Functional medicine is a form of medicine that encompasses a number of methods and treatments. Its proponents claim that it focuses on the "root causes" of diseases based on interactions between the environment and the gastrointestinal, endocrine, and immune systems to develop individualized treatment plans.[1] Some have described it as pseudoscience,[2] while others within the medical established have acknowledged that it can offer meaningful and clinically documented support to patients.[3]
Functional medicine was created by Jeffrey Bland,[4] who founded The Institute for Functional Medicine (IFM) in the early 1990s as part of one of his companies, HealthComm.[5] IFM, which promotes functional medicine, became a registered non-profit in 2001.[6] Later, Mark Hyman became a leading proponent.[4]
Description
Proponents of functional medicine oppose established medical knowledge and reject its models, instead adopting a model of disease based on the notion of "antecedents", "triggers", and "mediators".[7] These are meant to correspond to the underlying causes of health issues, the immediate causes, and the particular characteristics of a person's illness.[7] A functional medicine practitioner devises a "matrix" from these factors to serve as the basis for treatment.[7]
Treatments, practices, and concepts are generally not supported by medical evidence.[8]
Functional medicine practitioners claim to diagnose and treat conditions that have been found by research studies to not exist, such as adrenal fatigue and numerous imbalances in body chemistry.[9][10] Contrary to scientific evidence, Joe Pizzorno, a major figure in functional medicine, claimed that 25% of people in the United States have heavy metal poisoning and need to undergo detoxification.[11] Many scientists state that such detox supplements are a waste of time and money.[12] Detox has been also called "mass delusion".[13]
Reception
Functional medicine is controversial within the medical community. While some doctors and researches consider it to be a form of alternative medicine, functional medicine practitioners include board certified medical doctors, registered nurses and other credentialed medical practitioners who practice within the framework of evidence based medicine. For example, a 2019 study found demonstrated efficacy in the treatment of the autoimmune disorder Hashimoto's thyroiditis. [14]
In 2014, the American Academy of Family Physicians withdrew course credits for functional medicine courses, having identified some of its treatments as "harmful and dangerous".[11] In 2018, it partly lifted the ban, but only to allow overview classes, but not to teach its practice.[15]
Oncologist David Gorski wrote that the vagueness is a deliberate tactic that makes functional medicine difficult to challenge.[16]
The opening of centers for functional medicine at the Cleveland Clinic Foundation and at the George Washington University was described by Gorski as an "unfortunate" example of quackery infiltrating academic medical centers.[17]
References
- ^ Ehrlich, G; Callender, T; Gaster, B (May 2013). "Integrative medicine at academic health centers: A survey of clinicians' educational backgrounds and practices" (PDF). Family Medicine. 45 (5): 330–4. PMID 23681684. Retrieved October 8, 2013.
- ^ Hall, Harriet (2017). "Functional Medicine: Pseudoscientific Silliness". Skeptic. Vol. 22, no. 1. pp. 4–5.
- ^ Beidelschies, Michelle; Alejandro-Rodriguez, Marilyn; Ji, Xinge; Lapin, Brittany; Hanaway, Patrick; Rothberg, Michael B. (2019-10-25). "Association of the Functional Medicine Model of Care With Patient-Reported Health-Related Quality-of-Life Outcomes". JAMA Network Open. 2 (10): e1914017. doi:10.1001/jamanetworkopen.2019.14017. ISSN 2574-3805.
- ^ a b "Functional medicine: Is it the future of healthcare or just another wellness trend?". independent. 23 October 2018. Retrieved 2023-02-07.
- ^ Barrett, Stephen (11 September 2013). "Some Notes on Jeffrey Bland and Metagenics". Quackwatch. Retrieved 5 April 2022.
- ^ "Institute for Functional Medicine 2001 tax forms". ProPublica. 9 May 2013.
- ^ a b c Knott L (6 February 2015). "Therapies and Theories Outside Traditional Medicine". Patient. Retrieved 11 December 2015.
- ^ Sampson, Wallace (October 30, 2008). "Functional Medicine – New Kid on the Block". Science-Based Medicine.
- ^ Gorski, David (December 17, 2018). "Functional medicine: Reams of useless tests in one hand, a huge invoice in the other". Science-Based Medicine. Retrieved 30 October 2020.
- ^ "Adrenal Fatigue | Hormone Health Network". www.hormone.org. Retrieved 30 October 2020.
- ^ a b Bellamy J (26 October 2017). "AAFP: Functional Medicine lacks supporting evidence; includes 'harmful' and 'dangerous' treatments". Science-Based-Medicine.
- ^ "Scientists dismiss detox schemes". BBC. 3 January 2006.
- ^ Dixon, Bernard (2005). ""Detox", a mass delusion". The Lancet Infectious Diseases. 5 (5). Elsevier BV: 261. doi:10.1016/s1473-3099(05)70094-3. ISSN 1473-3099. PMID 15854880.
- ^ Abbott, Robert D.; Sadowski, Adam; Alt, Angela G. (2019-04-27). "Efficacy of the Autoimmune Protocol Diet as Part of a Multi-disciplinary, Supported Lifestyle Intervention for Hashimoto's Thyroiditis". Cureus. 11 (4): e4556. doi:10.7759/cureus.4556. ISSN 2168-8184. PMC 6592837. PMID 31275780.
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: CS1 maint: unflagged free DOI (link) - ^ Bellamy J (27 October 2018). "AAFP should publish research behind finding that functional medicine lacks evidence, contains harmful and dangerous practices". Science-Based-Medicine.
- ^ Gorski, David (11 April 2016). "Functional medicine: The ultimate misnomer in the world of integrative medicine". Science Based Medicine.
- ^ Gorski, David (September 29, 2014). "Quackademia update: The Cleveland Clinic, George Washington University, and the continued infiltration of quackery into medical academia". Science–Based Medicine. Retrieved 2016-12-02.