Ten places to look, in the right order.
Most families arrive having been checked for one thing at a time. A test for this, a specialist for that, each looking down their own corridor. What gets missed is the way the corridors connect.
We start somewhere else. Before anything is treated, we map ten root causes — the ten places a chronic problem tends to come from. Then we treat the heaviest one first, and watch what moves.
The ten root causes
Every family gets the whole map. Almost nobody has all ten. The list below is sized by how often each tends to be part of the picture in our practice — a map to start from, not a diagnosis.
Infection
Lyme and the infections that travel with it, Epstein-Barr, strep, PANS and PANDAS, mycoplasma, parasites, viruses that never fully cleared. This is the largest single piece of the picture in our practice, and the one most often missed once the first round of tests comes back clean.
Nutrition
Real, measurable shortfalls: vitamin D, B12, iron, magnesium, zinc. Not a supplement philosophy. A blood test, a number that is too low, and a plan to bring it up.
Gut
The lining, the microbiome, bacterial overgrowth, reflux, digestion that stopped working.
Environmental
Mold and the toxins it produces, heavy metals, pesticides, water damage at home or school. A child can do everything right and still be spending eight hours a night in the thing making them sick.
Medication
What long-term prescriptions deplete, and what they leave behind. Often nobody has looked at the whole list in one place — including the things stopped years ago.
Lifestyle
Sleep, movement, food, stress, screens. Ordinary, and the reason it works: these are the levers a family can actually pull between visits.
Mind & Mood
Anxiety, depression, obsessive thoughts, the weight of being unwell for a long time. Sometimes this is a cause. Sometimes it’s a consequence. Usually it’s both, and it still needs treating.
Genetics
Variations like MTHFR and COMT, and what runs in the family. Genes are not a verdict — they tell us which pathways need more support than most.
Hormones
Thyroid, cortisol, adrenal function, puberty. Slow to move and easy to overlook, and when it’s the answer, very little else works until it’s addressed.
Substance
Alcohol, cannabis, vaping. Asked plainly, without judgment, because it changes what we prescribe.
Heaviest first.
Once the map is drawn, we don’t work down it alphabetically. We work in the order that gives you the most back, soonest.
That order is different for every family. For one child it’s the mold in a bedroom. For another it’s an infection that has been quietly running for three years. Your practitioner decides the sequence from what the testing shows, and revisits it every cycle.
“Diagnose, sequence, then act.”
Six weeks at a time.
Map
Before the first visit, we read everything you’ve already been through, so the visit isn’t spent repeating it.
Test
We order what’s needed to turn suspicion into a number.
Treat the heaviest thing
One or two root causes per cycle — not ten at once, which is how families end up on twenty supplements and no clearer.
Re-test and adjust
What moved, what didn’t, what’s next.
Then again. This is the part that takes time.
Real progress, not a quick fix.
We don’t promise to make a diagnosis disappear. We measure something more useful: whether your child is living a fuller life than they were.
At the first visit we agree on the three things that would change your family’s life most — in your words, not ours. Sleeping through the night. Getting through a school week. Eating without pain. Those three become the measure everyone here works to.
A marker on a test can stay stubborn while a child gets most of their life back. We’d rather have the life.