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This week's topic: Functional Medicine & Surgery
Like many in the functional medicine space, I’m both a patient and a clinician. Going through 2 surgeries at the end of last year forced me to reflect on the nuances of - and how we can influence - the process of healing.
The back story: I twisted my knee early in 2025, and despite PT and integrative therapies, my knee kept locking. An MRI showed a complex meniscus tear, and I made the choice to have surgery in November. My second surgery was unexpected and more invasive, but the preparation for my first surgery helped me enter the second surgery with faith and confidence, knowing that the end result was worth it.
I’m sharing some of how I prepared in today’s email...
Overview of today's email:
- Factors to Consider When Undergoing Surgery
- My Protocol
Please do not take this article as medical advice or medical education. The following are things I personally did. Keep in mind that the details will change – more or less – depending on the type of surgery a patient is undergoing.
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1. Factors to Consider When Undergoing Surgery
Although we incorporate functional medicine practices to ideally prevent surgery, sometimes we need it (and we are blessed to have this as an option for care!).
When we go through a surgery, our remarkable bodies are tasked with rebuilding tissue, orchestrating immune defenses, cleaning up inflammation, removing trapped air or fluid from the surgery, and repairing. And I believe functional medicine practices can enhance and support these functions!
As I prepared for surgery, I broke down the process into 3 phases: Pre-surgery, Surgery, and Post-Surgery.
PRE-SURGERY
- Prioritize foundational support via nutrition and lifestyle. This can look different in everyone, but the basics are the same: minimize inflammatory intake, maximize supportive factors (e.g. protein, musculoskeletal health, sleep).
- Labwork. If a surgery is at least 3 months away, run labs to make sure nutrients, hormones, inflammation, and more are optimized.
- Support cellular health. For me, this looked like prioritizing cell membrane and mitochondrial ReDox support. I also incorporated a liquid FMD (fasting mimicking diet) to enhance autophagy (i.e. “clear out the old”) a few days before surgery. I can elaborate on this in more detail in a future email.
SURGERY
- Anesthesia considerations. To protect my brain and cognition, I discussed with my anesthesia team my desire to try to avoid opioids and benzos, and utilize agents that have potential neuroprotective effects (e.g. propofol, ketamine, dexmedetomidine).
- Antibiotics. These are often part of the surgery, so acceptance of this was the first step…and I made sure to ramp up gut support pre- and post-operatively.
POST-SURGERY
- Pain control. Inflammation (and pain) is inevitable and part of the healing process post-operatively, and in functional medicine we often try to avoid NSAIDs. But the reality is that there are not any supplements that are great for acute pain, so we have to be practical. For me, this looked like using ice, prescription analgesics, and ibuprofen as needed for a few days after surgery to address acute inflammation, then focusing on supplemental antioxidants to address oxidative stress (a form of inflammation).
- Wound healing. Protein, collagen, and red light therapy can be staples for this. And eventually a good scar gel or tape!
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2. My protocol
In my preparation, I read a lot and I wrote out a plan with supplements and lifestyle factors to incorporate. I already had good lifestyle foundations in place, so the following augment these habits (we can't out-supplement our habits!). Here are the categories I focused on pre- and post-surgery.
Nutrition (top 3 priorities): Hydration, increase protein to at least 100 grams a day (and increased my collagen dosing with Designs for Health Whole Body Collagen and Olivida I66 Elixir that includes food-based vitamin C), and consume at least 3 cups of sulfur-rich veggies a day.
Gut health (top 3 priorities): Prebiotic fiber via food, 3 forms of probiotic supplements (lactobacillus/bifidobacterium, S. boulardii, and spore-based), and supportive teas for gut barrier health and bile flow (e.g. dandelion root, fennel, mucilaginous herbal teas).
Biotransformation and liver support (aka “detox” support): I relied on a few supplements and Organic Olivia tinctures for this (beyond the sulfur-rich veggies and teas noted above).
Stress management and resiliency (top 3 priorities): Less sympathetic and more parasympathetic nervous system activity, guided meditation and visualization podcasts (compliments of my friend, Erica), and daily breathwork/prayer.
Mindset and grace: Although I put together a protocol, I did not aim for perfection. I followed the protocol an average of 5 days out of the week, and that was ok!
I shared screenshots of my protocol - with specific treatments I used - in my Substack.
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I hope this was clinically useful!
To see more of my deep dive into the literature, as well as my clinical insights, on this topic, subscribe to my paid Substack ($8 a month) to see the extended version of this email!
Meg
P.S. These emails take a lot of time to create (and I don't receive a lot of feedback on whether they are useful to those that receive them), so I've moved to Substack for an extended version of these at a low monthly cost (available within 24 hours of releasing this email). Why Substack? It has the benefits of being able to comment and ask questions about the posts, you're not bombarded with ads, I'm using the platform as a "micro-mentorship", and it's low cost!
Additional resources that may be helpful:
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