7 Root Causes of Chronic Disease with Dr. Richard Harris
Dr. Richard Harris is a physician, pharmacist, and MBA who practices functional medicine in Houston, TX and also works in urgent care a few times per month. Aside from this, he has an educational consulting business and is ultimately here to help you be your best self.
When you see a holistic medicine provider, they’re going to dig deep to find the root cause of your issue. In this interview with Dr. Harris, he’ll unpack the seven root causes of all disease, the symptoms and causes of each, and how you can counteract them to become a healthier you. Make sure to listen to the full video interview for all of the details!
The Root Causes of Disease
This is simply an imbalance of the gut microbial community thought to contribute to a range of health issues. This may cause a disturbance in digestion, immune surveillance, and signaling within the gut. In fact, our gut can sense viral infections and signal the body to deal with the issue. However, when you have dysbiosis, this signaling process is affected. Symptoms of this may include:
Constipation and bloating
Rash (the skin is our largest organ!)
Anxiety and depression (due to inflammation)
In fact, there are some diseases and conditions that researchers have linked to dysbiosis. These include diabetes, obesity, Alzheimer’s, irritable bowel disease and syndrome (IDB and IBS), eczema, asthma, and even colon cancer. Causes of dysbiosis that your functional medicine doctor may address include:
Poor dental hygiene
Excessive alcohol use
We discuss so much of this in everything we teach as well, and you’ll see a common theme as you read through this article. For example, if you’re eating fast food all the time, you’re going to have gut bacteria that love and crave fast food. On the flip side, if you eat a lot of broccoli (like Dr. Jenna does), your gut bacteria will crave broccoli. In regards to stress, this is a big one for women because women tend to be more sensitive to stress. If you’ve used antibiotics, especially oral antibiotics, this will also destroy your gut flora and it will take at least six months for your gut to recover. So many dry eye patients are taking doxycycline or similar antibiotics for their meibomian gland issues, and this is a big problem. This is only going to increase gut dysbiosis.
A comprehensive stool exam can be performed to compare the different populations of bacteria you have in your gut to what normal should be. Maybe you have a deficiency in some strains, or maybe you have an overabundance of others. Some bacteria strains are known to be pro-inflammatory and can cause further issues for you. This test really allows your doctor to examine your gut in detail and suggest possible treatments for you.
Treatment for dysbiosis will depend on your gut flora, but usually includes pharmaceutical options, probiotics and prebiotics, and other natural agents that work against harmful gut bacteria. A whole food nutrition plan will likely also be implemented including fermented foods (sauerkraut, kombucha, kimchi), a decrease in alcohol consumption, and the use of intermittent fasting. If stress is a cause, you’ll want to begin a meditation or mindfulness practice, make sure to exercise, and get enough sleep.
Toxins can be either natural or synthetic substances that cause harm to the body when present in specific concentrations. These are very dose dependent in most cases. However, some toxins may not have a straight dose response. Some are able to disrupt our normal body systems at very low doses.
Symptoms of toxicity may be different for everyone depending on the offending agent. Here are a few common issues:
Common sources of toxins include plastics (especially BPA and BPS), phthalates, PFOAs in cookware (such as Teflon or non-stick coatings), and processed foods (likely the number one source of toxins in America). To combat this, purchase a reusable metal or glass water bottle and refill it throughout the day with filtered water. Stop buying plastic water bottles and purchase a Big Berkey or other water filtration system instead. Store your food in glass instead of plastic, and choose stainless steel or cast iron pans for cooking.
Other sources of toxins include air pollution, cosmetics, tap water, cleaning products, and glyphosate (Roundup) fertilizer and herbicides. Diagnosis of a toxin issue involves a detailed lifestyle assessment, heavy metal assays, blood and urine testing, and possibly genetic testing to see if you have difficulty with detoxification.
Treatments for toxin issues will include removal of the toxins and changing lifestyle factors to more align with a toxin-free lifestyle. Also, consuming natural chelators and detoxifiers such as cruciferous vegetables (cauliflower, broccoli), cilantro, garlic, spirulina, and fibrous foods can also be very helpful. In addition to these lifestyle factors, some doctors may prescribe chelation therapy for heavy metals or recommend supplements to help with detoxification.
Hormone dysregulation is an issue for so many, and this is an imbalance of one or more hormones which contributes to disease or illness. Commonly affected hormones include cortisol, insulin, sex hormones (estrogen, progesterone, and testosterone), thyroid hormones, and vitamin D.
Although these hormones are all necessary for survival, an imbalance in them can be problematic. Cortisol, for example, is necessary and works great acutely. However, a chronic increase in cortisol can contribute to inflammation. These hormones have multiple different effects in the body, and they can cause a variety of symptoms depending on the hormone affected. These may include:
Loss of sex drive
Some of the common diseases associated with hormone dysfunction include diabetes, Alzheimer’s, infertility, autoimmune disease, and cancer.
The number one cause of hormone dysregulation is lifestyle. Often, you’re not getting enough sleep, nutrition is poor, stress is high, or you’re lacking exercise. Toxins, obesity, inflammation, and dysbiosis can also contribute to hormone issues. As you can see, many of the seven root causes we’re discussing can contribute to other root causes.
Diagnosis of hormone dysregulation is done through blood and urine testing. Functional medicine doctors will look at a much more complex panel of blood work than your general practitioner. They will look into all of the different enzymes, precursors, and hormones in your body. Estrogen metabolism is also important to look into because there are different types of estrogen that are better than others.
Treatment for hormone dysregulation often involves a stepwise approach. First, nutrition, exercise, sleep, and stress need to be regulated and optimized. Substances like cholesterol are so incredibly important for a properly functioning body, and if you’re avoiding cholesterol or taking a statin, this can be problematic for many of the systems in your body. Supplements may be added if lifestyle factors aren’t enough. These may include adaptogens, berberine, zinc, magnesium and others. Hormone replacement therapy is the last step in this process. This is usually the first step in the conventional medicine process, but the root cause truly needs to be addressed first.
This is the root cause of all root causes. This is a prolonged and abnormal immune system activation that results in maladaptive changes within the body. Symptoms of inflammation may vary from person to person, but they may include the following:
Acute inflammation can be a good thing. You want this during times when your body needs immediate attention (such as when you break your arm). With chronic inflammation, there is damage being done by the immune system even when there is nothing to be repaired. This continues to break down and dysregulate the body.
Inflammation can lead to any disease within the body, the most common being autoimmune issues, fibromyalgia, Alzheimer’s, diabetes, and cardiovascular disease. However, it can really lead to anything and this is where dry eye disease comes in.
Causes of inflammation that your functional medicine doctor may address include:
Data shows that 65-70% of our caloric intake in this country is processed foods. These are not true foods! They are devoid in nutrients and incredibly inflammatory. Sleep, stress, and other lifestyle factors can all play a role here as well.
Molecular mimicry, which you may not have heard of, is due to infections. We make antibodies to different particles on a virus or bacteria, but some of these look so much like our own cells that our immune system will begin to attack itself. Even after an infection is “finished”, you could still be suffering from molecular mimicry. This may be common in those with autoimmune conditions, Lyme disease, and multiple sclerosis.
Diagnosis of this root cause will include extensive blood work. Homocysteine, ESR, CRP, zinc/copper, ferritin, albumin, and the thyroid and sex hormones should all be evaluated. These markers help your doctor assess how the systems of your body are functioning as they relate to hormone levels and important minerals.
There is no one thing you can do to fight inflammation, so treatment is a multimodal approach. The following will all likely be addressed:
Meditation and mindfulness
Intermittent Fasting or time-restricted eating
Pulsed electromagnetic field (PEMF)
Great anti-inflammatory supplements include turmeric, sulforaphane, ketones, resveratrol, and melatonin.
Genetics can play a huge role in disease, because some of them may outright cause disease (such as in the case of cystic fibrosis and sickle cell disease). However, nature essentially loads the gun, but nurture pulls the trigger. This is epigenetics and means that you have a certain genetic makeup that may predispose you to certain diseases, but this does not mean that you will get that disease. How you live your life is so important because you cannot currently change your genetic code. A classic example includes APOE4, which predisposes you to Alzheimer’s disease. If you also have diabetes, cardiovascular disease and are obese, your risk greatly increases. However, if you avoid these conditions by living a healthy lifestyle, you mitigate that risk. Methylation is another great example.
Obviously, you get your genes from mom and dad, but epigenetics is on you. This is how you interact with your environment and is entirely within your control. One thing you’ll see a lot of in the news is telomeres. These are the end caps of genes, and you can examine these to see their length. This is one of the ways we determine biological age. Over time, they shorten but will shorten faster or slower based on how you live your life. This is a prime example of epigenetics and how what we do interacts with our DNA.
Genetic testing will be performed if this root cause is suspected, and it can be helpful in guiding treatment. As with the other root causes, treatment is going to be geared toward lifestyle factors. Nutrition, sleep and stress management, exercise, and avoiding toxins are all changes that you’ll be prescribed. Supplements used should be helpful for protecting DNA or changing the way your genes express themselves. Helpful ones include antioxidant vitamins A, C, and E, vitamin D, B vitamins and folate, resveratrol and others. Supplement recommendations will be based on the specific genetic issue you have.
You shouldn’t be surprised to see stress on this list, as it’s been a common theme throughout all of the root causes. Stress occurs due to a perceived threat that causes a physiologic response in defense. There are two forms of stress; mental and oxidative. When you’re mentally stressed out, your body undergoes the same fight or flight response that causes hormone changes. Oxidative stress is simply an imbalance between free radicals and antioxidants in the body. Symptoms of stress may include any of the following:
If you have cortisol excess: brain fog, elevated blood sugar, obesity, skin rashes, infections, mood swings
If you have cortisol deficiency: lethargy, muscle loss, mood changes
If you’re suffering from oxidative stress: this will depend on the organ system affected
So, what causes stress? Poor nutrition can cause stress because your body isn’t getting the correct nutrients to function properly. Smoking, other toxins, genetics, and life in general can all contribute to stress.
Diagnosis comes through discussion with the patient and hormonal testing. Adrenal stress tests and oxidative stress tests can be performed to determine the levels of stress in your body. Treatments to deal with stress include many of the same things mentioned previously. Nutrition, mindfulness, and sleep all come into play. However, be careful with intermittent fasting and exercise if you’re undergoing a lot of stress. These things are positive stressors but can overload you and make the problem worse. It’s better to get stress under control with the other lifestyle factors before introducing these. Antioxidants and other supplements may be used as well.
7. Nutrient Deficiencies
Did you know that 33 million people suffer from nutrient deficiencies in the United States alone? That’s 10% of the population! Our nutrition plans usually include a lot of calories but food that is devoid of nutrients. Aside from poor nutrition in general, other contributors include soil mineral depletion, toxins and medications, chronic medical conditions, dysbiosis and genetic factors. Many of these things cause damage in the body and lead to your system chewing up all of the nutrients you have available.
Medications that cause nutrient deficiencies may include all of the following (and we’ve included which nutrients they affect):
Birth control - This is arguably the most tragic, and it depletes B6, folate, and magnesium
Acid blockers - B12, magnesium, iron, vitamin D
Anticonvulsants - Vitamin D
Benzodiazepines - Calcium
ACE inhibitors - Zinc
CCB - Calcium
Statins - CoQ10, fat soluble vitamins
Metformin - B12, folate
In many of these cases, patients will need multivitamin supplementation to counteract the effects. The most common deficiencies seen by your doctor are iron, iodine, vitamins A, D, and K, B12, calcium, magnesium, omega-3 fatty acids and potassium. Certain nutrition plans are more likely to cause deficiencies, including veganism, ketogenic and carnivorous diets. The narrower the choice of foods you’re eating, the greater the likelihood of experiencing a nutrient deficiency. This isn’t to say that you should change what you’re doing, but it is something to be aware of.
As you can see, Dr. Harris is incredibly knowledgeable on this topic. Even more than functional medicine, he emphasizes that he practices lifestyle medicine. This is because if you’re not making the correct lifestyle choices, you’ll never solve the issue like you want it to be solved.
Dr. Richard Harris is a board-certified internal medicine physician and pharmacist. Dr. Harris attended the University of Texas at Austin for pharmacy school then pursued medical education at the McGovern School of Medicine in Houston. Dr. Harris is a lifelong learner and completed his MBA at the University of Houston. Dr. Harris has a client-centric view focusing on building relationships and trust through a comprehensive lifestyle medicine system combined with genetic and micronutrient testing. He currently runs an online health and wellness practice, is a partner in an education consulting firm, and consults/advises for several companies. In his spare time, he is an avid reader, weight lifter, video game enthusiast, and author. Dr. Harris also enjoys sports, traveling, philanthropy, church, and keto donuts.