The Functional and Holistic Medicine Approach

What is the functional and holistic medicine approach?

The functional and holistic medicine approach is not a treatment method; it is the way in which the physician structures the examination and the follow-up. It assesses the complaint not through a single organ or a single laboratory value, but together with nutrition, sleep, activity, stress and existing conditions. It operates within the framework of the internal medicine specialty, not in place of the standard diagnostic and follow-up steps but alongside them.

This distinction matters. Checking a patient's thyroid values is an ordinary part of internal medicine practice. The holistic approach means also recording, in the same consultation, that patient's sleep routine, the intervals between their meals, their activity habits and the other medicines they take, and assessing these not in isolation but as a single clinical picture.

The reasoning behind the approach concerns where the burden of disease comes from. According to World Health Organization data, noncommunicable diseases caused at least 43 million deaths in 2021; this corresponds to 75% of global deaths, excluding pandemic-related deaths. The same source lists tobacco use, physical inactivity, alcohol, unhealthy diet and air pollution as modifiable factors that increase the risk of dying from these diseases. In other words, the course of most chronic diseases also has to do with the time spent outside the consulting room.

Data from Türkiye also point in the same direction. The Ministry of Health of the Republic of Türkiye, General Directorate of Public Health, reports the prevalence of obesity over the age of 15 as 31.5% (39.1% in women, 24.6% in men) based on the results of the Türkiye Beslenme ve Sağlık Araştırması-2017. The same institution states that obesity increases the risk of type 2 diabetes, hypertension, coronary artery disease, hyperlipidaemia and metabolic syndrome.

In short: this approach recognises that areas which are followed separately (weight, blood sugar, blood pressure, blood lipids, thyroid) are most often intertwined in the same patient, and it organises the examination accordingly.

Who is this approach suitable for?

This approach is considered in adult patients whose complaint does not fit under a single heading, or who have more than one chronic condition at the same time. The most common reasons for attending are:

• Long-standing fatigue and weakness: where the cause has not become clear even though the investigations have been assessed
• Difficulty losing weight or gaining weight over a short period
• Drowsiness after meals, episodes of hunger, cravings for sweet foods
• Newly diagnosed, or with follow-up that has become irregular: diabetes, hypertension, thyroid disease, raised cholesterol
• Taking more than one medicine at the same time and the need to review these together
• Having frequent infections
• Metabolic complaints occurring together with widespread muscle and joint pain
• People with a family history of diabetes, thyroid or heart disease who want an early assessment

Where does the assessment begin, according to your complaint?

The table below shows which areas are assessed first at the examination, and the pages where the subject is described in detail.

This table is for information only. Which investigations are requested, and the diagnosis, are determined by a physician's examination.

Who is this approach not suitable for?

This is the most important section of the page and should not be skipped.

It is not suitable in emergencies. Chest pain, shortness of breath, confusion, sudden loss of speech or strength, uncontrolled bleeding, a severe clinical picture with a high fever: in these situations, go to the nearest emergency department. Do not wait for an outpatient appointment.

It does not replace established treatment. Cancer treatment, severe infection, advanced organ failure, psychiatric emergencies and conditions requiring surgery belong with the follow-up of the relevant specialty. This approach is not offered as an option that replaces that follow-up.

It does not mean stopping medication. The medicines being taken are changed, reduced or stopped only following an assessment by a physician. Nothing on this page is a reason to stop a medicine you are taking on your own initiative.

In the following situations, the plan for any procedures is assessed separately:

• Pregnancy and breastfeeding
• Under 18 years of age
• Advanced kidney or liver failure
• An uncontrolled bleeding disorder or the use of blood thinners
• Active oncology treatment
• A treatment protocol carried out by another physician in which no change should be made

These factors are assessed together with the questions asked during the examination. The decision on suitability is made at the end of the consultation.

How does the examination process work?

The examination proceeds in four steps.

1. A detailed medical history. When the complaint began, how it has progressed and the situations in which it worsens are recorded. Eating routine, the intervals between meals, sleep duration and quality, activity habits, the pace of work, all medicines and supplements taken, and the family history are asked about in the same consultation.
2. Physical examination and measurements. Blood pressure, pulse, height, weight and body mass index are measured; waist circumference is recorded and a systemic examination is performed.
3. Laboratory assessment. Investigations are requested according to the complaint and the examination findings. Which investigations are needed varies from person to person; no standard "package" is applied. If you have previous test results, these are also assessed at this stage.
4. Drawing up the plan together. The results are explained to the patient in plain language. Recommendations on eating, activity and sleep routine, any adjustment of medication that is needed, and the follow-up interval are determined together.

Where it is considered suitable, other procedures performed at the practice may accompany the plan: ozone therapy, vitamin and mineral applications or hijama. Each of these has its own criteria for suitability and unsuitability, and these are described separately on the relevant pages.

Which measurements are monitored during follow-up?

What distinguishes this approach is that, instead of a one-off assessment, the same measurements are repeated over time and their course is monitored. A single result shows a point; the course of the same measurement over three months shows a direction.

The measurements most often used in follow-up are listed below. Which of them are necessary in your case is determined at the end of the examination.

Not all of these measurements are requested in every patient; an investigation ordered without a clinical basis may produce unnecessary findings and unnecessary anxiety.

What does the internal medicine specialty cover in this follow-up?

Internal medicine is a primary specialty concerned with the diagnosis and follow-up of diseases of the internal organ systems in adult patients. Diabetes, thyroid diseases, blood pressure, blood lipids, kidney and liver dysfunction, anaemia and metabolic syndrome fall within the scope of this specialty.

This scope makes it possible to assess how the measurements listed in the table above relate to one another and, where necessary, to adjust medication. Thyroid values and the course of weight, the insulin response and blood lipids, blood pressure and kidney function are most often linked to one another in the same patient; this is why they are addressed together rather than separately.

At the practice, the service is provided by Dr. Suzan Alp, Specialist in Internal Medicine. The training received, the registered certificates and the professional association memberships are set out on the physician's page together with the awarding institution and the date.

How long does it take, and how many consultations are needed?

The first consultation generally takes longer than other outpatient examinations because of the detailed medical history. The second consultation, at which the results of the investigations are assessed, is generally shorter.

The number of consultations varies from person to person and according to the clinical picture. Some cases are completed with a single follow-up visit, while chronic disease monitoring may continue at set intervals. An exact number of consultations cannot be given in advance; the interval is determined by the physician after the first assessment.

What is decisive in chronic disease follow-up is not the number of consultations but continuity. The World Health Organization reports that, as of 2022, 830 million people worldwide were living with diabetes and that more than half of them did not take medication for diabetes that year. Uninterrupted follow-up is one of the most important elements in this situation.

What should you do before the first consultation?

To make the consultation productive, you are advised to bring the following with you:

• A list of all the medicines you take, together with their doses. If you prefer, you can bring the boxes instead of a list.
• Vitamins, minerals, herbal products and supplements: this is the area most often overlooked, because it is not mentioned to the physician.
• Test and imaging results from the past year
• Any discharge summary, operation report and previous physician's notes
• Your known allergies
• Your home blood pressure readings (if you measure regularly)

Whether you need to come fasting depends on which investigations are planned. You can ask about this when you make your appointment.

What happens after the consultation?

At the end of the consultation you are given a written plan. It sets out the investigations to be requested, recommendations on your eating and activity routine, any change made to your medication, and when the next follow-up is due.

When the results of the investigations are available, they are assessed together at the second consultation. The plan may be updated at this stage. In chronic disease follow-up, the intervals between visits are determined according to the clinical picture, and the measurements are repeated at each visit so that the course can be monitored.

In situations where the eating routine needs to be worked on in detail, the nutrition and dietary counselling process is planned separately.

The time it takes for an effect to appear varies from person to person. Changes to lifestyle are generally reflected in laboratory values over weeks to months.

Limits, risks and points to be aware of

The approach itself is not a procedure, and therefore carries no risk of a needle or incision in itself. However, the procedures that may be performed along the way (taking blood, intravenous applications, ozone applications, injections) have their own risks, and these are described separately on the relevant pages. You are advised to read the page in question before any procedure.

Points to be aware of:

• Taking supplements is not harmless. Vitamin and mineral supplements may provide no benefit when used without consulting a physician and without a demonstrated need; in some situations they may interact with the medicines being taken. Tell your physician about every supplement you use.
• Restrictive eating regimes are not suitable for everyone. In pregnancy, older age, kidney disease, a history of an eating disorder and with the use of certain medicines, a separate assessment is needed.
• A large number of investigations is not in itself an advantage. An investigation ordered without need may produce findings with no clinical basis and may lead to unnecessary anxiety. For this reason investigations are selected according to the complaint and the examination findings.
• Results vary from person to person. The course may be different in two people with the same clinical picture.

When should a physician be consulted?

In the situations below, an assessment without delay is advised:

• Unintentional and unexplained weight loss
• Fatigue that does not go away and has reached the point of disrupting daily tasks
• Blood pressure running persistently high on home measurements
• Frequent urination, excessive thirst, dry mouth
• Swelling in the neck, a change in the voice, difficulty swallowing
• Fever, night sweats and weight loss occurring together

In the case of chest pain, shortness of breath, altered consciousness or sudden loss of strength, go to an emergency department.

Frequently asked questions

Is functional and holistic medicine a medical specialty?

No. Functional and holistic medicine is not a medical specialty but an approach. At the practice, the service is provided by Dr. Suzan Alp, Specialist in Internal Medicine, within the framework of the internal medicine specialty. The training received and the registered certificates are listed on the physician's page together with their names, the awarding institution and the date.

Do I have to stop my current medication?

No. Medicines are changed, reduced or stopped only following an assessment by a physician. Do not stop a medicine on your own initiative. All the medicines you take are reviewed during the consultation; if a change is needed, it is explained to you together with the reason for it and given to you in writing.

Can I continue my follow-up with my current physician?

Yes. This approach does not replace follow-up that is already under way. If another physician is carrying out a treatment, that treatment and its plan are recorded during the consultation. If a situation arises that requires a change to the treatment plan, it is assessed and you are advised to contact the physician concerned.

Which tests are requested at the first consultation?

There is no standard list of investigations. Which investigations are requested is determined according to your complaint, the examination findings and any previous results you have. If you have test results from the past year, bringing them avoids repeating the same investigations unnecessarily.

How many times do I need to come?

The number of consultations varies from person to person, and no exact number can be given in advance. It generally proceeds as a first consultation, a second consultation at which the results of the investigations are assessed, and follow-ups determined according to the clinical picture. In chronic disease follow-up, monitoring continues at set intervals.

Are nutrition recommendations given as a diet sheet?

Recommendations start from your current eating routine and take the form of changes you can make. If a detailed nutrition programme is needed, the process is planned separately under nutrition and dietary counselling.

When is this approach not suitable?

It is not suitable in emergencies, during active oncology treatment, in advanced organ failure or in conditions requiring surgery; these belong with the follow-up of the relevant specialty. Pregnancy, breastfeeding, being under 18 years of age and the use of blood thinners are assessed separately. For details, see the "Who is this approach not suitable for?" section on this page.

Where do I make an appointment?

Appointment and practice details are on the contact page. The days and hours when patients are seen, together with the address, are kept up to date on the same page.

Related pages

Sub-pages under this topic

Internal Medicine Consultation · Diabetes Follow-up · Insulin Resistance · Thyroid Diseases · Hypertension Follow-up · Cholesterol and Lipid Disorders · Weight and Metabolism Management

Procedures that may form part of the plan

Ozone Therapy · Intravenous (IV) Therapies · Approach to Pain Treatment · Hijama

Bridging content

Skin Health · Nutrition and Dietary Counselling

Sources

1. World Health Organization, Noncommunicable diseases fact sheet, 25 September 2025. who.int/news-room/fact-sheets/detail/noncommunicable-diseases
2. World Health Organization, Diabetes fact sheet, 14 November 2024. who.int/news-room/fact-sheets/detail/diabetes
3. Ministry of Health of the Republic of Türkiye, General Directorate of Public Health, Obezite (data from the Türkiye Beslenme ve Sağlık Araştırması-2017). hsgm.saglik.gov.tr/tr/obezite