We dive deep into what functional medicine is, how it differs from traditional medicine, and what it takes to do well. In particular, we also highlight one company at the forefront of this field, Wild Health.
While we have no business affiliation with them, we do have personal experience as a patient with them, so read below for more on their philosophies, practices, and our experience on the patient side.
They also shared a discount code with us! So here is our first Nowgevity power-of-the-community challenge: if 10 or more members sign up for a Wild Health program we unlock a 10% discount. If we reach 20 or more sign ups everyone gets a 20% discount. Use the discount code ‘Nowgevity’ at checkout. Feel free to share with anyone you think might be interested. [We have no affiliation].
The Medical Practice Of The Future
If you were asked to imagine the medical practice of the future, you are likely to describe some version of functional medicine (sometimes referred to as integrative medicine), even if you are not familiar with the term. Ourselves, we imagine an approach aimed at prevention and early detection that takes a full-picture view of our health based on all available data, including lifestyle inputs. And that’s just to start!
The reality is that this “medicine of the future” is actually available now, yet the number of people benefitting from this approach is still very, very small.
A Budding Trend
The good news is that we are seeing the early stages of a trend towards this approach to personal health. There is a rapidly expanding list of doctors that have grown frustrated with the current approach to medicine (overly-siloed and specialized, focused on managing symptoms of disease rather than avoiding it in the first place), and have set out to build practices more aligned with the picture you probably imagined. Some more traditional institutions such as the Mayo Clinic are also increasing their investment in preventive approaches (though they are starting from a relatively small base).
The other reason for the relatively small adoption to date is the lack of consumer awareness. In a poll we ran in our private Facebook group a couple of months ago, we were surprised to learn that even the vast majority of our community—one that is clearly interested in and at the forefront of learning about optimizing healthspan—is unfamiliar with the concept of functional medicine.
So we figured it would be worthwhile to dig deeper into this topic by doing two things:
- Putting forward a more precise definition of what we think of when we talk about functional medicine; and
- Sharing a concrete example of a company that we are big fans of because they are pioneering a way to make functional medicine accessible at scale. The company’s name is Wild Health.
What Is Functional Medicine?
Part of the reason consumers may not feel they have a firm grip on the term “functional medicine” is that it is very generic, covering a wide range of approaches and philosophies. Bringing clarity to the definition of functional medicine is one of the key purposes of the Institute for Functional Medicine (IFM).
The IFM defines functional medicine as
“an approach to health care that conceptualizes health and illness as part of a continuum in which all components of the human biological system interact dynamically with the environment, producing patterns and effects that change over time.”
As you can see, this is still quite dense, so we’ll try to unpack it.
Functional medicine looks beyond the symptoms and focuses on understanding the underlying causes of illness. This starts by taking a full picture of the patient and understanding the interactions between metabolism, genetics, environmental factors, and lifestyle choices (e.g., nutrition, exercise, sleep, stress management) that influence healthspan.
This is a recognition that our health is heavily influenced not only by our genetics and predispositions but also by our daily habits.
The systems-based approach presents perhaps the starkest contrast with the traditional medical world we are all familiar with: a highly specialized (and siloed) view that focuses on the manifestations of disease in specific organs or systems.
Functional medicine is focused broadly on identifying the root causes of a condition, taking a holistic view across all organs and systems.
To better illustrate the concept, here are the seven key biological areas/systems identified by IFM in which imbalances and dysfunction occur and manifest as disease:
- Assimilation: digestion, absorption, microbiota/GI, respiration
- Defense and repair: immune, inflammation, infection/microbiota
- Energy: energy regulation, mitochondrial function
- Biotransformation and elimination: toxicity, detoxification
- Transport: cardiovascular and lymphatic systems
- Communication: endocrine, neurotransmitters, immune messengers
- Structural integrity: subcellular membranes to musculoskeletal integrity
With this different paradigm of disease, it becomes clear that an imbalance in one (or several) of these areas can manifest as many different diseases at the organ level. Conversely, it is also clear that one disease can be multifactorial and thus require a more nuanced treatment approach.
Functional medicine recognizes that every person is different and has had different life experiences that have shaped their health and behavior. Understanding the ways in which genetics, the environment, and lifestyle behaviors interact is important for developing a more comprehensive and patient-centered care plan. This stands in stark contrast to the one-size-fits-all approach that we are all familiar with.
Because of this, functional medicine practice requires investing time with the patient to gather a detailed history, including lifestyle and psychosocial factors, a physical exam, and objective lab and genetic data. With this information, the practitioner can create a personalized care plan for each patient based on their individual circumstances.
As suggested above, our understanding of functional medicine makes use of all the relevant data that can contribute to a more complete and personalized health picture. This includes blood panels that are much more detailed than the ones typically used in an annual check-up, as well as genetic and epigenetic sequencing, microbiome data, biological clock measures, and even data from your wearables and trackers.
Prevention and Longevity Focused
Lastly, but perhaps most importantly, functional medicine’s ultimate goal is to take a preventive stance against disease in order to help maximize your healthspan. The first strategies deployed to address health conditions in this approach are typically lifestyle adjustments. Some common interventions used in functional medicine care include personalized diet and exercise plans, stress management techniques, sleep hygiene and architecture work, and nutritional supplementation. If conditions persist, then pharmaceutical solutions are worked in.
Meet Wild Health—Leaders In The Functional Medicine Frontier
The best example of this longevity-forward approach to medicine that we’ve come across thus far—among many impressive efforts—is a company called Wild Health.
The company was founded just about 3 years ago by Matt Dawson and Mike Mallin, two ambitious doctors who, early in their careers (and each for their own reasons), grew convinced that there was a better approach to healthcare than the one they were trained to practice.
Dawson and Mallin met at the University of Utah, where Matt was doing his residency in Emergency Medicine and Mike was an Assistant Professor. In those initial years of medical practice, Dawson became acutely aware of the shortcomings of the one-size-fits-all traditional approach to medicine. He knew that you could practice a totally different and much more effective type of medicine, one centered around keeping people healthy by leveraging data and personalization.
Mallin arrived at the same conclusion but for different reasons. He had stubbornly high cholesterol levels which defied the indications provided by his own doctors. He ultimately was able to find a solution by digging into his genetic variants and better understanding his particular way of metabolizing fats. That opened the door to seeing medicine in a whole different light.
Matt and Mike saw the potential to truly revolutionize medicine by turning the patient-as-statistic paradigm into one based on personalization from individual information; a statistical group where the size, the “N”, is 1.
With this ambitious goal in mind, they decided to team up and create Wild Health: a data-driven, lifestyle & longevity-focused care platform that can be accessed from anywhere.
What they have been able to build in just a few short years is impressive. They started the company as a medical practice with an initial clientele of high-performance clients (athletes, CEOs). However, from the moment they launched, Matt and Mike knew they wanted to make their holistic approach to medicine accessible to the largest number of people possible. Early on they identified two areas that would be critical for them to work on in order to achieve that objective: software and training.
The Data Challenge
One of the biggest challenges that functional medicine practitioners face is managing and analyzing the sheer volume of relevant information that you can now bring to bear when trying to assess someone’s health status (DNA, gut microbiome, bloodwork, wearables, lifestyle inputs).
This becomes very difficult to sustain without an intelligent platform that can keep track of all the links between genetic variants and health predispositions (new links are being discovered constantly), not to mention what we’re learning about the microbiome’s role. Additionally, a lot of support is needed in the interpretation of the data.
The ‘Clarity’ System
Wild Health has addressed this by investing in technology early and developing a proprietary system they named Clarity. This platform helps with much of the upfront heavy lifting of functional medicine—establishing a baseline of your health and identifying areas that are good targets for improvement or correction.
This platform is what has allowed Wild Health to significantly lower the cost of caring for each patient while maintaining the high standard of fully individualized care, therefore bringing their prices for the consumer down. Admirably, Wild Health also makes this platform available to any doctor interested in practicing this type of functional medicine.
This leads to the other strategic bet that Matt and Mike made early on: they both knew that to truly revolutionize medicine, they had to help as many doctors and health coaches as possible learn the skills required to look at a patient holistically and interpret the implications of different DNA, biome, and blood test results.
Their solution: they offer a 12-month fellowship program for anyone interested in learning these skills. Wild Health provides access to this course on a cost basis, which comes out to about $900 per month for the duration of the program.
The inclusion of health coaches in the overall patient process was also a strategic bet. Rather than only meeting with a Doctor once a month or so, Wild Health patients frequently meet with their Health Coaches, who play a key role in providing the level of personalized medicine that Wild Health strives for.
Much of what a patient can do to improve their health outcomes involves making lifestyle design decisions and building good habits to back them up. The health coach brings both approachability and accountability to the process, which improves success rates.
We believe that in the (near?) future we will think of health coaches the same way we look at personal trainers: they can be your cheerleader and accountability buddy all-in-one. For Wild Health, coaches are also a key ingredient to making the cost to the consumer more accessible.
Virtual and Global
One more thing worth mentioning about Wild Health’s tech-forward approach is that the practice is fully virtual and accessible from anywhere. In fact, Matt lives in Kentucky and Mike is based in Oregon. While the pandemic has greatly accelerated the adoption of the idea of telemedicine in general, Wild Health was an early adopter of this style of care delivery. It’s another key ingredient to consumer accessibility from a pricing perspective.
How Does The Wild Health Program Work?
As described on the Wild Health website, their Clarity health plans follow a step-by-step blueprint to aid practitioners in creating an individualized care plan for each potential patient. These steps include:
Step 1: Genetics
Looking at your DNA to analyze all of your genetic advantages, disadvantages, and predispositions. They call this the ‘operating system’ of the human body, so it is critical to understand when optimizing your health
Step 2: Extensive Testing
Taking a comprehensive look at your current health through blood testing. This is a much more complete set of labs than is typically done, looking at lipids, thyroid functions, CVD risk, hormones, vitamin and mineral levels; anything that can affect how you feel.
Step 3: Longevity
They can now add a DNA methylation test to combine with your genomic and blood test results, creating a complete, personalized longevity protocol to reverse your biological age
Step 4: Lifestyle Factors
A close examination of lifestyle factors that impact healthspan and can’t be measured with a test: how do you eat, exercise, sleep, socialize, de-stress; what are your hobbies, mindfulness practices, etc.
Step 5: Personalized Medical Protocol
All of the above is combined into a complete health optimization plan using a layered approach to identify your ideal diet, exercise regimen, supplements (if needed), sleep routine, and other lifestyle factors for each individual.
Check out this episode of the Wild Health Podcast where health and longevity thought-leader Ben Greenfield experiences the Wild Health algorithm first-hand.
Our Personal Experience With Wild Health
While we have no business affiliation with the company, one of us here at Nowgevity signed up with Wild Health a few months ago in order to get serious about her longevity protocol. Below is an account of that personal experience as a patient:
I was diagnosed with a pathogenic gene mutation that seriously increased my chances of cancer in the course of my life. Traditional medicine basically told me I needed a preventative surgery and an amped-up screening schedule, but when I asked what else I should be doing to minimize my chances of cancer, I was met with blank stares.
Lifestyle definitely plays a big role in the development of chronic disease; as a regular reader of the Nowgevity newsletter you know that, and I knew it, too. Sleep, nutrition, stress, exercise—these are habits, not just genetic destinies, that influence our health. So how could I know what to do in each of these areas to optimize my long-term health?
Wanting to get serious about my long-term health and my longevity protocol, I signed up for a 4-month program with Wild Health.
This would include a monthly visit with my Health Coach, and 2 hour-long visits with my Doctor. And lots of work on my end in the in-between.
Immediately after signing up, my DNA test was dispatched—a simple “spit in this tube” kit arrived at home a few days later, which I completed and shipped back.
I also got choices: did I want to add an Advanced Blood Analysis and an Epigenetic Age test. Both are one-time tests and one-time additional costs; I opted to do both. I donated about 17 vials of blood to my local lab, who promptly shared all of those results with Wild Health.
Then, I met with my Health Coach for the first time. And this was where the difference with traditional medicine really started to become apparent: I was asked what my health objectives were, what I was hoping to get out of this process, and then I was asked about my life, my hobbies, my concerns, my stresses, my sleep habits, my diet and exercise, my mindfulness and/or any spirituality practices. In short, a real snapshot of me as a human patient.
And based on this initial assessment my Health Coach immediately had some ideas about where the ‘lowest hanging fruit’ would be for me to tackle my health optimization.
The Clarity Report: What Does It Include?
The next appointment I had was to meet with the doctor to discuss the findings from the blood work and my DNA results. Over the course of an hour, he walked me through, in detail, a full 50-page report based on all of the findings.
The Report is truly remarkable, and the end result of the Wild Health AI algorithm. The purpose is to provide you with a roadmap to improving your health and reducing your risk for disease and premature death, and boy does it get specific and deliver.
It typically ranges in length from 30 to 50 pages, depending on how much data was available / you opted to work with.
Here is the basic structure of the report:
- Tree of Life—The “Tree of Life” represents a visual of which areas are satisfactory and which areas need additional work. The roots of the tree contain baseline measurements of insulin resistance (IR), cardiovascular disease (CVD), sleep, cancer risk, exercise and gut health. The goal is to fully optimize the roots before moving on to more complex methods of health optimization (the leaves, e.g., brain, mind, longevity, etc.)
- Health Optimization Score—The health optimization score is a measure out of 100 that helps the practitioner (Wild Health and their coaches) estimate how much room for improvement there is on your health journey. It forms a baseline measurement, which hopefully only travels up from there.
- Overall Health Assessment—The overall health assessment presents you with your:
- Wild Health Score which is the aggregate of your scores in IR, CVD, sleep, cancer risk, exercise, and gut health. Areas marked with green mean that you’re at the goal; orange means that there is room for improvement. As you improve, your Wild Health Score will increase.
- Biological (Epigenetic) Age which represents that rate at which your body and organs are aging. This measure is important for improving longevity. The report also has a graph comparing your epigenetic age and chronological age to determine the exact rate of change. A value less than or equal to 1 is considered optimal. This is only available if you opted to include the Epigenetic Age test.
- Diet and Nutrition
- Macronutrients Risk Scores are determined by examining your lab values and genetic data. These scores tell you what your body prefers to use as an energy source and can be used to optimize your nutrition. This section also contains personalized recommendations on diet and macronutrient proportions.
- Micronutrient Methylation is a section that offers insights on your homocysteine levels (marker of inflammation) as well as risk scores for choline, folate, and TMAO. In the recommendations section you will find information on why your methylation might be low as well as personalized recommendations on how to improve.
- Metabolism of Micronutrients examines SNPs and micronutrient metabolism (e.g., n-3 fatty acids, vitamins A, D, B12, E, and C, zinc, iron, mg, BCAA, phytochemicals) as well as SNPS for caffeine metabolism and gluten sensitivity. At the end of this section there are personalized recommendations to improve and what you may need to avoid.
- Foods Lists of kryptonite and superfoods as well as personalized superfood recommendations.
- Exercise & Recovery—This section uses 3 polygenic scores to develop a personalized exercise plan for you. You will be presented with information on your predisposition to endurance v. resistance training, slow v. fast recovery, and low v. high intensity tolerance. Based on this information you receive personalized recommendations for exercise, detailed exercise plans, exercise-relevant lab values, and genetic SNPs.
I again found this super interesting, and highly specific. For instance, my genes showed I was at increased risk for Delayed Onset Muscle Soreness (DOMS). Which, yes, I have absolutely noticed that throughout life—one hard workout and the next day is ok, the day after that is brutal, and sometimes day 3 is even the worst. But a crystal clear pre-and post-workout supplement routine helps all of that. It’s glorious, and it’s been put into effect immediately.
The exercise routine that is recommended itself is good, too. It’s just on paper, though (e.g., this many lunges, this many push-ups), so hopefully in future their technology platform can be used to pull together videos of the recommended exercises for each day of the week. That would definitely make it easier, and also more motivational, to complete.
- Sleep Optimization—The sleep optimization section begins with general guidelines about sleep including the importance of good sleep hygiene. The report then moves onto circadian genetics and based on that data presents personalized recommendations for optimizing your sleep.
I was surprised to learn that genes can indicate alterations in circadian rhythms, which in turn can be associated with cancer risk. And that genes determine how much your wellbeing is affected upon experiencing disrupted sleep.
I was talked through a detailed sleep hygiene plan to address these issues, including how to activate the parasympathetic nervous system to try to alleviate my poor sleep record. I was surprised at how quickly I was able to improve here, as confirmed by the (two) sleep and activity trackers I wear.
- Neurobehavioral—The neurobehavioral section begins with general guidelines and patient education on why neurobehavioral factors, like stress reduction and mindfulness, are important for your health. The report then moves onto neurobehavioral genetics and based on that data presents personalized recommendations for optimizing stress management.
- Microbiome—Inflammation and Biodiversity Scores give you information on your gut health as it links to chronic disease risk (i.e., inflammation) and longevity (i.e.,biodiversity). This section also presents data on your ratios of important gut flora, TMAO producing flora, and provides recommendations for optimizing your gut health to reduce your risk of disease and increase your lifespan.
- Chronic Disease Risk
- CVD Risk Score includes your 10-year CVD risk, your genetic CVD risk, a combination of your CVD risk based on genetic data and lab work as well as recommendations for reducing the likelihood of heart disease, heart attack, and stroke as you continue to age.
- Dementia Risk Score includes your trophic support (molecules that help neurons develop and maintain their connections) and inflammation labs, and your genetic markers including your Apo-e3 status, TNF, and SIRT1, and provides recommendations for reducing your dementia risk over time.
- IR section includes risk based on genetic data and lab work, IR resistance score, and provides recommendations for reducing your risk for IR (and subsequently diabetes) over time.
- Inflammation section includes risk of low-grade, systemic inflammation based on labs and genetic data, a CRP scale (low v. high), and recommendations for reducing inflammation throughout the body to reduce your risk for chronic disease.
- Longevity Maximization
- Biological (epigenetic age) and Chronological Age, the aim of which is for your rate of change between the two to fall at or below 1 in order to improve your longevity.
- Longevity Labs and Geneticson oxidative stress, telomeres, cancer risk, dementia risk, metabolism.
- Patient education on calorie restriction and fasting for longevity as well as personalized recommendations for optimizing your longevity for a longer and healthier life.
There were some interesting findings and recommendations here; again some specific genes that carried specific cancer, dementia or other chronic disease risk and how best to mitigate those. A very worthwhile section that the doctor spent a fair bit of time on with me.
- Health Summary Report
- Recommended Supplements based on your genetic and lab data
- Genomic Glossary of SNPs and why they are important markers for health
- Your Lab Results for reference and self-quantification
In the end there were quite a few supplements that made sense for me to add to my longevity protocol. I felt no pressure to buy the brands they proposed—they do not have their own, but they do earn affiliate commissions on the brands they recommend—and the report provides plenty of clarity of what doses and types of supplements to look for if you want to source them yourself.
Mostly though, it has been about the improved habits (around Sleep in particular, for me, though I learned a lot about Diet and Exercise as well). I’m only halfway through my program and curious what my next meetings with my Health Coach and Doctor will bring.
I certainly feel much more ‘seen’, ‘heard’, and ‘coached’ in my health journey than with my traditional medicine family practitioner. Of course, there’s a role for them, too, and I will certainly keep mine—Wild Health is all virtual and is really not there to deal with checking out that strange bump that suddenly appeared on your leg, or reminding you to schedule your colonoscopy or mammogram.
I definitely have experienced added value from including a functional medicine approach to my health journey, however—someone who thinks with me about my goals, my concerns, where my body is at today, and how I can optimize where it will be at tomorrow. I don’t want to start my discussions with my doctor when there are symptoms, or major problems to treat. I want to start my discussions while there are none, and develop a plan to ensure there stay none for as long as humanly possible.
I feel I am now much, much better equipped with such a plan than I ever would be with a traditional medicine doctor ‘guiding’ me (that’s just not what they do), or than I would have been able to piece together myself (even working at Nowgevity, a place dedicated to empowering individuals with information and actions to live healthier, longer!)
That said, it is definitely an investment.
Pricing and Plans
The Clarity platform offers three functional medicine plans at varying price points, with different levels of coaching and performance optimization:
They have in the past offered more month-to-month or quarter-long plans as well, so worth asking them about it if that would be something you are interested in.
If you are, Wild Health was kind enough to offer our readers here a community discount: if 10 or more members sign up for a Wild Health program we unlock a 10% discount; if we reach 20 member sign ups we all get a 20% discount. The power of community at work! Use code ‘Nowgevity’ at checkout. [Please note: we have no affiliation].