a miracle! And then, THE EXERCISE IS WHAT HEALS THEIR BODY. This to me is the essence of functional medicine. Using functional lab tests to get people to a high enough point of health, vitality and energy that they can take on the activities that do heal, pretty much every time. Sleep, exercise, food and meditation/prayer.

Is Functional Medicine Legitimate?

This isn’t a radical or new idea. In mere fact that functional medicine’s legitimacy could even be questioned shows how messed up our system has become. Taken over by the concept of “getting away with it” we got lulled (somewhere between the late 1940’s and the 1960’s) into this idea of better living through science. Antacid medications instead of drinking more water, antidepressants instead of fresh air, sunshine and exercise, blood pressure medications instead of green veggies. I think it all made sense at the time. But taken collectively the accumulated toll of substituting drugs for common sense hasn’t served us well.

To me functional medicine is the pendulum swinging back the other way. Back to how medicine used to be practiced pre-1950’s, pre-big pharma. Rest at the seaside as a prescription, visiting patients homes to see what they are eating and how they are living. Coaching people back to health with lifestyle changes. The only real twist we use in functional medicine from doctors and healers of the past is the lab assessment tools that are a main feature of functional medicine.

I’m all for questioning everything I do with patients every day. The really funny part is every single day I see patients heal from conditions like depression, anxiety, skin disorders, chronic pain, Gi problems, hormone complaints, I see them heal so quickly that it actually scares me. Every day in practice I am just perplexed by how quickly the body and mind can repair just given the right circumstances. The healing power of nature is as awesome as a volcano erupting or a hurricane smashing or a flower blooming or a wave crashing. Nature has this figured out, if we just step out of the way a bit and let nature do it’s job then people get better. And as a functional medicine practitioner, I have the joy every day of watching the force of nature we call healing in it’s full display. Wouldn’t trade that for anything. It’s the true joy of my life to be in that chair and watch people heal.

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Dr. Dan Kalish

Dr. Dan Kalish

Founder of the Kalish Institute
Dan Kalish, DC, IFMCP, is founder of the Kalish Institute, an online practice implementation training program dedicated to building Integrative and Functional Medicine practices through clinical and business courses.