Functional diagnostics
Metabolic and mitochondrial testing, hormonal evaluation, gut health analysis and toxicological screening: the mechanisms behind fatigue, weight change, poor recovery and brain fog.
What functional diagnostics include →
Functional medicine · Bad Aibling, Bavaria · since 1991
Functional medicine at a hospital: How St. George Hospital works
Functional medicine looks for the reasons a body stopped working the way it should, measures them, and treats what it finds. At St. George Hospital that happens inside a 70-bed hospital with its own laboratory, so the work-up and the treatment sit under one roof and one physician team.
- 70-bed hospital, founded 1991, own laboratory on site
- Physician-led work-up before any treatment plan
- Video consultation in English before you travel
- Itemized invoice for US out-of-network review
Definition
What is functional medicine?
Functional medicine is a way of practicing medicine that looks for the causes of chronic illness in the body's systems, measures them with extended laboratory and functional testing, and treats what the measurements show. It asks which body systems have stopped functioning normally, what is driving that, and what a measurement would show if the driver were corrected. Infection, immune activation, hormone decline, mitochondrial impairment, toxic load and gut dysfunction are treated as connected, because in a chronically ill patient they usually are.
In practice that means three habits. Measure first: extended laboratory, immune, metabolic and functional testing before a treatment decision. Think in systems: a patient with fatigue, brain fog and joint pain is one patient with one history, not three referrals. Treat the driver: if the work-up shows a persistent infection, an autoimmune process or a metabolic block, the plan targets that, and the follow-up measurements show whether it worked.
What functional medicine is not: a supplement list, a food-sensitivity print-out or an alternative to conventional diagnosis. When a scan, a biopsy or a specialist opinion is needed, it is ordered. The functional work-up adds to standard medicine; it does not replace it.
Two words, one team
Functional medicine vs integrative medicine, and why we practice both
The two terms are often used interchangeably. They are not the same thing, and the difference matters when you are choosing where to be treated.
Functional medicine answers "why"
It is a diagnostic discipline. Its output is a map of which systems are impaired and by what. On its own it produces findings, not a treatment.
Integrative medicine answers "with what"
It is a treatment discipline. It combines conventional medicine with physical and biological therapies that have evidence behind them: hyperthermia, apheresis, infusion protocols, neuromodulation, rehabilitation.
An outpatient functional medicine practice can run the work-up but has to refer out for most of the treatment. A hospital that only offers integrative therapies can treat, but often without a precise picture of what it is treating. St. George Hospital was built to do both in sequence: the functional work-up produces the findings, the integrative program acts on them, and the same physicians see the patient from the first video call to the discharge report. How we work describes the six principles behind that sequence.
Root-cause diagnostics
What we test that standard labs do not
Most patients arrive with a folder of normal results and a body that disagrees. A standard panel is built to rule out acute disease. It is not built to find a chronic infection that hides in tissue, an immune system that is exhausted rather than absent, or mitochondria that produce energy at half capacity. Our diagnostic program is built for exactly those questions and is overseen by Dr. Martin Rößner, Chief Physician for Internal Medicine.
Laboratory and immune testing
Extended blood panels, immune system profiling, Lyme and tick-borne co-infection testing, autoantibody screening and inflammatory markers, from our in-house and partner laboratories.
What the laboratory panels cover →Imaging and specialist testing
Review and coordination of CT, MRI and PET, circulating tumor cell analysis and chemosensitivity testing for oncology patients, and physiological assessments.
Imaging and specialist tests →Most laboratory results are back within 24 to 72 hours, because the laboratory is in the building. That is the practical difference between a hospital work-up and a mailed-in kit: the physician who ordered the test reads it the same week, with you in the room, and can add the next test immediately instead of after another appointment. The functional medicine testing guide explains what the individual markers mean.
The hospital laboratory
Blood diagnostics in the clinic laboratory · Clinicum St. Georg 
A blood sample in the clinic laboratory · Clinicum St. Georg
Where it changes the plan
How functional medicine changes treatment for Lyme, Long COVID, ME/CFS and cancer
The work-up is only useful if it changes what happens next. In our four largest programs, it does.
Chronic Lyme disease
Whether a patient's persisting symptoms come from active Borrelia, from an untreated co-infection such as Bartonella or Babesia, or from an immune process the infection set off decides between antimicrobial therapy, whole-body hyperthermia and immune-directed treatment. The work-up answers that before the 2–5 week program is planned. See the Lyme program →
Long COVID / Post-COVID
Microcirculation, fibrinoid microclots and endothelial dysfunction, the research direction opened by Dr. Beate Jaeger, are measured rather than assumed. A patient whose findings point to impaired microcirculation is a candidate for H.E.L.P. apheresis; a patient whose findings point to immune activation or mitochondrial impairment is not treated the same way. See the Long COVID program →
Chronic fatigue syndrome (ME/CFS)
"All your tests are normal" is where most ME/CFS patients arrive. Mitochondrial function, immune status, hormone axes and autonomic testing give the diagnosis structure, and the treatment plan follows the findings: NAD+ infusions, IHHT, neuromodulation and pacing-based rehabilitation are chosen, not stacked. See the chronic fatigue program →
Integrative oncology
Alongside or after conventional oncology, the work-up adds immune status, chemosensitivity testing and metabolic findings to the tumor board picture. Hyperthermia and IPT are planned with the treating oncologist and with those results in hand. See the integrative oncology program →
The same logic runs through the longevity program, where the question is not which disease you have but which systems are drifting before one develops, and through every therapy we offer: a therapy is prescribed because a finding calls for it.
Hospital setting
Functional medicine inside a 70-bed hospital
Functional medicine in the United States is mostly practiced in outpatient offices. Testing is sent out, results come back over weeks, treatment is prescribed by phone and delivered somewhere else. That model works for patients who are stable. It struggles for patients who are not.
St. George Hospital, founded in 1991 in Bad Aibling, Bavaria, is a hospital: 70 beds, nursing staff around the clock, an internal medicine department, and the laboratory, the hyperthermia unit and the apheresis unit in the same building. A functional work-up here compresses into days what takes months as an outpatient, and the treatment that follows can be intensive because it is monitored. Programs run as inpatient stays of two to five weeks depending on the condition, with a physician visit every day.
For a patient traveling from the US that has a second consequence: one trip, one team, one report. Your first visit describes the sequence step by step.
- Before you travel You send your existing findings. A physician reads them and meets you in a video consultation in English. You receive a written estimate.
- Days 1–3 History, examination and the diagnostic work-up. Most laboratory results are back within 24 to 72 hours.
- Day 3 onwards The findings are discussed with you and the program is finalized. Therapies start, monitored daily.
- Discharge You leave with a treatment report for your home physician and follow-up measurements scheduled. Remote follow-up consultations continue from home.
Is functional medicine legitimate?
The tests are established laboratory methods. Evidence for the functional medicine model itself is emerging, and some therapies for chronic infections and post-viral illness have a stronger record in clinical experience than in controlled trials.
Read the full answer
A fair question, and the honest answer has two parts.
The diagnostic side rests on standard medicine. Immune profiling, autoantibody screening, hormone panels, mitochondrial and metabolic markers, PCR and serology for tick-borne infections are established laboratory methods; what functional medicine changes is how broadly they are ordered and how the results are read together. The therapies we build on those findings are chosen for the evidence behind them for a given indication: hyperthermia in oncology, apheresis in defined immunological and vascular conditions, neuromodulation for defined neurological symptoms. For the model itself the evidence is emerging: a retrospective cohort at an academic center found that patients in a functional medicine model of care reported larger improvements in physical health over 12 months than matched primary care patients (Beidelschies et al., JAMA Netw Open, 2019), an association rather than a randomized result. The research areas page lists the fields our physicians work in.
The limits are real and we name them. Some therapies we use for chronic infections and post-viral illness have a stronger record in clinical experience than in controlled trials, and we say so on the individual therapy pages. No program cures a chronic illness by promise; what changes and how much shows in the follow-up measurements, which is why we take them. If a work-up shows that what you need is a conventional specialist, that is what we tell you.
What separates a serious functional medicine program from a questionable one is simple to check: are tests ordered for a reason, are the results read by a physician, does the treatment follow the findings, and is the outcome measured afterwards. That is the standard we hold ourselves to and the one you should apply to any provider, including us.
Functional and integrative medicine physicians
Julian Douwes M.D.
Chief Medical Officer
Program leadership and treatment protocol development
Martin Rößner M.D.
Chief Physician
Chief Physician; daily clinical care and patient consultations
International Office
St. George Hospital
Your contact before, during and after the stay
+49 8061 398-0info@clinicum-stgeorg.de
- Julia Wingert, International Office secretariat
+49 (0) 8061 398-284 julia.wingert@clinicum-stgeorg.de
- Julia Wingert, International Office secretariat
A physician sees you every day of an inpatient stay, and the physician who plans your program is the one who reads your results. Consultations, reports and invoices are in English. Meet the physicians
Practicalities
Costs, insurance and how to start
Treatment at St. George Hospital is self-pay. Your written, itemized cost overview shows a package price plus individual add-ons. You receive an itemized invoice with diagnosis codes and procedure descriptions in English, which you can submit to your US health plan for out-of-network review. We cannot promise reimbursement and do not. Costs and insurance explains how to read the estimate.
Getting here is simpler than most patients expect. Munich Airport (MUC) is about 60 minutes by car and has direct flights from several US hubs; the International Office arranges the transfer (charged extra), accommodation for a companion, and correspondence with your home physician. Coming from abroad covers the details, including what to bring.
The first step costs you an email. Write to the International Office; it reviews your message and your case directly and gets back to you, and after your records have been reviewed it arranges a video consultation if one makes sense.
FREQUENTLY ASKED QUESTIONS
Common questions about functional medicine at St. George Hospital
What is the difference between functional and integrative medicine?
Functional medicine is a way of diagnosing: it asks why a system failed and measures the answer, using extended laboratory, immune, metabolic and functional testing. Integrative medicine is a way of treating: it combines conventional medicine with physical and biological therapies that have evidence behind them. At St. George Hospital the functional work-up comes first and the integrative treatment plan is built on its results.
Is functional medicine covered by US insurance?
Treatment at St. George Hospital is self-pay. You receive an itemized invoice with diagnosis codes and procedure descriptions in English, which you can submit to your US health plan for out-of-network review. Some plans reimburse part of the diagnostics or inpatient costs; many do not. We cannot promise reimbursement, and we say so before you travel.
Do I need to travel for the first consultation?
No. The first step is a short inquiry, free of charge. A physician reads your existing findings first, then discusses with you whether a work-up at the hospital makes sense, what it would include and what it would cost. You decide about traveling after that, with a written estimate in hand.
How much does functional medicine cost at St. George Hospital?
Costs are individual, a package price plus individual add-ons, because the work-up and the program are planned from your findings. After the video consultation you receive a written, itemized cost overview: a package price plus individual add-ons. Nothing is added during your stay without your agreement. Our costs page explains how to read the estimate.
Are your functional medicine doctors MDs?
Yes. Every physician at St. George Hospital is a licensed medical doctor practicing in Germany. The hospital is led by Julian Douwes M.D. (Chief Medical Officer) and Martin Rößner M.D. (Chief Physician). Specialty backgrounds are listed on the medical team page.
Do you test for gut problems, toxins or tick-borne co-infections?
Gut health analysis, toxicological screening, tick-borne co-infection panels, immune profiling and autoantibody screening are part of the diagnostics we run in-house and with partner laboratories. Which of them your work-up includes is decided per case, after the video consultation, and is listed in your written estimate so there are no surprises.
References
- Association of the functional medicine model of care with patient-reported health-related quality-of-life outcomes. JAMA Network Open 2019. PMID 31651966
From the journal
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Send a free inquiry
The initial inquiry is free of charge. The International Office reviews your message and your case directly and gets back to you.
- Phone
- +49 8061 398-0
- Hours
- Mon–Thu 08:00–17:00, Fri 08:00–14:00 German time (CET/CEST); in the US Mon–Thu 2–11 a.m. ET, Fri 2–8 a.m. ET.
Munich Airport (MUC), about 60 minutes by car.