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From the Townsend Letter,
the Examiner of Alternative Medicine
April 2006


Pathways to Healing
by Elaine Zablocki

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New Textbook Explores Functional Medicine
The Institute for Functional Medicine has just published an 800-page, 37-chapter textbook crammed with useful analysis and tools for health care practitioners who want to deepen their understanding of health and illness, and expand the ways they can help their patients. While designed for practitioners, this book will also be extremely valuable for consumers who want to delve deeply into causes and possible solutions for their own lack of full health. The Textbook of Functional Medicine is grounded in the principle that health is more than the absence of disease. "Health is a positive vitality," one author writes. "We recognize that wholeness signifies full function of the body-mind-spirit. In this light, it is not extreme to expect to feel fully alive, vibrant, and even joyful when healthy."

Functional medicine is a dynamic approach to assessing, preventing, and treating complex chronic disease. Our conventional, acute illness model looks for specific problems and treats those problems. Functional medicine looks at the complex inter-related network of causes that eventually manifest as problems. It looks at the relationship between diet, lifestyle, personal relationships, environment, and genetic factors. The foundational principles of functional medicine rests on the understanding that each human being is a unique genetic organism in a unique environment and that a patient-centered medical system must take this into account.

David Jones, MD"It's clear to anyone who thinks about it, when you don't have a diagnosable disease, that doesn't necessarily mean you're fine," says David S. Jones, MD, president of the Institute for Functional Medicine. "We don't want to limit ourselves to demonstrable problems. We want to go upstream and ask as early as possible, what isn't functioning properly?"

Many of the authors are MDs, but others are chiropractors or naturopathic physicians. Practitioners who come to the institute for training include MDs, chiropractors, NDs, massage therapists, and acupuncturists. "We're one of the few institutes that only requires that you be certified as a health care practitioner," Jones says. "The issue is, are you willing to do the hard work needed to understand functional mechanisms? If so, then you need to know how they function within the limits of your certification."

Analytic Tools for Health care Practitioners
Every health care practitioner is trained to use a patterned, logical approach when meeting new patients. "The problem with the conventional ‘history and physical' is that it's so compressed," Jones says. "It's like a closed accordion. The conventional intake process tries to reach a diagnosis quickly and then offer treatment, usually through medications. I loved this system when I first started using it – it was so elegant and so clear. The only problem is that we now know it doesn't work for 80% of patients, those with complex chronic illness."

Functional medicine uses a matrix of eight different aspects of functioning, offering a systematic way to look deeply into the core clinical imbalances that underlie various disease conditions. This functional review looks at the following:

  • Environmental inputs such as diet, nutrients (including air and water), and exercise
  • Mind-body-Spirit imbalances
  • Immune and inflammatory imbalances
  • Oxidation-reduction imbalances and mitochondropathy
  • Digestive, absorptive, and microbiological imbalances
  • Detoxification and biotransformational imbalances
  • Hormonal and neurotransmitter imbalances
  • Structural imbalances from cellular membrane function to the musculoskeletal system

The essence of the functional medicine diagnostic process is to expand the accordion, so the practitioner looks for and accepts more comprehensive information sources. The history should include the whole narrative: when the patient felt well, when they stopped feeling well, and what their physical and social environment was at that time. "The underlying process that leads one person to get diabetes may be quite different from someone else who gets the same disease, even though the diagnosis is the same," Jones says. "If you really want to get to the underlying mechanism, you have to expand the questions."

In the last section of the book, "Putting It All Together," the authors show how conventional medicine would evaluate a patient, and then how functional medicine would expand the areas of investigation. "In conventional medicine you make a diagnosis, prescribe a treatment, and send the patient on their way," says Jones. "But that is only part of the job. The other part is to ask the question 'why'. A diagnosis should be the beginning, not the end of the journey."

Consumers Learn How to Analyze Their Own Health
While this book is primarily designed for health care practitioners, it will also interest consumers who want to develop a sophisticated understanding of their own health. It helps us all understand the many different layers of functioning that go together to make up health or illness. It helps us understand how much information could be available and what to look for when seeking a health care practitioner. There are also checklists consumers can use to evaluate their own situation, such as the checklist for environmental sensitivity on page 777 and the life stress questionnaire on page 783.

The final section of the book demonstrates what can happen when a clinician looks at all the possible factors influencing someone's health. On page 701, there is an amazing story (originally reported in The Lancet) of a 32-year-old woman with progressive muscular weakness and pain. A thorough conventional medical workup hadn't diagnosed her problem, and after two years, she was wheelchair-bound. Then a more comprehensive investigation of her problem looked more broadly for possible underlying causes, triggers, and mediators. It turned out she'd had chronic Crohn's disease, treated by removing part of her colon. As a result, she wasn't absorbing vitamin D, and that deficiency proved to be the cause of her weakness and pain. Three weeks after starting appropriate replacement therapy, she was able to walk without assistance.

That's just one example of the way a systematic investigation that covers environmental inputs, genetic predispositions, and a wide range of potential imbalances can uncover the reasons for a previously undiagnosed illness. This textbook is a wonderful foundation for any health care practitioner who hopes to "expand the accordion" to help patients experience deep, long-lasting healing. Over time, as this volume influences many clinicians, we can hope it will help shift the health care system towards a more rational, preventive approach to care.

Elaine Zablocki is the former editor of CHRF News Files and Alternative Medicine Business News.

At present, the Textbook of Functional Medicine is available only through the Institute for Functional Medicine. The price is $189, and bulk pricing is available for orders of ten or more. Students are eligible for a special price, $149, with valid student ID at time of order. Libraries, schools and nonprofit organizations may also be eligible for special pricing. For more information, go to the website ( or call (800) 228-0622.


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April 21, 2006