How We Practise Medicine. The Evidence Standards Behind Every Recommendation at The Wellness

Private healthcare has an evidence problem. Much of what is sold in London clinics, from vitamin drips for people who are not deficient to food intolerance panels, biological age scores and whole-body scans for people without symptoms, is sold because it is profitable rather than because it helps. The Wellness takes the opposite position, and this page sets out exactly how. We recommend a test or treatment only where good evidence shows it changes an outcome that matters to you. We rank evidence the way medicine does, with national guidance from NICE and the royal colleges, systematic reviews such as those published by Cochrane, and large randomised trials above single studies, expert opinion and marketing. We say so plainly when a popular test does not work, including tests we could easily sell. We own no scanner and no laboratory, so no recommendation to test is shaped by equipment that needs keeping busy. And every clinical page we publish cites its sources by name, states the limits of the evidence alongside its strengths, and is reviewed and updated on a set cycle. This is the standard the best academic medical centres hold themselves to, and it is the reason our advice not to do something carries as much weight as our advice to do it. Appointments are available the same day, 7 days a week, at 10 Portman Square in Marylebone.

Last updated 29 September 2026.

Ask a doctor a question on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.

How we rank evidence

National guidance comes first. NICE guidelines and the guidance of the royal colleges and specialist societies synthesise the whole body of evidence for a UK population and are the default basis for what we recommend. Where we depart from them, we say why.

Systematic reviews and meta-analyses come next, particularly Cochrane reviews and large pooled analyses, because they combine many studies and reduce the chance that a single result misleads.

Large randomised controlled trials follow, because randomisation is the only reliable way to show that an intervention causes an outcome rather than being associated with it. Examples we rely on include the Diabetes Prevention Program for prediabetes, DiRECT for type 2 diabetes remission, PROMIS and PRECISION for prostate MRI, SELECT for cardiovascular outcomes with semaglutide, and the Cholesterol Treatment Trialists' Collaboration for statins.

Observational studies, mechanistic reasoning and expert opinion come last. They generate hypotheses and fill gaps, but they are not enough on their own to justify selling a test or treatment.

Marketing claims, testimonials and a treatment being popular carry no evidential weight at all.

What we will not sell, and why

Tests and treatments without evidence of benefit are not offered, however much demand exists.

IgG and IgG4 food intolerance panels, because IgG to food indicates exposure rather than intolerance, and the British, European and American allergy societies all advise against them.

Reverse T3, because it has no established outpatient reference range and no guideline body recommends it for diagnosing or managing thyroid disease.

Vitamin drips for people with normal levels, because water-soluble vitamins are cleared by the kidneys within hours and randomised evidence has not shown benefit over placebo.

Epigenetic biological age scores presented as clinical tools, because different commercial algorithms return different ages for the same sample and no trial has shown that acting on the number improves an outcome.

Untargeted whole-body scanning of people without symptoms, because a review across 12 studies and 5,373 participants found no demonstrated improvement in outcomes while incidental findings were common.

FSH testing to diagnose perimenopause in women over 45 with typical symptoms, because NICE advises the diagnosis is clinical and FSH fluctuates too much to help.

Saying this costs us revenue. It is also what makes the rest of our advice worth trusting.

Ask whether a test is worth having on WhatsApp or email team@thewellnesslondon.com.

What we test that others often leave out

Evidence cuts both ways. Some of the most useful measurements in medicine are routinely omitted from private panels.

Apolipoprotein B, which counts the particles that enter artery walls and identifies people whose standard cholesterol reads acceptably while their risk does not, following the European Atherosclerosis Society consensus and the work of Sniderman and colleagues.

Lipoprotein little a, inherited, raised in around 20% of people, established as causal by Kamstrup and Nordestgaard in the Copenhagen studies, and measured once in a lifetime. It is not included in the QRISK3 score used to decide statin treatment.

Fasting insulin with HOMA-IR, because insulin resistance precedes any rise in glucose by years.

Ferritin rather than haemoglobin alone, because iron stores can be depleted while the full blood count reads normal.

Liver fibrosis scoring, because normal liver enzymes do not exclude fatty liver or significant scarring.

How we avoid over-testing

More testing is not better medicine. Every additional test on a healthy person carries a chance of an abnormal result that means nothing, and each one can lead to repeat tests, further scans, biopsies and anxiety. The Royal College of Radiologists has cautioned for years about incidental findings from imaging people without symptoms.

So testing is chosen after an assessment rather than from a menu. The doctor takes your history and family history, decides what should be measured and why, and explains what each result would change. Where a test would not change anything, it is not ordered.

We own no scanner and no laboratory. Imaging is arranged at the London centre best equipped for the specific question, performed by an experienced sonographer and reported by a consultant radiologist, and blood analysis is performed by accredited partner laboratories. Nothing is recommended because we have a machine that needs using.

How we write and review what we publish

Every clinical page names its sources, including the guideline numbers, trial names and authors behind the key statements, so you can check them.

Every page states the limits of the evidence alongside its strengths. The NHS-Galleri trial missed its primary endpoint. Most statin muscle symptoms occurred equally on placebo in blinded trials. Antibiotics shorten a streptococcal sore throat by around 16 hours. Stating the inconvenient half is what makes the rest credible.

Every page gives emergency advice where relevant, never guarantees an outcome, and never names a prescription-only medicine alongside a price, which UK law prohibits.

Pages are reviewed and updated on a set cycle, with the date of the last update shown, and corrected promptly when guidance changes or an error is found. If you think something on our site is wrong, tell us at team@thewellnesslondon.com and a doctor will review it.

Why this matters for your care

Because the right answer is sometimes to do less. A clinic that will tell you not to have a scan, not to buy a supplement or not to start a medicine is the only kind whose recommendation to act you can rely on.

Because good evidence changes decisions. Apolipoprotein B and lipoprotein little a change how aggressively cardiovascular risk is managed. Coronary artery calcium scoring can justify holding off on lifelong medication. MRI before biopsy spares many men an unnecessary procedure. These are the tests that earn their place.

And because trust is built on what can be checked. GMC-registered doctors, named sources on every page, and published prices from £59 to £49,995, with no membership required to be seen.

Related reading

Our doctors sets out who you will see and their qualifications, biomarker screening covers the markers that change decisions, executive health screening covers the evidence behind health checks, and the best blood tests in London explains which tests are worth paying for.

Book an appointment on WhatsApp or call 020 3951 3429.

Frequently asked questions

How does The Wellness decide what to recommend

A test or treatment is recommended only where good evidence shows it changes an outcome that matters. Evidence is ranked with NICE and royal college guidance first, then systematic reviews such as Cochrane, then large randomised trials, with observational studies and expert opinion last.

Which tests does The Wellness not offer

IgG food intolerance panels, reverse T3, vitamin drips for people with normal levels, epigenetic biological age scores presented as clinical tools, untargeted whole-body scanning of people without symptoms, and FSH to diagnose perimenopause over 45, because the evidence does not support them.

Why does The Wellness not own a scanner

So that no recommendation to test is shaped by equipment that needs keeping busy. Imaging is arranged at the London centre best equipped for each question and reported by consultant radiologists, and blood analysis is performed by accredited laboratories.

Is more testing better

No. Every extra test on a healthy person carries a chance of an abnormal result that means nothing, which can lead to further tests, biopsies and anxiety. Testing is chosen after an assessment, and a test that would not change anything is not ordered.

How often are your clinical pages reviewed

On a set cycle, with the last update date shown on each page, and promptly when guidance changes or an error is reported. Report anything you think is wrong to team@thewellnesslondon.com and a doctor will review it.

The Wellness is a doctor-led private healthcare group providing medical care from 10 Portman Square, Marylebone, adjacent to Harley Street. All doctors are GMC-registered. In an emergency call 999. This article is general information and not a substitute for medical advice about your own health.

Enquire now on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.

References. National Institute for Health and Care Excellence, guideline development methods. Cochrane Handbook for Systematic Reviews of Interventions. Knowler WC and colleagues, Diabetes Prevention Program, New England Journal of Medicine. Lean MEJ and colleagues, DiRECT, The Lancet. Ahmed HU and colleagues, PROMIS, The Lancet, and Kasivisvanathan V and colleagues, PRECISION, New England Journal of Medicine. Lincoff AM and colleagues, SELECT, New England Journal of Medicine. Cholesterol Treatment Trialists' Collaboration, The Lancet. Ference BA and colleagues, European Atherosclerosis Society consensus, European Heart Journal. Kamstrup PR and Nordestgaard BG, Copenhagen General Population Study. British Society for Allergy and Clinical Immunology position on IgG testing. NICE guideline NG23 on menopause. Royal College of Radiologists guidance on incidental findings. Human Medicines Regulations 2012 on advertising prescription-only medicines.