Frequently Asked Questions About a Functional Medicine Approach for Dementia

What exactly is functional medicine?

From the Institute for Functional Medicine: “Functional medicine determines how and why illness occurs and restores health by addressing the root causes of disease for each individual.” A simple analogy coined by a forefather of functional medicine, Sidney Baker, is to think about a rock in your shoe. If you try to walk, it will cause you pain. You could take a medication to dull the symptoms, or you could just remove the rock. Functional medicine is all about removing the rock.

It is a scientific way of thinking about illness and requires clinicians to develop a detailed understanding of your genetic, biochemical and lifestyle factors. Clinicians use that data to create personalized treatment plans to improve your outcomes and quality of life. A condition like dementia can have many causes, and yet one cause, such as high blood sugar, may lead to dementia in one person, but in another person it may not.  With a functional medicine approach to dementia, the treatments are patient-centered. Clients and practitioners work together on more equal footing.

How is a functional medicine approach for dementia different from my usual medical care?

Most conventional medical practices rely heavily on prescribing pharmaceutical drugs to decrease symptoms or risk factors for a certain problem. Some examples include using medications to stop migraine headaches or to lower cholesterol so that you are less likely to have a stroke. In a functional medicine practice, we are looking for the reasons why the headaches happen and why the cholesterol is high, because we want to resolve those reasons if possible. While pharmaceutical drugs are sometimes necessary, they should not be the only way that we think about treating illness. Our practice digs deeply into your life history and ensures that a large part of your treatment plan is based on appropriate changes to lifestyle factors such as nutrition, sleep, and movement.  Also, we often identify situations of imbalance (for example, not having enough good bacteria growing in your gut, or having too much harmful bacteria growing there) that conventional medical practices are not looking for. This is important because those imbalances contribute to disease. When we find imbalances, we work with you to correct them.

Why don’t you accept insurance?

Because we are committed to excellent care for our clients, our appointment times are purposely long. An initial visit is expected to last at least 90 minutes, and follow-up visits are 60 minutes. This gives us a chance to really get to know our clients. It gives our clients time to discuss their concerns and questions. Insurance reimbursement assumes that clinicians are doing much shorter visits, so the payments are not enough to sustain the close level of attention we want to provide. Insurance also does not reimburse for health coaching or the support we make available between visits.

What is the purpose of all the testing?

In order to achieve the best possible outcomes for you, we need to have a thorough understanding of what is working well within your body and what is not. Think of this as knowing the terrain that we are climbing together. The testing is the map that helps us plan our course, stay on track and evaluate our progress. We want to be proactive about finding the potential causes of your symptoms and conditions. We want to cast a wide net, so we don’t overlook important issues. We work with you to ensure that costs are feasible for your specific financial circumstances.

Why do I have to commit to a program package instead of individual appointments?

We do not want to waste your time or money. For people already experiencing problems with memory and focus, it takes an average of three months on the Bredesen protocol to stop the progression of symptoms, and an additional three months to start seeing improvements or reversal of symptoms. It may take a year to see the full benefits of the program. We feel that a structured approach of appointments with a physician and a health coach as well as periodic testing offers you the best possible chance of healing.

How do I know which program package is right for me?

We have three-, six-, and twelve-month packages that all use a functional medicine approach to dementia. The three-month package is meant for people who do not have symptoms of cognitive impairment and who are looking to prevent those symptoms in the first place by understanding their strongest risk factors for dementia and making targeted changes to address those risk factors.

For those already experiencing memory changes, the longer program packages are more appropriate because there will be more significant clinical imbalances to diagnose and address. The twelve-month package is best for those who have complex medical histories (for example, history of cancer, stroke, heart attack, multiple surgeries or hospital stays) or those who prefer to make very gradual changes to nutrition and lifestyle. We will give some guidance on the most appropriate program length at your initial appointment. Those who decide that they want to extend their program package at a future time are able to do so.

Can I still see my other doctors?

We both encourage and require you to maintain a relationship with your primary care physician and relevant subspecialists. We are a small consultation practice, so we are not set up for urgent care appointments or general preventative care such as vaccine administrations or screening tests like colonoscopies. We correspond with your main physicians as needed about your care plan, and we provide them with documentation of our visits with you.