Addressing the Roots of Chronic Disease
As you learned with the garden metaphor above, functional medicine seeks to address the root causes of disease as far down the causal chain as possible, rather than merely managing symptoms with drugs or intervening with surgery.
Some of the roots of chronic disease that functional medicine addresses include:
Gut dysfunction and gut microbiome imbalances
Over 70% of our immune system is found in the digestive tract and there is a strong connection between gut dysfunction and many, if not most, illnesses.3,4 With every patient we see, we perform comprehensive testing to look for common issues such as yeast overgrowth, dysbiosis (an imbalance between healthy and unhealthy strains of bacteria), small intestinal bacterial overgrowth (SIBO), and gut inflammation. You might think that gut dysfunction would always manifest as digestive symptoms, but that is not always the case. While many of our patients do have GI issues that need to be addressed, impaired gut function can also manifest as skin rashes, anxiety/depression, cognitive impairment, sleep disruption, joint pain, or fatigue, among many other things. No matter what the symptoms, we always look at the gut as a starting place for intervention.
Our immune system is amazingly complex and elegant. Unfortunately, we are witnessing a meteoric rise in autoimmune conditions such as Rheumatoid Arthritis, Hashimoto’s thyroid disease, Sjogren’s syndrome, Ulcerative Colitis or Crohn’s disease, and more. Conventional medicine has limited treatment options for autoimmune diseases. Doctors often use expensive or poorly tolerated medications to turn off or control the overactive immune response and reduce inflammation. Unfortunately, this rarely addresses the main question in autoimmune cases: “what is causing the immune system overactivation?” At CCFM, this is our starting place. From there, we work to identify and treat root causes to enable the immune system to reset and calm down. With this approach, we help alleviate the associated symptoms. Gut dysfunction and chronic infections are significant triggers for autoimmune activation, and these must be addressed for the body to reset and heal.5,6
Our body’s hormonal systems all operate in a delicate balance and communication with each other. We carefully investigate the function of the various systems from the thyroid, adrenal, and sex hormones like estrogen, progesterone, and testosterone, to metabolic hormones like insulin, leptin, and adiponectin. It is not uncommon for us to see symptoms and lab markers showing adrenal dysregulation, estrogen dominance, or low thyroid function. We combine lifestyle and behavior modification to normalize hormones. We also incorporate nutritional interventions, dietary supplements, vitamins, and nutrients to help the body's hormonal systems regain their function. As appropriate, and in careful discussion with each individual, we also recommend bio-identical hormone support.
As microbiologist Dr. Justin Sonnnenberg of Stanford University has said, humans are essentially elaborate transport mechanisms for other microbes, which we carry on and in our bodies in staggering numbers.7 While numerous microorganisms are vital for our health, many can cause, trigger, or exacerbate illnesses. Many pathogens can exist as persistent infections or be reactivated when our bodies become imbalanced, causing various symptoms. These might include tickborne illnesses like Lyme disease and coinfections, Epstein-Barr (EBV) or other viruses, Chlamydia, Mycoplasma, and chronic inflammatory response syndrome (or mold illness). Identifying chronic infections and their effects on your health can be complicated and nuanced, but is critical to provide targeted treatment to get you better.
Inflammation is a key driver of many, if not all, chronic diseases, including diabetes, coronary heart disease, Alzheimer’s disease, and chronic fatigue, to name but a few.8 Numerous factors contribute to inflammation. However, we can modulate inflammation through interventions such as gut-healing protocols, treatment of chronic infections, meditation, exercise, and sleep, and more. Our goal is to discover where the hidden fire is and put it out, address why the fire started in the first place, and clean up the collateral damage.
While many people think of genetics as fixed and unchangeable, only a tiny minority of illnesses are determined fully by your genetic makeup. Rather, it is your diet and lifestyle choices and environmental exposures that are most influential in determining your health status. The process through which environmental cues change the expression of your genes and impact your health, without altering your underlying genetic code, is called “epigenetics.”12 While it may sound complicated, the important take-home message is that your genes are not always in control. You are!
Genetics and epigenetics
While many people think of genetics as fixed and unchangeable, only a very small minority of illnesses are determined fully by your genetic makeup. In fact, your lifestyle choices, environmental exposures, and internal body environment constantly communicate with your genes, switching genes on and off, changing which proteins and enzymes are produced, and how your body functions. You may have heard the phrase “genetics load the gun, but the environment pulls the trigger.” Another way of saying this is the more recent aphorism, “your zip code is more important than your genetic code.” Epigenetics is the growing area of science that studies how our genes are affected by what we are exposed to. You can think about it as a type of biochemical process or tag that switches genes on or off. While it may sound complicated, the important take-home message is that your genes are not always in control. You are!
Nutrition and food as medicine
It is often said that food can either be medicine or poison. We believe that food is the foundation of good health, and we use nutritional prescriptions and interventions with every patient we work with. Unfortunately, we live in a time where our foods are increasingly toxic and nutritionally depleted. There are many “food-like” products that people consume on a daily basis, most of which are highly processed and create inflammation in our bodies. We prioritize a nutritional approach that provides nutrient-dense foods, minimizes inflammation, and helps your body systems function optimally.
Stress and allostatic load
Allostatic load is "the wear and tear on the body" which accumulates as an individual is exposed to repeated or chronic stress.13 Chronic stress and a high allostatic load can significantly affect all aspects of health, including your mood and brain function, resulting in accelerated aging, inflammation, hormone disruption, immune dysregulation, and much more. Many factors act as stressors for your body, including hidden infections, poor sleep, inadequate movement, or an unhealthy diet. Furthermore, stressful experiences stack up over time, further depleting the body. Our goal is to identify current and past stressors, modify or eliminate them to decrease the overall load experienced by your system and to help you process and heal your brain and nervous system to get you better.
In his book Why We Sleep, Dr. Matthew Walker said it simply, “The shorter your sleep, the shorter your lifespan.” As a global society, we are in the midst of an epidemic of inadequate and poor quality sleep. Many people do not realize that poor sleep contributes to increased rates of cardiovascular diseases, metabolic diseases like diabetes, weight gain, cancer, anxiety and depression, suicide, and impaired immunity. Sleep is needed for our body to repair and rejuvenate itself; without it, our health will decline. At CCFM, we work closely with all patients to optimize sleep. We provide comprehensive testing to identify underlying imbalances that may be triggering poor sleep, coaches trained in the science of behavior change, advanced wearable technology (such as the Oura ring) to provide sleep data, proven lifestyle hacks, and supplements help you sleep better, feel rested, and function to your full potential.
Movement and exercise
What is standing in the way of getting more exercise? Most people report either a shortage of time or energy as barriers to making exercise a regular habit. We all know that exercise/movement helps with weight loss and/or weight maintenance, but it also is linked to improvements in the gut microbiome and improvement in mental health symptoms like anxiety and depression. Our bodies were designed to move, and healthy movement is an important foundation for overall health. A large study involving over 100,000 U.S. adults found that those who sat for more than six hours a day had up to a 40 percent greater risk of death over the next 15 years than those who sat for less than three hours a day. We strive to help our patients incorporate more exercise, active movement, and “non-exercise” physical activity into their day.