Fatigue and chronic fatigue
Including post-viral fatigue and ME/CFS.
Functional medicine
When nobody has explained why
Most people who come to see me have already been round the system. Tests were normal, or nearly normal. They were told it was stress, or age, or that they would have to live with it. They are not satisfied with that, and often they are right not to be.
What functional medicine actually means
The term gets used loosely, so here is what I mean by it. Conventional medicine is very good at naming a disease and matching it to a treatment. That works well for a heart attack or a fracture. It works less well for the person who is exhausted, bloated and foggy, whose blood tests are unremarkable, and who does not fit a diagnostic box.
Functional medicine starts from the mechanism instead of the label. Why is this person's system behaving this way? Usually several things are contributing at once, and the combination differs between two people who arrive with identical symptoms. The work is identifying which factors are active in you, and addressing those.
It is not an alternative to conventional medicine, and I have not left conventional medicine to practise it. It is a different set of questions asked of the same biology.
The two are not separate things
I describe this as functional medicine because that is what people search for and how the field is usually named. It is not quite how I think about it. What I actually do is integrate conventional medical training with functional medicine tools - and the integration is the point, not the label.
In practice that means the same consultation draws on both: hospital medicine to recognise disease, exclude the serious, read investigations properly and know when something needs a specialist; functional medicine to ask why a system is behaving this way, and to test and treat accordingly. Neither half does the job alone. A functional medicine practitioner without medical training will miss things that matter, and a conventional consultation rarely has the time or the framework to look for mechanisms.
What I do not do
I do not treat serious disease that belongs in a hospital, and I will say so plainly if that is what your history suggests. I do not offer naturopathy or herbal medicine as standalone services - where botanical or nutritional treatment is appropriate it forms part of a wider plan, not the plan itself. And I do not sell supplements as the answer to everything.
How the work goes
Four stages, though the timescale varies a good deal.
A comprehensive first appointment
Time to explore the case in depth. Full history, going back further than most consultations allow - childhood illness, infections, antibiotics, stressors, diet, work, exposures. Most of what turns out to matter comes from this conversation rather than from a test.
Testing that answers a question
I order tests to settle specific questions raised by your history, not as a panel applied to everyone. That usually means detailed blood work, and sometimes stool, urine or genetic testing where it will change what I do.
A plan of action you leave with
You go away with two things: dietary and lifestyle changes you can begin straight away, and a clear plan of any investigations I think are needed, with the reasoning. Written, sequenced and realistic - a plan you abandon in three weeks is worth less than a smaller one you keep going.
Review and adjust
We review what has changed and what has not, retest where it is informative, and adjust. Most people need several rounds of this. Anyone promising a single fix is overselling.
What people come with
Not an exhaustive list, and the pattern matters more than the label.
Gut and digestive problems
IBS, SIBO, bloating, reflux, and unexplained digestive symptoms.
Autoimmune conditions
Where the aim is to reduce the drivers rather than only suppress the response.
Hormonal and menopausal symptoms
Including thyroid problems and perimenopausal change.
Chronic infection
Lyme disease, co-infections, and reactivated viral illness.
Biotoxin illness and CIRS
Including mould-related illness in water-damaged buildings.
Discuss your case with Dr Greenland
A short discovery call is the usual starting point. It costs nothing, and it is the fastest way to find out whether this approach fits your situation.