Eczema is a skin condition characterized by redness, dryness, itching, and irritation. Mainly it occurs on the arms, inner elbows, knees, back, and head area, but remember that it can affect any skin area. The eczema symptoms may flare up, subsides, and repeat at different intervals. Studies reported that eczema is 15-30% prevalent in children and 2-10% in adults. [1]

Moreover, eczema is highly prevalent in children compared to males. It is estimated that eczema affected approximately 9.6 million children under the age of 18 in the US. Plus, around 31.6 million people in the United States have eczema. Note that eczema occurs in all types of skin, colors, and ethnicities.

Both genetic (mutation in gene Filaggrin) and environmental factors (Irritants and Allergens) are involved in eczema development. Moreover, research studies categorized eczema into seven types based on the area of the skin and symptoms. These include atopic dermatitis (most common form), contact dermatitis, Neurodermatitis, Dyshidrotic eczema, Nummular Eczema, Seborrheic Dermatitis, and Static Dermatitis. [1]

Signs and symptoms of Eczema

Studies reported the following signs and symptoms of eczema that may vary from person to person. [1, 2] These include:

It is important to know that eczema increases the risk of various skin infections caused by bacterial, viral, and fungal pathogens. Also, it negatively impacts daily life activities via sleep disturbance, asthma, and hay fever. [1, 2]

Eczema Diagnosis 

There are no specific lab tests and diagnostic techniques for eczema confirmation. The diagnosis involves the evaluation of clinical symptoms such as rash appearance and history. Plus, in some cases, allergy testing and patch testing are also considered for eczema diagnosis. [1, 2]

Eczema Treatment

The treatment of eczema involves the intervention of different therapeutic agents to ease symptoms, prevent a flare-up and improve skin conditions. Both systemic and topical agents are indicated over months or years, depending on the severity of the eczema condition. 

Medical research studies reported three treatment approaches for eczema management. [2, 3]

Basic Treatment

Basic treatment involves the application of emollients for the management of skin dryness and pruritus. Emollients restore cutaneous hydration that reduces flaring up the eczema symptoms. Topical emollient decreases dependence on topical steroids. It is important to know that apply emollient on the skin within three minutes of bathing with lukewarm water. The patient can use 250 g of emollients per week as per national institute for health and clinical excellence [NICE] guidelines. The selection of moisturizers depends on the patient's symptoms, skin physiology, and season. [2, 3]

Moreover, always consider other protective measures before the application of emollient. These include a detailed history, allergy tests, and careful evaluation of clinical manifestations to rule out the aggravating factors. Plus, always prefer wool clothing over nylon dressings as wool quickly absorbs sweat and prevents skin scratching. Remember that certain perfume ingredients can also aggravate eczema symptoms. Basic treatment also involves the intervention of psychological support and proper counseling for effective management of eczema complications. [2, 3]

Standard Treatment

Standard treatment includes the intervention of both systemic and topical agents. It is important to know that topical agents are preferred over systemic agents.  

Topical agents: 

Topical agents include corticosteroids, anti-infective agents, and calcineurin inhibitors. Topical steroids for eczema management are prescribed based on the severity of symptoms, the extent of disease, and distribution skin lesion distribution of lesions. Short-acting corticosteroids are usually preferred over long-term use of corticosteroids due to multiple side effects. Remember that potent corticosteroids are recommended for highly lignified skin conditions. Corticosteroids such as fluticasone 1- 2 times a week are recommended for eczema symptoms. The potential side effects of topical steroids include the development of acne rosacea, striae, perioral dermatitis, skin atrophy, and adrenal suppression. [2, 3]

Topical calcineurin inhibitors such as Tacrolimus ointments 0.03% and Pimecrolimus cream 1% are used as a secondary drug of choice for eczema management. They act as immunomodulators that inhibit the production of cytokines from activated T-cells and inflammatory cells. It is important to mention that these drugs do not possess health risks for 2-4 years and benefit eczema patients having age ≥two years. [2, 4]

The interventions of anti-histaminic agents such as Chlorpheniramine, Hydroxyzine, and Cetirizine help the concomitant urticaria or concurrent allergic rhinitis associated with eczema. Plus, these agents also ease itching during the night and promote a good night's sleep. The side effects of oral histaminic include drowsiness, impair driving ability, and learning capability. Topical infective agents involve applying antibacterial, antiviral, or antifungal formulations that prevent both aggravations of symptoms and skin infections at the site of itching. The potential adverse event includes the growth of resistant pathogens, including methicillin-resistant S. Aureus, with irrational use of topical antibacterial agents. Medical research studies recommend using fusidic acid/mupirocin ointment for local infections and cephalosporin/ penicillinase-resistant penicillins for extensive superinfections without S. Aureus. In comparison, in the case of viral infections, use systemic antiviral therapy with great care. Moreover, it is advised to use antifungal agents for dermatophyte infections as it aggravates the eczema symptoms. [2, 3]

Systemic Therapy: 

Standard systemic therapy has opted when the eczema symptoms are recurring and do not respond to the topical agents. The overview of systemic therapeutic agents is given below.

Cyclosporine: It is an immunomodulator that inhibits cytokine transcription and helps manage severe, refractory atopic eczema. The common disadvantage of cyclosporine is the rapid relapse after abrupt cyclosporine discontinuation. Plus, it can cause kidney or liver impairment, tremors, headache, nausea, myalgias, hyperlipidemia, paresthesia, gingival hyperplasia, and high blood pressure. [2, 3]

Systemic Glucocorticoids (Steroids): It helps temporary suppression of eczema symptoms. They are temporarily prescribed for short-term use to control eczema flares. It is advised to gradually discontinue the systemic steroid use once the symptoms subside. Don't stop the steroids use abruptly to prevent the risk of eczema flare-up or rebound. Side effects of glucocorticoids are gastric ulcer, Cushing syndrome, diabetes, osteoporosis, hypertension, and glaucoma. [2, 3]

Antimetabolites: Antimetabolites include Mycophenolate mofetil, Methotrexate, and Azathioprine that help the management of refractory eczema. They are also recommended for resistant pathogens and improve eczema symptoms. It is advised to carefully monitor herpes retinitis, and dose-related bone marrow suppression with antimetabolites use. Side effects of antimetabolites include Liver dysfunction, headache, fatigue, gastrointestinal complaints, gastrointestinal disturbances, pulmonary toxicity, liver dysfunction, and leucopenia. [2, 3]

 Interferon-γ: Interferon-γ reduces IGE levels and decreases the expression of th2 cells that help manage severe eczema conditions. They are usually safe for twelve weeks, but they can cause certain side effects, including fever and headache in the initial stage of administration. [2, 3]

Phototherapy: It involves the intervention of natural sunlight as a secondary option in eczema symptoms management. Phototherapy helps both acute and chronic cases of eczema. It uses UVA-1 of 340-400 nm wavelength light for acute cases and UVB of 311 nm wavelength light for chronic cases. UVA radiation may target the epidermal Langerhans cells and eosinophils. In comparison, the UVB radiations act as immunosuppressants and support eczema management. It is advised to carefully consider the phototherapy intervention for skin pain, pigmentation, cutaneous malignancies, pruritus, and erythema. [2, 4]

Allergen immunotherapy: It is another approach toward eczema management that involves the intervention of subcutaneous and sublingual immunotherapies. However, there are not enough studies about its effectiveness. Also, patients show poor compliance with allergen immunotherapies. [2, 3]

Biologics: Studies also reported the beneficial effects of various biologics in the management of eczema symptoms. These include Rituximab, Omalizumab, Pitrakinra, Dupilumab, Infliximab, Mepolizumab, and Tocilizumab or Atlizumab. However, future studies are needed to conclude final remarks about their safety and efficacy in eczema treatment. [2, 3]

Adjunct Treatment

Adjunct treatment involves the use of natural remedies, including herbs and supplements, to ease eczema symptoms. These remedies include primrose oil, omega-3, Vit D, Probiotics, and Korean red Ginseng. Different studies reported significant positive effects of these remedies in eczema symptoms management compared to placebo. However, extensive studies are needed to define their roles and effectiveness in eczema treatment. [2]

Studies also reported the use of following natural remedies for eczema symptoms management. [5, 6] 

Long term Use of Steroids for Eczema Symptoms:

The long-term use of steroids, both topical and systemic formulation, possesses harmful effects. It is advised not to use steroids for a more extended period in the treatment of eczema symptoms. The long-term use of topical steroids increases the risk of skin discoloration, thin spidery blood vessels, bruising and may develop permanent stretch marks (striae). Plus, they can also aggravate the symptoms of other skin conditions, including acne, perioral dermatitis, and rosacea. Moreover, the use of systemic corticosteroids for the long term favors the development of morbidities, including local skin atrophy and other side effects. These side effects include Cushing syndrome, diabetes, high blood pressure, glaucoma, gastrointestinal symptoms, and osteoporosis. Thus, the corticosteroids use for a longer term is not safe in the management of eczema symptoms. [3, 7]

References:

  1. Nemeth V, Evans J. Eczema. [Updated 2020 Nov 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538209/
  2. Lee, J. H., Son, S. W., & Cho, S. H. (2016). A Comprehensive Review of the Treatment of Atopic Eczema. Allergy, asthma & immunology research, 8(3), 181–190. https://doi.org/10.4168/aair.2016.8.3.181
  3. Megna, M., Napolitano, M., Patruno, C., Villani, A., Balato, A., Monfrecola, G., Ayala, F., & Balato, N. (2017). Systemic Treatment of Adult Atopic Dermatitis: A Review. Dermatology and therapy, 7(1), 1–23. https://doi.org/10.1007/s13555-016-0170-1
  4. Ring, J., Alomar, A., Bieber, T., Deleuran, M., Fink-Wagner, A., Gelmetti, C., Gieler, U., Lipozencic, J., Luger, T., Oranje, A. P., Schäfer, T., Schwennesen, T., Seidenari, S., Simon, D., Ständer, S., Stingl, G., Szalai, S., Szepietowski, J. C., Taïeb, A., Werfel, T., … Global Allergy and Asthma European Network (GA2LEN) (2012). Guidelines for treatment of atopic eczema (atopic dermatitis) part I. Journal of the European Academy of Dermatology and Venereology : JEADV, 26(8), 1045–1060. https://doi.org/10.1111/j.1468-3083.2012.04635.x
  5. https://www.healthline.com/health/natural-remedies-to-reduce-eczema-symptoms
  6. https://www.medicalnewstoday.com/articles/324228
  7. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Eczema: Steroids and other topical medications. 2017 Feb 23. Available from: https://www.ncbi.nlm.nih.gov/books/NBK424899/

Hypothyroidism is a medical condition characterized by low thyroid hormones in the body affecting vital physiological functions. Thyroid hormones, including T3 and T4, are secreted by a small, butterfly-shaped Thyroid Gland located in the front of the neck. Different factors impair the function of the thyroid gland that results in underactive thyroid or insufficient production of the hormone to meet the daily body requirements. [1, 2]

Remember that a low thyroid hormone level or hypothyroidism negatively affects lung function, metabolism, neurological function, body mass index, heart rate, and gastrointestinal health. It is estimated that about 4.6 percent of the US population, or approximately 10 million Americans have hypothyroidism.

Hypothyroidism Symptoms

The hypothyroidism symptoms vary among individuals. However, it involves the following signs and symptoms. [1, 2, 3]

Hypothyroidism risk factors

Hypothyroidism can occur in any individual, but certain risk factors increase the chances of its development. These risk factors include:

Also, the presence of certain medical conditions increases the risk of hypothyroidism. These conditions include pernicious anemia, Sjogren's syndrome, lupus, diabetes, Turner syndrome, and rheumatoid arthritis. [1, 2, 3]

Causes of Hypothyroidism

Different factors significantly impact the function of the thyroid gland and lead to the development of hypothyroidism. [1, 2, 3] These include:

Hashimoto's Thyroiditis is the most common cause of hypothyroidism. It is an autoimmune disease where the body's immune system attacks the thyroid gland. That results in the development of thyroid inflammation and leads to an impaired thyroid hormone level. Hashimoto's disease is the most common thyroid disorder in America, affecting around 14 million people. It is seven times more prevalent in women than men. Individuals with Hashimoto's disease are also at high risk of other autoimmune diseases. [7]

Types of Hypothyroidism

Hypothyroidism is divided into three main types based on the etiology of low thyroid hormone in the body. These include:

Moreover, a rare type of hypothyroidism caused by an abnormal expression of the deiodinase three enzyme in tumor tissues is termed Peripheral or Consumptive hypothyroidism. The elevated concentration of the deiodinase three enzyme inactivates thyroid hormone. 

Subclinical Hypothyroidism

Subclinical hypothyroidism is an early hypothyroidism form characterized by an abnormal thyroid-stimulating hormone and a normal thyroxine level with minimal or no symptoms. It occurs in about 15% and 8% of women and men respectively over the age of 60 years. Remember that subclinical hypothyroidism shares the same causes, similar symptoms, and treatment options to other hypothyroidism types. [6]

It is important to mention that levothyroxine is indicated during pregnancy or in women who want to conceive. It helps prevention of harmful effects of hypothyroidism both on pregnant women and fetal development.

Medical Complications of Hypothyroidism

Untreated hypothyroidism increases the risk of following medical conditions or aggravates their symptoms. [3]

Hypothyroidism Diagnosis

Sometimes the diagnosis of hypothyroidism is difficult due to the number of symptoms confused with other medical conditions. Medical history, family history, physical examination (enlarged thyroid, dry skin, puffy eyes, etc.), medical symptoms, and different blood tests are performed to diagnose hypothyroidism. The blood tests such as thyroid-stimulating hormone tests and evaluating the level of thyroxin level are highly recommended for hypothyroidism diagnosis. Plus, the physician may order a blood test for Hashimoto's disease to confirm the presence of hypothyroidism. Note that high thyroid-stimulating hormone levels and low levels of thyroxine indicate an underactive thyroid or hypothyroidism. [2, 3]

Hypothyroidism Treatment

The hypothyroidism treatment involves the restoration of normal thyroid hormone levels in the body. Moreover, the treatment aims must include complete control over the hypothyroidism symptoms, normalization of thyroid-stimulating and thyroxine hormone level, avoidance of overtreatment, and prevention of medical complications associated with hypothyroidism. It is important to know that hormone replacement such as levothyroxine is the primary therapeutic approach for hypothyroidism management. [4, 8]

Hormone Replacement Therapy

In hormone replacement therapy, synthetic thyroid hormone levothyroxine is prescribed to restore normal thyroid hormone levels in the body. The administration of levothyroxine (T4) maintains an optimal level of thyroxine and thyroid-stimulating hormones that prevent or manage hypothyroidism symptoms. Moreover, it regulates the high cholesterol level, metabolic dysfunctions and also helps the management of weight gain. Primarily, hormone replacement therapy is indicated for a lifetime, but the dose may vary with the patient's condition. Sometimes, Liothyronine (T3) combined with Levothyroxine (T4) is given to the patients when they do not feel better with single hormone therapy. At the beginning of therapy, a levothyroxine dose of 50-75 µg/day is indicated to treat mild to moderate hypothyroidism. However, the initial dose of levothyroxine depends on the patient's weight, age, pregnancy status in women, lean body mass, hypothyroidism type, TSH level, and other medical comorbidities. [4, 8]  

Note that all hypothyroid patients respond well to hormone replacement therapy. However, in severe myxedema (life-threatening hypothyroidism), the treatment approaches involve the parenteral administration of levothyroxine (T4), antibiotics, steroids, and optimal oxygen supply. [4, 8]

It is important to know that always consult and take great care about the dosage of synthetic thyroxine as a low dose can't benefit the hypothyroidism symptoms. In comparison, the high doses will result in the development of hyperthyroidism. Thus, it is advised to regularly check the thyroid-stimulating hormone and levothyroxine level for the first 6-8 weeks during hormone replacement therapy; after getting stable, check the levels at an interval of 6 months or can be extended up to 12 months. [4, 8]

The clinical benefits of hormone replacement therapy appear within 3-5 days, but the complete restoration takes 4-6 weeks. Moreover, the normal TSH reference level regulation may take several months due to the modulation of the hypothalamic-pituitary axis. Plus, it is recommended not to switches between different brands or generic formulations of levothyroxine to avoid dose fluctuation. [4, 8]

Different thyroids hormone formulations are available in the market for the management of hypothyroidism. The most popular formulation include Armour Thyroid, Nature Thyroid Tablet, NP Thyroid, Synthroid, and Cytomel. These medications are natural thyroids hormone formulation obtained from animal thyroid glands (usually a pig's) intended for hypothyroidism treatment. Side effects involve temporary hair loss due to the drug-body adjustment. Note that regularly confirm the normal thyroid level to avoid the hyperthyroidism symptoms. [4, 8]

The American thyroid association recommended the evaluation of certain situations or conditions that may alter the thyroxine level. Such as examine the patients for gastrointestinal disorders who need a higher dose of levothyroxine. Plus, always talk with a qualified physician about the initiation or discontinuation of other hormone replacement therapies such as androgen and estrogen hormone during TSH level assessment or levothyroxine therapy. Moreover, other medications such as tyrosine kinase inhibitors, phenobarbital, sertraline, phenytoin, carbamazepine, and rifampin may also alter the Thyroxine level. Also, the concomitant use of proton pump inhibitors, sucralfate, and supplements such as calcium, magnesium, etc., interfere with the levothyroxine absorption. Furthermore, consume the levothyroxine before 35-45 min before breakfast or at least 3 hours post-meal at bedtime for optimal absorption.   

Remember that if the hypothyroidism symptoms do not ease with hormone replacement therapy, one must consider and check for other medical causes instead of increasing the levothyroxine dosage. [4, 8]

Surgery

Hypothyroidism is rarely treated with surgical procedures. Surgery has opted in case of large goiters that negatively impact the function of trachea-esophageal tracts. [4, 8]

Treatment Concerns:

Medical studies reported that thyroid replacement therapy exacerbates the co-existing adrenal insufficiency condition. So, remember that treat or evaluate the adrenal insufficiently condition before initiation of thyroid replacement treatment. Moreover, it is important to know that adrenal insufficiency can also occur with subclinical hypothyroidism. Plus, always treat or confirm the adrenal insufficiency during severe hypothyroidism (such as during myxedema coma) for rational treatment options. Furthermore, in heart conditions such as coronary artery disease, ischemic heart disease, etc., medical studies suggested that always start with the lower dose of hormones. Then gradually increase the dosage over time for adjustment with heart conditions. At normal doses, levothyroxine does not cause any severe side effects. But overconsumption of overdosage of levothyroxine hormone increases the risk of poor muscle coordination, fatigue, disturbed sleep pattern, nervousness, excitability, tremors, feeling hotter than normal, osteoporosis, breathing difficulty, muscle weakness, atrial fibrillation, arrhythmias, heart palpitation, and increased appetite. [4, 5]

Natural remedies for hypothyroidism

Different natural interventions are also used to help the hypothyroidism symptoms. These include diet changes and administration of Supplements. Studies reported that selenium levels decrease during Hashimoto's disease and impair thyroxine levels. Selenium Supplementation helps regulate normal T4 levels and improve hypothyroidism symptoms. Moreover, a sugar-free diet also helps prevent aggravation of hypothyroidism symptoms. Studies showed that sugar consumption increases the risk of inflammation that impairs the conversion of T4 to T3 and thus may aggravate or favor the progression of hypothyroidism.

Further, the supplementation of Vitamin B12 improves certain hypothyroidism symptoms, including tiredness and healthy metabolism. Also, the consumption of probiotics restores healthy gut microbiota and improves gastrointestinal symptoms associated with hypothyroidism. Additionally, the supplementation of Zinc, Iron, Iodine, Vit D3 and Tyrosine combined with Iodine help regulate both the stimulating tissue hormone and thyroxine levels. [9] 

References:

  1. Chaker, L., Bianco, A. C., Jonklaas, J., & Peeters, R. P. (2017). Hypothyroidism. Lancet (London, England), 390(10101), 1550–1562. https://doi.org/10.1016/S0140-6736(17)30703-1
  2. Chiovato, L., Magri, F., & Carlé, A. (2019). Hypothyroidism in Context: Where We've Been and Where We're Going. Advances in therapy, 36(Suppl 2), 47–58. https://doi.org/10.1007/s12325-019-01080-8
  3. Patil N, Rehman A, Jialal I. Hypothyroidism. [Updated 2021 Jan 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519536/
  4. Jonklaas, J., Bianco, A. C., Bauer, A. J., Burman, K. D., Cappola, A. R., Celi, F. S., Cooper, D. S., Kim, B. W., Peeters, R. P., Rosenthal, M. S., Sawka, A. M., & American Thyroid Association Task Force on Thyroid Hormone Replacement (2014). Guidelines for the treatment of hypothyroidism: prepared by the american thyroid association task force on thyroid hormone replacement. Thyroid : official journal of the American Thyroid Association, 24(12), 1670–1751. https://doi.org/10.1089/thy.2014.0028
  5. Qari F. (2014). Hypothyroidism in clinical practice. Journal of family medicine and primary care, 3(2), 98–101. https://doi.org/10.4103/2249-4863.137609
  6. Gosi SKY, Garla VV. Subclinical Hypothyroidism. [Updated 2021 Jan 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK536970/
  7. Mincer DL, Jialal I. Hashimoto Thyroiditis. [Updated 2020 Aug 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459262/
  8. McAninch, E. A., & Bianco, A. C. (2016). The History and Future of Treatment of Hypothyroidism. Annals of internal medicine, 164(1), 50–56. https://doi.org/10.7326/M15-1799
  9. https://www.everydayhealth.com/hs/healthy-living-with-hypothyroidism/vitamins/

Mama Bess is exhausted napping in the heat while her baby is bouncing around with tons of energy… I laughed as I watched Baby Jiwa, full of energy, busy toddling around the yard with his blankie. Building a tent, eating bugs, chewing on pipes, and playing peek-a-boo with me. I love how his Mom tenderly reaches out in her sleep.

While it is definitely normal for women to feel too hot, fatigued, tired or depressed on occasion, it's not normal if it is happening all the time. When my female patients are constantly feeling exhausted, we need to check their hormones, vitamins, iron levels and basic blood chemistry. Being constantly tired or overheated can be related to hormone imbalance, anemia, and vitamin deficiency, such as low B-12.

Hormone imbalance, like low estrogen and/or progesterone can cause hot flashes and heat intolerance. Thyroid conditions can also disrupt temperature, causing women to feel constantly too hot or too cold. Constant insomnia, anxiety, or depression can also cause chronic fatigue.

As a women’s health doctor I have never seen the Mom's I care for more unhealthy. Many are overweight, and have been depressed, frustrated, stressed out and anxious this past year. Mom’s are drinking too much, eating too much, not sleeping and lacking adequate support. Mom’s have had to take major stress hits amidst lockdowns. Cancelled sports, and other activities, lack of help from older immunosuppressed relatives, and even online school. I know some Mom’s that have been forced to put their careers on hold for their children’s well-being, all of this can take its toll, mentally, physically, and emotionally.

The best part of back to school week is that some Mom’s can breathe a sigh of relief, and have some extra time to focus on their own physical and mental health. Now that our kids are back to school it is a very important time for every exhausted Mom to get their check up. It's important for each and every mom to put their health first and get labs scheduled to make sure they are healthy and have optimal hormones.

Dr. Nicole Sundene
(480) 837-0900
Visit me @thepromenadescottsdale

By Dr. Nicole Sundene, NMD

Naturopathic Female Hormone Expert

Chronic fatigue from imbalanced female hormones and adrenal stress hormones commonly can affect a woman's productivity and energy levels. My “Invincible Mommy Tea” herbal recipe is designed to decrease stress, boost immunity, balance hormones, optimize weight and perfect skin.

ASHWAGANDHA: Is the most important herb for frazzled burnt out Mom’s and broken souls. Neverending “Lifeguard Mode” watching kids can fry even the calmest Mom’s adrenal glands and cause trouble sleeping, imbalanced female hormones, constant anxiety, panic attacks and eventually just a blah depressed and drained state that is not improved by antidepressants. It can be used as a daily tonic or just for situational support. It’s mild enough for children and women that are pregnant or breastfeeding. Most Mom’s don’t have the time to pop a valium and take a nap. Research shows it actually heals nerve pain. So whether you have neuropathy like me and drink it often, or whether your “nerves are fried” after a tough day of parenting. I believe this gentle root is just what an agitated and exhausted soul needs right now! ❤️✅

ASTRAGALUS- The “Shield Herb” for daily immune protection. If you feel physically weak, depleted, drained and exhausted Astragalus will slowly build you back up. In Chinese Medicine they say it “keeps the thieves out”. So when you drink your daily astragalus tea you are “locking your doors” to the latest virus circulating.

LICORICE- In a small low dose works to rejuvenate a weak burnt out soul with low cortisol levels. It contains antiviral properties and immune enhancing properties and helps boost energy so that less caffeine consumption is needed and tastes sweet so we are happy with our tea and do not binge on sugar.

CINNAMON- Recovering from postpartum weight gain for many mom’s means getting insulin levels to return to normal. For many Mom’s this never happens. Insulin when elevated such as in PCOS is a leading culprit behind many health problems mom’s struggle from: Weight Gain, High Blood Pressure, Inflammation, Pain, Neuropathy, Diarrhea and Headaches.

RASPBERRIES- Are delicious and make the tea a treat but more importantly they are rich in flavonoids that balance women’s hormones and blood sugar. They protect and perfect the skin so Mommy looks fabulous at all times.

💜 Dr. Nicole Sundene

Female Hormone Specialist

Dr. Sundene is a Naturopathic Medical Doctor and considered a top leading expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for PMS, Postpartum, Perimenopause, Menopause, Thyroid, Hashimotos, Autoimmune and Adrenal Conditions with over 22 years of experience in both prescription and natural women's health and hormones. She has been an Herbalist for over 27 years and enjoys providing integrated health solutions for women to balance their hormones and optimize their health with herbs and bioidentical hormones. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan.

When you knock on the trunk of an Ironwood tree it will be VERY SOLID hence the name “Iron wood.” Ironwood contains anti-inflammatory compounds guaiaretic acid and guaiaconic acid. Which is why it was used historically by herbalists to treat gout, inflammation and arthritis.

Energetically Ironwood is known for promoting positive energy and strength which many of us need in these tough times.

Go knock on the trunk of an Ironwood whenever you need to remind yourself how tough you are!

You are always MUCH stronger than you think!

Join me for a FREE presentation on “Hormones, Inflammation & Metabolism” to learn more about how I treat my patients with Naturopathic Medicine!

Dr. Nicole Sundene

Naturopathic Doctor

(480) 837-0800

25 years ago I was constantly struggling with acne and eczema. No matter what I tried, these frustrating problems would never fully go away. It was not until I learned about Naturopathic Medicine for acne and eczema while enrolled at Bastyr University that I finally was empowered to discover the diet and lifestyle that works best for my skin type.

I still remember the day my professor explained the link between nutrition, the microbiome and the skin and everything I was battling made perfect sense! The light bulb went off and I followed the instructions my professor mapped out and received amazing RESULTS! My skin was also less sensitive to allergens and chemicals.

As my skin improved I was finally able to quit using all the different creams and antibiotics the Dermatologist was prescribing for my acne, hives, eczema, and allergies. I was truly shocked and amazed I could finally manage my annoying symptoms. I no longer needed to take antibiotics or use steroid creams.

Nothing brings me greater joy today as a Naturopathic Doctor but to see my patients heal their skin by treating the ROOT CAUSE.

If you are tired of relying on expensive Dermatology creams and prescription medicines... and open to making some diet and lifestyle changes, you are the perfect type of patient for me to help!

Please consider giving Naturopathic Medicine a try! It is works very well for patients that are SERIOUS about addressing the ROOT CAUSE of their acne, eczema, psoriasis, rosacea, hives and itchy skin.

If you truly want lasting solutions then Naturopathic Medicine is the only answer!

I would be happy to help you feel good in your skin again! Visit my appointment scheduling page and lets get started working towards perfect skin before you end up with permanent scarring like I have!

Dr. Nicole Sundene

Ocotillo is one of the STRANGEST plants in the desert. Just when we think it is completely dead and beyond hope it suddenly SPRINGS back to life and makes these GORGEOUS bright orange flowers! Native Americans traditionally used Ocotillo tea from the bark and flowers to treat coughs, bladder infections, pelvic congestion, varicose veins, swelling and sore muscles. The long spiny branches were also used to make fences.

The flowers can be eaten raw in salads and taste somewhat like chamomile when made into tea. The long tube-like flowers are a favorite of hummingbirds which is what helps them proliferate in the desert.

Ocotillo flower essence is indicated for “The Wounded Healer” as it is an energetic protector that is thought to help us respond and not react. It is energetically healing for those that feel victimized. As with any herbal remedy please check with your Naturopathic Doctor before using any new herbs!

❤️ Dr. Nicole

www.ScottsdaleNaturopathic.com

(480) 837-0900

Mystery solved! I found 2017 research that confirms Ginger actually helps to speed metabolism! This explains why my patients notice their metabolism increasing with this Gingerberry Blaster I prescribe for their inflammation.

This “Daily Ritual” herbal medicine recipe is a simple, delicious and powerful combination of my two favorite anti-inflammatory herbs, ginger, and berries. The flavonoids in berries are powerful antioxidants that help protect our cells from damage from inflammation.

The best part of using berries to reduce inflammation is that they are DELICIOUS MEDICINE. I have my patients with chronic pain drink my Gingerberry Blaster Recipe 2-3 times daily.

When using Herbal Medicine to treat chronic inflammation we must be committed to the long term big picture. The reason for this is that all the cells in the body need to be turned over to newer less inflamed cells and that can take time. Some of our cells such as skin cells turn over rapidly in a few days while other organs and tissues require months.

I bring this up because I often see my patients struggling and want to give up after a few days when they don’t receive instant results when they are used to popping a percocet or vicodin. I want to emphasize this IMPORTANT herbal medicine point today, that Herbal Medicine will not work at all when the patient cannot regularly stay dedicated to using it. When working to combat inflammation it is important that we are diligent with using herbs regularly.

Click the link below to watch my FREE presentation on how I use Naturopathic Medicine for inflammation with my patients. We will review 3 Naturopathic case studies on

1) Autoimmune 2) Migraines 3) Rheumatoid Arthritis

https://www.pge-2.com/free-webinar-reg

Dr. Nicole Sundene, NMD

Naturopathic Medical Doctor

www.ScottsdaleNaturopathic.com

(480) 837-0900

My baby has a sore throat today, so she asked me to whip her up some “throat tea.” Cloves are the first thing I know I have in the cupboard that come to mind as they are a natural analgesic and numbing agent for pain, the proanthocyanidins in blackberries are also powerful anti-inflammatories and immune supporting.

So I am dumping a whole bag of frozen blackberries in as potent medicine. Licorice is soothing to the throat, antiviral and gives a sweet flavor acting as an important “Synergist Herb” or the harmonizer which is the herb that binds all the other herbs together. Honey is antiviral and antibacterial (Do not give honeyto babies.) Cinnamon is antiviral and Star Anise is a powerful antioxidant and anti-inflammatory.

Basically the purpose of these oils in nature for ALL of these aromatic spices is to repel bugs and microbes naturally for the plant which is why they also work for us! I drink this straight but recommend giving about 1 Tbl to a child over 2 every 2 hours diluted in warm water. Work with your own #NaturopathicDoctor or #Herbalist

Testimonial: “This tea is totally nasty, Mom. But my throat feels so much better!” 😂😂😂

So there you have it! Natural Medicine works!

Dr. Nicole Sundene

By adding herbal teas to your daily routine you can reduce the amount of capsules and pills you need to take. Many herbs taste delicious and are enjoyable to drink and the added benefit is they are hydrating for those of us in the Arizona heat that need to be taking in more water. I love ginger, mint and licorice which all contain powerful antioxidants. Enjoy your herbal medicine tea iced for a refreshing change. Simply make your tea as normal, refrigerate and serve over ice.

clinicsneuropathic
Location: 16447 N Scottsdale Rd #D-105
Scottsdale, AZ 85254
Ph: 480-837-0900
Fax: 480-409-2644
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