Healthy living is all the rage, we are bombarded with health messages on instagram and youtube, at home test kits for blood testing are available, and there are stool and DNA test kits that promise to tell you exactly what foods to eat, how to sleep and exercise.
What does all of it mean, what is just good marketing and what is actually legit, and where does Functional Medicine take a slightly different viewpoint on all of the above?
I will dive into all of these in detail below.
But first let’s take a look at what we are actually trying to achieve with all these healthy living efforts. Optimal health, wellbeing and ‘anti-ageing’. Big words, but what do they really mean?
What makes up health, and, on the contrary, ‘ageing’ and illness?
We will go into the fundamentals of biochemistry here, some of which you may remember from biology class at high school.
For most of us, we wish to live a long and fulfilled life, whether that is because we would like to see our grandchildren grow old, whether we feel we have a purpose on this planet we would like to yet achieve, or simply because we enjoy living.
In order to fully live, we would like to have mental capacity including memory and happiness, a balanced mood that allows us to be in charge of our reactions, emotions and cognitive performance to achieve our goals and dreams, at work or home. We’d like a strong body that allows us to do daily and joyful activities without injury or pain, to feel energetic, and to look radiant and youthful.
All this equates to quality of life for most.
At any given moment, our bodies work in perfect symphony.
Messenger chemicals such as hormones and neurotransmitters are produced and sent around the different body parts to communicate, pump blood, digest, breathe, smile.
Old cells die, new cells are being made. We constantly have small mutations, some weak or old cells. We stay healthy if the body’s capacity to keep up with them, get rid of what is old and sick, and produce strong new ones, is in balance.
Ageing, on the contrary, means that the body is unable to stay on top of housekeeping. Old, sick, mutated cells accumulate and overall function starts to deteriorate, potentially leading to what we commonly refer to as ‘ageing:
On a less dramatic level, suboptimal cellular functioning may showcase as
So what tips the scale?
Every cell in our body has tiny energy producing factories, called mitochondria. When mitochondria burn food for energy, they also create ‘smoke’, called free radicals. These free radicals, when excessive, can damage our cells and pathways, which is then called oxidative stress.
Wait, what, we create free radicals?
You may have heard of substances like environmental pollutants and sun rays, that cause free radical damage in our body. Free radicals are actually a normal occurrence, and are even important in small amounts to keep our body and immune system on their edge. However, if more get produced than can get dealt with through strategies like antioxidants, cellular damage and potentially mutations occur.
In order for our body and mind to function optimally, we want this damage to be as little as possible, and therefore the energy source to be of the highest quality – picture your car, it doesn’t run that well and long-term if you give it cheap vegetable oil rather than ‘good’ petrol. It won’t burn as ‘clean’, start clogging up, and eventually stop working.
Another lead players in ‘ageing’ are substances called ‘advanced glycation end products’, in short ‘AGEs’, which are sugar molecules attaching to protein. Our entire body is largely made up of protein, so this occurs throughout. It is much like when you put a steak on the grill and it goes brown, or if you leave metal in the rain, it rusts. That ‘browning’ or ‘rusting’ happens in our body whenever we are exposed to sugar molecules. This is obviously inevitable, as we do need some sugars, but it is about the balance between how much ‘AGEs’ we create in comparison to the body’s ability to get rid of them, whether we tip the scales towards ‘ageing’ or ‘thriving’.
Other factors include infections and overgrowth of pathogens in the gut, environmental pollutants and low grade inflammation that lead to damage to our cells.
If we don’t get enough of the right building blocks, our cells cannot do their jobs properly. Interim products may build up, and there can be excess or not enough of substances like hormones and neurotransmitter. A common example is too much omega 6 in comparison to omega 3s, which tips the body towards producing more inflammatory molecules, rather than anti-inflammatory ones.
That is where the Health trend is coming into play, with health coaches sprouting up on every corner telling you to eat more greens, DNA test kits that warn you about impending Alzheimer’s, and at home blood test kits to measure your cholesterol levels. This is all amazing news, as with increased awareness and demand, the focus is changing more towards a healthcare rather than sick care world. But with all that money flooding into this area, there are, as to be expected, companies capitalizing on it, selling DNA and stool test kits that claim to tell you exactly what to eat, how to sleep and exercise.
So let’s look into what is actually legit, and where a Functional Medicine approach might take a slightly different angle.
To be honest, roughly 90% of what we consider ‘healthy living advise’ is the same for all of us. We all need vitamins and minerals, and should as such be eating our whole foods. We all should sleep and move, and reduce our stress levels. Heavy metal exposure is not good for anymore, nor is too much junk food or smoking.
If a company tells you differently, it is most likely great marketing.
Ok, so what is the whole point of the testing and tracking and all the great tools out there you may ask? Despite it being true that the majority of health advise really is the same for every one of us, but thanks to all the great researchers out there, new technologies and foreward thinking people, we can now test for the small differences and nuances. What might be important for one, may be even more so important, or in larger amounts, for another person. A bad habit someone may be getting away with for life, might affect someone else much faster, and they may really be better off choosing a different ‘cheat’.
If you think of it in terms of the 80/20 rule, it is more about personalising what really should go into your 80% box, and what into the 20% ‘cheat box’. That is where Functional Medicine comes into play.
Functional Medicine aims to looks for and address the root underlying causes of illness and degenerative processes like ageing by considering gene-environment interactions and biochemistry of the individual, rather than to focus on the name of the disease.
In the functional medicine model, the word function aligns with the understanding that disease is an endpoint, and function is a process and a web-like interaction between the different biochemical pathways that make up life.
Functional Medicine can also be considered the ‘clinical backbone’ to biohacking, with Functional Medicine Practitioners being the first point of reference when it comes to the safe and clinical application of the newest dietary and biotech approaches, and they can help guide you through making the right choices by ordering the right labs and drawing conclusions for you according to the newest data out there.
Within Functional Medicine, the term ‘Health’ implies optimal health, performance, wellbeing and quality of life, rather than merely the absence of disease- which is
Functional Medicine looks at the actual labs and biochemical interactions of all the biohacking trends. It takes the guess work out of your health.
Epigenetics is the study of changes in gene expression that do not involve changes to the underlying DNA sequence — in geeky words, a change in phenotype without a change in genotype — which in turn affects how cells read the genes.
In easier to understand words, epigenetics are all the factors prior to birth and during life that can change which genes we turn on or off, which of all our many genes get to express. They act like ‘bookmarks’ to tell our cells which parts of the DNA to read and express. More concretely, you may have a genetic predisposition for a certain illness, but, unless it is part of the very few genetic illnesses that always express and which you usually know about from an early age on, your lifestyle choices determine whether that particular predisposition gets ‘turned on’ or will be ‘bypassed’. This is where the Functional Medicine way of looking at genetics comes into play, which is different than most of the ‘DNA Health and Exercise’ analyses that are currently out there, that still operate on the ‘old’ viewpoint of our health being set in stone, depending on what genes we have, or taking the ‘uber optimistic approach’ that claim that only you need to eat greens due to your genes, or that you have to supplement a certain expensive nutrient for the rest of your life.
Rather than looking at genes as destiny, Functional Medicine looks at epigenetics as an empowering tool to make targeted lifestyle choices to thrive, and potentially prevent or delay illness, while being aware that roughly 80-90% of health advise should be comprised of the basics that do apply to everyone.
Functional Medicine looks at where one person may be slightly more prone towards inflammation if they have an imbalanced omega 3 to 6 ratio, or whether one may be more prone to problems with vitamin D or B12 deficiencies than others, as such clogging up the important pathways in our body, and potentially leading to more significant problems down the line.
It can tell you whether you may be more prone to peeing out zinc and vitamin B6 when you are stressed. Zinc and B6 are important for your immune system, but also to produce your happy neurotransmitter serotonin, your sleep molecule melatonin, testosterone and much more. But should that person then supplement zinc and B6 for the rest of their lives? No.
That is where the next step of a Functional Medicine approach to optimal health comes into play. If we know that someone has a genetic predisposition towards low zinc levels, or Alzheimer’s disease, we can then test something called predictive biomarker. These are markers in the blood, urine and other specimens that apply to everyone and can be tested on a regular basis to see where on the spectrum of health or ageing and decline one is, before a problem has occurred.
Genetics can particular emphasis the importance of some of them, or add a few extra ones that should be looked at on a regular basis. In the above example, that would be zinc and vitamin B6 levels. If a person is indeed low at that point in time, they may benefit from temporarily supplementing. However, the more important approach is to adjust the basics accordingly- reduce stress to avoid the excessive ‘peeing out’, and adding in more foods that are high in zinc and B6 on a regular basis.
However, the person with a genetic predisposition towards low zinc may actually be entirely fine and may have intuitively chosen a higher zinc lifestyle. Supplementing would be a) a waste of money, and b) may have detrimental side effects (Side note: zinc can be toxic if supplemented in too high levels).
Another step Functional Medicine does to help you achieve optimal health, is that it uses slightly different reference ranges to standard medicine.
Normal reference ranges are created by taking an average of the population. However, that average includes all the people that may not be clinically ill ‘yet’, but have lots of niggly symptoms, and may develop a condition in a few years time. Would you not rather know that your levels are in the optimal zone, rather than ‘just ok’ and not in the ‘danger zone’ yet? That is why in Functional Medicine, some of us practitioners go that extra mile to place your test results into much narrower reference ranges, to show you exactly that: Are you maybe doing everything just perfect, and there really is no need to worry, despite your family history of Alzheimer’s or stroke? Or are there certain markers you can work on, so the worst case doesn’t have to happen.
Side note: Not all Functional Medicine Practitioners apply the stricter reference ranges, as it takes a lot of extra time and effort, and many do not have the time, in order to help as many people as possible. Please check with them. That is why we are creating a tool specifically for that, on The Functional Medicine App. Once it is ready, you will be able to input your test results, either individually yourself, or send us your test results and we will upload them for you. The webapp will then put them into the strict optimal vs suboptimal vs out of range references, where that is currently available and scientifically validated.
Another side note: We are in the process of setting up a practitioner platform on your webapp also, so if you are a practitioner wanting to offer this to your patients, or you are a patient and would like your practitioner to use the tool, please contact us for details.