NEEDED: A Coherent Architecture for 21st Century Clinical Practice
and Medical Education - David S. Jones, MD


We need to build a new foundation for 21st century medicine. The architecture for 20th century organ-system medicine was not designed to accommodate both the robustness of traditional medical principles and wisdom and the riches that have poured from the biomolecular sciences in the last half century.

The Science of Meditation

 

Functional Medicine doctor meditating.

“Mindfulness is about being fully awake in our lives. It is about perceiving the exquisite vividness of each moment. We also gain immediate access to our own powerful inner resources for insight, transformation, and healing.” – Jon Kabat-Zinn, PhD

Kara Fitzgerald, ND, Explains the Uses of IgG and Celiac Testing in Patients

 

Kara Fitzgerald, ND, talks about the role of IgG and Celiac testing in patients who present with IBS. While some patients choose to do an elimination diet rather than an IgG test, most patients find the tests motivating and helpful in clarifying the causes of their IBS.

Introduction to Functional Medicine

 

Of total healthcare costs in the United States, more than 75% is due to chronic conditions. In 2008, the U.S. spent 16.2% of its GDP ($2.3 trillion) on health care. This exceeded the combined federal expenditures for national defense, homeland security, education, and welfare. By 2023, if we don’t change how we confront this challenge, annual healthcare costs in the U.S. will rise to over $4 trillion, the equivalent—in a single year—of four Iraq wars, making the cost of care using the current model economically unsustainable.

A visit to a Functional Medicine Doctor – a patient perspective

 

A few years ago, Louis Messina was in pain. Despite being on a variety of big-gun drugs to control his psoriatic arthritis, an autoimmune disease that attacks the joints, he still suffered from constant pain and swelling throughout his body. He walked with a limp because his left knee had arthritis-induced tissue damage; the big-toe joint on his right foot was similarly destroyed; and in the mornings, he would awake to find his hands balled up into fists. (They would unclench only after he submerged them in warm water for several minutes.)

Intestinal Permeability & Associated Diseases

Approximately 95% of the symbiotic microbes in the human body are in the gut. In a homeostatic state, this highly diverse population of microbiota promotes overall health. However, if the gut reaches a state of dysbiosis, a variety of diseases ranging from type 2 diabetes to inflammatory bowel disease may develop. More recently, intestinal microbial dysbiosis has been associated with several brain pathologies, including Alzheimer’s disease, Parkinson’s disease, and amyotrophic lateral sclerosis, suggesting a direct or indirect communication between intestinal bacteria and the central nervous system.

How Stress Changes Gut Function

Over the past few decades, researchers have worked to unravel the delicate connections between the human gastrointestinal microbiota and the brain, and there has been a growing emphasis on the way that psychological stress affects gastrointestinal function. Studies suggest that stress-mediated changes, like changes in the level of catecholamines including norepinephrine, may shift the microbial colonization patterns on the mucosal surface of the intestine and alter one’s susceptibility to infection. Changes in this environment may lead to a spectrum of other physiological changes, including hypothalamic-pituitary-adrenal (HPA) axis activation and altered autonomic nervous system (ANS) responses.

Stress, Bile Acids, and IBS Symptoms

Research is still uncovering the causes of and triggers for irritable bowel syndrome (IBS), many of which are lifestyle-related. In the past two years, increasing evidence has been found relating structural and biochemical factors to IBS development. Australian researchers note that low-grade mucosal inflammation, altered intestinal permeability, and altered bile salt metabolism (in diarrhea-dominant IBS) can be factors, as well as abnormal metabolism.

Understanding Lead Toxicity

A 2018 study published in The Lancet Public Health suggests that of the 2.3 million deaths every year in the US, about 400,000 are attributable to lead exposure, of which 250,000 are from cardiovascular disease. This estimate is about 10x larger than previous approximations; the Global Burden of Disease study estimated that 558,000 deaths were attributed to lead in 2015. Lead is one of many recognized risk factors for cardiovascular disease, and Lanphear et al were the first to test whether the relation with cardiovascular disease mortality was evident in a population with concentrations of lead in blood below 5 ?g/dL.

Gut Dysbiosis and Stress

 

Exploration of the brain-gut connection has led to a fundamental shift from thinking of stress as exteroceptive to understanding it is essentially grown from the inside out.1 The microbiome and microbiota are now understood to be the conductors linking brain with gut, impacting the enteric nervous, autonomic, and other systems.

Is AFMCP Online Right for Me? Take Our Quiz to Find Out!

Applying Functional Medicine in Clinical Practice (AFMCP) Online provides the same education and learning objectives as AFMCP in person. Everyone, however, will gravitate toward certain learning environments. Take this quiz to find out if AFMCP Online is right for you.

Free Download: Functional Medicine Timeline, a History-Taking Tool

History-taking is part of every clinician’s best practice, but its importance in facilitating patient compliance is sometimes overlooked. While most can agree that the patient perspective is a critical component of good medicine, research suggests patients will be more engaged in treatment plans when history-taking is patient-centered and not merely focused on patient-reported outcomes.

Toxin Exposures at Home

In August 2018, a provocative study published in Environmental Research suggested that hair products commonly used by African American women and children may contain multiple chemicals associated with endocrine disruption and asthma. A team of researchers used gas chromatography/mass spectrometry to test 18 hair products, including hot oil treatment, anti-frizz polish, leave-in conditioner, root stimulator, hair lotion, and relaxer. The products tested contained 45 endocrine-disrupting or asthma-associated chemicals, including cyclosiloxanes, parabens, and the fragrance marker diethyl phthalate (DEP).

Functional Medicine Tools Improve Patient Compliance

If you are frequently frustrated by patients who don’t stick with prescribed treatments, you’re not alone. Two important strategies for managing chronic disease are adherence to treatment and sustained, health-related lifestyle changes; however, research suggests that approximately 50% of patients with chronic conditions do not adhere to treatment, including dietary changes, physical activity, blood monitoring, and medication

Alternatives to Opioid Therapy for Chronic Pain

Nearly 1 in 10 American adults experience chronic pain; that’s more than 25 million adults reporting pain every day for three months. In this population, primary causes of pain include: severe headache or migraine and problems of the lower back, neck, knees, shoulders, fingers, and hips. Worldwide, in 2015, more than 1.5 billion people suffered from chronic pain, and approximately 3–4.5% of the global population suffered from neuropathic pain.

The Importance of Digestion in Chronic Disease

The gastrointestinal tract plays a central role in chronic, systemic disease, and in Functional Medicine, it can be an important starting point in improving overall health. A complex living system, the intestine protects the body from external influences, based on three constituents that are in permanent contact and dialogue with each other: the microflora, mucosal barrier, and immune system. Dysfunction in this system can wreak havoc throughout the body, and has been linked to allergies, arthritis, autoimmune disease, chronic fatigue and more.

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Articles & Interviews

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The Institute for Functional Medicine Names Patrick Hanaway, MD, As The 2017 Linus Pauling Award Recipient

LOS ANGELES, June 5, 2017 /PRNewswire-USNewswire/ -- On the final day of The Institute for Functional Medicine's 2017 Annual International Conference, held June 1-3, 2017, in Los Angeles, CA, IFM recognizes Patrick Hanaway, MD, as the honored recipient of the Linus Pauling Award. Dr. Hanaway receives this award for his innovation in medical education and pioneering work in clinical outcomes research.

Jeffrey Bland, phd, and Patrick Hanaway, md: Taking the Omics Revolution to the Street

Patrick Hanaway, md, is chief medical education officer for The Institute for Functional Medicine (IFM) Medicine and its 2015 conference, which will be held May 28–30, 2015, in Austin, Texas. Dr Hanaway is a board-certified family physician with his medical degree from Washington University and residency training at the University of New Mexico.

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Branched-Chain Amino Acids and Workouts:

By Robert Silverman, DC, DACBN, DCBCN, MS, CCN, CNS, CSCS, CIISN, CKTP, CES, HKC, FAKTR

Branched-chain amino acids are often recommended as a supplement for building muscles, helping you exercise harder and longer, and aiding recovery from training. They’re a powerful tool for athletes and bodybuilders—and anyone who wants to have more effective workouts.

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The Latest Research on Vitamin C

By Deanna Minich

 

Vitamin C is no stranger to the spotlight when it comes to powerful nutrients. When you get a cold, you might turn to vitamin C to give your immune system a boost, or you might supplement with it to help combat oxidative stress.  

Many of vitamin C’s functions are well studied and can be found in any nutritional textbook and articles out in the blogosphere.

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Having Trouble Sleeping? Can't Stay Asleep? These 10 MD-Approved Tips Are Actually Proven To Work

By Ellen Vora, M.D.

 

So you can't sleep? You're in good company (read: nearly everyone these days), but it's still a lousy problem. Chronic sleep deprivation can make you depressed, anxious, prone to getting sick, at higher risk for cancer, and it makes you more likely to gain weight and develop diabetes and dementia.

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Adding Fiber to a Ketogenic Diet

When following a ketogenic diet, it is not uncommon for people to neglect eating quality sources of fiber in an effort to avoid any carbohydrate intake. There is a chance this can lead to constipation, poor digestion, and a lack of certain vitamins and minerals.