Ahhhh The Matrix… Many of us know the late 90’s blockbuster movie. Red pill… Blue pill… Which one? The term “The Matrix” however, has a much different meaning for physicians who practice Functional Medicine. You may have heard of the term Functional Medicine, but what exactly is it and what is the Matrix as it pertains to health and wellness?
Functional Medicine is a science based approach to health that focuses on identifying and addressing the root cause of disease rather than just treating the symptoms. One condition or diagnosis may have many causes and one cause may actually produce many conditions. For example, if we look at the diagnosis of depression, we see in the image below that depression may have many causes. Likewise, a cause, such as inflammation, may lead to a number of diagnoses including depression. One person’s cause of depression may be very different from another person’s. So perhaps the reason your SSRI is not helping to resolve your depression is because your unique root cause is not being addressed.
The beauty of the functional medicine approach is that it takes the focus off of the name of the illness and instead allows the physician and patient to work together to find the underlying cause unique to each person in a truly personalized approach. Whether the diagnosis is anxiety, ADHD, acne, eczema, autoimmune disease, irritable bowel syndrome, migraine…it is important to look beneath that name and see what got you to the point at which you were given your diagnosis. Naming the issue is just the beginning! Getting to “the why” is where the magic happens. It is only then that we can achieve long term sustainable health without perpetually suppressing symptoms.
The Functional Medicine Matrix helps physicians to organize patient information and guides them where to begin treatment. The matrix shows how diverse symptoms may be linked and helps to determine which systems need the most support first. It allows for looking more deeply into where the imbalances for each individual may lie and where precipitating factors, triggers, and perpetuating factors keep the disease process going on. Looking at the “Functional Medicine Tree” is a great way to illustrate this process.
Rather than focusing on the branches and leaves at the very top of the tree which represents symptoms and diagnosis, the functional medicine model begins at the roots. The traditional medical model tends to focus in the branches and leaves. In order to keep a tree healthy, you need to support its very foundation- the roots and soil. If a tree is not healthy, the first place you should look is at these same foundational elements. During the patient interview, these foundational issues (sleep, exercise, nutrition, stress, relationships, genetics etc) are examined and addressed along with predisposing factors (antecedents), events (triggers) and ongoing physiological processes (mediators). These influences may then result in the core imbalances that we see in the trunk. The symptoms that patients experience are due to the body’s response to these functional core imbalances. Symptoms are in essence the body’s attempt to reestablish balance and restore health. A comprehensive medical history and physical examination conducted through the lens of this matrix along with diagnostic laboratory testing allows the physician to ask two very important questions which guide therapy:
1) Does this person need to be rid of something such as allergens, toxins, infections, stress, or poor diet?
2) Does this person have an unmet need that must be filled for optimal health and function such as vitamins, minerals, nutrients, protein, fats, carbohydrates, hormones, sleep, relaxation, community, purpose?
The aim is to answer these complex questions and work in therapeutic partnership with the patient and perhaps their family to remove the impediments to health and replace the unmet needs to restore the patient to optimal function. Not only does this approach help to tease through causes of symptoms and disease, it is also a very powerful tool for preventative medicine and overall health and wellbeing. In fact, in October 2019, a study was published in JAMA which demonstrated that the Functional Medicine model of care achieved better improvements in health related quality of life scores than standard medical care in a traditional family health center.
The conventional model of healthcare divides body systems and medical specialties into silos such as endocrinology, neurology, dermatology and gastroenterology. The human body, however, is wonderfully interconnected in an infinite web. If you would like to climb down from the canopy of leaves, dig in the soil and get down to the roots, perhaps the Functional Medicine approach is for you. Take a walk through the Matrix. You may be surprised with what you find.
Stephanie Strozuk, MD, FAAP is the founder of Evolved Adolescent and Young Adult Medicine- New Jersey's only private integrative medical practice dedicated exclusively to the health and wellbeing of tweens, teens and young adults. Dr. Strozuk is board certified in both Pediatrics and Adolescent and Young Adult Medicine. She has held academic positions at the Mount Sinai School of Medicine and at Rutgers - Robert Wood Johnson School of Medicine. She has also obtained additional training through the Institute for Functional Medicine and uses a functional medicine approach in her practice.