There is a wide range of Functional Medicine practitioners. For some it evolved from their Naturopathic Medicine training. Others, including MDs, DOs, NPs, DCs, and LAcs, have done anywhere from a weekend course to the very well known IFM (Institute Functional Medicine) certification program (six 3-day weekend classes plus written case studies). I went with the Kalish Institute of Functional Medicine because it focuses on:
* Clinical application vs medical theory,
* Patient based case study vs research study based learning,
* Specific clinically based product recommendations and treatment protocols vs. research based study and application of supplements,
* Live weekly case-based online grand rounds with a teacher vs. large conference settings for 6 extended weekends.
Another thing I liked about the Kalish program is that it really focuses on a few key functional medical labs out of the hundreds of labs that are available. By learning how to use these few labs really well, it’s easier to get a clearer, deeper clinical impression of the patient vs. getting overwhelmed with too much information from the wide variety of labs that are out there.
These labs include:
Hormone labs focusing on the HPA Axis, including the DUTCH Test, Genova Adrenal Stress Profile, and HUMAP. Using info from these labs, I’ve learned some really amazing protocols using low-dose bio-identical hormone drops along with herbal therapies that address specific enzyme dysfunction to treat hormone imbalances. This helps to simulate a more normal functioning endocrine system and induces the brain and body to behave in a normal manner that continues on its own after the treatments are discontinued at 6 months or so.
Another hormone lab I use is the Genova Rhythm, which measures estrogen & progesterone levels at different times during the menstrual cycle. This lab is not used that frequently by other practitioners, but can be very helpful for identifying and treating various menstrual cycle related disorders, including migraines, bleeding, infertility, and digestive problems.
Digestive stool labs – these range from PCR based labs that look for pieces of DNA of various friendly, unfriendly, pathogenic, and parasitic ‘bugs’ that make up our microbiome, to direct microscopic identification of parasites and bacteria. Most functional medicine providers use these labs as part of their patient assessment. These days we use the GI Map, a well designed, reasonably priced PCR based lab.
If needed, we can take it one step further with another lab that is not as well known, parawellnessresearch.com, run by a Vietnam veteran pathologist who has seen everything under the sun, and often finds parasites that other labs miss.
In terms of treating gut issues, one of the strengths of our approach that we first address the long term effects of stress on the body’s energy by running the hormone labs outlined above and treating deficiencies. This increases the body’s energy, making it stronger and more able to take on pathogenic bacteria and parasites in the gut, and restore a healthy microbiome and immune system.
Organic acids tests – these are complicated labs that measure key organic acids involved in important biochemical reactions. Initially developed in the 1950s to assess amino acid processing viability in infants, they are now used with adults to assess overall biochemical functionality, genetic snips that can affect enzyme efficiency, and nutritional status. These include markers for:
* Glucose processing (glycolysis),
* Fat processing (beta-oxidation),
* Kreb’s cycle (the 8 intermediaries of the TCA cycle),
* Inflammation and oxidation,
* Neurotransmitter & brain function (including dopamine, serotonin, and catecholamine status),
* Detoxification pathways (including glutathione status), and
* Compounds of bacterial or yeast origin.
Organic acids are complex, and new interpretations are still being developed. My teacher, Dan Kalish, DC, has 30+ years of practice experience and continues to study with Richard Lord, PhD, the original developer of the Genova Organix Profile.
Over the last 30 years, Dr. Kalish has studied and practiced with many of the pioneers in the field of functional medicine, developing lab interpretation and effective dietary, lifestyle, and supplement protocols that have evolved from years of trial and error. As a result, I’ve learned a highly refined and effective system of Functional Medicine that I get to share with you!
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