UpStream: Root-Cause Functional Medicine
Our practice is a functional medicine practice, which seeks to find and resolve the root cause of disease, rather than just treat the symptoms of the disease.
How is functional medicine different from conventional medicine?
Conventional (or traditional) medicine focuses solely on the symptoms of disease and threats these symptoms ‘downstream’ with pharmaceuticals and surgery when the disease is quite developed. That’s because conventional medicine – its traditions, culture and reimbursement – is ultimately built on the idea of acute interventions – like those for infections and injuries. That’s where it has made most progress during the 20th century, and where it can be justifiably proud of its achievements. Conventional medicine is less effective for chronic diseases, those that last a long time and are difficult to reverse. It tends to see them as a series of acute events, rather than as a developing story linked closely over time.
Why is functional medicine better at preventing and managing chronic disease?
Chronic diseases now represent the large majority of human health-related suffering – and of healthcare costs. These are diseases like hypertension, diabetes, depression, arthritis, cancer, pulmonary disease, cardiovascular disease, asthma, chronic kidney disease and obesity, to name the top 10 diseases that account for about 80% of all chronic disease. Functional medicine, unlike conventional medicine, does not see these diseases as a series of acute events, but rather as part of a long evolving story for each particular patient. The evolving story of each person’s chronic diseases is also interwoven with their overall life story and journey.
With chronic disease, our battle is not actually with life and death; it is far more concerned with the preservation of function (hence functional medicine). For many people who end up suffering with multiple chronic diseases, it is not their deaths that concern us but rather the quality of their lives that matter. That’s why we focus so much on the lived experience of each person in great depth, and their personal history, in our quest to find underlying root causes to either prevent chronic disease, heal a person so that they can regain function again, or even reverse or cure some chronic diseases.
Where do we focus in functional medicine?
Our bodies are incredible machines. We have about 37 trillion cells in our bodies, each of which has a specific role in the body. These cells together form organs, which perform our vital functions and keep us alive and functioning. Those organs together for our bodies, healthy or otherwise. If each cell can do what it is supposed to do, then each organ can perform its function and the body and mind stays well. If the cells cannot perform their roles properly, the organs of which they are a part then cannot function and the body and mind become chronically unwell.
By listening very carefully to your evolving life story; then by using advanced diagnostic testing of your blood and urine to identify biomarkers, we can develop a very accurate understanding of how well your cells are performing their functions. We can then explain clearly to you what is happening at that level, and work with you over time on issues such as your lifestyle and environment to improve the function of those cells, thus your organs, and eventually your entire body and mind. We show you how it is possible to feel incredible every day.
If we use the metaphor of a motor car, your body is like a machine with a dashboard – but on this dashboard there are only 7 ‘warning lights’ that can come on to give us an indication of where problems might be. These ‘lights’ are:
- Dysfunction in the way your cells produce energy to do their wok.
- Problems with the structure of your organs or body that prevent your cells getting their work done.
- Challenges with how your cells transport themselves around the body when they need to.
- Challenges with how your cells communicate with each other using, for example, hormones and neurotransmitters.
- How well your intestinal cells work to take in food and to remove waste from your body.
- How well your immune system cells works to protect (or over-protect) your body.
- What toxins, such as heavy metals, might be in your body preventing your cells doing their work.
For each chronic disease, one or several of these lights will be ‘flashing’ Those alters us to the root cause of those chronic disease and allow us to work together to resolve those problems.
In order to achieve this, we have designed a multi-stage process.
Our process in functional medicine
The first stage is to meet with the patient to establish our responsibilities to each other, and to spend time together exploring the past life history of the patient, the evolving story of their chronic conditions (if they have any) and establish the priorities of our work together. This usually takes about 60 minutes, and can range from a patient with no chronic conditions, with all of their conventional eating in the correct ranges, but who still ‘feels like crap’; to a person with multiple chronic conditions, all complicating each other. This is the single most powerful phase of our work together as it sets the agenda for everything else we do.
After this first encounter, we organize this information into sections, then proceed to the next phase – basic diagnostic testing. Over our years in practice we have developed a basic testing package that keeps costs low but which still identifies sufficient ‘biomarkers’ for us to see which lights on the dashboard are flashing. These biomarkers are indicators of your metabolic state (how you are producing energy at your cellular level; hormonal state (how your cells are communicating through chemical messengers) and nutritional state (how your body is being fed). Once these basic tests are done and fully interpreted, we can then set about the process of resolving your challenges at root cause level. The report of our initial discussion and the report of the diagnostic testing are combined together to give you a complete report to review and to study. This may be one of the most important and insightful documents you will ever read about your health.
In our second encounter, usually about two weeks later when all the test results have been returned, we answer all of your questions about these reports, and start the process of prioritizing the issues that matter most to you. Even if the list of challenges is long, we will get to them all over time. We help you to understand which conditions are linked at the level of root cause and agree how we want to approach your care. At the end of the second encounter, which usually takes 45-60 minutes, we should have a very clear shared picture of your health challenges, and be ready to start on addressing the first 3-4 root causes. You are already on your way to a much better life.
As we move on to addressing these root causes, we will establish some goals, and we will each commit to do our best to achieve them. Every goal we agree will be ‘SMART’ – it will be very specific (eg ‘get fasting blood sugar below 100mg/dl’); will be measurable (this one through a blood test in a few weeks); will be achievable ( Rome wasn’t built in a day so it may take several steps to achieve that goal); will be relevant (because this would show that your insulin is working much better as a communicator to your cells); and will be time-bound (eg test in 6 weeks by which time we expect to see improvement). We will work together to design changes to your lifestyle (such as rest, exercise or nutrition) or to your environment (eg toxic substances in your environment or required dietary supplements) yo achieve your goals.
Within those first few weeks, if we do our work well together, you will begin to experience extraordinary changes to your health and well-being.
The 4-Step UpStream Process
01
Deep Dive - Your Story & Goals
We start with a 60-minute conversation to get to know you—your health history, life story, and current challenges. Whether you have multiple chronic issues or just feel “off” despite normal test results, this is where we set the plan for everything that follows.
02
Precision Testing - Core Testing & Insights
Next, we run targeted lab tests to uncover key “biomarkers” that show how your body is working—energy production, hormone balance, and nutrient levels. We combine these results with what we learned in Stage 1 to create a clear, detailed health report just for you.
03
Root Cause Review - Review & Prioritize
About two weeks later, we meet again to explain your results, answer your questions, and decide which issues to tackle first. You’ll leave with a clear picture of what’s going on and a roadmap for your first steps toward better health.
04
The Smart Plan - Action & Measurable Change
Your treatment is Specific, Measurable, Achievable, Realistic, and Time-based, designed to restore balance and help you thrive. We set specific, realistic, and trackable goals together—covering areas like nutrition, movement, rest, and your environment. Within weeks, you should start feeling real changes as we work to restore function and address the root causes of your issues.
At UpStream, we look at your body as an integrated whole, uncovering what’s driving imbalance beneath the surface. This isn’t one-size-fits-all healthcare. It’s personalized, root-driven healing designed for lasting change.
Functional medicine seeks to understand why a person is ill, not just what disease they have, and it emphasizes healing and prevention by correcting imbalances at their source. It’s a proactive, collaborative, and holistic method that aligns well with the long-term management of chronic illnesses.
Getting the system balanced
The core framework used in functional medicine to understand and rebalance the body’s systems contains seven biological systems, also called core physiological processes provide a structured way to evaluate chronic disease and promote healing.
We use the framework to map symptoms to system imbalances, which guides our root cause analysis. This allows us to personalize interventions to restore harmony across the seven areas. By addressing dysfunction in these interconnected systems, the body can rebalance itself and reduce or resolve chronic disease.
The body's core physiological processes
Assimilation
Waste & Digestion
Defense & Repair
Immune System
Energy
Cellular Energy
Biotransformation & Elimination
Toxins
Transport
Cellular Transport
Communication
Cellular Communication
Structure
Structural Integrity
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We believe that health is a state of independence.
“There comes a time when we need to stop pulling people out of the river; we need to go upstream and find out why they are falling in”
Desmond Tutu
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