The 5M Framework
A systematic approach to identifying the root causes of chronic illness
The framework
Chronic illness is rarely a single problem. It sits at the intersection of what you've been exposed to and how your body is responding.
The 5M Framework maps both sides — three exposures and two response systems — so we can identify the layers driving symptoms instead of chasing them one at a time.
Hover any driver to see its symptoms · click to learn more.
Part 1 · The Exposures
What's coming in from the environment
Three external drivers we identify and address first.
Metals
Lead, mercury, arsenic, and cadmium accumulate in tissue over years — through contaminated water, dental amalgams, occupational exposure, and ambient pollution. They disrupt enzymes, damage mitochondria, and provoke chronic inflammation that mimics autoimmune, neurologic, and metabolic disease.
Testing: Urine heavy metal panels, provoked challenge testing, blood metal levels
Molds
Mycotoxins from water-damaged buildings activate the innate immune system and trigger Chronic Inflammatory Response Syndrome (CIRS). Roughly 25% of people carry HLA genotypes that block normal biotoxin clearance — so the inflammation persists long after the obvious mold is gone.
Testing: Mycotoxin urine panels, TGF-β, MMP-9, C3a, C4a, MSH, VIP, ERMI/HERTSMI environmental testing
Microbes
Tick-borne infections (Borrelia, Bartonella, Babesia, Ehrlichia), reactivated viruses (EBV, HHV-6), and persistent bacterial infections drive chronic immune activation. They're routinely missed by standard testing and can quietly fuel fatigue, pain, neurological symptoms, and immune dysregulation for years.
Testing: Specialized Lyme panels (IGeneX, Vibrant), co-infection titers, PCR testing
Part 2 · The Responses
How the body reacts
Two systems that become dysregulated under exposure — and where symptoms actually originate.
Mast Cells
Mast cells are immune sentinels. When they become hyperreactive in response to mold, metals, infections, foods, chemicals, or stress, they degranulate and flood the body with histamine and inflammatory mediators — producing unpredictable, multi-system symptoms that confound conventional diagnosis.
Testing: Serum tryptase, plasma histamine, prostaglandin D2, N-methylhistamine
Mitochondria
Mitochondria produce the ATP that powers every cell. When toxins, infections, or oxidative stress damage them, energy production falters — and systemic fatigue, exercise intolerance, and organ dysfunction follow. Mitochondrial dysfunction is usually downstream of the other four Ms: the body's response when exposures persist.
Testing: Organic acids testing (OAT), mitochondrial function panels, CoQ10 levels, lactate/pyruvate ratio
Matthew Everett, MD
We built the 5M Framework after years of treating patients whose complex symptoms were dismissed by conventional medicine. It ensures no common environmental trigger goes unexamined.
Not sure which M applies to you?
Our symptom assessment helps identify which environmental triggers may be driving your symptoms.