My daughter's skin

When my daughter was small, she developed eczema.

We did what everyone does. We saw doctors. We used the creams, and then the stronger creams, and then the steroids, and then the steroids more often, because the relief kept getting shorter. Every treatment we were offered worked on the skin. Nothing we were offered worked on whatever was driving the skin.

Somewhere in the middle of that I started reading. Properly reading, the way an engineer reads a system that keeps failing at the same point. I read about the gut. About food, and immune signalling, and the barrier function of skin. About what we were putting into her, and what her body was doing with it.

Then, slowly, we changed things. We worked on her gut. We identified the foods that were triggering her and took them out. We rebuilt her diet from something that was technically fine into something that actually nourished her.

Her skin cleared.

I want to be careful here, because this is where the internet fills up with miracle stories and I am not offering you one. It was not fast. It was not one supplement. It took months, and it took a lot of unglamorous consistency. But it worked, and it stayed working, and I could not stop thinking about the fact that nobody had ever suggested we look there.

That was the moment. I did not decide to change careers that day. But that was the day the question got its hooks into me.

It turns out I had been unwell for a very long time

Here is what I did not expect. As I learned to look properly at other people's health, I finally looked at my own.

For years I had lived with pelvic pain. Not the sort you mention in passing. The sort that kept me awake almost every night for one to two weeks before my period, and was then followed by seven to ten days of bleeding heavy enough to organise my calendar around. The PMS turned me into someone I did not recognise for a week out of every four. And underneath all of it I was tired. Not sleepy. Tired in my bones, in a way that sleep did not touch.

I raised it. Repeatedly. Over years I collected an extraordinary assortment of explanations, some of them imaginative, none of them right. I was told I was busy. That I was a mother. That my bloods were normal.

When I finally ran the right tests, and read them the way I had by then learned to read them, I found Hashimoto's thyroiditis: an autoimmune condition that had almost certainly been running quietly in the background for years, feeding the fatigue, the pain, the hormonal chaos, all of it.

Getting well was not dramatic. It was slow, deliberate and occasionally infuriating. I worked on my thyroid, my gut, my immune system, my nutrient status, my stress load and my sleep. I made mistakes. I corrected course. I did the thing I now ask my patients to do, which is to keep going through the stretch where nothing appears to be happening.

I am in my forties now, and I feel better than I did at twenty five.

What happens when we work together

1. 1

   We start with the whole story.

   Your first consultation is long, because your history is long. I want to know what changed, and when, and what was happening in your life at the time. I want to know about your sleep and your stress and your digestion and your cycle, even when you came in about something else entirely. Symptoms do not live in isolation and neither do you.

2. 2

   We test rather than assume.

   Where testing will genuinely change what we do, we test. I read pathology functionally, which means I am not only asking whether a result sits inside the reference range. I am asking whether it sits where it needs to be for you to feel well. Those are different questions, and the second one is usually where the answer is hiding.

3. 3

   We treat the driver, not the symptom.

   Suppressing a symptom is easy, and sometimes necessary. Understanding why it is there is harder and almost always more useful. Treatment might involve herbal medicine, targeted nutrition, dietary change, or a rethink of how you sleep and move and recover. Usually it involves several of those, sequenced in an order your body can actually manage.

4. 4

   We adjust.

   No plan survives contact with a real human life. We review, we refine, and we keep what works.

5. 5

   I work alongside your other practitioners, not against them.

   I refer when I should. I read your specialist's letters. Some of my best outcomes have come from good collaboration with GPs, endocrinologists and rheumatologists, and none of my good outcomes have ever come from telling someone to stop their medication.