Do you remember the last time you felt truly well? Not just ok – but vibrant, energetic and without any aches and pains? This could be one of the first questions a Functional Medicine Practitioner might ask you – and although it’s not always an easy question to answer, from a Functional Medicine perspective, it’s fundamental. Because knowing the ‘when’ often leads us to the ‘why’.

Addressing Imbalances

Functional Medicine doesn’t divide the body up by organ systems as traditional medicine does – but instead addresses any underlying imbalances. These are grouped into eight nodes. Each of these nodes make up part of the Functional Medicine ‘matrix’. The matrix is a tool that will help your Practitioner identify the ‘why’ or root causes of your symptoms – and later, devise a personalised treatment plan.

The Eight Nodes of the Functional Medicine Matrix

Here’s some information about each of the eight nodes within the tool known as the Functional Medicine matrix. I’ll speak more about each of these in future posts, but for now, here’s a quick summary.

1) Assimilation

This relates to the systems of digestion, absorption, microbiota, gastrointestinal tract and respiration. When these systems aren’t working as they should, all sorts of issues can arise such as IBS (Irritable Bowel Syndrome), constipation, diarrhea etc. Beyond these symptoms, new research is also exploring a link between unhealthy gut microbiota and conditions such as depression and motor neurone disease.

2) Defence & Repair

This relates to the immune system and repair mechanism that evolved to prevent infections and help restore an infected body. Inflammation, for example, is a common response mechanism used in the body’s defenses.When these systems work as intended, we avoid illnesses or recover quickly from infection – but when the immunologic response is prolonged or misplaced, or when the process occurs in response to our own body and not a pathogen, when the inflammation becomes chronic, the result can produce major dysfunction in any of our systems. This can cause major problems such as heart disease, diabetes or a wide range of autoimmune diseases.

3) Energy

Energy in the body is produced by mitochondria, which captures the energy from the breakdown of nutrients and transforms it into energy used by the body, called ATP (Adenosine Triphosphate) which is closely involved in energy transfer. This process requires the coordination of hundreds of metabolites – usually vitamins and minerals. A deficiency in these metabolites creates energy imbalances in the cells, which can ultimately affect how the tissues, organs and systems function.

4) Biotransformation and elimination

Biotransformation and elimination is the system that processes and excretes metabolites from the body. In addition, this system also chemically modifies substrates to allow their removal from the body. When this system is functioning as it should be, waste products are efficiently removed from the body via the gastrointestinal tract and urinary tract – and skin and toxins are eliminated efficiently without causing too much harm to our systems. If genetically, someone doesn’t have the most efficient detoxification mechanism, the body may experience increased toxic exposure, nutrient insufficiencies, metabolic dysfunction and intestinal symptoms.

5) Transport

Transport involves the movement of molecules within cells, between cells and tissues and throughout the body. Issues with transport, including the structural integrity can cause dysfunction in the cardiovascular and lymphatic systems. When materials cannot be transported efficiently through the body, metabolism slows, leading to problems such as heart failure, hypertension and kidney disease.

6) Communication

Communication relates to all the signaling interactions that occur within and between cells thanks to hormones, neurotransmitters and immune messengers. Cells are constantly in contact with their environment, sending and receiving signals. Optimal functioning in the communication system involves cells and organs sending, receiving and responding appropriately to signals from other cells. But any problems relating to the processing of these messages can have a serious effect – causing depression, hypothyroidism, insulin resistance and many other conditions.

7) Structural integrity

The structural integrity system relates to the integrity of the organelle membranes, the cytoskeleton and the cell membrane, the alignment of bones, ligaments, muscles and tendons, and the structure of the major organs. When structural integrity is optimised, functions such as movement, balance, strength and cognition can reach their maximum potential, while dysfunctional structures can lead to deficits in these body functions and, in some cases, cause severe pain. Common problems that involve dysfunction in structural integrity include osteoarthritis, osteoporosis, neuropathy and chronic pain.

8) Mental, emotional and spiritual factors

So far, all seven nodes explored have been to do with imbalances within the physical systems of the body – but the eighth and final node and the centre of the matrix relates to the individual’s mental, emotional and spiritual wellbeing. This includes their functions of cognitive and emotional self-regulation as well as their sense of self-worth and spiritual purpose. This final node is extremely significant – as one of the core beliefs of Functional Medicine is that optimal health cannot be achieved just by working on the physical body. To be able to live in full health, we need to consider the mental, emotional and spiritual factors as well.

Using the Timeline and the Matrix Together

As mentioned in last week’s blog, before the initial consultation, you’ll be asked to fill out the MSQ (Medical Symptoms Questionnaire). Although this can be time-consuming, this helps the Practitioner create a timeline to use as a tool alongside the matrix in your initial appointment.

The timeline will include your family history, your lifestyle and environment, to determine how you got to your current state of health. It includes antecedents, mediators and triggers, as well as all your symptoms from birth to date and any significant events, all plotted out in order on a timeline. Part of the initial appointment also includes a physical exam, centred around nutrition – I’ll share more about this in a future post.

The matrix tool will also include the antecedents, triggers and mediators as well as modifiable lifestyle factors and the eight categories or nodes detailed above. When all these steps are done and the imbalances identified, the Functional Medicine Practitioner will have developed a much clearer picture of the issues and will be able to use both these tools together to work on a treatment plan and (if necessary) suggest relevant tests going forward.

Participation Medicine

Functional Medicine is also known as ‘participation medicine’. This is because from the very beginning of the process all the way through to the treatment plan and the changes moving forward – the client is at the centre. They will be the one that will open the door to the answers for the Practitioner and they will be the ones to make the lifestyle changes further down the line. And so, the therapeutic partnership between the Practitioner and the Client is an important one – a partnership that together will involve the learning of the lifestyle factors at the root causes of the issues, the retelling of a story within a timeline and the application of the matrix to address the imbalances present.

Written by Andrea Okos


Just Be Well: A Book for Seekers of Vibrant Health by Thomas A. Sult