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.
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