By Josh Redd, MS, DABFM, DAAIM, Chiropractic Physician
Ask most people, “Do you know about functional medicine?” and usually their eyes glaze over. True, it’s a relatively recent medical specialty and not well known. The term is not catchy or sexy, but it is something you are going to keep hearing more about. Most important, functional medicine is the most effective approach out there to managing Hashimoto’s hypothyroidism.
Why is functional medicine growing in popularity and so good at managing chronic conditions such as Hashimoto’s hypothyroidism? Simply put, functional medicine:
- Addresses a health disorder by identifying its root cause.
- Relies on published, peer-reviewed science to understand how the body works and where breakdowns occur.
- Recognizes that the body is a highly complex web of interrelated functions.
- Recognizes that all systems and parts of the body are related
- Works to reverse or stop progression of chronic disease.
- Uses advanced, state-of-the-art testing to assess all body functions to detect trends that could lead to disease and track progress of treatment.
- Identifies problems before they become diseases to “diagnose.”
- Is all about “why” a health problem or symptom has occurred.
- Often can determine if a person is headed toward hypothyroidism, diabetes, or heart disease.
Functional medicine does not:
- Mask symptoms with drugs or surgery first.
- Attempt to correct physiologic function first with drugs or surgery.
- Specialize in one single organ or system.
How Functional Medicine Works
Let’s say ten different people visit a functional medicine practitioner with the same complaint, such as hypothyroidism, and they all have similar symptoms of depression, hair loss, weight gain, cold hands and feet, fatigue, and other hypothyroidism symptoms.
In the conventional medical model, only one thyroid hormone marker is typically tested and if that comes back positive, the patient is prescribed thyroid medication. If the lab test comes back negative, which is common in many cases of hypothyroidism, the patient is sent home untreated.
This model usually does not screen for autoimmune Hashimoto’s, even though the disease accounts for 90 percent of hypothyroidism cases. Why? Because it does not change treatment.
You see, Hashimoto’s is an autoimmune disease, which means an imbalanced immune system is attacking and destroying thyroid tissue. Autoimmune diseases are not curable, but they can be driven into remission.
Although you may still need thyroid hormone medication to compensate for the thyroid damage, scientific studies show a number of nutritional and lifestyle strategies can help put your autoimmune Hashimoto’s into remission. These are not the types of protocols medical doctors learn in med school.
Back to our example of the ten patients with hypothyroidism symptoms. Each of these ten people could have a different cause for the same health symptoms. For instance, one person’s chronic stress may be affecting her thyroid, causing hair loss, while for another it’s her chemical sensitivity to plastics triggering her Hashimoto’s hypothyroidism symptoms. Gut problems, chronic infections, food intolerances, or blood sugar imbalances are other examples of factors that can promote Hashimoto’s hypothyroidism symptoms.
These are the types of mechanisms we look for in a functional medicine approach, versus giving everyone the same protocol.
To ferret out the cause of the symptom, the functional medicine practitioner relies on a variety of science-based lab tests, assessments, detailed patient history, and in-office exams, to consider the person’s entire physiology and identify where the major areas of dysfunction lie.
Why Isn’t Functional Medicine Practiced by All Doctors?
- It takes time. The average visit with your MD is seven minutes these days, too short for a functional medicine exam.
- It takes work from the patient. Functional medicine usually requires changes to your diet and lifestyle, sometimes drastic changes. Not everyone is willing to make the efforts.
- It’s not always covered by insurance, which is ruled by diagnostic codes. Functional medicine doesn’t use diagnostic codes and there are no codes for risk of disease.
Principles of Functional Medicine Management
Once the potential problems or risks have been assessed, a functional medicine practitioner turns to a variety of science-backed, non-pharmaceutical approaches to restore health. These include:
- Diet adjustments.
- Lifestyle changes (such as eating breakfast, proper sleep hygiene, physical activity, or stress reduction).
- Use of botanicals or nutritional compounds to improve function and relieve symptoms.
- Nutritional strategies based on lab test results.
Cutting Edge Testing
Have you ever had a conventional blood test come back normal even though you suffer from fatigue, brain fog, hair loss, digestive issues, joint pain, or some other symptom? Did your doctor give you a prescription for antidepressants because, according to your lab tests, “You’re fine.”
It’s a common dilemma many of our patients have experienced. That’s because standard blood tests screen for diseases instead of trends toward disease. In functional medicine, blood tests assess disease risk so you can do something about a downward trend it before it’s too late.
For instance, functional medicine practitioners can identify a risk for diabetes long before the condition occurs or explain why you have hypothyroid symptoms despite normal lab results.
The lab tests a functional medicine practitioner recommends can be costly, but they can save you money in the long run by eliminating trial-and-error guesswork. Getting feedback from your lab tests also works wonders for compliance, helping you reach your goals faster and with more conviction.
Blood test for functional medicine is thorough. Because functional medicine practitioners look at a complete picture of physiological function, they use blood tests that include many more markers than standard tests.
For instance, many conventional doctors typically look only at blood levels of thyroid stimulating hormone (TSH), a basic marker of thyroid function, when they suspect hypothyroidism. In functional medicine, we understand that Hashimoto’s hypothyroidism is an autoimmune disease that attacks and destroys the thyroid gland. Therefore, we also order blood tests that measure thyroid antibodies, a marker of autoimmunity.
Functional lab ranges. Many standard lab ranges are based on the lab results of people who visited a particular lab over a certain period of time, many of whom are unwell. Functional lab ranges, on the other hand, are based on optimal health.
Looking for blood test patterns. A functional medicine practitioner is trained to assess patterns within blood test results rather than just looking at each marker individually. This allows the practitioner to evaluate the way in which different systems influence one another to cause a constellation of symptoms.
Comprehensive health lab testing
We also use the most advanced testing to better identify what is triggering mysterious symptoms or autoimmune flares.
Here are some areas where we do additional testing:
Food sensitivity testing: Identifies foods that are triggering an inflammatory reaction. Testing can also identify cross-reactive food intolerances. This is a situation in which the immune system mistakes one food for another. For instance, a gluten-free person may not feel better on a gluten-free diet if their body also responds to dairy as if it were gluten.
Leaky gut testing: Identifies whether the small intestine has become damaged and is allowing undigested foods, bacteria, and other pathogens into the bloodstream, where they trigger inflammation and Hashimoto’s flares. This is called intestinal permeability, or leaky gut.
Blood-brain barrier testing: Often when a patient tests positive for leaky gut, they also have a leaky blood-brain barrier. This means inflammatory particles can escape into the brain environment and trigger inflammation and tissue destruction in the brain.
Autoimmune testing: We use a Cyrex Labs test that screens for autoimmune reactions against 24 different tissues. This information can help you prevent the development of future autoimmune diseases and explain any current mystery symptoms.
In fact, in our offices, half of our Hashimoto’s patients also test positive for antibodies to nerve myelin sheathes, the protective coating of the nerves. This is the lab marker for multiple sclerosis.
Chemical sensitivities: You can develop an immune reaction to chemicals and heavy metals, such as plastics or flame retardants, which can drive your Hashimoto’s hypothyroidism. Knowing this can help you better put in safeguards to protect your thyroid health.
Stress hormones: This test measures your stress hormones. Often when stress hormones are too high or too low this can be a factor in driving your other health symptoms.
Hormone testing: Sometimes hormonal imbalances cause health problems, especially in women with polycystic ovarian syndrome (PCOS), premenstrual syndrome (PMS), low progesterone levels, and health problems during perimenopause and menopause. In aging men and women, declining levels of sex hormones can cause significant brain-based symptoms, such as memory loss, brain fog, fatigue, lack of focus, and irritability.
Genetic testing. Most people use this test to screen for a mutation in the MTHFR gene, which is linked to methylation disorders and the liver detox process.
Bottom Line: Why functional medicine will help you feel and function better
Autoimmune diseases have become frighteningly common, affecting one in five people, mostly women. These degenerative conditions, which can affect any tissue in the body or brain, happens when the immune system attacks and destroys body tissues as if they were foreign invaders. Here are some common autoimmune diseases:
- Hashimoto’s hypothyroidism
- Multiple sclerosis
- Rheumatoid arthritis
- Type 1 diabetes
- Celiac disease
The scary thing about autoimmunity is that it is often underway long before the tissue damage is advanced enough to be diagnosed as a “disease.”
In fact, untold numbers of people suffer years or decades from the symptoms of an autoimmune reaction before it progresses enough to be diagnosed as a disease. This is why so many patients show up at our office after years of confusion and frustration!
Fortunately, functional medicine shines in this arena. The information gleaned from specialized testing can validate people with symptoms who have long been dismissed or belittled by their doctors for “making things up.”
About Dr. Redd
Josh Redd, MS, DABFM, DAAIM, is a chiropractic physician and author of the Amazon bestselling book The Truth About Low Thyroid. Dr. Redd owns seven functional medicine clinics in the western United States and sees patients from across the country and around the world who are suffering from challenging autoimmune, endocrine and neurological disorders. Dr. Redd also teaches thousands of health care practitioners about functional medicine and immunology, thyroid health, neurology, lab testing, and more.