Here Are My Issues with Some Functional Medicine Practitioners and Practices.
If you’ve followed me for any length of time, you’ve probably seen me speaking out against some functional medicine practitioners and their treatments.
From DUTCH testing to detoxing to their pontifications about inflammation, there’s a whole lot of material for me to go after. And it’s not just Mark Hyman, the Medical Medium, and the rest of the functional MD crew – it’s also dietitians and nutritionists and naturopaths, too.
Of course, my rancor doesn’t apply to EVERY functional practitioner, so let’s not jump to that conclusion. Some are far worse than others, just like in every profession. Some functional medicine caregivers are amazing.
I do get a fair number of comments from people telling me that functional medicine can be beneficial, how it has helped people where the conventional medical system has failed, and that painting the entire discipline of functional and integrative medicine does my followers a disservice.
I was brought up in a medical household. My dad was an orthopaedic surgeon who did a lot of work in surgical oncology. My mom is a family therapist. Science was, and still is, the litmus test for me in terms of whether I, as a dietitian, will stand behind a test, treatment, or therapy.
That being said, I’m open minded to therapies that may be unproven but are harmless. If someone wants to try a functional medicine treatment that isn’t going to be detrimental to their health and wellness, I do encourage that.
So what’s my problem with functional and integrative medicine, then?
I see many of its practitioners doing the following things that I feel are a betrayal of peoples’ trust, not to mention potentially harmful. This isn’t okay.
Here’s why I have issues with some functional medicine professionals:
Many functional medicine professionals speak in absolutes.
The absolutes in the claims that many functional medicine practitioners make are what really bothers me.
When you tell a vulnerable layperson that a treatment will fix their problems, you’d better know for sure that it does.
You’ll see that I rarely if ever say that something ‘will’ have a certain result; I generally use the word ‘may’ – because the first thing I learned in nutrition school (and in life, really) is to never make promises you can’t keep.
When a person uses a hypothesis, animal or cell studies, or a wild association with no apparent causation as ‘proof’ of a link between diet and disease, or that a treatment works, I think this is a problem. Those things aren’t proof at all, but most people don’t know that.
For example, I see a ton of functional medicine professionals saying that gut ‘dysregulation’ is responsible for a whole host of specific diseases and symptoms.
The problem, is that we don’t have the proof to back that up for 99% of these conditions and diseases. We SUSPECT that the microbiome is linked to some of them, but we don’t know the connection.
We also don’t yet know what the ideal microbiome looks like for each individual (which is why those gut tests like Viome are BS), so even if your microbiome is suboptimal, we don’t have specific diet-based recommendations for each person.
Inflammation is another favorite of the functional medicine community. It’s used as a sort of bogeyman that’s blamed for pretty much everything, even when we don’t have proof.
Another common claim is that mushrooms can fix your cortisol levels.
Sure, adaptogens that are present in some mushrooms may impact cortisol in some way, in some amount, but there aren’t convincing human studies that prove this (or what the ideal dosage is).
They appeal to women under the guise of ‘empowerment,’ then do anything but that.
It doesn’t empower women to convince them that they have some mythical condition (mostly having to do with hormones and thyroid dysfunction), and then sell them a ‘cure’ for it. Yet that is what a lot of functional practitioners do – especially the high-profile ones.
Yes, women have been mistreated by the conventional medical community for years. So I understand the need for people to feel like they’re getting special attention from a caregiver rather than being given a short appointment in which to discuss their concerns.
But special attention and extra time with a practitioner doesn’t necessarily equal effective treatments, especially if you’re leaving their office with handfuls of supplements and a questionable diet.
They make mountains out of molehills.
Take a kernel of truth and spin it into something overblown that sounds science-y: it’s a tactic that’s used as a marketing tool, and here’s a few examples of how some functional medicine practitioners use it:
Functional diagnosis: hormone imbalance (which actually doesn’t exist – hormones are never ‘balanced’)
Functional treatment: more cruciferous vegetables and carrot salad.
Conventional wisdom: we have detox pathways that use the nutrients in carrots and broccoli – among many other foods. Drilling this process down to a couple foods is obtuse. Eating carrot salad doesn’t help your estrogen levels.
Functional diagnosis: intestinal parasites.
Functional treatment: papaya seeds and other treatments (see screenshots below).
Conventional wisdom: Intestinal parasites do exist, but most of us don’t have them. If we do, we need antibiotics and a real doctor.
Will Cole, Gwyneth Paltrow’s functional medicine person sidekick and author of Intuitive Fasting (read my review of his book here), is NOT a real doctor, but predictably, he has a lot of say about parasites on his website:
Functional diagnosis: candida.
Functional treatment: candida diet.
Conventional wisdom: candida exists, but there is no evidence to show that taking bread and beer out of your diet will help resolve it.
There will always be outliers – people who actually have parasites, for example. But the rest of us should be focusing not on carrot salad, but on our diet and lifestyle as a whole.
Eat broccoli. Don’t eat papaya seeds.
Functional medicine often ‘diagnoses’ unrecognized conditions.
Estrogen dominance: not a thing.
Adrenal fatigue: not a thing.
Heavy metal toxicity: it’s a thing that you probably don’t have.
MTHFR gene mutations: don’t worry about them. (Jen Gunter wrote a fabulous piece about MTHFR here)
Mold that impacts weight loss: not a thing.
Chronic lyme disease: sorry, not a thing.
These are just some examples of conditions that are not recognized by the conventional medical community. If they existed, common sense dictates that they’d not only be recognized, they’d also be treated by doctors.
Functional medicine practitioners love to talk about how Big Pharma is only out for our money. If this was true, why aren’t they making money off of these diagnoses?
Because they don’t exist.
They use terms like ‘root cause,’ which denigrates trust in the conventional medical system. They claim to address ‘the whole person,’ which most of us do, anyhow.
When I see the words ‘root cause’ in someone’s social profile, it’s immediately a huge red flag.
It tells me that they believe that conventional medicine isn’t interested in anything besides treating symptoms.
There’s this whole Big Pharma-profit thing that some functional providers like to talk about – how conventional docs and pill makers are only after profit, and aren’t ‘patient-centred,’ so they ignore prevention, push pills, and only treat symptoms to keep people sick.
This process purportedly makes Big Pharma more money (except, even people who work for Big Pharma (sic) get sick, or have loved ones who are dying from diseases, and want cures, not useless medication regimens, but anyhow)
So does this mean that the alternative therapists are offering their services for free?
They’re a profit-driven industry too, with their treatments and supplements. In fact, the complementary medicine industry raked in 82B in 2020.
Gundry likes to pontificate about how deadly lectins are (they aren’t), then turn around and sell you completely useless lectin blocker supplements. (read my post about lectins and The Plant Paradox)
One provider on Instagram sells the DUTCH test for $700.
Young Living sells an essential oil with ‘micronized wild yam’ to apparently help progesterone levels.
Also: conventional practitioners have no interest in keep people sick. We all treat the root cause of disease. What do organ transplants, chemotherapy, therapy, and diet and lifestyle changes do, then?
Functional medicine testing and treatments are often unvalidated and expensive.
IgG testing for food sensitivities: not recognized by any allergy or immunology society in the developed world. (Read my post about food sensitivity testing here)
MTHFR testing for MTHFR gene mutations: MTHFR variants have no connection with estrogen levels.
DUTCH testing for hormone metabolites: gives us nothing we can’t get from a conventional lab test. (Read my post on DUTCH testing here).
Hair testing for heavy metal toxicity: not recognized as reliable.
Immune-boosting herbs: FYI: ‘immune boosting’ isn’t what you want. Many of these herbs have little to no human research behind them, and there’s also this: herbal and dietary supplements are now responsible for 20% of liver injury in the United States, according to a piece in the Journal Hepatology.
IV vitamin cocktails: high-dose vitamin C may be helpful as an adjunct to conventional cancer treatment. But otherwise, these are junk. (Read my post about the IV cocktail trend here)
Hormone balancing diets: again, hormone balance isn’t a thing. And all these diets end up being, is one with whole foods and regular meals. (Read my post about how hormone balancing diets work (or don’t), here)
Seed cycling: phytoestrogens and other nutrients in seeds aren’t strong enough to impact your hormones.
Sauna detoxes: saunas don’t detox anything. (I love this Atlantic piece about saunas and detoxing)
Alkaline diets: useless mockery of basic physiology. (Read my post on why the alkaline diet is a scam, here)
And then there’s the Kangen water-selling ‘health coach’ that wrote me to let me know that Kangen water can cure cancer. (Read my review of Kangen water here)
Yeah, that was a special email.
But this is the issue: Kangen water doesn’t cure cancer. Nothing cures cancer except for chemo and surgery. Not high-dose vitamin C, not water, not herbs.
Food is NOT medicine. It definitely impacts our disease risk and our ability to fight disease, but it’s not medication, which is useful too. There is no shame in using both to achieve health.
This is where functional medicine sometimes fails – the vilification of potentially beneficial or even life-saving medications in favor of therapies that are ‘natural.’ Medication-shaming can have deleterious effects for people who truly need pharmaceuticals.
Much of functional medicine, like any quackery, is just good health – prevention and treatment through diet and lifestyle changes that good practitioner would – and should – recommend.
But then, it’s often padded with ‘whole body, whole person’ verbiage, supplements, animal studies, and anecdotes that can be misleading and unnecessary.
The danger of the above functional medicine practices is that they potentially damage not only physical health, but also emotional wellbeing in the form of a person’s relationship with food and their body.
Being told you have a disease that doesn’t exist, or that you can’t trust your body to do its job, or being misled about how the body works, or spending your money on testing that isn’t recognized, or being put into treatments that are unproven and unwarranted, can be physically and psychologically damaging.
There may be value in trying treatments that aren’t harmful, but going into any conventional OR functional medicine treatments with open eyes is important.
Don’t assume that just because something is ‘natural,’ or ‘individualized,’ that it’s superior.
Don’t believe that because someone spends an hour with you instead of 15 minutes, that their treatment is superior.
Both good and bad practitioners exist in every corner of the healthcare world. It’s our job to educate ourselves on how to choose the allies who are best for us.