When I started investigating my digestive issues years ago, I became the walking encyclopedia of all food, intolerance and gut tests available. After much unsuccessful Google self-diagnosis I was finally aided by a good nutritionist, and took charge of my gut health. But hen, just as all was getting happy digestive-wise, I hit 39 and suddenly started experiencing hormonal issues. I assumed it was because 40 was just around the corner and also, I was probably over-exercising and needed to relax more. So I went to see a leading endocrinologist here who confirmed that my hormone levels were slightly borderline but “nothing to worry about” – however she was concerned about my generally high cholesterol numbers (!), and suggested I exercise more, eat more greens and less bad fats. What? She clearly hadn’t seen my instagram fitness account….and did not realize how regimented my eating had been for the past two years – nor had she asked. After this, I went from specialist to specialist to understand my poor sleep quality, my increasing impatience, unexplained 5-pound weight gain or loss on any given week and all sorts of other hormonal-sounding symptoms. Until I met Dr. Shefali Verma, Partner and Medical Director of the Institute for Biophysical Medicine in Dubai, and discovered the wonderful world of functional medicine.
Functional medicine practitioners take the time to get to know your unique body chemistry and aim to connect the dots between your gut, your hormones and all the other systems in the body in order to find out what the cause is. So, for example, I found out my high cholesterol was linked to an underactive thyroid and that I was also creating antibodies to my own thryoid…that was partly due to the one thing I hadn’t yet eliminated from my diet, which was cow’s milk. So I cut it out, re-incorporated foods I had been too strict about, made a few other lifestyle changes and within a few months, started feeling more normal again. But I wouldn’t have figured that one without Dr Shefali.
So today ladies, I am over the moon because I get to introduce you to this wonderful woman, who will explain what functional medicine is and hopefully, you can get a sense of why so many leading doctors in the US and UK are calling it the medicine of the future.
WM: What is the difference between traditional and functional medicine?
Dr. SV: To me Functional medicine has more of an emphasis on a search for the root cause of a presenting complaint. A patient comes in with a presenting complaint and of course we hope to decrease or eradicate symptoms but on searching and dealing with the root cause we would hope that the relief of the symptoms would be a long-term solution. There is an emphasis on a detailed history taking session where we are able to gather as much information regarding the patient as possible to have the most accurate working diagnosis. I would also say those who go down the functional medicine root aim to not feel pressured by time, they don’t tend to be 10 minute consultations because a lot of fact finding takes place. I encourage follow-ups, so patients are accountable but we emphasis patient education as well. It is personalised, one size does not fit all. There is a strong knowledge of disease processes, that functional medicine practitioners are less “specialised” as they believe everything in the body is connected. One system rarely works independently.
WM: What kind of educational background does a functional medicine practitioner have?
Dr. SV: I studied conventional medicine first. I know many who similarly studied conventional nutrition etc. nowadays there a a few avenues one can take to train in functional medicine but the most recognised in the US is by the Institute of Functional medicine, where one can study/ attend all the modules and then complete the exam. In the UK the nutritional therapy qualification is equally based on the Functional medicine. The doctors who I have met doing functional medicine often feel there is more out there to be done for their patients and are still searching for those answers.
WM: What tests would one get done if they go see a functional doctor for the first time?
Dr. SV: I think every doctor treats their patients differently and I can’t speak for all functional medical doctors. I investigate and treat very individually. It all depends on their history. In fact two people with the exact same symptoms will still be treated differently. One size does not fit all.
I encourage a lot full medicals. I don’t just note if they are in and out of the range but I like to watch for trends. It’s a way of pre-empting disease. Ranges alone are too wide to be able to comment. Watching the trends over years allow us to ask questions and experiment regarding lifestyle in an attempt to change the trend. Again, this is prevention in action. Diet alone is not the only factor when we speak regarding lifestyle. One size does not fit all. The patients starting point and goal both determine the therapeutic advice. People can also have sensitivities that one can also test.
WM: Functional doctors seem to pay a lot of attention to the gut and hormones, why is that?
Dr. SV: I do pay a lot of attention to the gut, more than hormones because I do think in life it’s the first thing prone to get affected. I mean the gut can be affected just from the mode of delivery. A c-section will change the gut microbiome as does the first feed. What a mother eats will affect how a breastfeeding child reacts. The immune system will also be affected based on these small reactions. Then entre antibiotics, painkillers etc and many lifestyle choices, let alone stress. So many things can affect the gut, which effects all the other systems. The digestive system is to me one of the important systems when we are investigating root cause.
WM: How do you view hormones then? Some say they dictate a lot of what goes on in our bodies.
Dr. SV: A lot of people ask me about hormones. The hormone system doesn’t work independently of every other system. All our systems work together and feed off each other. A common question is “what’s wrong with my hormones?” We can test, in fact we do test, but the most important question is why. Why is it out of the range? Stress affects hormones, as does impaired gut health. We can supplement deficiencies but if that’s all we do and then take it away, we will be back to the start. If we alter reasons why it may be deficient and supplement, when we take it away there is a bigger chance it will be better than where you started. Looking for the root cause is the essence of modern Integrative Medicine.
WM: When we think of stress we automatically think of a state of mind; what do you define as stress?
Dr. SV: One of my teachers used to talk about the 7 elements that should be done “right” daily. These include:
- Eating right
- Drinking right
- Pooping right
- Sleeping right
- Moving right
- Thinking right
- Talking right
Stress for me is when any of these are not done right. Negative chronic elevated stress levels can affect physiology and should be kept to a minimum.
WM: What approach does functional medicine take with regards to medication and drugs?
Dr. SV: By the time a patient finds a functional medicine practitioner often they have seen many conventional doctors. They are often frustrated and often we are their last resort. Patients come in often on medication or even lists of medication. It isn’t my decision to take them off or put down any of the doctors or treatment previously advised. For me, it would be wrong to think that there is no role for conventional doctors. I often refer my patients to specialists for opinions of acute presentations of diseases. My first objective and most important objective is safety of the patient. Patients health should always remain stable. I even prefer it if we work together on patients because sometimes conventional doctors are open minded and open to the recommendations and tests I advise. If we are all on the same page it is a win win for all of us especially the patient. Now if we work on them and the need for the meds decreases then I will refer them back to the prescribing physician for them to maybe have a trial period without the drugs. Here there is a nice mutual respect building which is the best scenario for any patient.
WM: What about food? Are there any diets you recommend such as paleo, vegan, etc.?
Dr. SV: I do not recommend any particular diet because it depends on each patient, where they are at, what their objectives are and a host of other factors. The only thing I would encourage people to do is to eat foods that are as non-processed as possible – the less packaging you have, the better. Also, try eat organic when possible – I know it isn’t always easy and at times, people are doubtful as to whether or not produce sold as organic is actually organic. Nevertheless, if it is “certified organic”, there is a good chance it is, and it is better for you.
WM: What is your view of Eastern medicine like Chinese Traditional Medicine? Some integrative doctors seem value in them.
Dr. SV: In all honesty I don’t use a lot of Eastern medical techniques. I am not trained in them but am open to them. The only problem with various alternative methods is that often they are all used at the same time and we don’t really know for sure which one is the most impactful. With any treatment, I think its most important to have a working diagnosis and know what we are potentially hoping to achieve with every treatment modality. Less is more… in my opinion.
Dr. Shefali Verma, Partner and Medical Director of the Institute for Biophysical Medicine in Dubai, is an integrative General Practitioner with a special interest in Functional Medicine.
If you would like to know more information about functional medicine or take an appointment with Dr. Shefali, please visit the IfBM website or contact her by email at dr.shefali@ifbm-uae.com
You can also follow Dr Shefali Verma on Instagram @doctorshef
