Doctors, diagnosis and dilemmas

London is the diagnostic capital of Europe - with 4,458 GPs and thousands of practitioners offering alternative treatments, from homeopathy to crystal therapy in clinics, private homes and high street shops.

So, it's hardly surprising that advice from different practitioners giving conflicting diagnoses for a simple complaint can be confusing - possibly even wrong.

In a single day, we chose 10 practitioners at random and asked them to diagnose the cause of Becky Howard's chronic tiredness and suggest a remedy.

Before setting off she visited her GP, who diagnosed glandular fever and suggested she was run down and should get some early nights and eat properly.

Here, the 22-year-old actress reveals what the other diagnoses were - and how plausible she found them.

Craig McConnell, The Hale Clinic, 7 Park Crescent, W1; 020 7631 0156. Cost: £38 for 30 minutes.

This involves a lot of visual assessment and gentle prodding. Craig took a brief medical history and looked at body alignment, marking any differences in shoulder and hip height onto a pre-drawn body outline.

Next he made me lie face-down and held out my left arm. While moving down pressure points in my spine with the fingertips of one hand, he held my extended arm in his other hand and judged from the resistance, or lack of it, where I had weakness in my spine. He turned me over and repeated this exercise, this time using points on my face, chin and throat to assess the state of my neck.

Craig's diagnosis was that a car accident some years ago had left me with neck problems and that my spine was out of alignment. This was preventing energy from flowing freely up and down my spine, having a huge effect on my energy levels.

I need to correct the effects of the accident with weekly sessions of massage and manipulation to establish free-flowing energy.

I'm not sure how this diagnosis works, but I can see why neck and back problems would affect energy levels.

7/10

Marissa Peer, 25 Cloncurry Street, SW6; 020 7371 9367. Cost: £85 an hour.

Having asked me about my lifestyle, work and family, Marissa started the hypnosis - which, she explained, is more "distancing" than anything "trance-like". I've always been scared of being hypnotised, but felt completely in control and relaxed.

To begin, Marissa held up her hand and asked me to look at it without moving my head. Taking deep breaths, I closed my eyes on the exhalation and quickly opened them with each click of Marissa's fingers. This was repeated three times, and each time I sank deeper with Marissa encouraging me to "let go". Hypnosis revealed me to be a perfectionist with little self-esteem; desperate to fit in and in constant need of parental approval. The chronic tiredness, Marissa said, stems from not accepting-that I can't cope with everything. She recommended monthly hypnotherapy sessions and gave me a selection of tapes to take home. This will help to channel energy positively and help me accept that I can't please everybody all the time.

Having been quite against hypnotherapy, I'm converted.

8/10

Dr Jean-Yves Roy, GP, The Hale Clinic, as before. Cost: £50 per hour.

I was sure that "energetic medicine" had to be beneficial and arrived full of expectation. However, the " analysis" consisted merely of Dr Roy scanning me with his eyes. When I asked how he could tell what was wrong this way, he responded: "I don't know, I just can." He launched into a sales pitch for mesotherapy, acupuncture and a high-protein, lowcarbohydrate diet combined with meal replacement bars and shakes (sold by him). It left me baffled. If I have low energy, surely a low-carbohydrate diet is the last thing I should follow?

The protein diet and mesotherapy, which involves injections of caffeine, artichoke and "physiologique serum" - a plasma that is said to work by reducing isolated areas of fat - should be accompanied by acupuncture and a kind of quartz-stone therapy. Apart from the initial consultation, the meal-replacement foods would be £200 plus £120 for acupuncture and mesotherapy. Definitely not for me.

2/10

Medicentre, The Plaza, 120 Oxford Street, W1; 020 7637 7883. Helpline: 0870 600 0870. Cost: £49 for about 15 minutes.

Dr Johan du Plessis took a very detailed history, asking about my lifestyle as well as focusing on specific symptoms. His diagnosis was that I was doing too much, my stress levels were too high and my relaxation was zero. He told me my eating habits were too erratic and did a blood test for thyroid problems and glandular fever. The test results, which were negative, were available the next day. It was so quick that, in spite of the fee, I'd be tempted to go back. It would beat the two-week waiting-list to see my GP.

7/10

Doug Robertson, Body Mechanics, 4, The Arcade, St John's Wood, NW8; 020 7266 2368. Cost: £50 per hour. Doug assessed my posture, concluding it was not bad but, like most people, I would benefit from making my muscles work as they were designed to. The older we get, the more our muscles shift through doing the "wrong" things, twisting awkwardly, tottering on high heels etc. By making sure the skeleton, muscles and organs are all in their correct place, which Pilates aims to achieve, the body can work at its optimum level, using oxygen and energy supplies to best effect.

Doug diagnosed that my tiredness came from the fact that not enough oxygenated blood was pumping around my body and to the brain. He showed me various "cat stretches" which would help loosen muscles and get them in correct working order. He advised Pilates twice-weekly, but also recommended two hour-long cardiovascular exercise sessions a week to get the blood pumping. I felt Pilates would be a real investment in my health.

9/10

Diana Wright, Pure Medicine Group, 144 Harley Street, W1; 020 7935 0023. Cost: £75 for an hour.

After a thorough chat about my diet, I filled in an extensive questionnaire. Diana felt my eating habits were erratic and my goals should include a better understanding of food to maximise my energy supply. I need to take more B vitamins for energy and mental alertness, regulate my blood-sugar levels and replenish the store of good bacteria in the gut.

She recommended food supplements - amino acids, zinc and milk thistle - to help cleanse the system, and a two-week eating plan. She told me I needed to eat more carbohydrates at each meal, replacing protein with slowrelease carbos such as oats.

Diana's advice was sound, but changing my attitudes towards food would need long-term work.

7/10

Ana Maria Lavin Parot, The Kailash Centre, 7 Newcourt Street, NW8; 020 7722 3939. Cost: £60 first consultation (one hour), £45 for subsequent 45-minute visits.

Ana asked plenty of questions and, as is the Chinese medicine tradition, carried out a thorough examination of my tongue. She also checked my pulses to assess the state of my energy - or Qi - levels.

The pulse readings revealed that my energy levels are blocked, which Ana put down to a flu virus that I haven't shaken off and "excess heat in my body", demonstrated by a red, swollen tongue. This heat was emanating from my liver, large intestine and lungs, unbalancing my energy levels. Ana recommended Chinese herbs to reduce heat and twice-weekly acupuncture to unblock energy levels.

While I love the holistic philosophy behind Chinese medicine, I have never wanted to try acupuncture as I hate needles. I would be keen to try the Chinese herbs, but I'm not sure just how effective they'd be without acupuncture.

5/10

Karin Mittiga, The Kailash Centre as above. Cost: £50 for an hour.

Karin looked at my feet, assessing colour, texture and size. She then asked me about my lifestyle and medical history. Again, problems with my liver and intestine were mentioned but also tension in my back and neck. Interestingly, she suggested an emotional uncertainty resulting from a hormonal imbalance.

Her big concern, however, was my metabolism. It was sluggish. She believed this could be treated with regular reflexology and a Bach Flower Remedy, which she said could help my body use energy more efficiently. I'm a huge fan of reflexology, and Karin is very astute. Everything she said made a lot of sense and I like the idea of using the Bach remedies to help my body function more effectively.

9/10

Dr Mauroof M Athique, The Kailash Centre, as above. Cost: £35 for 30 minutes.

Another discussion about my general health and medical history and more pulsetaking with an electrical cuff.

Dr Athique diagnosed that my liver - associated with body heat and energy - is working too hard, apparently from too much protein in my diet. Also, I should avoid eating cold foods, such as salads, which require more body heat for digestion. It seems I have a poor digestive system which isn't absorbing enough nutrients from my food and have several mineral deficiencies - all of which account for my chronic tiredness. He recommended a six-week detox to calm my digestive system and ease the strain on my liver. I do eat loads of salad, so this diagnosis may be correct.

7/10

Dr Nick Avery, 14 Harley House, Brunswick House, NW1; 020 7935 7848. Cost: £125 for 40 minutes, follow-ups £78 for 20 minutes.

I never realised that homeopathy involved so much talking. This consultation was as I would imagine a visit to a psychiatrist might be.

Nick, also a qualified GP, was friendly and understanding, which prompted me to talk. There was no physical examination, apart from an ancient-looking machine which tested for allergies.

Nick felt that I had suppressed a lot of things, which had become the root cause of my tiredness. He suggested a homeopathic remedy which helps to release suppressed anger.

But perhaps most interestingly, the "allergy" machine, which showed whether my body accepted or rejected foods being tested, revealed that I should avoid wheat at all costs, because it can make the body very sluggish. I know many people who have cut wheat from their diet and felt a lot better for it.

For me, the homeopathy package was the most holistic as the combination of unburdening "therapy", physical assessment and remedies covers body and mind with understanding.

10/10