Beyond Functional & Integrative Medicine
Updated: Sep 28, 2022
I've written about functional and integrative medicine, both of which we specialize in our practice, but I haven't shared much about Asian systems or even more European systems. Interestingly, each of these are whole health systems, with modern conventional medicine being the only approach to healthcare that is specifically system specific, as I am aware. While I would not claim to have expertise in any one of these modalities, each of them intrigue me and have been utilized in my clinical practice to some degree through the years. Botanical medicine, in particular, has always been part of my practice and I do, truly adore this modality when appropriate in a client's treatment regimen.
Functional and integrative providers do often gravitate towards specific modalities they are more familiar or better identify. Sometimes a clinician will advance their practice through certification in acupuncture from Traditional Chinese Medicine. Other times practitioners will bring a massage therapist into their clinic to refer clients, which utilizes Traditional Chinese Medicine, Sowa Rigpa, and Ayurveda. Most of us are familiar with practices such as nasal cleansing, which is Ayurveda-based and I've sought additional training more specifically in both yoga and botanical medicine.
This digging in outside your own speciality truly is integrative medicine. It allows us to introduce and refer our clients beyond our own expertise so they can customize their own, very individualized treatment regimen or better, find an approach to wellness that they can sustain life long.
Asian systems such as Ayurveda, traditional Chinese medicine, and even Tibetan Sowa Rigpa are whole health systems, as are the European approaches, such as homeopathy, naturopathy, and even osteopathy and herbalism. It seems our culture is so confident that we are world leaders with regards to healthcare but fail to recognize we have some of the worse outcomes among industrialized countries, spend the most money for that substandard care, and have a model that in comparison, is really only in its infancy with regards to evidence and longevity.
Whole system approaches take the totality of symptoms whereas allopathy, or conventional medicine as most United States Americans understand healthcare, emphasizes only parts of the organism. A single organ or a system within the body, such as the nervous system or digestive system, is all that is evaluated which is why our healthcare system is broken into a plethora of specialities. Whole system approaches however, representing essentially every other healthcare system worldwide, takes into account all aspects of the physical, emotional, mental, and spiritual health of an individual when evaluating and working to optimize health. Balance is the big picture, whether we see that in yin/yang or various elements.
Chinese medicine correlates health to their five identified elements: water, earth, metal, fire, and wood. The Tibetan system also has five, although somewhat different: water, space, earth, fire, and air. Indian Ayurveda recognizes earth, water, air, fire, and spirit. Both the Ayurveda and the Tibetan Sowa Rigpa medical systems share the idea of diagnosis through the three humors and finding the constitution, which is how balance is obtained. Energy channels drive this model of care, also known as chakras.
Depending on one's constitution or chakra energy, treatment methods evolve. This may include changing the diet or altering behaviors such as committing to more meditation or yoga. Support may be offered utilizing botanical medicine, or animals and minerals may be utilized in treatment. Heat or cold therapy can offer balance, as can bathing, acupuncture, moxa or even blood-letting. Nature is also a great healer.
Traditional Chinese Medicine
Traditional Chinese Medicine (TCM) has evolved over thousands of years utilizing yin/yang, the five elements, zang/fu, channels/collaterals, blood and qi, body fluid, and various methods of diagnosis. Traditional Chinese Medicine consists of regulating the functions of the zang-fu organs in order to correct pathological changes. These practitioners use various psychological and physical approaches to address health concerns, primarily through acupuncture, Tai Chi, and herbal remedies. The natural element is also considered, in that changes in the four seasons can impact our health, as can alterations in day and night. Various geographical environments can also influence differences in body constitution. These factors are considered when diagnosis and treatments are given.
Acupuncture is a technique in which practitioners stimulate specific points on the body, usually by inserting thin needles through the skin, which can manipulate energy pathways. Our modern minds have concluded that this is often either a placebo effect or due to the response of our body releasing catecholamines due to the experience of pain from the needle injections. Evidence does exist however, in support of this modality, even to include improved conception for couples challenged by infertility.
Tai Chi is another modality within the Traditional Chinese Medicine approach, which combines certain postures, gentle movements, mental focus, breathing, and relaxation. Research findings suggest that practicing Tai Chi may improve balance and stability, reduce pain from osteoarthritis, and help individuals cope who suffer with fibromyalgia and back pain. Quality of life seems to certainly be improved.
Chinese herbal products are maybe a bit more controversy with regards to TCM. About one in every five individuals utilize TCM botanicals but studies are less available to offer much argument on whether these are effective or not. Certainly, when utilized properly and properly sourced botanicals are utilized, plant therapy can be exceedingly beneficial.
There really is a great deal of scientific evidence within this model of care, which encompasses acupuncture, Tai Chi, and even botanical medicine but controversy remains. There has been some concern with various Chinese medicine compounds, in that some have been found to have toxic components, such as heavy metals, pesticides, and microorganisms that can cause serious side effects. Manufacturing errors occur and all of these can result in negative consequence. However, acupuncture has relatively few risks and Tai Chi or Qi Gong appear to be safe practices.
Indian Ayurvedic Medicine
The word itself really encompasses the idea of looking at whole life. Ayurveda means life and veda is specific to knowledge or science, so the word represents knowledge of the lifespan and all that integrates through physical, emotional, mental, and spiritual health. This modality relies on ancient writings which are "natural" and holistic, one of the world's oldest medical systems still in practice and which remains one of India's traditional healthcare systems.
There are few well-designed clinical trials and systematic studies that suggest Ayurvedic approaches are effective, but little research does not equate to ineffectiveness. Turmeric, for example, is often used in Ayurvedic preparations and has some support in the literature. These remedies though, often do contain metal and one study found that those who take these preparations are more likely to have elevated levels of lead and mercury. Arsenic is another concern.
Western whole health systems includes homeopathy, taught by Hippocrates. This is a model of similarities and contraries. In the late 1700s or the 18th century, German physician, Samuel Hahnemann, really defined homeopathy as the Law of Similia or Law of Similars. Allopathic medicine would fall more into the Law of Contraries.
Homeo means similar in Greek and pathos is disease and suffering, so homeopathy is matching the symptom picture of the individual with a known pathogenesis of the medicine itself. Allopathy really looks at the common symptoms among different individuals whereas homeopathy looks at what symptoms are uncommon or unfamiliar and then look for that symptom in the remedy for treatment. The important principle in homeopathy is that a substance, when given to a healthy individual, produces a certain set of symptoms that they call the "proving," because the same substances then can treat those same symptoms when they appear in a sick person. This is then an individualized approach, which is really finding that single remedy for that individual person, assisting them to come back into balance.
Homeopathy is also concerned with minimum dose; the smaller the dose the greater the impact. This is where homeopathy really gets most of its criticism because to our comprehension of potency, this seems to make little sense. Homeopathy is diluted in such a way that there remains essentially nothing but a sugar pill. There is thought however, that the water could retain the healing properties even after the original DNA-containing solutions are ultradiluted to the point that there are no molecules of the original DNA remaining. This modality however, is quite popular in Europe and Latin America, but is still somewhat unfamiliar among Americans.
This is a model of manipulation, founded by Dr. Andrew Taylor, grew quite popular in the United States. Quickly there were doctors of osteopath in all fifty states by 1973.
This modality initiated or evolved in the 19th century, within Europe. It's a combination of practices that were practiced in Europe at the time which included diet, stress reduction, and herbal medicine. Individuals choose naturopathic practitioners as their primary care provider often because they want to optimize their health and treat a specific health concern.
In the United States, naturopathy is practiced by naturopathic physicians, traditional naturopaths, and other healthcare providers who also offer naturopathic services. There are three different pathways for education as a naturopath. This profession offers a four-year, graduate level degree but not all states license this type of practitioner. Traditional naturopaths are known as "naturopaths," and may receive training in a variety of ways. Their length of training and even the content obtained varies greatly, and there is no accreditation for this avenue of education. They are not eligible for licensing. Medical physicians, osteopathic physicians, chiropractors, dentists, and nurse practitioners sometimes offer naturopathic treatments, functional medicine, and other holistic therapies and often have pursued additional training in these areas, although again, this can vary widely.
Homeopathy is often practiced, along with herbalism, in a naturopathic practice. Manipulative therapies such as exercise, detoxification, psychotherapy, and counseling are also commonly practiced by naturopathic providers. Ultimately, this modality is also a practice of similarities.
Similar to homeopathy, herbal medicine can be utilized by essentially any practitioner. It is a whole health system approach, or holistic.