Do doctors treat the root causes of diseases or do they only treat the symptoms?

A common accusation has long been repeated in public discussions, social media posts, and some circles of so-called “alternative medicine,” namely that doctors do not treat the root causes of diseases, but merely suppress the symptoms.

This idea seems appealing and simple, and partly reflects the frustration of patients, especially those with chronic illnesses. But is it true? To answer seriously, we must move beyond slogans and ask a more precise question: What are root causes in medicine? And how does modern medical practice actually work?

misleading duality

The claim that medicine is forced to choose between treating symptoms or treating the causes presents a false dichotomy. In reality, clinical medicine operates on several levels simultaneously: alleviating suffering, preventing complications, reversing disease mechanisms when possible, and modifying long-term risk factors.

Treating symptoms is neither a moral failing nor an intellectual shortcut. Pain relief, fever reduction, and symptom control can often be life-saving interventions. Shock, asthma attacks, severe infections, diabetic ketoacidosis, and heart failure do not allow for the luxury of philosophical debate about the “main cause of the disease.” The priority is always immediate stabilization, but medicine does not stop there.

When does medicine directly treat the underlying cause?

In many cases, modern medicine targets the causes of disease with high precision:

1.  Bacterial infections are treated with antibiotics that eliminate the causative agent.
2.  Hormonal diseases such as hypothyroidism are treated by replacing the missing hormone.
3.  Vitamin deficiencies are corrected by replenishing the body with the missing elements.
4.  Autoimmune diseases are treated by modifying the mechanisms of the immune system responsible for causing the damage.
5.  Cancers are treated by targeting tumor cells with surgery, chemotherapy, radiation, immunotherapy, or targeted therapies.

Describing these interventions as “treating symptoms only” is inaccurate; they intervene at the core of biology, not its superficial manifestations.

Chronic diseases: a source of confusion

This accusation escalates when it comes to chronic diseases such as diabetes, high blood pressure, obesity, cardiovascular diseases, autoimmune disorders, and many psychological disorders.

Critics argue that doctors prescribe lifelong medication without addressing the underlying cause of the illness, but this criticism overlooks a fundamental truth: many chronic diseases do not have a single, simple, eradicable cause. They arise from a complex interplay of:

1.  Genetic factors.
2.  Early life exposures.
3. Lifestyles.
4. Social and economic conditions.
5. Aging.
6. Environmental factors.

In such cases, medicine does not ignore the causes, but rather deals with processes that are not entirely or partially reversible. Lowering blood pressure does not cure high blood pressure, but it prevents strokes, kidney failure, and premature death. Controlling blood sugar does not eliminate diabetes, but it protects vision, the heart, nerves, and human life. This is not superficial medicine, but rather practical medicine based on scientific evidence.

Doctors treat the causes within the limits of reality.

Medicine is not practiced in a theoretical vacuum or in an ideal world where diseases are reduced to a single cause that can be easily eradicated. The pathological cause is not always clear, nor is it eradicable, nor does it all fall within the authority of the doctor or his tools.

Therefore, the serious question is not whether doctors treat the causes or not, but rather the extent to which these causes are amenable to medical intervention within the conditions of biological, social and human reality.

There are diseases that remain intractable to medicine to this day, either because their pathological mechanisms have not yet been fully understood, or because their scientific understanding has not yet been translated into effective treatment.

This does not reflect a failure of medicine as much as it reflects the limits of knowledge at a particular historical moment. Medicine is not a complete system, but a science in constant evolution, where the scope of understanding expands and treatment possibilities change with the advancement of scientific research. Within these limits, doctors treat the causes through:

1.  Modifying risk factors (quitting smoking, weight control, blood pressure control).
2. Preventive medicine (vaccination, proactive screening, early detection).
3. Lifestyle guidelines (nutrition, physical activity, sleep).
4. Public health interventions (sanitation, food safety, infectious disease control)

The obstacle is not ignorance, but rather the applicability, patient commitment, time constraints, and social structures that medicine alone cannot fix.

A doctor can explain the role of ultra-processed food, stress, or lack of exercise, but they cannot redesign cities, income distribution, or food systems.
The romantic illusion of “root cause medicine.”

The promise that every disease has a single hidden cause, and that if it is removed the body returns to perfect health, is an attractive promise, but it is mostly mythical. It reduces biology to an investigation story with an elegant ending, while human physiology is much more complex.

Ironically, those who accuse doctors of only treating symptoms often offer explanations:

1. Mysterious (toxicity, inflammation, dysfunction)
2. Not amenable to scientific testing.
3. Not supported by real clinical results.

Treating a supposed underlying cause might seem intellectually elevated, but medicine is judged by results, not narratives, and the real problem isn’t the doctors, it’s the expectations. The existing tension stems less from medical practice itself and more from public expectations.

Patients want certainty, a cure, and simple explanations, while medicine offers probabilities, risk reduction, and imperfect control. When doctors treat symptoms, it is because suffering matters. When the causes are specific and modifiable, they treat them as well. When neither is possible, they aim to prevent deterioration. This is not a failure of medicine, but a sincere response to the complexity of biology.

In conclusion, doctors don’t choose between treating symptoms and treating causes; they consistently do both, often simultaneously. The real discussion shouldn’t be accusatory, but realistic: What can medicine change? What can it manage? And what lies beyond the clinic? A healthy, mature dialogue begins when we stop demanding miracles from medicine and start understanding it for what it truly is.