Complex chronic illness can involve persistent symptoms affecting multiple body systems, often with several interacting factors contributing to the overall clinical presentation. Some people have an established diagnosis, while others experience a collection of chronic symptoms that do not fit neatly within a single diagnosis.

I work with people experiencing conditions such as ME/CFS and chronic fatigue, fibromyalgia, post-viral illness and Long COVID, mast cell activation syndrome (MCAS), chronic or recurrent infections, autoimmune and immune-mediated conditions, and persistent gastrointestinal and microbiome disorders.

Assessment involves looking beyond individual symptoms to understand the broader health history, how the illness developed and the factors that may be contributing to its persistence. These may include immune and inflammatory dysfunction, previous or ongoing infections, gastrointestinal and microbiome disturbances, nutritional and metabolic factors, environmental exposures, sleep and stress physiology, medications and other established medical conditions.

An Individualised Approach

There is rarely a single treatment approach appropriate for every person with complex chronic illness. Two people with the same diagnosis may have very different symptoms, contributing factors and treatment requirements.

A comprehensive initial consultation considers the development and progression of your illness, previous diagnoses and investigations, medications and supplements, diet and nutritional status, gastrointestinal health, infections, immune and inflammatory symptoms, environmental exposures, sleep, stress and other relevant aspects of your health.

Where appropriate, care may incorporate:

• Nutrition and food as medicine — developing an individualised dietary approach that supports nutritional status while considering food intolerances, metabolic health and the particular requirements of the condition.

• Herbal and nutritional medicine — selected according to the clinical presentation, pathology, medications and individual tolerance.

• Immune and inflammatory health — considering factors that may be contributing to persistent or dysregulated immune and inflammatory responses.

• Gut and microbiome health — addressing gastrointestinal symptoms, digestive function and microbiome disturbances where these form part of the broader presentation.

• Infections — considering previous, recurrent or persistent infections where clinically relevant, alongside appropriate medical investigation and treatment.

• Environmental health — considering potential environmental exposures where the clinical history indicates they may be relevant.

• Sleep, stress and nervous system regulation — addressing factors that may influence symptom burden, recovery and overall resilience.

Investigation is individualised rather than applying the same panel of functional tests to every patient. Existing medical investigations are reviewed first, with additional pathology or functional testing considered where it is likely to provide clinically useful information.

ME/CFS, Chronic Fatigue & Fibromyalgia

Persistent fatigue can occur in many different conditions and requires careful assessment rather than being treated as a diagnosis in isolation.

People with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) may experience post-exertional malaise, impaired energy, sleep disturbance, cognitive difficulties, autonomic symptoms and other systemic complaints. Fibromyalgia may similarly involve fatigue and sleep disturbance alongside widespread pain and heightened sensory symptoms.

Management is individualised and may include nutritional support, gastrointestinal and microbiome health, sleep, appropriate activity and pacing, and consideration of immune, metabolic and other factors relevant to the individual presentation.

Post-Viral Illness & Long COVID

Some people experience persistent symptoms following an acute viral infection and do not return to their previous level of health. Presentations can include fatigue, post-exertional symptoms, cognitive difficulties, sleep disturbance, gastrointestinal symptoms, altered exercise tolerance and autonomic or immune-related symptoms.

Long COVID is one recognised form of post-viral illness, although persistent symptoms can occur following a range of infections.

The clinical approach depends on the individual presentation and may consider nutrition, gastrointestinal health, immune and inflammatory function, energy and activity management, sleep, autonomic symptoms and other co-existing health conditions.

Mast Cell Activation & Histamine-Related Presentations

Mast cell activation syndrome (MCAS) and other histamine-related presentations can involve symptoms affecting several body systems, including the skin, gastrointestinal tract, respiratory system, cardiovascular system and nervous system.

Assessment involves considering symptom patterns and potential triggers while also investigating other conditions that may produce similar symptoms. Dietary modification, gastrointestinal health, nutritional and herbal medicine and broader trigger management may form part of an individualised approach alongside appropriate medical assessment.

Chronic & Recurrent Infections

Previous or recurrent infections can sometimes form part of a more complex chronic presentation. These may include viral infections, tick- or insect-borne infections, gastrointestinal infections and other infectious conditions.

Where infection is suspected, appropriate medical investigation and diagnosis are important. Naturopathic care may be used alongside medical treatment to support nutritional status, gastrointestinal health, recovery and other aspects of the individual's broader health rather than assuming that persistent symptoms necessarily indicate an ongoing infection.

Autoimmune & Immune-Mediated Conditions

Autoimmune and immune-mediated illnesses can affect almost any body system and frequently coexist with gastrointestinal, metabolic and other health concerns.

Complementary care is individualised according to the specific diagnosis, disease activity, medical treatment and overall health. Areas of consideration may include dietary quality, nutritional status, gastrointestinal and microbiome health, lifestyle factors and appropriate nutritional or herbal medicine, with particular attention to interactions with immunosuppressant and other medications.

Chronic Gut & Microbiome Disorders

Persistent gastrointestinal problems may occur independently or form an important part of a broader complex chronic illness. I work with people experiencing conditions including irritable bowel syndrome (IBS), small intestinal bacterial overgrowth (SIBO), constipation, chronic diarrhoea, gastrointestinal infections, gastritis and other persistent digestive disturbances.

Assessment considers diet, digestive function, medications, previous infections, food reactions and the broader health history. Where appropriate, breath testing, stool or microbiome analysis and other investigations may be considered alongside conventional gastrointestinal assessment.

Treatment may incorporate dietary modification, prebiotic and probiotic strategies, herbal and nutritional medicine and other interventions selected according to the individual presentation.

Mould & Environmental Illness

Exposure to damp and water-damaged buildings can be relevant in some complex chronic presentations, but mould-related illness should not automatically be assumed to be the cause of otherwise unexplained symptoms.

Where the clinical and exposure history suggests that a water-damaged building may be relevant, both the individual's health and their environment need to be considered.

I have worked with mould-related illness and CIRS for more than a decade and have additional training in assessment of water-damaged buildings. More information about this area of my practice is available on the Mould-Related Illness & CIRS page.

Collaborative Care

People with complex chronic illness often benefit from input from more than one healthcare discipline. My approach is designed to integrate with existing medical care, and I regularly work alongside GPs, integrative doctors, medical specialists and allied health practitioners where appropriate.

The aim is not to attribute every symptom to a single underlying cause, but to develop a clearer understanding of the overall clinical picture and identify practical, individualised areas where nutrition, naturopathic medicine and lifestyle interventions may contribute to ongoing care.