Functional medicine‘ seeks to find the root cause of an individual patient’s symptoms: what exactly is going wrong or is imbalanced in this patient’s medical condition.
An individualised diagnosis can then lead to individualised treatment. Functional medicine tries to look deeply at the patient’s biochemistry: if possible is there a way to treat this patient with substances which are native to the human body rather than just suppressing disease process with powerful drugs.
As an analogy if we compare symptoms to there being a crack in the wall, functional medicine would recommend finding out (if possible) why there is a crack in the wall so that this may be remedied to prevent the crack next time. This is then followed by filling the crack. Standard medicine’s approach would be to put some strong wallpaper over the crack so that it is not seen i.e. to use powerful suppressive drugs such as steroids. The problem though is if the crack is not dealt with it will eventually get bigger and break through the thick wallpaper resulting in an even bigger problem in the long run.
The conditions which I see most frequently include: severe and debilitating fatigue, irritable bowel syndrome, persistent or recurrent infections such as recurrent sinus or chest infections, mood disorders related to the female menstrual cycle, pain disorders such as fibromyalgia, sleep disturbances, problems such as persistent unexplained itchy skin, recurrent or persistent vaginal thrush, disorders of libido, mood disorders not responding well to antidepressants.
Functional medicine tries to work in harmony with the body, look in detail at what is going on and provide natural rather than drug driven solutions. It involves teamwork between doctor and patient. In addition to biochemical interventions there will frequently be lifestyle interventions. I try to keep these as simple and as manageable as possible but these are something which the patient must put in place themselves and which I cannot do for you. You, the patient, will have to put the effort in as well, otherwise it will no bet worth your time or mine.
Functional medicine does not work on the basis of the placebo effect of long consultations or of medical sympathy. That being said I do know that patients are usually very grateful for having been listened to carefully without their symptoms being dismissed or greeted with a roll of medical eyes! Being listened to is important for the patient’s self respect and self-esteem and quite frequently patients may remark this at the end of the first consultation I have sometimes had conversations with medical colleagues who have told me that they accept that functional medicine may sometimes get results in situations where the standard medicine has failed. But then they go on to tell me that functional medicine is really psychotherapy in disguise and it only works as a talking cure i.e. because the patient was carefully listened to in long consultations. To say this is, I believe, insulting the intelligence of patients! When functional medicine works where standard medicine is fails it works because it looks in more detail at more aspects of the individual patient’s case.
No form of medicine whether it is functional medicine or standard medicine has an unblemished success rate. I have my failures as well as my successes. People come to see me when standard medicine has not worked for them and, as a rough guide, at any given time I will have to work harder on 5 to 10% of my patients because their cases will challenge my skills. This is my 36th year as a doctor and my practice has been predominantly based on the functional medicine model for the past 20 years. On the positive side what I can say is that many of the cases which I found difficult to treat five years ago I now find much easier to treat and cases which I found more difficult 10 years ago I found more easily five years ago etc etc . It’s a case of cumulative experience but I would point out that nobody has a a perfect track record. There certainly are no gold-plated guarantees of success.
Hormones are complex messenger molecules carrying a message of instruction from one site of the body to another (the receptor site), via the blood. Hormone and receptor sites are like a lock and key; they are very highly specific.
Bio-identical hormones are hormonal substances, identical to those normally present in the human body. This means that, in every respect, the molecule of the hormone is the same as the human hormone.
It is best to follow nature as closely as possible. Bio-identical hormones do as Nature intended. It is critical to use dosages reflecting natural circumstances and cycles. Bio-identical hormones are most useful as part of a comprehensive, integrative approach to wellness. This strategy will yield the best possible results for the patient. Testing hormone levels before and during treatment is an important part of tailoring the dose to suit the individual patient.
Bio-identical hormones are usually presented as gels and creams facilitating direct access to the blood stream without having to first pass through the liver. This ensures that the liver does not chemically modify the hormones prior to them reaching their target areas. In contrast, tablets or capsules taken by mouth, must first pass through the liver.
Bio-identical hormones have been in use since 1982. Jonathan Wright MD reports that a 48-year-old woman seeking treatment for menopausal symptoms approached him: she wanted him to prescribe natural hormones for her. At the time, only patented synthetic hormones were available. The commonly used one was Premarin® consisting of horse urine estrogens. This lady declined the Premarin prescription. As a result, Dr. Wright got to work on the optimal ratios for bio-identical hormone therapy in women; and he based these on the amounts of each of the three primary oestrogens: oestrone, oestradiol and oestriol normally produced by healthy reproductive-phase human females.
In women varying blends of oestrone, oestradiol and oestriol (the three most important human oestrogens) are used along with bio-identical progesterone – the use of progesterone is essential. Bio-identical testosterone is also usually part of the combination. The blend must be individualised for the particular patient based on clinical response and monitoring of hormone levels.
The use of Bio-identical testosterone replacement in men is growing and there is much by way of observational study and clinical research to support its use.
As well as helping mood and libido problems, bio-identical testosterone assists in the maintenance of physical strength and general emotional well being.
Bio-identical testosterone replacement in andropausal males may act as a mood elevator and is associated with a significant improvement in cognitive function and verbal memory. Contrary to conventional medical wisdom, testosterone may in fact benefit heart and circulatory health. Despite its usefulness, just like any other treatment, bio-identical testosterone works best as part of an individualised patient-specific wellness plan.
Proper medical supervision and check-ups including regular blood testing, is an important part of maximising patient benefits and minimising any potential downside from bio-identical testosterone replacement therapy.
Mesotherapy hair loss treatment is frequently very effective when individuals, both male and female, are having thinning of hair. It can also be very useful in patients who have e.g. hair thinning due to low thyroid hormone levels (hypothyroidism).
Mesotherapy works best if 6 to 8 sessions are initially done on a weekly basis followed by another treatment at approximately week 10 to 12 and another treatment around week 14 to 16. In my opinion Mesotherapy works well for about 80 to 85% of people. While it is very effective for most people it will not cure baldness.
Ideally the patient should start mesotherapy therapy treatment as soon as they notice hair beginning to thin, some results will be seen within 5 to 6 weeks. After the initial treatment, which lasts approximately three months, it is recommended to have 4 to 8 treatments per year to maintain hair growth.
A small portion of the population are troubled by excessive underarm sweating which usually results in extreme staining of clothes which, frequently, necessitates changing clothes, sometimes up to 9 or 10 times per day.
This can be very distressing for the sufferer and can severely affect colour choice of clothes e.g. often individuals feel obliged to only wear very dark, coloured clothes, usually black.
Frequently the treatment is given in spring or early summer and the patient will usually get the whole of the summer and the warmer part of the autumn out of the treatment; sometimes they do not need to come back to me until the following spring. It takes about 5 to 14 days for the treatment to become fully effective.
The patient needs to shave his or her underarm area and then a liquid and powder is applied to the area which will show up the areas of excessive sweating Multiple tiny injections are then inserted just beneath the skin, approximately 20 per side.
Wear an old T-shirt when you come for treatment and preferably avoid washing the area for at least 6 to 8 hours afterwards.