A frequent question that we are being asked is ‘what is the difference between Functional medicine and Integrative medicine?’

So, we wanted to share the differences and similarities between the two approaches. 

What is Integrative Medicine?

Integrative medicine is a holistic approach to medicine that views the whole person, including body, mind, and spirit. There are different variations of ‘integrative medicine,’ so we will look at the term in general. 

There are several definitions of what body, mind, and spirit actually mean. However, typically, the concept body would refer to the anatomic and physiologic parts, mind to our thoughts, inner believes, patterns of thinking or behavior, and spirit to energy, pray, or religion. 

In integrative medicine, the provider will typically utilize different modalities of care, that are considered within the field of alternative medicine, such as acupuncture, manual adjustments, nutritional supplements, meditation, together with supplements or pharmaceutical prescriptions. 

The healing tools are used to address the physical, emotional, and spiritual aspects of the patient to facilitate a positive change in their life.

What is Functional Medicine?

Functional medicine takes a different approach to health and disease. 

Functional Medicine is a new form of diagnosis and treatment that has been developing from the understanding that external factors can trigger a pathologic reaction by changing our inner biochemistry, such as the effect of flame retardants on the expression of our genes. 

Disease, according to Functional Medicine, is the result of an interaction of our cells and organs with environmental factors, diet, emotional state, trauma, and lifestyle, rather than the result of genetics or old age. 

Symptoms, according to Functional Medicine, rises from one or more biochemical imbalances or pathogens. To get rid of the symptoms, we must address the root cause of the problem. 

The Functional Medicine provider, in a similar way to a detective, starts by looking for clues to eventually identify the underlying cause of the symptoms and address it.  

How Functional Medicine and Integrative Medicine are similar?

Both types of medicine are powerful and have a comprehensive approach to healing. In both types of medicine, the mind-body approach is utilized, and nutritional medicine, a healthy lifestyle, and mindfulness and/or stress relief is included.

What is the difference between Functional Medicine and Integrative medicine?

The main difference is that in Functional Medicine the focus would be on finding and addressing the root cause of the symptoms. This is can be done by laboratory testing, symptom-based surveys, and patient’s medical history. 

Here is an example of a patient that comes in and is diagnosed with type 2 diabetes. 

A patient walks into your office and complains of fatigue, weight gain, frequent urination, and difficulty concentrating. You test and diagnose him with type 2 diabetes.

The integrative approach to medicine might include a prescription of Metformin, reduction of carbohydrates in the diet, a supplement of the antioxidant Alpha-Lipoic Acid (ALA), and meditation to support a reduction in stress and attenuate cortisol response that might increase sugar levels. 

The Functional Medicine approach includes a review of the patient’s history, lifestyle, and diet to better understand what led to the development of insulin resistance and/or decline in insulin production. 

The patient shares with you that symptoms started slowly in the last few years and was more noticed since he went through a stressful divorce. His diet is composed out of instant meals he buys in plastic packages and he uses canned food frequently. He has been working in construction for 15 years, mostly sanding old paint and painting. 

You, as the Functional Medicine provider, understand that lower levels of certain nutrients and accumulation of chemicals might lead to inflammatory and autoimmune conditions, including type 2 diabetes, as well as cognitive decline.

Therefore, you recommend a simple test of micronutrients and environmental chemicals. In the meantime, you recommend him a simple stress-reduction technique and a simple adjustment to his diet to eat more fresh food and reduce carbohydrates.

After reviewing the results of the test, you find out that his levels of lead (Pb) and Arsenic (As) are higher than normal and that his cellular levels of chromium, vitamin C, and zinc are lower than normal. Therefore, your recommendation includes detoxification protocol and supplementation of Chromium, vitamin c, and zinc. 

Note #1: Studies show that exposure and accumulation of heavy metals, such as arsenic and lead might increase the risk of metabolic diseases and diabetes. Some studies indicate a dose-dependent relationship between some chemicals, such as arsenic and diabetes. (Feng et al., 2015; Rhee et al., 2008) Furthermore, lead accumulation might also be associated with mild cognitive decline. (Fenga et al., 2016)

Note #2: Chromium is an essential nutrient in glucose metabolism in several ways, such as increasing the ability of insulin to bind to cells and increasing the number of insulin receptors, while zinc plays an important role in the function of β-cell and glucose homeostasis. (Anderson, 2000; Ranasinghe et al., 2015)

What is the conclusion?

Both integrative medicine and Functional medicine are powerful and have a comprehensive approach to healing. In treatment, both approaches utilize the mind-body approach and might include mindfulness, diet, lifestyle, and nutritional (or nutraceutical) supplements.

The advantage of Functional medicine is to provide a deeper understanding of the root cause of chronic diseases. If you are interested in diving deeper, widening your understanding of the triggers that might have led to the diseases in your patients, and helping them to address these triggers, then learning Functional Medicine might be the best place for you to start.  

Resources:

Anderson RA. Chromium in the prevention and control of diabetes. Diabetes Metab. 2000;26(1):22‐27.

Feng, W., Cui, X., Liu, B., Liu, C., Xiao, Y., Lu, W., Guo, H., He, M., Zhang, X., Yuan, J., Chen, W., & Wu, T. (2015). Association of urinary metal profiles with altered glucose levels and diabetes risk: a population-based study in China. PloS one, 10(4), e0123742. https://doi.org/10.1371/journal.pone.0123742

Fenga, C., Gangemi, S., Alibrandi, A., Costa, C., & Micali, E. (2016). Relationship between lead exposure and mild cognitive impairment. Journal of preventive medicine and hygiene, 57(4), E205–E210.

Ranasinghe, P., Pigera, S., Galappatthy, P., Katulanda, P., & Constantine, G. R. (2015). Zinc and diabetes mellitus: understanding molecular mechanisms and clinical implications. Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences, 23(1), 44. https://doi.org/10.1186/s40199-015-0127-4

Rhee, S. Y., Hwang, Y. C., Woo, J. T., Sinn, D. H., Chin, S. O., Chon, S., & Kim, Y. S. (2013). Blood lead is significantly associated with metabolic syndrome in Korean adults: an analysis based on the Korea National Health and Nutrition Examination Survey (KNHANES), 2008. Cardiovascular diabetology, 12, 9. https://doi.org/10.1186/1475-2840-12-9