Integrative Health Blog

by Chas Gant MD, PhD

Functional Medicine, which is neither Conventional nor Alternative Medicine

I have practiced functional medicine since it was invented over 30 years ago and during these decades I have reluctantly tolerated and overlooked being mislabeled as an “alternative medicine[1]” doctor.  Healthcare consumers and practitioners alike often fail to recognize that functional medicine has virtually nothing to do with alternative medicine practices such as homeopathy, acupuncture, herbal medicine or hands-on-healing. Functional medicine is also not conventional medicine.  Functional medicine is a third and completely different discipline.  Functional medicine’s uniqueness stems from its heavy reliance on certain basic sciences - toxicology, biochemistry, physiology, anatomy and genetics - which in widely varying degrees are part of the educational curricula of all licensed healthcare professionals. These basic sciences are also referred to as “pure sciences” because they conform more rigorously to scientific method. 

Scientific method refers to a body of techniques for investigating phenomena, acquiring new knowledge, or correcting and integrating previous knowledge. To be termed scientific, a method of inquiry must be based on gathering observable, empirical and measurable evidence subject to specific principles of reasoning. A scientific method consists of the collection of data through observation and experimentation, and the formulation and testing of hypotheses.  Once a hypothesis has been proven, it can provide a predictable model which can then be used to formulate further hypotheses and experimentation.  

Functional medicine differs from conventional or alternative medicine because it conforms to a far more rigid code of scientific method. Like their conventional or alternative medicine counterparts, a functional medicine practitioner begins by making a presumptive diagnosis based on the initial examination.  But unlike their conventional or alternative medicine colleagues, a functional medicine practitioner bases their next inquiry on hundreds of thousands of amassed, peer-reviewed studies, which have proven beyond a shadow of doubt that toxicological, biochemical, structural, physiological and genetic abnormalities are the root cause of their patient’s presumptive diagnosis and/or symptoms.  An extensive battery of laboratory and/or radiological tests is then typically ordered to determine if the expected causative abnormalities are present or not.  Guesswork is thus avoided, intuition is unnecessary and factual evidence is gathered. (see my other article "Functional Testing: If you don't test, you guess")

Based on the proven fact that human beings all share a similar genetic code, and the proven fact that all human beings have a similar biochemistry, anatomy and physiology in a healthy state, any laboratory results which deviate significantly from the healthy norms, especially those which have been proven in amassed scientific studies to be risk factors for the presumptive diagnosis, are taken seriously as potentially causative abnormalities.

Unlike their conventional or alternative medicine colleagues, a functional medicine practitioner then formulates a hypothesis based on amassed scientific studies and the laboratory-determined abnormalities, that the prescribing of certain supplements, bio-identical hormones, herbs and even medications (in that order of preference) to correct the abnormalities will result in sufficiently optimizing the genetic expression of their patient to the extent that their symptoms and/or disorder will disappear.  This testing of a hypothesis via scientific method constitutes a revolutionary advance in medicine, and defines the uniqueness of functional medicine.  If the hypothesis is proven to be true, and the symptoms or diagnosed disorder vanish, then the “experiment” so to speak has come to a successful conclusion and the patient is usually discharged.

If however, the hypothesis is shown to be invalid, and the interventions which were prescribed based on known toxicological, biochemical, physiological and genetic variables somehow failed to correct the symptoms, further diagnostic testing is warranted to look deeper into other laboratory-determined risk factors which could be causative of the unrelenting symptoms.  A new hypothesis is formulated; that any new findings on such additional laboratory testing in league with the original abnormalities from the first round of testing are likely to be causing the symptoms and originally diagnosed disorder. This second hypothesis is tested via a new prescription of supplements etc. which addresses all abnormalities found to that point.

If that hypothesis is found to be invalid, an unusual occurrence in my experience, then a third round of diagnostic testing can be ordered to repeat the cycle again or as many times as necessary.  At each stage, a hypothesis is tested and found to be valid or not. Scientific method is applied based on hundreds of thousands of amassed studies, not guesswork.  Sometimes the same diagnostic testing is repeated to certify that the reported lab results were accurate and that proper laboratory test procedures were followed.  Diagnostic testing can be repeated to also determine whether of not previous treatments did indeed correct the abnormalities originally found.  Rarely do patients need more than 2 or 3 rounds of this process to achieve good results.

Chas Gant M.D., Ph.D., is an integrative and functional medicine doctor, author, national lecturer, teacher and practices part-time at NIHA, an integrative medicine and dental center serving Washington, DC, Maryland and Virginia.