Pamela A. Popper, Ph.D., N.D.
Wellness Forum Health
Functional Medicine is a form of alternative medicine which was launched in 1991 by nutritionist Jeffrey Bland and his wife Susan. According to the organization’s website, the practice addresses the underlying causes of disease, and involves a partnership between the practitioner and the patient. Practitioners spend time with their patients, taking detailed histories and performing extensive testing, which followers say is needed due to the biochemic individuality of each person. Genetic and environmental factors are taken into consideration in order to support “…the unique expression of health and vitality for each individual.”[i]
As with many questionable health practices, Functional Medicine features some of the right ideas, such as questioning the traditional medical model, acknowledging the connection between diet and health, and focusing on the whole person. The fact that practitioners spend extensive amounts of time with patients is appealing since traditional medical doctors generally do not do this. The problem is that the time is spent administering unproven tests and “treatments,” many times for fictitious conditions. Functional Medicine practitioners focus on the liberal prescribing of dietary supplements to address health problems. They are the “holistic pharmacists” of medicine.
Jeffrey Bland has an interesting history, much of which involves selling dietary supplements about which he has made exaggerated claims. In 1995 the U.S. Federal Trade Commission levied a $45,000.00 civil penalty against Bland and one of his companies, HealthComm. The FTC action was in response to Bland’s violation of a 1992 order regarding deceptive health claims for supplements marketed by the company. Bland had claimed that UltraMaintain and UltraMeal altered the mitochondria in the cells in order to convert more food into energy, and made unsubstantiated weight loss, disease-symptom reduction, toxin elimination, blood pressure, and blood cholesterol claims about the products.[ii]
The Institute for Functional Medicine is chaired by Mark Hyman, M.D., who is housed at the Cleveland Clinic. Unfortunately, this has given both Dr. Hyman and Functional Medicine undeserved respectability. Why has an institution like Cleveland Clinic taken in Hyman? While the Cleveland Clinic features many great doctors, including Dr. Caldwell Esselstyn, the Clinic is like every other large medical institution in the U.S. Most of the medicine practiced there is NOT evidence-based. Hyman fits right in.
Chairman Hyman’s ideas about health are interesting, if not evidence-based. He is the author of several books, including the Blood Sugar Solution 10-Day Detox Diet. A website promoting the book includes a quiz which allows people to determine if they need his detox/blood sugar control program.[iii] The questions are:
- Do you crave sugar and carbs?
- Do you have belly fat?
- Do you have trouble losing weight?
- Do you have FLC syndrome, Feel Like Crap, fatigue, brain fog, digestive issues, mood problems, allergies, joint pain, skin problems, autoimmune disease?
Like many online diagnostic quizzes, it’s designed to show almost everyone that Hyman’s solutions are needed. What does Hyman offer for resolving these problems? One of the many products featured in his online store is a 10-day detox kit for $144 that includes:
- Multivitamins and minerals.
- MacularSynergy Complex, which is described as a “proprietary blend of lutein and zeaxanthin—two of the most crucial nutrients for macular function.”
- Metabolic GlycoPex, described as a “unique combination of alpha lipoic acid, cinnamon, and l-carnosine provides critical antioxidants and phytonutrients that help improve insulin sensitivity, scavenge free radicals, and support healthy blood sugar levels.”
- Metabolic LipidPlex, described as a “special blend of green tea catechins, taurine, and more supports insulin sensitivity, healthy fat burning, and metabolism.”
- Alpha Lipoic Acid with GlucoPhenol, described as “useful in supporting healthy nerve function in those with diabetes and pre-diabetes and a “powerful antioxidant and mitochondrial booster.”
- Omega-3 Fats, described as “crucial for healthy cardiovascular, nervous system, and immune function.”
- Taurine, described as a “powerful antioxidant” that “supports healthy cardiovascular, nervous system, skeletal muscular, and retinal function.”
No references are provided for the use of these supplements for detoxification or blood sugar control. It seems that Hyman is carrying on Bland’s tradition of just making stuff up.
The website claims that “The unique combination of supplements in this kit is designed to provide a foundation for cellular sensitivity to insulin as well as sustain the metabolism of fats and sugars. These supplements should be taken every day for the rest of your life for maximum effect.”[iv] Taking these every day for the rest of your life would cost $1,680.00 per year. Hyman sells many other products which he also says should be taken for the rest of your life, like Thyroid Support and Essentials for Men. An average family of four would need to commit a significant portion of household income just to pay for Hyman’s many supplement regimes.
Functional Medicine doctors usually begin with an extensive series of tests which include hair analysis and a metabolic profile, and testing for parasites, fungus, celiac disease, hormone levels, adrenal stress, food allergies, micronutrient status, GI function, heavy metal toxicity, neurotransmitters involved in mood and cognitive function, organic acids, and Lyme Disease. These tests provide “valuable” information about why people are experiencing conditions like weight gain, depression, and poor health.[v]
The problem is that there is little evidence to support the use of most of these tests. Take hair analysis, for example, which is unreliable and inconsistent. In 1995, researchers sent hair samples from two healthy teenagers to 13 labs that performed hair analysis. Reported mineral levels varied from lab to lab for identical samples, and even varied when identical samples were sent to the same laboratory which were represented to be from different patients. The definition of “normal” also varied between the labs. Six of the labs recommended dietary supplements, and the types and amounts varied between those labs.[vi]
A 2001 study confirmed that nothing had changed. Researchers reported that “Hair mineral analysis from these laboratories was unreliable, and we recommend that health care practitioners refrain from using such analyses to assess individual nutritional status or suspected environmental exposures. Problems with the regulation and certification of these laboratories also should be addressed.”[vii]
And a 2011 analysis showed that even when hair analysis is conducted correctly and appropriate reference ranges are used, which is not usually the case, correct diagnosis based on abnormal concentration of metals is not currently possible.[viii]
Space limitations prevent me from providing similar analysis for all of the tests, supplements, and other protocols recommended by Functional Medicine docs. I have had personal experience with many former patients of these doctors who have become members of Wellness Forum Health. While almost all were appreciative of the time their doctors spent with them, none of them benefitted much from the extensive testing, expensive supplement regimes, and strange diets, often with very long lists of foods to be avoided based on unproven allergy testing, which is why they called us. Per our instructions, many have asked their Functional Medicine docs to provide evidence for recommended tests and protocols and not one, so far, has done so.
Functional Medicine, while claiming to be a better alternative to traditional medicine, actually is a lot like traditional medicine. Functional Medicine docs run batteries of mostly useless tests looking for conditions like heavy metal toxicity, adrenal fatigue, and food allergies. Conventional docs recommend useless tests that turn healthy people into sick patients. Functional Medicine doctors engage in just as much disease mongering as conventional doctors.
The use of supplements to treat symptoms is based on the same reductionist model as conventional medicine. Dietary supplements, like drugs, do not address underlying conditions, and have never been proven to prevent, stop, or reverse disease. It could be argued that less harm results from prescribing dietary supplements, aside from the excessive financial cost, but the goal of alternative treatment should not be to hurt people less, but rather to improve long-term health outcomes. Like conventional doctors, the functional medicine disciples seem to confuse feeling better with getting better, and are just as focused on treating surrogate markers, only with supplements instead of drugs.
At Wellness Forum Health, we do not refer people to functional medicine doctors, and do not allow them to join our network. A few have inquired about taking our Institute courses but become disinterested when we talk about learning how to treat depressed people through therapy without drugs or supplements, reversing coronary artery disease with diet alone, and using long-term outcomes-based evidence to guide decision-making. These strategies are just as bad for business for functional medicine doctors as they are for conventional doctors.
[vi] Barrett S. “Commercial Hair Analysis: Science or Scam?” JAMA 1985;254(8):1041-1045
[vii] Seidel S, Kreutzer R, Smith D, McNeel S, Gilliss D. “Assessment of Commercial Laboratories Performing Hair Mineral Analysis.” JAMA 2001;285(1):67-72
[viii] Kempson I, Lombi E. “Hair analysis as a biomonitor for toxicology, disease and health status.” Chem Soc Rev 2011;40:3915-3940