This page answers questions you may have about my London functional medicine clinic in Marylebone. I will first describe what functional medicine is, how it relates to naturopathy and nutritional therapy and why we need functional medicine.
You can also find out what to expect in my London functional medicine clinic, how it works and the tools I use to support you towards optimal health. This will involve introducing a few more key principles of functional medicine to explain how and why I implement them in clinical practice.
Finally you can find a list of my London clinic services and prices.
What is functional medicine?
Functional medicine investigates the root cause of disease
A central principle of both functional medicine and naturopathy is to find the root cause (or root causes) of disease and to work primarily at that level. When symptoms are merely suppressed and the underlying disease process is not addressed symptoms are likely to appear at a later date, possibly returning with a vengeance and then being harder to deal with or manifesting as a completely different set of symptoms.
So according to functional medicine, mere symptomatic relief can be a case of ‘kicking the can down the road’.
That’s all very well as an interesting hypothesis, but you will be wanting a concrete example to really drive this home.
An example of the consequences of simply alleviating symptoms
If you have a headache you may take a painkiller. You want to numb the pain and that is completely understandable.
But what is causing your headache?
A headache could have many causes, but let’s say that was due to poor gut health and in particular a ‘leaky gut’.
In simple terms a ‘leaky gut’ (or intestinal barrier dysfunction) is when your gut wall is too porous and allows undigested food particles into your bloodstream as well as toxins from gut bacteria. These food particles and in particular bacterial toxins known as endotoxins or lipopolysaccharides are key drivers of inflammation which in turn could be causing your headache (1).
And what if your painkiller is actually making your disease process worse in the long run and even increasing your risk of more serious disease?
The most common class of painkillers used are non-steroidal anti-inflammatory drugs (NSAIDs), which are known to cause ‘leaky gut’. So if you take NSAIDS for your occasional headache perhaps they could become more frequent, so you would take the NSAIDS more frequently and you could end up with a chronic headache disorder. This vicious circle would lead to what is known in the medical research as a medication overuse headache (2).
A 2024 study found that in migraine sufferers medication overuse headache is indeed associated with increased levels of inflammatory endotoxins in the blood, suggesting that a ‘leaky gut’ caused by NSAIDs may indeed be causing inflammation and medication overuse headache (3).
Evidence suggests that elevated levels of endotoxins in the bloodstream due to a leaky gut may play a role in the development of many conditions, including cardiovascular disease (4), type 2 diabetes (5), Alzheimer’s disease (6), Parkinson’s disease (7) and CFS/ME (8).
First do no harm
Your original occasional headaches in the example above could have been caused by many other factors, but overuse of painkillers may then have then caused more serious health consequences.
This kind of ‘medicine’ transgresses the Hippocratic Oath “First do no harm”, which is another key principle of both naturopathy and functional medicine, and is still sworn by medical students to this day.
Hippocrates might have thought about this in the following hierarchy of benefit to risk:
Hippocrates’s hierarchy?
- food as medicine – the least harmful medicine
- herbal medicine (if food as medicine is not enough) – could potentially carry some risks as many herbs have some degree of toxicity and potentials side effects, contraindications and cautions around their use
- surgery (when food and herbs fail)- extremely risky in the 4th or 5th century BC
A benefit to risk hierarchy for a functional medicine practitioner might be as follows:
Functional medicine hierarchy?
- food as medicine, physical and mental exercise as medicine, spiritual practice and ‘energy work’ such as meditation, shiatsu, yoga, acupuncture and T’ai Chi Ch’uan
- nutritional supplements – active in the body as food is, but dosing and ‘non-food excipients’ carries some potential risk
- herbal medicine and supplements
- medical treatment such as medication and surgery – sometimes essential and miraculous when other approaches will fail – Please note I do not provide medical treatment. I am a functional medicine practitioner and not a functional medicine doctor.
The power of food to heal – Hippocrates as nutritionist?
I will leave it to classical scholars to reach a consensus on whether or not the phrase “Let food by thy medicine” originated with Hippocrates, but certainly he was a proponent of food as medicine in the wider sense of the word ‘medicine’ (9).
The power of diet to influence health and disease is an important principle of functional medicine, naturopathy and, as the name implies, nutritional therapy.
I am not intending to use Hippocrates as any kind of evidence for the power of food as medicine and for the key role that nutritionists can play in healthcare, but if you read my blog you will find numerous examples of the potential of food and lifestyle to both heal and to cause disease, with plenty of reference to the research literature to support my claims.
The roots of functional medicine and naturopathy
Since functional medicine and naturopathy seek to find the root causes of disease it seems worthwhile to follow the trail as best as we can to the roots of functional medicine itself, though this may involve a little historical speculation where more solid evidence is missing.
Functional medicine builds upon traditional food medicine by incorporating modern scientific discovery.
Whether or not a group of medical doctors really locked themselves in a room over weekend to hammer out the principles of functional medicine, those principles are, I would argue, exactly the same as the principles of naturopathy, albeit reworded.
It is hard for me not to come to the conclusion that functional medicine evolved from naturopathy.
The roots of naturopathy, in turn, may originate from much further afield in space and time than you might think, in an ancient philosophical tradition that can serve as strong guide for effective, safe and ethical clinical practice.
Functional medicine doctor vs functional medicine practitioner
Functional medicine practitioners who are not doctors
The work of most functional medicine practitioners who are not also functional medicine doctors is born from a conviction in the inherent power of healing with nutrition and lifestyle interventions. This is the area they train in, work in, and will usually focus most of their professional attention onto.
They will usually qualify for membership and be members of both a functional medicine professional body and a nutritional therapy or naturopathy professional body.
I fall into this camp; I do not offer medical treatment.
A functional medicine doctor prescribes medications
Functional medicine doctors usually begin their careers as a medical practitioners; as GPs if based in the UK or MDs if in the USA. As GPs or MDs they are trained in the use of medications and medical procedures, including some lab testing, but have very limited training in nutrition and lifestyle medicine if at all.
Later in their careers they may hear about functional medicine or something else prods them in this direction, and they may do some extracurricular training in dietary and lifestyle interventions and the functional medicine approach. They may then incorporate some of this knowledge into their medical practice.
Very few functional medicine doctors complete a post-graduate diploma in nutritional therapy or an MSc in nutrition to provide them with the breadth and depth of knowledge and understanding of nutritional and lifestyle medicine that is required for membership of a nutritional therapy or naturopathy professional body.
Nutritional therapy with naturopathy and functional medicine
In my London functional medicine clinic I am also guided by my training in naturopathy and nutritional therapy. As a nutritional therapist I combine the knowledge and skills of a nutritionist with the lifestyle medicine advocated by functional medicine.
There are some differences between functional medicine, naturopathy and nutritional therapy, but their principles are all in alignment.
My training and experience
Training I have completed in functional medicine forms just part of my CPD.
You can also find out more about me and what led me to do this work and my professional and research experience and accreditation.
Another way to get a perspective on my approach to nutrition, lifestyle and health is to read my blog, perhaps beginning with my introductory post on inflammation.
London functional medicine clinic services
How I investigate the root causes of disease at my London functional medicine clinic
Personalised medicine
Another principle of functional medicine is that each individual is unique and thus requires a personalised approach. Biochemistry, personality, genetics, life experiences, career, family commitments are just some of the areas that need to be take in to account and there is a danger in making generalised statements about health and nutrition that may not apply to you.
That is why I follow the functional medicine approach in asking detailed questions about your symptoms, medical history, family medical history, dietary and lifestyle habits, known toxic exposures, sleep patterns, stress levels and more, as well as assess functional lab tests and genetic tests as and when appropriate, all in order to make sure that the advice given is appropriate to your individual needs to the best of current scientific knowledge and also based on my clinical experience (since 2014).
Personalised assessment – questionnaires, diet diaries and gathering information in clinic
I ask these questions during the consultation itself, in a four day diet diary I ask you to fill in before each consultation and in a lengthy questionnaire I ask you fill in before your initial consultation.
Personalised explanations
I then seek to help you understand your health in a simple way (or in a more complex way if that is your interest), since this can be empowering for you in your own health journey and can increase your confidence and motivation. The explanation I give to you will not be the same as for another individual with the same set of symptoms as you or with the same medical diagnosis as you, unless the causes of and driving factors of your disease processes are very similar.
I personalise these explanations in another way; if you get easily overwhelmed by details I will bear that in mind but if you are hungry for more detailed explanations I will be very happy to answer any questions you have during your consultation.
Personalised recommendations
Recommendations generally fall into 4 main areas: dietary recommendations, lifestyle recommendations, lab testing and supplements.
I outline these during the consultation so that we can discuss any challenges you may have in implementing the recommendations. I do ask that you communicate any challenges you can foresee due to your personal life circumstances, preferences, religious or ethical beliefs, financial and time limitations and personal capacity to make changes in your life, so that together we can find the best approach for you.
Lab test interpretation
I explain your lab test results during a consultation.
In my interpretation I relate your test results to your symptoms, previous test results and any other relevant information, so that we build a fuller picture of what are the key causes or drivers of your symptoms and how best to support you in optimising your health.
The interpretation fee is included in the price of the test.
I charge an hourly rate for interpretation of the results of any lab tests that you have ordered independently or with previous practitioners. (This is the time it takes me to interpet your results before your consultation).
Written report
These recommendations are then sent to you in a written report usually with in a few days and always within a week of your consultation, barring exceptional circumstances.
Your report also includes a commentary section, in which I reflect some of what you have told me, record your progress, outline potential mechanisms at play as we discover them, and give my interpretation of any test results.
You do not need to take any notes, but if you ask me for more detailed and lengthy explanations that are not likely to go into your report then you may want to make a few notes of your own.
Frequency of consultations and support in between consultations
If you work with me I would typically meet with you for a consultation every 6-8 weeks, which gives time for completing any tests and receiving the results, implementing dietary and lifestyle changes and assessing their impact.
You may want to have consultations more frequently if you feel you need more regular support. This might be the case if your goal is to lose weight or if you are working with addiction or struggling to implement my dietary and lifestyle recommendations.
The consultation is when you can update me on your progress and ask me questions and it is when I will give my recommendations. Your consultation report also serves as a record of the advice I have given.
Coaching calls and support calls
I do not give further recommendations in between consultations. If you do need further support as you are meeting unforeseen challenges in implementing my recommendations, you can book a support call or a coaching call.
A support call can be helpful to fine-tune practical details to help you follow the recommendations successfully, rather than to give completely new advice.
A coaching call is more focused on the emotional or psychological challenges you may meet in implementing dietary and lifestyle changes into your daily life.
Nutrigenetics consultations
Nutrigenetics consultations are another way to personalise medicine. I present my interpretation of some of your key genetic variants and in a written report and in a 2 hour consultation. This includes some guidelines on how your genetic variants affect the best dietary and lifestyle choices you can make to optimise your long-term health.
Although personalised medicine and the use of genetic profiling carried out in this way is sometimes referred to as precision medicine, please be aware that knowing your genetic profile does not lead to a prescription of supplements in precise dosages and precise dietary and lifestyle interventions. Working with you to find out more about your current health status and how your genetic profile may currently be manifesting, and learning about your current dietary and lifestyle habits and the challenges you are meeting in you life can help guide me towards recommendations appropriate to your current circumstances.
A nutrigenetics consultation is best carried out after having at least one nutrition & lifestyle based consultation with me, so that I can relate your genetic variants to what I know about you. You may book, however, chose to book a standalone nutrigenetics consultation with me, in which case I will ask you for your main areas of interest so that I can select the most relevant genes to focus on.
For example if there is a tendency to heart disease in your family line and your are keen to avoid any cardiovascular complications, I could focus on any genes that may have an impact on heart health.
You will need to order your own genetic testing.
Who I do not work with and services I do not offer
I do not work with
- cancer
- anorexia nervosa, bulimia or any other eating disorders
- chronic kidney disease
- people who are unwilling to implement dietary & lifestyle changes
- people who are working with other practitioners who also recommend dietary changes, supplements or herbs
I do not offer
- meal plans
- e-mail support in between consultations – see my e-mail policy and guidelines
Why we need functional medicine
Nutrition, supplements and lifestyle changes may help in the following:
heart disease (1) diabetes (2) weight loss (3) fatty liver (4) high blood pressure (5) fatigue (6, 7) CFS/ME (8) inflammation (9, 10, 11) fibromyalgia (12) IBS (13) SIBO (14) candida overgrowth (15) dysbiosis (16) constipation (17) diarrhoea (18) bloating (19) food intolerance (20) acid reflux/GORD (21) leaky gut (22) ulcerative colitis (23) Crohn’s disease (24, 25) asthma (26) pain (27) gout (28) multiple chemical sensitivity (29) depression (30) | anxiety (31, 32) pyroluria (33) stress (34) insomnia (35) sleep apnoea (36) Parkinson’s disease (37) Alzheimer’s disease (38) Multiple sclerosis (MS) (39) thyroid imbalances (40) cortisol imbalances (41) fertility (42) pregnancy (43) lactation (44) PMS/PMDD (45) thrush (46) endometriosis (47) PCOS (48) fibroids (49) menopause (50) prostate health (51) libido (52) anaemia (53) histamine intolerance (54) oxalate toxicity (55) migraine (56) headaches (57) | brain fog (58) ADHD (59) cognitive function (60, 61) rosacea (62) acne (63) eczema (64) psoriasis (65) allergies (66) osteoporosis (67) arthritis (68) autoimmune disease (69) Hashimoto’s disease (70) rheumatoid arthritis (71) lupus (72) urinary tract infections (73) kidney stones (74) neuropathy (75) detoxification (76) mould/mycotoxin toxicity (77) shortness of breath (78, 79) heavy metal toxicity (80) salicylate sensitivity (81) longevity (82, 83) methylation issues (84) sinusitis (85) hair loss (86) |
London functional medicine, naturopathy and nutritional therapy services and prices
For prices of consultations in Devon (South Hams) see Nutritional Therapy in Totnes. For Zoom, Skype or telephone consultations see Nutritional Therapy Online on Zoom, Skype or Phone.
Initial consultation – up to 80 minutes – £250
The initial consultation lasts up to 80 minutes and consists of my analysis of a four day diet dairy and a detailed health questionnaire I ask you to complete in advance and further information gathering in person. During this time I will explain possible underlying factors and suspected imbalances contributing to your symptoms in simple terms or at least in terms aimed at your level of understanding and interest so as to motivate you rather than overwhelm you. I will also make suggestions and decide with you on the most effective dietary and lifestyle changes that you are ready to make and the most appropriate lab tests and supplements. A consultation report will be sent to you usually within a few days and always within a week as a pdf document. This includes all of my recommendations and commentary on your progress, on the underlying factors and suspected health imbalances that were discussed, so that you do not need to make any notes during the consultation itself. I allocate 45 minutes to prepare for the consultation and usually process the first half of the questionnaire in advance and cover the second half of the questionnaire during the consultation itself, the second half of the questionnaire usually being much faster to process.
Follow-up consultation – up to 80 minutes – £250
Lab test results are explained in follow-up consultations, when the dietary, lifestyle and supplement recommendations are updated and any challenges from the previous consultation are addressed. Changes are incremental and aimed at moving you in the right direction at a pace that is realistic for you, and thus usually take several consultations or more if you are working with a more serious and chronic condition. How many consultations it will take depends on your health goals, your current state of health and on the pace at which you can realistically make changes without excessive stress. You will again be sent the recommendations as a pdf document usually within a few days and always within a week, which also includes notes on the lab test interpretation and any new underlying factors and suspected health imbalances that were discussed.
Follow-up consultations are typically every 4-6 weeks but may be up to 8 weeks in certain cases and can even be every fortnight if you need more support. More frequent consultations can be helpful if weight loss is your goal or if you are working with addiction or cravings.
Lab test interpretation – £50 per hour
Interpretation fees are included in the cost of functional lab testing. If you would like me to consider and interpret test results that you have not ordered from me I charge £50 per hour. The test results need to be in digital format and sent to me by e-mail after being labelled as described here.
Telephone support in between consultations – £80 for 45 minutes, £60 for 30 minutes, £40 for 15 minutes
If you have questions in between consultations I generally recommend you make a note of them and ask me at your next consultation. However you may want to book a short telephone call with me if the questions are more urgent, perhaps regarding how you implement the advice I have given you, or if I have given you a protocol to follow for an extended period of time before your next consultation and you would like some support before then. If you are working with weight loss or addiction it may help you to send me a diet diary to discuss in a weekly phone call. Prices include a charge for 15 minutes for me to look through my notes for your most recent consultation before the phone call. If your questions require my looking back at my notes from earlier consultations I will do so during the phone call itself.
30 minute coaching phone calls – £40
Coaching calls are also recommended in between nutritional therapy consultations and can prove to be an indispensable support to help you deal with the emotional, psychological and spiritual challenges of dietary change. I use motivational interviewing techniques as well as coaching skills learned in more informal settings. These calls are not an opportunity to ask for technical support nor to make changes to your nutrition protocol as I will not be spending any time consulting my notes before or during the phone call.
Package – £1040
Please note that packages are limited. If I am not able to offer you a package immediately I may put you on a waiting list. Packages are non-refundable and expire within 9 months of booking.
4 consultations of 80 minutes each (including the initial consultation or all follow-ups) and 3 coaching phone calls. Coaching calls can each be replaced by 15 minute support calls.
Availability, frequency of consultations and continuity of care
Please bear in mind that I am often booked up 6-8 weeks in advance and cannot guarantee to have an available appointment for a follow-up consultation within 6-8 weeks of booking. It is therefore your responsibility to arrange follow-up appointments in good time. In order to guarantee continuity of care for current clients by offering consultations at 6-8 week intervals I do not take on new clients when I am fully booked for 8 weeks. If you require more frequent support than at 6-8 week intervals you are advised to book more than one appointment at a time.
Laboratory testing
The above fees do not include any laboratory testing.
Nutrigenomics – £500 (not including laboratory fees)
2-hour consultation for advice that is personalised according to your genetics. A nutrigenomics consultation usually follows nutritional therapy so that Tom can relate your genetics to how they are actualising in your current state of health and with your current diet and lifestyle. Nutritional therapy is generally more useful than nutrigenomics analysis for most people and is certainly the more useful focus in the early stages of working with Tom. Click here for laboratory fees for genetic testing.
Free 20-minute telephone appointment
Book a free no-obligation 20-minute telephone appointment using the box to the right to find out more about how I can help you before booking an initial consultation. Please note that for legal reasons I cannot give dietary or lifestyle advice in this short conversation. Before considering working with me it is essential that you read my e-mail policy and guidelines.
Further information
For the cost of functional testing please consult with me.
Consultations after 6pm may sometimes be possible but are charged at 1.5 times the normal rate.
Fees are normally paid by bank transfer two weeks in advance of the consultation. If paying by cheque add a £30 administration fee. Any bank transfer charges must be paid by you.
The above prices reflect the time in between consultations on researching the most effective and safe way to support your health according to your individual circumstances, interpreting any laboratory testing and the time and money spent on continuing professional development at the cutting edge of a field that is rapidly growing.
Prices are subject to change. You can ask me in the free telephone consultation about expected price changes and expected dates of price changes.
Consultations are held at Charterhouse Clinic, Marylebone, close to Marylebone, Edgware Road and Baker Street underground stations.
If you have any further questions about my London functional medicine clinic you can book a free 20 minute phone conversation with me using the form on the right hand side. This phone conversation is an opportunity to find out how I may be able to help you, though please note I cannot give any advice until you have a consultation with me when I will find out much more about you.
Please note: I am a functional medicine practitioner but I am not a functional medicine doctor. Therefore I do not offer medical advice nor emergency care. Nor is my work a substitute for medical care. In the interests of your safety you will be required to agree to my Terms and Conditions.