The truth? It is never one thing. Dale Bredesen, MD, coins the analogy of chronic illness as a roof with 45 holes. If we plug up one hole, your floor is still going to get wet. I add that those holes are not all the same size.
So let’s take a simple diagnosis: chronic fatigue. Not so simple, as nobody can really figure it out. Right? Well, it is because there are SO MANY potential causes. Anemia, vitamin deficiency, caloric deficiency, malabsorption, maldigestion, poor dietary intake, insomnia, chronic pain, sleep apnea (or your partner or pets are waking you up), chronic infection, depression, side effects of medication, or alcohol, or drugs, toxicity, hormone imbalance, chronic stress… The list goes on and on. In conventional medicine, they might suggest an iron supplement. Trying to get more sleep. Try to exercise more. And when those don’t work, maybe it is time for an antidepressant. From a conventional medicine sense, other than thyroid, CBC, and maybe a B12 level… that is the extent of your workup. Maybe if you’re male and older, and overweight they MIGHT ask you if you snore. If you do AND you meet all the criteria you might get a referral for a sleep study.
And that is it… That is the workup for chronic fatigue. And if there is not a glaring iron-deficiency anemia or hypothyroidism, or sleep apnea you are pretty much out of luck. Those things are all super important to rule out, so if they haven’t been, they need to be! But usually, that is not the whole picture. We need to be asking questions and listening to the answers. Synthesizing a total body, comprehensive experience web to be able to draw connections between symptoms that may or may not seem to be related. This is called a “systems-based biology approach”.
This is taking one symptom and seeing how others can contribute or are impacted by another.
Nothing in the body occurs in isolation. If you have chronic stress, you may experience immune dysregulation, gut imbalances, hormone imbalance, and neurotransmitter imbalances. You may not sleep as well. And the gut imbalances further perpetuate hormone and immune dysregulation, mental health concerns, inflammation, etc. And each of these things contributes to and perpetuates one another.
This is why the conventional medical model falls short in diagnosing and treating chronic disease. It is looking at one symptom, one cause, and one pill to “treat”. And fails to look at the whole person. This is why patients, on average, see about 17 different providers in search of answers. This is why functional medicine providers are jokingly called “resort doctors”. We are the (healthcare providers) of LAST resort. You make it to us when you are sick of being sick.
The conventional workups are done, and maybe there are no explanations for your symptoms, or there are, but the treatments aren’t working or are intolerable. That’s where we come in! To leave no stone left unturned. To plug as many of those holes in the roof, and to start with the biggest most impactful holes. THEN your floor will stay dry!