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
"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, NMD
Scottsdale Naturopathic Doctor
Anxiety anyone? Pretty much every patient I talk to lately is experiencing anxiety for one reason or another. Which is the inspiration behind my "ANTI-RAGE LATTE" recipe. So if you are feeling overwhelmed, stressed, drained, and hopeless please know that you are not alone. Life for many of us, has never been more stressful. So I am going to be writing a lot about anxiety, the adrenals glands, adrenal fatigue, and the importance of female hormone health with PMS, Perimenopause, "Hormone Rage," and Menopause until things can return to normal.
In the meantime, the Ruler of My Herbal Queendom shall be...Ashwagandha! While in Ayurvedic medicine they call it "King of All Herbs", in my women's health practice it of course shall be referred to as THE QUEEN OF HERBS! For many years my female patients have said things like "What is that ashwaghandadaddda thingy you put me on again? I need more of that immediately!"
One of my favorite anxiety disorder treatments for patients that are struggling from chronic fatigue and excess stress is Ashwagandha, formally known as Withania somnifera. With so many women feeling tired and stressed these days I am going to have to vote ashwagandha the #1 Best Herb to Help Women Cope! Which is why I put it in my "Invincible Mommy Tea." The best thing about Ashwagandha is it is gentle enough you can take it during the day while at work, it is tonifying so it helps restore you back to normal over time, and as I talk about in my "Anti-Rage Latte" Blog very much needed while everyone is extra angry, annoyed and agitated.
The root of this plant is best for those feeling very frazzled and in need of a nervous system reset. If you feel like you need to push the reboot button for your brain then this is the herb for you!
Ashwagandha is helpful especially for women that are extremely agitated. I love that it is also considered safe for women that are pregnant and breastfeeding (obviously check with your own OBgyn before starting any herbs.)
If you know someone that is annoying to be around you might want to sneak a 1/2 teaspoon in their coffee... (just kidding instead just anonymously email them this article, or print it, and leave it on their desk??)
In a 2017 Randomized Control Trial 300mg of Ashwagandha twice daily improved memory and cognition in just eight weeks. [1} Another study found it beneficial in suboptimal hypothyroidism. [2} A 2019 study found it decreased anxiety, decreased cortisol stress hormone, and increased testosterone levels in men with zero adverse side effects reported! [3] 2021 Randomized control trial found it improved sleep and was beneficial for insomnia patients! [4] 2019 research on schizophrenic patients administered 1000mg daily found it beneficial for improving their depression and anxiety. [5] In 2015 Ashwagandha was found to improve libido and lubrication in women. [6]
In 2015 ashwagandha was found to improve lean muscle mass at 300mg twice daily. [7] This is why we commonly prescribe this herbal medicine to weak patients with cachexia or muscle loss and wasting in cancer. When you are menopausal you lose your testosterone and muscle mass which causes your metabolism to slow down since the only thing really burning calories in your body is muscle! 2016 research found it beneficial to the reduction of OCD or obsessive-compulsive disorder symptoms. [8] 2021 research found it to enhance and improve cardiorespiratory performance in athletes. I have since been recommending it to my Long Hauler patients that need help getting their lungs and hearts back on track. [9] 2013 research found benefits with ashwagandha to bipolar patients. [10] A 2018 study found it helpful as an adjunctive treatment for Tuberculosis patients. [11] In 2019 it helped Covid-19 patients recover faster when used in conjunction with other herbal medicines so while we are sipping it for our mental health it should be considered as a potent antiviral for further research against Covid. [12]
Because the cinnamon in my "Anti-Rage Latte" Recipe is also antiviral I like to think that maybe we can treat our crappy moods and boost the immune system at the same time! Please let's get more research on Ashwagandha!
As I have been doing a lot of marriage counseling for my patients lately because they are simply spending too much time together, perhaps if men take ashwagandha to boost their testosterone and women take it to boost their libido and vaginal hydration we may have less fighting and more exercise at home!
Ashwagandha as an added bonus supports the immune system, is anti-inflammatory, anti-aging, and also helpful for those with impotence. It supports the woman that is feeling exhausted, deficient, and drained. If you are feeling somewhat like Scarlett O'hara's horse that is frothing at the mouth while she screams at it and beats it to keep going... then you probably should chat with your Naturopathic Doctor about starting some Ashwagandha or a similar adrenal adaptogen herb! As you need to work with an herbalist that knows what they are doing and some patients with Autoimmune disease such as myself do not feel good on certain immune-boosting herbs. Although I have thousands of autoimmune patients in my women's health practice and find this to be more of a myth as most adaptogen herbs are "Immune Modulating". This is why it is important to work with a Female Hormone Specialist such as myself if you have a chronic disease and are using herbs!
Otherwise, Ashwagandha is the REJUVENATOR that you need right now to pick your sad little stressed mess of life up and keep going if you have not been doing well. According to a 2011 Review article of Ashwagandha, it was found to be anti-tumor, protective to the adrenal glands, effective against tumors, fibroids, and neuro-regenerative for patients with Neuropathy, Parkinson's, Alzheimer's, Dementia, Huntington's, and children with ADHD and cognitive deficits. For children I divide their weight by an average adult weight of 150 pounds and that become their dose aka 1/2, 1/3 or 1/4 of a standard 500-1000mg adult dose twice daily is what I typically prescribe to my female hormone patients, as is also used in the majority of the above studies.
Ashwagandha was also found to help regenerate dendrites (the portion of the nerve cell that conducts electrical signals) which is amazing if you have neuropathy such as myself or a disease that causes nerve damage.
Studies show Ashwagandha improves energy, improves both Osteoarthritis and Rheumatoid arthritis, and is an anxiolytic that mimics GABA aka "Nature's Valium." This is why it is the leading herb in my "Anti-Rage Latte" recipe that you can watch me make on my Instagram page! Don't forget to follow me for my latest herbal recipes as I don't always have time to post the random herbal medicine videos I enjoy sharing on Instagram.
According to Naturopathic healing principles, women should notice the effects of their adrenal adaptogen herbs within three days, feel a restoration of their emotional and physical well-being after three weeks, and should no longer need to take the herb after three months. Hopefully once that three-month period is up, better coping mechanisms for stress management have been implemented! Such as breathing exercises, yoga, pilates, meditation, exercise, or my favorite is...crafting!
Are you beyond an "Anti-Rage Latte"? Is it time for you to start feeling your absolute best? Then treat yourself to a Naturopathic Hormone consultation with me by popping over to my SCHEDULE page so we can work together as a team to help you feel awesome! If you don't want to come into my clinic or are not in Arizona I am happy to help you by phone consult!
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:
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!
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!
By Dr. Nicole Sundene
Author of "The Hormonal Acne Diet"
Eczema was getting out of control for Ken, as his hands became painful as they began to crack and bleed from his serious eczema condition.
Overly conscious of the way his hands looked, Ken was embarrassed of the cracking and bleeding and began to avoid shaking hands with people. Eventually, Ken's fingers and hands became so painful, it was difficult for him to ride his motorcycle. It was so bad, at one point he could see he was actually losing the fingerprint on two of his fingers.
Ken finally went to a dermatologist who diagnosed him with Dyshidrotic Eczema and gave him some cream and oral steroids to help reduce inflammation.
But his hands never really got better. He began to worry he had a more serious issue, maybe MRSA because of the erosive nature of his eczema. He actually thought he had flesh eating bacteria.
The dermatologist was prescribing higher doses of steroid creams, but his issues didn’t get better. After 5 appointments for his skin and trying different remedies, there was only slight relief, the skin would not fully heal.
While his Dermatologist seemed happy with some of the progress, and mentioned “it could be worse.” Ken knew his hands were not all the way better. They still continued to feel really itchy and would still form blisters despite all the steroids.
He finally decided to try Naturopathic Medicine to treat the ROOT CAUSE of his skin problem. He felt that there had to be another solution.
Within a month of using my naturopathic approach, Ken’s eczema improved dramatically, and was almost gone! His hands were back to normal within 2 months.
Ken feels better than ever, and is happy in his skin again. The main thing I did for Ken was improve his nutrition. Eczema patients always have triggers we need to identify in their diets as well as hormone imbalance we need to test for to understand why the skin is so unhappy, as I discuss more in my "Hormones and Dermatology" blog. This is why women in perimenopause and menopause develop eczema later in life.
Need my help treating eczema? Simply visit my SCHEDULE page to treat yourself to a Holistic Dermatology visit. I would be happy to help!
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
Seborrheic Dermatitis, dandruff, itchy scalp, scalp eczema and psoriasis are so annoying they drive patients in droves to see me as a Naturopathic Doctor that specializes in Dermatology. This condition can become so severe it can even cause hair loss!
The good news is I have such a high success rate from treating these patients over the past fifteen years that we usually can get an itchy scalp problem better in just a few appointments. Often just one appointment is needed for my Seborrheic Dermatitis patients!
Nothing makes me happier than hitting a "Naturopathic Home Run," aka fixing a chronic annoying Dermatology problem in just one visit. Keep in mind that is generally the case with kids and teens, and that adults generally need multiple visits because their hormones are imbalanced and that is the #1 trigger for seborrheic Dermatitis.
Here is what my solution is to this frustrating skin condition:
WHAT IS SEBORRHEIC DERMATITIS?
An itchy dry, flaky scalp is typically “Seborrheic Dermatitis”commonly referred to as dandruff in adults and “cradle cap” in babies. Most standard anti-fungal shampoos, topical steroids, and topical treatments such as selenium sulfide and pyrithione zinc typically only provide temporary relief because they are not addressing the ROOT CAUSE of their Seborrheic Dermatitis. This requires me to put on my detective cap to figure out what is actually wrong and why the body is sending this negative itchy message that something is not quite right.
The fact that the body is out of balance must be addressed or the shampoo will simply not be enough. Although I do agree these shampoos are helpful for reducing symptoms while the actual cause is treated, they frankly are not the “be all end all”.
First of all seborrheic dermatitis is an inflammatory condition of the scalp that can manifest in the form of mild dandruff to dense, greasy scaling of the scalp. Mild cases of dandruff will typically resolve with the addition of fish oil, biotin and b-complex, zinc, and selenium, however more severe cases of seborrheic dermatitis will require further investigation.
The reason for this is that in babies the condition typically remits after 6-8 months, but in adults the Seborrheic Dermatitis is almost always chronic and will just tend to relapse and remit while it worsens over time. So let’s get this figured out now, shall we?
This condition is commonly correlated with a yeast, Pityrosporum ovale, but that yeast is predominantly everywhere right? It is not some random infectious disease like Ebola, it is simply a common thing in our environment, which gets me thinking…why doesn’t EVERYONE that is exposed to P. ovale have Seborrheic Dermatitis? The reason for that is that not everyone is pre-disposed to being susceptible to such a problem. There is a high familial correlation with this disease. Typically our diet, genetics, environment, lifestyle, and stress levels all contribute to causing Seborrheic Dermatitis, and an illness just chooses to show up on the body somewhere to show us that we are out of balance. Especially with dermatology it is as if your body is screaming at you to pay attention to what is wrong with it when the embarrassing dermatology condition shows up on the face or scalp. We can no longer ignore it and cover it up with clothes. Whether we choose to listen to the message or ignore the message while suppressing it with shampoos and topicals or what not is up to us, but rarely to patients find permanent relief from topical treatments from Seborrheic Dermatitis very similar to my long acne rant about how we need to treat the underlying ROOT CAUSE.
So what is out of balance? Most likely digestion and stress.
When I have worked with patients with very refractory cases of seborrheic dermatitis in the past they have all had food sensitivity components, especially to wheat, dairy, and citrus that needed to be addressed. For whatever reason imbalances in our gut always show up on the skin first. I always know my dermatology patient is going to have a great outcome when they understand the problem on their outside is actually caused by a problem on their INSIDE. My guess surrounding this is that people are naturally pretty vain and will easily ignore a stomachache, but not a skin problem. The body is very wise when sending messages. Also since 70% of our immune systems surround our gut in the form of “Gut Associated Lymphatic Tissue” or GALT, any inflammatory condition will improve by simply going on a trial hypoallergenic diet for several weeks and then testing for food sensitivity once the condition has cleared.
Be sure to start a whole foods diet whenever possible free of your individualized food sensitivities until the Seborrheic Dermatitis improves. Of added interest, this problem is predominantly male which suggests a male hormone component or imbalance. Most hormones are easily brought back in to balance by improving sleep and cleaning up diet and stress.
I would recommend for anyone with an itchy skin problem to read my article on eczema, as in my mind they are all basically the same thing and tend to resolve by using similar traditional nature cure means. All my friends that are Dermatologist friends hate me for saying that but I have worked in both conventional Dermatology for eight years for three Dermatologists and Naturpathic Dermatology for over fourteen years so with twenty two combined years of experience in Dermatology I feel I am entitled to my own opinion.
Of course Seborrheic Dermatitis in adults has been shown with good research to improve specifically from taking zinc daily (start with 15-20mg, but you can bump it up to 50mg daily, yet I would not do this long term as it will throw your other minerals out of balance), as well as selenium (150-200mcg), biotin (10mg), Folic acid (10mg), and B12 (1000mcg), but we really need to address the cause of the inflammation, or most people will have to be on these supplements long term. Please check with me or your own Naturopathic Doctor before starting any new vitamins, herbs or supplements.
For mothers of infants with cradle cap that are breastfeeding you can ensure that you are not deficient in these vitamins and minerals by taking a high quality prenatal vitamin at the full dose (don’t take mega doses of ANYTHING when you are breastfeeding unless prescribed by your Naturopathic Doctor!!!). But ultimately I would investigate food allergies, as a food you are eating is most likely upsetting the baby. Do add cultured foods like yogurt in to your diet to improve your digestion.
Topically a 5% Tea Tree oil shampoo has been shown to be effective against Seborrheic Dermatitis, but I would make my own conditioner instead and let it sit on the scalp. My rationale for this is that shampoos are really drying and the scalp is already dry and irritated. We want the medicine to sit on the scalp long enough to kill yeast in Seborrheic Dermatitis. I would prepare a topical solution using aloe vera gel or borage oil and tea tree oil. Add about 20 drops of tea tree oil to a ten ounce bottle of aloe vera gel. Shake that up and apply it to your scalp daily for 15 minutes to treat the Seborrheic Dermatitis. Depending on your sensitivity, you can add more tea tree oil than that, however it should NOT ever feel like it is burning. Never apply any essential oils directly to your skin without diluting them in aloe or a carrier oil first as they are caustic and will burn you. If you ever experience burning, rinse it off immediately. Topically aloe vera gel and borage oil have also been shown to be soothing for this condition. For babies you can simply rub their head with olive oil and then comb all the flakes out. Please do not treat your baby for Seborrheic Dermatitis without the help of a skilled herbalist or Naturopathic Doctor such as myself. If you need my help simply pop over to appointment SCHEDULE page and I would be delighted to help you!
Remember that if you discover you have food allergies it is not the end of the world, you simply eliminate the food for a period of time while the immune system forgets about it (typically three months for those blood cells to die and forget the food allergy or intolerance), take probiotics daily to reseed healthy gut flora, adopt better stress management coping techniques, and then rotate the foods that were causing the inflammation back in moderately.
As a final note on Seborrheic Dermatitis I would like to add that you should NOT ever take any new supplements without checking with your Naturopathic Doctor first (preferably me) and be sure that you have the correct diagnosis before attempting any home remedies or self treatments for dermatology issues. Heaven forbid my advice ever does more harm than good. Please read my long acne rant about how nothing you put on your skin ever really fixes your skin until we get to the underlying ROOT CAUSE of the Dermatology and Hormone symptoms of Seborrheic Dermatitis.
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, NMD
Scottsdale Naturopathic Pain Doctor
Chronic Pain: What is a Holistic Pain Specialist?
As a Naturopathic Doctor that has survived fifteen years of varying levels of severe pain from an Autoimmune disease causing Fibromyalgia and Neuropathy the first and most important thing I will do is BELIEVE you, and provide you with empathy and compassion. I have been to too many doctors that thought I was a whiner, a hypochondriac, or just a bored depressed woman that had nothing better to do with her time but go from doctor to doctor, specialist to specialist, and simply needed an antidepressant to cure all that was ailing me. Please watch my 30 minute free presentation, “Hormones, Metabolism & Pain” on my free class page for the full story.
Many chronic pain patients do improve from taking anti-depressants, simply because being in constant pain is depressing. As I tell the story of my own Fibromyalgia journey, I went from being an avid mountain biker that could mountain bike for eight hours a day and ride the STP- Seattle to Portland bike ride with my Dad to being completely bedridden. I lost connection with a lot of my friends because I was too sick to go to parties or social events. I was too tired to talk on the phone with anyone…and simply getting through a regular day of work or going to the grocery store was more exhausting to me than actually doing an actual Triathlon. As a former endurancd athlete, I was used to being in constant pain but it was “Good Pain.” My legs were weak and like Jell-O from riding my bike for 8 hours on the weekends. I loved that feeling.
But when I developed Fibro, my legs burned and felt weak when I had done nothing. I could barely climb the 8 steps out of my condo and walk to my car. Nobody knew what was wrong with me and I wasted many years of my life not getting the right treatments. Because we NEED to know what the diagnosis is in order to provide the chronic pain patient the correct treatment. When I was in Naturopathic school at Bastyr University, I learned a pain protocol for Fibromyalgia: Magnesium, Vitamin D, and Malic Acid. I literally graduated from Naturopathic school thinking this was what Fibro patients need and that is all we needed to do for them. Very sad right? And precisely why pain patients need to hire an expert such as myself that specializes in pain management.
In 2006 God gifted me with the Fibromyalgia label by a well-meaning doctor that tried to help me but simply did not know enough to order the correct tests, and my understanding of chronic pain shifted dramatically. As I graduated from school I was gifted this "Internship" by Life in Fibromyalgia and although I have felt very angry and frustrated with my body over the years.... Fibromyalgia has been my #1 Biggest Teacher. When the correct women in constant pain find my practice and finally feel heard and understood I get goose bumps and tears well up in my eyes because I realize that although Fibromyalgia was a brutal teacher... it taught me very well. Fibromyalgia has taught me many lessons that are important I share with my patients and the medical community so that we can shift how we perceive Fibromyalgia and we can stop failing all of our Fibromyalgia patients.
First of all, I tell my patients with Fibromyalgia to stop using the “F Word,” and I don’t mean the actual F word because I know people in pain often can ONLY say the F word, because they are hurting so badly that they really DO need to use that word. However, the F word I want them to stop using is Fibromyalgia. The reason for this is that as a Fibromyalgia Doctor with Fibromyalgia I believe with my whole heart that it is an utterly useless diagnosis that means nothing and allows your pain specialist or family doctor to continue to doctor you in a somewhat lazy way because it sounds like you finally have a diagnosis right? I remember calling my Mom in 2006 and saying in a state of shock, "They said I have Fibromyalgia!" And that is when my journey down the Fibromyalgia rabbit hole first began. That is why I hate and detest the word Fibromyalgia and that is why I encourage my patients to use more descriptive words like burning, stabbing, aching and so forth so that we are focused on the actual problem. Treating patients with Fibromyalgia is a lot like looking at snowflakes, while they may look similar from a distance there is quite a difference between the hundreds of Fibromyalgia patients in my practice. Should you be happy to be diagnosed with Fibromyalgia? Does this help you as a patient get the correct "Fibromyalgia" treatment or care? Fibromyalgia actually means something, doesn't it?
NO THAT IS 100% WRONG
Fibromyalgia means you have pain aka “myalgia” in your “Fibro” which is your joints and muscles. What good does this diagnosis do for you as a chronic pain patient? While I understand some patients are very attached to their Fibro label and I know thousands of Fibro Warriors between my Fibro practice and the online groups I participate in....personally as a Fibromyalgia Doctor I would encourage you to work to get your label undone. Personally, because I have a caregiver's heart and care about people, especially those also in pain, I want you to hate the word Fibromyalgia as much as I do as a chronic pain specialist for women. Mainly because the word Fibromyalgia tells me ZERO about what is actually wrong with you, and it provides the doctor ZERO help to provide you with the correct treatment plan.
I feel for some over-booked busy doctors and pain specialists, using the label Fibromyalgia allows them to take off their thinking caps and stop working to determine the ROOT CAUSE of your pain. My job as a chronic pain specialist is to ask the following questions like a detective, to look to find the actual cause of your chronic pain. Fibromyalgia is a description and not a diagnosis!
What is the cause of the patient's fibromyalgia or chronic pain?
When the adrenal glands burn out as I discuss in my Adrenal Gland Blogs: 1) “Adrenal Hormones: Are you Running from the Bear?” 2) “Adrenal Fatigue: Fight, Flight, and Fright?” When these adrenal glands become depleted, the patient feels exhausted, depressed, and has pain in their joints and lower back, with joints that are constantly cracking or popping. This is a picture of the adrenal fatigue patient. Constant stress and anxiety about a condition with no known cause and no known cure can cause adrenal fatigue and living with constant pain while people have unrealistic expectations because they may look completely healthy on the outside, as I do, yet are miserable and struggling with serious pain on the inside.
Your adrenals will likely need some treatment, which only exists in herbal medicine and naturopathic medicine, because other than prescribing a beta-blocker medication and telling you to take a vacation or do yoga, your MD has little to offer you for your adrenals, that are under constant stress from being in constant pain.
You can probably see there are already a bunch of tests that you likely have not been offered as a Fibromyalgia or Autoimmune patient. It is imperative you commit yourself to this process of working with me as a team so that we can unearth the cause or the causes of your pain. Often it is a combination of a few things on my list above. Seldom am I unable to help patients with their chronic pain. I may not be able to make it go away completely, but I can take the level of pain down once we target the correct herbs and nutrition to the correct chronic pain diagnosis.
Aside from listening and providing compassion, the second and more important thing we will do together as a team when you treat yourself to a Naturopathic pain consult with me, is to rely on lab metrics to determine the cause of your pain. Together we will order the proper labs to determine the cause of your pain. If you have decent insurance then your labs are covered per your insurance plan. There may be a few Naturopathic Specialty tests I will need to do for your pain, but I prefer to start with the testing that insurance will cover (Naturopathic Doctors cannot order labs in Arizona for patients on Medicaid or AHCCSS) but can order tests via most insurance plans such as Cigna, BCBS, Aetna, Ambetter, United Healthcare and so forth. Medicare labs are only covered if you go to Labcorp and some tests will simply not be paid for as the government could seriously care less about your vitamin levels although hormone testing for women is covered and patients with good secondary insurance generally receive a final bill under $100 for thousands of dollars worth of chronic pain testing. It is not realistic to expect 100% of anything to be covered by your insurance. But the initial Lab detective work is critical to the chronic pain patient's diagnosis and prognosis. Patients with Fibromyalgia that lack a diagnosis generally will have a worse prognosis because we are just throwing spaghetti noodles on the wall for your pain management plan and not targeting it towards an actual solid diagnosis. It is critical that you know what lab is contracted with your insurance plan for Fibromyalgia testing as it is the insurance’s preference of Labcorp vs Sonora quest that is more important than the ordering doctor.
More times than not, my fibromyalgia and autoimmune patients have not had the proper battery of tests that should be conducted. While hormone imbalance is not always the cause of chronic pain in my women’s health practice it is more commonly the problem, which is exactly why more women have fibromyalgia than men. Rarely if never do I receive adequate hormone testing or chronic pain testing done by a previous doctor. Many patients think they have had their hormones checked and I get one piece of paper with a TSH and progesterone level.
Often my new pain patient thinks they have been tested for autoimmune disease and just an ANA with reflex test was conducted with a CBC. I cannot help any pain patient that does not let me do my detective process properly and my #1 pet peeve is having someone's primary care doctor or another specialist that does not know what I know mess up my lab tests. Keep in mind I worked in regular Family Medicine for eight years and processed the lab letters for 20 doctors, so I already know what your Family Doctor is going to do for you, and since hormone testing is super complicated 9/10 times another doctor just screws it up and your valuable lab dollars are wasted and my hands are tied because the wrong doctor ordered the wrong tests and now we have to wait 6 weeks before your insurance will allow me to re-conduct the testing I need to help you. So please take your labslip directly down to the lab that is contracted with your insurance plan if we are working together so your time and money are not wasted.
Even if your pain is not caused by hormone imbalance, we will need to cross the hormone testing off your “Chronic Pain Bucket List.” As your holistic pain specialist, I will look at the big picture of your nutrition, stress, exercise, hormones, and blood tests.
My skills as a Female Hormone Specialist are extremely important to my chronic pain patients because oftentimes pain for women is related to hormone imbalance. If you notice fluctuations in your pain with your monthly cycle and get migraines or pain flares with PMS then there is likely a hormonal component to your pain. For women that have always been healthy and develop pain when they become menopausal, this is a very important reason to work with a holistic pain specialist. When estrogen levels decline inflammation goes up and that can cause women to have more pain in their hips, hands, and joints.
Too much estrogen such as in perimenopause, PCOS, and PMS can also cause joint pain and inflammation. So working with a doctor that understands optimal ranges for estrogen is extremely important. Estrogen is like water, and too much causes pain, inflammation, and weight gain, and too little causes joint pain, thyroid issues and inflammation.
The third most important thing I do for you as your integrated chronic pain specialist is prescribe medications, herbs and supplements to help you with your pain. I cannot do this properly and can only guess at what you need until we have gone through the process of testing your pain labs and hormones. There is no magical herb from the rainforest that will cure all of your fibromyalgia symptoms. If there was, I would be on it!
The treatments I provide as a naturopathic doctor will fail if we are not targeting the correct diagnosis.
I want to always treat the root cause, and while I am knowledgeable from working 8 years in conventional Family Medicine and know how to prescribe these meds, I am comfortable doing this for you. Prescribing pain meds is somewhat boring to me. Pretty much anyone can slap you on a bunch of vicodin, gabapentin, amitriptyline, gabapentin, Naproxen, and cyclobenzaprine and then quarterly test your liver and kidneys to ensure they do not fail.
If that is the route you prefer for your chronic pain then I am not the right doctor for you. I prefer to only prescribe pain medications for the purpose of tapering you down from them, which saves the pain patient from going to multiple specialists, as I personally know how exhausting that is. My goal is to taper you down from these meds that can be toxic to your liver and kidneys once your Naturopathic protocol begins to take effect.
As a chronic pain patient with Neuropathy, when I finally received that diagnosis, the supplements I used to treat the neuropathy were a huge game-changer for me. I was now targeting my treatment plan to heal and repair nerve damage, whereas before I was taking herbs and supplements for muscle pain. This is why it is critical to me that I know what the diagnosis is as a pain specialist otherwise I cannot get a good result for my patient and then I don’t get the “Joy of fixing you,” which is what puts a smile on my face every day as a doctor knowing that my patient is better and that the riddle of their Fibromyalgia has been solved.
Many chronic pain patients cry in my office because they realize quickly that my own horrific experience as an autoimmune patient has gifted me with a vast set of skills they could never find anywhere else prior to working with me. I am not trying to sound arrogant but unless you have lived severe pain you simply do not understand what it is like. I admit that I worked with autoimmune and fibro patients for eight years without fully understanding.
Due to my own medical mysteries causing my pain I have a lot of experience in specialties that are necessary to help chronic pain patients: Endocrinology, Pain Management, Gynecology, Urology, Family Medicine, and even Psychiatry. Because at one point I fell victim to a Psychiatrist actually convincing me that everything that was wrong with me was all in my head and I took five psychiatric meds that just made me and my chronic pain much much worse. So I know a lot about antidepressants and anti-anxiety medications as a result. I understand the anxiety and depression related to chronic pain too well and can easily help you with that.
Finally and maybe even the most important, what I can promise you as your holistic chronic pain specialist, is to oversee the big picture of your chronic pain treatment plan. This includes your referrals to Neurology, Rheumatology, or Infectious Disease, to make sure what we are doing for you is helping and not making you worse. Often my pain patients have bounced around from specialist to specialist and nobody is talking to each other. What I promise to do as your personal nerdy little detective, is to look at all your tests and make sure we have left no stone unturned.
This way, we have you at the RIGHT specialists and we are not wasting your precious energy on being a “Professional Patient.” Which I have wasted much of my time doing, and know exactly how emotionally exhausting these appointments can be. I understand how frustrating it is to keep telling your story to a new doctor over and over again, and what it feels like to be judged, criticized, and sadly I know also what it feels like to be yelled at by some MD’s.
WHICH PATIENTS ARE NOT GOOD CANDIDATES TO WORK WITH A HOLISTIC PAIN SPECIALIST?
I never want to enroll a patient into my practice that I cannot help. I don’t want to waste anyone’s time with fibromyalgia, chronic pain, or autoimmune that I cannot help. While I have a great success rate improving my patient’s chronic pain and my pain patients are constantly referring me new pain patients it is always important to me that the correct patient matches up with the correct doctor
Below are the patients I 100% CANNOT help as a holistic pain specialist. Please do not sign up to work with me if you match any of the following scenarios:
WHAT PATIENTS ARE THE MOST SUCCESSFUL WORKING WITH THE HOLISTIC PAIN SPECIALIST?
To learn more about my Naturopathic process treating pain, inflammation, and hormones you are invited to watch my free presentation, “Metabolism, Hormones & Pain” on my Free Class page. There is no charge to watch the presentation and the purpose of it is to educate you on the exact simple three-step Naturopathic Process I have used to help hundreds of women achieve relief from their chronic pain. If you already KNOW that I am the right doctor for you and that you are the PERFECT Naturopathic Patient then simply pop on over to my SCHEDULE page and treat yourself to a Naturopathic Consult immediately. We need to get to work on you before you have permanent damage to your body like I have. I found out my diagnosis ten years too late. I could have had answers sooner. I don't ever want anyone to suffer like I did when I just didn't have the right testing done. I was frustrated, my parents were frustrated and we simply lacked the proper blueprint to follow that could have saved me years of misery.
I am able to help you in my clinic and by telemedicine phone consultation. If you do not live in Arizona I can still help relieve your pain by doing the detective process work of diagnosing your pain, I simply cannot prescribe medications for you if you live out of state. Many Family Doctors and Pain Doctors are happy to work with me remotely in the event you need hormones or medications so if you do not live in the Phoenix area but have a supportive doctor that is open to Naturopathy we can still work together to help you feel better with your Chronic Pain, Fibromyalgia or Autoimmune Disease. Did you know I have patients in ALL 50 states? A lot of what I do is easy to help you with via telemedicine!
I look forward to helping you get back on track and feeling awesome again!
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!
