THANK YOU neighbors for voting me “Best Medical Professional of 2023” on Nextdoor!
This was an awesome email to receive!. Helping women feel AMAZING by solving complex hormone, gynecology, and bladder issues has always been my passion. Those that know me well, know that I also always enjoy a good challenge. I appreciate your votes as a favorite and the referrals I receive from my MD and Naturopathic colleagues on complex women’s health and hormone matters.
One of my greatest joys in life is getting to watch women transform into their BEST version of themselves by testing and perfecting their hormones, nutrition, micronutrients, and macronutrients. This can be very rewarding work.
Reading natural medicine research studies and providing women with the latest Women’s Health news on my blog is also one of my favorite free time activities. Reading research studies, blogging, and drinking herbal tea are my favorite things to do.
So, I am happy to hear my educational posts have helped many women that I have never even met! Many women in our Phoenix/Scottsdale neighborhood also do not have the opportunity to see a women’s health doctor, and I love receiving messages about how my natural remedies have benefited them and changed their lives.
Thank you for making me a favorite and to everyone that shares my natural Women’s Health tips from my blog on their own social media. I love seeing my male friends sharing women’s health tips and also supporting women! Women should not have to be embarrassed or suffer in silence with hormone imbalance, chronic bladder, and gynecological matters.
Times of hormone imbalance in a woman’s life such as Hormonal Weight Gain, Perimenopause, Menopause, Hormonal Acne, PCOS, and PMS can be very challenging without the right education and labs. Visit my blog for important information I think every woman should know as a Women’s Health Doc:
www.ScottsdaleNaturopathic.com/blog
All of my most important tips for women to know are 100% free to read and share with your girlfriends.
If you need my help solving your women’s health issue simply visit my SCHEDULE page to treat yourself to a Naturopathic Women’s Health Visit!
Dr. Nicole Sundene, NMD
Scottsdale Naturopathic Hormones
(480) 837-0900
Dr. Nicole Sundene
Hormones actually picked me many years ago! Did you know I was serendipitously selected by life to become a Holistic Hormone Doctor 23 years ago? Be it God, kismet, fate or dumb Luck, my old neighbor in Issaquah, Washington chased me down one rainy morning when she saw I worked at our neighborhood medical clinic and offered me a job working for her Hormone Doctor. She said there was an immediate opening, better pay and it sounded much less stressful than the busy Family Medicine and Dermatology clinic I worked at for 20 Docs rooming 100 + patients per day. Of course I took the job!
Little did I know this would be the #1 experience that would shape my future career as a Women’s Health Doctor and I was put in very special training with a genius Female Hormone Specialist that was a Pharmacologist and Internist. Working for the Hormone Doctor every day was a wonderland of fun for me! I left the office giddy with joy every day! The biochemistry nerd in me really enjoyed the hormone and hormone lab lessons on her specialties of Menopause, Perimenopause, Osteoporosis and Chronic Pain. She also taught me everything I know about autoimmune testing and hormones.
The Female Hormone Specialist also taught me a lot about chronic pain testing for women with Fibromyalgia. It is difficult to find a doctor to take you seriously when you are in severe pain, or struggling with bizarre autoimmune disease symptoms… but she did this with tremendous compassion, kindness and brilliant detective work. Fibro patients need a multitude of proper tests conducted to determine the cause of the pain which requires multiple specialists working together or someone with enough knowledge in Rheumatology, Endocrinology, Neurology, Nutrition and Infectious Disease such as Dr. Panitch.
Thankfully Dr. Panitch taught me a great deal about Menopause, Perimenopause and Osteoporosis, at the same time I also worked for 3 Dermatologists. While I loved helping them with their skin surgeries we would often see patients with chronic skin problems such as acne, psoriasis, eczema, dermatitis and MRSA struggle to get better. When I asked the Hormone Doctor about these patients she explained how a lot of chronic disease skin issues are actually hormone problems in disguise. Which makes a lot of sense when we see women get dry skin with menopause or thyroid disease, and oily skin with PCOS, Perimenopause and PMS. “Until we treat the cause of the Hormone Imbalance topical agents will continue to fail” is the take home message from my acne rant that prefaces the latest Natural Medicine research for Acne on my latest blog about “Hormonal Acne."
The #1 clue a symptom is related to hormone imbalance is fluctuation. Women who have fluctuating symptoms throughout the month or that begin with menopause, pregnancy or postpartum should be aware of how hormones can adversely impact their skin. There is way more to acne than just testosterone. Estrogen and progesterone are often to blame as well as many other hormones.
To properly balance hormones we need to use natural medicine to treat the root cause of the hormone imbalance. While we sometimes need bioidentical hormones or thyroid hormones, oftentimes from a Functional Medicine standpoint the cause of the hormone imbalance is something we address with herbs. Patients that like to drink tea, take herbal capsules, tinctures or supplements and improve their nutrition are perfect candidates for Naturopathy.
Patients that do not like those above things should stick with their MD's as it is difficult for me to help them as a Naturopath when they can't take herbs or make nutritional changes specific to what their body needs. Women are very unique as I discuss further in my Snowflake blog.
Today I wanted to share a picture of my favorite room, the "Herb Room" and remind you to drink more iced herbal tea to stay hydrated in the heat.
Teas are perfect for those of us in the Arizona heat that need to be taking in more water. I love to use ginger, mint and licorice which all contain powerful antioxidants and can help mask the flavor of herbs used for medicine. Patients can enjoy their herbal medicine tea iced for a refreshing change. Simply make your tea as normal, refrigerate and serve over ice!
If you need my help testing and balancing your hormones, or have not been feeling good and want to get to the "Root Cause," simply pop over to my SCHEDULE page to treat yourself to a Naturopathic visit!
Dr. Nicole Sundene, NMD
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Specialist in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
Dr. Nicole Sundene, NMD
Holistic Psychiatry & Women's Health
“What is the best natural treatment for depression?” Samantha Scottsdale, AZ
I am very passionate about helping people with depression as a Naturopathic Doctor.
Throughout my lifelong battle with severe depression, natural medicines and alternative therapies are really the only things to help me make significant progress as I share in my story "Why I Became a Naturopathic Doctor." Be sure to also read my blog "Seasonal Depression: Natural Remedies" as I discuss the importance of "Vitamin L" or Light Therapy for mood and lifestyle factors that should always be in place for depressed women.
I personally use a lot of curcumin every day to help my depression. Today we will discuss my other nine favorite natural treatments for depression. Check out my blog all about why I love curcumin and the 17 research studies for pain and depression: "#1 Pain Doctor's Remedy." The reason I love to use curcumin for my mood is it also helps my pain as a Lupus patient. The anti-viral, immune-boosting, anti-cancer and anti-aging properties are my favorite "side effects" of my favorite natural antidepressant.
As a Naturopathic Doctor, I have been blessed to know how to treat depression using natural means, and also rely heavily on my own life experiences when working with refractory cases of depression.
I am frank about my depression because I see it as a disease just like any other disease, and I don’t see any reason to be ashamed of it.
Nor do I want women to be ashamed of it, especially when it is often imbalanced female hormones to blame. I simply hope I can shed some light on depression for silent sufferers, and inspire them to get help, especially if they don’t respond well to traditional antidepressants. Some patients, such as myself feel no improvement with using an antidepressant because the problem is not low neurotransmitters.
For me, the problem was hormone imbalance related to my Adrenals, Thyroid, and Female Hormones. If you take thyroid medicine and are depressed, be sure to read my blog on "Thyroid Depression."
Antidepressants will not help in these cases. I was not receiving any benefits from the dozens of meds I have tried, instead, I just got side effects of weight gain, headaches, and stomachache. After gaining weight on antidepressants I was even more frustrated and hopeless feeling as I shared in my story about “Why I Became a Naturopathic Doctor.”
Alternative medicines, herbal medicines, nutritional therapies, diet, and lifestyle are wonderful complementary approaches to addressing depression over the long haul.
Women with depression may have a hormonal cause if they are experiencing monthly swings in their depression during their PMS window or days 21-25 of their menstrual cycle. Women can keep a period tracker app to watch for this pattern as PMDD-Premenstrual Dysphoric Disorder is a severe depression that occurs monthly for women in their reproductive years. When women suddenly become depressed in their 40's and 50's this also can be from dramatic hormone swings that occur with perimenopause and menopause. Hormones should always be of suspicion when women have depression or anxiety especially when it occurs without situational triggers. If you are struggling with a divorce or death of a loved one that is much different than just random depression that occurs out of nowhere. Depression without triggers indicates a physical imbalance such as with hormones, vitamins, minerals, nutrition, or neurotransmitters.
Specialty testing such as Neurotransmitter Testing and Food Sensitivity Testing can also be game-changers in helping pinpoint the specific treatment the patient needs. With Neurotransmitter testing, I was able to discover that I am low in serotonin and GABA. My body does not make these important chemicals that make people feel happy and calm. Knowing this I was able to target the right amino acids, vitamins and herbs to boost the low levels and finally my mood improved! For instance, 5-HTP helps boost low serotonin production and Passionflower helps to support my low GABA levels that cause insomnia as I discussed in my "Herbal Remedies for Anxiety" blog.
Please do keep in mind when I am discussing depression am doing so generally and you will need to work with your Naturopathic Doctor or BOOK WITH ME to receive optimal natural care. You should ALWAYS work with a professional when treating your depression because the consequences of sub-optimally treated depression can be life-threatening.
Please do not choose to discontinue your natural medicines without the advice of your physician, psychiatrist, or Naturopathic Doctor overseeing your care. Depression is complicated to sort out. Please do not try to do it alone. Someone needs to be documenting your mood fluctuations as well as when you start and stop specific therapies.
Before we get started let’s just be perfectly frank about what natural medicines and herbs will and will not do. Herbs work well for mild, moderate, and situational depression, however they will not likely be solely effective for SEVERE depression. Herbs are a great alternative for people that do not like the side effects of their antidepressant, or that feel they no longer need to be on a treatment as strong as a prescription antidepressant. Herbs are helpful for transitioning all the way off medications and can be used for a period of time after an antidepressant is discontinued to help stabilize the mood. Natural remedies may be helpful for women suffering from pre-menstrual, menopausal, or post-partum depression, however if you are pregnant or breast feeding you should never take any natural remedies aside from vitamins (at standard prenatal doses) unless advised by your physician.
Unless you are actually deficient in a vitamin, mineral, or amino acid that is causing your depression, natural treatments will not likely “cure” your depression, as they have similar mechanisms as medications, and most medications typically only work while you are taking them. Be sure, however, that you are not iron deficient if you are depressed, as a public health study saw a correlation between iron deficiency anemia and depression in young women. Herbs and natural medicines are more gentle than drugs and will thus take longer to work in your system. You therefore have to be PATIENT when working with naturopathic medicines. Most therapies will take at least two weeks to notice an effect. Natural medicines also require the same diligence as daily drugs and should be taken at the same time of day religiously for optimal effect.
Addressing the root cause of your depression with therapy is fundamental to any treatment plan, whether prescription or alternative. If counseling “did not work," please find a new counselor with a different approach or technique. There are so many helpful techniques out there, don’t give up on therapy, give up on the therapist if after three months you do not notice notable improvement. Ask your insurance if they cover an EMDR therapist. I see EMDR helping provide mental health patients the tools they need to cope rather than just talking about the problem.
1. St. John’s wort- Pictured above, the bright yellow flowers of the St. John’s wort plant are full of an oily red substance called hypericin. If you have St. John’s Wort growing nearby you can see the little red spots in the plant (hence the perforations in the name Hypericum perfoliatum), now roll the flowers between your fingers to release the red oils and see the medicine first hand! The red oily hypericin is the active constituent of Hypericum perfoliatum. This herb has been highly studied in many double blind research trials and shown to have significant effects similar to prescription anti-depressants. St. John’s Wort has also been shown to have a lower risk of side effects than conventional antidepressants.
THIS HERB SHOULD NOT BE COMBINED WITH OTHER MEDICATIONS! The reason for this, is that it activates the liver’s cytochrome p450 detoxification pathway and will metabolize drugs at a faster rate, thus moving them out of your system before they likely can have their therapeutic effect. This is why we don’t combine St. John’s wort and birth control pills. I find it interesting that St. John’s Wort works so well for depression and is also such a great detoxifying agent. According to Chinese Medicine most depressed people have “sluggish livers” and thus the liver/bowel meridians are typically treated. St. John’s wort should NOT be used with prescription antidepressants as it has a weak MAOI and SSRI effect similar to the standard activity of anti-depressants and thus may cause adverse effects. Standard dose of St. John’s Wort for those not on any other medications, is 300 mg THREE times daily of the 0.3% standardized extract is what was used in a research study demonstrating efficacy.
2. Schisandra- “Chinese Prozac” is the perfect herb for depressed people that are stressed out and need to lose weight as Schisandra aids fat burning. The berries of Schisandra chinensis improve mood, break up anxiety, support the adrenal glands through their “adrenal adaptogen” properties, enhance libido, and aid the liver’s detoxification.
I would say if you are a stressed out stay at home mom with a low libido and feeling frazzled as an exhausted Mom, then this herb is most likely created just for you! Standard capsule dose is two 500mg capsules taken twice daily. Take in the morning and at lunch. Because of the adaptogen properties, do not take this herb in the evening as we want it to support the adrenal glands when they are the most active. Adrenal gland support is imperative for people “running on empty” and under chronic stress, as the adrenal glands create the “fight or flight” response in the form of cortisol and catecholamines that eventually become burnt out and dysfunctional from chronic stress.
3. Passionflower- I have yet to meet a depressed person that does not have some degree of anxiety, so I am including this gentle nervine relaxant herb on my list so that if you are depressed because you are anxious, you can use Passiflora incarnata to help calm down a bit. From my observations anxiety typically feeds depression forward.
Watch your depression patterns, and if you tend to get REALLY stressed out, and then just crash and burn in to a depressive state, an herb like passionflower might help you more than an anti-depressant herb, or both can also simply be used. Implementing stress management tools like breathing, meditation and yoga is also important for mood. A research study found Passionflower extract at 45 drops daily (tincture) was shown to be as effective as oxazepam (similar to valium).
4. B-vitamins- Now I never prescribe B-vitamins alone without prescribing the WHOLE family. If you have attended dozens of mental health continuing ed lectures after a while you realize that it is all about B vitamins for mental health. There is also no point in prescribing them alone as they rely on each other to work. The family works synergistically together on the Kreb’s cycle to produce energy in the form of ATP as well as serves as very important coenzymes for a ton of other important biochemical pathways. B-12, methylcobalmin (cyanocobalmin is synthetic garbage), for instance is needed for the production of the myelin conductive sheath that insulates the neurons of our nervous system, adequate B-12 is thus critical to a healthy nervous system. B-6, pyridoxine, is imperative for women suffering from PMS, and folic acid has research supporting it’s ability to improve the efficacy of fluoxetine (prozac) in a clinical trial. Folic acid comes from “foliage” so be sure to eat your green leafies too! All depressed people need green vegetables. Be sure you are taking 800mcg of folic acid in the natural form methylfolate in your supplement.
B-vitamins are dirt cheap and can be like water on a wilting plant for a depressed person. A good quality multivitamin is typically what I prescribe to my depressed patients for B-vitamins. A multivitamin is a great insurance policy that nutritional deficiency is not contributing to depression. B-vitamins and standard multivitamin doses are most likely safe to take with antidepressants and most medications.
5. Calcium/Magnesium- Also dirt cheap are a simple quick fix for reducing the stress, muscle tension, and insomnia associated with depression. Most people on the Standard American Diet (SAD) are deficient in magnesium, and some are likely deficient in calcium. A 500mg calcium citrate with a 250 mg magnesium an hour before bed will help replete this likely deficiency while improving quality of sleep at night. Cal/mag is most likely safe to combine with most prescription medications, but always check with your doctor before starting anything new!
Magnesium helps SAMe donate methyl groups to form neurotransmitters, and is also needed for muscle relaxation as well as over 400 enzymatic processes in our body including detoxification pathways and is also beneficial for constipation, muscle cramping, torticollis, acute angina after myocardial infarction, stroke, asthma, kidney stone prevention, dysmenorrhea, premenstrual syndrome, acute gastrointestinal spasms or cramping, eclampisa, heart disease especially cardiomyopathy, diabetes mellitus, nocturnal muscle cramping, mitral valve prolapse, toxemia of pregnancy, fibromyalgia, migraine headaches, lead toxicity, and fatigue.
Calcium is of course necessary for bone and muscle health, optimal functioning of our nervous system and is shown in the research to benefit hypercholesterolemia, hypertension, blood clotting, periodontal disease, insomnia, smooth and skeletal muscle relaxation, anxiety, hyperactivity, lead toxicity, prevention of calcium oxalate stones, prevention of colon cancer, and leg cramps.
6. Omega 3 Fatty acids- although fish oil is likely more efficacious than flax oil, I would experiment with the oil that works best for you. You can read my article on “Fish oil vs Flax oil”. A concentrate of 9.6 grams per day was shown to be effective compared to a placebo in a small pilot trial. Patients in the study were not taken off their current medications. This is one natural therapy you can safely add as an adjunctive to most treatment plans unless you are taking blood thinning medications. I typically prescribe one tablespoon of Carlson lemon flavored cod liver right before a meal, and yes you can take it in capsules if the thought of drinking fish oil makes you gag. Ask your doctor if you can be on 3000mg of Omega-3 fish oil concentrate per day. That is generally what I start my patients on although the research study used three times that amount!
7. 5-HTP- Now most studies have been done on tryptophan, but because of past contamination issues it is tough to get your hands on tryptophan except through diet. 5-Hydroxy Tryptophan is just the new and improved tryptophan, and is a better therapeutic agent in my opinion because it is a biochemical step ahead of tryptophan in the production of serotonin, passing the “rate limiting step” that tryptophan fails to do. This means that 5-HTP can only feed forward in to serotonin and not go backwards in to something else.
With that being said this medicine can be a bit expensive, but is certainly worth a try! Do NOT combine this natural anti-depressant with prescription anti-depressants. I typically prescribe about 100-200 mg of 5-HTP on an empty stomach once or twice daily. This is pretty mega considering that most capsules start at 50mg-100mg. Start with taking this at bedtime to optimize sleep and serotonin.
5-HTP is also beneficial for insomnia, pain syndromes, schizophrenia, anorexia and bulimia, PMS, and migraine headaches. Excess tryptophan in the body is converted to serotonin (makes us happy) and melatonin (makes us sleepy). So if you have depression with insomnia 5-HTP should work well for you and low serotonin is the likely cause of your symptoms. Although it is possible to have hormone imbalance such as in menopause and perimenopause cause insomnia and mood disturbance.
8. S-adenosyl-Methionine (SAMe)- A natural amino acid antidepressant that is part of the homocysteine metabolism pathway and serves the role of “methylating” neurotransmitters. As SAMe converts to S-adenosyl-homocysteine it donates “methyl” groups (CH3) to the nervous system so that it can effectively produce neurotransmitters such as serotonin, dopamine, and catecholamines that make us feel GOOD and HAPPY. This natural antidepressant is also a great detoxifying agent for the body as it activates phase II detoxification pathways in the body.
If you are recovering from alcoholism or drug abuse this may be the better choice of natural antidepressants, however it should not be used by those that suffer from bipolar because of it’s ability to increase catecholamines and may trigger a manic episode. I would stick with St. John’s wort or 5-HTP for those susceptible to manic or hypomanic episodes. Do NOT combine with prescription drugs. Typical dose of SAMe is 50 mg once to twice daily. Always take SAMe with magnesium for optimal methylation of neurotransmitters, and a multivitamin as the B-vitamins folic acid, B-6, and B-12 are necessary for preventing homocysteinemia, a potential consequence of consuming elevated levels of SAMe. Homocysteine is correlated with cardiovascular damage, and B-vitamins will ensure it’s conversion to an inert substance.
9. Vitamin D- I typically place depressed patients on a starting dose of 2000 IU’s of vitamin D, check their calcium and vitamin D levels and then decide if the dose should go up or down from there. I have seen great responses to vitamin D especially in those that are low. Most people that live in the northern latitudes like Seattle will be low on vitamin D. Out of the hundreds of patients I have checked, I have only found one person in Seattle that had a normal vitamin D level. Repleting deficiency is imperative, as this vitamin that is now considered a “pro-hormone” may have more of a role in the physiology of the body than we are currently aware. Overdosing on vitamin D can result in a life threatening case of hypercalcemia as vitamin D and calcium absorption are interrelated.
Do NOT take more than 1000 IU of vitamin D without being monitored by your doctor. Although the active form of vitamin D in the body is 1, 25 cholecalciferol the best test for vitamin D levels is 25-D-OH, ask your doctor to do a basic metabolic panel and check your vitamin D, pre-treatment, a month out, 3 months out and so forth. If you are deficient in vitamin D and start a 2000 IU daily dose it will take about 1 week to raise your vitamin D levels 1 point.
So if your level is 16 and you need to get to 60, it will take about 44 weeks to get you back to the normal range. You are better off doing this gradually in my opinion as we do not want to cause atherosclerosis (hardening of the arteries) by hypercalcemia from taking large doses of vitamin D at once. Other naturopaths may be willing to dose you up really high, but I am completely against it, until we have more research supporting the safety of this fat soluble vitamin that stores in the body. Be sure to use vitamin D3 (cholecalciferol) in an emulsion form, because vitamin D2 is just crap, and not worth your time taking.
So that is a long list of natural medicines! Should you take these all at once?
Probably not!
So where to start?
If you are currently on anti-depressants, you need to work with a Naturopathic Doctor such as myself to safely implement natural meds that won't interfere with your antidepressant. I generally start by adding only vitamins, minerals, omega 3’s, exercise, and "Vitamin L" to see if your mood can be boosted enough to consider titrating off of them, work on implementing my Depression Diet gradually. NEVER ever ever… discontinue your prescription medicines without following the advice of the doctor that prescribed them. I have seen patients permanently damaged from doing this with their antidepressants and it is possible with Naturopathic medicine to reverse that reaction but it is a lot of work and we can save everyone the headache by tapering gradually down from all antidepressants. Last week I saw a new patient exactly for this reason and it was 2 years since she stopped her Effexor yet still is shaking, dizzy and has ringing in her ears and severe anxiety from the sudden withdrawal.
My blogs are designed to educate patients on how Naturopathy works so they know up front if they can do it. Check out my blog on "How to Be Successful with Naturopathy," to ensure you will be my next success story.
I typically start a depressed patient that is not on any anti-depressants on either St. John’s Wort, 5-HTP, OR SAMe in conjunction with a multivitamin, vitamin D, omega 3’s, and cal/mag. If stress and anxiety is a problem, I then add in schisandra or passion flower. Following my Depression Diet guidelines to ensure adequate amino acids in the nervous system to make neurotransmitters and adequate Omenga-3's to ensure your nervous system is functioning optimally is critical to maintaining mood without medication. Please also work with a counselor for your mood, counseling is imperative to a successful mind/body/spirit approach to the management of depression. Try the St. John’s wort, 5-HTP, or SAMe at least a month if not three before swapping out for a new treatment. Most research studies I read have a minimum of 8 weeks before improvement. While I do see patients improving before then it is important you have realistic expectations of herbal medicine for mood.
Be cautious when using combinations of herbs, amino acids and antidepressants as “Serotonin Syndrome” can occur and is dangerous. This results in too much serotonin causing anxiety, high blood pressure, profuse sweating, irritability, and agitation may occur.
Thank you for your Women's Health and Herbal Medicine questions. Please send them to me on a postcard as I love to get something in the mail that is not a bill. If your question cannot fit on a postcard then you need to treat yourself to a Naturopathic visit with me. Simply pop over to my SCHEDULE page to get set up. I love helping women with their depression, anxiety, ADHD, PTSD, and mental health!
Dr. Nicole Sundene, NMD
(480) 837-0900
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum Depression, Chronic Fatigue, Holistic Psychiatry, Depression, Anxiety, Chronic Pain, Autoimmunity, Food Sensitivities, Digestion, Dermatology, Acne, Psoriasis, Eczema, and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones, she presents to women the best-integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!
Dr. Nicole Sundene
Hormones and Dermatology are very interconnected in my mind as a Women's Health doctor. While many of my patients refer to me as a "Natural Dermatologist," what I am really doing is testing and perfecting hormones and nutrition which then results in perfect glowing skin!
From hormonal acne, and dry menopausal skin to perimenopausal “Allergic Skin” that causes eczema, psoriasis, cystic acne, Seborrheic Dermatitis, Dyshidrotic Eczema, and hives, all of these skin changes in women are actually an important alert that hormone imbalance may be the “Root Cause.” Women have fluctuating hormones throughout each month and decade of life.
While most people are aware that testosterone causes acne and hypothyroidism causes dry skin, we will discuss hormones and Dermatology in greater depth than that today to understand exactly what is happening to a woman as she move through her teens and twenties and battles hormonal acne as I once did.
I often see my patients experiencing perimenopausal or menopausal skin changes. Many Dermatologists send me their patients when they cannot resolve their patients symptoms with standard treatments or have noticed a hormonal pattern.
Women over forty in perimenopause and menopause often tell me they feel like they “Rapidly aged ten years overnight,” and ask why their skin has suddenly become so thin, saggy, has lost elasticity, and no longer has a healthy glow. We reminisce about the healthy glowing skin they once had when full of hormones during pregnancy as I fill out a lab slip to evaluate the hormones that are "off" with menopause.
WHAT IS THE CONNECTION BETWEEN HORMONES AND DERMATOLOGY?
As a Naturopathic Hormone Doctor that has treated a lot of women over the years, I do see women's skin changing as they transition through perimenopause and menopause. Generally the skin goes from oily to dry or from already dry to super dry and now having massive issues. Women commonly report new allergic skin conditions they never had before like eczema, psoriasis, hives, seborrheic dermatitis, or dyshidrotic eczema.
While we all tend to associate vaginal dryness with menopause, really the entire body is drying out along with the vagina. So today in this hormone blog I will be discussing exactly what women need to do.
In my mind as a “Holistic Dermatologist,” the main underlying issue is the change in the woman’s hormones. Especially when new skin condition’s pop up in a women’s forties and fifties the first thing we should be thinking about is hormone imbalance rather than reaching for that easy steroid cream to apply. The steroid cream basically is just slapping a band-aid on the Dermatology issue and not addressing it at the “Root Cause.”
Every woman nearing menopause wants to know why their skin is rapidly aging, thinning, and has lost its turgor and elasticity. So today we will be discussing the link between female hormones and skin aging.
ESTROGEN HORMONE AND SKIN HEALTH
Estrogen is responsible for helping keep our skin hydrated as well as builds the layer of collagen behind the skin. Loss of estrogen is why women suddenly notice their skin lacks elasticity, and has become very thin. Thin skin is more likely to bruise because there is less cushion to protect the blood vessels below it and with this women notice that cuts take longer to heal. Women that also bruise easily are those that tend to be low in progesterone which we will discuss next. Easy bruising can also be a sign of anemia from heavy bleeding in perimenopause.
Often women cannot rebuild enough iron stores with just food sources when they have had heavy periods prior to menopause. After the ferritin level is above >75 menopausal women generally do not need to supplement with iron as they are no longer losing blood each month.
Estrogen is the last hormone that women lose when women become officially menopausal. Most women in their late thirties and forties are dealing with low progesterone and low or high testosterone impacting their skin.
The sudden loss of estrogen in menopause though, is when women suddenly notice Hot Flashes along with new Dermatology complaints, or tell me that they have “Aged ten years overnight,” and think to seek me out. As a hormone doctor, I want women to be aware of the shifts to their hormones and skin ahead of time so we can prevent this "rapid aging syndrome" at menopause.
By checking hormones when women turn forty or sooner, we do not need to work to reverse rapidly aged menopausal skin! We can watch for trends and changes and be prepared and treat as needed. Prevention is the queen of Anti-Aging Dermatology!
PROGESTERONE HORMONE AND SKIN HEALTH
Progesterone levels are high in pregnancy which causes our capillaries to increase blood flow aka "vasodilation." This is why pregnant women have that amazing glowing skin everyone comments about, “Look at how she is just glowing!” As progesterone levels decline the blood vessels naturally narrow which is why menopausal women suddenly get High Blood Pressure and heart problems like palpitations, and PVC's that they never had before. The arteries of the cardiovascular system have smooth muscle in them that relaxes arteries, stomach, and lungs. When women develop asthma in middle age, they should consider progesterone deficiency as a "Root Cause" since progesterone is a natural bronchodilator.
However, when progesterone begins to naturally decline around the age of 35 and dwindles down to zero by forty or fifty, this is when women complain to me that their hair, nails, and skin looks sallow, dull, dry, and lacks any form of that “healthy glow.”
Progesterone is also important for vaginal hydration, dry eyes, and irritable bladder. Painful intercourse described often as “Having sex with sandpaper,” is not just caused by lack of estrogen but also lack of progesterone and testosterone. The 90's method of giving women with hysterectomies estrogen only with the new research we now have on progesterone is simply cruel.
For years doctors have argued that because "she has no uterus, she doesn't need progesterone," this gross scientific misnomer should be drop kicked straight back to the 1900's where it belongs. Estrogen monotherapy should be put out to pasture permanently with "Horsey Hormones" aka Premarin for the safety and sanity of women everywhere. Women need progesterone for their eyes, skin, vaginal health, blood pressure, hormonal acne, weight loss, and mental health. Women without progesterone often have troubled sleep riddled with night sweats, anxiety and insomnia.
TESTOSTERONE HORMONE AND SKIN HEALTH
Testosterone is oftentimes viewed as the “Most Evil Hormone” in Dermatology for causing Hormonal Acne, Rage, Oily Skin, and Cystic Acne in my PCOS patients. I worked for three Dermatologists over an eight year period that were constantly trying to battle the evil testosterone with spironolactone and birth control pills with some wins and losses because testosterone is not always the cause of the hormonal acne. Testosterone blocking treatments fail when another hormone such as estrogen, progesterone, thyroid hormone, or adrenal hormones like DHEA are out of balance.
While testosterone is sometimes to blame in hormonal acne, women do need some testosterone in their systems as this is the primary reason why “men age better than women.” Because they have testosterone levels of 800 while women are at 8 if not zero in menopause. Plus I see fantastic results treating my Chronic Fatigue, Chronic Pain, Depression, Anxiety, Mental Health, and Osteoporosis patients with testosterone!
Testosterone is why men don't generally get Osteoporosis unless they have low testosterone levels. Ironically, once I began to see benefits on my patients DEXA's and started to look into the research for Osteoporosis and testosterone, the only research study I found of course was done on men with low testosterone. The good news though, is that bone was built from supplementing with testosterone in the study! A minor women's health victory!
Since both my grandma's had severe Osteoporosis I want all women to know this stuff now so they can prevent painful debilitating fractures that may not ever be able to heal in their "Golden Years." I am excited about testosterone not just for avoiding wrinkles but also for bone health. I have seen testosterone build bone in the past decade of my practice faster than in the first half of my career when we just gave women premarin or natural estrogen aka estradiol for their bones.
Today, my patients that use a cocktail of estrogen, progesterone, and testosterone and eat the mineral rich foods on my Osteoporosis blog along with supplements to ingest the correct 1000 mg of calcium I recommend women intake daily for prevention, and combine all of that with weight bearing exercises at least twenty minutes three times a week, are able to reverse their T scores on their DEXA's.
Now I have revealed on my women's health blog that men age better and have better bone density than women, but we will never admit this out loud! This is a 100% private portal page for women on the internet right? 😉
But I bring this testosterone issue up because if you have ever seen a man wash his face with a bar of dial soap and use no moisturizer afterwards, you know exactly what I am talking about. Men make so much testosterone that their skin is naturally hydrated from within at it’s base and they generally do not need to apply lotion on top. The testosterone stimulates sebaceous gland oil production. Meanwhile women with low testosterone are applying nineteen different products and serums to their skin twice daily.
I just want women educated and understanding why neglecting their hormone imbalance is neglecting their skin, and yet again how unfair it is to be female versus male. Plus now you have medical proof to substantiate to your husband that you do need to buy all of those anti-aging serums and he is totally fine without any!
Testosterone naturally begins to decline around the age of 35. This is when women notice not just dry skin, but that their skin lacks any form of oil or hydration, and their hair is also suddenly dry and coarse. Perimenopause is also when female hair loss begins.
Women generally report lack of stamina, chronic fatigue, depression, and that they are not bouncing back as quickly from their workouts and their muscles and joints feel inflamed and in pain for several days after a workout. Suddenly it becomes exhausting to try to exercise two days in a row if not impossible.
Keep in mind that men with "low testosterone" of 300 complain of joint pain and muscle aches while many of my female patients are at zero. So men are tired and in pain at a level of testosterone 30 times higher than what most women have in menopause, and many of us will never be at that level, nor should we be.
Testosterone helps our joints and muscles heal and repair, so if you notice you are in chronic pain, more tired than normal after a workout this is generally one of the the very first early warning signs of perimenopause for most of my patients, and a sign you need to get on my SCHEDULE to have your hormones checked! Especially if you are having night sweats or beginning to feel overheated at night.
Testosterone has always been the villain in Dermatology because it stimulates the oil glands in our skin causing acne. However, we do need some testosterone as women or our skin looks dry and lacks any form of protective oil that provides shine to our faces. While we don’t need our complexions dripping with visible oil, we do need some oil to prevent rapidly aging skin in menopause!
WHAT IS THE TREATMENT FOR MENOPAUSAL HORMONE CHANGES TO THE SKIN?
Hormonal Acne, and Menopausal Hormone changes to the skin require a physician skilled in both Dermatology and Hormones. The first step is for a Female Hormone Specialist (please not your Family Doctor, Endocrinologist, or Obgyn) to check your full set of female hormones, adrenals, and thyroid as these are ALL equally important in my mind. Oftentimes I sadly receive new patients that think that they have “already had all their hormones checked,” only to receive one test or a one page report that they proudly hand me. A TSH is not a full hormone panel, it is not even a full thyroid panel. An FSH/LH to confirm you are menopausal is almost utterly useless. Why????
Occasionally the correct tests are ordered but the doctor ordering the test does not know how to properly interpret them because the hormones fluctuate in different parts of a woman's menstrual cycle and have to be tested at the right time. We also need to look at what is optimal and not just look for things in bold that are clearly abnormal when it comes to chronic skin conditions and Dermatology.
This is where I see a lot of women fail with having their hormones checked with perimenopause, PCOS, and hormonal acne. Testing hormones in the wrong part of the cycle, and/or not testing the correct hormones is totally ineffective for solving women's skin conditions.
Lets instead test all the nutrition and hormonal metrics related to skin health to properly address Dermatology conditions, especially in menopausal women and those with PCOS, thyroid conditions, and perimenopause.
My initial hormone test report is four pages long at minimum. Most insurance covers hormone testing for women unless it is of course government funded. Only the government could care less about your hormones! But they are still very important for proper skin health, which is why I have written this blog about how they impact women during different stages of their lives in my Holistic Dermatology practice.
So if you have not had hormones properly checked, and are struggling with skin rashes, hormonal acne, eczema, or psoriasis, simply visit my SCHEDULE page to treat yourself to a Naturopathic Hormone visit!
In my experience of fifteen years working as a “Holistic Dermatologist,” very few skin conditions in Women's Health are not hormonal.
Dr. Nicole Sundene
(480) 837-0900
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Specialist in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
Dr. Nicole Sundene
Hormonal Acne and Eczema were frustrating problems I personally battled twenty five years ago. No matter what I tried, the acne and eczema would never fully go away. My skin continued to worsen, until I learned about the importance of balanced Female Hormones, Nutrition, and Naturopathic Medicine for acne and eczema in Naturopathic school. I finally was empowered to discover the diet and lifestyle that works best for my hormonal, sensitive, skin type and treat the hormone imbalance. I then began to learn how to test for and treat and treat the different types of hormone imbalance that cause acne with natural medicine as I walk women through the nutrition process in my "Hormonal Acne Diet Program."
I still remember the day my Naturopathic Dermatology professor explained the link between acne and hormones, nutrition, the microbiome and the skin and everything I was battling made perfect sense! The light bulb went off and I followed the instructions the Naturopathic Doctor mapped out and received amazing RESULTS!
My hormonally triggered allergic itchy inflamed skin was suddenly less sensitive to allergens and chemicals. While I am still chemically sensitive and food sensitive to this day, balancing my hormones and nutrition has greatly improved my skin. I am now less reactive to foods and chemicals in general thanks to Naturopathy!
As my skin improved I was finally able to quit using all the different prescription 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 itchy painful skin symptoms. I no longer needed to take antibiotics or use steroid creams. My skin was no longer itchy or painful. I worked for three Dermatologists for eight years and nothing they prescribed ever gave me a lasting result. My skin was hooked on prescription drugs! At one point I had four different prescriptions I regularly had to apply. It was horrible!
HOLISTIC ACNE AND DERMATOLOGY TREATMENTS REQUIRE WE TREAT THE ROOT CAUSE!
Nothing brings me greater JOY today as a Naturopathic Doctor but to see my patients heal their skin by treating the ROOT CAUSE. I would like to take a few minutes to explain what this process entails so that patients know whether or not they will be able to follow the recommendations of their Holistic Dermatologist.
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 #1 perfect type of patient for me to help! If you are not open to making diet changes, I will not be able to help you. I have struggled to make the changes to, I understand it takes time for some of us, but if you are not open on working towards the new diet with me then I will likely not get a good outcome by enrolling you in to my Holistic Dermatology practice in Scottsdale. I never want to waste anyone's time or money when there are plenty of patients that seek the valuable women's health and hormone care I provide, and desperately need my Alternative Dermatology services to solve their mysterious dermatology condition. Sometimes women are stuck on a certain style of diet that is completely wrong for their skin or are so busy googling skin remedies they cannot focus on doing what I need them to do. While my process is simple and time tested to provide amazing results it does not work when the patient does not follow what I say to do. It's really that simple!
CAN YOU HELP ME WITH HORMONAL ACNE OR HOLISTIC DERMATOLOGY VIA TELEMEDICINE?
I am often asked this question several times per day. YES! Whether you need a Holistic Dermatologist in Arizona or whether you need to work via Telemedicine I am able to help patients with most skin conditions that are wiling to change their diet and take supplements. Simply snap photos of your skin condition and send them to me if you are unable to come in or do not live in Arizona. I can still help you over the phone via Telemedicine, I just cannot prescribe any hormones. In the event I discover you would need a hormone prescribed for your skin condition, I would make a recommendation you can take for your local Family Doctor. Itchy or painful Hormonal Skin conditions such as acne, eczema and psoriasis are my favorite conditions to help women with.
I would be happy to help you with any acne, cystic acne, psoriasis, eczema, dermatitis, scalp psoriasis or seborrheic dermatitis, hives or itchy skin! 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.
HOW DOES HOLISTIC DERMATOLOGY WORK WITH NATUROPATHIC MEDICINE?
Please keep in mind my Holistic Dermatology treatments are focused on treating the ROOT CAUSE of your skin problem and while I will prescribe natural remedies to apply to your skin... that is just "Slapping a Band-aid" on your dermatology complaint and it is not going to provide a lasting result. When we don't listen to the symptoms and understand why they are there the body just continues to scream louder and louder with the symptoms somewhat like an angry toddler when you cover your hand over their mouth to make them stop screaming. We all know when we remove our hand they will generally just scream louder and louder until they are "heard" and "understood."
When patients come to see me as their Holistic Dermatologist and they think I am going to just prescribe them some magical root from the Rain forest to cure their hormonal skin condition then we sometimes cannot realistically get a good result with Naturopathic Dermatology because that is not how it works. Incorrect nutrition causes imbalanced hormones especially Female Hormones and it is impossible for me to correct the hormone imbalance without the use of bioidentical hormones when the patient refuses to change their nutrition and work to a more Naturopathic Diet and lifestyle that helps them live itch free in their skin again. I struggle to make diet changes but know that the reward of feeling good in my skin is far greater than eating a few things that make me sick. My own personal triggers I have found are not even foods I enjoy eating but foods I thought were "Health Foods" and was eating them regularly to be healthy. So imagine my shock when I realize that these foods were creating eczema, psoriasis and inflammation in my skin?
The problem with your outside is on the inside. When I teach my new Dermatology patients their new diet for "their body," many choose to never return to their old way of eating because they feel so much better on the fuel that is correct for their body. Imagine having your skin improve AND feeling better, thinner and more energetic? That is what my Naturopathic diet for my skin does for me.... My weight is actually 25 pounds less than in my twenties when I had acne! I weighed 165 pounds when I was graduating college in 1999, and now easily maintain my weight at 140. So the benefits of thinking in a holistic manner for your skin are far greater than just improving your skin!
I only want patients to enroll in to my practice that will be my next Dermatology success story. I can confidently say after practicing Holistic Dermatology for over fifteen years that patients that are willing to follow my instructions will get better with their skin condition and those that are not on the same page as me and won't follow my instructions just don't get better. Many new patients erroneously feel we should be applying only topical treatments or are stuck in an allopathic naturopathic medicine model that treats each symptom with an herb rather than treating the underlying cause of the symptoms with an herb. When we give a patient an herbal medicine, vitamin or supplement for their skin symptom we are "Slapping a band-aid" on the skin problem in the exact same way that steroids and antibiotics do not address the underlying cause. In Naturopathy "Tolle Causom" is one of our most important healing principals because the patient WILL NEVER EVER EVER GET BETTER....Until we treat the cause!
In my fifteen years of experience successfully treating dermatology patients that is what all of my success stories have in common. They trust me to investigate the underlying cause of their itchy skin and they trust me to implement a plan that will address treating the root cause of their skin problems. Please do not take away my "Joy of fixing your skin" if you know you won't be able to change your diet to whatever I say you need to eat and remember to take your supplements as prescribed.
Holistic Dermatology is very complex and when hormone driven, is never usually what the patient thinks or suspects.... which is why it is difficult for me to help patients in Holistic Dermatology that do not understand this key concept and are not committed to finding and treating the underlying cause of their skin condition with natural medicine.
DO NATURAL TREATMENTS WORK FOR ACNE?
I know you all want me to prescribe herbs to apply to your skin and I will. I promise we will also do this. I promise we will still use 100% natural eczema treatments, natural acne treatments and natural treatments for psoriasis. However, I also promise that if you treat the hormone imbalance you will not need to continue to apply natural or prescription topical products. To me as a "Holistic Dermatologist" that is the ultimate goal... I want my patients to not have to apply anything to their skin. I know what a vicious frustrating loop that is and wasted years of my life fruitlessly applying things to my skin when ultimately the problem with my skin was brewing on the insides and I needed to treat my skin from within.
WHO WILL BE SUCCESSFUL WITH HOLISTIC DERMATOLOGY?
If you are able to precisely follow my directions, then I am able to help you with your Dermatology condition. I do not treat patients with skin cancer or provide minor surgery in my office. You would need to see an MD Dermatologist for skin cancer and have it properly removed.
IS HOLISTIC DERMATOLOGY SAFE FOR MY CHILD?
This is a top question we get every day. Can you help my teen daughter with her hormones and acne? Is it safe? As a mom myself, I can say with great confidence that Naturopathic Medicine is by far safer and better for your child than prescription drugs. Why would we want to put your undeveloped teen daughter on birth control pills or antibiotics? First of all birth control pills are causing osteoporosis from inhibiting female hormones needed for bone formation as well as other developmental markers.
Birth control pills do not fix the problem, they mask it. They also do not work when the hormone imbalance is not caused by female hormones and is originating elsewhere in the endocrine system.
Naturopathy is safe, effective and provides lasting solutions for children with itchy skin and acne. Pediatric Dermatology has been a passion of mine for years and it usually is about the child's diet and something wrong with the inside. Giving your child steroids, accutane or antibiotics is not good for their overall health and completely unnecessary if they are a good patient. Accutane can cause liver damage and suicidal thoughts.
WHAT TEENAGERS CANNOT BE HELPED WITH HORMONAL ACNE?
If your child has hormonal acne and you do not think they will make diet changes or remember to take supplements and you are not capable of enforcing this there is also little sense for parents to waste their time and money with Naturopathy. Although it can be helpful we will not see a result with chronic skin problems until we treat the ROOT CAUSE and heal the skin from the inside out. Generally children are my most compliant Dermatology patients because it makes complete sense to them that what they eat impacts their skin. They want to feel good in their skin. Many teen girls are my best acne patients because they feel such saddening shame with their skin.
Teens can also be stubborn though, so lets make sure they are on board with working with me! 😉
HORMONAL ACNE DIET AND NUTRITION
The most common causes of hormonal acne I see in my practice are from female hormone imbalance and insulin resistance. My "Hormonal Acne Diet Program" works to address both of these issues. We must treat the skin at it's Root Cause with the right nutrition and correct foods. I also help guide you through the process of eliminating and testing trigger foods that are starred for a reason in my program. As many triggers are very individualized and certain skin triggers that affect me, may not impact you.
Therefore my diet program will help give your skin a break from these trigger foods so that you can test them after being off them to see if this causes an acne flare within 1-7 days of eating the trigger food.
HOW DO YOU HELP PATIENTS AS AN ACNE DOCTOR?
With my Complete Naturopathic "Hormonal Acne Diet Program" and Telemedicine or In clinic hormone testing to determine the cause of the hormone imbalance impacting the skin we can work together to improve hormonal acne. Since I rarely prescribe medicine or hormone for acne, this is an easy thing for me to work with you on if you are not in Arizona. I do help patients out of state conduct hormone testing.
I am a living breathing success story for treating hormonal acne, eczema and psoriasis with natural medicine and nutrition. If you truly want lasting solutions then I believe in my heart that Naturopathic Medicine is the only answer! The only way out of hormonal acne is through my hormone testing process and "Hormonal Acne Diet" program. If you are not making significant progress with my program, then you definitely need to sign up to work with me so we can figure out why.
I would be happy to help you feel good in your skin again! Simply visit my SCHEDULE page and lets get working towards perfect skin before you end up with permanent scarring like I have!
Dr. Nicole Sundene, NMD
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
Dr. Nicole Sundene
Hypothyroidism and thyroid disease are the #1 conditions I treat in my Holistic Women’s Health and Hormone practice. Before I answer a lot of the questions I am commonly asked about hypothyroidism and discuss the best natural and prescription treatments, let me first take a minute to explain the process of how I help my patients with hypothyroidism achieve lasting solutions with natural thyroid hormones, herbs, nutrition and supplements.
I wish treating hypothyroidism was as simple as the current medical model that constantly fails women. Women with hypothyroidism are oftentimes frustrated because they are stuck in an antiquated hormone treatment system of:
Take X Thyroid Drug for X Symptoms
Oftentimes my thyroid patients are still complaining of common thyroid symptoms such as weight gain, chronic fatigue, depression, anxiety, cold intolerance, hair loss, heart palpitations, high cholesterol, insomnia, poor libido, dry skin, eczema, psoriasis, acne, and abnormal female hormones. All while their Family Doctor or Endocrinologist is saying the dose is fine. Half the time the dose is not properly tested and that is why it is not correct.
In Naturopathic and Functional Medicine, the body will continue to scream about its thyroid symptoms until we get the dose adjusted properly, changed to natural thyroid hormone and off the synthetic garbage.
After all, the thyroid is the “Mother of the endocrine system,” so we all know that when “Mommy” is not happy that none of the “Children” relying on her in female hormone and adrenal land will be happy! 😉
Here is the exact Holistic Thyroid detective process I perform as a Holistic Thyroid Doctor to fix hypothyroid symptoms:
#1 Why do you have hypothyroidism in the first place?
#2 What is the “Root Cause” of your hypothyroidism? Hint: It is different for each thyroid patient!
#3 Are vitamins, minerals, and nutrients the thyroid needs to make T4 and T3 hormones deficient?
#4 Assess adrenal function for women with chronic fatigue, anxiety and insomnia.
#5 Teach women my healthy hormone balancing Naturopathic meal plans and recipes my nutritionist designed to specifically help my overweight thyroid patients lose weight and balance female hormones.
#6 Addressing the gut inflammation is oftentimes why my patients have hormone imbalance in the first place, looking at the right nutrition for the individual patient, eliminating food triggers, testing the microbiome, and ruling out dysbiosis is critical for many of my thyroid patients.
#7 Continue to monitor the thyroid with FREE THYROID LEVELS AND NOT JUST USELESS TSH via blood hormone labs to confirm your thyroid function is OPTIMAL and that you are not running on an “Empty tank of gas” or at the bottom of the “hormonal normal range” which is not optimal, yet many doctors that do not specialize in hormones will decide it is totally fine despite being low and the patient frustrated by multiple annoying symptoms such as weight gain, hair loss, and chronic fatigue.
My TSH RANT: Please be advised if the doctor or Endocrinologist monitoring your thyroid is just checking TSH, or is checking total thyroid hormones and not free levels then they are not educated enough on this topic to be managing your hormones in my opinion. This is the #1 reason why my poor thyroid patients is suffering so badly. Checking TSH is 90's medicine and it is time for a better, modern, educated thyroid doctor!
If I treated my menopause patients this way, people would think I was insane to just check their FSH and not actual female hormones. Let's imagine if I stopped checking estrogen, progesterone, and testosterone levels to adjust menopausal women's bioidentical hormones and instead just adjusted hormones off of FSH or the message the brain is sending to the ovaries to make more hormones. Just as TSH is the message the brain is sending to the thyroid that it needs to make more hormones. Managing thyroid this way is a grave disservice to women everywhere.
We have much more sophisticated better ways to manage hypothyroidism now, thankfully! The only way we can stop this madness is to properly educate women and make sure they know what to expect on their labs tests so they can immediately fire their doctor if there is less than three thyroid tests being monitored.
I digress from my TSH rants, and want to move on to my "Root Cause" rant, because I want to take the time to investigate and understand #1 and #2 on my list, I sadly have seen many of my thyroid patients fail to improve over my seventeen years of experience working as a Naturopathic Hormone Doctor. Sadly then Natural Medicine also fails, and I don’t get to receive the “Joy of Fixing you” because I don't understand why the symptoms are here in the first place.
The real reason why most women don't feel good on synthetic synthroid and levothyroxine is because...
#1 Levothyroxine is a factory made synthetic compound.
#2 Levothyroxine is the dreadful "T4 monotherapy" that makes most of my thyroid patients fat because it needs to be converted to T3 to actually be useful. The T3 from the thyroid tells every cell in our body to work...somewhat like flipping on a light switch on or off.
#3 Lack of T3 means less collagen production, hair growth, and joint repair. Thyroid hormones set the pace for collagen production, along with metabolism. Therefore it is imperative that the thyroid levels for my chronic pain, autoimmune, Hashimotos, Rheumatoid Arthritis , and Lupus patients are in the optimal range and not just “normal.” Many of my unhappy thyroid patients are "Poor Converters" that are unable to convert the store hormone, T4 (Levothyroxine, Synthroid) to the active hormone that burns fat and gives energy=T3. This is why I firmly believe in natural thyroid hormone for women, and the majority of the women in my hormone practice ~95% are on natural thyroid hormone.
While many women are totally fine with their hypothyroidism utilizing the standard synthetic hormones synthroid and levothyroxine, many women specifically seek me out to fix their hypothyroidism related issues because they have been given these synthetic thyroid hormone replacements, yet still have symptoms and just don’t quite feel right.
I want every woman in my practice to be a success story. So please do treat yourself to a Naturopathic visit with me if you also want real answers, want the right nutrition for your body, want natural hormones, like to use herbal medicine, and want me to fix the underlying digestive and adrenal issues that are most often causing low thyroid function.
If that sounds like what you need to finally solve the mystery of your frustrating thyroid symptoms then please pop over to my SCHEDULE page and treat yourself to a Naturopathic visit! I would be happy to help! As a thyroid patients myself, this is of course one of my favorite hormone subjects! Now let me answer the most common questions I am asked about hypothyroidism.
WHAT IS HYPOTHYROIDISM?
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.
LOW THYROID: WHAT ARE HYPOTHYROID SYMPTOMS?
The hypothyroidism symptoms vary among individuals. However, it involves the following signs and symptoms. [1, 2, 3]
WHAT ARE THE RISK FACTORS FOR HYPOTHYROIDISM?
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]
WHAT CAUSES 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.
WHAT IS 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]
HOW DO WE DIAGNOSE HYPOTHYROIDISM?
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]
WHAT ARE THE BEST TREATMENTS FOR HYPOTHYROIDISM?
Hypothyroidism treatment involves the restoration of normal thyroid hormone levels in the body. Moreover, the treatment aims must include complete control over the hypothyroid 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 armour thyroid or levothyroxine, and cytomel are the primary prescriptions used for hypothyroidism management. [4, 8]
WHAT IS NATURAL THYROID HORMONE REPLACEMENT THERAPY?
In MD 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 thyroid hormone, 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 thyroid hormone increases the risk of poor muscle coordination, fatigue, insomnia, anxiety, 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]
Dr. Nicole Sundene, NMD
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
References:
By Dr. Nicole Sundene, NMD
Hashimoto’s thyroiditis is one of the most complicated hormonal and autoimmune conditions I commonly treat. I am sure you would not be googling natural solutions to solve Hashimto’s unless you were not getting lasting solutions that actually worked as I describe in my story about “Why I Became a Naturopathic Doctor.”
While I don’t have the autoimmune form of hypothyroidism, I do understand the ups and downs, the good days and flare days, and the other frustrations of having an autoimmune disease first hand. I know what it is like to not get lasting solutions that work, passed around from one uncaring doctor to the next, and wasting my money and time on useless treatment. I have wasted a lot of money in my life on useless natural remedies and prescription drugs to maintain my autoimmune disease and other conditions I have been challenged with such as acne, eczema, psoriasis, ADHD, depression, chronic pain, and anxiety.
Let me take a minute to explain how I help my patients with Hashimoto’s achieve lasting solutions so that they do not have to rely on prescription drugs, and only need natural hormones, herbs, and vitamins.
While our normal medical model in American health care works in a paradigm of: TAKE X Thyroid DRUG FOR X Hashimoto’s SYMPTOM
What I actually want to do as your Naturopathic Hormone Doctor is the following:
#1 Why do you have Hashimoto’s in the first place?
#2 Working to investigate the “Root Cause” of your symptoms.
#3 When did these symptoms start? What else was going on?
#4 Are there genetic or environmental causes?
#5 Are female hormones flaring Hashimoto’s?
#6 Eliminate food triggers
#7 Improve Insomnia so the body can actually heal and repair the joints
#8 Manage Hashimoto’s joint pain naturally
#9 Evaluate adrenal stress hormones that support the thyroid and reduce inflammation
#10 Implement gentle exercise or work with a fitness trainer
#11 Implement counseling for patients with anxiety from Hashimoto’s thyroid storms that transition to depression when the storm has passed and the thyroid hormones are burnt out.
#12 Test vitamins, minerals, and nutrients related to proper thyroid function
#13 Implement natural thyroid hormones, and properly adjust them
#14 Use herbal medicine and supplements for inflammation
#15 Teach my patients my simple 4 week Autoimmune meal program so they can learn how to eat in a healthy Naturopathic inflammation reducing manner that helps women with Hashimoto's actually lose weight, lower pain, and balance hormones. Thus no longer living on Tylenol and Advil for pain, and high amounts of caffeine for fatigue.
Without understanding #1 and #2 on my list, I sadly have seen many Hashimoto’s patients fail with natural medicine. I want every single patient in my practice to be a success story. So please do treat yourself to a Naturopathic visit with me if you want real answers about your Hashimoto's, want the right nutrition for your Hashimoto's, want me to fix the underlying female hormone imbalance that is most often causing weight gain, pain, swelling, and chronic fatigue and the #1 reason why more women have autoimmune disease than men.
While I love helping women with Hashimoto’s, I also have been doing this job for over seventeen years as a Naturopathic Hormone Doctor and I know what it takes to get results. We need to think of this as a process and not just one simple prescription that will magically fix it all.
Trust me, if that existed you know I would already be on it and be blogging about it! 😉
So let's have realistic expectation and work through each challenge around your Hashimoto's symptoms in steps. If that sounds like what you need then please pop over to my SCHEDULE page and let’s get working on your Hashimoto’s symptoms now! I would be happy to help!
Next, I will answer everyone’s most common questions I get about Hashimoto’s.
WHAT IS THE DIFFERENCE BETWEEN HASHIMOTO'S THYROIDITIS AND HYPOTHYROIDISM?
Hashimoto's thyroid treatment is extremely different than regular hypothyroidism in Naturopathic Medicine. In my mind, Hashimoto's requires a completely different treatment plan because it is an autoimmune disease, therefore I am working to balance the immune system as a Female Hormone Specialist and Naturopathic Doctor, in order to improve thyroid function naturally.
Patients with regularly hypothyroidism, such as myself require much less treatment to feel optimal than my autoimmune thyroid patients. Hashimoto's can be one of the trickiest conditions to treat, however many women are unaware they suffer from it.
Many of my patients have been treated for their thyroid for years without knowing what type of thyroid disease they have. Half the time most MD’s could care less what form of thyroid disease the patient has because it does not affect their thyroid treatment. The thyroid treatment is the same for an autoimmune Hashimotos as standard hypothyroidism. This makes little sense since we are comparing apples and oranges.
IS HASHIMOTO'S A HORMONE CONDITION OR AUTOIMMUNE CONDITION?
Did you know with Hashimoto's the real problem is actually the immune system attacking the thyroid, and there is generally nothing actually wrong with the thyroid gland itself? I like to think of the thyroid in this situation as the poor little kid getting bullied in the schoolyard. He is constantly under attack, but otherwise would be completely fine. When we fail to address the immune system in this frustrating autoimmune disease, we fail to ever truly help the patient return their inflammation levels to normal, restore energy, and reduce arthritis, achy joints, swelling and traveling pain that is the hallmark for Hashimotos.
If you are a thyroid patient that has not been tested for Hashimoto's yet, you have constant traveling mysterious aches and pains that no doctor or physical therapist can diagnose…I will bet the farm that the diagnosis is Hashimoto's.
As a thyroid doctor and Hashimoto's specialist, it is extremely important to me to understand my thyroid patient’s diagnosis, and if they have just a “Lazy Thyroid” as I have in regular hypothyroidism, or whether they have an autoimmune disease that is actually causing the hypothyroidism.
WHAT VITAMINS AND MINERALS SHOULD I TAKE FOR HASHIMOTO'S?
Nutrients that most thyroid patients are deficient in can also cause severe adverse reactions for my Hashimotos patients as I describe in my "Thyroid and Iodine" blog. This is why self treating Hashimoto's can be dangerous. I have seen patients harm themselves from too much iodine, zinc, tyrosine, b-vitamins and thyroid cofactors that can throw the sluggish low thyroid into hyperdrive and cause an actually “Thyroid Storm” where the immune system is ferociously attacking the thyroid, resulting in thyroid cell destruction.
During a Hashimoto's thyroid storm the thyroid hormones are dumped into the bloodstream causing the heart to be immediately triggered, as T3 stimulates contractility and thus palpitations, tachycardia and anxiety can ensue from the hyperthyroid storm.
When we work to address the autoimmune condition from a Naturopathic standpoint, we can calm these thyroid storm attacks down and lessen the rate of destruction the thyroid will endure. Once the thyroid has endured enough attacks, and as part of the natural aging process of our glands, most Hashimoto's patients eventually require thyroid replacement hormones.
WHAT IS THE BEST THYROID MEDICINE TO TAKE FOR HASHIMOTO'S?
While it may have a higher likelihood of adverse reactions for those with autoimmune Hashimotos I do see Armour Thyroid work the best to control symptoms and improve fatigue and weight loss. Armour thyroid is a generic term for “Natural Dessicated Thyroid” because the pig gland is desiccated generally there is no reaction to the natural thyroid medication for the majority of my Hashimotos patients and therefore the "rule" that autoimmune patients should not be given Armour thyroid is simply untrue.
WHAT IS THE MOST COMMON THYROID HORMONE YOU PRESCRIBE FOR HASHIMOTO'S?
Around 95% of the Hashimotos patients in my hormone practice prefer Natural Dessicated Thyroid or Armour over levothyroxine or synthroid.
The other choice is synthroid or levothyroxine combined with T3. I do not recommend patients take T4 alone or “T4 Monotherapy” unless they are great converters to T3, the metabolically active thyroid hormone. Because most women struggle with this conversion, especially when in Menopause and Perimenopause as female hormones can impact the thyroid levels and smother them, reduce thyroid function, and cause the metabolism to slow down.
Therefore monitoring the thyroid for women in their forties and fifties is critical in Women's Health.
Women with Hashimotos should find a seasoned Hashimotos Expert that specializes in Naturopathic Medicine, Herbs and Nutrition. Many other hormones can impact the Hashimotos patient such as adrenal hormones, estrogen, progesterone, and insulin. In my mind, there is no patient that needs a Naturopathic hormone doctor more than a Hashimotos patient!
Your naturopathic doctor should be providing hormone testing and treatment to the adrenals which are the underlying foundation of support for the thyroid, in addition to addressing gut health and the microbiome which are also triggering many women with this frustrating thyroid disease.
SHOULD I SELF TREAT MY HASHIMOTO'S?
Some of the most dangerous things I have witnessed patients do as a doctor is read random blogs and self treat their Hashimoto's which can be extremely dangerous and result in a heart attack or stroke if thyroid hormones are too high. Treating Hashimotos properly is extremely complicated and requires a multifaceted approach to correct hormones, nutrition, inflammation, and most importantly balance the immune system, helping it to become less reactive and thus less likely to “bully” or attack the thyroid.
If you would like my help with your thyroid condition simply visit my SCHEDULE page to set up your initial Naturopathic visit!
Dr. Nicole Sundene, NMD
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
Dr. Nicole Sundene
PCOS patients with imbalanced hormones should probably throw some pomegranate juice along with apples, aloe, ginger, curcumin, and cinnamon in their “PCOS Smoothie” recipe. The research is pretty consistent that pomegranate is beneficial for women with PCOS! As well as many of the other symptoms that impact women with Polycystic Ovarian Syndrome.
Recent research also demonstrates pomegranate is effective against Chronic Fatigue, Poor Memory, Poor Concentration, Weight Loss, High Cortisol Stress Hormone, High Blood Pressure, Inflammation, Aging Skin, Hyperpigmentation, Type 2 Diabetes, Insulin Resistance, Liver Disease, Fatty Liver: NAFLD, Heartburn, Bloating, High Cholesterol and Triglycerides which women with PCOS often struggle with. Pomegranate also protects against skin damage from UVB rays, helps with Stroke Recovery, and provided an anti-inflammatory benefit during hospitalization for a viral infection. [1-27]
PCOS, MENOPAUSE, HORMONES + POMEGRANATE
Pomegranate is not just for women with PCOS, but also for menopausal women. The researchers made me laugh out loud when they concluded pomegranate “significantly ameliorates the irritating symptoms of menopause.” I had to laugh at the description of "Irritating Symptoms" and had to wonder if the researchers were male or female. Because most women with menopause would describe their symptoms as far more disruptive than "irritating." Irritating symptoms are when we miss a few hours of sleep, or feel tired, sad or blah or blue for a few hours.
I listen to my menopause patients complain about symptoms that are far beyond irritating every day at work. They are severely fatigued from lack of sleep, they have brain fog and poor concentration, they are angry, irritable, over heated, on edge from feeling uncertain when the next hot flash will hit, or if they are going to be able to find a bathroom every thirty minutes because now they constantly have to pee all the time thanks to their new menopausal bladder.
Menopausal and perimenopausal women have Insomnia, and are waking up with night sweats because they are sweating and feel like they are internally boiling to death which then causes a horrible chronic Insomnia and they cannot sleep past 1-3am, and just start their day now at 2am! Or they cannot sleep at all and the insomnia is causing chronic fatigue and depression they never had before.
They are exhausted from lack of sleep, and the hormone shifts have now caused hypothyroidism or low thyroid function. Heavy bleeding in perimenopause prior to menopause also can leave many patients with severe anemia. Which is why women should have their iron levels and thyroid checked along with their female hormones.
Meanwhile the new hormone imbalance is causing Weight Gain, Anxiety, Depression, Bladder issues, Blood Pressure Issues, and Chronic Yeast Infections that they never had before. Most of my patients would actually describe their symptoms as "Moderately to severely disruptive to their quality of life."
Furthermore, I don't think women as a societal whole should tolerate having their menopausal symptoms minimized by researchers. Other doctors will then believe from reading conclusions of this type of research that menopausal symptoms are simply a little bit "irritating" or "annoying" when they actually can be life altering for many women and lead to divorce if not addressed properly. Losing your family to divorce, and splitting up children is beyond "irritating." Many menopausal women come to me in the midst of a divorce, separated, or just at wit's end with their partners. Menopausal hormone changes have caused both a lack of libido, and a lack of compassion from their partner as to what they are going through.
I have actually saved several marriages by sending a woman home with a set of horribly abnormal hormone labs I have scribbled all over and marked up with pen like an English teacher. The husband looks at the labs and sighs with relief that there is something wrong, that this situation is temporary, and his wife can be fixed. Then instead of fighting, the couple works as a team to help the wife get through this challenging time. Many husbands have learned to just quietly leave, go golfing, go to the gym, go on a walk and just give women time and space to deal with their hormone imbalance. Many women come back in tears and thank me for saving their marriage.
Women with menopausal hormone imbalance can end up divorced during this time in their lives because the symptoms are disruptive to their mental health, disrupting their sleep, causing them to feel fatigued and irritable, all while also causing low libido, which is now causing marital strain that never existed before... However, I will leave it up to the women to decide if their symptoms are life altering or simply irritating and am overall grateful to any researchers conducting research for women's health... So I will digress from my rant.... In another study pomegranate also improved women’s menopausal hot flashes, libido and quality of life. [12,15]
So pomegranate is officially the most perfect Herbal Medicine hormone food in my mind as it is providing fertility support to women of reproductive age, improves PCOS by lowering testosterone that can cause Hormonal Acne and infertility, and also is hormone modulating with estrogen and testosterone for women as they transition to perimenopause, and eventually menopause. Whether hormones are too high or too low pomegranate works to correct Hormone Imbalance!
So there you have it ladies, a pomegranate a day keeps the women’s health doctor away!
Basically pomegranate is a one stop shop women's health supplement that not only regulates female hormones but provides a myriad of other super food benefits. In my Instagram video, you can see how the groups of seeds somewhat look like eggs budding from our ovaries!
RED OR WHITE POMEGRANATE FOR HORMONES?
Being from Seattle, the first time I was walking down the street in Scottsdale and saw a pomegranate tree naturally growing I will admit, I actually stopped and freaked out as a Naturopathic Doctor and had to pick one and take a bunch of pictures!
So, if you live in Phoenix, you can grow your own pomegranates! If you do buy a pomegranate tree, buy a red pomegranate tree. As there are generally more flavonoids in deeply pigmented fruits than white ones.
I believe the red pomegranates are most likely more medicinal than the white ones, as it is the flavonoids that is the medicine here and those same flavonoids are much lower in white wine versus red wine. So it is safe to assume until proven otherwise we should eat the red pomegranates for the best benefits.
If research proves me wrong... I will let you know!
However, if we are intending to use pomegranate flavonoids for weight loss, and lipid metabolism, the red pomegranates were studied. Another study on pomegranates and fat metabolism concluded, “Short-term consumption of dietary doses of Pomegranate Juice exerts beneficial effects and affects lipid metabolism in overweight patients with dyslipidemia.” [17]
In another recent PCOS hormone study conducted in June 2023, they found testosterone levels were lowered for women with PCOS. Researchers concluded, “Serum testosterone levels were significantly decreased in overweight and obese women with PCOS who supplemented with concentrated pomegranate.” [2]
I found this very interesting as a Women’s Health Doctor because most of the research done on Pomegranate is for men's cardiovascular health, and "AMS" Aging Male Symptoms such as male erectile dysfunction. Interestingly my male patients with low tesosterone seem to find the most benefit from the Testosterone boosting formula “Testosterzone” by Progressive Labs in Fullscript, comprised of mainly pomegranate, along with ashwagandha, astaxanthin, and phosphitdyl serine.
Researchers found pomegranate beneficial for testosterone in men as it was modulating androgen production in prostate cancer patients, and was also helpful against AMS or “Aging Male Symptoms" when combined with chocolate! So my patients should be buying their husband’s some chocolate covered pomegranate seeds for Valentine’s Day! [9]
Another hormone study with pomegranate looked at cortisol, thyroid, and blood sugar levels in patients with Type 2 Diabetes and concluded that pomegranate improved blood sugar, lowered the stress hormone, cortisol in both men and women, but did not impact thyroid levels. This is good news for my diabetic patients that have been told to never ever ever drink juice…the exception to the rule is pomegranate juice! [21]
Okay back to Women’s Health….
My experience using pomegranate to boost testosterone in men leads me to hypothesize that pomegranate does not always raise testosterone, nor does it lower testosterone, it is likely more of a hormone “modulator” to the male and female reproductive system as was concluded in the prostate study. So whether testosterone is too low or too high, eating pomegranates, taking a pomegranate supplement or drinking pomegranate juice will likely help even things out.
IS POMEGRANATE JUICE SAFE?
Pomegranate juice is the only time I allow my patients to have fruit juice! I am a big enough person to admit when I am wrong and there is a research study combined chokeberry, cranberry, and pomegranate juice versus placebo, and concluded:
"Beneficial effects on lipid metabolism by reduced energy intake, modulation of biomarkers such as Phosphodiesterase activity and improved DNA integrity associated with Pomegranate consumption.” [4]
So in layman’s terms that means that pomegranate is anti-aging, anti-inflammatory, improves immune function, cholesterol metabolism, relaxes arteries, helping to open them up and increase blood flow, which is the primary mechanism as to why it helps lower high blood pressure and has been touted as a treatment for male erectile dysfunction for years.
BUT... every rule was made to be broken? Right? ?
Pomegranate juice for Women’s Health and Hormones is pretty much the ONLY TIME you will ever see me prescribing juice to my patients. Pure blueberry, blackberry, and cranberry are also the exceptions. As I generally think we should be eating the whole fruit or whole pomegranate seeds to get the fiber along with the sugar.
But I know many of you love to drink juice or add it to your smoothies and recipes, so as long as it is a pure form of Pomegranate juice then it can be used. Only 4-8 oz of juice is needed to receive medicinal properties which is nice to know for hormone patients as it can be one of the most expensive juices out there, just as Saffron is the world’s most expensive spice!
But because Pomegranate is such a tremendous anti-inflammatory, hormone balancing agent I wanted to share some of the exciting Dermatology studies I stumbled upon. Women should not only drink pomegranate juice for their hormones, but also for glowing skin, perfect hormones, and decreased weight and inflammation.
POMEGRANATE FOR DERMATOLOGY: ANTI-AGING, DARK PIGMENTATION + COLLAGEN
In an eight week Dermatology research study on skin aging and pomegranate, researchers concluded that pomegranate, “improved the moisture, brightness, elasticity, and collagen density of the skin of most subjects,” and improved the “moisture, brightness, elasticity, spots, UV spots, and collagen density of skin.” [15]
So this is great news because when I tell my patients that something I need to have them take for their hormone imbalance is actually anti-aging and will plump their collagen, smooth their wrinkles, and help fight dark spots…they suddenly become a million times more compliant with following their treatment plan!
Also for my patients that frequently sunburn or have history of skin cancer, we can increase Pomegranate in their diet to add an extra layer of protection against UVB rays (of course in Arizona and most areas you will still need to use a nontoxic sunscreen, like the Alba 50 SPF spray is my favorite since it gives your skin an added shine, goes on clear, smells like coconuts and is coral reef safe.)
Women can safely use Pomegranate juice to help balance female hormones. Everyone knows I ban juice as a mom and am very anti juice because of the high fructose corn syrup. I believe children should be fed fruit and not fruit juice, as the juice is generally missing the fiber.
But pomegranate juice, blackberry juice, and blueberry juice are exceptions to that rule because they contain one of the most powerful antioxidants on the planet, “proanthocyanidins” that help reduce inflammation, reduce chronic pain, reduce blood pressure, protect the skin from UVB radiation, and are generally anti-aging.
So there is the vanity...er... Dermatology motivation to stay consistent with pomegranate as medicine! 😉
Pomegranate helps our skin, helps balance hormones for Hormonal Acne and other female hormone conditions such as PMS, PCOS, Perimenopause, Diabetes, Estrogen Dominance, and Menopause.
In Herbal Medicine, pomegranate is a key reproductive herb that aids hormone balance, detoxification, reduces inflammation which then reduces insulin resistance and estrogen dominance. Estrogen dominance is the enemy of women because it is the very hormone imbalance we experience every month with PMS or Premenstrual Syndrome.
So when I tell women in perimenopause that it is basically now "Permanent PMS," unless we use herbal medicine to reduce the estrogen dominance, speed up liver detox pathways to eliminate this estrogen, address constipation that also causes estrogen dominance, and add a light progesterone cream or pill in a Bioidentical Hormone or BHRT form....women will feel much better!
Estrogen Dominance causes women to feel bloated, angry, agitated, annoyed, depressed, anxious, can be responsible for panic attacks, headaches, migraines, fibroids, high blood pressure, blood clots, endometriosis, crying, and severe chronic fatigue when estrogen is elevated. PCOS is oftentimes the culprit of estrogen dominance.
Did you know women have three forms of estrogen? Estradiol, the one your doctor frequently tests for is not the only estrogen and can cause the hormone test to be erroneously wrong. This is the medical equivalent of mammogramming one breast to assume the other breast is just fine.
Estradiol, estrone, and Total Estrogen should be tracked for women with symptoms of hormone imbalance. If the amount of estradiol and estrone do not closely mimic the Total Estrogen, then this is a common sign the woman is suffering from excess of Xenoestrogens from beauty products.
This is where shampoos, makeup, creams, and lotions with pthalates and parabens can actually screw up hormones and help to cause hormonal acne, and other disease of estrogen dominance.
Pomegranate juice and seeds primarily work via potent antioxidants to reduce inflammation. Inflammation is shown in multiple research studies to increase estrogen dominance and is therefore the "Elephant in the Room," many times causing women to have PCOS, Insulin Resistance, Rheumatoid Arthritis, Autoimmunity, Perimenopause, and the infamous PMS.
We need to work on both cleaning up the diet, AND cleaning up beauty products. If the beauty product is allowed per European guidelines, that is one of the easiest ways to know that it is clean. Or if it is made with certified organic ingredients. You have to be careful though, because just one of the ingredients can be organic and above that seal it says "With Organic Lavender," and the lavender is the only organic ingredient.
POMEGRANATE FOR BLOOD PRESSURE, HEART + CARDIOVASCULAR HEALTH
The pomegranate, when transformed into juice, does some amazing things for the body, and in particular, the cardiovascular system.
First and foremost it has been shown to lower blood pressure, and inhibit the formation of plaque along artery walls (aka atherosclerosis). Not only has it been shown to inhibit new plaque formation, but it also can reverse the atherosclerosis that has already occurred!
This last result is pretty amazing. Patients drank pomegranate juice daily, and then a Doppler ultrasound of the carotid artery showed up to a 30% decrease in the thickness of the artery. Patients who did not take the pomegranate juice showed a 9% increase in the thickness of their carotid arteries. [27]
Pomegranate has also been shown to help diabetic patients lower their LDL and total cholesterol, while having no significant effect on their blood glucose levels. Yep, you read that right, a juice that does not significantly increase blood glucose levels, but actually works to improve them!
You can find the juice at most supermarkets and health food stores. However, make sure it is 100% pomegranate juice with no added sweeteners or other types of juice as they will only add calories and reduce the positive effects you have just been reading about!
My favorite is of course the Pomwonderful brand. I have been a fan of Pomwonderful ever since it came out many years ago when they mailed me a case of it and I started reading pomegranate research.
I love that the juice is 100% pure pomegranate with no added sweeteners. Some of my patients find the flavor a bit too tart so I recommend they mix it with half of the PomBlueberry juice, or add stevia and dilute it with water. To make my fun non-alcoholic "Happy Hour Pom Pom" just add 1-2 packets of stevia to your pomegranate juice and then top off with lime or plain club soda (not tonic water as that is poison for PCOS.) If you add the club soda first you can float the pomegranate juice on top for a pretty effect.
Pomegranate is delicious in your PCOS Smoothie Recipe, or I add a few splashes to each cup of herbal tea I drink to give it a pleasant flavor and fun color.
So please enjoy the only juice I allow women to drink as a hormone doctor! ?
If you need my help with hormone imbalance, PCOS, perimenopause, menopause, or other Women’s Health matters simply give us a call or visit my SCHEDULE page to treat yourself to a Naturopathic visit! I would be happy to help.
Dr. Nicole Sundene
(480) 837-0900
References
Dr. Nicole Sundene, NMD
"Are you a Natural Psychiatrist? How does my monthly cycle effect my mood? " ~Morgan Scottsdale, AZ
Psychiatry is one of my favorite topics in Women's Health, however I am not a psychiatrist. Many of my patients refer to me as their "Natural Psychiatrist" though because I am working with them as a team with their counselor on managing their hormones, supplements, vitamins, and herbs related to their mental health. So they don't exactly want to be on psychiatric meds or need them, but they need something to improve their mood more than just counseling weekly with their therapist (highly reccomended!)
My mental health patients are generally women that prefer to take natural medicines, and are not in such a severe state that they require psychiatric care. Although I do have many women in my practice that work with me, a psychiatrist, and a counselor due to debilitating mental health challenges.
Many women with hormone imbalance end up sad, angry, depressed, anxious, and/or blah feeling.
Hormones should never be ignored in women with mental health challenges such as anxiety, depression, ADHD, rage, and PTSD.
With Holistic Psychiatry, we are treating your mood disorder such as anxiety, depression, bipolar, rage, ADHD, addictions, PTSD, OCD, and even schizophrenia with natural medicines. We also are more importantly following a detective process that utilizes metrics such as hormone testing, and nutritional testing, to determine if there is a vitamin or mineral deficiency or a hormone imbalance. An easy indicator a woman’s moodiness is caused by hormone imbalance, is seeing fluctuations in the mood during the monthly cycle. You can test this yourself at no charge by downloading a free “Period Tracker App” and rating your mood every day for an entire cycle.
If the mood is not good the 7 days prior to your period or the first few days of your period then we can work together to change that with Naturopathic Medicine! Also if your mood has suddenly shifted in your thirties, forties or fifties then I can bet your hormones have shifted as well.
Fear not, there IS HOPE! Let me walk you through my process of helping women with their hormones, nutrition, and mental health. First, lets go over what happens in a women's monthly cycle and then in her forties and fifties.
When women are generally happy in the first half of their cycle days 1-14, with day 1 being the first day you start bleeding, and then struggle with anger, agitations, depression, anxiety, hopelessness, rage, crying, and sadness during the PMS window or days 21-28 then you need hormone testing as there is likely a hormone imbalance going on that can be addressed with Naturopathic Medicine.
Also if you have never experienced anxiety or depression until after having a baby or with your forties or fifties and your mood suddenly shifts, this is a sign you are experiencing hormone imbalance. Common hormone imbalances in the following conditions can be improved for mental health patients with natural hormones or herbs such as Postpartum Depression, Hypothyroidism, Perimenopause, Menopause, or even Hashimotos impacting your mood.
The #1 Sign that something physical is causing the mental health disorder is when nothing stressful or sad is actually going on yet the patient feels anxious or depressed. When women tell me “My life is great, I love my husband, my kids are great, I love my job...I just don’t know why I feel like this…” This is when I think there is a mental health mystery for me to solve!
As a Naturopathic Doctor and Female Hormone Specialist, I love helping patients with depression and anxiety. Especially since I have battled my own depression and anxiety for over 30 years, and it started in my teen years indicating a strong hormonal link. I was never depressed as a child. I had a very happy childhood and wonderful parents. But suddenly, in my teens my attitude rapidly changed, I was angry at my Mom all the time. I was grouchy, depressed, sad, cried a lot, and constantly had anxiety about everything.
I had social anxiety and a lot of perfectionism OCD like anxiety about my school work. I was an overachiever that would cry over an A- or a “Chinese F’ as they call it. My older sister got all C's and none of this pressure was pushed upon my by my parents to obsess about my grades. I had enrolled myself into all honor's classes and put this all upon myself.
First, my parents sent me to counseling to no avail, then I tried a lot of different antidepressant medications, I was even sent to a psychiatrist to try to medicate my mood. Many of the antidepressants they gave me just made my mood worse and caused me to gain weight or have an upset stomach, which made my mood even worse because now I was overweight and my stomach hurt!
HORMONE TESTING FOR WOMEN’S MENTAL HEALTH
Hormone testing is the most important thing we do for women with PMS like hormone imbalance. I like to conduct “Biphasic Labs'' which means we test your hormones while you are happy and feeling good during the first half of your cycle, and then, we test them in the PMS window days 21-25 when you are feeling at your worst, so we can capture the hormone imbalance. As I describe in my PMS blog, Jenny's husband called me panicking and wondering if the mental health issue with her stuck on the floor crying was her hormones. He said, "If this could be a hormone problem, sign her up now!"
So I took her on as a Women's Health emergency, and then emailed him a lab slip while saying, “Take her in NOW to get her hormones drawn.'' Of course, it was the last thing Jenny felt like doing while suffering from a migraine, depression, and anxiety but as a Female Hormone Specialist, I know how important it is to get the PMS labs drawn when the patients are at their worst for me to solve the hormone puzzle. The best thing about getting your labs checked when you are at your best mood is, we can set those aside in the event you need bioidentical hormones someday with menopause, and then I know exactly what numbers I need to have you at, to make you feel your "personal awesome!" For more information about hormone imbalance and the blood hormone testing I conduct via women’s insurance please visit my HORMONE THERAPY page.
The state of Arizona does not allow Naturopathic Doctors to order labs for Medicaid patients. But most decent insurance plans including Medicare, allow me to check your hormones per your insurance plan reimbursement. So long as you are at the correct lab which is either Labcorp or Sonora Quest. Be sure to call your insurance and find out which lab is contracted with your insurance, otherwise, the testing can be quite expensive! If you do not have insurance I have cash lab options, and the first panel should be around -$500 depending on what is going on, so please do not sign up to work with me if you cannot afford cash labs, or have Medicaid insurance. My ability to help you will be left with just guessing as what happens in prescription psychiatry, and that is my personal pet peeve, and not how I work, I like to rely on metrics and numbers to ensure each woman is in an optimal range for their hormones and vitamins. Any doctor can randomly slap you on different anti-depressants and anti-anxiety drugs and study if you are made better or worse by them. That is not what I do, nor in my alignment with my philosophy on what women with mental health disorders truly need to understand, heal, and restore their mental wellness.
Once I have perfected physical health a lot of mental health and insomnia issues naturally subside.
Vitamin and Mineral Testing for Mental Health
Testing nutritional metrics is extremely important as many vitamins and minerals are the very cofactors, and coenzymes that form the neurotransmitters such as serotonin, dopamine, norepinephrine, and epinephrine that impact our mood. Most of this can easily be done via blood testing through your insurance, although I will say Medicare is the worst at reimbursing for vitamin testing. Basically, the government does not care what your vitamin levels are and they may or may not pay for this part of the testing if you have medicare. If you have a secondary insurance it may be picked up by that, but you still will get the “contracted price” which is generally $20-$50 per vitamin we test, so they usually cover the hormones and then send the patient a bill for the vitamins. Just because I think it is necessary does not always mean the government is going to agree with me. The good news with mental health testing is you are making a one time investment in understanding what your personal weak spots are and once we know what those are the follow up lab testing is never as expensive, as the first panel when I am on a Detective Mission to figure out the ROOT CAUSE of your mental health issue.
Neurotransmitter Testing for Mental Health
Is neurotransmitter testing really necessary for mental health patients?
Yes and No.
This is why it is the 3rd step, I list in my simple 3 step process of addressing the physical causes that impact the mental health of patients with anxiety, depression, and mental health disorders. Because, oftentimes we can determine the cause of the mood disturbance via hormone testing and vitamin and mineral testing. This is the final step I resort to when the above testing is not helpful in revealing any physical causes of depression.
For a small handful of my patients, I will admit that neurotransmitter testing has been a futile waste of their time and money. But for the majority of my patients that do not improve from balancing hormones and nutrition, the neurotransmitter and adrenal testing can unearth some very important neurotransmitter deficiencies or excesses that we can balance with “Amino Acid Therapy.” By using amino acids targeted to boost specific neurotransmitters that are low we can improve mood via a different pathway that an antidepressant works.
For instance, low dopamine can be related to depression, low motivation, memory issues, ADHD, addiction, impulse control disorders, dementia and even schizophrenia. Physical symptoms of low dopamine include Pain muscle cramps and stiffness, tremors, trouble swallowing, back pain, balance problems, and constipation,
Symptoms of low serotonin include depression, crying, insomnia, carbohydrate cravings, weight gain, nausea, poor self-esteem, anxiety, and poor memory. When serotonin is low then an anti-depressant is often useless for the patient because the way the antidepressant works is to recycle serotonin so if there are “no pop cans in the recycling program” then there is nothing to recycle. The patient gets no benefit from the antidepressant and gets side effects like dry mouth, sweating, weight gain, poor libido, erectile dysfunction or stomach ache. Neurotransmitter testing is also great for patients that have no triggers for their anxiety or depression yet feel flat, blah, anxious, or stressed and don’t know why. If it isn’t a hormone imbalance like what we often find via insurance-paid labs then we need to look at a neurotransmitter profile. This can be done via simple saliva and urine testing.
So that is the simple 3 step system I used in my Mental Health Detective process to understand any physical causes that may be contributing to your depression, anxiety, and mental health disorders.
WHAT WOMEN ARE THE MOST SUCCESSFUL WITH HOLISTIC PSYCHIATRY?
If you think we would be a good fit working together, pop on over to my SCHEDULE page and book your new patient visit so we can get started helping you feel better immediately. You do not have to live in depression as I did for many years, you do not have to live with anxiety and panic attacks in terror like I did for many years, I am happy to help you with your anxiety or depression. The #1 most important mental health disorder I have learned hormone balancing helps is PTSD, so please share this information with your loved ones struggling with their mental health.
Let's go through this detective process together so we can determine what your individual weak spots are when it comes to your personal mental health so we can strengthen your mood from the inside out!
Dr. Nicole Sundene, NMD
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones, she presents to women the best-integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter, and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
By Dr. Nicole Sundene
"My hair is thinning. Is this from hormones? What vitamins should I take for hair loss?"
Nancy M, Scottsdale, AZ
Female hair loss is much different than male pattern balding. Rarely do I NOT find a hormone imbalance when my female patient's hair is falling out. While I will discuss which vitamins hair needs to grow today it is important we always address and Treat the Root Cause of hair loss. We cannot just gloss over it with some vitamins.
Ladies your hair is your "Fifth Vital Sign." Hair loss is the #1 Women's Health alert your body sends when something is seriously wrong! I actually cannot think of a single time in over fifteen years that a patient did not have a mild to moderate level of hormone imbalance with their hair loss.
While nutritional deficiencies such as B vitamins, biotin, zinc, pantothenic acid, iodine, selenium, iron, and so forth can cause hair loss it is often multifactorial and there is a number of different physical issues I find on blood chemistry causing my patients to lose their luscious hair. If you are in your 20's enjoy your amazing hair and try to use some of my tips for prevention!
Women often have a hormone imbalance and nutritional deficiencies causing hair loss especially with Postpartum changes, PCOS, Hashimotos, Hypothyroidism, Adrenal Fatigue, and Menopause.
First and foremost let's analyze hair loss from a somewhat bizarre-sounding Chinese Medicine standpoint.... Chinese Medicine considers hair the ”glory of the kidneys." What that crazy talk means is that your hair is an excess of your total well-being it is your glory. If your "glory" is burnt out or burnt up so then so shall your hair be from an energetic standpoint.
“Kidney chi” is our “energetic bank” in Chinese Medicine, and if our energetic bank is all dried up, then there is not much left over for such frivolities as hair! Think about it. The healthiest women in my practice that eat super healthy all naturally have long healthy hair. In Chinese Medicine when they are referring to the kidneys they actually are talking about the Adrenal Glands. Too much constant stress taps the Kidney Chi Bank and can contribute to female hair loss.
Second and most importantly, I would like to just say FLAXSEEDS, FLAXSEEDS, FLAXSEEDS! If you get nothing from this discussion with me as a Female Hormone Specialist and Naturopathic Doctor on hair loss and how to grow your hair faster, please add 1-3 tablespoons of freshly ground flaxseeds to your daily routine. You can do up to three tablespoons twice daily if you are a flax seed fanatic like me, It's basically a functional food full of omega-3's, proteins, and phytoestrogens that help balance imbalanced hormones. So unless you have a Food Sensitivity to them they are the PERFECT women's health food to stir in your oatmeal, add to applesauce, and mix in to your smoothies.
I am pretty sure on my death bed I will still be mumbling about the importance of flaxseeds.
On the advice of my vet, since fish oil gives my dog the runs, I now give my Golden Retriever freshly ground flaxseeds and in just a week his coat became shiny, less itchy, and the bare patches filled in (normally this time of year he pulls his hair out like a mad man from Seasonal Allergies.
Thirdly we want to have PROTEIN. Flaxseeds are a great source of omega 3 oils and protein, but I would also drink a protein smoothie a day; you can add your flaxseeds to a smoothie with collagen and protein powder. You need to be taking either collagen, bone broth, or hyaluronic acid also in somewhat high doses until your hair is growing in again. You can get organic high quality brands through your account with Fullscript.
Omega Up! If you are doing the flaxseeds hardcore, you are getting enough omega 3’s to ensure shiny strong hair, if not, then try a tablespoon of fish or flax oil daily (no cod liver oil for pregnant women because the vitamin A is a teratogen.) Flaxseed can be used as a salad dressing, go in your smoothies, oatmeal, or drizzle on roasted or steamed veggies.
Multivitamin: B-vitamins and iron are crucial to hair growth as nearly the whole B family plays a role in hair growth. While it is nice to pretend like you are getting all your nutrients from your food the reality is a simple multivitamin can prevent a lot of different women's health issues I see with anemia, depression, and hair loss being the top three. If you are menopausal and no longer bleeding you should not supplement with iron without having your Ferritin stores tested. Your Ferritin stores should be above 75 at minimum for female hair loss. while too much iron is toxic not enough is the #1 cause of female hair loss that I almost always find. So please check your iron levels!
Multimineral: A mineral-rich diet is important for healthy hair growth. Deficiencies in calcium and iron are very common unnecessary causes of women's hair loss!
Biotin: Your multivitamin may not contain that much biotin so check the label and see if you are getting the RDA. I usually recommend 10,000 mcg of biotin daily for hair loss patients. Be sure to stop taking your biotin 2 weeks prior to any thyroid or hormone testing as it can cause abnormal results.
Skip the Sodium Lauryl Sulfate! A known carcinogen and skin irritant, look for SLS-free shampoos.
Skip the daily shampooing! You can still rinse your hair every day and condition it, but daily shampooing is stripping your scalp of essential oils. If you have a dry scalp, seborrheic dermatitis, or dandruff this is especially important. This saves not just your hair, but your water and shampoo bill. See? You can afford that more expensive SLS free shampoo after all now….No excuses, organic isn’t really that much more expensive when you look at it as a whole because now you are washing your hair every 2-3 days and using less shampoo.
SLS= Poison for your scalp!
Don’t forget to get a bit trimmed off your ends every 12 weeks or so. If you are growing your hair out it is okay to skip a few hair cuts but try not to skip them completely.
Try some handstands! If you aren’t a gymnast, you can still hang your head off the edge of the bed to increase blood flow to the scalp periodically throughout the day, or you can do some extra downward dogs if you are a yoga fiend like me. We recently bought a Yoga Trapeze stand which makes inversion therapy fun and easy!
Rosemary and Mint! The invigorating herbs of the Laminacea family bring more circulation to your scalp as I just talked about in the above handstand blurb. Rosemary has been associated with improving hair growth for quite some time. It is also anti-aging and good for memory and ADHD.
Buy organic rosemary essential oil and add a few drops to your favorite shampoo and conditioner. Start with 1-2 drops and then work up to about 5-10 drops of the pure essential oil (remember never apply any essential oil straight to the skin unless it is lavender.)
Horsetails and Nettles: have long been touted as hair-growing herbs because of their high silica and mineral content; unfortunately, as our soil becomes more toxic, I don’t feel comfortable using them unless they are certified organic. The reason for this is that they suck up minerals like silica from the soil along with toxic heavy metals such as cadmium and arsenic. So when I make nettle and horsetail tea I use organic herbs. I generally buy my organic herbs from Mountain Rose Herbs and Starwest Botanicals as my trusted suppliers. Please do your research and be sure you are buying good organic products for your herbal medicines!
While I am happy to share my basic Naturopathic strategy for female hair loss, please ensure you are working with a skilled hormone doctor that knows how to test you to determine the cause of your hair loss. If we do not identify and treat the cause of female hair loss it will just continue to get worse. So ladies please pay attention to this important "5th Vital Sign" ...Your Hair!
Treat yourself to a Naturopathic visit with me if you need my help. Simply pop over to my SCHEDULE page. Most decent insurance plans cover the labs I would need to order for hair loss (not Medicaid but Medicare is fine.) So if you are dealing with this I would be happy to run some screening tests so we know what is going on with your hormones, vitamins, and nutrition. It is important not to ignore female hair loss, while usually, I find hormone imbalance, sometimes more severe diseases such as Autoimmunity are actually to blame. Therefore we should never ignore hair loss! While hair is important to many of us women for vanity reasons it is also a clear indicator of my patient's overall health and well being.
Thank you for the great women's health questions. Please continue to send them to me on a postcard to my address below. Remember if your Naturopathic question can't fit on a postcard then you need to BOOK A VISIT!
Dr. Nicole Sundene, NMD
(480) 837-0900
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology, Acne, Psoriasis, Eczema, and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 23 years of experience in both Prescription and Natural women's health and hormones, she presents to women the best-integrated health solutions for their Chronic Disease. She has been an Herbalist for over 28 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan (not Medicaid) and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!
