Functional, Holistic, Integrative, or Naturopathic Medicine?

Tell us a bit about yourself, your medical background, and how you found your way to Ciba Health.

My name is Sandy Le and I’m one of the Medical Directors of Ciba Health, on the West Coast. Since we’re national, we have West and East regions. I’m a naturopathic doctor. I went to UCLA for undergrad and went to a naturopathic medical school in Portland, Oregon. I completed a two year residency in family medicine, and I’ve always kind of been in the realm of working in functional medicine with a lot of other MD’s. Because our view of medicine is basically the same, we’re getting to the root cause of the problem and being able to provide different modalities of treatment. These treatment modalities range anywhere from herbs, vitamins and minerals to doing diagnostic lab tests. So that’s how I finally found myself working with Ciba Health, because it’s such a neat platform where everything is done through telemed – and it’s increasing access to this type of medicine to everyone, which is a great thing.

What is functional medicine and how do you practice it?

Functional medicine is a personalized and integrative approach to healthcare. So it involves understanding “prevention management” or the root causes of complex disease. Functional medicine draws from a number of different healthcare models, for instance holistic healthcare, which is more focused on body, mind, and spirit. It also takes notes from naturopathic medicine, which is focused on getting to the root cause of illness with different modalities like herbs and supplements. Integrative medicine, on the other hand, is a broad umbrella term that encompasses all of these models that offer the most comprehensive, personalized, and effective approach to healthcare. So overall, functional medicine is more focused on personalized health and learning about how our genetics, our environment, and our lifestyle affect us. It’s about understanding how they all interact as a whole system and how we can use that to diagnose and treat based on whatever imbalances that we see. It’s really about getting to the root of the problem.

What was your first introduction to functional medicine? How did that introduction affect you?

When I was in college, I was pre-med. So I was on track just to go to regular, conventional medical school. I spent a lot of time volunteering at the UCLA medical centers. And I noticed that it was such a pill popping culture. Anyone would come in for something, like a headache. And they would say, “Here, take this pill.” Or, my blood pressure is elevated. “It’s okay, take this pill.” Or you have high cholesterol. “Okay. Take this pill.” No one was really delving into what was going on in their life or their diet. No one was saying, “Okay, well let’s do a rundown of your diet. Let’s talk about your lifestyle and why these headaches coming on.” None of these conversations were had then. I’m sure they are now because more people are more aware of the preventative medicine realm and are getting into lifestyle and nutrition and diet, but back then it was more of a pill popping culture. And I said to myself, I do not want to be in this style of healthcare. You’re not even asking the person the basic questions of what they’re eating or how they’re sleeping or what’s going on in their life. Or are they stressed out or not? Nothing.

For those who may not know, what’s the difference between functional medicine and conventional medicine, which we might be more familiar with?

The conventional medicine approach has a strong emphasis on characterizing disorders by diagnosis. It’s heavily focused on what symptoms or behaviors of the disease are happening, and the treatment relies heavily on synthetic medications or surgeries and invasive procedures. In conventional medicine, the body is viewed as different sets of organs that are all separate. There’s no interconnectedness. So when you have a high blood pressure problem or high cholesterol, you go see the cardiologist. Or if you’re having a lot of gas or bloating, you go see the GI specialist. Versus with functional medicine, you’re looking at the body as a whole. When you think about, for example, if the person has gas and bloating, you’re not just thinking about everything GI-wise. You have to keep into account everything else that’s happening in their environment, like what they’re eating and how stressed they are. So it’s a whole body approach.

How is functional medicine related to integrative medicine? How are those different from holistic medicine?

Integrative medicine is a model of healthcare where conventional medicine is integrated with a non-conventional or alternative modally. So that’s inclusive of herbs, chiropractic care, acupuncture, massage, aroma therapy, etc. In integrative medicine, you have a really big toolbox for evaluations and treatments. So it takes into account, not only the whole person, but also the mind, the spirit, and all aspects of lifestyle. Integrative medicine really emphasizes the therapeutic relationship and makes use of whatever appropriate therapies are out there, both conventional and alternative. So you could say that integrative medicine is also holistic. The terms are interrelated. But again, it all gets down to identifying the root cause of the disease.

Could you give us an example of someone who has come to you after they’ve seen a conventional medicine doctor, and tell us what have you been able to add to their patient experience? What have you been able to help them with in a different way than a conventional doctor has?

I had a 32 year old female come into my office because her hair had been falling out for the past year. She’d seen her primary care doctor who ran labs, including thyroid and iron. And everything on those tests came back normal, so the primary care doctor was like, “Well, I have no idea why your hair is falling out. It might be stress-related, but let’s have you go see the dermatologist.” So she goes and sees a dermatologist who says, “I’m looking at your hair under a magnifying glass and microscope. I don’t see anything crazy happening here. I don’t know why your hair is falling out, but go take some biotin.”

So then she comes to me, and she complains about the fatigue and the fact that her hair is falling out. So we run the appropriate labs, probably the same ones that her primary had run, but also we looked into micronutrients. And we found that her iron level, while it was in the range of normal, was on the low end of normal. These ranges can be from like 10 to a hundred and something, and her level was at around 12. So for her primary care doctor, that was normal because it was in range, but that’s really considered low because it’s not at an optimal level.

We put her on iron supplements and within two months her hair stopped falling out. And she was becoming energetic again. That was a very simple thing that was overlooked because doctors are writing her off and saying her levels were normal.

A lot of other people who come in to see naturopathic doctors or get functional medical care are those who’ve had a lot of chronic health conditions or a lot of gut problems. Usually, they’ve gone to many GI specialists, or many different doctors who don’t know what’s wrong with them. They get some medications to keep their symptoms steady. And then we end up stool testing these people and finding that they have leaky gut or overgrowth of bacteria and then treating that cause – and they end up feeling better.

Is it safe to say that if someone walked into a functional medicine clinic or a naturopathic medicine office, they would be heard more than they would be by a conventional doctor?

Right. We spend a lot more time with our patients. New patient visits can be anywhere between 45 minutes to 60 minutes. And then your follow-ups are around that time too, because you’re delving into everything about the person, like their entire health history, their diet, their sleep, the personal questions of their bowel movements. Everything. So we really want to understand the whole picture, and that takes some time.

You’re a member of the California naturopathic doctors association. Can you tell us a bit more about your role within this association and how naturopathic medicine plays a role in your practice?

I served on the executive board for about two years as their treasurer. The whole point of the California Naturopathic Doctors Association is to educate the public right about naturopathic medicine and our role in healthcare and providing access to naturopathic medicine. Because the problem is many insurances don’t cover it. They see it more as an alternative treatment, not a preventative treatment that would actually save insurance companies millions of dollars. So that’s why we are constantly trying to strive for education and awareness.

The model of naturopathic medicine again, is very similar to functional medicine where you are trying to get to the root of the disease. And by doing that, you’re looking at the person as a whole, and you’re focusing on diet, lifestyle modification, etc. You’re working with detox and other natural interventions. So very similar to functional medicine, you will do your diagnostic tests to see what’s going on, and then offering these different modalities as the form of treatment to get to the root of it. I would say the only difference between that and functional medicine is that functional medicine is a type of medicine where MD’s who’ve gone to conventional medical school realize it’s not for them, so they go and get additional training in functional medicine. Versus with naturopathic medicine, you’re learning this in your schooling from the get-go right. So when you’re in your classes, not only are you learning about conventional ways to treat high blood pressure or high cholesterol or gut issues, but you’re also learning what alternative methods there are to treat this and other whole body ways to look at illness.

Now that you’ve explained the differences between these different modalities, who do you think would benefit the most from a naturopathic medicine approach?

Anyone who’s gone through the rigmarole of seeing different providers with their chronic health issues would be a good fit for the naturopathic/functional medicine approach. There’s a time and need for medication, there’s a time and need for surgery, but not everyone needs to be medicated all the time. Someone who’s wanting to get to the root of their problem and not put a bandaid on the situation would really benefit.

If I wanted to go about finding a functional medicine or naturopathic medicine practice, where should I start?

You could definitely start at Ciba Health. We have a telemedicine platform with many providers on staff who are functional medicine trained and who are doctors of naturopathic medicine and they will definitely help you get to the root of the problem. If that does not work for you, there are different platforms out there. For example, IFM, the Institute of Functional Medicine, if you go on their website, you can find a list of functional medicine doctors. You’ll also find a list of doctors on the state association pages naturopathic medicine.