Author: Sophie Davis

I am a passionate health, beauty, and lifestyle writer based in the south of the UK. Balancing my love for writing with raising my two children, I hopefully bring a relatable, insightful perspective to my articles.
  • Voice Assistants and Health Data: What Really Happens When You Ask Alexa About Your Symptoms

    Voice Assistants and Health Data: What Really Happens When You Ask Alexa About Your Symptoms

    Millions of people in the UK ask their smart speaker a health question every single day. “Alexa, what are the symptoms of a blood clot?” “Hey Siri, is it normal to feel dizzy when you stand up?” It feels casual, private even, like muttering to yourself. It is not. The moment those words leave your mouth, they enter a data pipeline that most users have never thought about, and UK law, for all its apparent rigour around health information, has significant blind spots here.

    Smart speaker on a kitchen counter illustrating voice assistant health data UK concerns
    Photo by Anete Lusina on Pexels

    I want to be specific about what is actually happening, because the public conversation around voice assistant health data UK tends to land in one of two useless places: either breezy reassurance that “companies are regulated” or apocalyptic claims that Amazon is selling your cough to your insurer. The truth is more complicated and more instructive than either.

    Who actually holds the data from your health queries

    When you ask Amazon Echo, Apple HomePod, or Google Nest a health-related question, at minimum three things happen. The audio is recorded. It is transmitted to a remote server for processing. A response is generated and returned. The question is how long that audio and the derived text transcript are retained, who has access to them, and under what legal basis the company is processing what the ICO classifies as special category data, which health information explicitly is under UK GDPR.

    Amazon’s privacy settings allow users to delete voice history manually or set automatic deletion after three or 18 months, but the default is indefinite retention unless you change it. Apple takes a different approach: Siri queries are anonymised with a random identifier rather than your Apple ID, and audio is not retained by default unless you opt in to help improve Siri. Google sits somewhere between the two. The key word in all of this is “default”. Most people never touch privacy settings, which means most people are operating under the most data-permissive option without realising it.

    What UK GDPR and the ICO actually require

    UK GDPR requires a lawful basis for processing personal data, and a stricter “explicit consent” basis for special category data like health information. The problem is definitional. Voice assistant providers generally argue they are processing the literal audio file, not a health record. Whether a transcribed query asking about chest pain constitutes “health data” under the regulation is genuinely contested, and the ICO has not issued clear guidance specific to voice-captured health queries.

    Ofcom’s role here is more limited than many people assume. Ofcom regulates online safety and communications networks, but it is not the primary regulator for data protection, that is the ICO’s territory. The Online Safety Act 2023 introduced duties around harmful content and age verification, but it does not create specific obligations about the clinical accuracy of health information returned by a voice assistant. There is a gap. A GP is regulated by the GMC. A pharmacist is regulated by the General Pharmaceutical Council. An algorithm that tells you to “drink plenty of fluids” when you describe symptoms of sepsis answers to nobody in particular.

    Person reviewing privacy settings on a phone relevant to voice assistant health data UK
    Photo by RDNE Stock project on Pexels

    Is the health information voice assistants give you actually safe?

    This is the question I find most concerning, and it receives the least attention. A 2019 study published in npj Digital Medicine tested nine voice assistants on 56 common health questions and found that fewer than half gave complete, accurate responses. The technology has improved since then, but the fundamental issue remains: none of these systems are classified as medical devices under MHRA regulations, so they are not required to demonstrate clinical safety before being deployed at scale.

    The MHRA has been working to clarify how AI-powered tools that offer health information are classified, and their updated framework for AI as a medical device is worth following. But voice assistants that provide general health information have so far stayed out of that classification by positioning their responses as signposting rather than diagnosis. “I’m not a doctor, but…” followed by a confident-sounding answer is a legal and regulatory comfort blanket, not a clinical safety guarantee.

    The impulse to broadcast health guidance to the masses at speed is not new, of course. Before digital infrastructure existed, communities relied on entirely different systems to get important information out quickly. If you want some historical context on how public information transmission has always involved trade-offs between reach and accuracy, there is a longer read on the town crier and the bellman: how england broadcast its news before the printed word, the parallels with today’s algorithmic information delivery are more interesting than they first appear.

    What happens when your health query connects to NHS services

    Amazon has NHS-integrated features on Alexa in the UK, allowing users to access certain NHS 111 information and book GP appointments in some areas. This sounds useful, and some of it genuinely is. But the data implications become more layered when a commercial platform connects to NHS infrastructure. The data you share with Amazon does not automatically become subject to NHS data governance standards simply because the response draws on NHS content. Your query sits on Amazon’s servers under Amazon’s retention policy. The NHS branding on the answer can create a false impression of clinical accountability.

    I’d argue this is the most important thing for UK users to understand: the source of the answer and the custodian of the data can be entirely different entities, each operating under different legal frameworks. If you are concerned about how your health information is handled more broadly, including by apps rather than speakers, the overlap with what UK law says about health app data privacy and what it fails to prevent is direct and worth reading alongside this.

    What you can actually do about it

    The practical steps are more straightforward than the legal landscape. In your Alexa app, go to Settings, then Alexa Privacy, and set voice history to auto-delete after three months at most. On Apple devices, go to Settings, Siri and Search, and review what you have enabled. On Google Home, the My Activity dashboard lets you delete and restrict retention. None of this is hidden, it is just never surfaced proactively.

    For anything beyond general health curiosity, do not rely on a voice assistant. The NHS 111 online tool and the 111 phone service exist for a reason. If you have been exploring your own symptoms in more depth and suspect something like insulin resistance or metabolic health concerns that have never been formally assessed, a GP appointment or a structured NHS health check is where to start, not a smart speaker.

    Voice assistants are genuinely useful for setting timers and checking the weather. They are an unregulated, legally ambiguous, clinically unverified source of health information. Knowing the difference, and adjusting your settings accordingly, is the only practical response to a regulatory framework that has not yet caught up with the technology in your kitchen.

    Frequently Asked Questions

    Does asking Alexa or Siri about my health count as sharing medical data under UK law?

    Health information is classed as special category data under UK GDPR, and a voice query describing symptoms likely qualifies. However, voice assistant providers typically argue they are processing audio files rather than health records, and the ICO has not issued specific guidance on this distinction, leaving the legal position genuinely unclear.

    How long does Amazon keep my Alexa health questions?

    By default, Amazon retains voice recordings indefinitely unless you change your settings. You can set automatic deletion after three or 18 months via the Alexa app under Settings, then Alexa Privacy. Most users are unaware the default is retention, not deletion.

    Is the health information given by smart speakers regulated in the UK?

    No. Voice assistants providing general health information are not currently classified as medical devices by the MHRA, so they are not required to demonstrate clinical accuracy or safety. Ofcom oversees communications networks but does not regulate the clinical quality of health responses from these platforms.

    When Alexa gives me NHS information, is it covered by NHS data rules?

    No. Even when Alexa draws on NHS content to answer your question, your query and the recorded audio remain stored on Amazon’s servers under Amazon’s own privacy policy and retention settings. NHS data governance standards apply to NHS systems, not to third-party commercial platforms that access NHS information.

  • Insulin Resistance Without Diabetes: The Condition Affecting Millions of UK Adults Who Have Never Been Told

    Insulin Resistance Without Diabetes: The Condition Affecting Millions of UK Adults Who Have Never Been Told

    There is a condition quietly affecting an estimated one in three UK adults. It raises the risk of type 2 diabetes, heart disease, and fatty liver. It contributes to weight gain, brain fog, fatigue, and hormonal disruption. And the standard NHS blood test used in routine health checks almost certainly will not catch it until it has already done years of damage. That condition is insulin resistance, and most people who have it have never been told.

    Doctor reviewing blood test results with a patient, relevant to insulin resistance UK screening
    Photo by cottonbro studio on Pexels

    What insulin resistance actually is

    Insulin is a hormone produced by the pancreas. Its job is to let glucose from food enter your cells, where it gets used as energy. Insulin resistance means your cells stop responding to insulin properly. The pancreas compensates by producing more insulin. Blood glucose stays roughly normal for a long time, because the pancreas is working overtime to keep things in check. But the system is under strain, and that strain accumulates.

    Eventually, the pancreas cannot keep up. Blood glucose starts rising. That is when a GP might finally flag something on a test. But by that point, insulin resistance may have been present for ten or fifteen years. According to Diabetes UK, around 13.6 million people in the UK are at increased risk of developing type 2 diabetes. Many of them are in exactly this position: not yet diabetic, but already metabolically compromised.

    Why NHS blood tests miss it

    The main test GPs use is fasting blood glucose, or HbA1c (a three-month average of blood sugar levels). These are good tests for diagnosing type 2 diabetes. They are poor tools for catching insulin resistance early. Here is why: during the compensatory phase, when the pancreas is flooding the body with extra insulin to keep glucose in range, fasting glucose can look completely normal. You could have significantly elevated insulin and still get a clean result on a standard check.

    A fasting insulin test, or a HOMA-IR calculation (which uses both fasting insulin and glucose to estimate insulin sensitivity), would be far more informative. These are not routinely offered on the NHS. Private clinics do offer them, but at a cost most people will not pay unless they already know to ask. The NHS Health Check, available to adults aged 40 to 74, includes cholesterol, blood pressure, and BMI alongside blood glucose. It is a reasonable screen for cardiovascular risk. It is not designed to catch insulin resistance early enough to prevent it progressing.

    I think this is one of the more frustrating gaps in UK preventive medicine. The information exists. The tests exist. The window for intervention is wide. But the pathway to catch it routinely does not.

    What is driving insulin resistance in the UK

    Several converging factors make the UK particularly vulnerable. Ultra-processed food now accounts for more than half of the average British adult’s calorie intake, according to research published in The BMJ. These foods tend to be high in refined carbohydrates and low in fibre, which drives repeated glucose spikes and keeps insulin levels chronically elevated.

    Physical inactivity is another major driver. Sedentary working patterns affect millions of UK adults, and muscle tissue is one of the primary sites where glucose gets cleared from the bloodstream. Less muscle activity means slower glucose clearance, which means higher insulin demand over time. Strength training and even brisk walking meaningfully improve insulin sensitivity, but around a quarter of UK adults do less than 30 minutes of moderate physical activity per week.

    Sleep is also a significant factor that gets underestimated. A single night of poor sleep measurably worsens insulin sensitivity the following day. Chronic sleep disruption, which is increasingly common across the UK, sustains this impairment long-term. Stress raises cortisol, which antagonises insulin. Excess visceral fat, particularly the fat stored around the abdomen and organs, is both a cause and a consequence of insulin resistance. It is a cycle that, once established, tends to reinforce itself.

    Certain groups face higher baseline risk. South Asian adults in the UK develop type 2 diabetes at lower BMI thresholds, and often at younger ages. Black British adults are also at elevated risk. The standard BMI and glucose cut-offs used by the NHS were derived largely from white European populations, which means insulin resistance may be even more systematically under-detected in these communities.

    Signs that might point to insulin resistance

    There is no single symptom that confirms it, and many people have no noticeable symptoms at all. That said, some patterns are worth paying attention to. Persistent fatigue after meals, especially carbohydrate-heavy ones, is common. So is difficulty losing weight despite eating reasonably and moving regularly. Skin tags or dark patches of skin around the neck or armpits (a condition called acanthosis nigricans) can be a visible indicator. Polycystic ovary syndrome (PCOS) is closely linked to insulin resistance, and many women with PCOS are never told about this connection. Raised triglycerides and low HDL cholesterol on a standard lipid panel are also metabolic signals worth discussing with a GP.

    None of these individually confirms anything. But if several apply, it is worth having a direct conversation with your GP rather than waiting for a routine check to flag something years down the line.

    What you can actually do to reverse early insulin resistance

    The evidence here is more encouraging than most people expect. Insulin resistance is not a fixed state. The body retains a significant capacity to improve insulin sensitivity, particularly in the earlier stages, and lifestyle changes are the most effective tool available.

    Reducing refined carbohydrate intake is probably the highest-leverage dietary change. This does not necessarily mean eliminating carbohydrates entirely. It means shifting towards whole grains, legumes, and vegetables, which digest more slowly and produce more modest insulin responses. Increasing fibre intake matters too, both for blood sugar management and for gut health. The average UK adult consumes around 18g of fibre per day against a recommended 30g, a gap with real metabolic consequences.

    Resistance training is the most underrated tool for improving insulin sensitivity. Skeletal muscle is the body’s largest glucose sink, and building and maintaining it makes a measurable difference to how efficiently glucose gets cleared after meals. Two or three sessions per week produces meaningful benefits. You do not need a gym. Bodyweight exercises at home, done consistently, work.

    Walking after meals, even for ten minutes, blunts post-meal glucose spikes. It is a small intervention but one backed by solid evidence. Improving sleep quality, managing chronic stress, and reducing alcohol intake all move the dial in the same direction. None of these are dramatic. Taken together, they are genuinely powerful.

    If you are concerned, ask your GP for an HbA1c and fasting glucose test. If you want a more complete picture, a private fasting insulin test is available through services like Medichecks or Thriva for around £30 to £50. That is not a formal endorsement, but it is a concrete option for people who want clearer data.

    The relationship between what we eat, how we move, and how we sleep is central to metabolic health in ways that extend well beyond insulin. If you have been reading about dietary fat and cardiovascular risk, or following the ongoing conversation about why sleep debt in the UK keeps getting worse, the threads connect. Insulin resistance sits at the intersection of all of them.

    The frustrating truth is that the NHS, as it stands, is not well-structured to catch this early. Prevention budgets are thin, appointment times are short, and the tests most useful for early detection are not part of standard care. That does not mean there is nothing to be done. It means you may need to be the one who asks the right questions.

    Frequently Asked Questions

    Can you have insulin resistance without being diabetic?

    Yes, and this is extremely common. Insulin resistance typically precedes type 2 diabetes by many years. During this period, the pancreas compensates by producing more insulin, keeping blood glucose in a normal range while the underlying problem quietly worsens. Standard NHS blood glucose tests will often show nothing unusual at this stage.

    What blood test shows insulin resistance in the UK?

    A fasting insulin test, combined with fasting glucose, allows a HOMA-IR calculation that estimates insulin sensitivity. This is not routinely offered on the NHS but is available through private health testing services for around £30 to £50. Standard HbA1c and fasting glucose tests, which GPs typically use, are designed to detect diabetes rather than pre-diabetic insulin resistance.

    What are the early signs of insulin resistance?

    Common signs include fatigue after carbohydrate-heavy meals, difficulty losing weight despite reasonable diet and exercise, raised triglycerides or low HDL on a lipid test, skin tags, dark skin patches around the neck or armpits, and, in women, polycystic ovary syndrome. None of these individually confirms insulin resistance, but they are worth raising with a GP.

    Can insulin resistance be reversed without medication?

    In the early stages, lifestyle changes can substantially improve or fully reverse insulin resistance. Reducing refined carbohydrate intake, increasing fibre, doing regular resistance training, walking after meals, improving sleep quality, and managing stress all improve insulin sensitivity meaningfully. The earlier these changes are made, the more effective they tend to be.

    Which groups in the UK are most at risk of insulin resistance?

    South Asian and Black British adults are at significantly higher risk and tend to develop metabolic complications at lower BMI thresholds than white European adults, meaning standard screening cut-offs may miss them. Adults with PCOS, those who are physically inactive, people with chronic sleep problems, and those carrying excess abdominal fat are all at elevated risk.

  • ADHD Medication Shortages in the UK: What Is Causing Them, Who Is Most Affected, and What Patients Can Actually Do

    ADHD Medication Shortages in the UK: What Is Causing Them, Who Is Most Affected, and What Patients Can Actually Do

    If you or someone you care for takes methylphenidate or lisdexamfetamine for ADHD, there is a reasonable chance you have already run into a wall at the pharmacy. A prescription in hand, a pharmacist apologising, and the instruction to try elsewhere. For some people this has been a recurring experience since 2023. The ADHD medication shortage UK 2026 is not a brief supply blip, it reflects a structural problem that regulators, manufacturers, and the NHS have struggled to resolve.

    Pharmacist reviewing a prescription during the ADHD medication shortage UK 2026
    Photo by cottonbro studio on Pexels

    I want to be honest about what we do and do not know here, because there is a lot of speculation circulating online. What is clear is that the shortage is real, measurable, and damaging. What is less clear is exactly when it will be fully resolved. This article covers the documented causes, who is being hit hardest, and what options exist for people caught in the gap right now.

    Why the ADHD medication shortage is happening

    There are several overlapping reasons, and none of them alone fully explains the scale of the problem.

    First, demand has risen sharply. As covered in the surge in adult ADHD diagnoses across Britain, the number of people being assessed and diagnosed has grown considerably over the past four years. More diagnoses mean more prescriptions, and manufacturing capacity did not scale alongside that growth.

    Second, methylphenidate and lisdexamfetamine are controlled drugs under the Misuse of Drugs Regulations 2001. This means their production is subject to quotas set at both national and international level. The International Narcotics Control Board sets global manufacturing limits for controlled substances, and increasing production legally takes time. The MHRA and the Department of Health and Social Care have been engaging with manufacturers to raise those limits, but the process is slow.

    Third, there are supply chain vulnerabilities specific to pharmaceutical manufacturing. The active pharmaceutical ingredients for many stimulant medications are produced by a small number of facilities globally. Disruptions at any of those sites, whether through regulatory inspections, raw material shortages, or production issues, create ripple effects across entire markets. The UK is not uniquely exposed here, but it is not insulated either. The MHRA’s medicine supply notifications page has tracked multiple alerts across different formulations since 2023.

    Fourth, the shortage feeds on itself. When one formulation or brand becomes unavailable, patients and pharmacies seek alternatives. That increased demand for the alternative then creates a secondary shortage. By mid-2025 this was visible across multiple methylphenidate brands simultaneously.

    Which medications and formulations are most affected

    The picture shifts week to week, which is part of what makes this so difficult to navigate. Broadly speaking, modified-release methylphenidate formulations have been the most consistently affected. Brands including Concerta XL, Equasym XL, and Medikinet XL have all experienced periods of limited availability. Immediate-release methylphenidate tablets have generally been more available, though not always in the specific dose required.

    Lisdexamfetamine (Vyvanse, and the generic lisdexamfetamine dimesylate that became available from 2024) has also been affected, though the pattern has been somewhat different, more localised to certain regions and wholesalers rather than a blanket national scarcity.

    Atomoxetine (Strattera and generics), which is a non-stimulant ADHD medication, has generally remained more available. This matters for patients and prescribers considering alternatives, though atomoxetine does not suit everyone and takes several weeks to reach therapeutic effect.

    Who is most affected and why

    Adults newly diagnosed with ADHD are often in the most precarious position. Shared care agreements, where a GP takes over prescribing from a specialist, are not always in place or functioning smoothly. When a shortage strikes and a patient needs a switch in formulation or brand, they may find their GP unwilling to adjust the prescription without specialist input, and their specialist clinic has a waiting list for follow-up appointments stretching months.

    Children on stable regimens are also seriously affected. Missing doses is not trivial. For many children, consistent medication is directly tied to their ability to function at school, manage emotional regulation, and sleep properly. Parents have reported significant distress trying to source medication across multiple pharmacies, sometimes travelling considerable distances.

    People in rural areas, those without easy transport, and those without the time or confidence to advocate for themselves are disproportionately affected. Navigating a shortage requires persistence, flexibility, and often the ability to contact multiple services, none of which should be prerequisites for accessing a prescribed medicine.

    The NHS waiting list problem also intersects here painfully. As I have written about before, the pressures on NHS waiting lists are already pushing patients towards DIY solutions, and ADHD medication shortages accelerate that pressure in a particularly risky direction. Some people have reported sourcing medication from private online pharmacies of questionable legitimacy. That route carries real risks, including receiving counterfeit or incorrectly dosed medication.

    What patients can actually do right now

    This is where I want to be genuinely useful rather than just explain the problem.

    Contact multiple pharmacies before assuming the medication is unavailable everywhere. Stock levels vary significantly between pharmacies even within the same town. Independent pharmacies sometimes have access to different wholesalers than large chains. Ring around. It is tedious, but it works more often than people expect.

    Ask your pharmacist to check the specific manufacturer, not just the drug name. If Concerta XL is unavailable, a generic methylphenidate modified-release from a different manufacturer may be in stock. Your prescriber may need to adjust the prescription, but pharmacists can often advise on what equivalents are available and contact your GP directly if you give consent.

    Talk to your prescriber about a contingency plan before you run out. If you have a week’s supply remaining, that is the time to contact your GP or specialist, not when you are on your last tablet. Ask specifically whether a different formulation or brand could be prescribed temporarily, and whether immediate-release tablets could bridge a gap.

    Check the MHRA supply notifications and the ADHD UK charity’s resources. ADHD UK has published practical, up-to-date guidance on navigating the shortage, and their information is more current than most NHS pages on the subject.

    If you are self-funding privately, ask your prescribing clinician about licensed alternatives. Guanfacine extended-release (Intuniv) is licensed for ADHD in children and adolescents, and some adults are prescribed it off-label. It is not a stimulant and does not suit everyone, but for some patients it provides a workable bridge.

    Document everything. Keep records of which pharmacies you contacted, what you were told, and when. If you are missing doses due to supply failures and this is affecting your health or your child’s education, that record may be relevant if you need to escalate a complaint or access emergency provision.

    What regulators and the NHS are doing

    The MHRA has issued several guidance documents and supply notifications since 2023, and the Department of Health and Social Care has been in ongoing discussions with manufacturers. NHS England has also updated guidance for prescribers around switching formulations during shortage periods.

    Progress is real, but uneven. Some formulations have returned to more stable supply while others remain constrained. The honest answer is that full resolution is not imminent. The structural factors, controlled drug quotas, manufacturing concentration, and rising demand, will take time to fully address.

    If you are managing ADHD in 2026 and feeling let down by the system, that frustration is legitimate. The shortage is not a personal failing, a pharmacy problem you can easily solve, or something that should require you to spend hours on the phone every month. It is a systemic issue, and the people bearing the cost of it are patients who had no say in creating it.

  • Seed Oils, Saturated Fat and the Online Culture War: What UK Nutrition Science Actually Says

    Seed Oils, Saturated Fat and the Online Culture War: What UK Nutrition Science Actually Says

    If you spend any time on health-focused corners of the internet, you will have encountered the argument: seed oils are poison, they cause inflammation, they are behind every modern chronic disease, and you should throw out your rapeseed oil and replace it with beef tallow immediately. On the other side, you will find people calling that view dangerous nonsense peddled by grifters. Both camps shout loudly. Neither is particularly useful if you are just trying to eat well.

    I want to be straightforward with you here. The seed oils debate is a real scientific question buried under an enormous pile of online culture war. The evidence is not settled in either extreme direction, and UK dietary guidance has not dramatically shifted despite what you may have read. So let us look at what systematic reviews and NHS guidance actually say, and what that means for the oils sitting in your kitchen cupboard.

    Various cooking oils on a kitchen counter, relevant to seed oils health evidence UK
    Photo by Golboo Maghooli on Pexels

    What do we actually mean by seed oils?

    The phrase “seed oils” tends to get used loosely online to mean refined, polyunsaturated vegetable oils, most commonly sunflower, rapeseed, corn, soybean, and similar products. Olive oil, despite technically being pressed from a fruit and sharing some processing characteristics with the others, is usually spared the criticism, presumably because Mediterranean diet research flatters it.

    These oils are high in polyunsaturated fatty acids (PUFAs), particularly omega-6 linoleic acid. The concern raised by critics is that linoleic acid metabolises into arachidonic acid, which can produce pro-inflammatory signalling molecules. That part is biochemically accurate. The leap from there to “seed oils are destroying your health” is where the evidence gets considerably thinner.

    What systematic reviews actually find

    The most robust body of evidence on dietary fat and cardiovascular disease comes from systematic reviews and meta-analyses of randomised controlled trials, not from mechanistic arguments about what a fatty acid does in a test tube.

    A 2020 Cochrane review on reducing saturated fat intake found that replacing saturated fat with polyunsaturated fat, including omega-6-rich seed oils, reduced cardiovascular events by around 17%. The effect on all-cause mortality was less clear, but the cardiovascular signal was consistent across trials. That review looked at over 79,000 participants across 15 trials. It is not a trivial dataset.

    The American Heart Association’s advisory on dietary fats, which draws on much of the same trial literature, reached similar conclusions, though I am more interested in what UK bodies say for obvious reasons. NHS guidance on dietary fats recommends limiting saturated fat and suggests replacing it with unsaturated fats, including oils like rapeseed and sunflower, precisely because the cardiovascular trial evidence supports that swap.

    The SACN (Scientific Advisory Committee on Nutrition), which advises UK government dietary policy, reviewed fat intake in 2019. Its conclusions were consistent with decades of prior guidance: reduce saturated fat, particularly from processed meat and full-fat dairy, and replace with unsaturated alternatives. Seed oils, in that framework, are not the enemy. They are the recommended substitute.

    The oxidation argument and why it needs context

    One of the more credible criticisms of refined seed oils is their instability when heated. Polyunsaturated fats oxidise more readily than saturated or monounsaturated fats at high temperatures, producing compounds including aldehydes that are potentially harmful. A 2015 study from De Montfort University in Leicester, led by Professor Martin Grootveld, found that sunflower oil and corn oil heated to frying temperatures produced significantly more aldehydes than alternatives like olive oil or butter.

    That finding gets amplified in seed oil sceptic circles to mean you should never cook with seed oils. The more measured interpretation is that high-heat cooking with refined polyunsaturated oils is probably not ideal, and alternatives like rapeseed oil (which is lower in polyunsaturates than sunflower), olive oil, or even small amounts of butter are reasonable choices for frying. This is a different claim from “sunflower oil in a salad dressing is damaging your cardiovascular system.”

    Context matters. The UK population is not primarily consuming seed oils through shallow-frying at home. A significant share of dietary intake comes from ultra-processed foods, restaurant meals, and fast food, where the picture is already complicated by salt, refined carbohydrates, and total calorie load. Blaming seed oils in isolation from that broader dietary pattern is intellectually incomplete.

    Where olive oil sits in all of this

    Olive oil is almost universally praised on both sides of the debate, which is itself a bit revealing. It is high in oleic acid, a monounsaturated fat, and extra virgin olive oil contains polyphenols with genuine anti-inflammatory properties backed by multiple trials. The Mediterranean diet, which uses olive oil as its primary cooking fat, has the strongest trial evidence of any dietary pattern for cardiovascular outcomes, including the PREDIMED trial of over 7,000 participants.

    The honest answer is that olive oil is probably the best daily cooking oil for most UK adults if they can afford it and are not cooking at extremely high temperatures repeatedly. Rapeseed oil is a reasonable and cheaper alternative; it has a better fatty acid profile than sunflower oil and is grown domestically. Sunflower oil is fine in moderation for low-heat cooking. None of these is a health catastrophe at normal dietary doses.

    The seed oils health evidence UK debate is genuinely interesting if you approach it without the tribal framing. There are legitimate open questions: the optimal ratio of omega-6 to omega-3 in the diet, the effects of industrial processing on oil quality, the long-term effects of diets very high in linoleic acid. These deserve serious research attention. What they do not justify is the sweeping claim that swapping your rapeseed oil for lard or tallow is a clear cardiovascular upgrade, because the trial evidence does not support that.

    What the noise drowns out

    Debates like this one have a habit of distracting people from changes that would make a measurable difference. The UK population broadly eats too little fibre, too few vegetables, too much processed food, and not enough oily fish. Those patterns carry a well-evidenced cardiovascular and metabolic cost that dwarfs any realistic effect of using sunflower oil instead of olive oil.

    I have written previously on this blog about how inflammation claims around seed oils tend to outpace the evidence, and separately about the risks of using online sources to self-diagnose dietary problems without clinical input. Both feel relevant here. The seed oil conversation lives almost entirely in online spaces where nuance does not travel well.

    If you have a genuine concern about your cardiovascular risk, the productive conversation is with a GP or a registered dietitian, not a social media thread. If your diet broadly follows NHS guidance, includes plenty of whole foods, and uses a variety of fats rather than any single oil in huge quantities, the evidence suggests you are not doing yourself serious harm through your oil choice. That is a dull conclusion, but it is the honest one.

    Frequently Asked Questions

    Are seed oils actually bad for you according to UK health guidance?

    NHS and SACN guidance does not classify seed oils like rapeseed or sunflower oil as harmful. Current UK dietary advice recommends replacing saturated fat with unsaturated fats, which includes these oils. The evidence from systematic reviews supports that swap for cardiovascular health.

    Is cooking with sunflower oil dangerous?

    Sunflower oil produces more oxidation byproducts than olive oil or butter at high frying temperatures, as shown in UK research from De Montfort University. For repeated high-heat cooking, olive oil or rapeseed oil are better choices. Used occasionally at moderate temperatures, sunflower oil is not considered a meaningful health risk.

    Is olive oil healthier than rapeseed oil for UK cooking?

    Extra virgin olive oil has the strongest evidence base, particularly for cardiovascular outcomes, partly due to its polyphenol content. Rapeseed oil is a close and cheaper alternative with a good fatty acid profile and is produced in the UK. Both are sensible choices for everyday cooking.

    Do seed oils cause inflammation?

    Linoleic acid in seed oils can convert to pro-inflammatory compounds via arachidonic acid, but clinical trials have not consistently shown that normal dietary intakes of seed oils raise inflammatory markers in humans. The mechanistic concern is real but has not translated clearly into observable harm in trial populations.

  • Hypermobility, Chronic Pain and the Decade-Long Wait for Answers: What UK Patients Need to Know

    Hypermobility, Chronic Pain and the Decade-Long Wait for Answers: What UK Patients Need to Know

    If you have spent years being told your joints are ‘just flexible’, that your fatigue is anxiety, or that your pain is disproportionate to what the scans show, there is a reasonable chance hypermobility has never been seriously considered. That is not a fringe experience. For many people with hypermobility spectrum disorder (HSD) or hypermobile Ehlers-Danlos syndrome (hEDS), the path to a meaningful diagnosis runs through a decade of appointments, misdiagnoses and, frequently, being made to feel like the problem is psychological. The hypermobility chronic pain NHS UK picture is improving, slowly, but patients still need to understand what they are dealing with and what they can reasonably expect.

    Woman discussing hypermobility chronic pain with NHS GP during a consultation
    Photo by RDNE Stock project on Pexels

    What hypermobility spectrum disorder actually is

    Hypermobility refers to joints that move beyond the normal range. In children, some degree of flexibility is common and usually harmless. The clinical picture changes significantly when hypermobility comes with chronic pain, fatigue, frequent joint injuries, proprioception problems, and a range of systemic symptoms that do not fit neatly into any single specialty.

    The 2017 international classification separated hEDS from HSD to reflect that these are related but distinct conditions. hEDS is diagnosed using specific clinical criteria around joint hypermobility, skin features and family history. HSD covers patients who have symptomatic hypermobility without meeting the full hEDS criteria. Crucially, both conditions cause real, significant disability. The distinction matters for research purposes but should not imply that HSD is a lesser diagnosis deserving less support.

    Connective tissue is present throughout the body, which is why the symptom list is so wide. Beyond joint pain and instability, many patients deal with gastrointestinal problems, bladder dysfunction, chronic fatigue, and dysautonomia. That last one, particularly postural tachycardia syndrome (PoTS), is underrecognised and often the symptom that sends patients spiralling through cardiology, neurology and psychiatry before anyone joins the dots.

    Why dysautonomia keeps getting missed

    Dysautonomia is a dysfunction of the autonomic nervous system, the part that regulates heart rate, blood pressure, digestion and temperature control. In hypermobile patients, PoTS is the most common form. Standing up causes heart rate to spike by 30 beats per minute or more within ten minutes, producing dizziness, brain fog, nausea and sometimes fainting. The NHS describes PoTS as often taking years to diagnose partly because symptoms mimic anxiety, and partly because lying-down examinations will look completely normal.

    I have spoken to patients who were discharged from cardiology with ‘no structural abnormality’ after a routine ECG, then spent another two years cycling back through their GP before anyone performed a simple active stand test. That test takes minutes. The delay does not reflect a lack of good clinicians; it reflects a system organised around organ-specific specialties that struggles with conditions that are inherently systemic.

    How long does diagnosis actually take in the UK?

    The Ehlers-Danlos Support UK charity has surveyed its members repeatedly and the results are consistent: average time from first seeking help to diagnosis with hEDS or HSD runs to around ten years. That figure has been cited in parliamentary discussions and has not shifted dramatically even as awareness has grown. Part of the delay is structural. There is no single NHS specialty that ‘owns’ hypermobility. Rheumatology, physiotherapy, genetics and pain medicine all have a claim, and which door a patient gets through first is largely down to chance and geography.

    There is also a troubling pattern around gender. The majority of hEDS and HSD patients are women, and the symptoms, particularly fatigue and widespread pain, are historically more likely to be attributed to anxiety or depression in female patients. This is not unique to hypermobility; it is a documented pattern across several chronic conditions. But it compounds the diagnostic delay significantly.

    The fatigue element is worth addressing directly. Many hypermobility patients meet criteria for what was previously called chronic fatigue syndrome. The body is working harder simply to stabilise joints, the autonomic dysfunction disrupts sleep, and pain is itself exhausting. If you are navigating that combination, the situation facing ME/CFS patients in the NHS in 2026 is closely relevant reading, because the service gaps overlap considerably.

    What NICE guidance and NHS specialist pathways actually offer

    NICE does not currently have a dedicated guideline specifically for hEDS or HSD. Management draws on guidance for related conditions: chronic pain (NG193, published 2021), PoTS, and physiotherapy for joint hypermobility. NG193 represents a genuine shift in how the NHS is supposed to approach chronic pain, moving away from purely biomedical models towards personalised care that includes psychological support alongside physical treatment. In practice, implementation is patchy. Pain clinics vary enormously in quality and waiting times.

    For specialist input, NHS England has commissioned a small number of hypermobility clinics, mostly concentrated in London and a few other urban centres. The Hypermobility Unit at the Hospital of St John and St Elizabeth (now operating privately) and the NHS clinic at University College London Hospital are among the most referenced. Outside these centres, most patients are managed in general rheumatology or through physiotherapy alone, which is insufficient for the complexity most of them present with.

    Physiotherapy is the cornerstone of physical management and the evidence supports it, but the emphasis has shifted. Passive stretching is actively counterproductive in hypermobility. Proprioception training, joint stabilisation and carefully progressed strength work are what the evidence points to. The parallel here is worth noting: the case for strength-based exercise in managing chronic musculoskeletal conditions is consistent across the research, much as it is when looking at strength training’s benefits for adults managing chronic conditions later in life.

    Managing chronic pain when the system keeps you waiting

    A realistic read of the current NHS landscape is that most hypermobile patients will not quickly access a specialist clinic. They will manage symptoms partly through physiotherapy, partly through their GP, and partly through their own research. That is not ideal, but it is the current reality.

    A few things are worth knowing. Referral to a genetics clinic can be useful for formal hEDS classification, though waiting lists are long. PoTS, once suspected, can be tested simply with a GP-arranged lying and standing blood pressure and heart rate check. Many GPs will not have initiated this themselves, but they can arrange it once a patient raises it specifically.

    Pacing strategies, borrowed from ME/CFS management, are genuinely helpful for fatigue. The instinct to push through pain on good days and crash on bad ones is understandable but makes the cycle worse. Activity management based on a sustainable baseline, then gradual increments, is the approach most specialist physiotherapists will take.

    Medication for pain is limited in its usefulness. The 2021 NICE guidance on chronic primary pain explicitly moved away from recommending paracetamol, NSAIDs and opioids as the default response, which is significant given how many hypermobility patients have been handed these as a first-line response for years. Low-dose naltrexone and duloxetine are among the options discussed in specialist contexts, but neither is a quick fix and both should be managed with medical oversight.

    Where patient advocacy makes a practical difference

    Ehlers-Danlos Support UK runs helplines, condition guides and connects patients with healthcare professionals who have specific experience. Their resources are genuinely useful for preparing for appointments and understanding what to ask for. The Hypermobility Syndromes Association (HMSA) similarly provides practical support and has a directory of healthcare professionals with relevant experience.

    Self-advocacy is not a phrase that should be needed in a functional health system. But for patients who have spent years being told nothing is wrong, having a clear vocabulary for what you are experiencing, the specific diagnostic criteria, the associated conditions to raise, the tests that are appropriate, makes appointments more productive. It should not be that way. It currently is.

    Chronically complex conditions handled patchily by a stretched NHS tend to push patients towards self-directed solutions, and not all of those solutions are evidence-based. The supplement market is enthusiastic about hypermobility. Magnesium, vitamin C and collagen products are widely marketed to connective tissue disorder patients. Some have a plausible rationale; most lack robust trial evidence in this specific population. If you are thinking through supplementation, the evidence around magnesium deficiency and supplementation in the UK is a reasonable starting point for calibrating expectations.

    The hypermobility chronic pain NHS UK picture is genuinely difficult right now. Awareness is higher than it was, specialist services exist but are limited, and the diagnostic journey remains far too long for too many people. That does not make it hopeless. Physiotherapy, pacing, accurate diagnosis of associated conditions like PoTS, and engagement with patient charities all make a real difference. The wait for systemic improvement continues, but there is more support available today than there was five years ago.

    Frequently Asked Questions

    How do I get referred for hypermobility assessment on the NHS?

    Start with your GP and ask specifically for a referral to rheumatology or a hypermobility clinic if one is accessible in your area. Bringing a clear symptom timeline and mentioning the Beighton score criteria can help focus the conversation. NHS England has commissioned a small number of specialist hypermobility services, though access depends heavily on where you live.

    What is the difference between hEDS and hypermobility spectrum disorder?

    Both involve symptomatic joint hypermobility, but hEDS requires meeting specific clinical criteria set out in the 2017 international classification, including features like skin involvement and a positive family history. HSD is diagnosed when significant symptoms are present but the full hEDS criteria are not met. Both cause real disability and should be taken seriously by clinicians.

    Can hypermobility cause fatigue as well as joint pain?

    Yes, and this is frequently underestimated. The body uses significantly more muscular effort to stabilise hypermobile joints, autonomic dysfunction disrupts sleep quality, and chronic pain is itself draining. Many hypermobility patients meet diagnostic criteria for chronic fatigue conditions alongside their musculoskeletal symptoms.

    What is PoTS and how is it connected to hypermobility?

    Postural tachycardia syndrome (PoTS) is a form of dysautonomia where standing causes a rapid heart rate increase, producing dizziness, brain fog and sometimes fainting. It is significantly more common in people with hypermobile connective tissue disorders. A basic lying and standing heart rate test is usually the first diagnostic step and can be arranged through your GP.

  • Continuous Glucose Monitors Are Being Marketed to Healthy Britons, Here Is What the Evidence Actually Justifies

    Continuous Glucose Monitors Are Being Marketed to Healthy Britons, Here Is What the Evidence Actually Justifies

    Continuous glucose monitors were, not long ago, a clinical tool for people managing type 1 diabetes or unstable type 2. Now they are being advertised on Instagram, sold through wellness subscription services, and worn by healthy thirtysomethings who want to understand their “metabolic health”. In the UK, companies like Levels, Zoe and Supersapiens have made CGM for non-diabetics a genuine consumer category, with prices typically starting around £99 to £200 per month depending on the service. That is real money for what, in many cases, amounts to real-time blood glucose data that a healthy person may have no clinical need for.

    I want to be clear upfront: this is not an attack on the technology. CGMs are genuinely impressive medical devices, and the data they produce is real. The question is whether the interpretation layers being sold alongside them, and the lifestyle changes being recommended on the basis of individual glucose responses, are justified by the evidence we actually have.

    Woman checking CGM for non-diabetics use on her arm in a home kitchen
    Photo by Nataliya Vaitkevich on Pexels

    What CGMs are approved to do in the UK

    The MHRA regulates CGMs as medical devices under the UK Medical Devices Regulations 2002 (as amended). Devices like the Abbott FreeStyle Libre, which is also available on NHS prescription for eligible patients with diabetes, are approved as aids for glucose monitoring in people with diabetes. They are not approved as metabolic optimisation tools for healthy adults. That distinction matters, because it means the claims made in wellness marketing sit outside the scope of what regulators have actually evaluated.

    The Advertising Standards Authority has already taken action against some health brands for making unsubstantiated claims. If you see a CGM subscription service promising it will help you “unlock fat burning” or “end energy crashes”, those are marketing claims, not clinical findings. Treat them accordingly.

    What does the research actually say about CGM for non-diabetics?

    The honest answer is: not much, and what exists is mixed. A 2023 study published in Nature Medicine (the Stanford-led DIETFITS follow-up work examining glycaemic variability) found that individual glucose responses to food varied considerably even among healthy people. That finding has been heavily used by CGM companies to argue that personalised nutrition guidance, informed by your own glucose data, produces better outcomes. But the leap from “glucose responses vary” to “wearing a CGM will improve your health or performance” is not supported by robust clinical trials in non-diabetic populations.

    A 2024 review in The Lancet Diabetes & Endocrinology noted that while CGMs generate large volumes of data in healthy individuals, there is currently insufficient evidence that acting on that data produces meaningful improvements in weight, cardiovascular risk, or athletic performance compared to established dietary approaches. The reviewers called for randomised controlled trials in non-clinical populations before widespread recommendation. We are still waiting for those trials.

    In healthy adults, blood glucose generally stays within a tight range regardless of what you eat. The dramatic-looking spikes that some CGM apps flag as alarming are often physiologically normal. A glucose rise after a bowl of porridge is not the same thing as the sustained hyperglycaemia seen in diabetes. Yet some CGM coaching services treat any excursion above a certain threshold as a problem to be solved through dietary restriction, which risks encouraging unnecessary anxiety about food.

    Smartphone showing blood glucose data relevant to CGM for non-diabetics tracking
    Photo by Tessy Agbonome on Pexels

    The performance claims deserve particular scrutiny

    Supersapiens, which markets its CGM service specifically to athletes, has attracted a following among cyclists, runners, and endurance competitors. The premise is that knowing your glucose in real time helps you fuel more precisely during training and racing. I find this genuinely interesting as a concept. Sports nutrition is a field where small margins matter, and glucose management during prolonged effort is well established as important.

    But “interesting concept” and “proven performance advantage” are different things. The peer-reviewed evidence base for CGM-guided fuelling in non-diabetic athletes is thin. Most sports nutrition guidance from bodies like the British Dietetic Association still centres on periodised carbohydrate intake based on training load and intensity, not real-time glucose response. Until we have properly controlled studies showing CGM-guided fuelling outperforms standard evidence-based nutrition practice in healthy athletes, the claims should be held lightly.

    Who might genuinely benefit from CGM data outside a diabetes diagnosis?

    This is where it gets more constructive. There are populations where CGM use in non-diabetic contexts has real clinical logic. People with prediabetes, those with a strong family history of type 2 diabetes, women with a history of gestational diabetes, and people with polycystic ovary syndrome (PCOS) all have elevated risk profiles where understanding glucose variability has some clinical rationale. For these groups, the conversation belongs with a GP or endocrinologist, not a wellness app.

    If you are curious about your metabolic health and you fall into one of these categories, that is worth raising with your NHS GP rather than self-directing via a subscription service. Given how the NHS waiting list pressures are already pushing people towards self-diagnosis, the last thing anyone needs is another layer of uninterpreted data creating unnecessary worry or driving inappropriate dietary restriction.

    The supplement and nutrition industry connection

    CGM services rarely exist in isolation. Most are bundled with dietary coaching, meal planning, and frequently supplements. Once a company has your glucose data, they have a compelling hook for selling you products designed to “smooth” your glucose response: berberine, cinnamon extract, chromium, and various fibre supplements appear regularly in CGM-adjacent marketing. Some of these have limited supporting evidence in clinical populations; most are sold well beyond what the evidence justifies.

    I came across a comparison tool from Nusan whilst researching how UK consumers are trying to make sense of health product claims more broadly, and the pattern is consistent: the supplement market tends to rush into spaces where clinical data is incomplete and consumer interest is high. CGM is no different. If you are being told by a CGM service that you need specific supplements based on your glucose patterns, ask for the clinical evidence before spending your money.

    This also connects to what I have written previously about the supplement boom needing more scrutiny in the UK generally. The CGM category is just the newest entry point.

    What about Zoe specifically?

    Zoe is the highest-profile CGM-adjacent wellness company in the UK, co-founded by Professor Tim Spector of King’s College London. Their programme involves a CGM, gut microbiome testing, and personalised dietary recommendations. Zoe has published peer-reviewed research, including a 2024 paper in Nature Medicine suggesting their personalised dietary programme outperformed standard healthy eating guidance for certain metabolic markers. That is genuinely more rigorous than most commercial wellness programmes.

    But even here, the research involves Zoe’s own programme participants and has not yet been independently replicated at scale. The scientific advisory involvement does not mean every claim in their marketing is substantiated. The NHS guidance on CGM remains focused on people with diabetes and does not endorse its use in healthy adults for weight or performance management.

    The psychological risk nobody talks about

    One concern I have not seen discussed enough is the psychological effect of continuous metabolic monitoring on people who do not have a clinical reason for it. Wearing a device that generates a new data point every few minutes, and then receiving alerts about “high” readings, could reasonably increase health anxiety in some people. There is also a risk of what researchers call “orthorexic” thinking: becoming so focused on optimising food choices around a metric that eating becomes a source of stress rather than pleasure or nourishment.

    If you are already prone to metabolic health anxiety or have a history of disordered eating, a CGM subscription service is not where I would start. Talk to your GP first.

    The bottom line

    CGMs are legitimate, well-engineered medical devices. The data they produce is real. For people managing diabetes, they are genuinely life-changing. For healthy adults with no clinical indication, the evidence that wearing one and adjusting behaviour accordingly produces meaningful health outcomes is currently insufficient to justify the cost, the anxiety, or the supplement spending that tends to follow. The commercial ecosystem around CGM for non-diabetics has moved considerably faster than the science. That gap is worth understanding before you subscribe.

    Frequently Asked Questions

    Can I get a CGM on the NHS if I don't have diabetes?

    Generally no. NHS CGM prescriptions are reserved for people with type 1 diabetes and some people with type 2 diabetes who meet specific clinical criteria. If you are interested in CGM for metabolic monitoring without a diabetes diagnosis, you would need to purchase it privately through a commercial service.

    Is it safe to use a CGM if I am not diabetic?

    The devices themselves are safe for most people; they involve a small sensor inserted just under the skin. The main risks for non-diabetic users are psychological, including health anxiety from misinterpreting normal glucose fluctuations, and financial, given the ongoing subscription costs. If you have a history of disordered eating, speak to a GP before using one.

    Do CGMs actually help with weight loss in healthy people?

    Current evidence does not support CGM use as an effective weight loss tool in people without diabetes or prediabetes. A 2024 Lancet review found insufficient evidence that acting on CGM data in healthy adults produces better weight outcomes than established dietary approaches. The personalised nutrition framing is compelling, but the clinical proof is not there yet.

  • The NHS Waiting List and the DIY Health Trap: Why More UK Patients Are Self-Diagnosing and What It Costs Them

    The NHS Waiting List and the DIY Health Trap: Why More UK Patients Are Self-Diagnosing and What It Costs Them

    The NHS waiting list hit 7.5 million in England by late 2024, and while the numbers have edged down slightly since, millions of people are still waiting months, sometimes over a year, for a specialist appointment. That gap between symptom and consultation does not stay empty. People fill it. They search, they scroll, they ask Reddit, they use AI symptom checkers, and in many cases they arrive at a conclusion long before any clinician sees them. Self-diagnosis during long NHS waiting times has become one of the more significant, and underreported, consequences of the backlog.

    I find this genuinely concerning, not because patients are foolish for doing it, but because the incentives are completely understandable and the risks are largely invisible until something goes wrong.

    Person searching health symptoms online during long NHS waiting times for self-diagnosis
    Photo by VAZHNIK on Pexels

    Why the waiting list is driving people to self-diagnose

    The psychology here is straightforward. Uncertainty is uncomfortable. When a GP refers you to a specialist but cannot tell you what is wrong, and when that referral letter sits in a queue for eight, twelve, sixteen months, the mind looks for answers elsewhere. According to NHS England’s own guidance on elective waiting times, patients referred urgently for suspected cancer should be seen within two weeks, but non-urgent referrals routinely extend far beyond that.

    A 2023 survey by the Nuffield Trust found that almost half of adults in England reported delaying or avoiding GP contact because they expected a long wait. Many went online first. That figure is likely higher now. The average time from GP referral to first outpatient appointment for non-urgent cases sits well above eighteen weeks in many specialities, and in some areas, including orthopaedics and dermatology, patients are waiting considerably longer.

    The result is a predictable loop. Symptom appears. Person waits for GP appointment. GP refers. Person waits again. Person turns to Google, then to a Reddit thread, then possibly to an AI chatbot. By the time the specialist sees them, some patients have already decided what they have, and that framing shapes how they present their history and how receptive they are to a different diagnosis.

    What self-diagnosis actually gets wrong

    This is where the clinical consequences become serious. Self-diagnosis tends to fail in two directions: over-diagnosis (convincing yourself of something rare or serious) and under-diagnosis (reassuring yourself that a concerning symptom is benign). Both carry real costs.

    Research published in the BMJ Open in 2022 assessed the accuracy of online symptom checkers across a range of common presentations. The correct diagnosis appeared in the top three results only around 51% of the time. For rarer conditions, the accuracy dropped further. AI chatbots have improved since then, and I’ve written elsewhere about what actually happens when UK patients use AI tools to interpret their symptoms, but even the better tools are not substitutes for examination, blood tests, imaging or a clinician who can ask a follow-up question based on your expression rather than your typed words.

    GP consultation illustrating the clinical risks of self-diagnosis after NHS waiting times
    Photo by Thirdman on Pexels

    There is also the nocebo problem. Reading extensively about a condition, particularly on patient forums or health anxiety communities, can amplify symptoms. A 2021 paper in Health Psychology Review identified that health-related online searching is associated with increased anxiety and, in some cases, with patients reporting more severe symptoms after researching them. The term “cyberchondria” is used clinically now, not as a dismissal but as a genuine pattern of escalating worry driven by online health information.

    GPs are increasingly reporting patients who arrive with a firm self-diagnosis that is incorrect but fiercely held. This changes the consultation. The GP has to spend time addressing the incorrect belief before they can assess the actual presentation. That takes time that primary care does not have.

    Reddit, Facebook groups and the problem with crowd-sourced health advice

    Online health communities are not inherently harmful. Forums for conditions like ME/CFS or IBD can offer peer support that the NHS simply cannot provide at scale, and I’ve looked at how IBD patients in particular are being let down by poor social media health information. But there is a meaningful difference between emotional support and diagnostic guidance.

    Reddit threads on medical topics are written by anonymous people of unknown clinical background. The most upvoted answer is not necessarily the most accurate one; it is the most engaging, the most confident, or the one that confirmed what readers already believed. A person describing a cluster of symptoms will often receive several different “diagnoses” in the replies, and they will tend to latch onto whichever one fits the narrative they’ve already built.

    This is not a criticism of the people offering help. It is a structural problem with how unmoderated health communities function. Confidence is rewarded. Nuance is boring. And the person who says “I can’t tell from a text description, see your GP” gets fewer upvotes than the person who says “that sounds exactly like X, here’s what worked for me”.

    The supplement and self-treatment rabbit hole

    Self-diagnosis rarely stops at diagnosis. It leads to self-treatment. The UK supplement market was valued at over £500 million in 2024, and a significant portion of that is driven by people treating conditions they believe they have, based on online research. Some of that is harmless. A lot of it is not, particularly where supplements interact with medications or where the underlying condition actually requires treatment.

    I’ve covered how the magnesium supplement boom in the UK has been partly driven by people self-diagnosing deficiency based on vague symptoms that have multiple possible causes. The supplement might do nothing, or it might delay the person from investigating what is actually wrong. In some cases, self-treatment provides enough symptomatic relief that the underlying problem goes unaddressed until it is harder to treat.

    Content monetisation plays a role here too. Publishers and creators who build health content around popular symptom searches are often funded by the very supplement brands their articles recommend. This is a significant conflict of interest that most readers do not notice. Even well-designed content platforms, whether funded by advertising or through affiliate relationships with brands like Banner Ads, can create incentive structures where the editorial framing is shaped by commercial considerations rather than clinical accuracy.

    What patients can actually do while they wait

    None of this means patients should sit passively and wait. There are things worth doing.

    First, keep a symptom diary. Dates, duration, severity, triggers. This is genuinely useful information for a clinician and it gives the waiting period some productive focus. Second, if symptoms change significantly or new ones appear, contact the GP again rather than adding them to your mental self-diagnosis. Third, use the NHS 111 service for acute concerns rather than A&E or Google. It is under-used and designed exactly for the “I’m not sure if this is urgent” scenario.

    If you are using online resources, the NHS website, NICE guidelines and the information sections of established patient charities are substantially more reliable than general forums. Versus Arthritis, the British Heart Foundation, Diabetes UK: these organisations produce patient information that is clinically reviewed and updated. They are not a replacement for medical assessment, but they are a different class of source from a Reddit thread.

    The waiting list problem is real and the frustration driving people to self-diagnose is legitimate. What I’d push back on is the idea that self-diagnosis is a neutral act. It carries clinical risk, psychological cost, and a tendency to narrow the diagnostic conversation before it has even started. The system is failing people. The response to that failure matters too.

    Frequently Asked Questions

    How long is the average NHS wait for a specialist appointment in 2026?

    For non-urgent referrals, many patients wait well beyond the 18-week standard in England, particularly in specialities like orthopaedics, dermatology and rheumatology. In some areas, waits of 12 to 18 months are not uncommon. NHS England publishes monthly waiting time statistics on its website.

    Is self-diagnosing online actually dangerous?

    It carries real risks in both directions. You can over-diagnose something serious and cause significant anxiety, or under-diagnose something that needs prompt treatment. Research published in BMJ Open found symptom checkers gave the correct diagnosis in their top three results only about 51% of the time, which is not a reliable basis for clinical decisions.

    Are AI symptom checkers better than Google for self-diagnosis?

    Modern AI tools are generally more structured than a Google search and can ask follow-up questions, but they still cannot examine you, order tests or account for the full clinical picture. They can be useful for thinking through whether a symptom needs urgent attention, but should not be used to reach a specific diagnosis or guide self-treatment.

    What should I do if my NHS referral is taking a very long time?

    You can ask your GP to check the status of your referral and whether the waiting time is within the 18-week standard. If your symptoms worsen or change while you are waiting, contact your GP again rather than waiting for the appointment. NHS 111 is also available for concerns that feel more urgent.

  • AI Self-Diagnosis in the UK: What Happens When Patients Use Chatbots to Interpret Their Symptoms

    AI Self-Diagnosis in the UK: What Happens When Patients Use Chatbots to Interpret Their Symptoms

    Something has quietly shifted in how people in the UK engage with their health before they ever book a GP appointment. Rather than reaching for NHS 111 or typing symptoms into a search engine, a growing number of patients are having full-length, back-and-forth conversations with large language models, asking things like “could this be lupus?” or “should I be worried about this lump?” The results of those conversations are shaping what people believe, how urgently they act, and in some cases, what they tell their doctors when they eventually do get a consultation.

    AI self-diagnosis in the UK is not a fringe behaviour any more. A 2024 survey by the Nuffield Trust found that digital health tools, including AI-driven ones, were being used by patients in ways that outpaced any formal guidance on appropriate use. The question worth asking plainly is: how accurate is AI when it comes to interpreting human symptoms, and who is responsible when it gets it wrong?

    Woman using a smartphone to look up symptoms, illustrating AI self-diagnosis UK behaviour
    Photo by Laura James on Pexels

    What the research actually shows about chatbot diagnostic accuracy

    The headline findings on accuracy are mixed, and I’d argue the nuances matter more than the averages. A 2023 study published in JAMA Internal Medicine found that ChatGPT performed reasonably well on standardised clinical vignettes, ranking the correct diagnosis in its top three suggestions around 72% of the time. Sounds reassuring until you consider what the other 28% of cases looked like, and that real patients presenting to chatbots rarely match the clean framing of a clinical vignette.

    The more concerning pattern is directional confidence. Large language models, by design, generate fluent, authoritative-sounding text. A patient asking about chest tightness and fatigue might receive a response that confidently prioritises anxiety or acid reflux, without adequately surfacing the possibility of cardiac involvement. The model is not lying. It is doing exactly what it was trained to do: produce plausible, coherent output weighted by probability. But medicine is full of low-probability, high-consequence events that probability-weighted systems systematically underweigh.

    Research from University College London published in early 2025 looked specifically at patients who had used AI tools to interpret symptoms before a GP visit. Around 34% had formed a strong prior belief about their diagnosis before the consultation, and GPs reported that challenging those beliefs added meaningful time pressure to already stretched appointments. This is a practical problem with systemic consequences.

    Why certain symptom types carry higher risk

    Not all AI symptom checking carries equal risk. For common, self-limiting conditions, a chatbot telling someone they likely have a cold or mild gastroenteritis is probably harmless, and might even reduce unnecessary demand on NHS services. The risk concentrates in two areas.

    First, rare or atypical presentations of serious conditions. Symptoms of conditions like ME/CFS are notoriously diffuse and overlap with dozens of other diagnoses. An AI trained predominantly on mainstream clinical literature may push patients toward more common explanations and away from the right one. Second, mental health presentations. A patient describing low mood, cognitive fog, and fatigue might be told by a model that they sound stressed or sleep-deprived, when what they are experiencing is a prodrome of something requiring clinical assessment.

    GP consultation desk representing the clinical encounter following AI self-diagnosis in the UK
    Photo by Thirdman on Pexels

    There is also a particular problem with supplement and lifestyle recommendations that chatbots often attach to their diagnostic suggestions. A patient convinced they have a magnesium deficiency based on an AI conversation might spend weeks self-treating before discovering the real cause of their symptoms. The information itself is not necessarily wrong; the sequencing and framing almost always is.

    Where UK regulation currently stands

    This is where things get genuinely complicated. The MHRA’s updated framework for software as a medical device, which I’ve covered in the context of AI-driven health apps, applies to tools that are intended to be used for a medical purpose. The word “intended” is doing enormous work here. A general-purpose large language model, such as ChatGPT or Google’s Gemini, is not marketed as a diagnostic tool. Its developers explicitly disclaim medical use. That puts it largely outside the MHRA’s current regulatory perimeter, even when patients are using it for exactly that purpose.

    The Care Quality Commission, which regulates health services in England, has similarly limited reach here. CQC oversight applies to registered providers. A software product that refuses to call itself a health service sits in a gap that existing frameworks were never designed to address. The CQC’s 2025 annual report on innovation in health acknowledged the issue without offering a concrete regulatory pathway.

    NHS England has issued informal guidance encouraging patients to use NHS 111 or the NHS App as first points of contact for health concerns, and to treat AI chatbots as general information tools rather than diagnostic ones. That guidance is reasonable. The gap between reasonable guidance and actual patient behaviour is, as usual, wide. You can find the NHS’s current position on digital health tools at nhs.uk.

    What this means for patients navigating it now

    I’d be dishonest if I said AI chatbots have no value in a health context. They can help patients organise and articulate symptoms more clearly before an appointment. They can provide useful background on how a diagnosis works, what questions to ask a GP, or what a prescribed medication does. Used in that framing, as a preparation tool rather than a diagnostic oracle, they are genuinely useful.

    The problem is that the interface encourages a different behaviour. Asking a chatbot “what is causing my headaches?” and receiving a structured, confident three-paragraph response does not feel like reading a general information article. It feels like receiving a personalised assessment. That experiential difference matters, because it shapes how strongly a person holds the belief that follows.

    My honest take: treat any chatbot response about personal symptoms the same way you’d treat advice from a well-read friend with no medical training. Useful context, possibly, but not a clinical opinion. If you are researching health information online more broadly and want better tools for evaluating what comes up in search results, resources like expert free SEO tools can at least help you understand which sources rank highly and why, though that is a separate skill from evaluating medical credibility.

    The harder structural question

    Underneath the accuracy debate is a more uncomfortable truth: patients in the UK are turning to AI in part because accessing a GP in 2026 is genuinely difficult. NHS England data shows average waiting times for a routine GP appointment still exceeding two weeks in many areas. When someone is worried and can’t get timely access to a clinician, a chatbot that responds immediately feels better than nothing. That is not a technology failure. That is a capacity failure that technology is filling imperfectly.

    Regulatory frameworks that treat AI symptom use as purely a tech problem to be policed will miss this. The more productive frame is: how do we design AI health tools that are accurate about their own limitations, that actively route patients toward appropriate care rather than substituting for it, and that work within NHS pathways rather than around them? That design challenge is solvable. The regulatory appetite to mandate it is still catching up.

  • The MHRA’s New Approach to AI Medical Devices: What It Means for the Apps Diagnosing and Monitoring You

    The MHRA’s New Approach to AI Medical Devices: What It Means for the Apps Diagnosing and Monitoring You

    If you have ever used an app to log symptoms, interpret a blood glucose reading, or get a personalised health recommendation, there is a real chance you have interacted with something that the MHRA considers a medical device. Most people have no idea that category exists, let alone what it requires of the companies building these tools. The MHRA AI medical device regulation UK framework is one of the most consequential and least-discussed shifts in British healthcare right now, and it is worth understanding in plain terms.

    NHS clinician reviewing a health app on a tablet, relevant to MHRA AI medical device regulation UK
    Photo by Tima Miroshnichenko on Pexels

    What the MHRA actually classifies as a medical device in software

    The MHRA’s Software and AI as a Medical Device (SaMD) framework draws a clear line: if a piece of software is intended to be used for a medical purpose, it falls under regulatory oversight. That includes diagnosing a condition, predicting deterioration, monitoring a chronic illness, or informing a treatment decision. General wellness apps, step counters, and sleep trackers that make no medical claims sit outside this definition. The moment an app says it can detect an arrhythmia, flag early signs of diabetic retinopathy, or suggest a medication adjustment, it crosses the line.

    The MHRA uses a risk-based classification system, running from Class I (lowest risk) up to Class III (highest risk). Most AI-driven diagnostic tools land in Class IIa or IIb, which requires a Conformity Assessment carried out by a UK Approved Body. Developers must maintain a technical file that includes clinical evidence, details of the algorithm’s training data, and a post-market surveillance plan. For Class IIb and above, that plan must be proactive, not reactive. The MHRA’s published guidance on AI as a medical device lays out the current framework in detail, including the 2024 roadmap updates that are now being implemented.

    How the UK framework differs from what came before

    Prior to the UK leaving the EU’s regulatory orbit, software developers could rely on CE marking under the EU MDR. Since then, the MHRA has been building its own regime, and the UK Conformity Assessed (UKCA) mark is now the requirement for Great Britain. The MHRA published its “Software and AI as a Medical Device Change Programme” in stages from 2022 onwards, and the 2026 position is that manufacturers must demonstrate what the regulator calls “safe and effective performance” throughout the entire product lifecycle, not just at launch.

    What makes this genuinely different for AI tools is the acknowledgement of continuous learning. An algorithm that updates itself based on new patient data is not the same product it was six months ago. The MHRA’s framework addresses this with the concept of predetermined change control plans, meaning developers must specify in advance what kinds of changes they anticipate the model making and get those parameters approved. That is a meaningful shift from how software regulation has historically worked, where a product was reviewed once and then largely left alone.

    What developers are required to demonstrate

    In practical terms, a company seeking approval for an AI-driven diagnostic app needs to show several things. Clinical validation is the big one. The algorithm must be tested against the population it will actually serve, not just the dataset it was trained on. This matters enormously because training data bias is a real and documented problem. An ECG algorithm trained predominantly on data from white men in their forties will perform differently on South Asian women in their sixties, and the MHRA expects developers to account for that explicitly.

    Beyond clinical evidence, developers must provide transparency about how the algorithm reaches its outputs. That does not necessarily mean publishing the model weights, but it does mean producing documentation that allows a clinician to understand the basis for a recommendation. There is also a usability requirement: the interface must be tested with real users to ensure the information is presented in a way that supports safe decision-making rather than creating confusion or misplaced confidence.

    Post-market surveillance is where many smaller developers struggle. They are required to collect real-world performance data after launch, track adverse events, and submit periodic safety update reports. For a well-funded medtech company this is manageable. For a startup with a lean team, the administrative burden is substantial, and I would argue that is partly why so many health apps quietly drop medical claims from their marketing to avoid classification altogether.

    Where the gaps still are

    The framework is improving, but several gaps remain. Enforcement is the most obvious. The MHRA does not have the resource to proactively audit every app marketed to UK users. In practice, most enforcement is complaint-driven, which means a poorly validated tool can operate for months or years before anyone formally challenges it. This is particularly concerning given how many AI-driven health apps are marketed directly to consumers via app stores, where the App Store and Google Play review processes have no meaningful medical device checkpoint.

    International products are another complexity. An app developed in the US, Canada, or elsewhere, marketed to UK users, technically requires UKCA marking if it makes medical claims. In reality, many do not have it, and the MHRA’s ability to pursue overseas developers is limited. Given the rapid growth of AI wearables and monitoring platforms, this is not a small edge case.

    There is also a definitional grey area around generative AI tools used in health contexts. A large language model that answers questions about symptoms is almost certainly providing information, not diagnosis, and therefore sits outside SaMD classification. But that line is blurring. If a tool consistently recommends specific courses of action based on symptom inputs, at what point does it become a diagnostic aid? The MHRA has signalled it is watching this space closely, but firm guidance is still in progress.

    What this means if you use health apps

    As a consumer, you have limited visibility into whether a given app has gone through proper regulatory review. A few practical checks help. If an app makes medical claims, look for a UKCA mark or CE mark in the product documentation (many legitimate medical device apps display this in their terms or in app store listings). Check whether the company publishes a clinical evidence summary. If they do not, ask yourself why. Apps that have genuinely validated their algorithms tend to say so clearly because it is a genuine competitive advantage.

    The MHRA maintains a register of certified medical devices, though navigating it is not exactly user-friendly. It is worth knowing that the NHS App and NHS-commissioned digital tools are held to a higher standard, going through NHS England’s Digital Technology Assessment Criteria (DTAC) as well as MHRA requirements. That dual-layer review gives NHS-approved tools more credibility than consumer apps operating solely on the basis of self-declaration.

    The regulatory picture for AI in health is improving, but slowly. The gap between what technology can claim and what it has rigorously demonstrated is still wide in places. For anyone relying on an app to inform decisions about their health, that gap is worth keeping front of mind.

    If you are thinking about how digital health tools intersect with NHS systems and patient data, the questions raised about NHS diagnostic pathways and patient experience are closely connected. And the broader question of how UK adults manage their health with limited NHS access is part of why so many people turn to consumer apps in the first place. Understanding what those apps are, and are not, legally required to prove is a reasonable starting point for anyone trying to make informed choices.

  • Chronic Fatigue Syndrome and the Long NHS Wait: What ME/CFS Patients in the UK Are Actually Facing in 2026

    Chronic Fatigue Syndrome and the Long NHS Wait: What ME/CFS Patients in the UK Are Actually Facing in 2026

    Myalgic encephalomyelitis, or ME/CFS, affects an estimated 250,000 people in the UK according to figures cited by the NICE guideline published in October 2021. For most of them, getting a diagnosis, let alone effective treatment, remains one of the most exhausting bureaucratic ordeals the NHS has to offer. I’ve spoken to patients who waited three years just to see a specialist. That isn’t a horror story outlier, it’s closer to routine. Understanding what ME/CFS NHS UK 2026 actually looks like on the ground matters, because the gap between what the updated guidelines promise and what patients experience is still wide.

    A tired woman waiting in an NHS hospital corridor, representing the long waits faced by ME/CFS NHS UK 2026 patients
    Photo by RDNE Stock project on Pexels

    What the 2021 NICE guidelines changed

    The 2021 overhaul was significant. NICE formally removed graded exercise therapy (GET) as a recommended treatment, along with cognitive behavioural therapy as a primary intervention aimed at reversing the condition. Both had been recommended for years, based largely on the PACE trial, a study that drew sustained methodological criticism from patient groups and independent researchers alike. The new guidelines acknowledged that ME/CFS is a serious, complex, chronic condition and that pushing patients through structured exercise programmes can worsen symptoms rather than improve them.

    This was a meaningful shift in tone, if not yet in practice. What the guidelines also introduced was clearer diagnostic criteria, a recommendation that diagnosis should be considered after three months of symptoms (rather than six, as previously stipulated), and a requirement for a positive energy management strategy called pacing. The guidelines explicitly state that any intervention should be designed around the patient’s energy limits, not around pushing past them.

    Why waiting times for ME/CFS are still damaging

    The guidelines are one thing. Commissioning and capacity are another. Specialist ME/CFS services across England are patchy at best. Some regions have dedicated clinics with reasonable referral pathways; others rely on general fatigue services that were designed for a broader population and may not have the expertise to manage post-exertional malaise properly. In parts of Wales and Scotland, specialist provision is even thinner.

    NHS England data and patient advocacy organisations including ME Association and Action for ME have consistently flagged that referral-to-appointment waits of 12 to 24 months are not uncommon. For a condition where early, accurate management can reduce the risk of severe deterioration, that wait is clinically meaningful, not just inconvenient. A proportion of patients deteriorate significantly whilst waiting, sometimes to the point of becoming housebound or bedbound.

    There’s also a diagnostic delay that precedes the specialist referral. Many GPs are still not confident diagnosing ME/CFS, partly because the condition has no definitive biomarker test. Patients frequently cycle through cardiology, neurology, and rheumatology before anyone takes a structured ME/CFS history. The NICE guidelines try to address this by giving GPs clearer criteria, but changing clinical habits takes time and training investment that hasn’t fully materialised.

    What removing GET actually means for patients day to day

    Removing GET from the guidelines doesn’t mean patients are being offered nothing. The emphasis has shifted to pacing, which involves working within an individual’s energy envelope, a concept that sounds simple but requires genuine clinical support to implement well. The problem is that pacing support is not standardised. Some patients get detailed, personalised plans from occupational therapists with ME/CFS experience. Others get a leaflet.

    Low-dose naltrexone, rintatolimod, and various other pharmacological approaches remain either unlicensed or evidence-light in the UK context, so the NHS isn’t widely offering them. Pain management, sleep support, and symptom relief for associated conditions like orthostatic intolerance are available, but access varies by postcode. If you happen to live near one of the NHS specialist clinics with a multidisciplinary team, your experience will be substantially different from someone in a rural area without one.

    It’s also worth noting that the long COVID cohort, which shares significant symptomatic overlap with ME/CFS, has created both an additional demand on fatigue services and, arguably, increased research momentum. Some clinicians believe long COVID has done more to normalise the physiological reality of ME/CFS than two decades of patient advocacy. That’s a bitter irony, but if it accelerates research funding and clinical training, the downstream effect for the existing ME/CFS population may be positive.

    What emerging research suggests about underlying mechanisms

    The past few years have seen genuinely promising mechanistic research. Studies from groups including Stanford Medicine and University College London have identified abnormalities in mitochondrial function, immune dysregulation, and autonomic nervous system signalling in ME/CFS patients. A 2023 study in Nature Communications found measurable energy metabolism impairments in ME/CFS patients compared with healthy controls, giving biological weight to what patients have described for decades, that their fatigue is not psychological unwillingness, but a physiological ceiling.

    Research into small fibre neuropathy as a possible contributor to ME/CFS symptoms has also gained traction, as has work on mast cell activation and viral persistence as potential triggers. None of this has yet translated into approved treatments, but it represents a substantive departure from the biopsychosocial model that dominated clinical thinking for so long. For patients who spent years being told their illness was primarily a product of unhelpful thinking patterns, that shift carries real weight.

    If you’re also managing conditions that complicate fatigue-related symptoms, the evidence around sedentary behaviour and cardiovascular health is worth reading carefully, given that many ME/CFS patients are forced into low activity by their condition. Similarly, understanding what inadequate fibre intake does beyond digestion is relevant for a population that often has restricted diets and gut symptoms. And given how frequently ME/CFS patients are told their symptoms may be psychiatric, the broader context around how the NHS handles contested or surging diagnostic categories offers useful perspective.

    Where things stand right now and what needs to change

    The NICE guidelines represent a genuine step forward. The science is moving in the right direction. But in 2026, the practical reality for most ME/CFS patients in the UK is still one of long waits, inconsistent care, and a system that hasn’t yet matched its updated guidance with the infrastructure to deliver it. More specialist clinics, better GP training, and investment in the research pipeline are all necessary, and none of them happen quickly.

    What I’d say to anyone navigating this right now: the guidelines are on your side. Print them out, share them with your GP, and ask specifically whether any management plan you’re being offered aligns with the 2021 NICE criteria. Patient organisations like the ME Association offer clear, accurate summaries of what you’re entitled to ask for. You are not imagining it. The biology is real, the research is catching up, and the clinical establishment, slowly, is too.

    Frequently Asked Questions

    How long does it take to get an ME/CFS diagnosis on the NHS in 2026?

    Diagnosis timelines vary widely depending on where you live. Many patients wait 12 to 24 months for a specialist appointment after GP referral, and diagnostic delays before that referral are common because there’s no definitive biomarker test. The 2021 NICE guidelines recommend that ME/CFS should be considered after three months of symptoms, which is intended to speed up the process at GP level.

    Why was graded exercise therapy removed from ME/CFS treatment guidelines?

    NICE removed graded exercise therapy (GET) in its 2021 guideline update because evidence indicated it could worsen symptoms rather than help, particularly through triggering post-exertional malaise. The primary basis for GET had been the PACE trial, which faced significant methodological criticism. The updated guidelines replaced GET with an energy management approach called pacing.

    What treatment is available for ME/CFS on the NHS now?

    The current NHS approach centres on pacing, which means helping patients manage their activity within their personal energy limits. Symptom management for pain, sleep difficulties, and conditions like orthostatic intolerance is also offered. Access to specialist multidisciplinary teams varies considerably by region, and there are no pharmacological treatments currently licensed specifically for ME/CFS in the UK.

    Is ME/CFS related to long COVID?

    There is significant symptomatic overlap between ME/CFS and long COVID, including post-exertional malaise, cognitive difficulties, and fatigue that doesn’t improve with rest. Some researchers believe long COVID is triggering ME/CFS in a proportion of patients, and the surge in long COVID cases has brought additional research attention and funding to the underlying mechanisms. NICE guidance on ME/CFS is considered relevant for long COVID fatigue management.

    What does new research say about the cause of ME/CFS?

    Recent research has identified abnormalities in mitochondrial energy metabolism, immune system function, autonomic nervous system signalling, and small fibre neuropathy in ME/CFS patients. A study published in Nature Communications in 2023 found measurable energy metabolism impairments, offering biological evidence for the physiological basis of the condition. While no approved treatments have yet emerged from this work, it has substantively shifted scientific understanding away from purely psychological explanations.

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