Conditions
Migraine
Migraine is a neurological condition, not a bad headache. It has its own mechanisms and its own management, and it deserves to be treated as its own problem rather than filed under pain.
By Dr Andrew Greenland· Reviewed
At a glance
Greenland Medical is a doctor-led practice in Twickenham, London, where Dr Andrew Greenland assesses migraine and chronic headache, in person or online, alongside neurology where it is needed. The focus is the right acute and preventive treatment, medication overuse, and treatable contributors.
- Who you see
- Dr Andrew Greenland, GMC-registered (4419909), at every appointment
- Where
- The Maris Practice, Twickenham TW1 3HQ, and online across the UK
- What is looked at
- Headache pattern and medication days, sleep and sleep apnoea, iron deficiency, thyroid disease and hormonal patterns
- Working with neurology
- Referral where it is needed, including for CGRP treatments, which neurologists prescribe
- Fees
- Initial consultation £880 (120 minutes), follow-up £440. Testing is separate, with a written estimate first
- First appointment
- Usually within two to three weeks
- Guidance followed
- NICE CG150, headaches
- Next step
- A free 15-minute discovery call
What I look for
Patterns first: timing, relationship to sleep, hormonal cycle, meals and stress, and what the prodrome looks like. Migraine diaries are tedious and genuinely informative.
Then the modifiable contributors that turn up repeatedly: blood glucose swings, magnesium status, sleep disorder, hormonal fluctuation, dehydration, and in some people specific food triggers, though these are over-attributed as often as they are missed.
Working with neurology
If you have frequent or severe migraine you should be under neurological care, and newer preventive treatments have made a real difference for many people. This is not an alternative to that.
What I add is the metabolic, nutritional and hormonal picture around it, which conventional consultations rarely have time to explore.
Common questions
When does a headache need urgent assessment?
Sudden severe onset, headache with fever or neck stiffness, new headache after 50, headache with neurological signs, or a marked change in your usual pattern. Those need urgent medical assessment, not a functional medicine consultation.
Related
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.