Rooting out the Causes of Chronic Conditions

A year ago, a patient with ulcerative colitis visited Mark Hyman, MD, at The UltraWellness Center in Lenox, Massachusetts. The patient had been hospitalized a dozen times, was on a TNF-alpha inhibitor and had low productivity and function. Applying the principles of functional medicine, Dr. Hyman restored the patient’s quality of life: She is off medication and has not returned to the hospital.

A patient-centered model of care, functional medicine addresses the root causes of disease using a systems-oriented approach. It considers the unique genetic makeup of individuals as well as lifestyle choices and environmental influences, such as exposures to toxins. “Functional medicine attempts to understand the body’s core physiological systems, then optimize, enhance, balance and restore normal function to those systems,” says Dr. Hyman. “The body is a complex, adaptive system, and medical practice needs to address disease through the lens of systems thinking and our biological networks. It is medicine not by organ, but by organism. It is medicine by cause, not by symptom.”

In 2014, Cleveland Clinic became the first major healthcare organization to establish an independent functional medicine facility. Dr. Hyman serves as Director of Cleveland Clinic’s Center for Functional Medicine, a center created in collaboration with the Institute for Functional Medicine where Dr. Hyman serves as Chairman. At the center, a team of seven practitioners treats patients with a host of chronic conditions, including autoimmune diseases, cardiometabolic conditions, digestive disorders, neurological conditions, mood disorders, skin disorders, hormonal problems and more.

A paradigm shift

Cleveland Clinic’s Center for Functional Medicine provides clinical care as well as participates in research, education and training. The goal is to shift the paradigm from a conventional disease-centered focus of medical practice to a patient centered, systems-based healthcare approach. Functional medicine is a science-based biomedical approach that brings emerging strategies for chronic disease into clinical care, including:

• An emphasis on food as medicine, nutrition, diet, exercise and mind-body medicine
• Leading-edge laboratory testing and diagnostic tools
• Prescribed combinations of drugs, botanical medicines, supplements, detoxification programs and/or stress management techniques

Using science, clinical wisdom and innovative tools to identify underlying causes of chronic conditions, healthcare professionals at Cleveland Clinic’s Center for Functional Medicine hope to remedy the dysfunctions both before and after disease presents itself. That mission is critical considering that more than half of all Americans suffer from one or more chronic diseases and that over 75 percent of our healthcare expenditures are for chronic diseases that can be both prevented and treated with lifestyle choices.

Personalized care plans

Functional medicine centers on treating the patient, from genetic and biochemical as well as psychosocial perspectives rather than the disease. “If you have head pain, we call it migraine. If you have stomach pain, we call it reflux. But those are simply names we give to conditions shared by a group of people,” says Dr. Hyman. “Migraine isn’t the cause of the pain — it is the name of the type of pain. The causes might be multiple and different, and thus the treatments should be different depending on the causes.”

For instance, autoimmune disease can have multiple causes. It may be triggered by gluten creating increased intestinal permeability or leaky gut. It may be from an altered microbiome triggering an inflammatory response, or from environmental immunotoxins or autogens. Rather than treating the patient with an anti-inflammatory drug, functional medicine practitioners begin by asking why the immune system is irritated and treat the root causes while restoring a normal gut ecosystem and healing the leaky gut with probiotics, nutrients and more.

Digging deeper down

“The key is figuring out the root causes,” says Dr. Hyman. “Functional medicine is the map — the GPS system — that we use to navigate the landscape of chronic disease.” Practitioners at Cleveland Clinic’s Center for Functional Medicine obtain each patient’s complete story, address lifestyle choices, organize the patient’s clinical imbalances and personalize therapeutic options.

“We are allies in helping primary care physicians optimize their patients’ health, getting at the root causes of illness and providing you back patients who are self-empowered and can practice self-care,” says Dr. Hyman. “We invite the institutes and the Cleveland healthcare community to refer their most challenging and chronic cases so that together we can create health.”