Root Cause Care: Real Life Examples
Erica Armstrong, MD, FMCP-M
|
Aug 13, 2026
Member #3:
He was told diet wouldn’t help
This member had tried blood pressure medication and had side effects. When he raised diet questions with his PCP, he was told that diet was unlikely to move his numbers meaningfully. Due to the difference in philosophy, he declined further follow-up with his PCP.
Unfortunately, this outcome is common when primary care is not equipped to handle nutrition advice. He was a person who had concluded that the visits were not producing anything he could use.
He started with Root instead and stayed. Within months, he had lost weight through changes to his diet, and his blood pressure had moved from the low 150s over the mid-80s into the low 130s over the low 70s.
Two other things surfaced along the way. He completed colorectal cancer screening, and precancerous polyps were found and removed. His ferritin, which had been low, has roughly doubled into the normal range.
The impact:
What changed that was finding a care team who took his question seriously and could answer it with a plan. Nutrition is first-line therapy for hypertension in the guidelines, and he had been told it would not work for him.
Once he was engaged, the rest followed. His low ferritin came out of a comprehensive workup rather than a targeted test. He agreed to colorectal cancer screening he had been avoiding because he had a clear reason for why it was needed (low ferritin), and the polyps that were found and removed took a meaningful amount of future risk off the table.
Member #4:
Referred by a holistic PCP
A member came to Root with rheumatoid arthritis, on Enbrel and methotrexate. Enbrel alone carries a list price around $8,000 per month. She had seen a PCP, gastroenterology, neurology, and dermatology. Her symptoms persisted.
Her concerns when she reached us: constipation, bloating, fluid retention, waking at 3 AM, joint pain, neuropathy, hypothyroidism, and chronic fatigue. She was also perimenopausal. No one had addressed her hormones.
She was referred to Root by her own PCP — a physician her community regards as holistic and integrative. That referral came after she had also been seeing a separate functional medicine provider once a year, with no noticeable change.
Our approach addressed the physical and the behavioral together:
- Removing inflammatory foods, with coaching through the transition rather than a handout
- Personalized microbiome testing and a targeted gut healing protocol
- Low Dose Naltrexone to support autoimmune remission
- Optimizing her thyroid hormone replacement
- Balancing estrogen and progesterone with HRT
Within six months she was off both Enbrel and methotrexate, and her RA is in clinical remission. She also avoided the additional GLP-1 medication her rheumatologist had proposed adding. She lost the weight without it, by addressing the root causes of inflammation.
The impact:
Her PCP is functionally trained by reputation and genuinely wanted to help. She referred out because her practice model could not deliver this. And the separate functional medicine provider she had been seeing annually did not move anything either, which points to the inconsistency across functional medicine practices outside of Root.
Functional medicine is not a label that produces results. The results come from core Root clinical processes, the visit length, the retesting intervals, the contact between visits, and a physician who does this work all day and has seen this pattern before. Run it once a year and it does not work, no matter what you call it.
What these have in common
These four members already had a primary care physician. Two had an on-site clinic available to them. The care they were receiving was appropriate to the models delivering it.
What they were missing was a layer built for reversal: enough visit time to reconcile a medication list, enough contact to run a nutrition intervention through to an A1c result, enough clinical depth to catch a Hashimoto's diagnosis that had been sitting in plain sight, and enough trust to bring someone back who had written off the system.
That layer is what employers are buying when they add Root. It sits alongside primary care rather than replacing it — and, as the fourth case shows, sometimes primary care is the one making the referral.
Clinical details shared with permission and/or have been generalized to protect member privacy. Root has thousands of cases similar to the cases noted here. Individual results vary; these cases are illustrative and are not a guarantee of outcome.
Reference:
Bell K, Parasuraman S, Raju A, Shah M, Graham J, Denno M. Resource utilization and costs associated with using insulin therapy within a newly diagnosed type 2 diabetes mellitus population. J Manag Care Spec Pharm. 2015;21(3):220-228. doi:10.18553/jmcp.2015.21.3.220
Reference:
Bell K, Parasuraman S, Raju A, Shah M, Graham J, Denno M. Resource utilization and costs associated with using insulin therapy within a newly diagnosed type 2 diabetes mellitus population. J Manag Care Spec Pharm. 2015;21(3):220-228. doi:10.18553/jmcp.2015.21.3.220