We had been searching for answers for months. Four different doctors had given four different diagnoses. Finally, a specialist gave us the diagnosis of psoriasis.
My husband had an autoimmune disease that meant his own body was essentially attacking his skin.
We were written the standard prescription for steroid creams and instructed to return for heavier medications when they ceased working.
We were not warned to beware of telltale signs of joint pain, since 20% of psoriasis sufferers develop an even worse condition that attacks their joints, called psoriatic arthritis (which Shane would later be diagnosed with). That would be a rheumatologist’s area of concern, I guess.
Nobody else seemed to be asking the same question I was: Why?
Why was his body attacking itself? Why had the immune system that normally protected him gone awry? Would he really have this forever? And why could we only expect it to get worse?
Learning Functional Nutrition for Autoimmune Arthritis
I had already been a dietitian for several years when my husband received his first autoimmune diagnosis. But my conventional-medicine training had given me few tools to help with autoimmunity.
But when steroids stopped working after a couple of years, heavy meds were the next step for Shane, and he wanted to avoid them if at all possible. He asked if nutrition could somehow help. And honestly, I wasn’t sure!
At first, I could find no answers. My go-to sources for good information gave mostly lists of medications as treatments and possibly some vague lifestyle recommendations.
Frustrated, but determined, I expanded my research to research articles, books, and podcasts from other experts. I consumed everything I could get my hands on and curated nuggets of information into a plan that might help my husband.
Our hope that he could do more than suffer through this was rekindled. I was thrilled with the information I was discovering.
When I began to “experiment” on my husband and family members (how grateful I am for them all believing in me!), and was actually seeing results, I realized that nutrition is SO much more powerful than I realized!!
What Does Functional Nutrition Mean?
Functional nutrition is a shift in how we typically look at diseases like arthritis. In a nutshell, it asks “Why?”
Functional nutrition:
- “considers the whole person, not just an isolated set of symptoms”
- “addresses the underlying causes of disease”
- “engages both patients and practitioners in a therapeutic partnership” (3)
- “proposes that even a minor imbalance within the body can produce a cascade of biological triggers, commonly termed a ‘snowball effect’”
- relies on “knowledge of the dynamic interplay of genetics, biochemical processes, and biological systems and networks for establishing an innovative, holistic nutrition care process”
- “incorporates varied modalities such as… food elimination diets; … supplements… and detoxification programs” (4).
Doesn’t this sound like what healthcare should be?
Though they are not exactly the same, you might also hear functional nutrition referred to as (3):
- Food as medicine
- Nutritional medicine
- Complementary medicine
- Alternative medicine
- Integrative nutrition
- Holistic health care
I can’t talk about functional nutrition without talking about functional medicine. The two are inseparable because nutrition is at the heart of every functional medicine treatment plan. (That’s why a good functional nutritionist is essential to include in your healthcare team.)
I will explain more of why functional medicine is so powerful in a minute, but first I want to touch on why chronic diseases like arthritis and fibromyalgia need functional medicine in the first place.
Why Arthritis Needs a Dietary Approach
Arthritis is Out of Control
Maybe you’ve heart these statistics before, but they are staggering to me every time (2, 11, 13):
- 30% of Americans have some form of arthritis
- 25% of those with arthritis experience major joint pain
- 1/3 receive little benefit from medications, and many detest the side effects
- Arthritis is one of the most expensive conditions to treat with annual costs of $304 billion in 2013
- More and more people under age 65 are getting arthritis- especially inflammatory forms like rheumatoid and psoriatic
- Many people with arthritis have comorbidities such as heart disease and other symptoms
- We spend 1.5 to 2 times more per person on healthcare than other industrialized countries, but rank last in most health outcomes, including percentage with multiple chronic diseases and life expectancy.
Arthritis is Disabling
Despite all of our medical advances, chronic diseases continue to afflict and kill more Americans than ever. The most disabling or deadly chronic diseases right now are (1,2):
- Arthritis
- Heart disease
- Cancer
- Chronic lung disease
- Stroke
- Alzheimer’s
- Diabetes
- Chronic kidney disease
Arthritis Is Only Getting Worse
Despite an increased number of medications, the number of Americans diagnosed with arthritis continues to grow.
Arthritis is no longer just a disease of the elderly. Adults are now being affected at younger ages, and in greater numbers than ever before.
Our modern medical system is incredible at saving lives related to infections, trauma, and so much more. We’ve made incredible advances in the past century.
But the same medical model that works so well for these acute conditions is still being applied to chronic diseases like arthritis. And it clearly isn’t working.
Health Professionals Lack Training
Nutrition and lifestyle choices can be used to manage chronic disease (7), but their use as a first-line therapy has been challenging for doctors because (11):
- most feel unprepared to deliver lifestyle recommendations, even though nutrition and lifestyle are a foundation for most guidelines.
- they lack nutrition education,
- they lack confidence in the available nutrition evidence
- their time with the patient is so limited.
A 2005 survey found that even dietitians lack education in complementary and alternative medicine. ACEND (Accreditation Council for Education in Nutrition and Dietetics) has recommended more functional medicine education in schools so that dietitians can be leaders in this practice area. (3)
This may be the reason that some of my dietitian colleagues discredit functional nutrition approaches as well. Unless we have sought out the education on our own, many dietetics training programs lack, and even discourage, functional nutrition.
Nutrition Guidelines are Not Being Used
In 2012, the American Medical Association issued a call to action for physicians to “offer evidence-based, lifestyle medicine interventions as the first and primary mode of preventing and, when appropriate, treating chronic disease within clinical medicine” (15).
In addition, many major agencies recommend diet and exercise for prevention or treatment of various chronic diseases, including:
- The American Heart Association
- US Department of Health and Human Services
- US Department of Agriculture
- American Cancer Society
Americans Want a Food as Medicine Approach
Meanwhile, Americans WANT a food as medicine approach. Over half of Americans are buying supplements (3). Many are trying various diets to help their diseases without guidance from true health professionals.
It Takes a Team
It would be crazy to expect doctors, nurse practitioners, physician assistants, and nurses to be experts in nutrition therapies and behavior change, in addition to all of their other areas of expertise.
I believe a TEAM approach that also involves, at a bare minimum, a physician and a functional nutritionist is most effective. Health coaches, mental health experts, physical therapists, and others would also be very helpful.
Indeed, functional medicine clinics that use an interdisciplinary team are getting their patients better results for far less money than conventional medicine clinics (11).
Why Use Diet (aka Functional Nutrition) for Arthritis
Here are several ways that functional nutrition is a better approach to autoimmune arthritis:
Functional Nutrition Asks Why
In a nutshell, functional nutrition asks why.
It recognizes that dysfunction in your body begins long before symptoms pop up or a disease is diagnosed (5, 6, 13).
Together with my clients, we explore subtle clues in their history that might help us understand WHY and WHERE things began to go wrong.
Functional Nutrition Recognizes It’s All Connected
Modern medicine classifies diseases according to the body system where symptoms are most prevalent (5).
My husband was referred to a dermatologist for his psoriasis and a rheumatologist for his arthritis. A gastroenterologist would be the one to see for the chronic acid reflux and swallowing issues he used to have.
However, all of your body systems are actually connected. Dysfunction in one organ has a ripple effect on all the other organs. Especially when it comes to chronic conditions like diabetes, Hashimotos, or Crohn’s Disease.
If my husband’s dermatologist had considered ALL of my husband’s symptoms, not just the skin ones, we may have realized that he also had psoriatic arthritis (not just a “bad back” and “weird toenails”) years earlier, and prevented years of joint damage at the same time.
Functional Nutrition Addresses Root Causes
Functional medicine proposes that if we can remove the root causes, the body can heal itself. Rather than suppressing symptoms, we try to address the deeper imbalances that are causing the symptoms (5, 6, 13).
As we explore your history, lifestyle, genetics, and ALL of your symptoms, we can clue into the imbalances behind your arthritis. Root causes that might be considered include:
- Chronic vitamin or mineral deficiencies
- Food sensitivities and intolerances
- Bacterial, fungal, or viral infections or overgrowths
- Stress or trauma
- Microbiome health
- Genetic variations
- Diet quality
- So much more….
Functional Medicine Seeks to Reverse Disease
Conventional medicine believes my husband’s autoimmune arthritis and psoriasis (and most chronic conditions) are incurable and require lifelong treatment and an increasing cocktail of medications to manage them.
Functional medicine proposes that if we can address the root problems, the body can heal and even reverse disease (9,11, 13).
It also advocates for using food and lifestyle to correct early dysfunctions and prevent disease (4, 5, 9).
Functional Nutrition Embraces Many Healing Modalities
The treatment for every imbalance almost always involves nutrition and sometimes supplement support.
But it often involves other therapies that address sleep, stress, mind-body practices (like yoga or meditation), exercise, nature and sunshine, and conventional drugs or surgeries when needed (4).
This is again where that interdisciplinary team is so important (11).
Functional Nutrition Involves the Patient
You can expect your visits with your functional doctor or dietitian to be longer, especially the initial visit. You may be surprised that they want to hear your story. The health history they collect will likely be much more extensive (4).
Functional nutrition requires action on your part, beyond popping a pill or prescribing a standard diet. A good functional nutritionist will work with you to create a step-by-step plan that works with your circumstances. Your nutritionist will ask you to work hard, without overwhelming you.
Your healthcare team will guide you to what will work, follow up with you, trouble shoot with you, and give you every resource to succeed… but ultimately, YOU are the one that makes the magic happen (10, 11).
You might require more follow-up visits at first than conventional treatments typically require. Plus, more tweaking of “treatments” to find your optimal health long-term.
Functional Nutrition is Evidence Based
Functional nutrition is informed by available evidence and based in science. We combine knowledge from published research with our in-depth understanding of the body, food, and nutrient interactions, along with expert experience and opinions to help you achieve your optimal health (4, 10).
Elizabeth Boham, MD, MS, RD states: “The evidence is now incontrovertible that the root causes of chronic disease are to be found primarily in diet and lifestyle choices. It is only logical… to confer that a treatment plan that focuses on diet and lifestyle is far more likely to reverse and prevent the vast majority of chronic diseases–an inference that is increasingly supported by a growing evidence base.” (9)
Functional Nutrition is Getting Better Results
One study compared patients treated at a family medicine clinic vs. an Integrative and Functional Medicine Clinic. The functional medicine patients reported bigger improvements in physical and mental health scores at six months and one year increments (11).
Note that this functional medicine clinic involves a TEAM. Every patient visits with a doctor, dietitian, and a health coach. AND mental health professionals are also available.
One study looked at pre-diabetics using “lifestyle interventions” versus the popular drug Metformin. “Lifestyle interventions” reduced diabetes by 58% and delayed onset for those who did get it for 11 years! Those given the standard drug therapy of Metformin delayed diabetes for only three years and reduced cases by 31% (16). Food and lifestyle ARE the best medicine!
Functional Nutrition is Cost Effective
Studies are finding functional medicine is not only effective, but cost effective (13, 15).
Boham urges, “Nutrition is one of the most powerful interventions available to clinicians. In many cases, it is less expensive, safer, and more effective than reaching for a medication to relieve every symptom….
“Optimal nutrition interventions to both prevent and treat disease… can help patients reach the highest expression of their health.” (9)
Functional medicine treatments often involve food, sleep, exercise, and other free or inexpensive therapies.
Even with increased appointments or prescribed supplements, they are usually cheaper than medications, and often temporary while you correct imbalances, rather than lifelong.
Is Functional Medicine the Future?
ACEND has called for more integrative medicine education in dietitian training programs (3).
The American Medical Association has called for more education in nutrition and lifestyle medicine for physicians (14).
In fact, there is a whole “Personalized Lifestyle Medicine” movement that is based upon functional medicine and is gaining acceptance among healthcare practitioners (14).
Many major agencies already have extensive nutrition and lifestyle guidelines in place.
The American people are craving nutrition treatments (no pun intended) and the chance to be partners in their healthcare.
And a growing body of evidence supports functional medicine as more effective, safe, and affordable than conventional methods.
I think it is safe to say, functional medicine (and nutrition) are here to stay and will only become more mainstream.
A functional medicine proponet, Dr. Boham, urges fellow practitioners to use food as an intervention with EVERY patient. “Diet is often addressed when patients are obese,” but she encourages us to consider diet with other diagnoses like:
- arthritis
- autoimmune diseases
- fatigue
- mood changes
- irritable bowel syndrome
- acid reflux
- insulin resistance
- diabetes
- metabolic syndrome
- dyslipidemia
- hypertension
- osteoporosis
- Asthma
- chronic obstructive pulmonary disease
- inflammatory bowel disease
- cancer
In short, “We should think about the nutritional status of every patient we see,” says Boham (9).
How Do I Find a Functional Nutritionist?
I’m a board certified functional nutritionist and I am a food sensitivity expert certified in LEAP therapy! Click here to get to learn how to work with me!
I would be thrilled to get you started on your journey to true healing through using food as medicine! Most of my clients see vast improvements time and time again with my program. I seek to make progress through steps that won’t overwhelm you throughout our work together, but improve your health step-by-step along the way.
Summary
In short, functional nutrition takes a different approach to chronic diseases like rheumatoid arthritis, psoriatic arthritis and fibromyalgia than our conventional medicine system.
Natural treatments like food, movement, sleep, and mind-body exercises are at the heart of every treatment.
Studies are finding functional medicine is safer, cheaper, and more effective in many cases.
It involves you as the patient more, views the body as an interconnected whole, and seeks to reverse root causes behind the disease, rather than treating symptoms alone.
Of all the solutions we have tried to help my husband’s autoimmune arthritis and psoriasis, both conventional and functional, diet therapies have brought the best results with the least ill side effects and risks.
As a dietitian, using functional nutrition with my clients has allowed me to help people find healing for chronic disease I never thought possible!
I believe functional medicine is the future of healthcare! I hope if you’ve failed to find answers to your health struggles, you’ll look to functional medicine for hope and healing! And I would be honored to help you on your path to healing!
