Have you ever had a persistent symptom that just won’t stop bugging you? Maybe you’re struggling with fatigue, or your gut is constantly irritated? The causes of symptoms like these are often hard to get to the bottom of — and believe it or not, sometimes they may be caused by a problem somewhere else in your body that you might think is unrelated. But how do you find the root cause and treat the problem?
This question forms the basis of functional medicine, and the answer is you have to look at and treat every aspect of your being — not just that symptom on its own.
Functional medicine is a highly personalized practice that works to uncover the root cause of an illness by taking into account the whole person, rather than looking solely at a set of symptoms. Many chronic diseases and illnesses are caused or aggravated by seemingly unrelated factors, which can result in frustrating unresolved pain or symptoms. Oftentimes, the only way to get to the bottom of these is by examining your life history, physiology, environment and exposures, genetic makeup, and lifestyle.
The interactions between genetic, environmental, and lifestyle factors influence your long-term health and complex, chronic disease. In addition to looking into these interactions, the physicians at PALM Health find it imperative to address the health of each of the elements of your being through the lens of functional medicine.
Imagine a three-legged stool. It can only stand if all three legs are intact, right? If one of those legs is broken or uneven, the entire stool will topple over. Your being functions just like that stool: the three legs are your mind, your body, and your spirit. If one of those elements of your being is suffering, it becomes more difficult to flourish as a whole.
What does it mean to have a healthy mind, body, and spirit? A healthy mind is well-practiced in controlling stress; focuses on positivity, gratitude, and joy; and is exercised regularly with an eagerness to learn. A healthy body is properly nourished, active, and free of disease. A healthy spirit feels connected to others and understands its place within something larger than the self.
Your mind, body, and spirit make up your person as a whole and the balance between them influences your overall health. The PALM Health approach is unique in the way it addresses this. It employs a combination of conventional medicine, preventive care, and integrative therapies to not only diagnose the root cause behind your symptoms through functional medicine, but to also treat and strengthen all three legs of the stool that is your being. The objective? To improve your overall wellness and achieve your health goals.
Functional medicine may seem overwhelming. You may be wondering how to get started, or what the process involves. Let’s take a look at what your journey through functional medicine might look like as a patient, and how it can not only treat your symptoms, but also improve your overall well-being.
The Initial Visit
One of the main ways that the functional medicine process is unique is the initial visit. When you see a functional medicine practitioner for the first time at PALM, your visit will be one to two hours long. This involves an in-depth conversation with the provider about your health history and background, all the way from childhood until present day. During this exploration and documentation of your history, the provider completes a “timeline” and a “matrix.”
According to Amanda Peregrin, functional medicine nurse practitioner at PALM Health, “The initial visit is not exclusive to standard health history like surgeries, allergies, and previous illnesses — you’ll also discuss things like toxin exposure, trauma, gut health, diet and exercise habits, relationships, work and home environment, and more.”
The timeline and matrix are incredibly helpful for a multitude of reasons. They are a comprehensive way for the provider to learn about the critical events in your life story (via the timeline) and organize your history to uncover the key contributors, triggers, and mediators (via the matrix) that contribute to your health.
Essentially, the matrix constructs the backstory to understand where you may have a core clinical imbalance that has led to your illness. It can give hints as to the source of your symptoms while also providing an overview of your lifestyle that will help your provider structure a treatment plan that is best suited to your individual needs.
When 47 year-old Susan Jones (name changed to protect privacy) came in for her initial visit with Dr. Karrie Hohn, functional medicine physician at PALM Health, she was struggling with several aspects of her daily life. She was having difficulty focusing on tasks at work and found herself frequently forgetting why she walked into a room or what she was talking about. On top of this brain fog, Susan was gaining weight and dealing with heightened fatigue, finding it difficult to get through the day without experiencing total exhaustion.
After constructing Susan’s matrix and timeline, Dr. Hohn knew the next step for Susan was a directed laboratory evaluation to get to the bottom of her symptoms based on the information she had gathered.
As a key part of her workup, Susan underwent standard and advanced testing to dig into what else could be underlying her symptoms. As an example, standard testing generally consists of basic thyroid tests, blood chemistries, blood counts, and lipid analysis. In functional medicine, advanced testing offers a deeper look into root causes such as metabolic, gut, and immune health that may are not often assessed in standard labs. These specialized tests offer valuable biochemical information that can help the practitioner identify patterns and connect the dots between symptoms and a diagnosis.
Susan’s testing found that she had borderline low thyroid hormone, elevated thyroid anti-bodies, and a severe leaky gut. You may be wondering what leaky gut is and what it had to do with Susan’s symptoms. Believe it or not, it was the key to her treatment.
Leaky gut syndrome, also known as intestinal permeability, occurs when your diet, as well as psychological and physical stress, causes the gut lining to become more permeable to food particles, bacteria, and toxins. When this happens, certain molecules that haven’t been fully digested “leak” through the gut lining and into the bloodstream. The body perceives those molecules as foreign and mounts an immune response to fight those unrecognizable molecules, which leads to inflammation.
For Susan, her advanced testing was able to identify the foods that were “leaking” and causing sensitivity and inflammation in her body: milk products, certain grains, and eggs.
Although Susan ate “relatively healthily,” her diet and leaky gut were causing her to be in a state of perpetual inflammation, which in her case led to an autoimmune disease called Hashimoto’s Thyroiditis with elevated thyroid antibodies. Both the inflammation from her leaky gut and the thyroid issues were likely worsening her brain fog, fatigue, anxiety, and weight gain.
The functional medicine evaluation, including advanced testing, allowed Dr. Hohn to get to the bottom of Susan’s hypothyroidism and find significant inflammation with elevated thyroid antibodies and food sensitivities. This discovery allowed them to move forward in creating a completely personalized treatment plan to address Susan’s leaky gut — the upstream root cause of her thyroid illness.
The Personalized Treatment
The foundation of treating disease takes into account all three legs of the stool: mind, body, and spirit. “Addressing all of these aspects of the self together allows for a more holistic improvement of whatever illness you are struggling with,” says Amanda Peregrin.
As Dr. Hohn and Susan moved forward with structuring a plan for her recovery, several different therapies were recommended to treat her whole person: these included dietary changes, supplements, wellness therapies, and meditation techniques.
Oftentimes, your diet is a major factor in determining your overall health and wellness. So, it’s commonly one of the first aspects of your lifestyle that functional medicine practitioners will address.
In Susan’s case, her advanced testing found that she had a severe leaky gut with a sensitivity to milk products, certain grains, and eggs. In order to treat this, Dr. Hohn recommended an elimination diet in which Susan would temporarily remove these items from her meals to bring down inflammation and give her gut the chance to heal.
Dietary changes don’t always have to be permanent, thankfully. Many individuals with leaky gut will only have to remove items for 4-6 weeks to repair the gut. Dr. Hohn and Susan decided to check her antibody levels repeatedly and confirm that her inflammation was decreasing before weaning her off the elimination diet. Susan was slowly able to reintroduce some of her favorite foods after 6 months. Other individuals elect to change their lifestyle more permanently and keep their diet free from certain foods because they feel so much better without them.
Supplements are often a crucial component of treatment in functional medicine. Although the goal is to get everything you need through your diet, sometimes it is not possible to eat enough to maintain all of your nutrient levels. Supplements may help replenish your natural vitamins, enzymes, amino acids, and minerals that may be out of balance, especially when you are dealing with a chronic illness. Different supplements target different areas: there are options for gut health, stress, sleep, brain function, bone and muscle strength, and more.
When Susan began her elimination diet to treat her leaky gut, she was simultaneously given an L-Glutamine supplement, an amino acid which directly supports the health and integrity of the intestinal barrier that is disrupted by a leaky gut. This supplement, in conjunction with the elimination diet, allowed Susan a recovery period to heal her gut.
While treating any disease of the body, it’s crucial to take equal care of your mind and spirit. Wellness therapies are an extremely useful part of integrative treatment because they can help with mood, fatigue, and anxiety while also providing physiological benefits.
Susan was recommended to incorporate the Trilogy, one of the most comprehensive wellness services offered at PALM Health, into her routine once or twice per week to help with mood, inflammation, stress, fatigue, resilience, and detoxification. The Trilogy is actually a combination of three therapies done back-to-back: cryotherapy, a BioMat or infrared sauna session, and a Himalayan salt room session.
Cryotherapy is a cold therapy that promotes anti-inflammatory properties in the body, while also increasing metabolism, releasing endorphins, and giving an energy boost.
The BioMat is a medical-grade heating pad that uses far-infrared waves to penetrate deeper into the body and improve blood flow, relaxation, and muscle tension. This can be used interchangeably with the infrared sauna, which uses a similar far-infrared heat technology to detoxify, relieve pain, and re-energize.
The Himalayan salt room is infused with purified salt particles that, when breathed in, reduce inflammation and mucus in the lungs, purify the skin, and help with stress and insomnia.
Chronic stress and mood disturbances (depression or anxiety) are highly prevalent in the United States; Susan herself was struggling to prioritize her self-care, was stressed about her work-life balance, and was feeling anxious — especially at night. This ongoing stress also contributed to her leaky gut.
Depending on the person, treatment plans may include coaching and counseling, and at PALM Health, the doctors commonly incorporate meditation and Cardiac Coherence into their recommendations.
Cardiac Coherence combines a specific breathing technique with biofeedback to provide in-the-moment objective visualization of your current state of calmness and show the changes that occur when you implement this breathing technique. This service is centered on providing balance to your autonomic nervous system (think: rest and digest versus fight or flight responses), and, when practiced long-term, can lead to a decrease in stress and anxiety as well as improvement of emotional control.
Within 4-6 weeks on an elimination diet, taking L-Glutamine supplements, and engaging in various wellness therapies, Susan started to see a major decrease in her brain fog, fatigue, and anxiety. She was able to re-establish a healthy lifestyle and find productivity in her daily routine again. And that isn’t all.
After 3- and 6-month laboratory checks of her inflammation and thyroid, Susan had objective laboratory data to confirm these improvements. In fact, since the autoimmune reactions from the leaky gut were aggravating her thyroid in the first place, cleaning up her gut actually improved the hypothyroidism enough that her medication could be decreased over time.
Getting in the Mindset of Functional Medicine
As is evident from Susan’s experience, treating an illness with functional and integrative medicine is often complex and involves many components as well as dedication from the patient. It’s easy to become overwhelmed by the options and recommendations given by the provider, especially when many of those recommendations will alter your daily routine and lifestyle. However, what’s important to understand is that you can be successful in your functional medicine journey even if you need to tweak the details of what has been recommended to you.
Susan’s treatment plan involved elements that she decided upon together with Dr. Hohn. “Because this process is so highly personalized, your practitioner will do everything they can to meet you where you are and find a compromise that works for you,” says Amanda Peregrin.
Before beginning your experience with functional medicine, take some time to reflect honestly with yourself about your health goals and what you are or aren’t willing to do on the journey. How willing are you to change your diet? Do you have room in your schedule to make time for certain therapies? Are you okay with altering your exercise routine?
If you can prepare for your initial appointment by developing an idea of the extent to which you can commit, your provider will have a better understanding of your situation right off the bat. Then, he or she can facilitate a smooth and efficient plan tailored to your needs.
Functional medicine aims to dig into what is really going on at the root of your symptoms. Sometimes, the symptoms you are having may be caused by something seemingly unrelated or something you didn’t even know was there. It isn’t always the case that you have to accept that you’re “stuck” with a disease. Likewise, treating an isolated set of symptoms won’t always resolve the issue.
At the end of the day, identifying and treating the root cause of your illness while prioritizing the overall health of your mind, body, and spirit can not only improve your ailments, but also put your quality of life back on track.