Interview with Dr Mann about functional medicine

Functional Medicine is a fundamentally new way of thinking about health and disease and puts the power of being healthy back in the patient’s hands, in a partnership with their doctor.
— Sunita Mann, MD – Functional Medicine Specialist

What you do in your chosen field?

I practice a relatively new field of medicine called Functional Medicine, which strives to reveal the root cause of chronic health issues by looking at the patient’s entire body and their environment. The key to this approach is to look beyond a group of symptoms, and instead, treat the underlying cause of the condition. Many chronic diseases such as Diabetes, Chronic Fatigue, Neurological disorders, Menopause and other hormonal imbalances, cause significant problems for people, preventing them from living a healthy life and resulting in a dependence on prescription drugs. However, there is much more to healing than drugs. Functional Medicine is a fundamentally new way of thinking about health and disease. Conventional Medicine (which is what I was taught in Medical School) treats the signs and symptoms of disease, often individually. We were taught to look at the body as systems rather than the whole being, in which so many health issues are interconnected.

How did you become involved in this field?

I’ve found that many functional medicine doctors become involved in Functional Medicine through their own health journeys. The same is true for me. My Conventional Medicine training was in Diagnostic Radiology and Neuroradiology, fields which gave me a great background in diagnosing medical problems. I practiced Radiology for 13 years, until December 2013, when I developed a life-threatening anaphylactic reaction to the contrast dye I routinely used in my radiology procedures. I found myself going from a healthy woman in the prime of her life to someone unable to walk more than 50 feet without getting short of breath, unable to climb steps or drive a car, and unable to care for my family. After many months of recovery, during which I realized I could not continue to practice in my chosen field of medicine, I knew it was time to take care of my health and that journey led me to discovering a whole new world of medicine which combines medical principles that are thousands of years old with the cutting edge technology of modern laboratory diagnosis. Because of my background, I needed to see the evidence of what was going on in my own body and from there, discover that health is a continuum: from optimal health, through problems such as weight gain, to high cholesterol, to high blood pressure and high blood sugar, to fatigue, etc., all the way to disease. This is a fundamentally new way of thinking about health and disease, and puts the power of being healthy back in each of our own hands, in a partnership with our doctors.

As I began a journey towards wellness, I realized that my new-found knowledge could help others dealing with illness. I then began my formal certification in Functional Medicine so I could offer these techniques to my patients.

What is the main difference between conventional medical care and functional medicine?

Conventional or traditional modern medicine is great at treating acute problems, such as pneumonia, heart attack, infections, trauma, and without this type of medicine, I would not be alive today. After such a severe anaphylactic reaction, the only reason I am here is because of the amazing medical personnel who reacted so quickly to save me. However, once a person is out of an immediate health danger, conventional doctors are not trained to keep people in optimal health. A conventional doctor may counsel patients on eating a healthy diet, and getting exercise but they often don’t have the time or tools to help the patient with their specific health concerns. Functional medicine is Personalized Medicine and allows the doctor and the patient to work together to look at the specific genetics, environment, laboratory findings and risk factors to formulate a specific plan to achieve the goal of optimal health.

What are the benefits of personalized medicine?

Personalized Functional Medicine individually treats the whole person rather than parts of the person. By looking at a combination of genetic predispositions, family history, and lifestyle factors (such as nutritional status, exercise, stress levels, relationships, sleep), and then using targeted diagnostic tests to see what is going on inside the body, including the hormonal status of that person, I can provide an individualized plan to get a patient to optimal health. The goal is to find and reverse physiological imbalances that may be present for years before a person manifests disease… and in someone who already has a disease, to use those same tools to reverse the process.

What is the most rewarding part about your profession?

The most rewarding aspect of my practice is to be able to help people who have been to many different conventional doctors looking for help, often bewildered by how they got to this point, who come to the realization that they can achieve optimal health.

What is the most challenging?

The most challenging part of what I do is that it requires a real commitment from the patient to be my partner in getting healthy. Some people hope for a “magic pill” to solve all their chronic health problems and the simple truth is that there is no such thing. Like anything worth having in life, good health takes commitment and a real desire to change the habits and often the attitudes that lead that patient down the path to illness.

Another challenge I often face is the cost of some of the testing I do on my patients. Unfortunately, some of the tests that really help in functional medicine diagnosis are not covered by insurance so the patient and I have to make a decision about which testing is the most important to start with. I try to always work within the cost constraints but as I explain to patients who have already seen so many other doctors, sometimes paying for that testing themselves makes all the difference in getting healthy.

What are the most common issues you see in your profession?

What I see the most of in my practice, are the most common health concerns present in modern America such as obesity and diabetes. These are the main drivers of the common killers: heart attacks, strokes, cancer, dementia. Conventional medicine waits until you have diabetes, hypertension, or heart disease to start treatment. Functional medicine uses testing to find the earliest signs that a patient is at risk for a disease like diabetes. I look at the body’s response to certain foods or the presence of food sensitivities, the level of inflammation in the body, and the health of the gut. All of these factors can be tested for and if a person is found to have problems in any or all of these areas, they can be treated with a very personalized plan to reverse these changes.

I also see many patients with hormonal problems who are afraid to take hormones because they’ve heard that taking hormones can increase risk of cancers and other problems. One of the things I educate my patients about is that Bio identical Hormones are very different from the hormones derived from horse urine that many women have used in the past. Bio identical hormones are a natural replacement for the hormones we all lose as we age and in fact, they are crucial for good health.

Tell us about yourself.

I grew up in Edison, N.J. and after graduating from J.P. Stevens High School, I obtained my undergraduate degree in Biology at Rutgers University and then went on the Medical School at UMDNJ-Rutgers Medical School. After an internship in Internal Medicine, I obtained my degree in Radiology from UMDNJ- University Hospital and then received advanced fellowship training in neuroradiology at the Mount Sinai School of Medicine and Mount Sinai Medical Center. After practicing Radiology for 13 years, I began my certification in Functional Medicine from the Institute of Functional Medicine.

My husband, Dharam, who is also a physician, and I live with our three children (Anjali, age 16; Anisha, 11; and Akshay, 10) in Marlboro, N.J. We practice in Monmouth and Ocean Counties. My office is located in West Long Branch.

As a board-certified medical doctor, I use my extensive background in diagnostics to find the “root cause” of diseases.

How do you relax after a long day at the office?

Optimal health requires healing the body and I use many relaxation techniques in my personal life and as well as with my patients. One of the most powerful tools available to all of us, is the practice of using breathing techniques to actually change our physiology. I practice yoga breathing exercises in the morning to get me ready for the day, along with meditation later in the day to help me unwind. By practicing these techniques regularly, we can reduce stress and directly reduce inflammation in the body, which I believe is the main cause of chronic diseases.

Are there any cases that stick out in your mind (most memorable)

A recent case that really shows how strongly I believe in the power of functional medicine is that of a 52 year old woman who came to see me because of severe fatigue, weight gain and hot flashes. She said she tried to eat right and exercise but was often too tired to exercise more than a few minutes. Her Ob-Gyn had put her on an estrogen patch after checking her hormones. However, her symptoms only improved slightly. After taking a complete history and looking at risk factors, I sent her for advanced hormone testing including hormone metabolism testing which looks at how a person breaks down the hormones in their bodies, especially estrogen. I discovered she wasn’t breaking down estrogen properly and this in fact could lead to an increased risk for breast cancer and other cancers in the future. I also discovered her mother and sister had a history of breast cancer. Based on these findings and some other functional medicine tests, I stopped her estrogen patch and started her on bio identical hormones to mimic the hormones she was deficient in and, even more importantly, started her on supplements to help her convert the hormones to a safer form that could be easily excreted from the body. By changing the way she processed the hormones, her hot flashes resolved and repeat testing showed she no longer had the bad hormones building up in her body. I also checked her thyroid function using tests not done by her conventional doctor. One very important thing I discovered was that her fatigue was due to abnormal levels of another hormone in the body, called cortisol, and over time I was able to correct that as well. Once the fatigue was improved, she was able to start an exercise program which helped her lose the unwanted pounds and feel like herself again.

The true difference that functional medicine can make in a patient like this is in the way we can gather pertinent information and the use of advanced testing, beyond what conventional doctors typically do. Also my greatest emphasis is on eating healthy food. As Hippocrates, the father of modern medicine said “Let food be thy medicine and medicine be thy food.” This is a motto I try to live by every day.