Functional Medicine: A Deeper Understanding of Health

It could be the medication, the sleepless nights or stress, but something isn’t right lately. You’re not feeling well. The question is how to get to the root of the problem when there are so many variables playing havoc on your health. That’s where Functional Vitality MD can help.

By Laura J. Perricone
Photographs by Michael Griffin Jr. 

Dr. Katherine Birchenough, a Greenville-based physician, board certified in pediatrics and emergency medicine for the past 15 years, has embarked on a new approach to wellness. It’s called Functional Medicine, and although it has been around at least 20 years, it’s a new concept to many people in the Upstate. Birchenough said this method of healthcare unravels the web of disease and offers a better chance at reaching optimal health.

“I call it 21st century medicine,” said Birchenough, who will be the fourth medical doctor in the state to be certified through the Institute for Functional Medicine. “It’s not new. It’s not alternative. It’s not a substitution for conventional medicine. It’s the evolution of medicine, and a necessary response to the epidemic of chronic disease and the health challenges of this century. So, although it doesn’t replace your primary care doctor, it takes what he or she does a step further.”

A medical doctor since 1998, Birchenough learned the value of Functional Medicine when she had her own health crisis seven years ago. She had been working in the fast-paced confines of the emergency room, and due to poor nutrition, disordered sleep, and high stress, was on her way to being “beyond burned out.” She took a good look at her lifestyle and realized she needed to help herself as much as she wanted to help those who came through the double doors of the emergency room.

“As I spent more and more time in the acute care setting, what I saw opened my eyes to a new way of applying my medical knowledge,” Birchenough said.

She saw patients who were frustrated when they weren’t getting the help they needed within a 15-minute appointment during a standard check-up or visits to specialists.

“Those are the people who made me wake up and realize that many, many people needed a deeper understanding of what was going on with them,” Birchenough said. “And that’s what Functional Medicine is. It’s a much deeper understanding of a person’s health. The goal is to restore a person to his or her best health.”

Molly Moon of Greenville is a registered nurse and one of Birchenough’s patients.

After having vague issues and seeing five doctors, Moon was referred to Birchenough by another physician. She said Birchenough took a completely different approach and examined her down to a cellular and molecular level.

“I have studied a lot of different complementary and alternative approaches,” Moon said. “I do a lot of research to understand the science behind them. I believe there are lots of different roads to healing. Keep searching to find what works.”

Moon recommends checking references and trusting your intuition for anyone looking to Functional Medicine.

“She wasn’t trying to sell me anything,” Moon said. “I was paying for her brain power.”

The premise of Functional Medicine, founded by Dr. Jeffrey Bland more than 20 years ago and adopted early on by physician leaders such as Dr. David Jones and Dr. Mark Hyman, is treating the root cause of a disease rather than just the symptoms.

Birchenough refers to the Institute of Functional Medicine’s tree symbolism to explain how she views health and illness at her Functional Vitality MD clinic in the Upstate: “Genetic predisposition, experiences, attitudes, beliefs, and mental and spiritual influences are the roots. The soil is made up of the person’s lifestyle and environmental influences that start even before birth. As the tree sprouts and grows, everything in the air, water, and soil play a part in how strong and healthy it becomes. The branches and leaves are what we see as symptoms. Treating only what you see in the part of the tree above the ground is incomplete. You have to look at the roots to find the cause and ultimately treat the dysfunction where it originates.”

Lifestyle, which includes sleep, exercise, nutrition, stress levels, attitude and beliefs, plays a big role in a person’s overall state of wellbeing, she said. If there is an imbalance, it can throw off other bodily functions, such as digestion and energy. These imbalances eventually lead to noticeable symptoms, and if left unaddressed, to a definable disease.


6 CORE PRINCIPLES
OF FUNCTIONAL MEDICINE

1. Understands the biochemical individuality of each patient (not a one-size-fits-all approach).

2. Uses a patient-centered – not a disuse-centered – approach.

3. Aims for dynamic balance between internal and external mind, body and spirit.

4. Recognizes the interconnections of internal physiological factors – systems biology.

5. Seeks to enhance the health span, not just the life span.

6. Identifies health as a positive vitality beyond just the absence of disease.



Birchenough looks at each part of this tree, mapping out nutrition, exercise regimens, stress modulation, and adding supplements while finding ways to either enhance current medications or get rid of them altogether.

Prior to the first appointment, patients who visit Functional Vitality MD fill out a comprehensive health history form, which Birchenough studies for any red flags of an encroaching disease or clues to the reasons for an existing one. Birchenough said the process is a good exercise for the patient as well, giving them insight and a hand in their journey to wellness.

The next step is the office visit, a two-hour session that zeros in on the problem at hand and the steps needed to get to optimal health. The Functional Vitality MD office, temporarily located in Birchenough’s Greer home, has an exam table and several shelves stocked with supplements and healthcare products. Patients are sent to a lab for blood work to determine any nutritional deficiencies, metabolic dysfunction, toxicity, and to look at markers of inflammation. Plans are in the works to open a permanent clinic in Greenville, where all blood work will be drawn in-house.

The entire process from the initial meeting to follow-up visits can take anywhere from three to six months with plenty of communication along the way. She said her patients are equipped with the tools they need to take charge of their lifestyles and start their journeys to better health.

The entire process from the initial meeting to follow-up visits can take anywhere from three to six months with plenty of communication along the way. She said her patients are equipped with the tools they need to take charge of their lifestyles and start their journeys to better health.

“Once I take you on, we stay in touch. I’m the little voice in your ear, your coach as we go along,” she said.

Birchenough has had several patient referrals from primary care doctors already. One such patient was suffering from chronic fatigue, fibromyalgia and hypothyroidism, and though all the tests looked normal, was still having energy problems and muscle pain.

“She knew something was wrong,” Birchenough said. “When she came to me, we looked deeper and looked at her entire health history from birth until now, and we examined patterns of illness in her life. By doing that, we were able to pinpoint where things may have gone wrong.”

Birchenough was then able to determine what testing needed to be done to check for hormonal imbalances, micronutrient deficiencies, and evidence of environmental toxicities. Then she devised a treatment plan.

“In her case, we found that the thyroid replacement she was on was not effective. She needed a different type of thyroid hormone,” Birchenough said. “She also had a previously unrecognized selenium and B12 deficiency that needed to be remedied before she could fully benefit from her thyroid treatment.”

That discovery made all the difference in the wellbeing of this particular patient, who now enjoys optimal health, Birchenough said.

“Health is not just the absence of disease. Health is a positive vitality where you wake up every day feeling optimistic about life. No one should have to feel defeated by an illness.” – Dr. Katherine Birchenough

Unlike conventional medical practices, Functional Vitality MD does not deal in acute care, but instead addresses chronic symptoms and disease. Birchenough says such a model allows her to practice proactive, predictive and personalized medicine.

Functional Vitality MD also works with healthy people to help them maintain that level of wellness. Birchenough said those patients contact her so they can learn ways to handle any potential stumbling blocks that come along with age. Functional Vitality MD can offer preventative tools to meet each individual’s need.

“You don’t have to be sick to see me,” she said, “but you do have to be motivated to make a change.”

Birchenough’s goal is to one day have a destination wellness center with a variety of healthcare providers working under one roof to address all the needs of a patient. Until then, she is trying to spread the word about the importance of Functional Medicine.

“I had a realization that if I can feel this much better (through Functional Medicine), then what can I do for other people?” she said. “Health is not just the absence of disease. Health is a positive vitality where you wake up every day feeling optimistic about life. No one should have to feel defeated by an illness.”


Editor’s Note: Dr. Katherine Birchenough has since joined practices with her husband, Dr. Shawn, to offer concierge health at a new location, OptimalSelf MD, in Greenville, S.C.

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