Dr Andrew Greenland

Two kinds of medicine, not two careers

I trained conventionally and I still practise conventionally. I work at consultant level in a West London hospital alongside this practice, and I have done for many years. That is deliberate, and it is the single most useful thing I bring to this work.

It means I recognise serious disease. It means I know when a symptom needs urgent investigation rather than a nutritional plan. And it means I am comfortable telling someone that what they have described belongs with a neurologist, a cardiologist or an oncologist, not with me.

Functional medicine attracts practitioners from a wide range of backgrounds, and standards vary. Knowing where someone trained, and what they are regulated by, is a reasonable thing to want to know before handing over several thousand pounds.

Why cognitive decline

It became the centre of my practice because it is where the gap between what is possible and what is offered feels widest. Families are often told there is nothing to be done, when in reality there is a great deal that is worth investigating - metabolic, vascular, inflammatory, nutritional, hormonal - particularly early on.

I want to be careful about how I put this, because the field attracts overstatement. I cannot promise to reverse dementia and I do not claim to. What I can do is look properly for the contributing factors in a given person, treat what is treatable, and be honest about what the evidence supports.

How I work with people

Comprehensive appointments, because the history is where most of the answer is and it takes time to explore a case properly. You will not be rushed, and I would rather cover the whole picture once than piece it together across several short consultations.

You leave with a plan of action rather than a summary. That means dietary and lifestyle changes you can begin straight away, and a clear plan of any investigations I think are needed and why. Written down, so you are not relying on memory.

And direct answers, including when the answer is that I do not know, or that I cannot help.