What a Functional Medicine Evaluation Actually Involves

If you have been researching functional medicine, you have probably run into two versions of it. One is a supplement protocol with a consultation attached. The other is a very large panel of tests, a PDF of results, and not much help making sense of them.

Neither is what I do, and I understand why people ask what they are actually buying. It is a meaningful amount of money, most of it is not billed to insurance, and the thing being sold is hard to picture from the outside. So here is the work itself, step by step, including what it costs and the circumstances where I would tell you not to bother.

Why the first visit runs an hour

A standard primary care visit is built around one problem. You get somewhere between twelve and twenty minutes, which is enough to address a defined complaint and not much else. That model works well for a sore throat or a medication refill. It works poorly when the problem is that you have been tired for two years and nobody can say why.

The reason is not that your previous clinicians were careless. It is that the kind of problem you have requires a different instrument, and the instrument is time. Symptoms that span several systems — fatigue plus bloating plus disrupted sleep plus a shortening cycle — only make sense when you can see them together. You cannot see them together in fifteen minutes, because you spend all fifteen on whichever one the patient leads with.

So the first visit runs a full hour. Not as a courtesy, and not to seem thorough. It takes that long to get the information the rest of the process depends on.

What I'm doing while you talk

I am building a timeline. When did this start, and what else was happening then? Which symptom came first, and which ones arrived together? What have you already tried, and what happened when you tried it — including the things that partly worked, because those are frequently the most informative.

Before we meet, I go through whatever records and previous laboratory results you can send. That matters more than people expect. A ferritin from eighteen months ago, read next to one from last month, tells a story that neither value tells alone. Three normal TSH results drifting steadily in one direction across two years is a finding, even though each individual result was reported as unremarkable.

Most of what I find useful in a first visit is not something a test produced. It is the shape of the history.

Which labs I order — and why not more

Here is where I differ most from the version of functional medicine you may have encountered. I order a test because I expect the result to change what I recommend. If I cannot say in advance what I would do differently depending on the answer, the test is not worth your money.

That rules out a lot of panels that get marketed heavily. A test that produces an interesting-looking result but no change in plan has cost you a few hundred dollars to tell you something you cannot act on.

In practice, most evaluations start with a comprehensive conventional baseline — a thorough look at thyroid function, iron studies including ferritin, B12 and folate, inflammatory markers, a full metabolic picture, and the relevant hormones for where you are in life. This is ordinary blood work, ordered thoroughly and read carefully. A surprising proportion of long-standing fatigue turns out to be explainable from exactly this, interpreted properly, with nothing exotic required.

Advanced testing — a DUTCH hormone panel, a GI-MAP or GI Effects stool analysis, organic acids — comes in when the history points somewhere specific and the result would genuinely redirect the plan. These panels are ordered selectively and interpreted alongside everything else, not read in isolation. They are also billed directly by the testing company, separately from my fee, and I will tell you the expected cost before anything goes out.

Functional medicine has a reputation for ordering everything available. That reputation is earned in places. It is not how I practise, and if you have been burned by it before, that is a reasonable thing to ask me about directly.

The review of findings, and what you leave with

A second visit, about forty-five minutes, is where the evaluation actually pays off. We go through what the results show, what they do not show, and how they fit the history you gave me. You should leave understanding your own laboratory work well enough to explain it to someone else.

You also leave with a written plan. What I think is contributing and why, in order of how much it is likely to matter. What to change first, which is usually fewer things than people expect. What we would expect to see if it is working, and on what timeline. What to do if it is not working. And what we deliberately are not doing yet, with the reasoning, so that the plan has a shape rather than being a list.

I want to be careful with language here. Functional medicine gets talked about as finding "the root cause," singular, as though there is one hidden thing and the work is locating it. That is rarely how bodies behave. Usually there are several contributors of different sizes, and the useful question is which ones are both significant and changeable. A plan that names three real contributors and addresses the largest one first will do more for you than a search for a single explanation that may not exist.

What it costs, and what the number includes

A Root Cause Review is $575. That covers the comprehensive questionnaire, review of your previous records and results, the hour-long consultation, the pattern analysis between visits, the forty-five-minute review of findings, and the written plan. If your history makes it clear from the start that an advanced specialty panel will change the plan, the version that includes one is $775 plus the laboratory cost.

If you already have recent blood work and mainly want to know whether there is anything in it worth pursuing, Lab Launch is a $97 thirty-minute review of what you already have. It is an educational visit rather than a treatment visit, and it is a reasonable way to decide whether a full evaluation is worth it before committing to one.

If you decide to continue into a structured program afterward, Reset is $2,995 over three months and Rebuild is $5,995 over six. Your Root Cause Review investment, plus the cost of any advanced panel ordered with it, is credited toward either one. Additional testing is billed separately.

All of it is listed on my pricing page, which exists so that you never have to get on a call to find out what something costs.

When I tell people not to do this

A few situations come up often enough to name.

If you have not had a thorough conventional workup, start there. It is cheaper, it is frequently covered by insurance, and it answers a meaningful share of cases on its own. I would rather you spend $200 on blood work through your plan than $575 with me to discover you needed exactly that.

If your symptoms point to something with a clear conventional pathway — a suspicious lump, chest pain on exertion, a new neurological change — that needs the appropriate specialist promptly, not a functional evaluation.

If what you want is a specific test and a prescription, you do not need me for that, and paying for an evaluation to get there is an expensive route. And if the money would be a genuine strain, say so on the intro call. I would rather point you toward the highest-value single step you can take than take a payment that costs you something you cannot spare.

What I do with this in practice

The honest summary is that you are paying for time and for interpretation. The tests are not the product. Anyone can order a DUTCH panel; plenty of companies will sell you one directly. What is hard to come by is someone who takes an hour of history, reads the results against it, tells you which findings matter and which are noise, and then stays your provider while you work through it.

If that is what you have been looking for and have not been able to find, a free fifteen-minute call is the right next step. Tell me what has been going on and what you have already tried, and I will tell you honestly whether this is the right fit — including if the answer is that it is not.