The "Textbook of Functional Medicine" is available for purchase at www.functionalmedicine.org.

The recently published Textbook of Functional Medicine is well-organized and follows a logical progression by first introducing the reader to the definition and basic principles of functional medicine then progressing to using those principles clinically. This is not a "cookbook" which lists physical complaints or diagnoses and offers a list of therapies. Instead, it sets out a way of thinking clinically that will enable the practitioner to assess cases and develop a plan to correct underlying imbalances to improve the patient’s overall health. The 820 page textbook is a comprehensive compilation of the knowledge and experience of 48 contributing authors, all acknowledged leaders in their respective fields. This book is destined to become an essential reference for anyone interested in advancing health care from a disease oriented model to a newer paradigm of patient-centered wellness.

Sections I & II introduce basic principles of functional medicine beginning with the principle that a patient centered approach to diagnosis depends on the knowledge of mediators, triggers and antecedents to a patient’s specific disease. The introduction also defines the "functional medical matrix" and introduces its use as an analytical tool in evaluating each case.

Subsequent sections III and IV build on these concepts with outstanding reviews of basic biology, genetics, physiology and biochemistry, nutrition and mind-body links. This section alone is worth the price of the book, as it provides an instant refresher course and update of the most current knowledge in these fields. Despite following the medical literature closely for the past 20 years, I still found this section full of useful clinical pearls and concepts to incorporate into practice.

Sections V and VI then define and explain fundamental clinical imbalances such as defects in detoxification, hormonal balance, inflammatory cascades and digestive function and show how these imbalances can contribute to chronic illness. Later chapters integrate the fundamental concepts into an organized clinical approach to complex problems within each of these larger systems. They demonstrate the interconnected- ness of physiologic systems in ways which might not be immediately apparent to doctors new to this approach. For example, discussions explain how overgrowth of abnormal gut bacteria can trigger autoimmune joint inflammation, how imbalances of essential fatty acids can affect insulin sensitivity, and how deficiencies of vitamin D can contribute to cancer risk. Other clinical pearls are too numerous to list.

Section VII ties together all the previous information into a clinical strategy. Happily, the importance of the mind- body link is acknowledged as well as how to more fully elicit information from patients and involve them as a member of the therapeutic team. For example, page 689 notes two potential benefits to eliciting a compre- hensive patient history rather than the more common brief review of systems; the patient experiences being understood, and hope is established in the minds of both patient and doctor. Both outcomes are essential in helping patients with complex medical problems who seek help from functional medicine providers. In addition to discussing diagnostic and therapeutic strategies in this section, there is advice on how to help patients implement positive lifestyle changes which can at times be the most challenging part of practice. The guidelines on assessing patient readiness to change and appropriate interventions for each stage of readiness can make the process more successful for both patient and doctor.

The textbook ends with a series of useful appendices including forms and questionnaires for in-office use as well as patient handouts such as shopping lists. I was especially pleased to find a review of the major cytochrome p450 enzymes along with substrates, inhibitors and inducers to each. Although this information is available on the web, having an easily accessible resource at hand when reviewing patient medication lists can help identify potential negative drug-drug, drug-herb and drug-food interactions. The Textbook of Functional Medicine would be a valuable addition to the library of anyone in clinical practice. It would be especially so for providers just beginning to incorporate wholistic principles into their practice. One of the questions most frequently asked by conventionally trained health care providers is "where can I find a logical and well referenced book to educate myself?" This textbook would be my first recommenda- tion. It covers the subject comprehensively and clearly, supporting all key concepts with citations for peer- reviewed research for those wishing to further explore a topic. The Textbook of Functional Medicine belongs on the bookshelf of anyone interested in increasing their ability to help patients achieve full health.

Dr. Reilly is a clinician with the Seattle Cancer Treatment and Wellness Center. He serves on the Board of Directors of the American Association of Naturopathic Physicians and co-authored a book on cancer treatment He holds a doctorate degree in Naturopathic Medicine from Bastyr University and also completed his Masters Degree in acupuncture. In addition to his practice, Dr. Reilly has been a research consultant for Scientific Botanicals, a Seattle pharma- ceutical company. He also is a part-time faculty member at Bastyr University.