​WHAT CREDENTIALS SHOULD A CLINICIAN HAVE TO DO FUNCTIONAL OR INTEGRATIVE MEDICINE?

 

Physicians can get a certification in Integrative Medicine from the American Board of Integrative Medicine or a certification in Functional Medicine (which is more rigorous) from the Institute of Functional Medicine.

Dr. Simkin is certified in both.

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Why are there so many “natural products" sold in the market? 

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In October 1994, the Dietary Supplement Health and Education Act (DSHEA) was signed into law. Under DSHEA, the FDA is not authorized to approve dietary supplements for safety and effectiveness before they are marketed.

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Are all supplements safe?

A supplement company does not have  to provide FDA with the evidence it relies on to substantiate safety or effectiveness before or after it markets its  products.  In fact, companies can lawfully introduce dietary supplements without notifying the FDA. However, they cannot advertise the use of supplements to treat a diagnosis. Other than the manufacturer's responsibility to ensure safety, there are no rules that limit a serving   size or the amount of a nutrient in any form of dietary supplements.

 

Therefore, the supplement industry has become a  billion dollar business that markets supplements without proper dosing or evidence based on research. Therefore, due to possible health benefits, as well as risks, the FDA advises consumers to ask their doctor or clinician before using.

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What resources can I use to know what is safe?

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1. The National Center for Complementary and Integrative Medicine (NCCIM) at the National Institute of Health (NIH) is a good resource. 

Strategic Objectives for NCCIM are:

• Advance research on CAM pharmacological and dietary interventions and approaches.

• Advance research on mind/body and manipulative/manual CIM interventions.

• Increase understanding of “real-world” patterns and outcomes of CIM use and its evidence-based integration into practice and care.

• Improve the capacity of the field to carry out rigorous research.

• Develop and disseminate objective, evidence-based information regarding the role of CAM interventions for the public and health care providers.

2. Consumers can goggle Pub Med at NIH to obtain research on supplements. 

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What is Personalized or Precision Medicine?

As noted by the Federal Drug Administration, the term "personalized medicine" is often described as providing "the right patient with the right drug at the right dose at the right time."  

 

More broadly, "precision medicine" may be thought of as the tailoring of medical treatment to the individual characteristics, needs, and preferences of a patient during all stages of care, including prevention, diagnosis, treatment, and follow-up. Functional Psychiatry just expands this definition to use genetics, triggers and perpetuators that caused the disease state in order to hopefully move towards the pre-disease state.  In this way we can either prevent the disease from re-emerging or stop the progression.
 

What is mindfulness or meditation?

 

Mindfulness or meditation is used to teach the brain to not be distracted by the external environment or our

 own thoughts. So, for instance, if you are focusing on your breath, each time a thought jumps into your head or you hear a noise, you focus back on your breathe. There are many types but all of them decrease cortisol and adrenalin (associated with fight and flight) and decreases inflammation associated with PTSD, anxiety, TBI and depression. 

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What is the Gut-Brain- Axis?

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Any changes in the normal bacteria in the gut is called "dysbiosis".

 

This causes an inflammatory response in the gut. This causes the blood-brain barrier to open allowing inflammation in the brain, as well as throughout the body leading to depression, hormone changes, insulin resistance and diabetes,  inflammation in arteries and increased cardiac risk, poor absorption of nutrients the body needs to function, auto-immune diseases, etc.

 

What causes dysbiosis?

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Looking at lifestyle and how it produces inflammation in the gut is important in functional medicine. Factors that can cause inflammation in the gut are seen below.

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Sedentary lifestyle

obesity

Stress

Processed foods and high fat foods

Lack of sleep

Antibiotics and medications like anti-acids

Artificial sweeteners

Alcohol

Sugar

History of physical or sexual abuse

Pesticides and toxins in the environment

Any infection of the GI tract

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Why was Complementary, Alternative  and Integrative Medicine not incorporated into Western Medical  Schools?​

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In 1910 the Flexner Report on medical education was commissioned by the Carnegie Foundation for the advancement of teaching. This resulted in restrictions of what could be taught in medical schools in order to be accredited and the focus became acute or chronic care, rather than preventative medicine.

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The discovery of penicillin led to the “magic bullet” mentality for fixing everything. This led to the huge growth in hospitals and money spent to fix everything.

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Managed care was created to slim down costs.

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Hence,  a reduction in services and payments for services occurred and devaluation of time spent with the practitioner occurred.

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What was forgotten was the question as to why diseases occurred.

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