Determining the Underlying Drivers of Disease
Let’s start at the beginning… the beginning of the healing process, that is!
Understanding (even partially) what is causing the bulk of inflammation and symptoms that a patient is presenting with is a huge step forward in the direction of healing, disease reversal, and diminishing symptoms.
Once you have clarity about the primary underlying cause(s) of the current set of symptoms, you know what the treatment plan priorities need to be, and an effective, strategic treatment process can begin.
Yet all too often, determining these causes is not an easy task. Patients with complex illness often have a myriad of symptoms with numerous diagnostic labels attached to them. Most of these medical diagnoses (such as chronic fatigue syndrome, migraine headaches, or irritable bowel syndrome) lack the all-important insight into the actual cause (or causes) of the disease process.
Without this knowledge, it’s not possible to address those causes, and attempts at healing will ultimately be stymied.
Successful treatment involves making sense of the complicated symptoms and manifestations of body-mind dysfunction. To do so, we must learn to read the pattern language of the body, especially the immune system.
Here are 3 principles that can guide us:
- Symptoms show us what the immune system is paying attention to and putting resources towards. They show us what is highest priority on the immune system’s agenda. Symptoms can form a constellation — if we connect the dots accurately, the invisible drivers of illness become visible.
Ask your patient (or yourself): What are your top 3-5 symptoms (i.e. the worst, most intense, debilitating or bothersome symptoms)? These top 3-5 symptoms are like the brightest stars of a constellation. Once they are mapped, they form a pattern that points in the direction of a particular underlying cause, or at least narrows it down to the 1-3 most likely factors that are currently contributing to inflammation and illness.
Know the unique characteristics of the common drivers of chronic illness. These include things like:
Lyme or other tick-borne disease
Chronic viral infection
Mold toxicity or fungal infection
SIBO, leaky gut or other GI dysfunction
Heavy metal or chemical toxicity
Mast cell activation
Stress or poor vagal motor outflow
Food intolerances and/or nutrient deficiencies
This knowledge is gained through education, research, and clinical experience. Learning from a more advanced practitioner who has gained this clinical experience will greatly accelerate your ability to match a symptom constellation to the underlying cause.
- Utilize labs as needed to validate your clinical suspicions, but don’t rely primarily on them. Know that your clinical recognition of certain symptoms, combined with other evidence from the patient’s history and intuitive sense of causation, is probably more accurate than what labs can reflect..
The reason for this is twofold. First, while labs provide hard data, we can’t conclude that just because something is appearing abnormal on a lab, that it is the cause of the patient’s symptoms.
Second, many labs that test for the common causes of chronic illness are not entirely accurate, so depending on them exclusively will lead you astray. For example, if a patient is positive for Lyme, Epstein Barr virus, has a low white blood cell count and low estrogen, we still have to discern what is the primary cause of their top symptoms of fatigue, night sweats, swollen glands, and inflamed muscles. The factors that the lab reveals may or may not be the primary drivers of these symptoms.
It is important to consider other possible factors as well, such as mold exposure and Bartonella or Babesia infections (which often return false negatives on common labs). Any evidence derived from lab results should be considered and may fill in gaps of the overall picture or validate your clinical hunches, so they are useful in that sense.
The ultimate way to uncover the underlying drivers of disease is a thorough questioning process that differentiates among the many common causes of chronic illness. This may seem daunting, but over time, as each patient brings a fresh challenge and new opportunities to learn, the practitioner will grow in this ability and the clearer each picture becomes!
Yours in Health,
Are you a health practitioner who wants to take your knowledge deeper?
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