Functional medicine

Functional medicine is a form of alternative medicine^[1] which proponents say focuses on interactions between the environment and the gastrointestinal, endocrine, and immune systems.^[2] Practitioners attempt to develop individual treatment plans for people they treat.^[2] Functional medicine encompasses a number of unproven and disproven methods and treatments,^[3][4] and has been criticized for being pseudoscientific.^[5]

Description

The discipline of functional medicine is vaguely defined by its proponents.^[5] Oncologist David Gorski has written that the vagueness is a deliberate tactic which facilitates the discipline's promotion, but that in general it centers on unnecessary and expensive testing procedures performed in the name of "holistic" health care.^[5]

Proponents of functional medicine take a stance opposed to mainstream medicine and reject its models, instead adopting a model of disease based on the notion of "antecedents", "triggers", and "mediators".^[6] These are meant to correspond to the underlying causes, the immediate causes, and the particular characteristics of a person's illness respectively.^[6] A functional medicine practitioner will devise a "matrix" from these things which acts as a basis for treatment.^[6]

Treatments will generally be those not supported by good medical evidence.^[3] These include

• Orthomolecular medicine ^[7]
• Detoxification of undocumented toxins.^[8]
• "Biochemical Individuality" (i.e. the notion that the nutritional needs, chemical constitution and disease states are unique for every individual;^[9] this represents a revival of the mainstream medical conception of disease common before the development of germ theory^[10])
• Organ reserve
• Diagnosis of chronic occult infections (e.g. so-called chronic Lyme disease)^[11]
• Homeopathy, including "Biopuncture", the injection of homeopathic remedies^[12]
• Scientifically unproven nutritional interventions, including avoidance of gluten for people who do not have celiac disease or non-celiac gluten sensitivity^{[13][14][15][16]}
• Antivaccine advocacy^[5] including promotion of the discredited link between MMR vaccine and autism^[17] (the retracted Lancet paper by Wakefield et al.^[18] is cited in The Textbook of Functional Medicine)^[19]
• Leaky gut syndrome^[20][21][22]

Institute for Functional Medicine

Institute for Functional Medicine

Founded	1991
Founder	Jeffrey Bland, PhD
Focus	"To serve the highest expression of individual health through the widespread adoption of functional medicine as the standard of care."[23]
Method	Education, Research, Collaboration
Key people	Mark Hyman, MD, Chairman
Website	functionalmedicine.org

Functional medicine was invented by nutritionist Jeffrey Bland.^[24] He and Susan Bland founded the Institute for Functional Medicine in 1991 as a division of HealthComm.^[25][26] That year, the U.S. Federal Trade Commission said that Jeffrey Bland's corporations HealthComm and Nu-Day Enterprises had falsely advanced claims that their products could alter metabolism and induce weight loss.^[25] The FTC found that Bland and his companies violated that consent order in 1995 by making more exaggerated claims. The UltraClear dietary program was said to provide relief from gastrointestinal problems, inflammatory and immunologic problems, fatigue, food allergies, mercury exposure, kidney disorders, and rheumatoid arthritis. The companies were forced to pay a $45,000 civil penalty.^[25]

The opening of centers for functional medicine at the Cleveland Clinic Foundation and at George Washington University has been described by Gorski as an "unfortunate" example of pseudoscientific quackery infiltrating medical academia.^[5]

References

1. Pal, SK (March 2002). "Complementary and alternative medicine: An overview" (PDF). Current Science 82 (5): 518–24.
2. Ehrlich, G; Callender, T; Gaster, B (May 2013). "Integrative medicine at academic health centers: A survey of clinicians’ educational backgrounds and practices" (PDF). Family Medicine 45 (5): 330–4. PMID 23681684. Retrieved October 8, 2013.
3. Sampson, Wallace (October 30, 2008). "Functional Medicine – New Kid on the Block". Science-based Medicine.
4. Sampson, Wallace (July 9, 2009). "Functional Medicine (FM) What Is It?". Science Based Medicine. Retrieved May 20, 2014.
5. Gorski, D (September 29, 2014). "Quackademia update: The Cleveland Clinic, George Washington University, and the continued infiltration of quackery into medical academia". Science–Based Medicine. Retrieved November 2014.
6. Knott L (6 February 2015). "Therapies and Theories Outside Traditional Medicine". Patient. Retrieved 11 December 2015.
7. "Nutritional Medicine/Orthomolecular Medicine". www.centerforfunctionalmed.com. Center for Functional Medicine.
8. "Detoxification/ Heavy Metals". www.centerforfunctionalmed.com. Center for Functional Medicine.
9. Jonas, Wayne (2005). Mosby's Dictionary of Complementary and Alternative Medicine. ISBN 0323025161.
10. Carter, K. Codell; Carter, Barbara (2005). Childbed Fever. A Scientific Biography of Ignaz Semmelweis. Transaction Publishers. ISBN 9781412804677.
11. Hyman, Mark (n.d.), "Systems biology, toxins, obesity, and functional medicine" (PDF), 13th International Symposium of the Institute for Functional Medicine, retrieved November 10, 2014.
12. Prescott, David (June 2007). "Lessons from the California practice rights litigation". Chiropractic Journal 21 (9): 11, 41.
13. Gaesser, G; Angadi, S (September 2012). "Gluten-free diet: Imprudent dietary advice for the general population?". Journal of the Academy of Nutrition and Dietetics 112 (9): 1330–3. doi:10.1016/j.jand.2012.06.009. PMID 22939437. Retrieved October 18, 2014.
14. Marcason, W (November 2011). "Is there evidence to support the claim that a gluten-free diet should be used for weight loss?". Journal of the American Dietetic Association 111 (11): 1786. doi:10.1016/j.jada.2011.09.030. PMID 22027062.
15. Richard (December 9, 2013). "Gluten summit recap". sanjosefuncmed.com. San Jose Functional Medicine. Retrieved November 10, 2014.
16. "Could an undetected gluten sensitivity be contributing to your symptoms?". www.atlantafunctionalmedicine.com. Atlanta Functional Medicine. July 18, 2014. Retrieved November 10, 2014.
17. Taylor, LE; Swerdfeger, AL; Eslick, GD (June 2014). "Vaccines are not associated with autism: An evidence-based meta-analysis of case-control and cohort studies". Vaccine 32 (29): 3623–9. doi:10.1016/j.vaccine.2014.04.085. PMID 24814559.
18. The Editors Of The Lancet (February 2010). "Retraction – Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children". The Lancet 375 (9713): 445. doi:10.1016/S0140-6736(10)60175-4. PMID 20137807.
19. Baker, Sidney MacDonald; Bennet, Peter; Bland, Jeffrey; Galland, Leo; et al. (2010). Textbook of Functional Medicine. Institute for Functional Medicine. ISBN 9780977371372.
20. "Unlocking the connection between intestinal permeability and autoimmune disease" (PDF). Institute for Functional Medicine. 2013. Retrieved November 10, 2014.
21. Grisanti, Ronald (n.d.). "Leaky gut: Can this be destroying your life?". Functional Medicine University. Sequoia Education Systems. Retrieved November 10, 2014.
22. "Leaky gut syndrome". NHS Choices. April 9, 2013. Retrieved November 10, 2014.
23. "Our Mission". December 2014.
24. Leyton E (2006). "Functional medicine". Can Fam Physician 52 (12): 1540. PMC: 1783750. PMID 17279230.
25. Barrett, Stephen (September 11, 2013). "Some Notes on Jeffrey Bland and Metagenics". Quackwatch. Retrieved June 2014.
26. "Founders". www.functionalmedicine.org. Institute for Functional Medicine. n.d. Retrieved November 10, 2014.

Further reading

• Merrell, Woodson C. (July–August 2006). "The Textbook of Functional Medicine". Alternative Therapies in Health and Medicine (Book review) 12 (4): 72.
• McManus, Joanne (29 November 2001). "Functional medicine". Far Eastern Economic Review (Brief news story) 164 (47). p. 46.
• Gorski, David (14 April 2014). "Bill and Hillary Clinton go woo with Dr. Mark Hyman and 'functional medicine'". Science-Based Medicine.