Many of my patients use functional or integrative medicine. In most cases, they have tried this prior to Chinese medicine. In some cases, they are either using it at the same time or considering adding it to their health care regimen. It may seem that these systems share a similar outlook and are compatible or synergistic. While this can sometimes be true, often the therapeutic approaches differ and when simultaneously applied can pull the body in different directions.
Classical Chinese medicine is based on evaluating the body’s physiology, and administering treatment to make corrections when there is imbalance. There is consideration to the weather, stress and negative emotions, diet, lifestyle, injury, and overall makeup. In a practical sense, the therapies of Chinese medicine (acupuncture, herbs, dietary changes) are focused on restoring balance to the body so that pain and illness will not be present.
Functional medicine conceptually shares this basic outlook. However, the premise of functional medicine is physiological imbalances that are identified through alternative lab testing. As a profession, functional medicine positions itself as advanced biochemical medicine. The lab tests are utilized to evaluate and quantify system dysfunction, with the resultant therapy being primarily nutritional supplementation, herbal medicine, and dietary restrictions. The outlook is fundamentally one of lack; i.e., lacking vitamins, minerals, and enzymes necessary for optimal biological functioning. While this idea is not necessarily in conflict with Chinese medicine, the implications differ.
Functional medicine is based on an assumption that the labs, the tests, the test results, and the subsequent corrective therapies are all tested, proven, valid, and consistent. There is a reason these lab tests are not utilized in conventional Western medicine, and that reason is that they have not been carefully validated. Chinese pulse diagnosis is 2,500 years old. Conventional lab testing is 100 years old. Functional medicine testing is 20 years old. While new science, understanding and technologies continually develop, functional medicine testing is still very new and with significant flaws in methodology and application. That being said, there are labs and tests that have high standards and produce useful, clinically validated tests. One difficulty though is that with the spread of functional medicine, individuals and companies are contracting and relabeling tests as their own. There can be benefits to this, as a provider may organize the tests they most frequently use into one panel. The potential negative side is that it becomes very difficult for an individual to know which lab it is that is actually producing and running the tests. The accuracy and results of a given test can vary greatly from one lab to another.
Test results from functional medicine labs often produce generalized and similar results for many patients. One of the most common diagnoses is gut dysbiosis / microbiome dysfunction. Chinese medicine typically agrees with the overall perspective, that gut and digestive function are critical to good health. Chinese medicine, however, individualizes the diagnosis and treatment, including acupuncture, herbal medicine and dietary suggestions. Functional medicine tests, on the other hand, often funnel treatment to a handful of standardized treatment protocols, generally including probiotics and some sort of anti-organism supplement. These supplements often contain herbal medicine, and sometimes are marketed as being based on Chinese medicine due to their individual components. From the point of view of Chinese medicine however, these supplements are often cold, bitter, and cause damage to the Spleen and Stomach. That is to say, they injure exactly the organ systems they are designed to benefit. This is a problem that arises from lack of a more comprehensive view of organ function and health, and also from lack of millennia of clinical validation that only comes from experience.
Functional medicine tests are costly. The information gained from them can most often be obtained through simple history taking, examination, and application of Chinese medical principles. The results of a digestive panel may look complex and impressive, in naming for example various pathogenic organisms that need to be treated. The resultant therapies, however, do not actually focus on organism specific treatment; they are general therapies aimed at restoring normal gut function. This is not inherently negative; but the approach of trying to kill organisms by using cold, bitter substances is not alternative or holistic medicine. It is exactly the same idea that conventional Western medicine uses with antibiotics. In situations where this is necessary, medication is often better tolerated and more effective than prolonged herbal therapies that aim to produce the same effect but are less efficient in action.
Digestive tract imbalances are not the only focus of functional medicine. It is not my argument that all functional medicine is bad or wrong or ineffective. It is a very different system and approach than Chinese medicine, and is actually closer to conventional treatment. There are many good labs, useful tests, and skilled doctors who can apply functional medicine in a therapeutically beneficial manner. It is my opinion that this comes from having a larger perspective that forms the basis for using functional medicine as one part of a larger and more holistic approach. It’s my experience that this perspective is relatively rare among functional medicine practitioners, and does not describe the average functional medicine doctor. To be fair, the same can be said of Chinese medicine or any other doctor or system. The safety and efficacy is dependent upon the person applying it.