A few years ago, Louis Messina was in pain. Despite being on a variety of big-gun drugs to control his psoriatic arthritis, an autoimmune disease that attacks the joints, he still suffered from constant pain and swelling throughout his body. He walked with a limp because his left knee had arthritis-induced tissue damage; the big-toe joint on his right foot was similarly destroyed; and in the mornings, he would awake to find his hands balled up into fists. (They would unclench only after he submerged them in warm water for several minutes.)
"Morning stiffness may sound like a minor problem, but it's a big thing," Messina says. "If you can't open your hands up in the morning, you really can't do much. You can't brush your teeth, or wash your face, or shave."
Nor can you perform surgery. At the time, Messina was in his early 50s and putting in 60 to 80 hours weekly as chief of vascular surgery at the renowned University of California, San Francisco School of Medicine.
"I was quite incapacitated," he recalls. "It was at the point where I couldn't really make rounds with the residents in the mornings because I wasn't able to easily walk up and down the stairs."
Frustrated and thinking about early retirement, Messina made an appointment with Mark Hyman, MD, the medical director and founder of the UltraWellness Center in Lenox, Mass., and a leading expert in functional medicine. "I had never even heard of functional medicine," Messina says. "I went on the recommendation of a friend of mine and, frankly, because my wife wanted me to go."
Hyman took a detailed medical history, asking Messina very specific questions about his diet, lifestyle, early childhood illnesses, stresses, and recent health challenges, which included reflux, migraines, and more. Then he ordered a battery of tests to deepen his understanding of Messina's overall health. (To get an idea of some of the tests Hyman ordered, see "Basic Tests Used in Functional Medicine" below in the sidebar.)
The results showed a variety of underlying gut problems, such as yeast overgrowth, a leaky gut, and allergies or sensitivities to many foods, including gluten. Tests also revealed low levels of vitamin D and magnesium; hypothyroidism; and prediabetes.
"He had all kinds of problems," says Hyman. "But once we treated his poor, inflammatory diet and his underlying gut issues, which generated significant inflammation throughout his body, all of those problems went away."
For Messina, who up until this point had been offered only surgery or drugs (which cost more than $30,000 annually and had serious side effects), it was an unprecedented medical experience.
"The rheumatologist that I had been seeing before Dr. Hyman still can't believe it. She's never seen anything like it," he says. "My arthritis, my pain and swelling, it's all gone. I now go faster on the stairs than my residents."
Messina's experience, while notably rare in conventional medicine, is actually quite characteristic of functional medicine, an increasingly popular healthcare model. Its claim to fame: seeing the big picture, treating the whole patient, and recognizing and treating the root of disease, as opposed to just the most visible symptoms.
Some folks have the mistaken idea that functional medicine is simply lifestyle-based medicine, but it is a systems-oriented, science-based approach that involves taking a patient's biochemistry, physiology, genetics, and environmental exposures into account when looking for the cause of a specific medical issue or set of symptoms.
Practitioners in the hyperspecialized, overbooked world of conventional medicine, says Hyman, sometimes don't have the time or inclination to adopt this wider perspective. In Messina's case, doctors had focused only on suppressing the inflammation — which was just a symptom — as opposed to digging deep and investigating what was causing that inflammation.
"Most doctors aren't trained to think about the underlying causes of disease, such as toxins, allergens, microbes, nutrition, and stress," says Hyman, who is chairman of the Institute for Functional Medicine (IFM). "Conventional medicine is the medicine of what — what disease do you have, what drug should I give you. Functional medicine considers the diagnosis, of course, but it also seeks to answer the question why."