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Joanne Pizzino, MD, MPH

Joanne Pizzino, MD, MPH is board-certified in Preventive Medicine and a board-diplomate in Integrative Medicine. She has been trained and practicing Functional Medicine for over 20 years. She now offers telemedicine services for functional medicine via video conference from the comfort of your home or office through Parsley Health. Visit consultation for a free consultation to learn more about our functional medicine and telemedicine services to help you heal chronic disease

What Is Functional Medicine and
How Can It Reverse Chronic Disease?

By Joanne Pizzino, MD, MPH
Medical Editor of Health&Healing

Dr. Pizzino

Never heard of Functional Medicine? Neither have lots of doctors. And, it is time to raise awareness about this science-based system of precision, personalized health care that focuses on the root causes of disease to prevent and reverse them. It is personal, because it is very much about you: your own distinctive set of internal and environmental influences which make up, well, you!.

Functional medicine is precise, not because it chooses a label for a disease from thousands of ICD-10 code diagnoses, but because it uses unique testing, including genetic factors, to determine which of seven essential functions are out of balance and to correct them by turning on the innate natural healing ability built into your body. These seven essential functions control virtually every aspect of our bodies and minds, and are at the root of those thousands of chronic disease diagnoses. (Learn more about the seven essential functions on our YouTube channel Whole Health Solutions Cary NC)

A Case in Point: Fatigue

So, let’s look at how a functional medicine physician would approach a very common complaint: fatigue. Lack of energy is an epidemic in our modern go-go-go world, and is common to many chronic diseases, including autoimmune disorders such as multiple sclerosis (MS), metabolic disorders such as diabetes, and chronic infectious diseases such as Lyme disease. It turns out that treating the fatigue often gets to the root causes of the disease—so it may be more important to look at this symptom than the disease label.

We will use a real world example I will call Rachel. Rachel is a 43-year-old mother of two teenagers who also runs her own business. Rachel has been tired for 15 years since she was pregnant with her second child. This pregnancy was actually twins, and one of the twins died, leaving the other born very early with special needs. She, like many people, thinks the fatigue is just a result of the many stresses she is under. She often feels anxious, but who wouldn’t under these circumstances? Between being a mother, wife and boss, she rarely gets more than six hours of sleep, and often needs a few glasses of wine or a little alprazolam to be able to fall asleep and stay asleep. She has to have her coffee or a cola to get going in the morning, and is noticing brain fog more often.

Diagram courtesy of Institute for Functional Medicine, learn more at

Rachel has to make a lot of lists to remember every-thing. Although she buys fresh fruits and vegetables with good intentions to make them for her family, they often grab meals on the go, running from school to work to activities. About every one to two months, she pushes herself through some mild flu-like symptoms with swollen glands, headache, and more fatigue than usual. She loves her Zumba class, but it often leaves her more tired with sore muscles. She has been noticing more gas and constipation for a few years, but just puts up with them. With these very common symptoms, Rachel actually meets the criteria for Chronic Fatigue Syndrome (CFS).

Find the Root Cause

The Functional Medicine Tree pictured here helps us organize our approach to getting to the root causes of Rachel’s fatigue, which is actually more than just stress. Stress certainly keeps the body off balance, preventing it from repairing itself, but there is more going on here if we look. Most doctors focus on the branches and leaves of the tree, as they are trained in organ-system diagnosis. We are going to focus on the roots where we see antecedents (what set the person up for chronic disease), triggers (what started the imbalance causing symptoms), and mediators (the factors keeping the body from returning to its natural balance). Feeding the roots, we also see several lifestyle factors that are ultimately delivered to the leaves, leading to those chronic disease labels.

Using specialized functional medicine testing, we find that Rachel has malfunction of her adrenal glands from a combination of food sensitivities and non-restorative sleep. She also has an imbalance of flora in her gut microbiome called dysbiosis. Both of these issues have contributed to sluggish ability to remove toxins from the body, poisoning the powerhouses in the cells called mitochondria. We address these via a cleansing nutritional program to stabilize blood sugar for her adrenals, restore a healthy gut lining, and promote toxin removal including regular bowel movements.

Genetic testing showed she has difficulty absorbing vitamin D and vitamin B12 from her food. We support these with supplements, as well as adaptogenic herbs to help her make and process hormones more efficiently. These also improve sleep, which we optimize with mindfulness practice and biofeedback. Now she can enjoy Zumba again without the sore muscles, and she is noticing she doesn’t have to refer to her lists as often because her memory is improving. Her symptoms have improved about 50 percent, so now, with a healthy intestinal tract, we will address more aggressive detoxification of the heavy metals found on testing.

Beyond Treating Symptoms

Although everyone craves the simplicity of a “one and done” treatment in our busy world, that approach does not honor the vast complexity of our bodies. Covering up symptoms so that we can just “keep going” every day ultimately prevents the body from using its own built-in rebalancing processes. Rachel found a health coach enormously supportive in helping her gradually make the lifestyle changes that naturally fed her roots what they needed to make healthy leaves. Consistent “baby steps” are often the key to overcoming chronic disease. Published research shows this functional medicine approach has been found to reverse severe long-term conditions such as cardiac disease, arthritis, skin disorders, MS, and dementia. Whether your symptoms have a label or not, you owe it to yourself to get off the prescription refill treadmill, and work with a functional medicine physician toward optimal well-being.