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This week on Cracked Science:

Daddy jokes, astrology, body regeneration but, most of all, functional medicine.

What is it?

Hey, this is Jonathan Jarry and you're watching Cracked Science, the show from the McGill

Office for Science and Society that separates sense from nonsense on the scientific stage.

You may have heard of functional medicine and are wondering what it is.

Wonder no more.

Here is Dr. Mark Hyman, perhaps *the* leading proponent for functional medicine, explaining

what it is and what he does at a TEDMed Talk:

You may think this is Mark Hyman's pick-up line, but it's not.

Functional medicine is a real thing, with centres and institutes and websites.

Now, what it is, beyond a dad joke seen by a quarter of a million people, that is, uh,

more difficult to define.

Actually, here's the definition on the website of the Institute for Functional Medicine (registered

trademark), and tell me if this makes sense to you:

Its individualized, its patient centered, its science based, it empowers patients and

practitioners to work together, it addresses the underlying causes of disease and promotes

optimal wellness.

It requires an understanding of a patient's genetic, biochemical and lifestyle factors,

it generates a personalized treatment plan.

It addresses root causes.

It targets the specific manifestations of disease in each individual.

Now, you can't see them right now, but there are doctors watching this who are nodding

so much, they're gonna get whiplash.

Stop nodding.

I can read your mind.

You see, what I just read to you is medicine.

Medicine is patient-centered, it is science based, it addresses the underlying causes

of disease.

But clearly, there has to be something else to functional medicine that can't be captured

by its official definition.

So let's look at a specific case described by Mark Hyman to see if we can spot the difference

between functional medicine and, you know, medicine.

It's the case of a cute 10-year-old girl from Texas who loved riding horses

Welcome to the Scholastic version of a Nicholas Sparks novel.

Now, this girl's immune system had turned against her and it was attacking her entire

body.

Mark Hyman thought that this situation could have been triggered by a mold found in her

house,

by the fluoride her mom had been exposed to working in limestone pits,

by the mercury from her childhood vaccines (and hold that thought, we'll come back to

that).

So Mark Hyman told this cute 10-year-old girl from Texas to stop eating sugar, to stop ingesting

dairy,

to remove gluten from her diet, to start taking a multivitamin, to take supplements of vitamins

D, B9 and B12, to take fish oil,

to take evening primrose oil, to take an anti-fungal agent, to take N-acetyl cysteine,

to add probiotics to her diet, and to take DMSA to remove the mercury from her system.

Oh, also some herbs to support her adrenal gland.

What Dr. Hyman doesn't mention is how much this all cost.

Another example of functional medicine was dug up by Dr. David Gorski for Science-Based

Medicine.

It's an 80-year-old woman with breast cancer and, while she got chemotherapy and surgery,

she also received,

wait for it, 97 infusions of vitamin C,

despite there being no evidence that it works as a treatment for cancer or to alleviate

the symptoms of chemotherapy.

She was also told to remove dairy and gluten from her diet, and to start taking the following

supplements.

Note that she was prescribed 18 to 24 grams of vitamin C to take by mouth...

on top of the infusions of vitamin C she was getting!

Just by mouth, she was taking 360 times the amount of vitamin C found in a single orange.

Functional medicine looks very tempting on the surface.

It is based on the idea that each patient is a unique snowflake and requires its own

bespoke list of interventions to get better.

It uses more tests than would be carried out by conventional doctors and a lot more "treatments",

but many of the tests used are of dubious value and many of the so-called treatments

have never been shown to work.

And while this looks like "personalized medicine", which has been endorsed by numerous academic

health centres,

it's actually quite different.

Personalized medicine or precision medicine classifies patients into subgroups, whereas

functional medicine treats each patient uniquely.

For example, when I was working in molecular pathology, we were testing lung tumours to

see if it had a mutation in a gene called EGFR.

So you were either in the group whose tumour had a mutation or the group whose tumour did

not,

and the treatment was different for each group.

These types of interventions are usually based on good, emerging science, but functional

medicine is not.

And beneath the veneer of individualized,

patient-centred care, functional medicine has a, shall we say, less "sciency" side...?

As Dr. Harriet Hall pointed out, Functional medicine was invented by a single individual:

Jeffrey Bland.

He's not a medical doctor.

He's a Ph.D. who sells dietary supplements.

His supplement companies have been fined repeatedly by the FTC and FDA and have been ordered to

stop making medical claims for their products.

In between getting fined however, he founded the Institute for Functional Medicine, on

whose board of directors Mark Hyman sits.

Mark Hyman has published books.

He has two podcasts.

He is a medical advisor to Hillary and Bill Clinton.

And he makes the occasional dad joke.

All that is fine... but you don't even have to scratch the surface to spot things that

run the gamut from concerning to downright ridiculous.

He's flirted with denying the germ theory of disease in 2010.

A podcast he's involved with has had the Food Babe as a guest, as well as Max Lugavere and

Steven Lin,

a "functional dentist" who wrote that fluoride, a neurotoxin, can build up in the pineal gland,

causing it to calcify.

Hyman has a store where he sells 10-day detox supplements, even though you don't need to

detoxify your body,

but also a traditional Indian herb to support male sexual function, and... just... so much

stuff... and that's just the "A"s!

And while you're there, you can probably throw this book into your virtual basket, you know,

the one written by Robert Kennedy Junior entitled "Thimerosal: Let the Science Speak: The Evidence

Supporting the Immediate Removal of Mercury-a Known Neurotoxin-from Vaccines",

the one to which Mark Hyman wrote a preface that reads: Given the simple fact that mercury

is toxic,

I can come to no other conclusion than this: we should immediately remove Thimerosal from

vaccines and all other products used in medicine.

So, problematic stance on the germ theory of disease;

sale of a shedload of unproven supplements;

espousal of a thoroughly debunked connection between thimerosal in vaccines and autism.

Oh, did I mention he's an advisor and guest co-host on the Dr. Oz Show?

You know, the Dr. Oz Show.

He's even had, and this brings me so much joy,

he's even had a shaman on his podcast who claimed to be able to regrow a new body.

And there's zero pushback from Hyman.

Watch!

And he's not kidding.

Welcome to functional medicine, where we test 200 different things in your blood, focus

on the false positives,

stuff you full of expensive supplements that have never been shown to work and, if that

fails, we send you to the "Indiana Jones of the spirit world",

that's what Hyman called him, to grow a new brain.

Sigh.

You know, I flipped through Hyman's book, Food: What the Heck Should I Eat?,

and it's frustrating, because it has sensible recommendations and antiscientific rhetoric

and it's not easy for the average person to tell the difference.

On the plus side, he wants us to cook more and avoid ultra-processed food;

he writes that fruit juice is just sugar without the fibre;

he correctly points out that, unless you're playing hardcore sports in hot conditions,

you do not need a sports drink.

But then he rails against MSG and genetic engineering;

he says that dairy is full of hormones that cause cancer;

and he thinks we'd all probably be better off without gluten.

The problem with this book and with functional medicine more generally is this obsessive

fixation on details and the nonsensical paths down which this fixation leads you.

It's not unlike the compulsion shown by conspiracy theorists to hunt for anomalies and fixate

on them as if they hold the real answer institutions publicly deny.

There's a campaign called "Choosing Wisely" which reminds physicians and patients to not

order unnecessary medical tests,

because the more tests you order, the more likely you are to get a scary result back

that isn't real,

simply because tests aren't perfect.

And this scary result leads to anxiety and more invasive testing.

Functional medicine does the opposite:

it actively encourages the hunt for these anomalies and hands you a suitcase full of

supplements while it sifts through your wallet.

And if you think it is based on science, that system of knowledge generation that tries

to prove itself wrong,

that encourages criticism, and that never makes absolute statements, I will leave you

with this golden quote, by the president and CEO of the Cleveland Clinic,

when he announced the opening of their Center for Functional Medicine:

What we really want is validation of what we believe to be true."

- Toby Cosgrove

My recommendation this week is a short blog post by Dr. Alex Lickerman entitled

[Why the practice of medicine must be evidence-based",

it was published on his blog, ImagineMD.net.

In it, he writes about medicine as the art of applying science to an individual patient's

health issues, while also decrying the problems with functional medicine, notably the leap

of faith from basic research findings to clinical practice.

This was the last episode of Cracked Science.

If you want to join the thousands of people who subscribe to our weekly newsletter, go

to mcgill.ca/oss.

In the meantime, you can follow me on Twitter @crackedscience and follow our office at mcgilloss.

The Description of Functional Medicine (CS31)