Mix of both.
Went through massive medical problems. Zero support from doctors fo years.
I had to go into trail and error mode for years to start figuring out what was wrong, and what effected me.
All with an Exhaustion and pain level on par with a dying cancer patient. Oh and a comet brain fog.
Eventually found answers, several conditions that were inter-related. Uncommon response to most drugs the doctors tried.
If I hadn’t gone through this trial and error approach, I would not have lived through it all.