Discover How Functional Medicine is Helping Patients with Chronic Illnesses and Autism

And meet our expert, Dr. Karima Hirani.

Unlike conventional medicine, which places heavy emphasis on clinical trials and pharmaceuticals, functional physicians look for the root cause of a disease, analyzing factors like a patient’s diet and stress levels. Here VB editor Linda Grasso takes a deep dive into functional medicine with Dr. Karima Hirani, who pivoted from being a conventional family physican 20 years ago after realizing that she just couldn’t provide her patients with enough answers.

Compare integrative with functional medicine.

An integrative physician is a regular doctor who may integrate practices that are not considered the standard of care in their practice, like acupuncture or chiropractic. A functional medicine physician is looking at the person as a whole and looking for root causes of disease.

Give us an idea of some of the illness that you treat patients for.

I see a lot of chronic fatigue, and I find that infections play a big role in that. I find evidence of exposure to Lyme, Epstein-Barr virus and strep. I also find evidence of toxins—heavy metals like mercury and lead—especially if the patient has a mouthful of silver fillings or eats a lot of seafood.

What do you do for patients with metal toxins?

We’ll do detoxifications that remove heavy metals from the body, basically administering agents to treat toxicity.

How do you treat depression and anxiety?

The first thing I do is recommend that the patient read Lost Connections, by social scientist Johann Hari. His book is very illuminating. The pharmaceutical industry does not want you to know this: the SSRI drugs that conventional doctors prescribe work no better than placebos in most cases. With most of my patients, we change the diet, and then we measure their hormone levels. For example, we look at their thyroid—and we think outside the box. So if the patient has overwhelming symptoms of low thyroid and depression, but their lab results show normal levels, I will prescribe thyroid hormone.

Have many of your patients come to you after not getting relief from conventional medicine?

That is true most of the time. But I do have a group of patients who are just distrusting of conventional medicine. Conventional medicine just doesn’t have all the answers to the diseases we are seeing today. Compartmentalizing a patient’s illness by organ systems instead of looking at the patient as a whole is the reason for the failure of conventional medicines to successfully treat chronic illness.

How do you treat autism?

One of the first things I do is change the diet. We remove all gluten, dairy and sugar, GMO, corn and soy and recommend that the patient eat only organic.

Is there any scientific research to support that treatment?

Research has shown that autistic children often have intestinal permeability or leaky gut. One study found that when fed a restricted diet, they not only improved clinically but also the parameters of the leaky gut testing improved.

What exactly is leaky gut?

When the junctions of the intestinal cells are no longer tight and instead they are porous. Food needs to be broken down into smaller molecules and then carried across the digestive tract into your bloodstream. When there are larger macromolecules in the bloodstream that don’t belong there, it sounds the alarm to the immune system, which then sets up an attack. So now you have an onslaught of antibodies and inflammation, and these immune complexes are being deposited elsewhere in your joints. It can create pain and give people headaches. The person can also suffer from fatigue, depression, anxiety, insomnia and digestive complaints like irritable bowel.

You started out your career as a conventional family medicine doctor. What made you switch?

I was working for a group of family physicians in Santa Monica. It was your typical HMO-type of health care. And it was frustrating. I had to see patients every 15 minutes. If I wanted to send a patient for an X-ray or to see a specialist, it would have to get reviewed. And then often there would be a rejection by the review committee and the patient would get mad at me. There was constant paperwork. It was a horrible way to practice. Along the way my patients kept asking me questions about using supplements for ailments like arthritis. I felt like I should have an answer. I felt guilty, like, why don’t I know this? After about a year and a half, I just up and quit.

Health insurance will not cover functional doctor fees. What can patients expect in terms of cost?

There is often a new-patient consultation fee, which the patient pays. In my office, for example, that is $600. And there are lab tests that the patient has to pay for. We try to work with labs that will bill insurance. Patients are often frustrated when they come to us, so we do everything we can to get them well without additional stress.

For more on Dr. Hirani and functional medicine, check out the SheSez with Linda Grasso podcast at