Autoimmune Clinic
Conditions such as Sjogrens, Hailey Hailey and Ehlers-Danlos are notoriously difficult to treat with conventional medication. By looking at lifestyle factors such as sleep, nutrition, exercise and the possible addition of supplements and LDN, as well as keeping up to date with the global research on these conditions, I have seen an improvement in many patients who have been at ‘the end of their tether’ in trying to keep the symptoms of these conditions at bay.
The sense of community in patients with autoimmune conditions is quite extraordinary, and the sharing of knowledge and experience is paramount in our search for treatment therapies for this group of patients.
LDN
My work with autoimmune patients and LDN has enabled me to see symptoms not as single factors which need treated separately, but rather as a set of signs that gradually appear over a period of time because of an underlying problem with our immunity. If we can get to the root cause of these symptoms, addressing gut health, adrenal function, thyroid function, nutrition and lifestyle, we can often improve symptoms and subsequent wellbeing. LDN can help as an initial boost to increase the efficiency of our endogenous endorphins in order to bring vitality and health back into our lives.
Long Covid
My interest in this novel and ever-shifting range of symptoms has come from my work with post-viral Chronic Fatigue Syndrome patients and the prescribing of LDN. Many of the presenting symptoms of Long Covid are similar to the ones we see in this group of patients so it made sense to look at the work done in Europe and USA on LDN therapy in Long Covid. My patients are often 30-40 year old high achieving professionals who have suffered extreme fatigue, muscle weakness and brain fog since having Covid, therefore I look at nutrition, lifestyle and adrenal fatigue with them and work together to create a personalised plan to aid in rehabilitation and getting back to the energy levels they are used to.
Hypothyroidism
Many autoimmune patients have thyroid function which is below normal but unfortunately may not always show up in normal NHS blood tests. I believe that we should look at a full thyroid function blood test, measuring levels of TSH, T4, T3 and antibodies to enable us to look at thyroid hormone activation and deactivation at a cellular level. LDN has been shown to modulate the immune system and reduce abnormal production of antibodies, so in some patients, this approach, alongside nutritional changes, seems to help us get the thyroid functioning well again.
Meet the Team
-
Janine Milne
Founder & prescribing pharmacist -
Ersa Tsoutsoura
Prescribing pharmacist -
Sara Bhatti
Prescribing pharmacist
Janine Milne graduated from Strathclyde University with a BSc(Hons) Pharmacy degree in 1992 and has worked in hospital and community pharmacy in France, Australia, and the UK, culminating in managing her own pharmacies for two decades in the UK.
She gained her prescribing diploma in 2012 and has since specialised in CFS, ME, hypothyroidism, and other autoimmune conditions, which are typically difficult to treat in mainstream medicine.
Working within a multidisciplinary team and exploring various alternative treatments for Long Covid, with a special interest in LDN, Janine has developed a protocol that may support the treatment of this debilitating condition.
She adopts an integrative, holistic approach to wellbeing and health, aiming to address ‘dis-ease’ by combining conventional medicine with therapies such as nutrition, supplementation, homeopathy, mind therapies including meditation and mindfulness, as well as exercise therapy.
Prescribing is conducted on a case-by-case basis, which has led to the pursuit of a Masters Diploma in Integrative Medicine from NCIM, Bristol, UK.
Through her work supporting patients referred by the LDN Research Trust (ldnresearchtrust.org), Janine has engaged with many individuals with intractable autoimmune diseases. These patients often experienced treatment resistance and multiple unsuccessful referrals. By incorporating LDN into their regimes, alongside careful consideration of nutrition and monitoring of vitamin and thyroid hormone levels, improvements in symptoms have been observed in the majority of cases.
Ersa Tsoutsoura, MPharmS, is a highly experienced clinical pharmacist and independent prescriber, currently practising within secondary care in the NHS with a specialist focus on dermatology, immunotherapy, and biologics. With more than 15 years of experience across NHS services, private practice, and international pharmacy leadership, she manages a high volume of dermatology cases each week—developing safe, effective, and personalised treatment plans for patients with complex needs.
Through her private integrative medicine clinic, Ersa brings together evidence-based dermatology and holistic care. She provides expert support for a wide range of skin conditions, including adult female acne, acne vulgaris, hormonal acne, psoriasis, eczema, atopic dermatitis, vitiligo, disseminated superficial actinic porokeratosis, seborrhoeic dermatitis, rosacea, melasma, hyperpigmentation, perioral dermatitis, hidradenitis suppurativa, urticaria, lichen planus, male pattern alopecia, alopecia areata, fungal skin infections, and sensitive or reactive skin syndromes.
Her unique approach combines advanced prescription medicine, lifestyle optimisation, and cosmeceutical science to achieve lasting improvements in both skin health and overall wellbeing.
Please note: mole assessments and diagnosis of suspicious lesions cannot be carried out via virtual consultation. Any changes in moles or new lesions should always be reviewed in person by a dermatologist or GP.
Sara Bhatti is a pharmacist independent prescriber with a passion for improving patients’ quality of life through a holistic, personalised approach to care. Having worked extensively across hospital and community settings — including respiratory medicine, cardiology, surgery, and transplant care — Sara understands how challenging it can be to live with complex or long-term conditions.
Her specialist interest is in Low Dose Naltrexone (LDN) therapy, which can offer new hope to people with autoimmune conditions, chronic pain, and other persistent health issues. She works closely with patients to create tailored LDN treatment plans, taking into account not just symptoms but also lifestyle, nutrition, and overall wellbeing.
Sara’s goal is always to provide compassionate, evidence-informed care that empowers patients to take control of their health and feel supported every step of the way.
Consultations
Consultations take place via the telehealth portal as well as in various pharmacies throughout Scotland. To enable us to have a good patient-practitioner relationship, and for me to understand exactly where you are now in your life, and what has led you here, I require you to fill in an intake form that asks about your medical history and lifestyle. This enables us to peel back the layers of events and triggers (such as childhood viruses/medications/food intolerances) that may have caused the core imbalance in health and immunity.
We discuss a lot in our first consultation so it may be useful to note things down as we chat.
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How I can help
- Long Covid
- Hypothyroidism
- Autoimmune Clinic
- LDN
- Dermatology