"Never Been Well Since": Tracing the Root Cause

30 Mar

By Joana Amram — Registered Nutritional Therapist (ANP/APENB), CNM London
Gut health & root-cause work · Lisbon & online · joana-amram.com

"I've never really been well since…" It's one of the most common things I hear. Since a holiday illness. Since a course of antibiotics. Since a stressful, burnt-out year. Since a surgery. If you can point to a moment when your health shifted and never quite returned, that memory isn't trivia — it's often the single most useful clue you have.

Why the turning point matters

Conventional care tends to look at symptoms as they are now, in isolation. But chronic symptoms usually have a story — a point where the body's balance was tipped and never fully reset. Identifying that turning point doesn't just explain how you got here; it often points directly at what needs addressing.

Common "never been well since" triggers

Certain events come up again and again: a gut infection or food poisoning (a well-documented trigger for lasting digestive issues — see SIBO vs IBS), a course or several courses of antibiotics that reshaped the microbiome, a prolonged period of intense stress or burnout, a major hormonal shift, surgery or illness, or an environmental exposure such as mould. Any of these can tip a system that then struggles to find its way back.

Why symptoms persist long after the trigger is gone

This is the part that confuses people: the original event is long over, so why are the symptoms still here? Because the trigger often set off changes that became self-sustaining — a shifted microbiome, altered gut motility, a more permeable gut barrier, a dysregulated nervous system, or low-grade inflammation. The initial cause may be gone, but the consequences keep running. Addressing the symptom alone doesn't switch them off.

Why this matters for getting better

When you treat each symptom separately — something for the bloating, something for the fatigue, something for the skin — you can end up managing a long list without ever addressing what connects them. Tracing back to the turning point reframes the whole picture: not a dozen unrelated problems, but one story with a beginning.

How a root-cause approach works

This means taking a proper history: when things changed, what was happening in your life, what came before the symptoms — and then looking at what's still being driven by that original event. It's detailed, individual work, done alongside your doctor. The goal isn't to manage symptoms indefinitely; it's to understand and address why your body hasn't reset.

If you can name when your health changed, that's the place to start. Let's trace it together — no cost, no obligation.
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You can read more about how I work with complex cases on my services page.

This article is for educational purposes and is not medical advice. Always work with your doctor for diagnosis and before making changes to your care.

Frequently asked questions

Why do my symptoms persist long after the event that started them?
A trigger can set off self-sustaining changes — in the microbiome, gut barrier, motility or nervous system. The original cause may be gone, but its consequences keep running until they're addressed.

What kinds of events commonly start chronic symptoms?
Gut infections, courses of antibiotics, prolonged stress, hormonal shifts, surgery, and environmental exposures are all common turning points people can identify.

Why does identifying the root cause help?
It reframes scattered symptoms as one connected story, which often points directly at what needs supporting — rather than managing each symptom in isolation.

Can I work with you online if I'm not in Lisbon?
Yes. I support clients online in English, Portuguese, Spanish and French, as well as in person in Lisbon and Estoril.

Let's find your root cause

Ammar Health