Who is Functional Medicine right for?
Functional Medicine is one of the greatest investments a person can make in their health.
The Functional Medicine path is for the patient who is ready for a true and complete transformation of their body, mind and spirit; who may have tried everything else and not found any answers to their health problems; who knows something is wrong, despite being told “everything looks normal” by their doctor; for the patient with chronic issues that just won’t go away or with vague symptoms that never seem to get better.
Functional Medicine is also for the healthy person with no apparent issues at all who is looking to optimize their health and performance in order to achieve the greatest and fullest expression of their being.
What makes Functional Medicine different?
Functional Medicine views health with the understanding that the part cannot be well unless the whole is well and that the interconnectedness of the body must be acknowledged in order to achieve truly optimal health and wellness.
To this end, Functional Medicine investigates all aspects of the body, all systems, all physiological functions and each organ system regardless of the symptoms to ensure no stone is left unturned in the pursuit of whole body healing.
At the heart of the Functional Medicine path are specialized, advanced labs and blood work at the cutting edge of medical testing. These tests go far above and beyond the standard, basic blood work a patient receives at their regular doctor.
Functional Medicine labs use more biomarkers and analytes than conventional labs. This means we have hundreds if not thousands more data points to interpret when looking at a patient’s overall lab work.
With greater data sets, we yield more information. With more information, we gain a deeper understanding. With deeper understanding, we reach superior diagnosis and treatment. With superior diagnosis and treatment, we achieve the ultimate level of healing possible.
In addition to using the most comprehensive and advanced screening tools available, Functional Medicine compares every result to improved optimal ranges that are different from the standard ranges used in conventional medicine.
Functional Medicine does not settle for results that simply confirm there is no immediate health emergency. We instead work to move a patient’s biomarkers into what are considered to be the most optimal range of health and vitality in order to help a patient not just simply survive, but actually thrive in their life.
Is there any reason not to choose Functional Medicine?
It must be emphasized that Functional Medicine is not a path for the casual patient looking to dip their toe in the water of healing; this is a deep dive into every aspect of health in the body. The level of engagement and compliance each patient brings to the process directly correlates to the amount of success they will have in their own outcome.
Functional Medicine is not a passive medicine. One must be prepared to make fundamental changes to every aspect of their life, with a strong emphasis on the food they eat, the lifestyle they lead, the behaviors they exhibit, the activities they partake in and even the people they engage with.
If you are looking to keep consuming all the same things you’ve been consuming and keep doing all the same things you’ve been doing and also see big changes in your health and life, then the Functional Medicine path is not for you.
The convention of a patient’s role in their health ending with the act of popping a pill while making no other changes is a broken paradigm and a mindset that must be released in order to reach real, lasting healing.
Nothing changes if nothing changes.
There can be no great shifts without great shifts.
One cannot heal in the same environment that made them sick.
What is the difference between Functional Medicine and Conventional Medicine?
If you have been struggling with your health, Functional Medicine is a hard reset to the patterns in your life that have brought you to this point of dis-ease. It is a chance to change the course of the rest of your life and an opportunity to fix things before they become unfixable.
In Functional Medicine, we are able to focus our treatments upstream by identifying problems early on while they are still correctible. In doing so, we change the downstream effects and prevent more serious, sometimes irreversible illness before it ever develops.
Conventional medicine is great when it comes to emergency care, acute illness and physical injuries. If we have a broken arm, a very bad infection or need life saving surgery, conventional medicine is the answer, but it was never intended to be preventative medicine.
Conventional medicine is sick care, not health care. Only when a person’s health has reached an extreme imbalance will conventional medicine step in, typically employing strong, toxic drugs that carry with them a long list of side effects. These interventions may or may not address the issue, but they almost always create new problems along the way.
What does the Functional Medicine path look like?
So, what does the process look like? It’s certainly different than your annual physical.
When you book your initial Functional Medicine appointment, you will receive an email confirmation asking you to complete a series of comprehensive new patient medical forms. You can expect to spend 1-2 hours filling these out, so please be sure to set aside focused, thoughtful time to do so.
Your responses to these questions will form the foundation of your entire treatment plan, so answering every question to the best of your ability is critical to the success of your healing. The more information we have to work with, the greater the outcome will be. These forms paint a detailed portrait of your life, overall state of health and are what we use to determine where we need to look closer.
Once all the forms are completed, Dr. Ryan Monahan thoroughly evaluates and reviews everything in order to form an initial set of diagnoses. At the first video appointment, we will go over your health history, symptoms, concerns, goals and expectations, as well as review the initial diagnoses based on the forms you completed and what follow up labs need to be ordered to investigate further.
Lab kits will be shipped directly to your address on file. Depending on the test, you will either complete the labs at home if they are stool, saliva, hair, urine, breath or blood stick, or have a blood draw completed at your home by a mobile phlebotomist or at the nearest available blood draw site to your residence. Depending on where you live, this may be a free service or may require a small fee.
Once the ordered labs have been completed and all results are received by Dr. Ryan Monahan (usually a 2 to 4 week turnaround), a second video appointment takes place, at which a Report of Findings is reviewed and delivered to the patient, including a detailed explanation of interpretations for all relevant lab results. These are the factors that identify and determine what has been causing health imbalances.
A comprehensive, individualized treatment plan specific to every patient and their lab work is also prescribed at the second appointment and included in the Report of Findings. This will typically include customized nutrition plans, recommended lifestyle changes and behavior modifications, physician-grade prescription supplements, cleanse and detox protocols, systemic clear and repair plans and much more depending on what is needed in each individual case.
What tests will be run?
The initial patient work-up makes sure to look at every system of the body in order to understand the patient in a truly holistic way. By exploring every aspect of your health, we leave no stone unturned and don’t risk missing vital indicators that could be contributing to or entirely responsible for the patient’s chief health concerns. You can’t find what you aren’t looking for.
In almost every case, the cause of a patient’s condition is multi-faceted. Everything is connected and interdependent. The part cannot be well unless the whole is well. We can’t just patch holes, we must look at it all and fix everything for complete, long-lasting health.
While every case is unique, the basic work-up for every patient is likely to include the following recommended tests:
Comprehensive Functional Medicine Blood Panel
Over 70 unique blood markers, including an expanded thyroid panel, metabolic panel, lipid panel, iron panel, liver and kidney markers, inflammation markers, nutrient markers and complete blood count, plus dozens of other critical markers not included in standard blood work. Beyond looking at almost 40 more markers than conventional blood work, we interpret every value through an idealized functional range that prioritizes optimizing the patient’s health, rather than the conventional approach that simply settles for confirmation of no immediate medical threat. In this way, we take a preventative medicine approach rather than an emergency medicine reaction.
Complete Hormone Panel with Organic Acids and Neurotransmitters
We utilize the best hormone panel on the market that goes far above and beyond the standard hormone test conducted in conventional medicine. Our hormone panel includes analysis of 35 different hormones, including estrogen, progesterone, testosterone, DHEA-S, and cortisol along with their metabolites, the overall diurnal pattern of free cortisol, plus the cortisol awakening response (CAR) and melatonin to further understand the critical HPA axis. In addition to the most comprehensive look at hormones available, we include an organic acids test that analyzes hormone-influencing nutrient markers such as vitamin B12, vitamin B6, glutathione, as well as neurotransmitters like dopamine, norepinephrine, epinephrine and more.
Comprehensive Nutritional Assessment with Detoxification and Toxic Elements Profile
A blood and urine test that evaluates over 125 biomarkers and assesses the body's functional need for 40 antioxidants, vitamins, minerals, essential fatty acids, amino acids, digestive support and other select nutrients. This includes markers for metabolic analysis, malabsorption and bacterial/yeast dysbiosis; cellular energy & mitochondrial function; neurotransmitter function including epinephrine, norepinephrine, serotonin and dopamine; vitamin markers including A, B-vitamins, C, D, E, magnesium, manganese, zinc, CoQ10, alpha-lipoic acid and molybdenum; toxin & detoxification markers to assess the body's detox capacity; essential and nonessential amino acids; urea cycle markers to assess nitrogen detoxification; methylation effectiveness and capacity; essential and metabolic fatty acids, including omega 3, 6 and 9; saturated fatty acids; monounsaturated fats including omega 7 and unhealthy trans fats; delta-6 desaturase activity; cardiovascular risk; oxidative stress markers; vitamin D status; elemental markers; toxic elements assessment indicating exposure to lead, mercury, arsenic, cadmium or tin.
Total Gut Health & Digestive Functionality Testing
Stool and breath testing that investigates digestive function at every level. Markers provide in-depth information on inflammation, microbiome balance, maldigestion, dysbiosis, metabolite imbalance, infections, overgrowths, parasites, fungus, yeast, commensal bacteria and more. This includes a comprehensive assessment of complete gut health, exploring the root cause of most GI complaints utilizing a combination of PCR, culture, and microscopic methods to ensure any and all relevant organisms are identified. The stool testing we run recovers live organisms (yeast and bacteria) for susceptibility testing and improved treatment options. Labs measure metabolomics and can assess the interaction between the microbiome and its host. Results include detailed interpretations of stool inflammatory markers, such as calprotectin, EPX and sIgA. Patient outcomes are compared with a database of hundreds of thousands of complete stool profiles to ensure data-driven, evidence-based analysis with the highest standard of analytical validity and clinical utility.
Food Immunology Testing
While there are many food tests available, there is only one gold standard. Cyrex Laboratories stands high above all others with the most innovative, advanced, useful, reliable food testing available. If it isn’t a Cyrex food test, we don’t trust it. This is not simply food allergy testing, this is food immunology testing, meaning we are looking at how the foods you eat affect immune responses in your body that can lead to systemic chronic inflammation, destruction of vital organ tissues, intestinal permeability and even autoimmune conditions and diseases. If food is medicine, we must not only make sure we are eating the right foods, but even more importantly remove the wrong foods that are provoking full-blown immune responses every time we consume them.
Can I just use blood work I already have?
While you are encouraged to share any previous blood work or labs run in the last three months, rarely are these results comprehensive enough or comparable to the extensive, advanced labs we run in a Functional Medicine work-up. Testing with the labs described above and potentially additional tests will be necessary to properly assess your overall health from a Functional Medicine perspective.
Do we really have to do all the labs? Can we skip some or do them one at a time?
Functional Medicine uses extensive lab testing to build you a strong, safe, effective bridge. Standing on one side of this bridge is you with whatever current health concern, ailment, disease or disharmony you want to fix. On the other side of this bridge awaits the healthy, optimized, thriving version of you.
As Functional Medicine practitioners, we are being asked by the patient to build them a bridge to health. We know what materials, tools and timeframes are needed to successfully build a safe, effective, reliable bridge that will carry the patient from sickness to health and keep them there for years to come.
If we are then asked by the patient to cut corners and build their bridge to health cheaper or faster or both, the result will be a poorly constructed bridge missing essential parts, pieces and materials that will be unlikely to help the patient arrive at their desired destination of long-term health.
If you want a job done right, give the builder the materials and the time they need. In the case of Functional Medicine, this means running all the labs and blood work necessary to get the full picture all at once that is required to properly assess and diagnose the patient and then build them a safe, effective treatment plan that will successfully help them heal in a real and lasting way.
With this in mind, we can always begin with one or two tests to get started if that is most supportive to the patient. Feeling as if you must run everything or nothing is not the intention. Much can be accomplished with even one lab, depending on the patient's concerns. If further investigation is warranted down the road, additional labs can be added in later.
How long does the Functional Medicine path take?
While every patient is different, a focused window of healing will typically take around three to six months to reset the body. In some cases it is shorter, in some cases it is longer. During this time it is imperative that the patient adhere to the treatment plan and all recommendations in order to reach a timely and successful outcome.
This is where compliance, engagement and self-awareness are vital. No one will be there to look over your shoulder every day and it will depend on you to stick to the treatment plan in order to achieve the desired results.
After this healing window, there is a follow-up appointment to review progress and order any additional lab tests that might be required in order to confirm we have achieved our health goals. If there’s still some work left to do, we make adjustments and tweaks to the treatment plan.
If things look good, the process is completed and the patient typically feels better than they have in a very long time and sometimes better than they’ve felt their whole life. They are free of the health burdens that plagued them before and filled with all the new energy, clarity and optimism every person deserves in their life.
Who is this path not right for?
Functional Medicine is a new paradigm in health care. With new paradigms, come new ways of doing things.
While the old paradigm of health care typically involves going to a doctor's office, sitting in a waiting room for an extended period of time and spending only a few minutes face to face with the doctor before being prescribed a pill to take that encompasses the totality of the treatment, Functional Medicine is something entirely different.
This path will ask for much more engagement from the patient. To that end, anyone who is not ready to engage in their health beyond taking a pill everyday may want to reconsider pursuing a Functional Medicine path until they feel ready to partner in their healing in a very proactive way.
Here are some examples of who this path may not be right for:
Anyone who is not able to complete at-home test kits on their own (stool, breath, saliva, urine) that require reading and following step-by-step directions, attention to detail and independence.
Anyone who cannot drop completed test kits with pre-paid mailers at local shipping facilities.
Anyone who cannot complete blood draws by traveling to an assigned local lab for a blood draw or alternatively receiving an at-home mobile phlebotomist to complete the blood draw for an additional fee.
Anyone who has difficulty with technology, computers, email, video conferencing or working with a practitioner virtually.
Anyone who expects immediate or urgent 24/7 responsiveness from Dr. Ryan and his team or direct access to Dr. Ryan over email, phone or text.
Anyone who expects their insurance to cover this process or expects assistance with completing their insurance claim. We do not accept insurance in our practice and are not involved in the patient's insurance claim process at any level whatsoever. All insurance claims must be handled entirely by the patient on their own independent of our involvement. We do not provide any documents, forms, charts, notes, letters, superbills, signatures, verifications, numbers or codes for insurance.
Anyone who is uninterested in completing extensive medical forms that supply a detailed background for the practitioner to better understand their case.
Anyone who cannot swallow dietary supplements, including pills, tablets, capsules, liquids, powders, etc.
Anyone who is unwilling to make any changes to what they eat and drink or their lifestyle and behaviors.
How much does Functional Medicine cost?
Because the Functional Medicine lab tests we order are very advanced, as well as typically developed and run by smaller, independent labs, they do cost more than basic, conventional labs.
This is in large part due to the much smaller volume of these specialized tests being run. When a massive, global lab like LabCorp or Quest runs millions of tests per day, it’s easier to lower the price based on sheer volume and standardization. Small, independent labs are simply operating at a much smaller scale, so the volume of tests they run requires a higher price point.
In addition, the research and development needed to create these unique, advanced tests requires a large investment by these small labs on the front end, which must be recouped on the back end. Because of this, the cost of Functional Medicine tests are higher and not always covered completely by insurance. On average, with good insurance, a patient can expect to receive up to 50% of the cost of their labs covered, but there are no guarantees.
It is always advised that every patient enter into this functional medicine path assuming they will pay 100% out of pocket for the entire process, including all appointment fees, all lab work and testing, all prescribed supplements, and any other costs associated with the process. If any insurance reimbursement takes place after the fact, that is viewed as a bonus, not an expectation. Please consider this carefully before committing to starting this path.
A patient on the Functional Medicine path with good insurance should be prepared to spend $800 to $1800 or more out of pocket on the initial work-up lab testing. Insurance coverage will vary considerably depending on each carrier and specific plan. We have found the typical coverage to be around 40%-60%, but there are no guarantees with regard to coverage of lab testing.
While patients are free to check with their insurance beforehand to inquire about coverage, in our experience insurance companies are not able to quote patients specific numbers and simply ask that they submit the claims after the labs have been run to determine actual coverage.
The Initial Functional Medicine video appointment is $350.
The Follow-Up Functional Medicine video appointment is $550.
Touch Base appointments are $60 for 15-minutes and $120 for 30 minutes (available to existing patients only)
What Can I Expect From Each Appointment?
Overview
The standard work-up for a new patient consists of two appointments: an initial appointment and a follow-up appointment.
This is considered one course of treatment.
Dr. Ryan’s consultation fee for one course of treatment is $900, paid as $350 at the initial appointment and $550 at the follow-up appointment.
All costs beyond Dr. Ryan’s consultation fees, such as lab tests, blood work and draw fees, and supplements, are separate independent costs paid by the patient. These costs will vary in amount by every patient based on their individual case.
Beyond the two appointments included in the first course of treatment, any questions, concerns, conversations or discussion of new symptoms with Dr. Ryan will take place over Touch Base appointments scheduled by the patient.
A 15-minute Touch Base appointment is $60.
A 30-minute Touch Base appointment is $120.
Dr. Ryan does not offer consultation over email, phone call, text message or any other way than scheduled video conference appointments booked by the patient through his website.
Dr. Ryan’s practice does not treat emergency or acute cases that require immediate or urgent attention. If this is needed, please contact your primary care provider, an urgent care or emergency room.
Initial Appointment | $350
The first appointment is an opportunity to establish the patient and practitioner relationship.
The intent of this initial appointment is for Dr. Ryan to hear the patient's story in their own words, which may include their medical history, a timeline of significant events affecting their health, a description of symptoms, what has helped, what makes things worse, and anything else the patient would like to share regarding their health and goals in partnering together.
The initial appointment will also include Dr. Ryan’s recommendations for lab work to be ordered that will help to further investigate and understand the underlying mechanisms that may be contributing to imbalances in the patient’s body.
Once the patient approves the recommended tests to be ordered, test kits will ship to the patient to begin the testing process.
Please note: No treatment recommendations will be made at the initial appointment.
A comprehensive treatment plan will be presented as part of the Report of Findings at the second appointment, known as the Follow-Up Appointment.
Up to 45 minutes are reserved for Initial Appointments.
Some appointments run the entire 45 minutes, some finish earlier if everything has been covered.
There is no prorated pricing based on the amount of time used and time not used in this appointment does not roll over, nor can it be banked for later use.
The cost to reserve a 45 minute time block in Dr. Ryan’s schedule is $350, regardless of the duration of the meeting.
This time policy is true for all appointments, including the Follow-Up and Touch Base appointments.
It’s recommended that each patient come to the appointment prepared with a list of all the questions they may have for Dr. Ryan to ensure the appointment time is maximized and utilized to its fullest potential to meet all the patient’s needs in a concise and comprehensive manner.
Follow-Up Appointment | $550
The second appointment that takes place is the Follow-Up Appointment.
In this appointment, the Report of Findings will be presented by Dr. Ryan to the patient. The Report of Findings is a detailed, comprehensive written review of all the labs that were run, including an explanation of relevant lab markers and an interpretation of what it all means for the patient.
The Report of Findings will also include the patient’s customized treatment plan, inclusive of physician-grade prescription supplemental protocols built by Dr. Ryan for the patient, a detailed food plan with specific foods for the patient to consume and avoid, lifestyle recommendations and various educational handouts to support the patient’s health journey going forward.
In some cases, this may be the conclusion of the process. In other cases, additional follow-up testing and treatments may be recommended. This will vary by each patient.
Touch Base Appointments | 15-minutes at $60 & 30-minutes at $120
Should an existing patient have any follow-up questions at any point, or want to discuss new symptoms or concerns, or simply engage in a general conversation about health and wellness, Touch Base appointments are available at any time to all existing patients.
This is an opportunity for existing patients to connect directly with Dr. Ryan beyond the initial and follow-up appointments.
Anything that you’d like to discuss with Dr. Ryan should be scheduled as a Touch Base appointment.
In this way, Dr. Ryan will be able to create the time and space to give each patient the focused and thoughtful attention they require on their journey towards health.
Please note: Touch Base appointments are not available to new patients.
Does Dr. Ryan provide consultation via email, phone or text between appointments?
No. All consultations with Dr. Ryan must take place over scheduled HIPAA-compliant video appointments booked in advance by the patient through the website.
Patients are free to email DrRyanAssistant@gmail.com at any time for basic support regarding general inquiries, logistics and non-medical questions associated with working as a patient under Dr. Ryan.
While every effort will be made to respond to each email in a timely manner, instant, urgent or emergency response times should not be expected.
If you have any questions, concerns or new symptoms that you would like to discuss directly with Dr. Ryan between Functional Medicine appointments, we offer Touch Base appointments of either 15 or 30 minutes that can be booked through the website by patients at any time.
In this way, Dr. Ryan can create the necessary time and space to provide thoughtful consideration, expertise and guidance for any questions or concerns you may have.
We recommend compiling a list of everything you want to discuss, so as to be efficient with the time in the Touch Base appointment and address everything all at once in a concise and thorough way.
Does Dr. Ryan provide urgent or emergency care?
No. Dr. Ryan does not practice acute care or emergency medicine.
Functional Medicine is a slow, thorough, exploratory process meant to investigate and address chronic, long-standing conditions at a deep level and can take weeks or months to reach resolution.
If you are in urgent need of medical consultation or treatment, or are experiencing a health emergency, please contact your primary care provider, or go to an urgent care or an emergency room.
Dr. Ryan is not a resource for emergency or urgent care.
Are you ready?
Functional Medicine is a major commitment, both of yourself and to your health, and it is also a commitment that asks a lot of your time, energy and investment.
Functional Medicine is not a quick fix or an easy pursuit, but it is the most transformative and lasting path in terms of health and wellness.
One must be sure they are ready, willing and able for what is asked of them personally, financially, emotionally and spiritually.
If you are ready to start this path, know that great changes are in store for you.
All the hard work you put into yourself now will pay off for the rest of your life––and undoubtedly make it exponentially better in every way possible.