Updated: Mar 20
Functional medicine is a way of thinking about health and disease that focuses on optimal functioning of the body, using more natural ways to address the root cause of a symptom.
It’s just a small step in a different direction for a pharmacist to begin to practice functional pharmacy. As Pharmacists, we are often asked for recommendations to address a particular symptom or health complaint. When this happens, by asking just a few simple questions, we may be able to address the potential root cause and alleviate the symptom.
How many times has a patient (or family member!) asked you what to take for gas, bloating or diarrhea? Your first thought is to go back to what you learned in your OTC course in pharmacy school and recommend simethicone for the gas, which might work well to alleviate some of the gas and bloating, but not the diarrhea. Or maybe a probiotic would seem appropriate. But… if you think about what might be causing the gas, bloating and diarrhea, you might look to the person’s diet to help them make some changes to address the symptoms.
Inquiring about any precipitating factors may also help sort out whether a dietary change is worth trying. Here are some considerations:
Dairy can be a very common cause of these kinds of GI symptoms. Lactase is an enzyme required for the breakdown of lactose, or milk sugar, and some people don’t digest it well. This is referred to as a lactose intolerance and is a very common problem in certain populations. It can develop at any age and renders a person unable to breakdown lactose causing gas, bloating and diarrhea.
If the patient consumes dairy regularly, you can ask if they would be willing to try giving it up for a week to see if the symptoms resolve. You might also ask if they tend to tolerate fermented dairy such as yogurt, aged cheese and kefir but not milk, ice cream or sour cream. The bacteria used to ferment these dairy products partially digest the lactose making them more digestible and so they produce fewer symptoms. The patient could also try Lactaid or Lactaid milk which contains lactase and helps digest the lactose and decreases or eliminates the symptoms.
Another common health complaint is insomnia. Recently there have been some reported adverse effects with long term use of medications with anti-cholinergic effects such as increased risk of dementia, mental confusion, memory loss and worsening mental function.
What can we offer someone looking for help with insomnia besides a medication? To start, ask about their use of digital devices that emit blue light during the evening hours. How much are they on their phone, tablet or laptop?
The blue light emitted from digital devices affects the body’s ability to make melatonin and causes increased alertness when our bodies should be winding down preparing for sleep. Many children are spending time on iPads, phones or laptops in the evening and you may want to restrict their use after supper, particularly if they’re having trouble sleeping. (Click here to read more)
There is a setting on smart phones that can change the blue light to a red light in the evening. They can also purchase blue light filtering glasses for a reasonable price (Amazon lists them for $15-20) or just refrain from using these devices in the evening.
Ask about the amount and timing of caffeine consumption. Even if they are only having a morning cup of coffee, some people are slow metabolizers of caffeine and it may still affect their sleep. Individual variations in CYP1A2 can cause the half-life of caffeine to vary from 1.5 to 9.5 hours. Switching to half-caf or decaf coffee or pop may solve their problem.
These are some easy things we can explore with patients to help them figure out what may be causing their health complaint. As pharmacists, we learned about a pill to address every symptom but first we can look for the cause instead of only treating the symptom. Lucinda Harms
Lucinda is a traditionally trained pharmacist, graduating from the University of Iowa College of Pharmacy, that has been interested in an integrative approach to health and disease for 20 years. She has used nutritional supplements and herbs in her practice since 2008.