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Functional Medicine

Dr. Keith Holden - Functional Medicine

Functional Medicine is a science-based, personalized healthcare approach that assesses for and treats underlying causes of illness through individually tailored therapies to restore health and improve function. Functional Medicine involves "lifestyle medicine," in which the patient takes an active role in improving their health by using food as medicine, and by using proven stress reduction techniques. Functional Medicine tends to work best for chronic diseases and conditions, often finding the root cause of the disease state, and correcting it to allow for healing and resolution of the illness.

Functional Medicine has taught me that compartmentalized healthcare like that found in the traditional healthcare model with its system of specialists, is not the optimal way to prevent chronic disease or eliminate it completely. Depression is not a Prozac deficiency, heartburn is not a Prilosec deficiency, and diabetes is not a Glucophage deficiency. These and other chronic illnesses represent imbalances in the body's systems, which can be found and corrected with more natural interventions.

Functional Medicine focuses on patient-centered rather than disease-centered care, and recognizes the web-like interconnectedness of all our organ systems in the context of our environment and genetic predisposition. Using a very thorough interview process, which looks at all aspects of a patient’s life, combined with a thorough physical examination, and specialized laboratory testing, the Functional Medicine practitioner acts as a detective to find the root cause of disease. He or she doesn’t just stop at the diagnosis and prescribe a drug, but digs deeper in an attempt to find the causative factor upstream.

My favorite aspect of Functional Medicine is that it has taught me why diseases occur and how to intervene at a root-cause level. For example, one of the basic tenants of Functional Medicine is that to optimize immune system function, one must optimize gastrointestinal (GI) system function. This is because over 70% of the body's lymphocytes (white blood cells) are found in the lymphoid tissue surrounding the GI tract, and because you must have adequate GI function to assimilate and absorb nutrients necessary for proper immune system function.

Functional Medicine looks at how our environment, including trauma, chemicals, heavy metals, allergens, hidden and overt infections, drugs, toxins, and stress, impact the body’s defense and coping systems. Functional Medicine recognizes that each individual is biochemically different, and that an individual may, for example, require a higher level of a nutritional substance than another person for a more optimal level of function. 

Functional Medicine looks for imbalances in eight core physiologic systems, including nutrition, immune/inflammation, hormonal, digestive, detoxification, energy metabolism, body-mind, and structural imbalances of the body. These imbalances can be found by evaluating blood, salivary, or urinary levels of amino acids, vitamins, antioxidants, immunoglobulins, hormones, fatty acids, minerals, heavy metals, markers for oxidative stress, neurotransmitter metabolites, stool markers for altered digestion, and identification of gut flora.

Special tests may include urinary organic acids, salivary cortisol/DHEA, comprehensive digestive analysis, and heart rate variability testing. Many of the tests from the specialty labs can be done using hair, saliva, urine, and finger stick blood testing. 

These tests can reflect what is going on at the cellular and biochemical level and enable a definitive focus for intervention. Sometimes all it takes is “cleaning up the gut” by putting a patient on a hypoallergenic elimination diet, and starting digestive enzymes, probiotics, and fish oil, to have a profoundly positive impact on the patient’s overall health. Other times, it takes a methodic and careful step-wise approach over many months, to safely eliminate a heavy metal from the body before a patient begins to feel well again.

A good Functional Medicine practitioner acts as an educator and coach, rather than a dictator. He or she attempts to partner with the patient and use non-invasive, low risk, and more natural approaches to therapies, knowing that the human body is an amazing organism capable of great feats of self-repair when properly supported.

As a core concept, Functional Medicine acknowledges that food is medicine, and all patients are given nutritional counseling. Ideally, it is much better to get your vitamins, minerals, antioxidants, and phytonutrients from a whole food diet than from a supplement. But if your diet is lacking, then nutritional supplements will be used in your care.

If you are interested in seeing a Functional Medicine practitioner and want positive results, be ready to commit to lifestyle changes, especially that regarding your diet.  You must also be an active partner on the Functional Medicine practitioner’s team, taking full responsibility for your actions as it relates to improving your health. A lot of times in the current healthcare system, we give away our power to doctors, hoping they will give us a pill or potion to fix us. We forget about our inner physician who, in many instances, is quite capable of empowering our road to recovery if properly supported.

For more information on Functional Medicine, and to find a Functional Medicine practitioner in your area, go to

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