Functional medicine addresses the underlying causes of disease, using a systems-oriented approach and engaging both patient and practitioner in a therapeutic partnership. ~ Mark Hyman, MD

Working with a Functional Medicine practitioner

The Functional Medicine practitioner assesses the patient’s overall status relating to modifiability lifestyle factors and fundamental clinical imbalances through careful history taking, physical examination, and laboratory testing. Multiple factors are taken into consideration, including:

Environmental inputs – The air you breathe and the water you drink, the particular diet you eat, the quality of the food available to you, your level of physical activity, and toxic exposures or traumas you have experienced all affect your health.

Mind-body connections – Psychological, spiritual, and social factors all can have a profound influence on your health. Considering these areas helps the Functional Medicine practitioner see your health in the context of you as a whole person, not just your physical symptoms.

Genetic makeup – Although individual genes may make you more susceptible to some diseases, your DNA is not an unchanging blueprint for your life. Emerging research shows that your genes may be influenced by everything in your environment ,as well as your experiences, attitudes, and beliefs. That means it is possible to change the way genes are activated and expressed.

Through assessment of these underlying causes and triggers of dysfunction, the Functional Medicine practitioner is able to understand how key processes are affected. These are the body’s processes that keep you alive. Some occur at the cellular level and involve how cells function, repair, and maintain themselves. These processes are related to larger functions, such as:

• how your body rids itself of toxins
• regulation of hormones and
• neurotransmitters
• immune system function
• inflammatory responses

All of these processes are influenced by environmental factors and your genetic make-up; when they are disturbed or imbalanced, they lead to symptoms, which can lead to disease if effective interventions are not applied.

A Comprehensive Approach to Treatment

Most imbalances in functionality can be addressed; some can be completely restored to optimum function, and others can be substantially improved.

Prevention is paramount. Virtually every complex, chronic disease is preceded by long-term disturbances in functionality that can be identified and effectively managed.

Changing how the systems function can have a major impact on the patient’s health. The Functional Medicine practitioner examines a wide array of available interventions and customizes a treatment plan including those with the most impact on underlying functionality.

Functional Medicine expands the clinician’s tool kit. Treatments may include combinations of drugs, botanical medicines, nutritional supplements, therapeutic diets, or detoxification programs. They may also include counseling on lifestyle, exercise, or stress-management techniques.

The patient becomes a partner. As a patient, you become an active partner with your Functional Medicine practitioner. Such a partnership allows you to be in charge of improving your own health and changing the outcome of disease.

One in five people suffer from depression at some point in their lives. It is more than just feeling upset – it can be an intense darkness that becomes so overwhelming that it interferes with everyday life. Although some depressive episodes may be milder than others with recovery being common, sometimes it may return, known as a relapse. Often it is possible to identify an obvious reason for becoming depressed, but at other times it may not be so clear-cut. You may not realise how depressed you are because the onset has been gradual, and you may try to hang on and cope by keeping busy. This can have the effect of making you even more stressed and exhausted. Physical pains such as constant headaches or sleeplessness may appear, and these physical symptoms can be the first sign of depression. Treatment often involves talking therapy such as Cognitive Behavioural Therapy (CBT) and/or antidepressants.

Society's favourite drugs are alcohol and tobacco, which are widely available and frequently misused. Many other drugs are also addictive, of which some are legal and others illegal. Even medicines such as painkillers and certain drugs for sleep problems can be addictive, particularly if they are not used in the prescribed manner. Young people may take drugs out of curiosity, peer pressure, or as a way to cope with difficult situations or feelings. Others may 'resort to drugs' as an escape from the daily toils of life, to overcome shyness or to give them the drive to keep going. Although at first you may seem to be in control of your drug use, over time it could be that the drug is controlling you. In the long term, this may lead to mental health problems like depression, memory impairment and even psychosis, in addition to social, occupational and familial conflict. Treatment often involves looking at whether change is possible and how to go about it. The goal of treatment ranges from controlling consumption and harm reduction, to detox and giving up drinking or drugs completely.

The most common form of psychosis is schizophrenia, which is a condition that affects thinking, feelings and behaviour. It is most likely to start between the ages of 15 to 35 and will affect about 1 in every 100 people during their lifetime. Genetic factors, brain damage at an early age and psychotropic ‘street’ drugs can often trigger the first episode. Stress and family tension may make it worse or lead to a recurrence. Sufferers may report abnormal experiences such as hearing voices that do not exist or believing something that is out of context with such conviction that they lose touch with reality. Sometimes they may appear apathetic, uninterested in their usual activities, neglect personal hygiene, feel uncomfortable around others and become socially withdrawn. The earlier it is detected, the sooner that treatment can be commenced and the better the outlook for recovery.

With advances in medicine and technology, people are living longer and many look forward to enjoying life after retirement, spending time with their families, and taking up new hobbies. But for others, increasing age may bring problems that can impair their enjoyment of life. There is a transition to perhaps being unemployed, having less disposable income, the potential of health problems and enduring the death of a partner or friends. Most older people cope well in spite of these difficulties, but depression can affect one in five seniors living in the community. Depression, worry and anxiety in the elderly may sometimes present as confusion, also known as pseudo-dementia.

Problems in childhood are often multi-factorial and the way in which they are expressed may be influenced by a range of variables including developmental stage, temperament, coping and adaptive abilities within the family, and the nature and the duration of stress. In stressful situations, young children tend to react with impaired physiological functions such as feeding and sleeping disturbances. Older children may exhibit relationship disturbances with friends and family, poor school performance, behavioural regression to an earlier developmental stage, and development of specific psychological disorders such as phobia or psychosomatic illness.

In our busy schedules, we often neglect the importance of a good night's sleep. An occasional night of tossing and turning will not harm you, but if this pattern continues for weeks or months it can affect your health. Inadequate and disrupted sleep leads to a greater likelihood of high blood pressure, diabetes and a tendency towards weight gain. There are many reasons for tiredness and poor sleep: some may be physical (being under- or overweight, exercising too much or too little, suffering from medical illnesses such as sleep apnoea, hormonal imbalance or other chronic ailments); some psychological (daily worries, depression, emotionally taxing or stressful life events, unhealthy sleep habits); or a variety of causal factors, like shift work, parenthood, or a noisy environment. It may sometimes be useful to undergo a sleep study to rule out other causes of insomnia.

Our brain makes up about 5% of our body mass, and it consumes 20% of the energy we use every day, making it one of the most active organs in our body. Certain amino acids, minerals, vitamins, cholesterol, and, in particular, long chain omega-3 fatty acids in the form of EPA and DHA are vital to the structure and function of the brain. How we eat affects the way our brains function, as evidence is mounting that some foods we eat can cause chronic inflammation of the brain, which may be the common pathway to many mental health illnesses, such as depression, anxiety and poor mental function.

Our brains have evolved to use the raw materials absorbed from our gut to function properly. And living in our gut are over 100 trillion bacteria from nearly 1000 different species that make up 90% of the cells of our body, known as the gut microbiome, that not only help us digest food, but also regulate our hormonal, immunal and nervous systems. Certain foods may cause inflammation in our gut, resulting in a "leaky gut" that reduces our body's defence to combat the buildup of toxins, leading to more inflammation. Choosing your foods carefully can help you calm down that inflammation and ensure your brain is able to function at its best.

Despite our busy lives, it should not be difficult to make better food choices if we know the basic rules on how to plan our meals. Obtaining our vitamins and minerals from minimally-processed, nutrient-dense food is the best way to ensure our brains are fuelled optimally. These nutrients work with each other intricately, so eating whole foods mean we are getting the right balance of nutrients as nature intended, rather than supplementing with a specific vitamin or mineral unless you have a known deficiency. For those with particular health issues, getting a thorough evaluation and advice on dietary intake can improve not just your brain health, but your overall well-being too.

As society develops an ever-increasing awareness of nutrition and health, a broad variety of dietary patterns have emerged. Although some of these are beneficial to our general health, others have been driven in part by an intense fear of gaining weight. Such nutritional habits may cause extensive damage to our physical and mental health and are often categorised as eating disorders. The two most prevalent disorders are Anorexia Nervosa and Bulimia Nervosa, which are up to 10 times more common in women than in men. If concern exists regarding eating behavior, it would be prudent to get a physical health check, as eating disorders can often lead to physical problems, and some physical illnesses can mimic anorexia. With treatment, about half of those affected will recover, but the process can be long, frustrating and traumatic for them and for their friends and family.

Bereavement is our experience of grief when someone we care about has died. It encompasses a range of different emotions, from feeling numb, agitated, angry or guilty before gradually moving onto sadness, reflection, and finally resolution and being whole again. We most often grieve for someone that we have known for some time. However many of the same emotions will be encountered when experiencing loss of another kind, such as the end of a relationship, a miscarriage, or even giving up a part of yourself that defined you. For those who find it hard to come to terms with such loss, it often helps to talk with others who have been through similar experiences, or to a professional therapist.

Hong Kong is a city that continues to attract expatriates due to employment and business opportunities and a favourable lifestyle. Sometimes however, the process of settling into a foreign environment can create challenges that are difficult to overcome. Adjusting to a new home, language and culture and having to assimilate with new colleagues and into an unfamiliar social setting can result in anxiety, loneliness and depression. These feelings may be compounded by pressure in the workplace and concerns over relocating a family, to the point that physical and mental well-being is affected. In such cases, therapy may help to enhance resilience and develop more adaptive coping strategies.