095: Finding and Working in Partnership with An Integrative or Functional Medicine Doctor

095: Finding and Working in Partnership with An Integrative or Functional Medicine Doctor

In the final installment of this mini-series, we explore Tiers 3 and 4 of the Functional Nutrition Framework.

If your health concerns aren’t resolved in Tiers 1 and 2, there’s likely some complicated dysfunction happening. You’ll hear how in Tier 3, we look to add an Integrative or Functional Medicine doctor to the partnership if one isn’t already involved. I share:

  • How I found the functional and integrative doctors 

  • How I guide my clients to find one to work with them no matter where in the world they’re located

  • What to consider when selecting one

After resolving your health problems in Tiers 1, 2 or 3, we move to Tier 4 and maintaining your new normal. I share my new normal is and how I maintain it seasonally.


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Welcome back to The Live FAB Life Podcast. I’m your host, Naomi Nakamura.

And we’re wrapping up our mini-series on the Functional Nutrition Framework.

To recap the first two parts in the series, in Episode 093 we talked about establishing a solid foundation for health by stepping back and taking inventory that you’re doing the basic practices of health and wellness before moving on to the more advanced, sexy practices that we tend to navigate straight to.

I know it can seem boring and trivial to do a quick check-in and make sure that you’re adequately hydrated, practicing good sleep hygiene, getting enough yet not too much exercise, eating a refined sugar, gluten and perhaps dairy-free diet in a mindful way, allowing ourself time for rest and relaxation to restore your mind, body, and spirit.

Simple things that you can easily skim over yet, without a solid foundation of these practices, any advanced diets, supplements or other things you might try may not be as effective or may not even work at all.

Or, you may be pleasantly surprised that your health concerns might be resolved by simply taking care of these basic essentials.

In Episode 094, we talked about the second step or tier in the Functional Nutrition Framework - what to do if your concerns aren’t resolved after doing Tier 1.

Tier 2 is where we start to do more assessing and tracking, deeper work in the areas of gut health restoration, elimination and specialty diets as well as supplementation and perhaps lab testing.

Today we’re going to talk about the next two Tiers and what happens if Tier 2 doesn’t bring full resolution.

But first, let me repeat my earlier disclaimer that I did not come up with this framework. This is part of what was taught in my studies at the Functional Nutrition Alliance. My own added flavor is Tier 4, which I’ll get to in a bit.

So if you did the work in Tiers 1 and 2, yet your issues weren’t completely resolved, then clearly there are complicated things going on, likely multiple issues that are causing dysfunction in your body.

As in the other two episodes, I’ll use myself as an example because I had, and still do have, a lot of things going on in my own health. I had adrenal fatigue, IBS, I overtrained, had low thyroid function, SIBO, a fatty liver, heavy metal and non-heavy metal toxicities, plus just the daily life stressors that we all deal with.

I remember before I even knew what a health coach was, I consulted with Dr. Google to see what I should do for adrenal fatigue. Well, it was different than what I should do for my thyroid dysfunction, which was very different than what to do for SIBO.

I remember being SO CONFUSED - like, what are you supposed to do if you have more than one thing going on?

This is where Tier 1 is a great place to start because no matter what your issues are, what you address in Tier 1 universally benefits everyone and by doing just those basic things, you WILL improve your health.

When you start to do deeper work with assessing and tracking, working on basic gut health repair, a lot of those practices can be universally applicable while still practicing bioindividuality.

But in Tier 3, this is where as a health coach, or unlicensed practitioner, it’s time to bring in a licensed medical practitioner, if you’re not working with one already.

When I work with individual clients, this is where I recommend that my client find a naturopath, an integrative doctor or a functional medicine doctor.

One question that I’m frequently asked is how does one find a functional medicine doctor.

So let me share with you my experience in how I found one that I worked with, then what I now advise my clients and who I personally work with now for my own healthcare needs.

So back in 2013, I was chatting with a friend of mine and her husband was having complex health issues like I was. Not the same issues, but complex nonetheless.

She told me about this special but different kind of doctor that was treating her husband. This doctor had ordered a bunch of tests so he could find out what foods he was reactive to.

At that time I was at the peak, the worst of my IBS symptoms and knew that food had a lot to do with it. But I was so confused because I was eating healthy foods but still feeling terrible and I just didn’t know what to do. I didn’t know what food intolerances and sensitivities were. I only knew about food allergies and knew I wasn’t eating I was allergic to and thus so confused about what I should even be eating.

So her sharing that intrigued me, but the doctor they were working with was relatively far from me and I wanted to find someone closer. I looked on the doctor’s website and she called herself a “functional medicine doctor” so I googled, “functional medicine doctor near me.”

That’s how I found Dr. Melissa, who I interviewed in Episode 002 of this podcast, who I worked with for about two years.

Dr. Melissa ended up closing her practice and moved on to do other things, so I didn’t see anyone for a while.

While a lot of my concerns had been cleared up after working Dr. Melissa, I still had lingering, unresolved issues. I didn’t really have the energy to go about finding another functional medicine doctor until I saw a tweet about an integrative medicine doctor who had just written a book who practiced at Sutter Health.

This piqued my interest because, for those of you who aren’t in the San Francisco Bay Area, Sutter Health is one of the largest health care providers in the area. It’s where I go for my primary healthcare and most importantly, my insurance covers the costs of my care when I go there.

You see, most functional medicine doctors don’t take insurance. Dr. Melissa didn’t, so when you see a functional medicine doctor, it will likely be out of pocket. But that’s definitely an important question to ask when you’re qualifying one to see.

And I get why they don’t. The healthcare system in America is a hot mess. It’s run by insurance companies and there’s a lot of red-tape. I get it. I respect their decisions not to accept insurance, I certainly don’t blame them, but it is a cost that as a patient, you have to consider when choosing a provider. This is why its really important to do your due diligence to find out what the process for treatment is if the doctor is heavy into (expensive) lab work upfront, etc.

This is also why putting in the time and effort to work in Tier 1 can be a huge money saver for you. Do the basic stuff, clear the slate, assess, track and document, then see where you’re at.

There’s also a huge benefit for the functional medicine doctor because they are in such high demand, many of them have months-long waiting lists and because of that, many are now starting to adopt rules where they won’t even see a new patient unless they’ve already removed sugar, gluten and dairy from their diet, as well as worked on some of the non-negotiables we address in Tier 1.

Their time is too valuable and needs to be spent with people who have already done the basic work, and they rely on health coaches, people like me, to help those just starting out on this journey take care of the foundational pieces.

Sorry, that was a bit of a tangent, but getting back on track, I personally see an integrative doctor at the Institute of Health and Healing, a department at Sutter Health, a large conventional medicine healthcare provider in my area.

The Institute of Health and Healing is a treasured gem, in my opinion, because it combines the practices of functional medicine, integrative medicine, holistic medicine, and conventional western medicine in their treatment. Really, all areas are considered which I think is the best of all worlds.

Now I know you’re probably asking yourself, “well what’s the difference between all of these kinds of practices?” While I am certainly not the expert, I will share with you my take on them:

A naturopath is a doctor who specializes in and focuses on natural, non-invasive methods for healing An integrative medicine doctor brings all aspects of healing into consideration. Like I just mentioned, they consider many different facets and modalities of healing - lab work, medications, supplements, nutrition, chiropractic medicine, psychotherapy, Chinese medicine and acupuncture, bodywork through reiki and massage, etc. In fact, all of these services are in fact offered at the Institute of Health and Healing A Functional Medicine doctor is focused on finding the root causes of a person’s illnesses through lab tests, and then using supplements and medications for healing, as well a focusing on lifestyle habits like diet, exercise, sleep, emotional support through community, etc.

But I would take it a step further and say that a really good functional medicine doctor will also take it a step further, especially when doing really deep work and consider life triggering events that may have happened in your life, no matter how long ago. They’ll want to know your family’s health history, your birth story, literally anything that’s happened in the course of your life that might be a factor in what’s manifesting in your health right now.

If you’re lucky, like I am, then you’ll find a provider that brings all of these things into their practice. And many of them do these days.

And when someone comes to me and asks me how they find one, I direct them to the Institute of Functional Medicine’s website, where they have a referral network right on their home page. You can input where you are in whatever country you’re living in (yes, they are an international organization). That’s where I direct people to and then from there, I urge them to do their due diligence and not be afraid to ask questions to find out if a provider is the right fit for them.

So how does this fall into Tier 3? Well in Tier 3, because there’s still unresolved dysfunction going on, this is where an integrative or functional medicine doctor is brought in and then we work together in partnership to use more advanced practices and treatments to address the conditions. I want to emphasize partnership because no one person is “the boss” of the other. The client, doctor and health coach work together as a team.

That really what defines Tier 3 - deeper, more advanced partnership work.

Now I mentioned adding on my own tier to the Framework, and that’s Tier 4.

I consider Tier 4 to what happens after your health issues are resolved.

After working in Tiers 1, 2 and possibly 3, having your health problems cleared up, you should now have discovered your new normal. That’s going to look different for each of us.

My “new normal” is always gluten-free, dairy-free, mostly refined sugar-free. What that looks like for me is a mindful periodic indulgence of treats like a Pressed Juicery freeze, vegan ice cream or a Paleo treat.

But on occasion, usually, during the summer or the holidays, I go through a period of maybe one too many Paleo treats. Or maybe a stressful period that leaves me feeling out of balance.

This, in addition to my strong belief of eating with the seasons, the topic of Episode 045, for 7-10 days each season, I like to do seasonal detox or cleanse. It’s a great way to reset my body on a quarterly basis.

The seasonal detoxes that I do are closely tied to Chinese medicine, focusing on the focal organs of the season. As expected, the produce is organic and focused on ones that are in season, the animal protein is always wild, grass-fed and organic and sugar, gluten, dairy, corn, soy, and eggs are avoided (side note, with the exception of eggs, this is how I eat anyway).

This time always gives me the opportunity to return to body support practices, if I’ve fallen out of habit with them, things like oil pulling, dry skin brushing, castor oil packs, rebounding, all activities encouraged during a detox.

I find doing a detox like this four times a year, usually aligned with the first day of the new season helps me to maintain my repaired health and renew my mind, body, and spirit.

If you’re interested in doing a season detox, I offer these primarily as a self-paced offering over on my website so you can head over there to check them out. A new one will be published every season.

So that wraps up the Functional Nutrition Framework, and how I’ve aligned my services to it. I’ve created a visual representation of it over on the show notes for this episode at www.livefablife.com/095.

And if you’re not sure where you currently fall in the framework, head on over to my website at www.livefablife.com to take a free quiz so you can see what tier you’re currently aligned to.

That’s all that I have for you this week. You can find links to everything mentioned in this episode at www.livefablife.com/095 and I’ll see you back here again next week for another episode!



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Naomi Nakamura is a Functional Nutrition Coach who helps women in tech who struggle with everyday health concerns that if left unaddressed can add up to big problems. She teaches them how to identify and address the root causes of their conditions. By taking practical actions towards improving diet and gut health, and reduce exposure to environmental toxins she helps them bring their body back into balance.

Naomi resides in the San Francisco Bay Area, is an avid fan of Bay Area sports, and can often be found exploring the Bay Area with her puppy girl, Coco Pop!

Connect with Naomi at: Facebook | Twitter | Instagram | Pinterest