What is Functional Medicine?

Exploring Alternative Medical Care Options.

What is functional medicine, and is it right for you? If you’re exploring alternative medical care options, functional medicine is one system of care that you’ll at least want to look into. Monique Class, MS, APRN, BC is a board-certified family nurse practitioner and clinical nurse specialist in holistic health at Cleveland Clinic’s Center for Functional Medicine. In this Q&A, she helps to shed light on what functional medicine is and why it’s been growing in popularity over the past nearly 20 years. 

Peppermint Tea & Me: What is functional medicine?

Monique Class: Functional medicine is root cause medicine. I’m always looking for the cause to the symptomatology or to the diagnosis of the person sitting in front of me. In western medicine, ( I’m trained in both medicines), we’re trained to look for “What’s the diagnosis?” Give me this collection of symptoms and give me the diagnosis. in functional medicine, the training is, “What’s the root cause of these symptoms and this diagnosis?” What caused the dysfunction in the physiology? 

Monique Class, MS, APRN, BC

Another key thing is understanding that the body is made up of systems that communicate with each other. One system affects the other system. It’s understanding how different parts of the body influence other parts of the body and that it’s a network. Hormones influence the digestive system, and stress impacts the nervous system which impacts the digestive system and can be a root cause of many things. And long-term chronic stress turns on inflammation in the body that could turn on any inflammatory disease. So, it’s understanding how things are linked together and need to be unraveled. 

The third piece is that it’s patient-centered. It’s not protocol-driven. It’s individualized based on the patient. What is their belief system and what are they looking for? It’s looking at their story and their timeline in a useful way to see patterns and connections. We’re not trained to do that in western medicine. We’re trained to ask very specific questions to get very specific answers so we can get a diagnosis. We then give a protocol that everybody else with that diagnosis gets, so there’s no personalization of the medicine or deeper understanding of the human being. Functional medicine is understanding what gives our patients meaning and purpose and helping them make the right choices for their particular situation.

PTM: You can do all of that and still do all of the things that a conventional practitioner can do?

MC: Yes, and we do. Functional medicine includes conventional medicine. It’s not like you’re doing one or the other. Functional medicine expands on our knowledge base. It’s not throwing out conventional medicine. It’s embracing conventional medicine and then expanding it to look at other influences. We identify root causes and work with collaborative care teams to help change behavior. If you want to look at it this way, functional medicine is a panoramic view. What’s happening with traditional medicine is they’re looking at just that one snapshot, and they’re not looking at a panoramic view of things. 

PTM: You have certifications in imagery and meditation and mind- body medicine and yoga. What is imagery, and what is mind-body medicine?

MC: Mind-body medicine is really engaging the mind in the healing process and understanding how the mind influences the body and how the body influences the mind and getting people to understand that it’s all connected. it’s one big system. If you come in through the body, you’re influencing the mind. If you come in from the mind, you’re influencing the body. They’re intimately connected. It’s working with all of those dimensions and not just working with the body but engaging people’s mind.

Imaging is a way to get people in touch with the unconscious thoughts and images that are in their mind that drive choices one way or the other. It’s understanding what’s going through the mind stream and what the pictures are that people have attached to their thoughts. A lot of times, the images are all around negative things that are going to happen or past regrets that have happened, and people get stuck. You work with their images to help them create healing images that then drive the physiology. 

The research is there. One study had surgeons practice a specific surgery in their heads. They saw themselves doing it well with no complications. When you do that, you’re actually on a physical level. You’re priming those pathways and stimulating that neural plasticity for what you want to happen. For the surgeons who did that, their heart rate variability was more in coherence. They had less cortisol and were more focused. So that’s the end state imagery. It’s working with people to understand what their images are that they’re not even conscious of that are driving their fear and anxiety and then having them create new images. These new images begin to change thought patterns at the level of the mind and the unconscious mind.

 PTM: What is your general approach to using medication to treat illnesses or symptoms?

MC: I use it when I need to. It’s the wise use of medication in the right dose as a bridge, while you’re working on the lifestyle stuff. I’m looking to take them off medication once we get the rest of it, but I’m not afraid to use meds when I need to use meds. The conversation is, “We’re using this, we’re going to work on all this stuff and then we’re going to try to back down off of it.” If I don’t need it, I don’t go there first. Medication is a bridge. It’s not a permanent player if at all possible. 

PTM: Why did you decide to go into functional medicine?

MC: Functional Medicine was for me part of my larger vision of health. When I was looking at the way we were treating people in conventional medicine – both in the hospital and in the doctor’s office that I was working in – I felt like they weren’t getting better. We were just perpetuating a disease model. I wanted a model that worked higher upstream. A model that saw people as individuals and understood that the mind and the choices people make have a great influence on the body. If you work at the level of the mind and change the choices, you can reverse engineer complex chronic diseases. It’s very different than an attitude of “You’ve got this diagnosis, take this medication and see you later.” I wanted something more than that for myself and for my patients.

PTM: Do you ever find that patients or even other practitioners are skeptical of what you do?

MC: Not anymore. In the beginning, they didn’t understand what we were doing. Now, people are seeking us out. Functional medicine has really caught on among the lay public. People are finding us. We don’t have to advertise anymore. They’re coming to us because they want a functional medicine approach. We’re addressing them as human beings and finding out what’s meaningful to them and what they’re looking to achieve. We’re trying to help them with that in the gentlest way possible. 

PTM: Everything you’re describing sounds like it takes more than the 15 minutes allotted for conventional medicine. How does that work?

MC: We’re not in insurance anymore, but we did it for years. When we were in insurance, I would have people come back every two weeks for half an hour as we made needed lifestyle and behavior changes. Now, we are out of insurance, and we’re a fee for service. My first visit is about an hour and 15 minutes. Then we have follow-ups, and we work with coaches in our office to help coach people on behavior change. 

The model of utilizing collaborative care teams with coaches is used a lot. It’s focused on the care plan that the patient helps co-create with us as doctors based on their lab results, their symptoms, their individual stories and what their goals are. They then work with a team on these things and then loop back to me. It truly is a team approach. 

Important note about insurance and functional medicine

If you decide to work with a functional medicine provider, be sure and check with them on whether they accept insurance. If they don’t, and you’re planning to file your insurance yourself, check with your health insurance company about whether it covers the facility and type of program that you are considering. In addition, if you have a healthcare reimbursement account, you can also check to see if the services that you’re considering are covered by your plan. 


What is Real Health?

Actionable Steps to Achieve Real Health.

Have you ever had periods of time where you simply feel right? We’re talking both mentally and physically. You feel in balance, you feel strong, you feel… well. That’s what I call Real Health.

If you have felt that or you still do, this website is geared toward helping you maintain that incredible state of being. If you haven’t felt that in a long time or maybe ever or when you did, it was fleeting, helping you achieve your version of Real Health is what Peppermint Tea & Me is all about. That’s why we need to define what Real Health is as well as lay out some actionable first steps that you can take to achieve it.

Please Note that as an Amazon Associate, I earn from qualifying purchases made through some of the links included on this page. 

What is Real Health?

As you’ll be reminded frequently if you hang out in this space regularly, I believe that Real Health is achieved by recognizing that every part of us – mind, body and nutrition – is connected. Monique Class, MS, APRN, BC agrees. She’s a board-certified family nurse practitioner and clinical nurse specialist in holistic health at The Institute for Functional Medicine.

Monique Class, MS, APRN, BC

In a conversation about holistic health, Monique told me that “the mind, body and spirit (if you want to use that word), are all connected and are a unified whole. There’s bi-directional communication, meaning what happens to the body influences the mind and the emotions and what happens in the mind influences the body.”

This is understanding that when it comes to our health and overall wellbeing, causes and effects are not simply either physical or “mental.” Most of the time, they’re both. Melissa Grabau, PhD reminds us in her book, The Yoga of Food: Wellness From the Inside Out (affiliate link) that “How we feel day to day, our general health and energy levels, and our overall sense of safety and peace in our own flesh have an enormous impact on how we feel about ourselves and our capacity to function effectively in the world.”

Role of Nutrition

Julie McGregor, MD

So, what does all of this have to do with nutrition? Everything! Julie McGregor, MD works with the Integrative Medical Clinic of North Carolina and is a board-certified internist and nephrologist trained in integrative medicine. She told me that, “Nutrition is a part of building up our physical cells, but it’s also an emotional choice and has a lot of overtones. What we choose to eat has to do with where we are emotionally and also then leads to an emotional response in our body.”

This connection can lead to a healthy, well-oiled machine when it comes to our body and our mind. Failure to recognize this relationship though can lead to us living a life that is less than our best or even worse, spiraling through physical or mental issues that we have more control over than we may think.

Photo by Teejay from Pexels

Common Barriers to Real Health

According to our experts, the most common barriers that many women run into when it comes to achieving Real Health can really be narrowed down to two primary areas.

1. Unhealthy relationship with food.

Both Monique and Julie say this is one of the primary issues they see when women especially don’t recognize how connected everything really is. Some of the primary reasons for this unhealthy relationship can include emotions, social or community expectations, or programming.

Monique gives the example of coming home at 8:00 p.m., going straight to the freezer, pulling out the ice cream and eating it until the whole container is gone. If you do that every night, it becomes a pattern. “We know physiologically that every time you do that pattern, you create wiring in the brain. It’s called neuroplasticity. So, neurons that fire together wire together. Every time you do something over and over again or choose a particular food over and over again, you get hardwired into the brain where that choice becomes automatic and not conscious.”

The same concept is true of emotions. If you reach for chocolate or something sweet every time you feel anxious or stressed or alcohol every time you feel angry, you’re hardwiring your brain to react to those emotions with food.

2. Lack of self-care.

Julie says this is a huge issue for women because we put so much pressure on ourselves to be perfect in every aspect of our lives. To have perfect careers, to keep a perfect home, to be a perfect mom, to be perfect daughters and to be perfect friends.

“There’s a lot of pressure that we put on ourselves, and the one who ends up coming last is ourselves. So many of my female patients who are in their 50s or 60s come to me fatigued, worn out, completely depleted, having not concentrated on wellness for themselves. They were out trying to achieve perfection in every component of their lives for, you know, 50 or 60 years. Then, they just can’t keep going because there isn’t that attention of self-care or focus on wellness for oneself.”

She’s found that this often leads to obesity, depression, thyroid disorders and general physical unwellness that plagues us around the time of menopause. “This, coincidentally, is a lot of times when we’re retiring or when we’re empty nesters, or during these transitions when the adrenaline stops and the body is just feeling the effects of decades of neglect.”

First Steps Toward Achieving Real Health

To shift away from these barriers, there are several first steps that you can take to achieve Real Health.

1. Love yourself and be happy with yourself just as you are.

There may be things that you want to change, but Monique says that accepting and loving where you are right now has to come first. Then you can identify and become aware of the areas that you want to change in a healthy, realistic way.

2. Carve out time for self-care.

We may not be able to exercise for an hour every day, get a massage once a week or meditate for 30 minutes every morning, but there are plenty of things that we can do. It’s all part of making sure that we’re the best versions of ourselves now and that we don’t end up tired and depleted when we finally do feel like we have the time.

3. Become aware of the choices that you’re making.

According to Monique, this is critical for making any kind of change in your life. She suggests that as you reach for that ice cream every night, that you notice the behavior and check in with yourself and think about what you’re feeling, what you’re eating for, or what you’re hungry for. More times than not, you’ll find that you’re not hungry for the food, you’re looking for something else.

The first step, she says, isn’t taking that food or behavior away. You have to first recognize the behavior and then begin to figure out what you’re really hungry for or what you really need in that moment. At that point, you can substitute the behaviors that truly address those needs for the ones that aren’t serving you well.

4. Drink more water

You may think that you don’t like water, but your body does. In fact, the U.S. Geological Survey says our bodies are made up of up to 60% water, so we have to have it to survive. Since we want to do more than just survive, we want to thrive, Julie puts this step toward the top of the list for achieving Real Health and adopting an attitude of overall wellness.

5. Get better sleep.

Julie says this has to be a priority. I’m the first to acknowledge that this isn’t always as easy to do as it sounds, but there are things you can do to not only make sure that you’re getting the amount of sleep you need but that it’s quality sleep as well.

6. Move as much as you can.

Here are some ways that you can work movement into your day, whether you have 30 minutes at a time or 5-10 minutes here and there.

Photo of coins pouring out of a jar as an example of Real Health on a budget

Real Health on a Budget

“That all sounds great, but even if I can find the time to take care of myself and to eat more healthy, nutritious food, I can’t afford it.” If that’s what you’re thinking, I’m here to ask you to be willing to think differently. Gym memberships are not a requirement for achieving Real Health and neither is having someone else to watch your kids while you focus on yourself.

Yes, whole, nutritious food is going to be more expensive than a 99-cent fast food burger, but in the long run, it evens out. Without health issues that could have been prevented with different lifestyle choices, you’ll likely save money in a number of ways. These include doctor’s visits and prescriptions as well as not missing work or losing opportunities among many others.

Real Health on a budget isn’t about an attitude of lack, it’s about an attitude of abundance. It’s being grateful for what you have and recognizing that healthy can be affordable. It’s also allocating your dollars in a way that supports your priorities rather than automatically spending money in ways that don’t serve you well. 

Mind + Body + Nutrition + On a Budget = Real Health

Julie sums it all up in a beautiful way. “How we exercise and what we choose for our physical wellbeing as far as movement and environment and choices about stretching or meditation, and our choices with our nutrition all affect how we think and our emotions. In turn, all of our emotions affect how we move, where we put our bodies and the choices we make for our physicality and our diet.”

Because of how entwined these factors are, Real Health looks different for everyone. Yes, the general steps outlined here are good places to start in achieving it, but Real Health is very individual. What it looks like for me probably won’t be the same for you. The goal for all of us though is to live in that place of personal wellness as much as possible and to draw on the strength and power that brings to live our best life possible.