Stop patching the symptoms and fix the root cause

I have a belief that much of the thinking we apply to our personal lives and even humanity as a whole is leading us astray to the wrong causes.

One of the most common area I see this type of thinking applied is in health and nutrition. Since the human body is a complex system that has thousands of environmental inputs we have a hard time determining what is the cause when things go wrong.

Root causes of chronic disease

Infectious diseases like Polio or Tuberculosis were the easy part. For infectious diseases where our immune system responds, we came up with vaccines to trigger enough of a response in our body to never get sick when we come across the disease. For bacterial infections like Tuberculosis we invented Penicillin to fight off the bacteria in our body. Easy as that. But most of us today die from “chronic diseases” like Alzheimer, Diabetes, Heart disease and Cancer.

How did humanity approach these diseases? By trying to correlate the symptoms of the disease with possible root causes, without truly understanding the underlying mechanisms. And that is where things went wrong.

In his fantastic book Tripping over the Truth, Travis Christofferson gives a history of cancer from its early discovery through all frustrating attempts to understand and fix it. In short, three possible theories on the origins of cancer exist: the Chromosome theory, the virus theory and the metabolic theory. The chromosome and virus theory later converged to the generally accepted notion that Cancer is a genetic disease.

As researches found mutations in the DNA of cancer cells that might explain some behavior that those cells expressed, they not only linked the two. They determined that mutations in the genome must be the root cause of the disease. That send humanity down a disappointing research journey that resulted in… well almost no progress.

Most of the real markers of cancer treatment did not really improve from when they first treatments started in mid 20th century. Chemotherapy and radiation, the most common treatments for cancer, are essentially a nuke option destroying not only cancer but also healthy cells. Cancer treatments became exponentially expensive, but often they only delivered on vanity metrics like reduction in tumor growth instead of the one thing that counts: survival rate.

The other approach to cancer, the metabolic one, was pursued by a German scientist called Otto Heinrich Warburg. He observed that cancer cells prefer glucose as an energy source, even when oxygen is present in the cell. They used an energy pathway to ferment that glucose. In itself, this observation was just that, an observation. There was no underlying theory and it did not explain by itself how cancer cells proliferated.

A small community of scientists revived the Warburg observation and Thomas Seyfried finally developed a coherent theory around cancer as a metabolic disease that could be proven.

This theory shows that gene mutations are not really a root cause, but a side effect. As Seyfried puts it: “…, the gene mutations observed in various cancers and all other recognized cancer hallmarks are considered downstream effects, and not causes, of the initial disturbance of cellular energy metabolism.”¹

A very simplified causal chain of the genetic theory of cancer would look something like this:

The metabolic theory identifies gene mutations as a mere side effect instead of the root cause:

Think about the implications this has. A crude analogy would be if you tank your car over time with the wrong fuel. Your motor will start to give off strange sounds. You will have engine damage over time. And your car might not start right away. You can go to a mechanic and explain these issues. But until you clean out your tank and start tanking the right fuel you won’t resolve the issue.

Many of you will not believe in this new metabolic theory. It seems impossible that some of the smartest researchers in the world have been studying cancer for a century and most of them went down a dead end. But in complex fields it is easy to get convinced by early correlations that you might have found the cause of something.

Health and nutrition is an infinitely complex topic and I will discuss some faulty causal chains in that space in a separate post. But how do you make sure you don’t introduce faulty reasoning in your life when trying to make a decision or researching a problem?

How can you improve your thinking around root causes?

You can find many writings about techniques like the root cause analysis and the Five Whys online. This blog post on proximate and root causes by Farnam Street is a great practical introduction on how to improve your thinking.

A great way to think about root causes is to think in first principles. I explained in an earlier blog post how Elon Musk uses this technique to make significant changes in stagnant industries. Dig deep into why things are the way they are until you arrive at universal truths.