Functional Medicine Assessment

What Is A Functional Medicine Assessment?

Functional Medicine (FM) is a holistic, integrative approach to health and well-being that evaluates how each biological system is working and supporting the health of the whole, interconnected body.

Physicians who use this approach look for signs of imbalance and areas of health that can be optimized. If deficiencies are found, FM doctors investigate the root cause of the deficiency by looking at the patient’s environment, thoughts, diet, lifestyle, possible infections, medications, levels of activity, social support (family, friends), and level of stress, as all of these factors could be supporting or exacerbating the disease.

Functional Medicine differs from Conventional Medicine in that while Conventional Medicine is excellent at treating acute and urgent conditions, it tends to treat symptoms and not the underlying cause of those symptoms.

Functional Medicine physicians assess six major areas of health.

In looking for clues that may be contributing to symptoms of illness or disease we systematically assess and optimize the following six major areas of health:

  1. Immune system: We look for signs of inflammation and auto-immune diseases (including Hashimoto’s thyroid disease, lupus, multiple sclerosis, inflammatory bowel disease, pain, allergies/sensitivities, etc.).
  2. Energy systems: We assess for factors that may be depleting your body’s energy, including your mitochondrial (energy part of cells) health, nutrient deficiencies and excesses.
  3. Heart and metabolic systems: We evaluate for signs of heart and vascular disease and abnormal blood sugar values.
  4. Hormone systems: For women, we assess for signs of PMS, fibroids, perimenopause and menopause, estrogen dominance, and other conditions of hormone imbalance; and for men, we assess for signs of loss of motivation, focus, low libido, andropause (low testosterone), erectile dysfunction, poor work-out recovery, poor exercise endurance, fatigue, and other conditions of hormone imbalance.
  5. Detoxification system: We assess for signs of toxin overload or the inability to release toxins from your liver and body. This system is key for optimal health of the body as well as maintaining a youthful appearance and vitality.
  6. Gastrointestinal/digestive systems: We look for signs of inflammation in the gut, food sensitivities, and infections. This system is also vital to all other systems operating effectively and preventing autoimmune diseases, weight gain, and inflammation throughout your body (joints, sinuses, lungs, thyroid, etc.).

What a Functional Medicine Assessment entails

  • listening to what your concerns are and asking questions that help and reveal any issues.
  • performing an exam to assess for any physical signs of deficiencies or signs of excess that may be supporting disease in your body.
  • ordering tests that will look at how effectively your body is performing certain functions. Some tests include:saliva tests to evaluate your body’s ability to respond to stress and maintain healthy sleep and energy levels;
    • hormone tests that show if your body is releasing optimal amounts of hormones to support your energy, mood, sexual health, brain clarity, bones, focus, energy;
    • thyroid tests that can demonstrate if you are producing the proper levels of thyroid hormones to support mood, energy, weight, skin/hair/nails, brain clarity, and more;
    • stool analysis that reveals if your gut and immune system are sufficient to support your digestive and immune system needs;
    • food sensitivity and allergy testing that may uncover an unhealthy gut and foods that are contributing to brain fog, bloating, constipation/diarrhea, IBS, weight gain, and more;
    • lipid profile that assesses if you have the type of cholesterol molecules that lead to cardiovascular disease;
    • inflammation profiles that evaluate the level of inflammation that your body is dealing with;
    • and many more tests are available if needed.

Why would you do a Functional Medicine assessment if you’re healthy?

Because of its whole health approach, an FM assessment and its recommendations can help prevent illness while optimizing your current state of health, so you can:

  • enjoy vitality, longevity and a youthful appearance at every age;
  • maximize your energy and mobility to live the life you choose;
  • prevent unnecessary weight gain;
  • maintain healthy heart function;
  • allow smooth transitions into each phase of life, i.e., young adult years, reproductive years, retirement years, menopause/andropause, etc.;
  • maintain hormone and thyroid health;
  • support your immune system to prevent illnesses;
  • optimize your gut health to support your immune system, weight, and tolerance to different foods and prevent disease;
  • support healthy mood and mental health;
  • encourage healthy sleep and rejuvenation;
  • prevent metabolic disorders like diabetes and insulin resistance;
  • and so much more!

We’ve gathered all of this information, now what?

Functional Medicine’s approach is patient-centered and patient-directed; once we’ve gathered all of your information, we listen to you. Together we’ll discuss and prioritize your unique wellness goals. Once those are established we can start working towards the areas that will best help your major wellness goal first, then systematically addressing all other issues, as supporting longevity and wellness relies on improving all facets of your health.

This approach typically utilizes several modes of treatment, including stress reduction & management, mind-body tools, improving nutrition, healing your gut, supporting detoxification, exercise, acupuncture, herbs/botanicals, supplements, manual medicine, and when needed, medic

Regenerative Medicine

Patients are increasingly seeking non-surgical treatment options for orthopedic and sports injuries. Regenerative medicine, which enhances the body’s natural healing process to repair damaged tissues, is one of the fastest growing fields in medicine. If you have sustained a tendon or ligament injury, or suffer from chronic back or neck pain, you may be a good candidate for Prolotherapy, Platelet Rich Plasma (PRP), or Stem Cell Injections, depending on your unique medical condition.

Prolotherapy

Prolotherapy, which is short for “proliferative therapy,” is an injection technique where natural solutions (from a simple dextrose solution to more complex stem cells) are delivered to the injury site to restart and maximize the body’s own healing process This healing technique is applied to unstable and injured joints, ligaments, and tendons to encourage the restoration of normal, healthy tissue. As such, prolotherapy can help people avoid surgery.

Where and how does prolotherapy work?

The amount of clinical research on prolotherapy has increased substantially over the last several years.  Multiple studies have demonstrated its effectiveness in treating neck pain and instability; low back pain; sacroiliac dysfunction; chronic groin pain; osteoarthritis of the knee and hand; tennis elbow (lateral epicondylosis); knee tendon, ligament and meniscus injuries; and Achilles tendon injury. In everyday clinical practice, prolotherapy is used to treat painful conditions in virtually every major area of the body with excellent results. The healing response itself is triggered when the prolotherapy solution causes the injured tissue to release specific growth factors that attract tissue-healing cells to the injury site.

Who can benefit from prolotherapy?

Good candidates for prolotherapy include people who have joint or muscle pain. Prolotherapy works synergistically with treatments such as physical therapy, manual adjustments, massage therapy, and other treatments. The root causes of the pain can be wide-ranging, including osteoarthritis, sports injuries, post-surgical complications, ligament laxity from hypermobility, and direct trauma caused by an event such as a fall or car accident.

What is a prolotherapy treatment like?

After answering any questions, the doctor will examine the area to be treated via ultrasound or fluoroscopy (x-ray) and may note a few anatomical “landmarks” on the skin surface with a pen. The treatment area is then thoroughly cleansed and sterilized, so treatment can begin. Although prolotherapy involves injections, sometimes to multiple areas, it is generally very well tolerated. Because the areas of the body that are being treated are already injured and sensitive, the injections typically cause some temporary pain and discomfort. Our highly trained doctors take several measures to minimize this discomfort, such as using the smallest and thinnest needles possible, prescribing medications to reduce pain, and sometimes recommending anesthetic creams which numb the skin before the procedure. Since the body’s natural healing response can be a slow process, it may take two to four weeks before patients notice significant improvement. The results, however, are often long-lasting and may even be permanent in some cases.

What is the bottom line?

As with any other medical treatment, prolotherapy does not work in all cases. But it can provide long-term pain relief in situations where multiple other therapies have been unsuccessful. When performed as part of a comprehensive treatment strategy that maximizes your healing potential by improving your overall health, prolotherapy can be the catalyst that helps to bring you out of pain and back into the game of life.


Platelet Rich Plasma (PRP)

Platelet Rich Plasma Therapy is an exciting treatment that uses one’s own blood platelets to activate tissue regeneration and accelerate tissue repair following an injury, surgery, or degeneration.

How does PRP work?

Treatments are a multi-step process that is completed in one doctor’s visit, PRP involves:

  1. drawing a patient’s blood;
  2. placing it in a centrifuge to separate the plasma from the red blood cells; and
  3. injecting the plasma solution back into the patient’s body at the site(s) of the injury.

The high concentration of platelets in the plasma solution creates a localized inflammatory reaction that stimulates the growth of new ligament and tendon fibers, cartilage, and bone. The PRP process replicates the body’s natural healing response where blood swells around an injured area of the body to protect it and facilitate healing.

This technique can help shorten the rehabilitation time following an injury or surgery and can often help patients to avoid surgery or the need for cortisone injections. Compared to surgery, PRP carries a substantially lower chance of infection, leaves no scar tissue or irreversible destruction of cartilage. Visits, which include preparation and injection of the plasma solution, take approximately 50 minutes. In addition, the recovery period post-PRP is considerably shorter than post-surgery, and PRP is considerably less expensive than surgery.

In addition to orthopedic injuries, PRP can be used to improve painful intercourse (dyspareunia), vaginal dryness and even enhance orgasm. For more information on the O-Shot®, click here.

Depending upon your particular circumstances, your Kaplan physician will utilize ultrasound or fluoroscopic guidance during the PRP procedure.

Article: New State-of-the-Art Fluoroscopy Suite Expands Treatment Options for Patients


Stem Cell Therapy

As people are living longer and engaging in activity well into their golden years, the prevalence of musculoskeletal degeneration and orthopedic injuries have also increased. Stem cell therapy is another type of regenerative medicine treatment that is revolutionizing the way injuries and degeneration of muscles, tendons, and ligaments are treated.

Mesenchymal stem cells (MSCs) are a type of adult stem cell that can be found and collected from bone marrow. Stem cells have the distinct ability to turn into various specialized cells that repair degenerated or damaged tissue. Because of their ability to develop into other tissue types, stem cells accelerate the healing process, alleviating pain symptoms and providing a faster recovery from injury or illness.

Sources of Adult Stem Cells

At the Kaplan Center, we use stem cells obtained from either bone marrow or umbilical cord tissue, primarily the latter. While adult stem cells can also be derived from adipose (fat) tissue, we do not utilize this method.

  • Umbilical cord-derived stem cells: Women who are undergoing a cesarean section birth can choose to donate placental tissue and umbilical cord to a laboratory which harvests the Wharton’s jelly, connective tissue from the umbilical cord. This tissue from healthy births would otherwise be medical waste. Wharton’s jelly is very rich in young mesenchymal stem cells, cytokines, and growth factors. Mesenchymal stem cells are different and should not be confused with embryonic stem cells.
  • Bone marrow-derived stem cells: The process of collecting bone marrow stem cells is surprisingly quick and simple. Like other regenerative injection treatments, this is a same-day procedure that takes approximately 90 minutes. After collecting bone marrow from the patient utilizing ultrasound or fluoroscopic guidance, the different compounds are spun in a centrifuge and separated. The stem cells, proteins & growth factors are then extracted and injected into the site (Depending on the site, dynamic ultrasound and x-ray fluoroscopic guidance are used to selectively target the injured structures as painlessly as possible.)

Hormone Replacement Therapy

Often we find that patients suffering from chronic pain, illness, or fatigue have been living with hormonal imbalances that have never been properly diagnosed. If your symptoms warrant it, our physicians rigorously investigate this possibility. During your first visit to the Kaplan Center, your physician will conduct a comprehensive health history and physical examination, and if appropriate, order laboratory tests to explore whether a hormonal imbalance is causing or contributing to your condition.

If the lab results indicate there is a hormonal imbalance, your individual treatment plan may include traditional hormone replacement. Many patients, however, are also interested in considering alternative therapies, such as natural hormone replacement, bioidentical hormones, nutritional supplements, herbal remedies, dietary changes, acupuncture, and compounded hormones (where the physician instructs a pharmacist to create a special formulation of a hormone replacement or supplement suited to the needs of a particular patient). Our goal is to develop a treatment plan that is effective and comfortable for you. All of the Kaplan Center’s physicians screen for and treat hormonal imbalances using traditional and alternative therapies.

For more information about how the Kaplan Center physicians diagnose Hormone Disorders please click here.


Additional Resources:

Article: Hormones, The Great Communicators | A look at some of the causes of hormonal imbalance
Video Series: Hormone Therapy: Myths & Current Research, presented by Dr. Lisa Lilienfield

Acupuncture

The Kaplan Center for Integrative Medicine offers patients acupuncture within the context of their entire treatment plan. Research has demonstrated that it can have direct and lasting positive effects on the body’s neurological (nervous), endocrine (hormonal), and immunological (disease-fighting) systems. In 1998, a Consensus-Conference Panel of the National Institutes of Health (NIH) found that acupuncture is an effective non-invasive modality in treating a variety of medical and pain problems, including migraines, osteoarthritis, and infertility.

What is Acupuncture?

Acupuncture is a practice of Chinese medicine that relies upon the therapeutic insertion of slender needles into the body to improve a person’s health. According to Chinese medicine, health is dependent on the balanced flow of “Qi” which is pronounced “chee” and refers to the vital life force within each person. Blockages or imbalances in Qi result in pain and illness. A thorough medical history and examination reveals the nature of these disturbances, so that acupuncture needles can be inserted in the proper points in the body to restore the balance and flow of Qi. An understanding of the anatomy and principles of acupuncture allow your practitioner to design a treatment program that meets your needs. In this way, it can help reestablish your good health and sense of well-being.

What Conditions Can Be Treated with Acupuncture?

Acupuncture can be useful for treating a large range of illnesses and pain syndromes, including arthritis, headaches, allergies, neck and backaches, coccydynia (tail-bone pain), fibromyalgia, and other joint or muscle pain. The therapy strengthens the body’s immune system; therefore, it also can alleviate immunological disorders such as asthma, allergies, Graves’s Disease, Sjogren’s Syndrome, and ulcerative colitis.

Supporting the body’s immunological functions through acupuncture also can help restore a person to good health after surgery or shorten the duration of an infectious illness, such as a cold, sinusitis, or pneumonia. Cancer patients often find it can help relieve the symptoms of nausea, vomiting, and fatigue caused by chemotherapy. Acupuncture also can be effective in relieving problems such as chronic fatigue syndrome, dysthymia (general lack of well-being), sleep disorders, infertility, and menstrual irregularities, including menstrual pain and premenstrual syndrome (PMS).

At the Kaplan Center acupuncture is also used by people who are looking for a natural, alternative way to reduce the signs of aging and improve inner vitality for a healthy appearance to their face. Cosmetic Acupuncture provides a non-toxic, non-surgical way of looking and feeling your best at any age.

Acupuncture has also long been known to produce relaxation, reduce muscle tension, and increase mood. How? We know that acupuncture releases endorphins, our body’s natural opioids. These are largely responsible for the pain-relieving effect but these neurotransmitters also produce a relaxation response. Researchers at Georgetown University have shown that acupuncture in clinical models releases endorphins and lowered stress hormones including the sympathetic NPY peptide pathway.

Providers

Dr. Kaplan and Dr. Lilienfield are members of the American Academy of Medical Acupuncture, the organization that has established the training requirements for physician-acupuncturists in the United States. The Center’s physicians are not just experts in the clinical practice of acupuncture, they also are leaders in the field of medical acupuncture. Dr. Gary Kaplan was a founding board member of the American Academy of Medical Acupuncture and also served as president of the Medical Acupuncture Research Foundation. Dr. Kaplan also has served as an advisor to the National Institutes of Health (NIH) on research and practice issues concerning acupuncture.

Rebecca Berkson is a licensed acupuncturist and is NCCAOM Board certified in Acupuncture and Oriental Medicine. Her training includes traditional Chinese medicine coupled with anatomy and clinical sciences to provide the safest and most effective care to patients. Rebecca has also studied with teachers in different practices of acupuncture including traditional Chinese medicine, Five Element, and various styles of Japanese acupuncture.

There are a variety of acupuncture disciplines or methodologies, and each has its strengths in terms of treating particular medical problems. Dr. Kaplan, Dr. Lilienfield and Rebecca Berkson are proficient in many acupuncture disciplines, including Traditional Chinese Medicine, French Energetics, Auricular, Five-Elements, Scalp, and Neuroanatomic (Craig Percutaneous Nerve Stimulation or CPNS) Acupuncture.

Acupuncture services at the Kaplan Center are available for both patients and non-patients. Please call (703) 532-4892 if you would like to schedule an appointment.

 

Nutritional Testing, Counseling & Coaching

Although food provides us with both nutrition and pleasure, poor nutritional choices can lead to serious health problems. If you follow an essentially healthy diet but still find yourself ill or in pain, you might be eating the wrong foods for your body.

Marilyn Barbone © 123RF.com

At the Kaplan Center for Integrative Medicine, we take special care to explore the possibility that your nutrition may be causing or contributing to your pain and illness. For example, magnesium or vitamin deficiencies, genetic weaknesses, food sensitivities, and allergies can create or contribute to pain problems in two major ways: 1) by causing tissue inflammation and 2) by interfering with the proper absorption of the nutrients you need to stay healthy. Inflammation is a concern for many people with chronic illnesses, such as osteoarthritis and rheumatoid arthritis, heart disease, hypertension, fibromyalgia, and autoimmune diseases, including celiac disease, and lupus.

When it appears that nutrition may be playing a significant role in a patient’s medical problems, we often recommend laboratory testing to identify potential food allergies, food sensitivities, or digestive problems. After identifying your specific nutritional needs, your Kaplan healthcare providers will work with you to create measurable goals and a nutrition regimen that improves your health and fits your lifestyle, preferences, culture, taste, and time constraints.

Good nutrition is also critical in preventing disease and attaining optimal health so that we can feel great, act with vitality, think clearly, and look our very best. Although our nutritional goals may be clear, sometimes the path to attaining them seems to be filled with obstacles. For example:

  • Do you know what you should and want to do with your diet and health, but lack the support, structure, encouragement, and feedback to make it happen?
  • Have you tried a variety of diet plans, but not yet succeeded in making the lifestyle changes that will allow you to sustain a healthy weight?
  • Do you have a strong sense of where you want to be with regard to health and fitness?

Then wellness coaching may be a great fit for you. Coaching is based on achieving your own vision of how you want to live your life, and developing small, sustainable goals to get you to optimal health with diet, exercise, stress management, etc.


Additional Resources:

Article: 11 Food Rules For The Ultimate Anti-Inflammatory Diet

Physical Therapy

In treating chronic pain, there is an important role for invasive measures, such as epidural steroid injections, the surgical implantation of dorsal-column stimulators and other surgical options. But there are also a multitude of effective, non-invasive manual treatment options available to patients, which have far fewer side effects and pose less risks, such as physical therapy. When these therapies are incorporated into an individualized and comprehensive treatment plan your healing is likely to be much faster and more complete.

If your Kaplan physician determines that physical therapy will speed your healing, you will be referred to a member of our physical therapy team, which includes: Pat Alomar, Jeanne Scheele, Michele McLellan, and Jessica Coleman. Our physical therapists combine outstanding manual skills with a comprehensive understanding of body mechanics. This enables them to successfully treat a wide range of chronic musculoskeletal pain problems.

Our PTs will spend the better portion of an hour working with you, providing hands-on, deep tissue physical therapy and teaching you exercise programs that you can do at home to help regain your strength and flexibility. Your physical therapist will consult with your physician about your treatment plan and your response to those treatments. The purpose of this ongoing communication between you, your physical therapist, and your physician is to ensure that we support, in every way possible, your body’s ability to heal itself as quickly and as completely as possible.