In addition to being called a wellness philosophy and alternative medicine, it also explains why former POTUS Bill Clinton was able to bounce back from a quadruple bypass surgery in 2004 and also slim down.
Meet functional medicine, which is best described as an approach that “asks how and why illness occurs by addressing the root causes of disease for each individual,” says Dr Joel Evans, chief of medical affairs at The Institute for Functional Medicine (IFM) in the US.
It was founded in 1991 by Dr Jeffrey Bland as the foundation for his “individualised, patient-centred, science-based approach”. For him, it was important to realise that one cause can result in many conditions — especially with the growing number of chronic disease sufferers.
According to the Health Promotion Board, one in four Singaporeans aged 40 and above has at least one chronic disease such as diabetes, high blood pressure or high blood cholesterol.
Practitioners of functional medicine have the knowledge and skills to look for the root cause of a health problem, and to take genetic, biochemical, and lifestyle factors into consideration. They believe this significantly improves patient outcomes.
As Dr Evans explains, “The drug-based model refers to the use of medication to have specific effects, such as an antibiotic to treat an infection, a diabetes drug to lower blood sugar, or an antidepressant to improve mood… There are specific protocols for using particular medication regimens for different diseases, such as statins for elevated cholesterol or first-line antihypertensive medications for elevated blood pressure.”
It is only when the functional medicine practitioner also customises a secondary treatment for the individual that the difference appears.
“Functional medicine practitioners determine treatment options specific to the patient. Functional medicine… might prioritise working on stress for one person with hypertension, weight loss for another, and potassium deficiency for yet another.”
Hollywood star Gwyneth Paltrow is a fan of functional medicine.
The functional medicine model uses medications when needed but tries to find other ways to improve long-term health.
As an example, he cites how a functional medicine practitioner might treat someone with type II diabetes by normalising sugar levels first with medication and then providing advice on nutritional supplements, dietary changes, stress reduction and exercise routines to address each patient’s specific nutritional deficiencies or excesses.
As part of his advice from Dr Mark Hyman, one of the most prominent functional medicine practitioners in the US, Bill Clinton switched from his vegan diet to a Paleo diet, which is said to have helped him lose weight.
Hollywood star Gwyneth Paltrow has also publicly thanked functional medicine or, more precisely, her functional medicine practitioner, Dr Will Cole for helping her to recover from her post-Covid-19 brain fog and fatigue by getting her onto a routine of fish oil, B vitamins, selenium and zinc supplements.
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Functional medicine is like assembling the pieces of your health puzzle
Josephine Ng, a registered UK-trained nutritional therapist and functional medicine practitioner at The Nutrition Mentor in Singapore, tells us that while functional medicine involves both dietary changes and taking supplements, there is more “hard work” required in the form of changing one’s lifestyle habits, managing stress and addressing the underlying causes of an usually-chronic health condition.
“Apart from diet and supplements, the client may need to do other things like remove themselves from certain toxic exposures like mould that are contributing to their ill health, or toxic relationships.”
She compares a person’s state of health to “a complicated, multilayered jigsaw puzzle”.
“Functional medicine asks where are the missing bits, why are the pieces of the wrong size or shape, when did they go missing, and how did it happen? As part of solving this puzzle, functional medicine listens to a person’s entire history — even his or her parents’ and grandparents’ histories and family genetics — and everything, including test results, should be interpreted in the context of their unique case history,” Ng elaborates.
For this reason, her consultations can take up to two hours for the first session while follow-ups generally last an hour, with further consultations done through emails or a short telephone call in between face-to-face sessions.
Ng became interested in functional medicine as a result of her own health challenges. For some time, she had “very bad gut issues” and would feel sharp pains. She went for an endoscopy and was simply told that she might have irritable bowel syndrome. While working in London, she became interested in nutrition therapy and later, functional medicine. With her newfound knowledge on how to prepare home-cooked diets free of refined, processed and fast foods, she found relief from her gastrointestinal issues.
Ng, who says that she is among the pioneering cohort of nutritional therapists who took the IFM’s first functional medicine training course in the UK, is listed as one of four functional medicine practitioners based in Singapore on IFM’s website.
Another functional medicine practitioner based here is Dr Menka Gupta, a practising medical doctor in India and the UK and now a functional medicine practitioner and nutrition expert at Nutra Nourish.
Previously, the 21-year veteran worked at the National University of Health in Singapore in the Obstetrics & Gynaecology department.
The Peak understands that medical doctors here are not allowed to practise functional medicine and functional medicine practitioners in Singapore do not diagnose their clients’ ailments.
The experience that led Dr Menka to functional medicine was similar to Ng’s. Her mother, who had lost six siblings to cardiac issues, was diagnosed with ulcerative colitis in her 30s, diabetes in her 50s, and high cholesterol, hypertension and heart disease by her early 60s. She was initially able to control her diseases with her medications, but the dosages had to increase as time went on to manage her symptoms effectively.
In 2010, Dr Menka learned about functional medicine from peers in the US and the UK, and applied its principles to help her mother who started to feel “significantly better and had more energy”.
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A school of thought in which there is no diagnosis
Functional medicine, Dr Menka says, does not have a diagnosis. In its place, the practitioner identifies an individual’s core imbalances and then addresses the “modifiable lifestyle factors”.
“We have to address these before we can get to the ‘meat’ of the core imbalances. These can include nutrition, stress, sleep, relationships and exercise. Each one tends to affect the others. It is imperative when trying to improve one’s health that each of these be looked at carefully and seriously.”
Functional medicine, she says, can help those “seeking optimum health and prevention of disease”. More specifically, it could be beneficial for those with gut and skin issues, hormonal dysfunction, as well as autoimmune and cardiometabolic diseases.
As the practitioner, the idea client is motivated to change and do the work, regardless of their state of health. It is a partnership between us.
Dr Menka Gupta, Nutra Nourish
In addition to gastrointestinal issues like bloating and acid reflux, Ng says she sees cases of gastrointestinal issues like bloating and acid reflux, high blood pressure, migraine, panic attacks, hormonal imbalance in women, food sensitivities, and skin reactions. Her clients usually present with multiple symptoms. For instance, they might be diagnosed with lupus, but they also experience brain fog, fatigue and irregular menstruation.
According to her, functional medicine is appropriate for anyone who has a health challenge, even if they have obvious symptoms but wish to improve their health.
“However, most of the time, it’s the ones who are chronically ill and who have not managed to get much improvement through more conventional modalities who come to see me. Sadly, it’s often when they are desperate that they become motivated to see someone like me. As the practitioner, the ideal client is motivated to change and do the work, regardless of their state of health. This is someone who understands this is a journey as there are no quick fixes. It is a partnership between us because we both have to do our part.”
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