One of the things that surprises people most during their first visit with me is that we spend a lot of time talking about things that don’t seem related to the reason they came in.
If you scheduled an appointment because you’ve been dealing with chronic fatigue, brain fog, digestive issues, joint pain, autoimmune disease, recurrent infections, unexplained inflammation, rashes or hives, hormone changes, or simply a collection of symptoms that no one has been able to connect, you probably expect me to ask about your symptoms.
And I do.
But I also find myself asking questions like:
“When did this first begin?”
“What was going on in your life a year or two before your symptoms started?”
“Tell me about your childhood.”
“Have you ever had a major illness or infection?”
“Have you ever lived in a home with water damage or mold?”
“Tell me about your environmental exposures.”
“How has your health changed over the years?”
At first, those questions can seem completely unrelated.
They’re not.
In fact, they’re often some of the most important questions I ask.
Every Symptom Has a Story
Recently, I met a woman whose primary complaint was anxiety.
Of course, we talked about her anxiety.
But I was much more interested in understanding when it began.
She paused for a moment.
Then she started telling me her story.
About a year before her anxiety developed, she experienced profound loss and family upheaval.
As we continued talking, we built a timeline of her health over the following years. Soon after, she lived in an apartment with significant water damage. She developed recurrent sinus infections, followed by unexplained episodes of hives. Stress accumulated. Sleep became disrupted. Each event seemed unrelated on its own.
Together, they painted a much clearer picture.
Was any one of those experiences the cause of her anxiety?
Probably not.
But together, they helped explain how her physiology had changed over time.
That’s something I see every day in practice.
Root-Cause Medicine Isn’t About Finding One Root Cause
One of the biggest misconceptions about root-cause medicine is that there’s always one root cause.
Sometimes there is.
More often, there isn’t.
Chronic illness is usually the result of multiple factors interacting over time.
Our bodies are remarkably resilient.
They’re designed to adapt to infections, stress, hormonal changes, environmental exposures, poor sleep, and the countless demands of everyday life.
But that ability isn’t limitless.
Layer enough physiologic stressors together over months or years, and the body’s adaptive capacity begins to shrink. Think of it like a bucket slowly filling with water. One more stressor may not seem significant, but eventually the bucket overflows.
That’s often when symptoms appear.
Those stressors may include:
- Hormonal changes
- Chronic stress
- Poor sleep
- Nutrient deficiencies
- Viral illnesses
- Repeated antibiotic use
- Environmental exposures
- Gut dysfunction
- Insulin resistance
- Autoimmune activation
- Childhood adversity
None of these may be enough on their own.
But layer enough of them together, and they can fundamentally change how the body functions.
My job isn’t to find one root cause.
My job is to understand which factors changed your physiology, which ones are still driving your symptoms today, and which ones we can actually change.
Why This Is Especially Common in Women
This pattern is especially common in women.
Autoimmune diseases disproportionately affect women, and many complex chronic conditions, including migraine, irritable bowel syndrome, mast cell disorders, POTS, and chronic fatigue syndromes, are also far more common in women than men.
One reason is that hormones influence nearly every system in the body, including the immune system, metabolism, the brain, the cardiovascular system, the gut, and our ability to respond to physiologic stress.
Throughout life, women experience several major hormonal transitions, including puberty, pregnancy, the postpartum period, and perimenopause. While each is unique, they all require the body to adapt to significant physiologic change.
For years, the body may compensate remarkably well despite chronic stress, nutrient deficiencies, infections, environmental exposures, poor sleep, and the countless demands of everyday life.
Then comes a period of hormonal change.
The transition itself doesn’t necessarily create all of these problems. More often, it reduces the body’s ability to compensate for physiologic stressors that may have been building quietly for years.
What once felt manageable suddenly isn’t. Symptoms that were subtle become persistent. New symptoms appear seemingly out of nowhere.
The hormonal transition wasn’t necessarily the beginning of the story.
Often, it was the moment the story could no longer be ignored.
The Same Symptom Can Have Many Different Causes
Take fatigue, for example.
Two women walk into my office and tell me exactly the same thing.
“I’m exhausted.”
The symptoms are identical.
The cause may be completely different.
One woman may have an underactive thyroid.
Another may be iron deficient after years of heavy menstrual bleeding.
Another may be living with chronic stress that has kept her nervous system in overdrive for years.
Someone may be living with chronic stress that has kept her nervous system in overdrive for years.
Or perhaps fatigue began after a viral illness and her body simply never fully recovered.
They all have fatigue.
They should not all receive the same treatment.
Iron won’t correct hypothyroidism.
Hormone therapy won’t treat iron deficiency.
And no amount of caffeine will fix chronic sleep deprivation.
The treatment has to fit the physiology.
That’s the difference between treating a symptom and treating what’s driving the symptom.
What Does Root-Cause Medicine Actually Look Like?
One of the biggest differences in root-cause medicine is our ability to look deeper when the clinical picture doesn’t add up.
Most of my patients have already had routine blood work. They’ve often been told their labs are “normal,” that everything looks fine, that their symptoms are simply part of aging, or that stress is to blame.
Routine laboratory testing is excellent at diagnosing many diseases.
But it isn’t designed to answer every question.
Many of the physiologic changes that contribute to chronic symptoms develop long before they meet the criteria for a diagnosis. Nutrient deficiencies, hormone imbalances, early metabolic dysfunction, environmental exposures, gut dysfunction, and changes in inflammatory pathways are often not evaluated or may not be apparent on routine testing alone.
That’s where advanced diagnostics can be incredibly valuable.
The key is knowing when to use them.
Testing should never replace listening. It should answer the questions that arise after we’ve taken the time to understand your story.
That’s why we begin by building a timeline, reviewing your medical history, physical exam, lifestyle, nutrition, sleep, movement, medications, previous laboratory work, and, when appropriate, advanced diagnostic testing.
The goal isn’t to order more tests.
It’s to order the right tests so we can better understand what’s happening beneath the surface.
Once we understand why your symptoms developed, treatment becomes much more personalized. Rather than simply trying to suppress symptoms, we build a plan that addresses the underlying physiology. That may include nutrition, movement, sleep optimization, stress reduction, targeted supplementation, medications when appropriate, hormone therapy, or other therapies designed specifically for what’s driving your symptoms.
Why It Takes Longer—and Why It’s Worth It
This approach takes time.
It requires curiosity, careful listening, and connecting pieces that may not seem related at first.
It also requires patience.
Most chronic health conditions don’t develop overnight.
They evolve gradually over years, sometimes decades, as multiple physiologic stressors accumulate. It isn’t realistic to expect the body to fully recover overnight, either.
Healing is a process.
As we identify and address the factors contributing to illness, the body begins to regain its resilience. Some people notice improvements quickly. For others, progress happens one step at a time. Our goal isn’t a quick fix. It’s lasting health.
One of my favorite moments in practice is when a patient looks at me and says,
“No one has ever asked me those questions before.”
Or,
“That actually makes sense.”
To me, that’s where healing begins.
Not because we’ve solved every problem in a single visit.
But because we’ve finally started asking the right questions, understanding the story behind the symptoms, and creating a plan that treats the why, not just the symptom.
Disclaimer
This article is intended for educational purposes only and should not be considered medical advice. Every individual is different, and the information presented here is not a substitute for personalized medical evaluation, diagnosis, or treatment. Always discuss health concerns and treatment decisions with your healthcare provider.
Clinical stories shared in this article are composites created from real clinical experiences. Details have been modified to protect patient privacy and should not be interpreted as describing any single individual.