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Why We Get Sick—and How to Get Well


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If you have one of the many chronic health problems that people suffer from today—such as IBS, fibromyalgia, chronic fatigue, and autoimmune disease—you will likely be given a drug to manage your symptoms and not much else. The key to successfully treating these conditions, however, is addressing their underlying cause. This is the promise of Functional and evolutionary medicine.

why we get sick
Getting to the root of why we get sick is how we determine how to get well. Okea/iStock/Thinkstock

We’re in the midst of the most serious epidemic of chronic disease humans have ever faced. Six in 10 adults in the United States have a chronic health condition, and four in 10 have two or more. (1) Seven of the top 10 causes of death in 2010 were chronic diseases, and two of them—heart disease and cancer—together accounted for almost half of all deaths. (2)    

While some of these problems (like heart disease) are fairly well-understood by conventional medicine, others are more mysterious. Conditions like Irritable Bowel Syndrome (IBS), chronic fatigue, diverticulosis, fibromyalgia, and autoimmune disease together affect hundreds of millions of people around the world, but in most cases, patients are told that the causes of their condition are unknown and simply prescribed drugs to manage the symptoms.

But is it really true that we don’t know what causes chronic illness? Certainly, there are particulars related to each specific illness that we don’t yet understand. But I would argue that we do, in fact, have a solid grasp on the most important factors that contribute to virtually all chronic disease. This means that it is within our power now to prevent, and even reverse, many of these conditions.

Do you know the eight underlying causes of most chronic disease? Check out this article to find out and learn how Functional Medicine can solve them. #functionalmedicine #unconventionalmedicine #kresserinstitute

The Functional Medicine Systems Model

As many of you know, I train clinicians in Functional Medicine through the ADAPT Practitioner Training Program. In preparing for that program, I created a “unified theory” of what causes disease that I call the Functional Medicine Systems Model. I’d like to share that with you here, and use it as a springboard for our discussion.

exposome + genome copy

As the diagram illustrates, the interaction between an individual’s genome, epigenome, and exposome is at the core of what determines our health.

The genome is our complete set of DNA, containing all of the information needed to build and maintain the human organism.

The epigenome consists of chemicals that modify the genome in a way that tells it what to do, where to do it, and when to do it. These modifications do not change the underlying genes, but they can be passed on to future generations.

The exposome represents the sum total of all non-genetic exposures an individual experiences from the moment of their conception through the end of their life. It includes the food we eat, the water we drink, the air we breathe, the chemicals we’re exposed to, the social connections we have, and the environment we live in.

To use an analogy, the genome is like a piano; the epigenome is like the sheet music, and the exposome is what determines how the music is written and performed. The quality of the piano will certainly affect the sound that it produces. But the finest piano in the world will still sound terrible if the sheet music and performance are terrible. Likewise, a virtuoso pianist performing a Mozart piece will not be at her best playing a poor-quality piano.

In the same way, genetics do play an important role in human health and disease. However, we now know that the exposome (and its influence on the epigenome) is far more significant in most cases. In fact, it is responsible for more than 90 percent of human disease. That is why the exposome is at the core of the Functional Medicine Systems Model, and should always be the first thing addressed regardless of the patient’s complaint.

The modern diet, lifestyle, and environment affect the expression of our genes and lead to pathology, which in turn cause disease and symptoms in the patient.

But what are those pathologies?

The Eight Core Pathologies That Underlie All Chronic Disease

I believe that virtually all diseases and symptoms that we experience are caused by one or more of the following eight core pathologies:

1. Gut Dysfunction

Gut dysfunction includes small intestine bacterial overgrowth (SIBO), infections (e.g. parasites, pathogenic bacteria, viruses), low stomach acid, bile, and enzyme production, intestinal permeability, and food intolerances.

2. Nutrient Imbalance

Nutrient imbalance includes deficiency of nutrients like B12, iron, folate, magnesium, zinc, EPA/DHA and fat-soluble vitamins (most common), and excess of nutrients like iron (less common).

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Chris Kresser in kitchen

3. HPA Axis Dysregulation

HPA axis dysregulation includes regulating the communication between the hypothalamus, pituitary, and adrenal glands, and balancing the production of hormones associated with those glands (e.g. DHEA, cortisol)

4. Toxic Burden

Your toxic burden includes exposure to chemicals (e.g. BPA, phthalates, etc.), heavy metals (e.g. mercury, arsenic), biotoxins (e.g. mold/mycotoxins), or impaired detoxification capacity due to nutrient deficiency, GI issues, or other causes.

5. Chronic Infections

These include “stealth” infections by tick-borne organisms (e.g. Borrelia, Babesia, Bartonella, Erlichia), intracellular bacteria (e.g. Mycoplamsa, Chlamydophila), viruses (e.g. HHV-6, HPV), and dental bacteria.

6. Hormone Imbalance

Hormonal imbalance can include those associated metabolism (e.g. insulin, leptin), thyroid, and gonads (e.g. estrogen, progesterone, testosterone).

7. Immune Dysregulation

This includes autoimmunity, underactive immune function, and chronic, systemic inflammation. 

8. Cellular Dysfunction

Cellular dysfunction can refer to impaired methylation, energy production, and mitochondrial function, and oxidative damage.

These pathologies (and the exposome-genome-epigenome interactions that lead to them) are at the root of everything from obesity, to Hashimoto’s thyroiditis, to asthma, to autism spectrum disorders, to depression. The understanding that the same eight core pathologies underlie most modern, chronic diseases has profound implications for how we should address these conditions.

In conventional medicine, the focus is often on diseases and the symptoms; it works “from the outside in.” For example, let’s say that you go to the doctor for your annual exam and your blood tests reveal that you have “high cholesterol”. The most likely outcome in this situation is that you’ll be prescribed a statin, and in some cases be told to exercise more and eat better. There is rarely any serious investigation into what caused the high cholesterol in the first place.

In Functional Medicine, however, we work “from the inside out.” We pay less attention to the symptoms and more attention to the pathology that produces those symptoms.

High cholesterol is a symptom, not a pathology. The pathologies that can lead to high cholesterol include poor thyroid function, intestinal permeability, disrupted gut microbiome, chronic viral or bacterial infections, insulin and leptin resistance, and nutrient imbalances—to name a few. If I find high cholesterol in a patient, we will examine all of these potential pathologies, and of course, we will also look at how the individual’s genetics, diet, lifestyle, and other factors related to the exposome may be contributing to them. Once we have addressed all of the core pathologies, the cholesterol levels typically normalize on their own.

Whether the patient’s main complaint is infertility, fatigue, sinusitis, or skin problems, I will focus on these eight core pathologies because I know (from both clinical experience and research) that they are the most likely underlying causes of their condition. In my practice, most of my patients are dealing with not just one of these pathologies, but several.

As you can see, this is a fundamentally different approach than what is typically done in the conventional setting. The downside is that it requires a lot more testing and investigation up front, which can be costly and time-consuming. The upside—which obliterates any of the downside considerations—is that it becomes possible to not only prevent but even reverse many chronic disease conditions without the need for taking medication for the rest of your life.

Unfortunately, the Functional Medicine approach is not yet embraced within the conventional healthcare model. But I believe that is changing. The prestigious Cleveland Clinic established the Center for Functional Medicine, directed by Functional Medicine pioneer Dr. Mark Hyman. This is a big step toward mainstream acceptance of Functional Medicine, and the research the center is engaged in will almost certainly lead to even broader recognition.

I think health insurance companies will also see the benefits of Functional Medicine. They’ll recognize that spending a little more money up front to properly diagnose and treat the root of the problem will lead to enormous savings down the line.

These changes aren’t going to happen overnight, and we still have a lot of work to do. But the tide really is starting to turn!

If you’re a healthcare practitioner and you’re interested in training in this approach, learn more about the ADAPT Practitioner Training Program.

If you’re struggling with a chronic health problem and are interested in learning more about this approach, click here to learn more about how the team at the California Center for Functional Medicine can help. The membership-based health transformation service offered by CCFM is 100 percent virtual, and it’s designed to offer you the support, tools, and team you need to get well.

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Join the conversation

  1. I’m so grateful that my work has been helpful to those of you commenting on this thread, and I really appreciate your feedback. This is why I do what I do, and hearing about your experiences makes it all worthwhile!

  2. Hi Chris,
    Thank you so much for all you do. I have your book and read your newsletters, which have helped me seek out a ND. I am currently being treated for the top three of your eight as well as hormone imbalance. I was just diagnosed with SIBO and have just started treatment. I went to different MD’s and kept getting more and more medications, now with the help of a ND and Integrative doctor I have gotten off 4 meds already !
    Thank you so much for being the inspiration for me to invest in my health by getting to the root cause!

  3. Thanks for all of your informative articles! Can you point me at any resources for fluctuating hearing loss? I lost my hearing for a few years in one ear then it came back for a few years. It is gone again for the last 4-5 years. The hearing loss pattern is similar to Meniere’s but I don’t have other symptoms. The specialist at MGH Eye & Ear diagnosed me with fluctuating hearing loss and said it could eventually result in Meniere’s. I have searched the web but can’t find out much about this. Do you know of any resources? Otherwise I am healthy and following an 80/20 primal eating pattern. I did try the 30 day plan in The Paleo Cure but that didn’t change anything (I did cheat on red wine, though 😉

  4. You could say there are only TWO types of medicine:-
    1. Functional medicine.
    2. Dysfunctional medicine

    • Clever phasing and a month ago I would have agreed wholeheartedly. Now I would rephrase it as Functional Practitioner vs Dysfunctional Practitioner. I went to a functional doctor and got useful test results and some potentially useful treatment. But I also got conflicting recommendations with no help in resolving the demands of multiple health issues. Worse, I was accused of lying about what I eat and it was implied that I was so inactive that even a little housework would be good for me. Meantime, I told my new regular doctor about the test results and she keyed in on them, suspected sleep issues and I am now being treated for sleep apnea. Clearly, one of the doctors practiced functional medicine and one had the true functional mindset.

  5. I can not use your method as I do not know what to do 🙁
    I have a skin rash for 10 yrs. now, I’m always tired, I have arthritis (which the surgeon said I need both knees replaced), I’ve been diagnosed with depression, fibremiology, I have difficulty going to sleep, my right foot hurts and burns so much I can’t walk sometimes and I have difficulty actually getting out of be ie I’m awake for several hours before I can actually get moving and last but not least I’m often very light headed. NOW……can you help me on a road of recovery?

    • Hi
      While my and my wifes symptoms are nowhere as poorly as yours we both changed up to LCHF. We have lost weight lots of it, improved our lipids, reduced pain to more manageable levels, chucked statins, and I have stopped blood press meds all with improved lipids. So my suggestion is to research LCHF or Paleo, get yourself going, and monitor progress. You should see an improvement. Then experiment makes it better still. Bearing in mind Chris’ points above. You will find as I did, that with research lots of it, understanding, experiment, that you realise what Chris means. That is for non-medical trained people go practical to find out what it means and what is happening to you.

    • Susan I can sympathize with you…I went through many years with chronic issues. You have to start with food, stress relief, sleep and safe movement. Chris offers a 14andfour program that would be beneficial to a beginner in this method of approach to getting well. I recommend you explore that resource in the links at the top of his website.

    • Hi Susan,

      Sorry to hear you’re going through so much. I know it can be difficult to figure out to do when you are dealing with multiple health problems.

      In regard to the light-headedness, have you been looked into adrenal or cardiac problems? If it was me, I would want to rule out cardiac, as that’s usually more serious. Looking up adrenal insufficiency or fatigue (term differs depending on who’s doing the talking) should give you lots of info on that, it is one of the common causes of feeling light-headed (you might notice it a lot when you’re changing positions from lying or sitting down, bending over, etc.). Chris has several articles dealing with it, and Dr. Alan Christianson is another good source of info. The difficulty going to sleep and needed a long time to get going in the morning sound a lot like adrenal issues, too.

      I would also check into hypothyroidism and Hashimoto’s disease; if your adrenal glands are having a problem, very often the thyroid will be as well. Being tired all the time is common with hypothyroid/Hashimoto’s.

      Several of your health issues might be helped by a low oxalate diet. I highly recommend the Trying Low Oxalates yahoo group run by Susan Costen Owens. The lowoxalate dot info website also has lots of information regarding the subject. Many of the members at the yahoo group have had improvement in their fibromyalgia.

      I don’t know if it would help in your specific knee situation, but my friend had very good results from a gel injection (she said it was derived from rooster combs). She had pain relief for about a year before she needed another injection.

      Lastly, the burning pain in your foot, although obviously many things could be causing it, I would suggest that you check into Reflex Sympathetic Dystrophy, if only to rule it out. Burning pain is the biggest symptom of this condition. A lot of doctors are not familiar with it and early treatment can make a huge difference. I certainly hope that isn’t what it turns out to be, but if it does, don’t be discouraged. Just finding out what is causing the problem is a relief, and the condition can improve a great deal after you start doing the right things. And in some cases stop doing the wrong things! Icing the area is extremely bad for RSD, it interferes with myelin regrowth around the nerves and makes everything worse.

      I wish you the best, and hope you are able to find healing.

    • Hi Susan,

      Have you been tested for Lyme Disease? To me this sounds like a textbook case, and pain and burning in the feet is commonly associated with a Bartonella co-infection.

      The conventional lab testing for Lyme and co-infections is extremely unreliable, so I would recommend testing through IGeneX labs. Hope this helps!

      Feel better,

    • Susan, I had a lot of these symptoms though for not such a long time as you and most of them got better with a Gluten Free diet, the rest have been bettered by LCHF diet and drinking Kefir, (home-cultured not the comercial kind). Some people are even better completely grain-free and /or dairy free,
      I hope they may work for you.

    • Forgot to say that have Hashimotos thyroiditis, diagnosed 2009) but the medication didn’t relieve my exhaustion symptoms, muscle pains and spasms, arthritis pains in my hands and feet, and I got so that I couldn’t turn over in bed without hanging onto the mattress, I was permanently fatigued,slept badly, had permanent itchy yeast rashes and eventually Derm. Herpetiformis before going gluten free. Now almost everything is resolved and am fitter than I have been for years plus the debilitating migraines that I had suffered since puberty have completely disappeared, all thanks to diet.

    • hi Susan De
      It has been about 18 months since you wrote the above comment. I would be interested in your success.
      Did you try LCHF?

  6. I have suffered from psoriasis for over 30 years. Not comfortable with the idea of a lifetime of treating only the symptoms, I began researching what might be at the root cause of this disease and stumbled upon the possible connection between gut permeability, diet and psoriasis. I have spent the last two years healing my leaky gut and improving my diet. I’ve added digestive enzymes, a good probiotic, eliminated night shades and processed junk, and started making my own bone broths and fermented foods. My skin is almost clear now. (I know I need to give up gluten if I’m going to heal completely, but I’m an avid baker so this has been hard for me.) At first my dermatologist was rolling her eyes at me… but at this last visit, she asked if it would be ok if she gave my phone number to her patients who asked about diet and healing psoriasis. I have opened her eyes to the functional medical world. I listen to your podcasts religiously and share them with as many people as I can. You have changed my life. I wish my medical insurance would cover a full-blown functional medical workup, but maybe someday soon!

    • Hi Jackie!
      Glad to hear you’re doing much better! But as I was reading your post, I cringed when you said you were still eating gluten!
      You’ve come a long way and by eating gluten you are stopping
      yourself from fully healing. You said you’re trying to repair your leaky gut but gluten is one of the number one contributors to gut permeability! You will not fully heal unless you get off the gluten. You’ll just have to learn to start baking gluten free! There are great recipes out there! Also glad to hear that your dermatologist is finally on board. Good luck with everything!

      • Jackie, you are amazing!! Because of your psoriasis you have entered a world that will change the quality of your life forever. You’re making lemonade :)!! And now you are sharing that experience with others so that they can take action and heal their autoimmune diseases, whatever they may be. I find it EXTREMELY UNFORTUNATE that Lizzie responded with the ONE thing you still have left to work on instead of focusing on the ONE HUNDRED things you have already done to heal, that is so negative, so just let it go. I believe this path is a journey and we take the steps we are ready to take. When you are ready for the next step you will take it. Keep smiling and doing what you are doing … I could read your excitement through your words!

    • You’ve taken some major steps, and seeing results. Psoriasis is an auto immune condition. Eliminating gluten just may make all the difference in crossing the finish line. You mentioned being an avid baker, perhaps you could exchange that culinary craft for another, such as a fermentation artist. All the best!

    • Jackie or Chris – regarding psoriasis. Your story is very encouraging. I have been dealing / managing psoriasis now for 10 years. Over the past 3 years is when it really started to affect me – primarily on my hands and then led to joint flare-ups. I have been following the Autoimmune Paleo diet but I occasionally use a biological to help while I am figuring this out. The skin on my hands is the toughest to resolve. Since you’ve had psoriasis for so long, have you ever used the biological? Curious to see if you did and how long it took for you to fully be off of them.

      Thanks so much!

      • I brought him a quart of raw unprocessed milk a day and his skin was almost clear in 5 days. Is it available in your area?

        • This was a person I worked with who knew a guy that knew a guy selling fresh unprocessed milk.

        • Thanks Mike. Yes, I do have access to raw milk but that did not seem to help. This is certainly a tricky one for sure.

          All the best,

          • I’m not selling milk. I’m sure any healthy diet would probably work. Just curious. Are we both talking about the same thing? You are referring to raw unpasteurized milk either strait from the farm or a small health-food store, right? Not just organic milk from Whole Foods. Did you drink at least a quart a day? Two quarts a day is not hard.

            Here’s a little copy paste: “The Raw Milk Cure: The therapy is simple. The patients are put at rest in bed and are given at half hour intervals small quantities of milk, totaling from five to ten quarts of milk a day. Most patients are started on three or four quarts of milk a day and this is usually increased by a pint a day.”

            I used to drop a half gallon bottle in my back pack. We had two cup holders and two 8 oz cups on the dash of our service truck. We’d have a glass between jobs and finish it by the end of the day. I noticed that if you drank the milk before you got hungry it could prevent the purchase of a soft drink. Which is why weight gain was not a problem.

    • Am interested in your comments in regards to psoriasis diet.
      I have tried many diets and removed many things and generally take all necessary supplements you mentioned, however I have noticed my psoriasis flares up very irregularly and I cant after 15+ years find the trigger.
      Any advice your willing to share would be really appreciated.
      Many thanks

    • Thanks for sharing your inspiring story. In my practice, I’ve found that skin conditions are (almost) always related to gut pathology. There are often other factors as well, but focusing on the gut tends to make the biggest impact.

    • Go gluten-free and become a different kind of baker. There’s a large and growing market for it, and it’s an art! You’d be helping your own cause and others’ too!

    • I think you and Chris have hit the nail on the head. I knew a guy with psoriasis. I brought him a quart of raw unprocessed milk a day and his skin was almost clear in 5 days. If you are an avid baker you should start with organic wheat and sugar. They have half as much glyphosate. Try and go gluten free. Pamela’s pancake mix is a good start. It’s getting easier to go sugar free with the new stevia products. Then there’s raw honey or sweet fruits and vegetables. Organic of course. I’ve had some luck with heirloom grains. Heirloom grits are fabulous. There are many I haven’t tried yet. We really should make an effort before they are all too contaminated by GMOs. I have heard there are no seeds that can be guaranteed 100% GMO free.

      • I believe the main problem with gain is the (herbicide/descale agent/antibiotic) glyphosate rather than the gluten.

    • Jackie,

      Good work between you and your dermatologist: sounds like progress and I’m glad to hear it!


  7. Hi Chris

    I have ME/CFS ( the sort with disproportionate and delayed fatigue rather than Chronic fatigue of ‘just tired/wired’). I have used your Paleo diet book here in the UK to reduce some of the symptons, but we are not there yet

    I have a an experienced nutritionist and we have done genetics to find out I have a sulphur CBS mutation so high sulphur foods ( i.e. kales, crucifers, eggs, whey etc) common Paleo food!, were actually flaring my symptoms

    I hope this can be covered in your future work and really show that one size does not fit all. Although suffering with ME/CFS for over a year now I am fascinated in how food can cure and hoping I will regain my health

    I have asked to be considered for your training as would like to teach more people in the UK about the benefits


    • Hi Kirsty
      I am also in the UK, can I ask how you did the test to find you has a sulphur CBS mutation? I haven’t been able to eat those foods for the last 16 years and so find it hard to nourish myself back to health with a very leaky gut…Can i ask you if you have found a functional doctor in the UK?
      Chris, thank you so much for all your information, you have really helped me over the years and many of my friends’ with the knowledge you share. I am so grateful…and I still need a functional doc here in UK:) If my brain was working and not ill I would do the training you are about to offer…

      • There is at least one in Suffolk, use google, at Stowmarket, his website shows a range of testing packages.

    • Chris , That’s the same things I’ve had problems with, plus spinach ,nightshades and coconut products . Well to name a few with all my allergies on top. So going strictly lchf makes things very hard. It’s been 7 months , but I found other low carb choices . Can’t come up with too many different dishes. For me I rather go without and have the benefits of feeling healthier ,

  8. Hi Chris

    This is a perfect opportunity to thank you for all you publish (and most for free) that enable people like me to take control of our health, and in particular steer others in the right direction.

    My daughter (here in UK, so NHS – ‘free’ in theory…) aged 23 diagnosed with RA, PCOS, also given antidepressants and tested as pre-diabetic last year and miscarried at 18 weeks last autumn (a missed miscarriage in fact – so emotionally very tough). By this point she was 5 stone over the weight she left home 5 years before.

    Her GP wanted her to take a fat-absorption inhibitor drug and go on no fat diet before she would even check her hormone levels again when she visited Spring this year.

    Since last November (when I sent her your latest book) she has taken her health into her own hands and with my help (my expertise is entirely gained through your information and others in the field) We’ve got her down 3 stone and counting, her cycle has re-established, unwanted hair growth has disappeared, she can fast at will, she no longer has RA (been signed off by the clinic). She weaned herself off the anti-depressants within weeks of starting you eating protocol.

    We added probiotics, HIIT, lots of walking and I sent her a bundle of all the likely deficient vitamins given her symptoms and previous diet. It took a couple of months of healing and feeling better before the weight started going, in fact 6 months, which fits with her having ‘abused’ her body for 6 years. She never took the fat-busting prescription BTW and she still can’t get them to test her hormones again, but she knows she is improving all the while.

    So thank you so much.


    • Kelda, I second your first paragraph many times over! Chris, my heartfelt thanks — you have an incredible ability to take emerging and evolving info about health issues and brilliantly organize and explain to the layperson so that it is easier to apply for real results. It’s a roadmap that’s not always easy to do, but the results follow if one is persistent.

      Kelda, your description of your daughter’s health issues shows that you don’t have to perfectly understand what is wrong in order to apply principles of good health — and get real results! Congratulations to both of you for having the courage to follow Chris’ roadmap, thereby finding a healthier way than the traditional medicine treatments.

      I bet some of her doctors were irritated / angry that she didn’t follow their directions, and I bet virtually none are curious about what she is actually doing to successfully heal her health issues.

      • They haven’t even asked her what’s she’s done! It amazes me, if I were a doctor and saw such improvement I’d want to know how so I could help my other patients.

  9. Dear Chris
    Your articles on digestive disorders have been immensely helpful to me and have enabled me to deal very effectively with esophagus and hiatus hernia issues. I don’t think you mention in your articles physique-related issues such as flabby stomach muscles, weak diaphragm, poor posture, stooped/rounded back and the muscular movement of the ribs when breathing. I have worked on all of these issues with pilates, yoga, breathing exercises, vibration, massage and drinking much more water….. and surprisingly (to me) the arrhythmia I had been experiencing cleared up!
    Thank you.

  10. Dear Chris
    Had I followed my doctor’s advice I would have been taking statins, beta-blockers, warfarin and proton pump inhibitors daily from as early as 1991, not to mention other medication to deal with the side-effects from these drugs. However I was fortunate enough to find your website! Thank you.
    If you do not already know about it, you might be interested in an initiative called the Choosing Wisely Programme which started in the US and has now been taken up in the UK by the Academy of Medical Royal Colleges.called the Choosing Wisely Programme. Its purpose is to limit inappropriate interventions by the medical profession. A steering group has been established in the UK at [email protected]
    Kind regards

  11. I wish to say a heart-felt thank to you Chris. I was diagnosed with severe Rheumatoid Arthritis (RA) 3 years ago and conventional treatments did not work (except for prednisone) in fact, they made me more sick. My mother also had RA and passed away at an early age of atherosclerosis, which may have been the result of the high doses of prednisone she was prescribed – hence me not wanting to take it. So, I took to the internet to research and I extremely happy to say I found you! I have followed everything you recommended I do having an autoimmune disease. I follow a Paleo lifestyle (well 80/20) and lost 33kgs (73 pounds) and also take the supplements you recommend. The icing on the cake was approaching my specialist and asking to be prescribed Low-Dose Naltrexone (LDN) which she luckily was open to and even enthusiastic for me to try. Hand-on-heart I am now completely pain free, actually I feel disease free and twenty years younger! I am truly grateful and cannot thank you enough for giving me back my quality of life – please, keep up the great work!

  12. Hi Chris,

    Do you know good healthcare providers who can find the root cause in the Netherlands?

    I suffer from POTS (postural ortostatic tachycardia syndrome), CFS (depends who you ask) and bloated bellies.

    Paleo helped me a lot but adding safe starches makes me fatigue and eating LC pales is hard in a professionally life.

    Thanks for your advice and suggestions.

  13. Hi there,
    I was diagnosed at the age of 16 with familial hypercholesterolaemia and told there was no other option but to go on a Statin. I remained defiant and refused to go along with this initial advice, instead learning more about the role of fatty acids and lifestyle changes to alter my cholesterol levels instead.
    At the time of the diagnosis I was quite sedentary, consumed a vegetarian diet; albeit very high in simple carbohydrates and a fairly low amount of fats.
    Post diagnosis I began regular exercise, started eating a higher protein, lower carbohydrate vegetarian diet and increased my fats through both diet and supplements. I used butter, coconut oil and olive oil with all my meals and even added extra if i was still hungry. I started taking supplementary fish oil in the highest recommended dose 3 times a day.
    The doctors were very cautious of my new regime but within the year my new cholesterol level was within the normal range and my HDL:LDL ratio had improved dramatically, and continues to this day (age 27yrs).
    After reading this article I just want to highlight the importance of persistence, research and what can seem like slow progress…….when, it can in fact change even your genetic predisposed trajectory without a prescription ever even being filled!
    This new medical model definitely deserves to be implemented before often unnecessarily lifelong treatments are initiated.

  14. hi Chris, great article.

    I have been treating blastocystis parasite infection for over 3 years, prior to that conventional doctors and natural practioners purely treated IBS symptoms or bloating, food intolerance and fluid etc. I am in my 50’s and suffered bad stomach / GI issues since a child. Finally an integrative doctor was over cautious and did many tests to uncover parasites and h.pylori.

    I have been cleared of everything finally after multiple antibiotic treatments over 3 years including the colonic infusion of strong antibiotics which did the trick.

    My question is, what if you can tick off 4 of the above pathology “causes” would you still focus on eliminating the parasite (if carrying a sub type aligned to chronic illness) or focus on other pathology issues first. As you know the medical world is divided on whether blasto is in fact pathogenic and many people believe it is purely opportunistic and enters the body when you are immune compromised. Personally, removing blasto with antibiotics was the only thing that settled down my symptoms and supported me with all other pathology issues and healing my gut (and finally absorption and hormonal issues). Natural or diet change did not work only as a symptom reducer temporarily.

    My second question is, what is your experience with parasites, and blasto in particular, which is known as a very resistant parasite to clear. What approach do you take if a chronically ill patient presents with long tenure of symptoms and failed “treatments”.

    Thanks 🙂

    • Someday I’ll write a blog post or series on Blasto. It’s such a fascinating question, but the short version is Blasto can be both nonpathogenic, and incredibly pathogenic, depending on a variety of factors including host-pathogen interaction and the particular subtype (or even variations within subtypes) of the organism. I recently read a study suggesting that over 80% of healthy people have Blasto, so it certainly can’t be possible that Blasto is always a pathogen. Yet there are also many other studies that confirm it can be pathogenic, and we see that in our practice. (Blasto was, in fact, one of the parasites that made me sick and I definitely improved when I got rid of it.)

      This uncertainty really complicates the picture when Blasto is found on a stool test.

      • Thanks so much Chris for responding. A blog on blasto would definitely be of interest to so many people across the globe as there are still too many grey areas in how one should approach blasto. This is mainly due to the variances you speak of in how it effects people so differently, and a great divide in the medical community on best treatments due to limited or outdated research or limited experience with blasto in particular . Look forward to seeing research develop with blasto, understanding more about the sub types, variances within sub types, blasto a role in the body (if it has one) and best treatments to eliminate or live with blasto. Thanks again for responding.

  15. Chris, do you have experience with treating OCD? What do you find the most common root cause is? Gut dysfunction (I’ve got that), hpa axis dysregulation, low neurotransmitters?

    • All of the above, but I would add poor methylation as another crucial factor.

        • Sorry, comment got cut off:
          Thanks for the reply, Chris.
          1. Which one would you recommend focusing on first (I have to address my gut first due to constipation)?
          2. Would you recommend taking 5 htp or tryptophan for rebalancing serotonin (also maybe to help with constipation)?


  16. Chris,
    I’m curious if you would add “9. Negative Emotions” to your list of causes. You often mention stress as a contributing/underlying factor in many conditions, and in my personal experience, I’ve found it to be the the sole cause of certain health conditions I’ve suffered.
    I’m forever grateful to Dr. John Sarno’s books and his concept of TMS for curing my sciatica and IBS. In my case, the underlying cause of these physical issues was entirely emotional. I had strong negative emotions that I was repressing, and once I acknowledged these feelings, actually allowed myself to feel them, and worked through the underlying issues, the physical pain/symptoms dissipated. When my sciatica starts to return, it’s a signal to me that I’m not tending to my emotional needs and something in my life needs to be addressed. Sarno and other doctors contend that there are many medical conditions caused by TMS (such as musculoskeletal issues, chronic pain, fibromyalgia, CFS, digestive issues, etc.) and those who are Type A, conscientious, perfectionistic types are most susceptible.

    • Negative emotions, psychological and even spiritual issues would be included in the “exposome + epigenetics + genetics” area. These are core things like diet, lifestyle, and other internal and external influences that interact with the genome/epigenome and give rise to the 8 pathologies. You can also think of the pathologies as mechanisms. They are the physical manifestations/consequences of imbalances in diet, lifestyle, emotions, etc.

  17. I (and probably lots of other folks) would be grateful for some specific advice for those of us who have genetic cholesterol problems.

    The transcripts of your conversations with Chris Masterjohn seem to indicate that those with familial hypercholesterolemia might actually benefit from taking statins, but that isn’t something I’m currently willing to do.

    • Chris,

      Sorry to seem like a nag, but I see that you just posted some responses.

      I have been getting conflicting advice regarding my cholesterol issue, even from the functional medicine doctor that I am seeing.

      I really respect the your opinion and the work you do, so if you have time for even a very brief response of any sort, I’d be so grateful.

      Thank you.

      • Yes, some of the data suggest statins may be beneficial in people with FH. But there are likely other options that, when added together, may have a similar impact in reducing heart attack risk. It’s far too much to cover in a comment, or even a series of blog posts (though I have reviewed the basics in my “diet-heart myth” eBook, which is free). The High Cholesterol Action Plan digital course I created goes into a lot of depth on this.

        • Chris,

          Thank you so much for taking the time to respond. I did read the diet-heart myth e-book. I’m going to look for the course you mentioned.


  18. I think Amy’s question is the biggest challenge most of us face. Unable to work because of these health issues, so unable to get to the root of the problem because we have no money to fund the tests/labs/dr appts./supplements/special diet. It has created a vicious cycle of debt for me. Which has brought on more stress in an already stressful situation. Nobody has ever addressed this issue in the3years I’ve been around this community. Its like it’s no big deal…only $500 for an mthfr test. I wanna scream…PEOPLE!! I’VE BEEN OUT OF WORK FOR 2 YEARS!! Lol. I don’t expect charity, but there has to be another/better way.

    • Five hundred dollars for an MTHFR test is some of the worst of FM or integrative med, when you can get your genome direct-to-consumer with some 750,000 SNPs for $99 from 23andme.com, which includes the key SNPs on the MTHFR gene. Then you can opt run your genome thru independent specialized programs for nominal prices for more info if you want.

      Most FM testing is like other shopping challenges — you have to learn the best places to get things, and what time of year to get them on sale in some cases. The people selling an item for high dollar aren’t going to educate you on that.

  19. I am a practitioner. I think it is so important to find the “root” cause for sure BUT it can be very expensive for patients. What happens if a patient needs help and cant afford functional medicine to find the “root”….? Sure they can eat paleo and do what they can but if the root is an infection they need help finding that and treating that….Supplements and tests for functional medicine are very expensive. Any thoughts on this. thanks

    • I wish I had a good answer for that, but I don’t. The tests and supplements are definitely expensive, and unfortunately not often covered by insurance. We need to continue to work toward broader acceptance of functional medicine in the reimbursement model—and initiatives like the Cleveland Clinic Center for Functional Medicine are a step in that direction.

      • I also struggle with this. Living in New Zealand, it is extremely difficult to find functional medicine practitioners. The tests are even more expensive here because they often have to be shipped to Australia or the USA for analysis.

        I know that functional practitioners are in high demand and not necessarily subsidized by the health care/insurance system in any way, but I still don’t understand why $750-$950 is a reasonable fee to ask for a consult. Unfortunately, functional practitioners themselves are also often prohibitively expensive, in addition to the expenses of running all the tests themselves.

        I hear a lot of practitioners banging on about changing the system, while limiting their own patients to ‘haves’ because the ‘have nots’ will never even get a look in!

        • Hi Sarah,
          I have been consulting with a naturopath via Skype (he’s more than 600km from my home) with excellent results – I had an organic acids test done in Victoria (just posted the urine sample to them in kit supplied) which revealed some amazing info about my health, which I have been able to act on with equally amazing outcomes
          If you search http://www.planetnaturopath.com/ you will find his website

      • Hey Chris,
        While searching for an insurance plan to help with the testing costs I found mygreensurance. It’s a coop that supports 100% for functional medicine. It’s the first of it’s kind and I was very excited to find it. It’s cheaper than a conventional PPO for a family. I think this would be the answer you guys are looking for as well to help support the cost of these tests. A few features of the plan: Allows you to really choose any doctor / alternative practitioner anywhere in the world, monthly premium is 200/m for a normally healthy single person, is open to anyone in the us living in any state. The yearly “deductible”/ donation for a single person is 500$. This works out a whole lot cheaper for me than conventional health plan.

  20. Chris, I am a licensed acupuncturist in CA. Will CEUs be available for CA LAcs? Thanks!

    • I’m not sure yet. I would like to be able to offer that, but it’s somewhat difficult to get set up. If not the first year, hopefully the second and thereafter.