Dr Andrew Greenland - Greenland Medical

19/08/2026

Of 77,356 adults on long-term omeprazole or lansoprazole across 62 English general practices, 62% had no recorded reason for it anywhere in their notes.

Not a weak reason. None at all.

This is rarely carelessness. It is what happens when a medicine is cheap, works well and causes no trouble today. It gets copied from one repeat prescription to the next for a decade and nobody feels they own the decision to stop it.

Two things worth knowing. The safety picture is more reassuring than the headlines suggest: a three-year randomised trial found no rise in fractures, dementia, kidney disease or heart disease. And stopping abruptly after years can produce a rebound in acid, which more than 40% of people get and most read as the original problem returning.

Some people should stay on these medicines, and stopping would be wrong. The question is not whether the drug is helping. It is what it is treating now.

Full essay here.

Of 77,356 English adults on continuous proton pump inhibitor treatment, 62% had no recorded indication anywhere in their notes. Not a weak one. None.

17/08/2026

You probably bought the wrong magnesium.

There are loads of forms and they all do different jobs. The type that helps you sleep isn't the type that helps your bowels.

Rather fix the deficiency than guess? Send me a DM! 💊



Disclaimer: This video includes AI-generated media.

17/08/2026

Around 45% of dementia cases worldwide could be prevented or delayed by addressing risk factors we already know about. That figure is from the 2024 Lancet Commission, and it should change how we think about memory loss.

A new peer-reviewed paper does something useful with it. Instead of presenting a diet as a diet, it maps how nutrition connects to insulin resistance, inflammation, vascular health, sleep, circadian rhythm and the gut, and turns that into something researchers can actually test.

That is not proof. It is a Perspective paper, not a trial. What it does is move lifestyle medicine from "this seems to help" towards "here is why it should, now go and check".

Drugs or lifestyle is a false choice. The more useful question is which biological networks are failing in this particular person.

Full essay here.

A new peer-reviewed paper hands the KetoFLEX 12/3 approach a testable mechanistic framework. That matters more than another diet study would.

15/08/2026

England has never diagnosed cancer earlier. Survival still trails Australia, Canada and Norway. Those two facts should not sit comfortably together.

Nearly 3 in 5 common cancers are now caught at stage 1 or 2, a record, and good news. But finding cancer earlier is not the same as helping people live longer.

So what are we missing? I'd argue we're missing the terrain. Two patients with the same tumour at the same stage can have very different outcomes, and the difference lives in the body the cancer grows in: visceral fat, insulin resistance, chronic inflammation, the gut microbiome, fitness, sleep and stress. We screen the tumour meticulously and largely ignore the host.

The evidence here is maturing fast. The CHALLENGE trial put structured exercise into colon cancer follow-up and moved hard outcomes, not just wellbeing scores. These aren't wellness add-ons. They're oncology.

Where do you think the next survival gains will come from: earlier detection, or a fitter host?

13/08/2026

Of 6,828 big-name health influencers, only 17% are actual medical professionals.

76% of UK adults now use the internet to make health decisions, and misleading health videos often outperform accurate ones. The algorithm rewards confidence, and confidence is exactly what careful medicine can't always offer.

This isn't abstract. In clinic, "harmless" advice has real teeth: St John's wort quietly weakening contraception. Keto started by someone on diabetes medication that makes it risky. High-dose vitamin A in pregnancy. None of these people were being reckless. They were following advice that was right for someone, just not for them.

The biggest danger isn't misinformation. It's one-size-fits-all certainty. Broad principles are useful. Prescriptions are personal.

What's the worst piece of health advice the internet has served you lately?

11/08/2026

Hot take: "It's normal at your age" is the most dangerous sentence in medicine.

Forgetfulness and brain fog get waved away as a natural part of ageing far too often.

Here's the truth: cognitive decline is common, but common is not the same as inevitable, and it does not mean nothing can be done.

The earlier you investigate the changes in your memory and focus, the more there is to protect. Waiting is the one thing the brain can't afford.

At Greenland Medical we investigate now, with science rather than a shrug.

If you've been told to wait, send us a message.

11/08/2026

A viral headline claims inhaling high-dose CO₂ clears Alzheimer's proteins from the brain.

The study behind it wasn't even an Alzheimer's trial.

It was a Parkinson's study. The amyloid finding everyone is sharing comes from a 10-person substudy, and the "high-dose" protocol was a tightly controlled 5% CO₂ mix, not something anyone should try at home.

The pattern is familiar: interesting physiology wrapped around a fragile signal. Blood levels of certain proteins rose, which is being read as "the brain is clearing them out". But proteins rising in the blood is not the same as a cleaner brain, and p-tau217, one of the markers that matters most in Alzheimer's, barely moved.

None of this makes the science worthless. But there is a wide gap between "promising mechanism in a small substudy" and "breakthrough treatment", and headlines keep vaulting over it.

What's the most overcooked health headline you've seen this year? I collect these.

10/08/2026

Brain fog is not normal. Stop blaming your age.

That fuzzy, can't-find-the-word feeling is your brain waving a flag, blood sugar, inflammation, gut, or hormones.

If brain fog is stealing your sharpness, DM me the word CLEAR. 🧠



Disclaimer: This video includes AI-generated media.

09/08/2026

The NHS says take 400 IU of vitamin D. For a lot of people that advice is right, and still not enough.

Every autumn the message goes out, and it is worth following. But the standard dose quietly misses something I see in clinic all the time: one person does well on a modest dose while another stays stubbornly low on exactly the same amount.

That gap is rarely about effort. It's biology. Body weight changes how vitamin D distributes. Gut health changes how it absorbs. Age, medications and genetics all move the dial. Give two different bodies the same 400 IU and you should expect two different results.

The honest position sits in the middle. A public health floor and a personal optimum are not the same thing. Some people benefit from testing and a higher dose. Many don't need either.

Do you take vitamin D through the winter? And has anyone ever checked whether your dose is actually working?

08/08/2026

Get the best prices on tickets for Cyrano de Bergerac in London on TodayTix. When beauty lacks words, a poet lends his voice and risks his heart.