Transcription:
What is Functional Medicine?

Melanie Cole, MS (Host): There are so many types of specialists and practitioners these days. It can be very confusing to determine the best one for your health needs. There is one thought model called functional medicine that you might be interested in. My guest is Robin Meneguzzo. She’s a certified family nurse practitioner with Aspirus Keweenaw Hospitals and clinics. Robin, tell us a little bit about the field of functional medicine. Can it treat any type of condition? Tell us a little bit about the thought model.

Robin Meneguzzo, FNP-C (Guest): Yeah. So functional medicine is actually a kind of shift paradigm in our current medical model. It’s actually the goal is to help treat and identify chronic health issues that currently we are really struggling with in our country. So that can range anywhere from diabetes to heart disease to digestive issues to skin problems. It can kind of range the whole gamut. So really it can be used for any type of health condition.

Host: Speak about this thought model and the basic principles behind functional medicine. How it treats the underlying cause of disease and the whole person and the whole body.

Robin: Yeah. So, we use something called a functional medicine matrix model. So, what that is is it’s understanding that the body is completely interconnected. So, all of the different systems work together to create our health. So, when you think about that, you can't think about the heart is separate from the kidneys is separate from the skin is separate from all of these things. So instead, what we try to see is that because it’s all connected if you have a problem in one area, it could be affecting other parts of our body.

So, by understanding that the body is interconnected like that, we try to find clues and then try to work with lifestyle changes, especially dietary. We do a lot of recommendations as far as exercise and sleep and stress reduction because those are really the basis of our health. Then when we start to work on those things, we can also start to identify different areas that we can target for people. But all the while, seeing that it’s all connected. So instead with a functional medicine provider, you might be able to work on your dermatologic issues and your urinary issues and maybe your digestive issues all at one time by using these kinds of combined approaches with lifestyle medicine.

Host: What’s the difference between functional medicine and integrative or holistic medicine?

Robin: I would say functional medicine probably falls under and into that category. It’s definitely an integrative model. As I've said, it’s looking at everything as a whole. So again, there’s both of those words. But the functional medicine is a specific training where you learn how to use this kind of framework to approach patients. And it really stresses understanding people’s biochemical, genetics, lifestyle factors and brining those together with their histories. Then trying to figure out kind of problem solving how you can individualize the patient care instead of using kind of a more generalized approach that you could use for everyone where you really want to target it for this specific person.

Host: As I said in my intro, Robin, there are so many different types of practitioners these days. What kinds of practitioners practice functional medicine and what’s the training for this?

Robin: Yeah. So, there’s a lot of different people that can be trained in functional medicine. So that can range from medical doctors, so MDs and DOs. It can be naturopathic doctors, chiropractic providers. It can be physical therapists. It can be nurse practitioners like myself. And dieticians actually can go through the training as well. So, there’s a lot of different people that can be trained. The training program is a step program where you do different course work and there’s conferences that are held all over the country and you have to move through the different coursework, and then you sit for a certification exam at the end of that. Which I did that, I completed that course.

Host: Is this being accepted or used in the mainstream Robin? Because as we’ve seen things like chiropractic, physical therapy, orthopedics all kind of coming together—acupuncture—is that what’s happening with functional medicine as well? Is it coming into and being accepted by mainstream medicine?

Robin: Yeah. I definitely think it is. One of the best examples that I can provide is the Cleveland clinic. It’s actually the… It’s one of our greatest hospitals, I think in this country, and I think many would agree at that. It also has a huge new program that’s a functional medicine specialty clinic there at their hospital. So, it’s definitely leading the nation as far as in the mainstream medicine. But I do think that people are starting to see the functional movement really moving into the thought process as we start to merge bringing in our research closer and closer to our clinical practice instead of having to wait long periods of time between when that’s actually brought in and used in clinical medicine.

Host: All clinicians generally take family history, but what makes the functional medicine timeline different Robin?

Robin: So, when you're doing a timeline, it’s really important to understand a lot of different pieces for a patient. So, I start off even sometimes asking people what was their mom’s pregnancy like? Do they know? How was their birth? Was the mom exposed to things during her pregnancy? Was there a lot of stress in her life? Then I go through what happened in their childhood? What happened maybe into their adolescents and adult years? By understanding that whole history and kind of writing out a time line with patients, sometimes it really helps us understand where they are now because of everything they’ve gone through. So, taking a very detailed history is one of the most important pieces of functional medicine.

Host: What about things like cancer and acute diseases? Where do they fit into the functional medicine picture? Even for some chronic conditions. You mentioned diabetes and urologic conditions and gastrointestinal, which are so huge these days. Where do all of these kinds of things fit into the functional medicine picture?

Robin: Yeah so, I think that acute care, infectious disease, surgeries, medications. Those are all absolutely necessary things that we need. Functional medicine is only a pairing to those. It’s an additional approach that can be used. Really anyone in any one of these different diagnoses, no matter what your diagnoses is, whether it’s hormonal dysfunction or cancer or diabetes or heart disease. I believe that everyone can benefit from a functional approach because it really is, again, using those basis of health things. How are you eating? Are you getting activity? Are you sleeping well? What’s your stress level? Those are things that everyone needs support in. Functional medicine providers have a lot more training than, I think, I can say that I've learned in my nurse practitioner training for more specific education that I can provide patients.

So, I think that any diagnosis, it just can be a beneficial thing to pair with it. It’s not something stand alone or that it’s gonna cure cancer on its own. I don’t believe that. I think we definitely need our specialists care and people using traditional methods, but I do think that it can be something to support it. Now where it really shines is with our chronic illness. That’s really where functional medicine is starting to see al to of benefits. So, again, because a lot of our chronic disease is a lot of lifestyle things that can be done to help with interventions instead of just using pharmaceuticals. So that’s where I really see that it’s beneficial for my patients and the greater population.

Host: Well I'm glad you brought that up because that segues nicely into my next question about nutritional supplements and the food is medicine theory that so many integrative types of practices utilize. So how is functional medicine using nutritional supplements and food to help?

Robin: Yeah. So, one of the big pieces of functional medicine is talking about diets, is talking about food. Is really trying to get people into the understanding that our food is our fuel source. It is what keeps us running. I try to tell people it’s kind of like a car. If you were to drive up to a gas tank and put water in your gas tank instead of gasoline, your car is not going to run well. It needs the right pieces in order to run properly. The same is true with our diet. We really have to have these basic pieces, our healthy proteins, different healthy fats, different carbohydrates. I think that there's a lot of information out there, but what functional medicine providers are taught is very scientific based nutritional interventions that can be helpful. Then you tailor it to people. So, there is no one diet fits all.

So, I really have to take each person and determine what would be the best food plan for them. Then I try to spend time educating patients about food because I think it’s a very complex conversation. I think there’s a lot of information out there. Some of it’s good, some of it might not be. So that’s definitely a large piece of what I do. Definitely with nutraceuticals or the food supplements. I think those can be used. They have a time and a place, but I really try to focus on getting people to have that nutrition through their food.

Host: It’s really so important. Before we wrap up, are tests and lab tests a part of functional medicine?

Robin: Yes. So, I definitely do use lab tests. I use our traditional labs. There’s definitely things that I can look at. But I do also largely try to focus on how is someone feeling and are the interventions that we’re doing, are they noticing change in the way their energy is or their sleep? Or their weight or their blood sugars? You know how are they actually seeing this translate instead of just going off of what it says on a piece of paper. So, I really try to bring in the patients and have it be something where the patient is largely driving things too. You know it’s not just about me making decisions and saying this is what you need to do. It’s about it being a partnership where patients and myself are working together as a team.

Host: Wrap it up for us. What an interesting topic and an interesting field that you're in Robin. Tell the listeners what you’d like them to know and take home with them about functional medicine. Should they be looking for a healthcare provider of just a bit of a different sort. Someone that will look at their whole body and their whole person and the underlying cause of any disease state they might be looking to help.

Robin: Yeah. So, the Institute of Functional Medicine, which is where I had my training, they can actually be found online at www.ifm.org and that is a site that you can actually locate providers who have gone through functional medicine training. So, there’s a great practitioner locator tool that’s on there. There also is some more information if people are interested. They have some great videos and information for patients as well. That’s a definite thing that you can check out.

I would say one of the things I tell most patients, if I could tell anyone, the basis of health things that they can do right now would be trying to limit how much sugar we take in in our diet. Increasing our vegetable intake, trying to get enough sleep, seven to eight hours a night, and really trying to work on our stress levels. Whether that be through movement, whether that be though yoga, mindfulness, doing artwork. Whatever that is, but it’s important to have joy and things that we look forward in our life to help balance because we’re not just a physical body. We’re an emotional and spiritual body too. So, I would really encourage patients if it speaks to them to look more into it.

Host: Great information. Thank you so much for coming on and explaining what functional medicine is because many people do not know. What a wonderful way to look at a person and to be able to help them. Thank you so much for joining us. This is Aspirus Health talk. For more information, please visit aspirus.org. That’s aspirus.org. This is Melanie Cole. Thanks for tuning in.