Author: Dr Lucy Hooper MB BS BSc MRCGP MA DRCOG DCH

  • Bowel cancer: risk factors, genetic testing and screening explained

    Bowel cancer: risk factors, genetic testing and screening explained

    Bowel cancer is the third most common cancer in the UK, affecting men and women in roughly equal numbers. But many cases are preventable, and when it is caught early, survival rates are high. This guide covers what raises your risk, how inherited gene mutations are involved, and what screening is available.

    In this guide

    1. What causes bowel cancer?
    2. Family history and genetic risk
    3. Lifestyle risk factors
    4. Symptoms to know about
    5. Screening options
    6. Genetic testing for inherited risk
    7. Support and further information

    What causes bowel cancer?

    No single thing causes bowel cancer. For most people it comes down to a combination of genetics, lifestyle, age, and chance. Cases are most common after 45, but we are seeing a significant rise in bowel cancer in younger adults. Cases under 50 are predicted to double in the next ten years, which is one reason why earlier screening and genetic testing matter more than they used to.

    The good news is that bowel cancer is often slow to develop. The process from a normal bowel cell to a polyp to a cancer typically takes over ten years. That window is an opportunity. Identifying risk early, and screening at the right time, gives us a real chance to detect cancers before they cause symptoms, and in some cases to prevent them altogether.

    Family history and genetic risk

    Family history

    Having a parent or sibling with bowel cancer more than doubles your risk. If a close relative had polyps removed, your risk may also be elevated by as much as 35%. Family history matters even when there is no known genetic mutation, and it should always be factored into decisions about when to start screening.

    Inherited gene mutations

    Around 5% to 10% of bowel cancers are caused by an inherited fault in a gene. These mutations account for around 35% of bowel cancers diagnosed under the age of 50. The main conditions to know about are:

    Lynch syndrome is the most common inherited cause of bowel cancer. It is caused by mutations in one of five genes: MLH1, MSH2, MSH6, PMS2, and EPCAM. These genes normally produce proteins that repair errors in DNA. When they do not work properly, errors accumulate in bowel cells over time, making cancer more likely. Bowel cancer risk in Lynch syndrome ranges from around 12% to 75% by age 75, depending on which gene is affected. Lynch syndrome is also linked to cancers of the womb, ovaries, stomach, kidneys, and other organs, so a family history of any of these is relevant.

    Familial adenomatous polyposis (FAP) is caused by a mutation in the APC gene. It causes large numbers of polyps to develop in the bowel from childhood. Without treatment, up to 90% of people with FAP will develop bowel cancer by age 45. Some APC mutations cause a milder form, with fewer polyps and cancer developing slightly later, on average around age 54.

    MUTYH-associated polyposis (MAP) is caused by mutations in the MUTYH gene. People are usually only significantly affected if they inherit two faulty copies of the gene, one from each parent. The lifetime bowel cancer risk with two MUTYH mutations is estimated at between 43% and 100%. People with one faulty copy may also have a modestly increased risk.

    Other rarer mutations linked to bowel cancer risk include POLE, POLD1, MSH3, and NTHL1.

    Other health factors

    People with type 2 diabetes have a 22% to 33% higher risk of bowel cancer than those without. Inflammatory bowel disease, particularly ulcerative colitis, also raises risk. Previous radiotherapy to the abdomen or pelvis is another factor worth flagging to your GP.

    Lifestyle risk factors

    Alcohol

    Around two units of alcohol per day is associated with roughly a 4% increase in bowel cancer risk. As with most cancers, risk increases with the amount consumed.

    Weight and body fat

    Being overweight increases the risk of bowel polyps and bowel cancer. Weight carried around the abdomen is particularly significant. Visceral fat, the fat stored around the internal organs, is more metabolically active and more directly linked to cancer risk than fat stored under the skin. Waist measurement gives a rough guide, but an MRI body composition scan provides a more accurate picture.

    Exercise

    Regular physical activity has a meaningful protective effect. Brisk walking for 30 minutes five days a week can lower bowel cancer risk by up to 50%. This is one of the largest modifiable risk reductions available for any common cancer.

    Smoking

    Current smokers have around a 21% higher risk of bowel cancer compared to people who have never smoked.

    Diet

    Processed meat, including sausages, bacon, and ham, is associated with increased bowel cancer risk. High-quality unprocessed red meat eaten once or twice a week is likely to carry much lower risk as part of a balanced diet. A diet high in fibre supports a healthy gut microbiome and is recommended by the World Cancer Research Fund as a way to reduce bowel cancer risk. There is also some evidence that calcium-rich foods may be protective.

    Symptoms to know about

    Most bowel cancers found through screening are detected before any symptoms appear. But knowing the warning signs matters. See a GP promptly if you notice any of the following. None of these automatically means cancer, but all of them should be investigated.

    Bleeding from the back passage. Blood in your stools. A change in how often you go to the toilet, or persistent diarrhoea or constipation. Unexplained weight loss. Persistent tiredness without an obvious cause. A pain or lump in your abdomen.

    Screening options

    At-home stool testing

    Stool testing looks for tiny amounts of blood in a sample, invisible to the naked eye, that can indicate bleeding from the bowel. A small sample is collected at home, placed in a tube, and posted to a laboratory. A positive result doesn’t mean you definitely have cancer, but it means further investigation, usually a colonoscopy, is recommended.

    The NHS in England currently offers at-home stool testing to people aged 54 to 74, every two years, sent automatically to your registered address. People aged 75 and over can request a kit. Those at higher risk due to a known inherited condition may be offered earlier or more frequent testing.

    At Coyne Medical, we offer at-home stool testing from age 45, earlier than the NHS programme. We also use a lower detection threshold than the NHS standard, which means we identify more potential cases at an earlier stage. Testing is available every year rather than every two years. Annual testing in large studies has been shown to reduce the risk of dying from bowel cancer by around 33% over 30 years. The cost is £84, including the kit, results, and a free GP follow-up consultation for any abnormal result. You can add the test to any GP consultation and we include it with all our Health Screening Packages.

    Colonoscopy

    Colonoscopy is the most thorough bowel cancer screening test available, with a sensitivity of around 95% and the ability to both detect and remove polyps in the same procedure. Long-term data shows it can reduce bowel cancer incidence by 31% to 71% and mortality by 65% to 88%.

    A thin flexible camera is passed through the bowel, allowing direct inspection of the entire bowel lining. If polyps are found they can be removed immediately, which reduces future cancer risk. The preparation involved, a special diet and bowel-clearing medication beforehand, puts some people off, but the procedure itself is usually well tolerated. There is a very small risk of complications, around 4 to 8 in 10,000 procedures. For people not eligible for NHS colonoscopy, private costs are typically around £1,900 to £2,200. Some international health insurance policies cover colonoscopy screening as standard.

    Both FIT testing and colonoscopy are well-supported by evidence, and both UK and US guidelines agree these are the two options with the most benefit. The right choice depends on your circumstances. Colonoscopy is preferred for people with a higher-risk family history, a known gene mutation, or previous polyps. Annual FIT testing is a very reasonable starting point for people at average risk who want a non-invasive option. Your GP can help you decide.

    People with a confirmed high-risk inherited mutation such as Lynch syndrome are typically recommended colonoscopy every two years from age 25 rather than stool testing alone.

    Multi-Cancer Early Detection: TruCheck

    TruCheck is a blood test that detects circulating tumour cells shed by cancers into the bloodstream before symptoms develop. It screens for over 70 cancer types from a single blood draw, including bowel cancer. It is not a replacement for FIT testing or colonoscopy but adds an additional layer of detection, particularly useful for people who want comprehensive early cancer surveillance. It is generally suitable for people aged 40 and over without a prior cancer diagnosis.

    Multi-Cancer Early Detection →

    Genetic testing for inherited risk

    Genetic testing used to be reserved for people who clearly met high-risk criteria. But research shows this approach misses around half of people who carry a harmful mutation. Only about 5% of people in the UK with Lynch syndrome have been diagnosed. For each person identified, there is an opportunity not just to help them but to alert their relatives, who have a 50% chance of carrying the same mutation.

    At Coyne Medical, we offer genetic testing to everyone, not just those who meet the NHS criteria.

    Who should particularly consider it

    A personal or family history of bowel cancer, especially under age 50. Multiple relatives on the same side of the family with bowel cancer or related cancers such as womb, ovarian, or stomach cancer. A family history of ten or more bowel polyps. A known mutation in the family. Even without a clear family history, genetic testing is worth considering as part of a comprehensive health assessment.

    What a positive result means

    A positive result does not mean cancer is inevitable. What it does is change what screening makes sense for you, and opens up options that can significantly reduce your risk. For someone with an MLH1 mutation, for example, daily aspirin taken for two years has been shown to reduce bowel cancer risk by 60%. Colonoscopy screening from age 25 allows polyps to be found and removed before they become cancers. Some women with Lynch syndrome choose to have their womb removed after completing their family, to reduce the risk of endometrial cancer. Knowing your result puts these options within reach.

    What a negative result means

    No harmful mutations were found in the tested genes. This is genuinely reassuring, though it does not eliminate all bowel cancer risk if you have a strong family history. Appropriate screening based on your other risk factors should continue.

    Protecting your family

    When one person discovers a gene mutation, they can share that information with relatives who can then be tested themselves. Many people find real comfort in knowing they have given their children or siblings the chance to get ahead of something that might otherwise go undetected.

    Vaccinations on the horizon

    The University of Oxford is currently developing a cancer prevention vaccine for people with Lynch syndrome. This is one example of how rapidly the science is moving. Knowing your genetic risk now may open the door to treatments and prevention strategies that do not yet exist.

    At Coyne Medical we offer an inherited cancer risk panel covering 35 genes including all of the Lynch syndrome genes, APC, and MUTYH, available as an at-home saliva test from £650 or an in-clinic blood test from £900. Our Advanced Genetic Screen covers 55 genes and also includes a pharmacogenomics report, it is included as standard in our Ultimate health screening package.

    Inherited cancer risk panel →

    Advanced genetic screen →

    Support and further information

    Lynch Syndrome UK is a patient-led organisation providing information, support, and advocacy for people affected by Lynch syndrome. Lynch Choices offers support from testing through to diagnosis and information on screening and preventive therapies. The Royal Marsden Hospital provides a detailed Beginner’s Guide to Lynch Syndrome online. PolyposisPatient offers peer support for all polyposis conditions. Bowel Cancer UK provides information and helpline support for anyone affected by bowel cancer.

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  • Can you prevent breast cancer? Risk, screening and genetic testing explained

    Can you prevent breast cancer? Risk, screening and genetic testing explained

    Breast cancer affects 1 in 7 women over their lifetime. But risk is not uniform, and early detection changes outcomes dramatically. This guide covers what raises your risk, what the latest screening tools can offer, and when genetic testing should be part of the picture

    1. What causes breast cancer?
    2. Family history and genetic risk
    3. Lifestyle risk factors
    4. Breast density
    5. Symptoms to know about
    6. Screening options
    7. Genetic testing for inherited risk
    8. Support and further information

    What causes breast cancer?

    No single thing causes breast cancer. For most women, it comes down to a mix of genetics, hormones, lifestyle, and chance. The good news is that many risk factors can be identified, and some can be changed.

    Breast cancer is the most common cancer in UK women. Around 150 new cases are diagnosed every day. 1 in 7 women will be diagnosed with breast cancer during their lifetime. Survival has improved a lot in recent years, mainly because of better treatments and earlier diagnosis. Stage 1 breast cancer now has a five-year survival rate above 98%. That figure drops significantly when cancer is found later, which is why screening matters so much.

    Family history and genetic risk

    Family history

    If your mother, sister, or daughter has had breast cancer, your own risk is roughly double the average. The risk is higher if they were diagnosed under 50, or if several relatives on the same side of the family have been affected. It is also worth knowing that breast cancer genes can be passed down through male relatives, who may carry a mutation without ever developing the disease themselves.

    Inherited gene mutations

    About 5% to 10% of breast cancers are caused by an inherited fault in a gene. The most well known are BRCA1 and BRCA2. Women with a BRCA1 mutation can have a lifetime breast cancer risk of up to 90%. Other genes, including PALB2, CHEK2, and ATM, also raise risk, though usually by a smaller amount. These gene faults do not cause cancer directly. What they do is make it harder for the body to repair DNA damage over time, which means errors in cells are more likely to build up into cancer.

    Hormonal factors

    Starting periods early or reaching menopause late both mean more years of oestrogen exposure, which is linked to a modest increase in breast cancer risk.

    The relationship between HRT and breast cancer has caused a lot of confusion, but the evidence is now much clearer. Combined HRT, which includes both oestrogen and a synthetic progesterone, does carry a small real increase in risk. The estimate is around ten extra cases per 1,000 women taking it for up to 14 years from age 50. Body-identical progesterone (sometimes called Utrogestan or micronised progesterone) appears to carry much less risk, and current evidence suggests the increase may be close to zero in the first five years of use. Women who take oestrogen alone, because they have had a hysterectomy, are not thought to have any meaningful added breast cancer risk from HRT. If you are weighing up HRT and are worried about breast cancer, your GP should look at your full risk picture rather than giving a blanket answer.

    Lifestyle risk factors

    Alcohol

    Even moderate drinking raises breast cancer risk. Around two units a day, roughly a single glass of wine, is linked to about a 9% increase in risk. That is a bigger rise than most people expect, and larger than the risk from combined HRT.

    Weight and body fat

    Being overweight after the menopause increases risk. Fat tissue produces oestrogen, and higher oestrogen levels after the menopause are linked to breast cancer. Weight carried around the middle is particularly important. Visceral fat, the fat stored around your internal organs, is more hormonally active than fat under the skin, and more directly linked to cancer risk. This is why knowing your body composition, not just your weight, matters.

    Exercise

    Regular exercise reduces risk. Brisk walking for 30 minutes, five days a week, can lower breast cancer risk by up to 12%.

    Smoking

    Current smokers have around a 10% higher risk compared to people who have never smoked.

    Having children and breastfeeding

    Women who have had children have a lower overall risk than those who have not. Breastfeeding adds further protection, probably because it delays the return of periods.

    Previous radiotherapy

    If you have had radiotherapy to your chest, for example for lymphoma, this raises your breast cancer risk. Let your GP know so they can factor it into your screening plan.

    Breast density

    Breast density is one of the less talked about risk factors, even though it affects up to half of women over 40.

    Dense breast tissue means your breasts contain more fibrous and glandular tissue relative to fat. This matters for two reasons. First, women with the highest density category have roughly double the breast cancer risk of women with mostly fatty breast tissue. Second, dense tissue and potential cancers both appear white on a mammogram, which means dense breasts can hide problems that mammography might otherwise catch.

    Breast density can only be seen on a mammogram. It has nothing to do with how your breasts feel. We have written a dedicated guide that covers what dense breasts mean for your screening choices and what options are available at Coyne Medical.

    Understanding dense breasts →

    Symptoms to know about

    Most breast cancers are found through screening before any symptoms appear. But it is still important to know what to look out for. See a GP promptly if you notice any of the following. None of these automatically means cancer, but all of them should be checked.

    A lump or swelling in the breast, upper chest, or armpit. A change to the skin, such as puckering or dimpling. Redness or a change in colour of the breast. A nipple that has become newly inverted or changed shape. A rash or crusting around the nipple. Unusual discharge from either nipple. A change in the size or shape of the breast that you cannot explain.

    Screening options

    NHS mammography

    The NHS invites women aged 50 to 71 for a mammogram every three years. Mammography uses low-dose X-rays and can detect cancers before they are large enough to feel. If you think you may have missed an invitation, you can find your nearest NHS breast screening centre online and self-refer. Women identified as higher risk through family history may be offered NHS screening from age 40 instead.

    Why starting earlier makes sense

    The UK starts breast screening later than most comparable countries. There is strong evidence that annual mammography from age 40 can reduce the risk of dying from breast cancer by around 25% over ten years. At Coyne Medical, annual mammography from 40 is included as standard in our Complete and Ultimate health screening packages. Mammograms are mildly uncomfortable but only take a few minutes. Modern machines use a very low radiation dose, similar to about seven weeks of natural background radiation.

    Breast ultrasound

    Ultrasound uses sound waves rather than radiation and is particularly useful for women with dense breasts. It can find cancers that mammography misses, and it can tell the difference between solid lumps and fluid-filled cysts. At Coyne Medical, breast ultrasounds are carried out by Dr Neil Upadhyay, a Consultant Radiologist at Imperial College Healthcare NHS Trust with specialist expertise in breast imaging.

    Book a breast ultrasound →

    Breast MRI

    MRI is the most sensitive test available for breast cancer detection. It is recommended for women at high risk, such as those with a confirmed BRCA1 or BRCA2 mutation, or women who have had radiotherapy to the chest. The European Society of Breast Imaging also recommends MRI for women with dense breasts who have additional risk factors, such as a significant family history. It is not used for general population screening because of cost and a higher rate of false alarms, but for the right patient it offers much greater sensitivity than mammography alone. If you have dense breasts and other risk factors, speak to your GP about whether MRI is appropriate for you.

    Multi-Cancer Early Detection: TruCheck

    TruCheck is a blood test that looks for tumour cells that have broken off from a cancer and entered the bloodstream, before any symptoms have appeared. It screens for over 70 types of cancer from a single blood draw.

    The evidence for breast cancer detection is particularly strong. In a 2022 study by Crook et al., published in the journal Cancers, the test correctly identified breast cancer with a sensitivity of over 92% across a population of more than 9,000 participants. A follow-up clinical study found similar results.

    TruCheck Multicancer Early Detection Blood test is generally suitable for people aged 40 and over who have not previously been diagnosed with cancer. People aged 35 to 39 with a strong family history or a known gene mutation can also be considered. It is not a replacement for imaging but adds an extra layer of detection.

    Multi-Cancer Early Detection →

    Genetic testing for inherited risk

    Genetic testing used to be offered only to people with a clear family history of cancer. But research now shows this approach misses nearly half of people who carry a high-risk mutation. Mutations can run through male relatives who never develop breast cancer. Relatives may have died young before any cancer appeared. Families may simply be small, with no obvious pattern to notice.

    At Coyne Medical, we offer genetic testing to everyone, not just those who meet a high-risk threshold. We know fewer than 5% of people in the UK with a high-risk mutation have been identified. We want to help you find any inherited risk early.

    Who should particularly consider it

    A personal or family history of breast or ovarian cancer, especially under age 50. Several affected relatives on the same side of the family. Male relatives with breast, prostate, or pancreatic cancer. Ashkenazi Jewish heritage, which carries a higher rate of BRCA1 and BRCA2 mutations in the population. A known mutation in the family. If any of these factors apply to you, it is worth finding out.

    What a positive result means

    A positive result does not mean you will get cancer. What it does is change what screening makes sense for you, and opens the door to options that could significantly reduce your risk. Women with a BRCA1 mutation, for example, are offered annual mammography and MRI by the NHS from age 30, and may be candidates for medication or surgery that can cut breast cancer risk by over 95%.

    What a negative result means

    No harmful mutations were found in the tested genes. This is genuinely reassuring. It does not eliminate all breast cancer risk, particularly if you have a strong family history, but it is meaningful information. You should still continue appropriate screening based on your other risk factors.

    What about male relatives?

    Half of people who carry a BRCA1 or BRCA2 mutation are male. Men with these mutations have a raised risk of prostate cancer, male breast cancer, and pancreatic cancer. A man with a BRCA2 mutation has up to a 60% lifetime risk of prostate cancer, more than eight times the population average. Male relatives in families affected by breast or ovarian cancer should consider testing too.

    At Coyne Medical we offer an inherited cancer risk panel covering 35 genes, available as an at-home saliva test from £650 or an in-clinic blood test from £900. Our Advanced Genetic Screen covers 55 genes and also includes a pharmacogenomics report. Genetic testing is included as standard in our Ultimate health screening package.

    Inherited cancer risk panel →

    Advanced genetic screen →

    Support and further information

    If you have concerns about your breast cancer risk or about inherited breast cancer in your family, the following organisations can help. The National Hereditary Breast Cancer Helpline offers support for people at risk of hereditary breast cancer. Breast Cancer Now is a leading UK charity with information and a clinical nurse helpline. Jnetics focuses specifically on prevention and diagnosis in the Jewish community. Peer support groups for people with BRCA and other gene mutations are also available online and can be a valuable source of connection alongside clinical advice.

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  • Understanding dense breasts

    Understanding dense breasts

    If you’ve been told you have dense breasts after a mammogram, you may have questions about what it means and whether you need to do anything differently. This guide explains what breast density is, why it matters for cancer detection, and what your options are.

    What are dense breasts?

    Breast tissue is made up of a mixture of fat, fibrous tissue, and glandular tissue. Breast density refers to the proportion of fibrous and glandular tissue relative to fat, as seen on a mammogram. The more fibrous and glandular tissue you have, the denser your breasts are considered to be. On a mammogram test your breast tissue will appear more white.

    Density is graded on a four-point scale, from A (almost entirely fatty) through to D (extremely dense). Categories C and D are generally referred to as dense. Up to half of women over 40 years of age have dense breast tissue, so if you have been told your breasts are dense, you are far from alone. Density is a normal biological characteristic, not a disease or abnormality in itself.

    Why breast density matters

    There are two distinct reasons why breast density is clinically relevant, and it is worth understanding both.

    The first is cancer risk. Dense breast tissue is independently associated with a higher risk of developing breast cancer. Women with category D density have roughly double the risk of breast cancer compared to women with category B tissue. The reasons are not fully understood, but this association is well established in the research literature and informs screening guidance worldwide.

    The second is mammogram sensitivity. Dense tissue and potential cancers both appear white on a mammogram, which means that dense tissue can obscure abnormalities that might otherwise be detectable. Studies suggest that between 30% and 50% of cancers may not be visible on mammogram in women with dense breasts. This is sometimes called the masking effect.

    These two factors together mean that if you have dense breasts, your standard mammogram may be both less reassuring and less complete than it would be for someone with fatty tissue.

    What the guidance says

    The European Society of Breast Imaging published updated guidance in 2022 recommending that women with dense breasts be informed about the limitations of mammography and offered additional imaging, either ultrasound or MRI, depending on their overall risk profile. In the United States, mammogram facilities are now legally required to report breast density to patients so they can make informed decisions about supplemental screening. Extra screening is also routine in other European countries including France.

    UK guidance has been slower to formalise this, but the clinical case for supplemental imaging in women with dense breasts is well supported by the evidence, and an increasing number of women are seeking private assessment outside the NHS screening programme as a result.

    Your options for supplemental screening

    For most women with dense breasts who are at average or slightly elevated risk, breast ultrasound is the recommended first step beyond mammography. It uses sound waves rather than radiation, is non-invasive, and is particularly good at distinguishing between solid masses and fluid-filled cysts in dense tissue. It can detect cancers that are not visible on mammogram.

    For women at higher than average risk, for example, those with a strong family history of breast cancer, a breast MRI is the most sensitive available test. Your GP can help you discuss whether MRI screening is appropriate for your situation.

    If you are unsure which option is right for you, a GP consultation is a good starting point. Understanding your full risk picture, including family history and any relevant genetic factors, will help you and your doctor decide on the most appropriate next step.

    How Coyne Medical can help

    We offer breast ultrasound at our Fulham clinic with Dr Neil Upadhyay, a Consultant Radiologist with specialist expertise in breast imaging. Appointments are available on a private self-pay basis without a GP referral, though we would always recommend discussing your results with a GP who knows your full history.

    If you would like to understand your broader cancer risk before or alongside breast imaging, our genetic cancer testing service covers 35 inherited cancer risk genes including BRCA1 and BRCA2, with results reviewed by a Coyne Medical GP.

    Book a breast ultrasound →

    FAQs

    You may be told in your mammogram report. In England, NHS mammogram letters do not routinely tell you about breast density. At Coyne Medical we always request this extra information in your mammogram report, if you are using a different private provider do ask them about this. If you are unsure what your report says or what it means for you, bring it to a GP consultation and they can help you interpret it in the context of your overall health history.

    Yes. Breast density typically decreases with age and tends to reduce after the menopause, partly because falling oestrogen levels lead to a reduction in glandular tissue. Hormone replacement therapy can maintain or increase density in some women. It is worth being aware that your density category at one screening may not reflect your density at the next.

    Yes. Breast ultrasound uses sound waves and does not involve ionising radiation, making it safe to repeat as often as clinically indicated. It is the same technology used in pregnancy ultrasound scans and has an extensive safety record.

    No. The majority of women with dense breasts do not develop breast cancer. Density is one risk factor among several, and having it does not make cancer inevitable. What it does mean is that your standard mammogram may not give you the full picture, and supplemental imaging is worth considering.

    There is no reliable way to significantly reduce breast density through lifestyle changes, though maintaining a healthy weight and limiting alcohol may have a modest effect for some women. The most important thing is not to try to change your density, but to make sure your screening approach accounts for it.

    Genetic testing is a separate consideration from breast density, though for some women the two are relevant at the same time. If you have dense breasts and a family history of breast or ovarian cancer, or if you are of Ashkenazi Jewish heritage, genetic testing for BRCA1, BRCA2, and other inherited cancer risk genes is definitely worth discussing with your GP. At Coyne Medical, we offer inherited cancer risk panels as a standalone service or as part of our health screening packages. We offer this to all women regardless of family history, as studies show about half those that test positive for a gene like BRCA1 do not have a worrying family history.

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    Not sure which screening is right for you?

    Book a 30-minute Discovery Call with one of our GPs. We will talk through your health history, your concerns and your goals, and recommend the right programme for you.
    The £250 fee is fully credited against any health screening package you go on to book.

    BOOK A DISCOVERY CALL

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  • What your mouth can tell you about your health

    What your mouth can tell you about your health

    Most people think of oral health as something their dentist handles. Bleeding gums, cavities, the occasional check-up. What most people do not know is that the health of your mouth has a direct and well-evidenced connection to your heart, your immune system, and your metabolic health. What happens in your mouth does not stay there.

    The bacteria that cause gum disease do not simply sit in your gums. They enter your bloodstream. They have been found inside the walls of arteries. They trigger inflammatory signals that affect your heart, your blood sugar, and your immune response. Research shows that treating gum disease reduces a key marker of systemic inflammation by an amount comparable to some dedicated lifestyle interventions. This is not a fringe idea. It is increasingly recognised as one of the most overlooked connections in medicine.

    At Coyne Medical, we include an oral health screen as part of the Ultimate Health Screening for exactly this reason. This guide explains what the test looks at, what the results mean, and why your mouth is worth including in any serious health assessment.

    What the oral health screen measures

    The test is simple. During your GP assessment, we use a small cotton swab to collect a saliva sample. That sample is then applied to a test card and analysed on the spot. No laboratory, no waiting weeks for results. The findings feed directly into your overall results consultation.

    The sample is measured across seven markers.

    P. gingivalis is the main bacterium responsible for gum disease. It is also the organism most directly linked to cardiovascular and gut consequences of oral inflammation. Researchers have found it not just near arterial plaques but inside them. The test shows whether levels are within the good range, poor, or very poor.

    MMP-8 is an enzyme your immune system releases when gum tissue is under attack. Raised levels indicate active inflammation in the gums, often before you have noticed any symptoms yourself.

    Salivary pH measures how acidic your mouth is. A pH between 6.5 and 8.5 supports a healthy balance of bacteria. A more acidic environment lets harmful bacteria thrive and protective ones retreat.

    Buffering capacity is your mouth’s ability to neutralise the acids that bacteria produce. When this is low, the risk of enamel erosion increases and the conditions for an imbalanced bacterial environment are in place.

    Nitric oxide is a molecule that plays a role in keeping blood vessels healthy and blood pressure regulated. Part of it is produced through activity in the mouth, which makes salivary nitric oxide a useful window into cardiovascular and metabolic health.

    Salivary proteins are part of your mouth’s first line of defence against infection and inflammation. Low levels suggest that defence is reduced.

    Salivary glucose, a good picture of metabolic health.

    All seven results are reviewed by your Coyne Medical GP alongside your cardiovascular markers, metabolic blood results, and full clinical picture. That is what makes the findings meaningful rather than just numbers on a page.

    Why oral health affects the rest of your body

    Your heart

    Gum disease increases the risk of coronary heart disease by roughly 25 to 35 percent. The bacteria responsible for gum disease can enter the bloodstream through inflamed gum tissue and travel to the arteries, where they contribute to the build-up of plaques. They also trigger the production of inflammatory molecules that drive that process further. These are the same inflammatory signals that cardiologists spend significant effort trying to reduce.

    Studies have shown that treating gum disease lowers a widely used marker of inflammation in the body by a meaningful amount after six months of treatment. That is a real clinical effect from addressing something that needed treating anyway.

    Your blood sugar

    The relationship between gum disease and type 2 diabetes runs in both directions. High blood sugar creates an environment in which harmful oral bacteria thrive. And in turn, chronic inflammation from gum disease makes it harder for the body to regulate blood sugar effectively. Treating gum disease has been shown to improve blood sugar control in people with type 2 diabetes. The mouth is part of the metabolic picture.

    Your immune system

    Your mouth is home to over 700 species of bacteria, making it the second most diverse microbial environment in the body after the gut. When that balance tips toward a harmful mix, the effects do not stay local. You swallow around 1.5 litres of saliva every day, and whatever bacteria are living in your mouth travel with it. Harmful oral bacteria have been found in inflamed gut tissue. Chronic oral inflammation also primes immune cells in ways that can amplify inflammatory responses throughout the body.

    Understanding your results

    Each of the seven markers is rated across a range from good to very poor, with reference values in the report. A result outside the optimal range is not a diagnosis. It is a signal worth understanding in the context of everything else your health screen has found.

    Some patterns that commonly come up and what they tend to suggest:

    Elevated P. gingivalis alongside raised inflammatory markers elsewhere in the blood results points toward gum disease as an active contributor to systemic inflammation. The starting point is almost always a dental review and professional periodontal assessment.

    Low buffering capacity combined with a poor salivary pH often reflects frequent consumption of acidic foods or drinks, and can also indicate dehydration or mouth breathing, both of which carry broader health implications worth discussing.

    Low nitric oxide, particularly alongside elevated blood pressure or cardiovascular risk markers, adds a useful piece to the cardiovascular picture. Increasing dietary nitrate through vegetables has good evidence in this context and is something your GP can discuss with you at the results consultation.

    Low salivary proteins can reflect immune suppression, chronic stress, or nutritional factors. It is most useful when considered alongside the full screening picture rather than in isolation.

    High salivary glucose levels match closely to your blood glucose levels, we can correlate these with your blood results.

    What happens next

    Where all six markers are within normal ranges, no specific action is needed beyond maintaining good oral hygiene and seeing your dentist regularly.

    Where results fall outside optimal ranges, your Coyne Medical GP will discuss the findings at your results consultation. Depending on what is found, this may include a referral to a dentist or periodontist for professional assessment, dietary changes targeting specific markers, further investigation of relevant blood markers, or a follow-up review at three to six months.

    The oral health screen does not replace dental care. Its role is to make sure that meaningful signals in your mouth are not missed in the gap that tends to exist between medical and dental medicine

    Frequently asked questions

    Is the oral health screen a dental test? No. It is a health screen that uses saliva to look at markers connected to cardiovascular risk, inflammation, and metabolic health. It complements your dental care but does not replace it. All results are reviewed by a Coyne Medical GP, not a dentist.

    Do I need to have gum disease for this to be relevant to me? No. Many people with elevated oral inflammatory markers have no symptoms at all. The test is most valuable as part of a comprehensive health screen precisely because it can identify signals before they become visible problems.

    Why is this test included in the Ultimate Health Screening? Oral health is one of the most well-evidenced and most overlooked contributors to cardiovascular risk and systemic inflammation. Including it within a comprehensive screen allows the findings to be interpreted alongside cardiovascular, inflammatory, and metabolic data, which is where the clinical value lies.

    What is P. gingivalis and why does it matter? It is the main bacterium responsible for gum disease, and the one most directly linked to effects beyond the mouth. It has been found inside arterial plaques and in inflamed gut tissue. Most people have never heard of it, but it is one of the more significant organisms in the body from a systemic health perspective.

    Will my results be shared with my dentist? Not automatically. The report belongs to you, and many patients choose to share it with their dentist as a starting point for a conversation about their gum health. Your Coyne Medical GP can help you understand what to share and how.

    Is a saliva test accurate enough to be clinically useful? The test measures specific biochemical markers directly from saliva and is designed for use in clinical settings. It does not replace a full laboratory periodontal analysis, but as a systemic risk indicator within a comprehensive health screen and interpreted by a GP alongside other clinical findings, it provides genuinely useful information.

    A note from Dr Lucy Hooper

    Medicine and dentistry are treated as separate disciplines, but the biology does not respect that division. Your gut begins in your mouth. Inflammatory signals from your gums enter your bloodstream. Bacteria from your oral environment travel to your arteries and your gut. Yet in most medical settings, the mouth is simply not examined.

    We added the oral health screen to the Ultimate screening because we want to close that gap. Not to become dentists, but to make sure that when we are reviewing someone’s cardiovascular risk or their inflammatory markers, we are not ignoring something significant and treatable happening upstream. For some patients, what we find in their saliva will be the most actionable result in the whole screen.

    Discover the Ultimate Health Screening

    The oral health screen is one part of the Coyne Medical Ultimate Health Screening. It sits alongside whole body MRI, VO2 max testing, pharmacogenomics, a 55 gene inherited cancer risk panel, and a full advanced blood panel. Find out what is included and how to book.

    Explore Ultimate Health Screening

    DR LUCY HOOPER
    MB BS BSc MRCGP MA DRCOG DCH

    Lucy is a GP and co-founder of Coyne Medical. She graduated with honours from Imperial College London, trained at St Mary’s Hospital, and holds a Master’s in Medical Ethics and Law. Her clinical interests span women’s health, preventive medicine, and genomics, with a particular focus on using advanced biomarkers to build a more complete picture of long-term health.

    British Society for Genetic Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in BBC, The Guardian, Women’s Health, The Times and Tatler

    Book a GP Consultation

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Longevity & Healthspan Guides
  • Gut Microbiome Testing: How Your Gut Health Affects Weight, Mood & IBD

    Gut Microbiome Testing: How Your Gut Health Affects Weight, Mood & IBD

    Is Your Gut Controlling Your Health? Why Gut Microbiome Testing is a Game-Changer

    Just 1% of the DNA in our body is human, the rest belongs to the large community of microbes that live within our body. The richest area is in the gut. The gut microbiome is about much more than digestion, it has impacts on your metabolism, cancer risk, mood and much more. Read on to learn what your gut microbiome does and how gut microbiome testing could improve your health.

    What is Your Gut Microbiome (And Why Does It Matter)?

    The bacteria in your gut are not just passengers along for the ride, they have their own metabolism and complex connections. When you consume fibre, these bacteria digest it and produce short-chain fatty acids (SCFAs), like butyrate, propionate, and acetate. These SCFAs

    These SCFAs are critical for your health. They:

    • Act as the main energy source for your gut lining.
    • Help maintain your “intestinal barrier,” keeping unwanted substances out of your bloodstream.
    • Regulate inflammation throughout your body.
    • Influence your lipid and glucose metabolism.

    Understanding ‘Dysbiosis’: When Good Guts Go Bad

    A healthy gut microbiome is balanced, it contains a wide variety of different species. This is important because the bacteria help to support each other, and make the microbiome more resilient. There are some key bacteria that we know are usually beneficial and associated with good health. Dysbiosis is the term used to indicate loss of healthy microbiome balance. This has impacts well beyond the gut and is associated with a wide range of chronic diseases, including obesity, type 2 diabetes, inflammatory bowel disease, cardiovascular disease, and even neurodegenerative disorders.

    The Surprising Link: How Gut Health Affects Your Weight and Diabetes Risk

    If you struggle with your weight, your microbiome might be a factor. Dysbiosis is linked to obesity and T2DM in several ways:

    1. Increased Energy Harvest: Some bacteria are too good at their job. They possess enzymes that break down indigestible fibres, extracting more calories from your food, which promotes weight gain.
    2. “Leaky Gut” and Inflammation: The microbiome has vital roles in keeping the gut barrier intact. The gut wall stops unwanted bacteria and other substances getting inside the body. A damaged gut barrier allows bacterial components, like lipopolysaccharide (LPS), to “leak” into your bloodstream. This triggers chronic, low-grade inflammation, chemical messengers trigger insulin resistance and metabolic syndrome. These changes to the metabolism mean it is easier to gain weight and harder to lose it. 

    Hormone Disruption: Your gut microbes can even alter the secretion of satiety signals like GLP-1. Made famous by weight loss medicines, like Mounjaro and Ozempic, GLP-1 is a key chemical signal to tell us we have had enough to eat.

    Beyond Weight: Is Your Gut Linked to Inflammatory Bowel Disease?

    Gut microbiome changes can affect our body in many ways. 

    Inflammatory Bowel Disease (IBD): We can actual spot specific patterns of gut organisms, microbiome signatures, which are linked to the future onset of inflammatory bowel disease such as Crohn’s disease. These changes can be seen up to 5 years before symptoms appear. This includes a decrease in anti-inflammatory bacteria. Bacteria like Roseburia intestinalis for example can increase the number of regulatory T cells, these cells are part of the immune system and help to control inflammation throughout the body. If you are lacking these ‘good’ bacteria it increases inflammation levels. ‘Bad’ bacteria like Ruminococcus torques, cause their impact by degrades the protective layer of mucus which lines the gut and helps protect it’s surface cells.

    The Gut-Brain Axis:Depression & Mental Illness

    We all know that familiar feeling of butterflies in the stomach before an exam. The links between our brain and gut are strong and multiple. We are now learning more about how these links go beyond nerves to include changes to chemical messengers in the bloodstream and brain. We know probiotics and a Mediterranean diet can be an important component of depression treatment, the microbiome is a key part of why those treatments work. 

    Studies show major differences in the gut bacteria of people with depression. This includes a reduction in anti-inflammatory, butyrate-producing bacteria like Faecalibacterium and Coprococcus. Increased numbers of bacteria such as Eggerthella have been linked to causing mood disorders like depression, they may work by changing the amounts of brain chemicals such as tryptophan and serotonin.

    Cancer: from inflammation to DNA damage

    We know that gut dysbiosis can impact your risk of cancer in multiple ways. 

    • Chronic inflammation
      • Many of the changes we see in dysbiosis cause changes to the level of inflammation both in the gut and through immune system and chemical signals throughout the body.
      • These systems go well beyond the gut to the brain, oral microbiome and the whole body.
    • Genotoxins
      • Bacteria such as Fusobacterium nucleatum are one change seen in dysbiosis. These are termed harmful bacteria because they produce toxins (e.g. colibactin). These ‘genotoxins’ can cause direct damage to the DNA in the cells of the gut lining. DNA damage is a critical step in allowing the cells to become cancerous.
        • This process has been especially flagged as perhaps being key to early-onset colorectal cancers, those occurring under 50 years of age.  
    • Slowing the immune response
      • Cytotoxic T cells, are a specific type of immune system cell that play a key role in killing harmful things such as bacteria, but also tumour (cancer) cells. In dysbiosis the changes can mean that the T cells are fewer and less effective at killing cancer cells. 
    • Beyond the gut
      • Dysbiosis does not just affect your colorectal (bowel) cancer risk. It has also been linked to cancers of the breast, lung, liver, pancreas, prostate, cervix, urinary tract, skin, lymphoid tissues, and acute myeloid leukaemia.

    The Gut-Autoimmune Connection: Is Your Immune System Being Confused?

    Your gut and immune system are closely intertwined, they are constantly communicating with each other. Your gut is the largest part of the body in contact with the outside world, so it makes sense that up to 80% of your immune cells are found in the gut to protect your body from invaders like unhealthy bacteria. When you have a healthy microbiome balance the gut helps regulate the immune system, so it can differentiate between friend (your own body and good bacteria) and foe (pathogens). 

    When dysbiosis occurs, two key things can happen:

    1. Systemic Inflammation: An unbalanced microbiome drives chronic, body-wide inflammation.
    2. “Leaky Gut”: The intestinal barrier can be disrupted, allowing bacteria and metabolites to “leak” into the circulation.

    This combination can confuse the immune system, leading it to mistakenly attack your body’s own tissues. This is the hallmark of autoimmune diseases like:

    • Type 1 Diabetes: The loss of the gut barrier is well-documented as a trigger for the T-cell response, these are your own immune cells. In Type 1 Diabetes they attack beta cells in your pancreas that produce insulin. Destruction of your beta cells mean you can no longer produce your own insulin and need lifelong therapy.
    • Rheumatoid Arthritis: Dysbiosis (like an increase in Prevotella copri bacteria) triggers the body to produce antibodies against it. But unfortunately the antibodies that are made to fight Prevotella can then make your immune system start to attack the joints, in a process called ‘molecular mimicry’. 
    • Multiple Sclerosis (MS): Strong links exist between dysbiosis and MS onset. The dysbiosis means there are less healthy bacteria, which digest fibre to produce butyrate. Lower butyrate levels means the gut barrier and the blood-brain barrier are disrupted, this lets more inflammatory cells reach the bloodstream and brain.

    How Do You Test Your Gut Microbiome? The Answer is ‘Shotgun Metagenomics’

    We can not take the guesswork out of your gut health. We now have the technology to let you test your gut microbiome. This is analysed by a fully UKAS-accredited laboratory.

    The test is simple:

    1. You collect a stool sample conveniently at home using the provided kit.
    2. The lab uses a powerful technology called “shotgun metagenomics”.
    3. Unlike older methods, this technique sequences all the DNA present. This allows us to identify not just the bacteria, but also fungi and viruses. It doesn’t rely on growing or culturing them in a lab.

    Your comprehensive report will then give you personalised, actionable insights and recommendations based on your unique results. If you are interested in discussing your gut health then make an appointment to see one of our doctors today for a consultation. The Gut Microbiome Test can be added to your GP consultation or health screening, the Test fee is £311, which includes the collection kit, sample delivery, laboratory analysis and personalised report.

    5 Actionable Ways to Improve Your Gut Microbiome Health Today

    While your test results will give you personalised targets, you can start supporting your microbiome right now with these evidence-based steps:

    1. Eat More Fibre: Aim for diverse, plant-based foods. The recommendation is for 30g per day, the average UK intake is about 18g so most of us have room for improvement.
    2. Try Prebiotics: These are foods that feed your good bacteria, not to be confused with probiotic supplements. Think garlic, onions, chicory root (Inulin), and Jerusalem artichokes. These contain special fibres which can’t be digested by us but instead are digested by our gut bacteria.
    3. Eat Fermented Foods: Add yogurt, kefir, and other fermented products to your diet. Find your favourite and make it a regular part of your nutrition routine. Kimchi is another firm favourite, check out this Dr Rupy recipe for inspiration.
    4. Exercise Regularly: Both aerobic and resistance training have been shown to improve gut biodiversity.
    5. Avoid Smoking and Limit Alcohol: both are well known to be harmful to gut microbiome health and it’s important to limit alcohol and avoid smoking altogether.

    DR LUCY HOOPER
    MB BS BSc MRCGP MA DRCOG DCH

    Lucy is a GP and co-founder of Coyne Medical. She graduated with honours from Imperial College London, trained at St Mary’s Hospital, and holds a Master’s in Medical Ethics and Law. Her clinical interests span women’s health, preventive medicine, and genomics, with a particular focus on using advanced biomarkers to build a more complete picture of long-term health.

    British Society for Genetic Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in BBC, The Guardian, Women’s Health, The Times and Tatler

    Book a GP Consultation

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Longevity & Healthspan Guides
  • Are You Worried About Statin Side Effects? Why 47% of Patients Stop Their Medication

    Are You Worried About Statin Side Effects? Why 47% of Patients Stop Their Medication

    Have you been prescribed a medication, like a statin, and worried about side effects? Did you stop your medication? Or maybe you never even started it.

    Traditionally doctors have relied on a ‘trial and error’ approach to medication.

    The “Trial-and-Error” Gamble with Statin Prescriptions

    Over 5 million people in the UK are prescribed statin medication every year. But we know that approaching 50% of patients stop them in the first year, or never even get their tablets.

    Either experiencing side effects or worry about them are two of the biggest reasons for this. This is a big problem for your health. Cardiovascular disease is the leading cause of death, but a massive 80% of cardiovascular disease is preventable. Controlling lipids with medications like statins is a key weapon to prevent deaths from cardiovascular disease.

    What is Pharmacogenomics (PGx)? The End of “One-Size-Fits-All” Medicine

    Pharmacogenomics analyses your DNA, looking at specific genes which dictate how your body responds to medicines. We have excellent detailed data that can predict how your body will metabolise drugs. This impacts not just whether the drug is effective, but also the risk of nasty side effects.

    In the clinic we take a simple blood sample which is analysed in a specialist genetic laboratory in Germany. The result gives us a detailed profile of your pharmacogenomics.

    How a Simple Genetic Test Can Predict Your Body’s Response to Statins

    The SLCO1B1 gene in your DNA codes for making a protein that is vital in controlling the metabolism of statins by your liver. We all have slightly different copies of this gene, called polymorphisms.

    Up to 36% of people tested have a copy of SLCO1B1 with decreased function. This means that the body has trouble clearing statins from the bloodstream to be metabolised by the liver. This means levels of the statin drug can build up in the blood stream, and cause side effects such as muscle pain and inflammation.

    A Patient Story: Replacing Statin Fear with Confidence

    In the clinic we can check your pharmacogenomic profile before starting medication. This means we can then choose a statin or other cholesterol lowering medicine which is much safer for you. You will be less likely to experience side effects and the drug is also more likely to be effective.

    We had a patient recently who wanted to start a statin to reduce their long-term risk of heart disease, they had read a lot about people experiencing muscle pain. As a really fit and active person they didn’t want anything which would impact their busy lifestyle. Their pharmacogenomic profile showed they have decreased SLCO1B1 function and were at high risk of side effects with the most commonly prescribed statins, atorvastatin and simvastatin. We were able to choose a low dose of rosuvastatin for them, this is the most effective and safest choice for them.

    Take the Guesswork Out of Your Heart Health

    We are incredibly lucky to be alive in a time where medical advances give us the chance for preventative healthcare. This chance was denied to many generations before us.

    We know though that many patients worry about taking medications, especially about unwanted side effects. Pharmacogenomics is a key tool we can use make sure you get the right medication. We can go from ‘trial and error’ to a truly personalised cardiovascular disease prevention plan.

    Interested in finding out your pharmacogenomic profile and what real-life personalised medicine means? We’d love to help you, so book today or get in touch.

    DR LUCY HOOPER
    MB BS BSc MRCGP MA DRCOG DCH

    Lucy is a GP and co-founder of Coyne Medical. She graduated with honours from Imperial College London, trained at St Mary’s Hospital, and holds a Master’s in Medical Ethics and Law. Her clinical interests span women’s health, preventive medicine, and genomics, with a particular focus on using advanced biomarkers to build a more complete picture of long-term health.

    British Society for Genetic Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in BBC, The Guardian, Women’s Health, The Times and Tatler

    Book a GP Consultation

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Lab Tests & Results Guides
  • The Complete Doctor’s Guide to Your Weight Loss Injection Journey

    The Complete Doctor’s Guide to Your Weight Loss Injection Journey

    Welcome to the start of your treatment journey. Embarking on a new path to manage your weight is a significant step, and we are here to support you. We are fortunate to be in a time when we have these powerful medicines to help weight loss. We have seen the most success in our patients when combined with positive and sustainable lifestyle changes. We want you to succeed, we’ve created this guide for getting the most out of your treatment safely and effectively.

    Your First Steps: Dosing, Titration, and What to Expect

    Understanding Your Dosing Schedule (Titration)

    Your dose will start low and be gradually increased over several weeks or months. This process, called titration, is essential. It allows your body to adapt to the medication, which significantly reduces the intensity of potential side effects. Please follow the prescribed schedule and do not increase your dose faster than recommended. Some patients may even benefit from a slower titration, especially if you have troublesome side effects, talk to your doctor to see if this might work for you.

    How to Manage Common Side Effects on Wegovy and Mounjaro

    Most side effects are mild and tend to improve as your body adjusts. We’ve gathered a few tips that can make those first few weeks easier. If you are concerned about your side effects at any time please talk to your doctor for personalised advice.

    Tips for Dealing with Nausea and Indigestion

    Nausea is the most common side effect, it affects up to 70% of people. Eating smaller, blander meals (e.g., toast, rice, bananas) can help. To avoid indigestion and reflux, try to avoid very fatty, greasy foods and an excess of fizzy drinks. Over-the-counter indigestion remedies like Gaviscon can be used if needed.

    Managing Constipation and Fatigue in the First Few Weeks

    The medication can slows down your gut, and cause constipation. Ensure you are drinking plenty of water and eating high-fibre foods. If this isn’t enough, speak to your doctor about gentle remedies. Some patients also feel more tired initially; prioritising good sleep and gentle movement can help boost energy levels. Fruit is a great choice for people on these medicines, the natural sugars can give a good energy boost, plus fibre will help regulate your gut. Some people worry about the “sugar” in fruits, but it is not the same as sugars in processed foods. To get the most benefit eating fruit whole though is much better for you than juices or smoothies.

    The Best Diet Plan for Weight Loss Injections

    Your nutrition is vital for not just your long term success but also your overall health. These medicines will reduce your appetite, if you are eating much less than usual then it becomes even more important to choose the best foods for your body.

    The Importance of Protein, Fibre, and Hydration

    Aim to drink plenty of water throughout the day to stay hydrated. This can also help with fatigue or feeling light-headed. Include fruit, vegetables, and whole grains to boost fibre, which supports gut health and energy. If you want to check your fibre intake, we’ve got a quick online score here, which is a good place to start. Prioritise protein-rich foods (e.g., chicken, fish, eggs, Greek yoghurt) in your meals and snacks, as protein helps you feel fuller for longer. We all know how important protein is for keeping a healthy muscle mass. When people lose a significant amount of weight they often lose muscle. Trying to minimise muscle loss is important, this is because in the long term a healthy muscle mass will help to ensure you have good metabolic health and stay a healthy weight. If you feel your appetite increasing then make sure you start with a high-protein food.

    Foods and Drinks to Avoid to Minimise Side Effects

    As mentioned, very fatty, greasy foods and sugary, fizzy drinks are common triggers for bloating, nausea, and indigestion. Listen to your body and take note of any foods that cause you discomfort.

    A Note on Alcohol Consumption and Cravings

    Be mindful of your alcohol consumption. Alcohol contains a significant number of calories which can hinder your progress. Furthermore, some people find their tolerance to alcohol changes, or that it can worsen side effects like acid reflux. Interestingly many patients report they don’t desire alcohol as much on these medicines. This is likely from how they affect our ‘reward’ pathways in the brain. We’ve seen similar positive effects on other addictions like gambling. Many people also notice their cravings or “food noise” are much less.

    Lifestyle, Exercise, and Your Mental Wellbeing

    We want our patients to be succesful for the long term. We have seen this is more likely to happen when these injections are used as part of a complete plan including your lifestyle, exercise and psychological wellbeing.

    Finding an Exercise Routine That Works for You

    Increasing your activity is crucial and can help you remain on the lowest effective dose. This isn’t just about going to the gym. Daily movement is very important, think about how you can make your life active, rather than just a few sessions per week. Take the stairs, go for a walk on your lunch break, or enjoy active hobbies. Every step counts!

    What to Do When You Hit a Weight Loss Plateau

    Weight loss is not always a straight line. It is normal to have weeks where your weight loss stalls. We recommend using other measurements alongside regular weigh-ins, simple at-home tests include measuring your waist and hips with a tape measure. There are also lots of great options for ‘smart’ scales that estimate body fat and muscle mass. Focus on “non-scale victories” like your clothes fitting better, having more energy, or improved health markers, and discuss any concerns with your doctor.

    Navigating Social Events and Eating Out

    Social events centred around food can feel challenging. Plan ahead: look at menus online to choose a lighter option, consider ordering a starter as your main course, eat slowly, and focus on the social connection rather than just the food.

    Looking After Your Mental Health During Your Journey

    Adjusting to changes in your body can be an emotional process. Be mindful of your mental health. Simple things like daily walks, talking to supportive friends, or seeking professional support can be incredibly beneficial. Some people find support from sharing their journey with friends, others prefer to keep it private. Either option is absolutely fine.

    A Practical Guide to Your Medication

    Here are the essential practicalities for handling your medication safely and confidently.

    How to Inject Wegovy, Saxenda, and Mounjaro Safely

    It is vital that your injections come from a regulated UK pharmacy to ensure they are genuine and safe. Using the correct injection site is also important for absorption and comfort. Please refer to the manufacturer’s official guidance for your specific medication.

    Forgot Your Injection? What to Do for a Missed Dose

    The advice for a missed dose varies between medications. Always refer to the patient information leaflet that comes with your medication for precise instructions, or contact us at the clinic if you are unsure.

    Managing Your Prescriptions and Travelling with Your Medication

    Always ensure you order your repeat prescriptions in good time, especially before holidays or if you are planning to travel. Our patients may contact us by email to reception@coynemedical.com with prescription requests. It is helpful to share an up-to-date weight at the same time so we can monitor your progress. We usually recommend a doctor’s review at least every 3 months to ensure you get the most from your medicines.

    Safe Disposal: Using Your Sharps Bin Correctly

    You must use a dedicated sharps bin to safely dispose of your used needles and pens. You can buy these easily through online retailers or from your pharmacy. When full sharps bins must be safely disposed of, your pharmacy or local council should be able to advise on how to do this.

    Long-Term Success: Maintenance, Stopping, and Overall Health

    Thinking about the future is an important part of your journey. Here’s how to plan for sustainable, long-term health.

    Important Drug Interactions to Be Aware Of (Thyroid, HRT, etc.)

    Ensure your doctor is aware of all medicines you take. These injections can affect the absorption of some oral medications, so it’s particularly important to discuss if you are taking medication for your thyroid, on HRT, or use the oral contraceptive pill.

    Planning to Stop or Reduce Your Dose? Read This First.

    As you approach your target weight, work with your doctor to create a plan. Some patients benefit from a slow dose reduction, while others may stay on a lower maintenance dose long-term to prevent weight regain. Having a robust plan for your nutrition and exercise is essential during this phase.

    The Role of Vitamins and Long-Term Health Monitoring

    If you are on the medication long-term, we may recommend occasional blood tests to check your nutritional status. A good quality multivitamin and a Vitamin D supplement are sensible for most, but please discuss this with your doctor first.

    This is a collaborative journey. Please never hesitate to contact us with any questions or concerns. We are here to help you achieve your health goals.

    DR LUCY HOOPER
    MB BS BSc MRCGP MA DRCOG DCH

    Lucy is a GP and co-founder of Coyne Medical. She graduated with honours from Imperial College London, trained at St Mary’s Hospital, and holds a Master’s in Medical Ethics and Law. Her clinical interests span women’s health, preventive medicine, and genomics, with a particular focus on using advanced biomarkers to build a more complete picture of long-term health.

    British Society for Genetic Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in BBC, The Guardian, Women’s Health, The Times and Tatler

    Book a GP Consultation

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Longevity & Healthspan Guides
  • Major Changes to the Childhood Vaccination Schedule: What Parents Need to Know

    Major Changes to the Childhood Vaccination Schedule: What Parents Need to Know

    Big changes are coming to the UK’s childhood vaccination schedule, including a new appointment at 18 months. Here’s what it means for your child — and why at Coyne Medical we already recommend one of the key changes: an earlier second dose of the MMR vaccine.

    What’s Changing in the NHS Childhood Vaccination Programme?

    The UK Government and the Joint Committee on Vaccination and Immunisation (JCVI) have announced significant updates to the childhood vaccination schedule. Many changes begin rolling out from July 2025, with further changes from January 2026, aimed at improving early childhood protection and simplifying immunisation.

    Key Changes

    From July 2025:

    • Meningitis B vaccine: Second dose moved from 16 to 12 weeks
    • Pneumococcal vaccine (PCV13): First dose delayed to 16 weeks
    • Hib/Men C vaccine (Mentorix): Removed due to discontinuation
    • Selective neonatal Hepatitis B dose: No longer offered at one year

    From January 2026:

    • New 18-month appointment introduced:
      • A fourth dose of the 6-in-1 vaccine (DTaP/IPV/Hib/Hep B)
      • Second MMR dose moved forward from 3 years 4 months to 18 months

    Key Changes

    These updates follow clinical evidence and supply changes, reflecting the growing importance of early protection. Moving the second MMR dose earlier has been shown to improve overall uptake and provide better protection during toddlerhood, when outbreaks can spread quickly.

    Our Approach at Coyne Medical

    At Coyne Medical, we already recommend giving the second MMR dose at 18 months — particularly in response to increased cases of measles and mumps in London. This proactive approach:

    • Provides earlier protection against these highly contagious illnesses
    • Reduces the risk of complications, especially in children attending nurseries or starting school
    • Enhances community immunity, helping to protect vulnerable individuals
    A Special Note: Catch-Up for Children Who Missed MMR

    During the COVID-19 pandemic, many families experienced disruptions to routine vaccinations and some children may have missed one or both MMR doses.

    Why this matters:

    • Measles can cause serious complications including pneumonia and brain inflammation (encephalitis)
    • Mumps, especially when contracted after puberty, can lead to orchitis (inflammation of the testicles) in boys and infertility in rare cases
    • Rubella poses a particular danger to unborn babies if contracted during pregnancy

    What parents can do:

    • Check your child’s vaccination record — especially if they were born between 2018 and 2021
    • Book a catch-up appointment — it’s never too late. We offer catch-up MMR vaccinations for children, teens, and adults
    • Be aware of symptoms: swollen salivary glands (parotitis), fever, and fatigue in an unimmunised child could indicate mumps — speak to your GP immediately

    Catching up now is vital to prevent complications and reduce transmission, especially in schools and crowded settings.

    We’re Here to Help

    Whether you’re following the standard NHS schedule, catching up after delays, or wanting the most up-to-date protection — we’re here to support your family. Contact us or call us directly to speak to a doctor about your child’s vaccinations, review their record, or book an MMR catch-up.

    Note: For parents with concerns about MMR vaccine safety, the University of Oxford has detailed information available.

    DR LUCY HOOPER
    MB BS BSc MRCGP MA DRCOG DCH

    Lucy is a GP and co-founder of Coyne Medical. She graduated with honours from Imperial College London, trained at St Mary’s Hospital, and holds a Master’s in Medical Ethics and Law. Her clinical interests span women’s health, preventive medicine, and genomics, with a particular focus on using advanced biomarkers to build a more complete picture of long-term health.

    British Society for Genetic Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in BBC, The Guardian, Women’s Health, The Times and Tatler

    Book a GP Consultation

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Child Health Guides
  • Introducing the Ziwig Endotest: A Revolutionary Saliva Test for Early Endometriosis Detection

    Introducing the Ziwig Endotest: A Revolutionary Saliva Test for Early Endometriosis Detection

    Endometriosis is a painful, often life-disrupting condition affecting millions of women worldwide. Despite its prevalence, diagnosis can take years — with the average delay currently over 8 years and 10 months.

    Traditionally, the only definitive way to diagnose endometriosis was through laparoscopy, a surgical procedure under general anaesthetic. But today, a groundbreaking innovation is transforming that reality.

    At Coyne Medical, we are proud to offer the Ziwig Endotest — a non-invasive, saliva-based test developed in France that enables the early detection of endometriosis without the need for surgery. Validated in large-scale clinical trials, with results published in the New England Journal of Medicine in 2023, this test is helping women access faster, safer diagnosis and timely treatment.

    🤍 Understanding Endometriosis: Symptoms, Challenges & the Need for Early Diagnosis

    Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus (womb), often causing:

    • Chronic pelvic pain
    • Heavy or painful periods (dysmenorrhoea)
    • Pain during intercourse (dyspareunia)
    • Digestive symptoms
    • Infertility

    Around 1 in 10 women of reproductive age in the UK are affected, but symptoms often overlap with conditions like IBS (irritable bowel syndrome) or pelvic inflammatory disease, making diagnosis difficult.

    Nearly half of women report 10 or more GP visits before receiving a diagnosis.

    Standard tests such as blood tests, hormone levels, ultrasound, or MRI can often appear normal — leaving patients feeling unheard or doubting their symptoms. The current reliance on laparoscopy delays care and can impact fertility, quality of life, and mental wellbeing.

    🔬 How the Ziwig Endotest® Is Transforming Diagnosis with Non-Invasive Technology

    The Ziwig Endotest® offers a powerful alternative to traditional diagnostic tools:

    • Saliva-based, non-invasive
    • No anaesthetic, no surgery
    • Minimal preparation
    • Results within 3–4 weeks

    In studies across France, the test achieved:

    • 97% sensitivity (correctly identifies 97 out of 100 people with endometriosis)
    • 93% specificity (accurately rules out endometriosis when it’s not present)

    This means women can now receive a reliable diagnosis without undergoing surgery or hospital referral — enabling earlier access to care and treatment.

    🧬 The Science Behind the Ziwig Endotest®

    The test works by detecting over 100 specific microRNA molecules present in saliva — tiny regulators that influence how genes behave in the body. These biomarkers are extracted through Next Generation Sequencing (NGS) and interpreted with advanced artificial intelligence (AI).

    This cutting-edge combination of molecular biology and AI allows the Endotest® to identify even early or subtle signs of endometriosis — even when imaging and blood tests are normal.

    Ziwig is also exploring this technology to diagnose ovarian cancer, fibroids, and other gynaecological conditions.

    👩‍⚕️ What to Expect: Patient Guide to the Ziwig Endotest®

    Step 1: Saliva Collection
    A simple, in-clinic collection of a small saliva sample at your GP consultation.

    Step 2: Laboratory Analysis
    The sample is sent for processing, where RNA biomarkers are analysed using NGS and AI algorithms.

    Step 3: Results
    You’ll receive a report within 3–4 weeks, showing whether the biomarkers linked to endometriosis are present.

    Step 4: Next Steps
    Our GPs will review the results with you and develop a personalised care or referral plan as needed.

    ✅ Who Is the Ziwig Endotest® Suitable For?

    Age range: Women aged 18 to 43 years
    Symptoms:

    • Chronic pelvic pain
    • Painful or heavy periods
    • Pain during sex, urination, or bowel movements
    • Rectal bleeding or shoulder-tip pain during menstruation
    • Difficulty conceiving

    The test can be done at any time during the menstrual cycle, including while taking hormonal treatment.

    ❌ Who Should Not Take the Test?

    • Under 18 or over 43 years of age
    • Current infections (including oral or systemic)
    • History of HIV or cancer

    📊 Comparing Traditional vs. Ziwig Endotest®

    Diagnostic MethodTypeInvasivenessPreparation / RecoveryLimitations
    UltrasoundImagingNon-invasiveMinimal preparationMay miss subtle or deep endometriosis
    MRIImagingNon-invasiveMinimal preparationMay not detect small or early lesions
    LaparoscopySurgical procedureInvasiveRequires anaesthetic and recoveryGold standard, but involves surgical risks
    Ziwig Endotest®Saliva-based testNon-invasiveNo downtime; minimal preparationNew technology; not yet standard NHS practice

    ⏳ How the Ziwig Endotest® Helps Reduce Diagnostic Delays

    The current delay in endometriosis diagnosis causes avoidable distress, prolonged symptoms, and fertility complications.

    By offering an accurate, in-clinic diagnostic test, we can:

    • Shorten time to diagnosis
    • Reduce reliance on surgical procedures
    • Improve early access to treatment
    • Support fertility planning

    ❓ Frequently Asked Questions

    Is the Ziwig Endotest® accurate?
    Yes — it detects 97% of confirmed endometriosis cases and is supported by peer-reviewed research.

    Is it covered by insurance?
    Coverage varies by provider and policy. Please check with your insurer directly.

    Is it painful?
    No — the test is completely non-invasive and pain-free.

    How much does it cost?
    The laboratory test costs £1020, plus a GP consultation (£160) at Coyne Medical.

    How do I access the test?
    Book an appointment with one of our experienced GPs to confirm suitability and begin testing.

    📅 Book Your Ziwig Endotest® Consultation

    If you’re experiencing symptoms such as chronic pelvic pain, painful periods, or difficulty conceiving, early diagnosis is essential.

    Our expert team at Coyne Medical offers personalised support and fast access to the Ziwig Endotest®.
    Book now to explore if this test is right for you.

    👉 Book a GP Consultation Online or call us to schedule your appointment.

    DR LUCY HOOPER
    MB BS BSc MRCGP MA DRCOG DCH

    Lucy is a GP and co-founder of Coyne Medical. She graduated with honours from Imperial College London, trained at St Mary’s Hospital, and holds a Master’s in Medical Ethics and Law. Her clinical interests span women’s health, preventive medicine, and genomics, with a particular focus on using advanced biomarkers to build a more complete picture of long-term health.

    British Society for Genetic Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in BBC, The Guardian, Women’s Health, The Times and Tatler

    Book a GP Consultation

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Women’s Health Guides
  • The New RSV Vaccine: What You Need to Know

    The New RSV Vaccine: What You Need to Know

    We can now offer vaccination against RSV (respiratory syncytial virus (RSV). This is great news so we can protect our patients from this nasty infection.

    💉 Great news! We can now offer vaccination against Respiratory Syncytial Virus (RSV). It causes serious respiratory infections in babies, older adults, and those with weakened immune systems.

    This new RSV vaccine can help protect vulnerable groups and reduce hospitalisations. Here’s everything you need to know.

    🔍 Understanding RSV

    What is RSV?

    RSV is a common respiratory virus that can cause:
    ✅ Runny nose 🤧
    ✅ Coughing & sneezing 😷
    ✅ Fever 🌡️
    ✅ Shortness of breath 🫁

    👶 In babies, RSV can lead to bronchiolitis—a severe lung infection.
    👂 In older children, it can cause middle ear infections & croup.

    💡 How does RSV spread?

    • Through coughing & sneezing 🤧
    • By touching contaminated surfaces (RSV can survive for hours!) 🦠
    • From close contact with infected people 👥
    ⚠️ Who is at Risk?

    RSV can affect anyone, but some groups are more vulnerable:

    👶 Babies under 6 months (especially those born August to November)
    🏥 Premature babies or those with lung or heart conditions
    🧓 Older adults (60+ years)—RSV can be fatal for some
    🤒 People with weakened immune systems

    Each year, thousands of babies, children, and adults in the UK are hospitalized due to RSV. Now, we finally have a vaccine to help prevent it! 🎉

    💉 The RSV Vaccine: How It Works

    The RSV vaccine (Abrysvo® by Pfizer) is NOT a live vaccine. It works by:
    1️⃣ Exposing your immune system to a small part of the virus (an antigen).
    2️⃣ Helping your body develop protective antibodies.
    3️⃣ Allowing your immune system to recognise & fight RSV quickly if exposed.

    💪 The result? A much lower risk of serious RSV infection!

    📊 How Effective is the RSV Vaccine?

    For Infants (via Maternal Vaccination)

    👩‍🍼 Pregnant women who receive the vaccine pass antibodies to their babies. This has been shown to:
    ✅ Reduce severe RSV infections in newborns by ~80%

    For Older Adults (60+ years)

    📊 Studies show that vaccinated adults have an 80% lower chance of severe RSV infection.
    ⏳ Protection has been shown to last at least 2 years.

    ⚠️ Is the RSV Vaccine Safe?

    Yes! The vaccine has been rigorously tested and used in real-world settings, such as the USA, since 2023.

    Possible Mild Side Effects (like other vaccines):

    💪 Soreness at the injection site
    🤕 Mild fever or headache
    🦵 Muscle aches

    🚨 If you have a history of allergic reactions to a vaccine, consult your doctor before getting vaccinated.

    👩‍⚕️ Who Should Get the Vaccine?

    Currently, the RSV vaccine is licensed in the UK for:

    🤰 Pregnant women (recommended at 28–36 weeks of pregnancy)

    • Antibodies pass to the baby through the placenta
    • If you miss the timing, you can still get vaccinated later in pregnancy, antibodies can also be passed through breast milk 🍼

    👵 Older adults (60+ years)

    • RSV can cause hospitalisations & deaths in older adults
    • The vaccine is especially important for those with lung or heart disease

    🏥 Where to Get Vaccinated?

    NHS Eligibility

    ✔️ Pregnant women—Available during routine antenatal care
    ✔️ Older adults—Currently offered to:

    • 📅 Ages 75–79
    • 📅 Ages 80+ (if you turned 80 after 1st September 2024 and before Aug 31, 2025)
      🩺 Check with your NHS GP to confirm availability.

    Private Vaccination at Coyne Medical

    🏥 We offer RSV vaccination for:
    ✅ Pregnant women (28–36 weeks)
    ✅ All adults aged 60+

    📅 Book an appointment online or contact us to schedule your RSV vaccination today!

    🔮 Looking Ahead

    Currently, there is no RSV vaccine licensed for babies & young children in the UK.
    🔬 However, monoclonal antibody treatments are available for high-risk infants under hospital care.

    📢 Take Action – Protect Yourself & Your Loved Ones!

    💡 With ongoing research, we hope to see more RSV protection options available soon!

    ✅ Pregnant? Over 60? Get vaccinated today!
    📅 Book your RSV vaccine now to stay protected.

    💬 Got questions? Contact us at Coyne Medical—we’re happy to help!

    DR LUCY HOOPER
    MB BS BSc MRCGP MA DRCOG DCH

    Lucy is a GP and co-founder of Coyne Medical. She graduated with honours from Imperial College London, trained at St Mary’s Hospital, and holds a Master’s in Medical Ethics and Law. Her clinical interests span women’s health, preventive medicine, and genomics, with a particular focus on using advanced biomarkers to build a more complete picture of long-term health.

    British Society for Genetic Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in BBC, The Guardian, Women’s Health, The Times and Tatler

    Book a GP Consultation

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Longevity & Healthspan Guides