Functional medicine aims to take into account the whole person and addresses the root causes. While it sounds like a utopia compared to mainstream medicine, functional medicine is still an evolving field where technology may not have caught up with the philosophy. And while functional medicine has used various metabolite panels, what’s lacking is a tool that truly incorporates it all to help with assessment and decision making. So, it’s normal to struggle with the tsunami of data and what to do with all of it.

Metabolomics and microbiome testing together with AI that takes into account all the data points like Aristotle will be a perfect symbiotic match for more precise assessments of the functional health of an individual. Read below to understand how these disciplines complement each other.

What is Functional Medicine?

Functional medicine is a systems biology approach to medicine that focuses on addressing the “function” of the individual, rather than merely focusing on their individual morbidities. 

This approach involves:

• In-depth history-taking
• Mapping symptoms to categories within the functional medicine matrix, an outline for practitioners to organize the patient's clinical imbalances into biological systems. 
• Considering health history, antecedents, triggers, mediators, and lifestyle factors as well as mental and spiritual health

In contrast to traditional medicine, the treatments may involve:

• Improving lifestyle factors, such as sleep and physical movement
• Food and nutrition, such as an elimination diet and nutrient therapy
• Addressing chronic infections and environmental factors like mold
• Testing for and correcting any deficiencies or imbalances in the body.
  
  

What is Metabolomics? 

Metabolomics is the study of collections of metabolites in an organism together in a systems manner, in a way that gives insight about the whole person.

In addition to the test, metabolomics also includes the collective computational analysis that looks at all the data points at the same time to deduce insights. Since metabolites have been identified and studied since the 1970s, we know a lot about each metabolite and what disease signatures may look like. At Theriome, our machine learning algorithm takes into account all available clinical literature, along with the patient’s history and goals.

Metabolomics = measurement of representative metabolites + collective computational analysis of the measurement data. 

Properly analyzed metabolomic data can give you insights about your patient’s health risks and the best courses of actions to optimize their health. For a more thorough explanation of what metabolomics is, please read our article here.

How Metabolomics Complements Functional Medicine

In short, the philosophy of functional medicine is very similar to that of any kind of -omics research—to look at the whole individual as one system greater than the sum of its parts.

Each metabolite is an output of one or a few biochemical pathways. Therefore, the level of metabolite can indicate how well a biochemical pathway is working. Collectively, a subset of metabolites can tell if an organ system is working, and an individual’s whole metabolome is very indicative of their health or health risk. 

While metabolomic provides a snapshot of a person’s health, it doesn’t necessarily tell the timeline, although metabolomics can support inferences about their functional systems. 

Whereas, in functional medicine, listing antecedents, triggers and mediators, dating back from one's birth to their current health concerns. Additionally, assessing each area of function in order to best address which area(s) are most important to target in terms of restoring function through targeted interventions. Let’s examine a few examples:

Example 1: Tryptophan Assimilation

Part of a functional medicine work-up is to assess assimilation. This would involve assessing digestion function by reviewing for the presence of dysfunctional assimilation symptoms such as gas, bloating, constipation, diarrhea, as well as many other associated symptoms. Assessing assimilation also includes analyzing relevant laboratory data. 

Metabolomic data also provides the ultimate comprehensive glimpse into how one's pathways are functioning. In the case of assimilation, assessing tryptophan metabolites is of particular interest as abnormal tryptophan metabolism can occur in the presence of dysbiosis, leading to impaired assimilation [1]. This is when you have patients who consume plenty of protein but exhibit some mood symptoms that may reflect functional tryptophan deficiency. In these cases, metabolomic tests may pinpoint the affected biochemical reactions and whether this problem could be solved with supplements or require deeper interventions. 

Example 2: Methylation

Methylation status can be tricky to diagnose based on genes, as it takes guestwork on whether the gene is being expressed. Blood tests like homocysteine don’t always pick up methylation problems. Furthermore, people can have low methylation of neurotransmitters but high methylation in some detox pathways. In these cases, our metabolomic test can accurately pinpoint where you have methylation problems.

Many patients who have methylation problems also have other problems like inflammation and detoxification. This is where metabolomics shines in comparison to any other methylation test–it tests the whole person and identifies these problems without missing the forest for the trees.

Metabolites Relevant to Functional Medicine: Examples

Using the Theriome Aristotle Metabolomic Test in a Functional Medicine Practice: Precision Functional Medicine 

While three metabolite examples for each functional domain are listed above, extrapolating the number, combinations and associations of metabolites that impact human health are beyond that of human comprehension. For the most accurate assessments of how groupings of metabolites impact various functional domains, and how interventions will impact individuals' metabolites and functional domains, one needs artificial intelligence. For example, using a digital twinning protocol allows for more precise recommendations for addressing the overall function of the individual, not just one area of function or just one metabolite.

The Theriome Aristotle test serves as an excellent baseline assessment for function. It investigates 12 key health domains that provide inferences regarding the function. The Aristotle test also provides protocols for optimizing function, targeting overall health as well as specific functional health domains. It does this by utilizing artificial intelligence to assess metabolite interactions and for wellness protocol generation. Additionally, should dysfunction lead to disease, the Aristotle test also extrapolates disease risk based on the presence or absence of collections of disease-associated metabolites.

Functional medicine represents the leading edge of medicine by utilizing a systems biology approach to health and wellness. The utilization of omic technologies in practice presents an opportunity for clinicians to be more precise with their functional medicine assessments and interventions. Utilizing the Theriome Aristotle metabolomic test equips a practitioner for the next stage in the evolution of functional medicine: personalized functional medicine.

[1]  Gao, K., Mu, C.-L., Farzi, A. and Zhu, W.-Y. (2020) Tryptophan metabolism: A link between the gut Microbiota and brain. Adv. Nutr., Elsevier BV 11, 709–723