VP #1 What is Functional Medicine - Final
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Welcome to Functional Medicine with Dr. Var. This podcast is to help you explore the underlying root causes of your chronic symptoms and health challenges. Reset your health and reclaim your life.
VARSHA: I'm so excited to be here with you today.
Let's get ~to it ~to the first episode. ~You know, ~I've been a family medicine physician for over 20 years, and I am seeing alarming trends in medicine. I'm seeing people getting sicker and sicker at a younger age, even though we have more and more medicines and medical interventions.
~And ~When I first started, there was maybe about 20% of patients on five or more medicines, and now I feel like that's more of the norm instead of the exception. ~And ~I actually looked up the numbers because I was like, is it just my population or is this true across the nation? Back in the early 2000's about 23% of adults over the age of 65 were [00:01:00] on five or more medicines, and by 2025, that doubled to 42%. Now under the age of 65. It was about 8.2% back in the early 2000's And the last set of data that I could see was in 2018, and it doubled to about 16%.
~So ~ It's been seven years since then, so I can only imagine what the percentage is now. But when you're on 5 or more medicines, we call that polypharmacy ~and. ~Polypharmacy can put you at risk for major complications and even death, number one, from the medications itself. Adverse drug reactions ~are, ~are one of the leading causes of deaths.
You also can have side effects to the medications that can cause sedation falls and other adverse effects ,
Polypharmacy is a symptom of a much bigger problem, that more and more people are getting sick and having chronic conditions at a younger age.
We're seeing [00:02:00] diabetes in teenagers now or even younger.
I am seeing anxiety depression in ~like ~one outta every five teenager. A DHD. Almost everybody has some sort of stomach issue and is either on an acid reducer, nausea medicine, or IBS medicine.
Now, let me be clear. I'm not anti-medication. I'm actually grateful for medications 'cause it does save lives and it's great for acute symptoms and it's great for preventing acute flares of chronic conditions, but I feel like it shouldn't be the end all be all.
And it shouldn't be ~like, ~okay, you're on a medicine, you have this condition, you have it for the rest of your life, and one and done. But there should be. more questions that are asked, like, why is this happening? Why are we getting sicker and sicker as a population? And to be fair, I think there are a lot of healthcare providers that are asking that question, and hence why I think there is a greater interest from healthcare providers ~that ~looking into functional medicine and integrative medicine, where back in the day it might have [00:03:00] been considered woo woo,
But , now there's the American College of Lifestyle Medicine that's been there for many years, but they use some phrase words that have been used in functional medicine looking at the underlying root cause through primarily lifestyle, which are nutrition, sleep movement, stress management.
and connections. So these are things that functional and integrative medicine have been focusing on, and so it's so great to now have a specific board certification within the conventional medicine framework that does focus on that. In fact, they even say that they look at the lifestyle to try to help make changes that can reverse and prevent chronic disease, whereas
before it was just once you had a chronic disease, that was it. And
I'm actually going through their program now and hopefully will get a certification from them because I feel like there's no one perfect mode of medicine. Even functional medicine, integrative medicine, there are some limitations w ith that, and [00:04:00] perhaps I'll do a video comparing the strengths and benefits of each medicine model, but I just wanna have all the tools I can have so I can better take care of my patients, provide education for you so you can take this information to your doctor and hopefully they'll get interested in looking at other ways and options and getting these additional tools to help their patients.
But I'm trying to figure out what I can do to help people heal because I didn't get into medicine just so I can write prescriptions and just constantly put bandaids on people. I got in medicine because I wanted to serve and I wanted to heal and help people, and most health care providers don't wanna write more prescriptions. They want to try to do well for their patients. Most health care providers have good intentions and them writing you a prescription is not a bad thing.
But we need to try to have more of the culture that this shouldn't be the norm and it should be more of the exception.
This is one of the [00:05:00] reasons why I was very interested in functional medicine, because functional medicine helps to look for the underlying root causes of chronic disease. So when you get a diagnosis and you're prescribed something, we don't just stop there.
We ask, why do you have this and what is going awry in your body as a whole that could be causing this?
It ~is ~given me tools to look deeper into why somebody might be outta balance, and more importantly, what can I do to help them feel better and possibly have a chance of not being on a ton of medicines. And by the way, we don't want them on a ton of supplements either. ~In functional medicine, the, ~we might use supplements to help people come into balance.
And of course there are some supplements that might be beneficial to take lifelong just for general health. But overall, we don't want you to be on 20 supplements either
I realize that many healthcare providers have a lot of misconceptions about functional medicine, and also many patients don't know what [00:06:00] functional medicine is and don't realize that there are options to help them feel better .
Let's break down what functional medicine is and how we go about. assessing you if you were to come in for a functional medicine visit.
So when you come in for your first visit, usually as a functional medicine provider, we like to get the story of your life to see what types of events or triggers. That could have led to your chronic symptoms or chronic disease. We may even ask about your birth history, like if you were born vaginally or by C-section, because that can affect your microbiome if you were on a lot of antibiotics as a kid.
'Cause that also can affect your microbiome if there are any major illnesses or surgeries. If you had a lot of trauma or even little t traumas growing up, if you felt like you had to walk on eggshells all the time and always in defensive mode. That can be a very big stress and that can affect you [00:07:00] whether you realize that or not.
How was your adolescent years? How was your twenties and thirties, and if you're in a relationship and what things are like? Then we look at your lifestyle. What's your diet like? , Exercise like?
What's your stress level? How are you sleeping? And what are your connections? Because all of those are very important in how you feel and how chronic symptoms or chronic disease may manifest because of imbalances if you have a not so great lifestyle.
Sometimes I'll have patients complete a head to toe symptom questionnaire and a food journal to see what their nutrition is like and what symptoms are really bothering them, and to what degree. Now I work within a conventional medicine framework, and I'm very lucky because the hospital network that I work for.
Have been very open and allowing me to have 40 minutes for patients, uh, which is usually, it's like 15 or 20 minutes, uh, for like even follow ups. They've been very [00:08:00] open to me practicing functional medicines. But there are a lot of hospital networks that.
Still want, they focus on their providers being productive. Um, which mine does, don't get me wrong there, but they are better than most. And I'm, and I'm very grateful. But if you go to a functional medicine provider that is not constrained within a, a conventional medicine framework, if they have their own practice, they may spend up to two hours with you just getting your whole history and really help develop a plan.
So we just try to get a good history of what your life is like, and get to know you as a person and get to know what things may have contributed to to how you are feeling now. And maybe some things that you haven't dealt with, like if you haven't dealt with trauma, then that is definitely something that you may need to resolve because trauma will show up as some sort of chronic symptom or chronic disease elsewhere in the body.
I mean, I can't even tell you how many patients, unfortunately, where their spouse may pass away and they end [00:09:00] up getting cancer like one or two years later . And I just kind of wonder, is it because of the grief is so hard on their body and that trauma is so great and it's hard to process,
so there's so many things that can affect us and trauma and stress. I would say it's like one of the biggest contributors, and we don't really often ask about that in conventional medicine.
In functional medicine, we look at six core pillars, and these aren't in any particular order, but number one is gut health. Number two, mitochondrial health. Number three, toxin exposure and detoxification. Number four, your immune system and inflammation.
Number five. Cardiometabolic system. And number six, hormones. We also look at structural integrity, which is your muscles and joints, and then also your mental, psychological, and spiritual health too.
~So ~I am gonna go over each of these pillars to give you an idea of what types of things we look for. ~So ~in gut health, we look at digestion. How well [00:10:00] are you digesting your food because digestion. Is how your body starts extracting your nutrients that you need for many of the processes in your body to run.
If you're not even able to digest your foods properly, you're not gonna get those vital nutrients that you need setting you up for possible vitamin deficiencies and other symptoms because other processes in your body can't run because they need certain vitamins and minerals to.
move forward. We also look to see if there's a lot of inflammation in your gut. 70% of your immune system is in your gut, so if you have a lot of inflammation, you're going to be setting off your immune system and creating all these inflammatory cells that can seed elsewhere in the body and cause inflammation in your joints, in your brain, on your skin.
So some people have gut health issues. And may not have gut symptoms, but if they have skin rashes, brain fog, joint pains, then we definitely will still look into your gut because the gut can cause [00:11:00] that.
We also look at your gut microbiome. Do you have more good bacteria than bad bacteria in your gut microbiome? These good bacteria produce substances that can be very beneficial for your body, such as a short chain fatty acid and those short chain fatty acids.
Play a part in regulating your weight, regulating your moods, and also reducing inflammation in your gut. We also look to see if there's infections. I have had patients where we did the standard conventional medicine stool test. They had the million dollar workup with the colonoscopy and upper GI and was just told they had IBS.
From a functional medicine standpoint, we looked for other infections and found that they had something called small intestinal bacterial overgrowth and got treated and started them on a particular diet short term, and they were feeling better and we're just starting to rebalance her gut. And then we look how your gut affects your moods. You have something called the gut brainin axis, which is how your gut and brain communicate, [00:12:00] and they communicate via something called the vagus nerve, which is basically a nerve that goes from your gut ~stops on its way to ~innervate all your organs and goes to the gut.
And so your gut can have a role on how you feel if it's not communicating well with your brain.
Number two is the mitochondrial function. Mitochondria are your little energy producers of each cell, so it's. Really important that they are healthy because they take your breakdown products of your food. Your protein, fats and carbohydrates, and they convert it into energy.
So if they don't have everything that they need, which they rely on a lot of different vitamins and minerals to run, or if they are damaged because you have been exposed to certain toxins, or you eat a lot of sugar ~or many other reasons. ~Then you're not gonna make enough energy, so you're gonna feel tired.
You also may not have enough energy to run other processes in your body, and so you can end up with other symptoms. It is very important that your mitochondria have what it needs to run efficiently.
[00:13:00] Number three is toxins. And how well are you detoxifying? ~You know, ~we're exposed to thousands of toxins a day. From our food, water environment and you can't avoid it a hundred percent. ~Uh, ~but we wanna make sure that we're detoxifying well because these chemicals, like I mentioned, can damage our mitochondria.
THIS CAN Cause other problems, such as cancers obesity, cognitive disorder. So looking to see what your toxic burden is, is something that's very important. ~Now ~we also wanna look at detoxification because everybody's different. Some people can be exposed to a lot of toxins, but because they detoxify well, it's not as detrimental as to someone who's not detoxifying well, and they may just be exposed to a third of what the other person was and have more clinical effects.
Number four is cardiometabolic Health. This includes looking at the metabolic parameters like we do in conventional medicine. ~So ~looking at your cholesterol, your sugars, [00:14:00] your blood pressure. However, with sugars, before you get to diabetes and even pre-diabetes, we look at something called insulin resistance.
Insulin resistance is the first step before you're even pre-diabetic that can indicate that you are starting to have what we call metabolic dysfunction. And if you have metabolic dysfunction, it can set you up for all kinds of things like fatty liver, cardiovascular disease, strokes, and many more. Catching this metabolic dysfunction at a earlier time before you're pre-diabetic or diabetic may be more beneficial to prevent some of those effects that can happen. ~So ~I don't just check A1C, I will check insulin level to see if your body is starting to have problems processing
sugars, because you can have a normal A1C, but if your body is making high levels of insulin, that's gonna still control your blood sugar, but the insulin is causing inflammation andSetting you up for chronic disease
later on, we will even check a more advanced cholesterol panel if you're at high risk [00:15:00] because two people can have the same LDL, but one might be at higher risk versus the other based on further deep dive into their cholesterol and their cholesterol particles. And if you wanna know more about that, I do have a video on my YouTube channel about other cholesterol tests
we ~also ~may look at other cardiovascular risk markers that ~may also ~help us assess your risk. And this helps me determine how aggressive I should be in treating someone.
When you catch thesemetabolic parameters early, then there's a chance that you can help prevent complications from it.
Number five is hormone balance. ~So ~I'm not just talking about estrogen and testosterone. ~I mean ~those are important and we might have other testing that we can do to look at that, but we look at it differently. Because we also look at the adrenals and how the adrenal glands can affect your other hormones because stress is a very big problem
i'm prone to it, but stress can really cause a lot of problems with your other hormones. ~So ~we may look [00:16:00] at that to see if there's anything we can do to help balance that. In addition to balancing your other hormones, we also might look at a more expanded thyroid panel, and the reason I do it is not to justify adding or putting you on higher doses of medicine, but.
To see if there is a potential vitamin or nutrient deficiency that might be affecting either the production of your thyroid hormone signaling, of your thyroid hormone receptors, or conversion of your inactive thyroid hormone to its active form
~and. ~We also look at insulin resistance in regards to your hormones as well, because if your insulin levels are high, that can also affect your production of certain hormones over others.
And number six is your immune system. ~So ~is your immune system awry? Like do you have autoimmune disease? And if you have autoimmune disease, ~and ~we kind of circle back to the gut health because that's very important in regards to autoimmune disease.
Do you have a lot of food [00:17:00] sensitivity, food allergies, or just allergies in general?
Do you have signs of inflammation that indicate that we need to calm your inflammation down to help things function better?
And then we also look at the mental, emotional, and psychological health, ~um, ~because you can't separate your body from your mind. ~I mean, ~your mind. ~It ~does play a role in how your body functions, if you've had any history of trauma, the trauma can get stored in the body if you haven't processed it and lead to chronic disease in the future.
, There's more to our mind and our spiritual and mental health that plays a role in our physical health.
Addressing the whole person, the body, the mind, the spirit is so important in healing.
We also wanna look at lifestyle factors, how many hours a night are you sleeping and are you getting good quality sleep? Do you have sleep apnea that could be putting at risk for insulin resistance and diabetes and dementia?
What's your diet like? Nutrition plays such a huge role [00:18:00] in how you feel and in ~the, ~your risk of chronic medical conditions. And it's amazing because when I tell some patients this, they are so surprised because they have been told for many years the medicine is the only way. And then also your relationships and your connections. Do you have fulfillment in your life? Do you have a sense of purpose?
All of these play a role in your healing.
Here's what I wanna leave with you today. ~You know, ~in the beginning I started talking about polypharmacy and it is a real problem and it is a red flag, that we are getting sicker at a younger age and we need to do something about it.
I believe the best medicine is a combination of functional and integrative medicine and conventional medicine. ~You know, ~we need to have something for acute symptoms, and conventional medicine does save lives. But let's take it a step further and look at underlying root causes
and taking a look at how we can help our patients heal instead of just constantly fixing them with band-aids, ~and maybe we do everything and ~[00:19:00] some of the functional medicine. Strategies may not be doable for patients, but at least we've tried. At least we've given an effort and feeling like we serve our patients because I know part of my burnout that I had several years ago was because I felt like I was just a legalized drug dealer.
I was just prescribing and people weren't feeling better, and they would get to the point where I had no additional tools to help them, and I felt. So bad, and I dreaded seeing them on my schedule because I was like, I don't know where to go. But now I have tools that can help people.
And I have a mission to help educate patients so they know there are other options out there to help educate providers so they can open up their mind and not just think this is woo woo. I think the more medical providers ~like. ~PAs, nurse practitioners and doctors that go into functional medicine. ~Then ~the more this can be a standard of norm, and then as you, as a patient ask for it, .
And [00:20:00] demand it. Then maybe it'll be woven into conventional medicine. I mean, I'm already seeing things in there. When I studied for my obesity boards, they were talking about gut microbiome. They were talking about toxins and how they can disrupt your hormones and cause you to gain weight. So I have so much hope, but we need to all band together and we need to not fight each other.
There's so much antagonism between conventional and functional medicine, and it shouldn't be that way. We should be working together, so that we can provide the best care for patients.
I don't think either one itself is a hundred percent. Even functional medicine has its limitations. It's not the perfecta either. So why don't we take the best of all the modalities of different ~me ~medical models, ~you know, ~functional in integrative, there's lifestyle medicine, longevity medicine and conventional medicine, and let's weave it all together.
I'd love to hear what you think in the comments, subscribe and share and help me spread awareness. ~And education. So more and more healthcare providers will be interested and more and more patients will be interested, ~so we can truly change medicine.
I hope you found this informative. Please [00:21:00] subscribe and share so that you don't miss out on any future podcasts.
In future episodes, we'll be diving deep into gut health, inflammation, mitochondria and energy, detox, and many other topics. And there will also be shorter daily wellness tip and habit challenge for you to follow along every day.
So by the end of the year, you will have racked up small habits that can help you feel healthy so you can reset your health and reclaim your life. And if you wanna watch the video version, you can head over to my YouTube channel Functional Medicine with Dr.
Var. Thanks for listening or watching, and have a fantastic day.
