The Hidden Causes of Stroke: What Your Doctor Isn’t Testing For

by Dr. Kilcup | Dec 23, 2025 | Articles, Stroke

A medical diagram illustrating the functional medicine chain reaction trigger for strokes. It shows a glowing red 'Limbic Dysfunction (Trauma/Stress)' in the brain causing inflammation that travels to the gut, resulting in 'Leaky Gut & Inflammation.' Inflammatory particles escape the gut into a blood vessel, leading to plaque buildup and a 'Stroke Trigger' clot.

Introduction: The Question Nobody’s Asking

Let me be blunt: if you’ve had a stroke or you’re watching someone you love recover from one, you’ve probably been told it was “bad cholesterol,” “high blood pressure,” or “just getting older.” You’ve been handed pills. You’ve been told to “watch your diet.” And you’ve been sent home with the vague hope that lightning won’t strike twice.

Here’s the truth nobody’s telling you: that’s not good enough.

Because the hidden causes of stroke go far deeper than what shows up on a standard cholesterol panel. Strokes don’t just happen. They’re the final event in a chain reaction that’s been building for years—sometimes decades. And if you don’t identify what lit the fuse in the first place, you’re not preventing the next one. You’re just waiting for it.

Standard care focuses on managing stroke risk. We focus on resolving it. There’s a massive difference. Management means you’re stuck with the problem forever. Resolution means we find the hidden causes of stroke in YOUR body, we fix them, and we give your system the tools to heal itself.

Stay with me here, because what I’m about to show you changes everything about how you think about stroke prevention. And if you’re serious about understanding your hidden stroke risk factors and actually preventing a second stroke, this is the roadmap you’ve been missing.


Key Takeaways

  • The hidden causes of stroke include trauma, chronic stress, limbic dysfunction, and gut inflammation—not just high cholesterol
  • Your limbic system (the brain’s alarm center) can get stuck in “threat mode” after trauma, driving inflammation that damages blood vessels
  • Leaky gut isn’t just digestive—it’s one of the most overlooked hidden causes of stroke, allowing toxins that trigger vascular damage and clotting
  • Standard cholesterol panels miss 80% of the real risk—advanced testing reveals the hidden causes like ApoB particles, TMAO, hs-CRP, and toxic burden
  • You can work with a functional medicine doctor virtually to run the right tests and uncover YOUR hidden causes of stroke
  • HBOT and red light therapy accelerate healing—but only after we’ve identified and addressed the root causes
  • Don’t DIY this—random supplements without testing can make things worse

Estimated reading time: 18 minutes


The Hidden Causes of Stroke: Why Standard Care Misses the Real Triggers

Here’s what happens when a stroke occurs: a vessel in your brain either clots off or ruptures. That’s the event. But the cause of that event? That’s where things get interesting—and where conventional medicine completely drops the ball by missing the hidden causes of stroke.

Let me walk you through the chain reaction that nobody’s connecting for you.

Hidden Cause #1: The Trauma Connection

Trauma—whether it’s physical (car accident, concussion, surgery) or emotional (loss, chronic stress, PTSD)—is one of the most overlooked hidden causes of stroke. It doesn’t just “go away” because time passes. Your limbic system, the alarm center deep in your brain, is designed to keep you safe. But when trauma happens, especially repeated trauma or unresolved stress, that alarm system can get stuck in the “ON” position.

Think of it like a smoke detector that won’t stop beeping even after you’ve opened the windows. Your body is living in a constant state of threat, pumping out stress hormones (cortisol, adrenaline) 24/7. And here’s what nobody tells you: chronic stress hormones are inflammatory.

According to the CDC, chronic stress is a recognized stroke risk factor, but they treat it like it’s just about “relaxation techniques.” That’s not the full picture. When your limbic system is dysregulated, it’s not just stress—it’s a biochemical cascade that damages your blood vessels directly. This is one of the hidden causes of stroke that standard medicine completely ignores.

Hidden Cause #2: Inflammation Goes Systemic

Now your body is pumping out inflammatory molecules—cytokines, reactive oxygen species, all the markers that show up on tests like hs-CRP (high-sensitivity C-reactive protein). This inflammation doesn’t just float around harmlessly. It attacks the lining of your blood vessels (the endothelium).

Imagine your blood vessels are garden hoses. Inflammation is like sandpaper scraping the inside of those hoses, day after day. Eventually, the lining gets damaged. And when that happens, your body tries to “patch” the damage with cholesterol and calcium deposits. That’s what plaque is—it’s a repair attempt, not the original problem.

But wait, there’s more.

Hidden Cause #3: Leaky Gut Pours Fuel on the Fire

This is one of the biggest hidden causes of stroke that nobody talks about. Your gut lining is supposed to be a one-cell-thick security fence. It lets nutrients in and keeps toxins, bacteria, and undigested food particles out. But when you’ve got chronic stress, poor diet, medications (especially NSAIDs and antibiotics), or infections, that fence develops holes.

Now you’ve got “leaky gut,” and all those toxins and bacterial fragments (like lipopolysaccharide, or LPS) are slipping into your bloodstream. Your immune system sees them and goes into attack mode. More inflammation. More vascular damage. More plaque.

And here’s the kicker: your gut bacteria also produce a compound called TMAO (trimethylamine N-oxide) when they break down certain foods. Research published in the New England Journal of Medicine shows that elevated TMAO directly increases stroke and heart attack risk by promoting clot formation and accelerating plaque buildup.

Your doctor isn’t testing for TMAO. Or hs-CRP. Or ApoB particles (the cholesterol carriers that actually matter). They’re checking your total cholesterol and LDL and calling it a day. That’s like checking the oil in your car and declaring the engine is fine. Meanwhile, the hidden causes of stroke are building up unchecked.

Hidden Cause #4: Toxic Burden Nobody’s Measuring

Heavy metals, environmental toxins, pesticides, plastics—these accumulate in your body over decades. When your detox pathways (liver, kidneys, gut) can’t keep up, these toxins drive oxidative stress and vascular inflammation. This is another one of the hidden causes of stroke that won’t show up on standard testing.

The Perfect Storm

So now you’ve got:

  • A dysregulated limbic system driving chronic inflammation (hidden cause)
  • Damaged blood vessel linings from systemic inflammation (hidden cause)
  • Leaky gut feeding toxins into your bloodstream (hidden cause)
  • Gut bacteria producing clot-promoting compounds (hidden cause)
  • Toxic burden overwhelming your detox pathways (hidden cause)
  • Plaque building up in your arteries as a desperate repair attempt

And then one day, a clot forms. Or a vessel ruptures. Stroke.

This is NOT about “bad genes” or “bad luck.” These hidden causes of stroke can be identified and interrupted—but only if you know where to look.


Doug’s Story: What Happens When You Find the Hidden Causes

Let me tell you about Doug. You can read his full story here, but I want to highlight what made the difference for him.

Doug came to me after suffering a stroke. He’d been through the standard hospital protocol—imaging, medication adjustments, physical therapy. He was functional, but he wasn’t well. He had lingering cognitive issues, fatigue, and the haunting fear that another stroke could hit at any moment.

Here’s what we found when we ran actual comprehensive testing to uncover the hidden causes of stroke in his case:

  • Elevated ApoB particles: His standard LDL looked “okay,” but his ApoB count (the number of cholesterol-carrying particles that can actually lodge in vessel walls) was through the roof.
  • Sky-high hs-CRP: His inflammation markers were screaming. This wasn’t just “a little inflammation”—his vascular system was on fire.
  • TMAO elevation: His gut bacteria were producing excessive amounts of this clot-promoting compound—one of the hidden causes nobody tested for.
  • Gut permeability markers: He had significant intestinal barrier dysfunction—leaky gut confirmed.
  • Toxic burden: We found heavy metal accumulation and environmental toxin exposure that his body couldn’t clear—another hidden cause.

Once we had this roadmap of his personal hidden causes of stroke, we knew exactly where to focus. We worked on:

  • Sealing his gut lining to stop the flood of inflammatory toxins
  • Shifting his gut microbiome to reduce TMAO production
  • Supporting his detox pathways to clear the toxic backlog
  • Calming his limbic system (yes, we address brain retraining—it’s not optional)
  • Using hyperbaric oxygen therapy (HBOT) and red light therapy to accelerate vascular healing and neuroplasticity

Doug’s life changed. His energy came back. His cognitive fog lifted. And most importantly, his markers normalized. We didn’t just make him “feel better”—we eliminated the hidden causes of stroke that threatened his life.


The Functional Medicine Solution: How We Actually Find the Hidden Causes

Here’s what I want you to understand: you cannot fix what you do not measure.

If you don’t know your ApoB, your hs-CRP, your TMAO, your gut permeability status, your heavy metal burden, your omega-3 index, and a dozen other critical markers, you’re flying blind. And flying blind after a stroke is not an option. We need to uncover the hidden causes of stroke that are specific to YOU.

Comprehensive Testing: The Only Way to Uncover Hidden Causes of Stroke

When someone comes to me—whether they’re local to Arizona or working with me virtually from across the country—we start with testing. Real testing. Not the basic metabolic panel your doctor runs every year. I’m talking about the tests that reveal hidden causes of stroke:

  • Advanced lipid panels: ApoB particle count, LDL particle size, remnant cholesterol
  • Inflammatory markers: hs-CRP, IL-6, oxidized LDL (hidden causes of vascular damage)
  • Metabolic markers: Fasting insulin, hemoglobin A1c, HOMA-IR (insulin resistance)
  • Gut health panels: Zonulin (leaky gut marker), TMAO, comprehensive stool analysis (hidden causes related to gut dysfunction)
  • Nutrient status: Omega-3 index, vitamin D, B vitamins (especially B12 and folate)
  • Toxic burden: Heavy metals, environmental toxins (hidden causes that accumulate over years)
  • Genetic factors: MTHFR, ApoE status (affects how you process fats and clear toxins)
  • Hormone status: Cortisol patterns, thyroid function

This is NOT overkill. This is the minimum you need to understand the hidden causes of stroke in your body and how to prevent the next one.

And here’s something most people don’t realize: you can do all of this virtually. I work with people across the country who will never set foot in my Arizona office. We run the testing through labs near you, we review everything in detail over video calls, and we build your personalized roadmap together to address YOUR specific hidden causes.

General Treatment Approaches: Addressing the Hidden Causes

Once we know what’s broken, we can start fixing it. But I want to be crystal clear about something: I’m NOT going to give you a “stroke prevention protocol” with specific supplements and dosages. Why? Because that’s dangerous.

What works for Doug might make you worse. If you’ve got a clotting disorder, some natural compounds could increase your risk. If you’ve got methylation issues, certain B vitamins could cause problems. If you’ve got gut infections, random probiotics might feed the wrong bacteria.

This is why testing comes first, and this is why you need a professional guiding the strategy to address the hidden causes of stroke.

That said, here are the general goals we’re working toward:

Goal #1: Lower the Toxic Load
Your body is trying to process toxins from your gut, your environment, and your own metabolic waste. If your detox pathways are sluggish (common with genetic variants or nutrient deficiencies), those toxins accumulate and drive inflammation—one of the hidden causes of stroke. We support liver function, bile flow, and kidney clearance.

Goal #2: Seal the Gut
If you’ve got leaky gut—one of the major hidden causes of stroke—nothing else matters. You’re constantly re-inflaming yourself. We use targeted nutrition and specific gut-healing compounds (chosen based on your testing) to restore that security fence.

Goal #3: Shift the Microbiome
If your gut bacteria are producing excessive TMAO (a hidden cause of clotting), we need to shift the population. This isn’t about taking a random probiotic from the store. It’s about knowing which strains you need and which foods support the right bacteria.

Goal #4: Reduce Vascular Fire
We target the inflammatory pathways that are damaging your blood vessels—addressing one of the core hidden causes of stroke. This involves omega-3 fatty acids (in the right form and dose for you), antioxidants, and sometimes natural compounds that modulate immune response.

Goal #5: Calm the Limbic System
If your brain’s alarm center is stuck in overdrive—one of the hidden causes of stroke related to trauma and chronic stress—you’ll never fully heal. We use a combination of brain retraining techniques, nervous system support, and sometimes neurofeedback to reset that alarm.

Goal #6: Optimize Metabolism
Insulin resistance, blood sugar dysregulation, and mitochondrial dysfunction all feed stroke risk. We address these at the cellular level with targeted nutrition and lifestyle changes.

Integrative Therapies: HBOT and Red Light (For Local Patients)

For patients who can come to my Arizona clinic, we have two game-changing therapies: hyperbaric oxygen therapy (HBOT) and red light therapy.

HBOT floods your tissues with oxygen under pressure, which does several critical things:

  • Stimulates the growth of new blood vessels (angiogenesis)
  • Reduces brain swelling and inflammation
  • Promotes neuroplasticity (your brain’s ability to rewire and heal)
  • Accelerates tissue repair

Red light therapy (photobiomodulation) works at the mitochondrial level, boosting cellular energy production and reducing oxidative stress.

But here’s the key: these therapies are the accelerator, not the foundation. They work best when you’ve already identified and addressed the hidden causes of stroke through testing and personalized nutrition/lifestyle strategies. You can’t out-HBOT a leaky gut and a toxic burden.

If you’re not local, don’t worry—the testing and strategic roadmap to uncover your hidden causes are what matter most, and we can do that virtually. The in-office therapies are a bonus for those who have access.


Practical Action Steps: Investigating Your Hidden Causes of Stroke

Okay, let’s talk about what you actually do with all this information. Here are the steps to start uncovering the hidden causes of stroke in your body:

Step 1: Demand Advanced Testing

Call your doctor and ask for an advanced lipid panel (including ApoB), hs-CRP, fasting insulin, and a comprehensive metabolic panel. If they push back or say “your cholesterol is fine,” find a doctor who understands functional medicine and knows how to test for hidden causes of stroke. Or reach out to me—this is what I do every single day.

Step 2: Stop Inflammatory Triggers

You know what they are: processed foods, seed oils, excess sugar, alcohol, smoking. You don’t need me to list them. If it comes in a box and has ingredients you can’t pronounce, it’s inflammatory. Period. Reducing inflammation is critical to addressing the hidden causes of stroke.

Step 3: Hydrate Like Your Life Depends on It

Because it does. Dehydration thickens your blood and promotes clotting. Drink clean, filtered water. Half your body weight in ounces is a good starting point.

Step 4: Address Stress—For Real

Here’s the thing about stress: it’s not just “in your head,” and meditation apps aren’t going to fix it if there’s a deeper root cause. Chronic stress is a symptom of something, just like inflammation is—and it’s one of the hidden causes of stroke. Maybe it’s a toxic relationship that’s draining you. Maybe it’s unresolved trauma that never got processed. Maybe it’s a neurotransmitter imbalance—low serotonin, depleted dopamine, or cortisol that’s been running too high for too long.

We test for neurotransmitter imbalances and hormone dysfunction because you can’t “mindset” your way out of depleted brain chemistry. And we talk about your life—what’s actually causing the chronic activation of your stress response. Sometimes the solution is therapy. Sometimes it’s boundaries. Sometimes it’s fixing your gut (because gut bacteria literally produce neurotransmitters). Toxic emotions create toxic biochemistry—and that biochemistry damages your vessels just as surely as a bad diet does. The point is: we find the source of the stress and address that, not just hand you a breathing exercise and call it good.

Step 5: Support Your Gut (Carefully)

Eliminate obvious gut irritants: gluten (especially if you have autoimmune markers), dairy (if you’re sensitive), and any foods you know don’t agree with you. But don’t just start throwing probiotics and gut supplements at the problem—get tested first so you know what you’re dealing with. Leaky gut is one of the major hidden causes of stroke, and you need to address it properly.

Step 6: Don’t Go It Alone

Here’s the warning: Do NOT just start buying random supplements because they “support heart health” or “reduce inflammation.” Without testing, you’re guessing. And guessing after a stroke is reckless when there are hidden causes you haven’t identified yet.

Work with someone who knows how to interpret advanced testing and design a strategy for you. Again, this can be done virtually. I work with people from all over the country who send in labs and we build their roadmap together over video calls to address their specific hidden causes of stroke.


FAQ: Your Questions About Hidden Causes of Stroke Answered

Q: Can I really work with you if I don’t live in Arizona?

Absolutely. The majority of what we do—testing to uncover hidden causes of stroke, interpretation, strategy, nutrition planning—happens virtually. I work with patients across the country. You run labs near you (I’ll tell you exactly which tests and which labs to use), we review everything in detail over video, and I guide you through the entire process. The in-office therapies like HBOT are a bonus for local patients, but the core work is finding and addressing the hidden causes of stroke, and that’s 100% doable remotely.

Q: How is this different from what my cardiologist is doing?

Your cardiologist is focused on managing risk with medication. That’s valuable, and I’m not telling you to stop your meds. But management isn’t the same as resolution. We’re looking for why your vessels got damaged in the first place—the hidden causes of stroke like inflammation, gut dysfunction, toxic burden, and limbic dysregulation. We’re addressing root causes, not just covering symptoms.

Q: I’m already on a statin. Do I still need all this testing?

Yes. Statins lower cholesterol, but they don’t tell you anything about ApoB particle count, inflammation, TMAO, insulin resistance, or gut health—the hidden causes of stroke. You can be on a statin and still have massive stroke risk if those other factors aren’t addressed. Testing shows us what’s really going on and reveals the hidden causes specific to you.

Q: How long does it take to see results after addressing hidden causes of stroke?

It depends on how deep the dysfunction goes. Some people see improvements in energy and cognitive function within weeks once we start addressing gut health and inflammation. Normalizing vascular markers can take 3-6 months. Healing from significant trauma and limbic dysfunction can take longer. But here’s the key: we’re tracking progress with testing, not just how you feel. You’ll know it’s working because your numbers improve as we address the hidden causes.

Q: Is this covered by insurance?

Some testing is covered, some isn’t—it depends on your plan. Functional medicine visits are often not covered, but many patients use HSA/FSA funds. We provide superbills you can submit for reimbursement. I’ll be honest: most insurance doesn’t pay for the level of testing and care I’m talking about, because the system is designed for management, not resolution of hidden causes. But the investment in understanding and fixing your root causes is worth more than a lifetime of medications and the fear of another stroke.

Q: What if I’ve already had multiple strokes? Is it too late to address the hidden causes?

It’s never too late to address the hidden causes of stroke. I’ve worked with people who’ve had multiple strokes, and once we find and fix what’s driving the problem, the trajectory changes. You may not reverse all the damage that’s already been done, but you can stop the chain reaction and give your body the best possible chance to heal and prevent future events.

Q: Can I just do this with diet and lifestyle, or do I need supplements?

Diet and lifestyle are the foundation—non-negotiable for addressing the hidden causes of stroke. But in most cases, especially after a stroke, you will need targeted supplementation to address nutrient deficiencies, support detox pathways, heal the gut, and reduce inflammation. The key word is targeted. Not random. Not based on what your friend took. Based on your testing and your specific hidden causes.


Conclusion: The Hidden Causes of Stroke Can Be Found—and Fixed

Here’s what I need you to hear: if you’ve had a stroke, or if you’re terrified you’re headed for one, you are NOT powerless. And you do NOT have to settle for a lifetime of medications and crossed fingers.

The hidden causes of stroke are real. Trauma triggers limbic dysfunction. Chronic stress drives inflammation. Leaky gut floods your system with toxins. Your gut bacteria produce clot-promoting compounds. Your blood vessels get damaged, plaque builds up, and eventually—stroke.

But every single one of these hidden causes of stroke can be identified, measured, and addressed. That’s what functional medicine does. That’s what advanced testing reveals. That’s what a personalized roadmap gives you.

You can work with me virtually from anywhere in the country. We run the testing, we find the hidden causes of stroke in YOUR body, and we build a strategy that actually resolves the problem instead of just managing it.

Don’t wait for the next stroke to prove that what you’re doing isn’t enough. Take control now. Get the testing. Find the hidden causes. Fix what’s broken.

If you’re ready to stop guessing and start healing, let’s talk. My personalized stroke recovery program combines advanced testing, targeted nutrition, lifestyle strategies, and for local patients, cutting-edge therapies like HBOT and red light. This is how you move from fear to confidence, from management to resolution by addressing the hidden causes of stroke.

Your brain can heal. Your vessels can repair. Your life can get back on track.

But it starts with uncovering the hidden causes of stroke that standard medicine is missing.

Let’s find out what yours are.


About Dr. Darrell Kilcup, DC, CFMP
Dr. Kilcup has been helping patients identify and address root causes of chronic illness for over 35 years through his practice in functional medicine, chiropractic care, hyperbaric oxygen therapy, and red light therapy. He works with patients both locally in Arizona and virtually across the country, specializing in complex cases where conventional medicine has fallen short—including uncovering the hidden causes of stroke that standard testing misses.

Darrell Kilcup, DC, CFMP

Hi there! I’m Dr. Kilcup. You know that health problem you’ve been dealing with – the one that doctors can’t seem to solve, that’s stealing way too much of your time, energy and joy? I can help you get to the bottom that. I am passionate about using the best of science and nutrition to find and fix root causes of health issues. Start your journey towards healing and relief today.

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I have been using the Hyperbaric Oxygen Therapy for the last few weeks and It has helped me so much. I struggle quite a bit with work related stress. When I'm in the chamber I feel completely relaxed, so much so that I can bring my laptop inside and work without stressing. The calmness I feel in the chamber lasts for the remainder of the day as well. I have found too, the more consistent I am with sessions throughout the week the better I feel. The office staff seems well trained in running the tanks too, so I feel safe. I see Dr. Kilcup as well for my brain and gut health. Until now, I don't think I've ever known what "normal" or "healthy" feels like. Thank you all, sincerely!
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Mike Kutz
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Dr. Kilcup is a pleasure to work with. His office is beautiful! I can’t wait to try his hyperbaric chambers!
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Sarina Gomez
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Darrell is highly knowledgeable and really gets to the root of the problem. Unlike a lot of doctors, Darrell doesn't just throw prescriptions at issues. He will test and test - digging for the cause and then working on fixing the issue. He and his staff are professional, courteous, and a joy to be around.
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I am very grateful to have found Dr. Kilcup and be his patient for the last couple of years. He has helped me restore my health back after being exposed to toxic mold for years. He helped identify and treat all of my symptoms I was experiencing and address the root problem. I was looking for the right person who could help me heal with natural therapies and supplements and Dr. Kilcup was the perfect fit. Every appointment and session was necessary and one step towards all the progress I made. Dr. Kilcup is a great functional medicine doctor who was also an advocate for my own health and well-being. I never received any care or attention to detail from other Doctors in past experiences except with Dr. Kilcup. Anyone who is seeking a holistic path towards healing or improving their own health should see him.
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