Dr. Nicole Sundene

Female Hormone Specialist

Why is cinnamon one of my favorite herbs as a Naturopathic Hormone Doctor you ask? Cinnamon is not only super effective, but most women find it a delicious herb to incorporate in their daily diet. Today I will go over the latest women’s health research on cinnamon, and how to use cinnamon as a tea and in foods. 

The most important condition I think of using cinnamon for is PCOS. As cinnamon is one of the most helpful herbs for PCOS, especially when it is the insulin resistant or “metabolic type” as I discuss on my PCOS blog. 

Exciting new research shows diabetes and peripheral neuropathy pain improve with cinnamon! Cinnamon actually helps regenerate nerve damage [11].

CINNAMON’S LATEST RESEARCH: 

Cinnamon research demonstrates benefit in Type 2 Diabetes, PCOS, Migraines, Cramps, improved nerve damage in Peripheral Neuropathy, and improved pain [1-11]. Cinnamon aromatherapy actually helped newborns in the ICU go home an average of 3-4 days sooner [12]. 

Diabetes: Researchers found that only 500mg of daily cinnamon was needed to improve Type 1 Diabetes [1, 7]. This is fantastic because I have most of my diabetics taking 2 x 500mg capsules of cinnamon twice daily with meals and see this dose helping lower the need for Metformin. Some can’t handle taking that much as I discuss in the contraindication section further, so it is amazing to know that even one capsule daily provides benefits!

Most capsules of herbal medicine are 500mg. Most of the research studies cited here were done with 500mg capsules. Make sure you check the product you are using so you know the dose and then always stick with the same brand to avoid dose variations especially for those with diabetes and high blood pressure relying on cinnamon as medicine. You don't want to unwittingly increase or decrease your dose of cinnamon. Check out my Diabetes Diet for more tips. 

I immediately prescribe 1000mg of cinnamon twice daily with meals to all of my diabetic patients and ask them to take as much as they can tolerate with food. Cinnamon is nature’s metformin and it works beautifully to support the pancreas and help stabilize blood sugar. With stable blood sugar my diabetics can mentally make healthier choices and have less episodes of low blood sugar causing them to crave carbs and fall off their diet. 

PCOS: Three x 500mg capsules of cinnamon daily were beneficial for both PCOS and Insulin Resistance [2]. In another study, 1500mg of cinnamon not only improved PCOS symptoms but also lowered insulin and cholesterol [17].

An herbal formula containing 1) Cinnamon 2) Licorice 3) Flaxseed 4) Vitex was found beneficial for improving menstrual flow in PCOS patients better than metformin [10].

Migraines: Cinnamon is commonly used to treat pain. Researchers studied fifty patients with migraine headaches given cinnamon, and found cinnamon to be beneficial for migraines [3].

Cramps: Hooray! Researchers found that “cinnamon can reduce the intensity of primary dysmenorrhea” or painful cramps. Cinnamon was given at onset of cycle for 72 hours for 2 cycles and found helpful [5].

Peripheral Neuropathy Pain: Cinnamon improved nerve damage in peripheral nerves [11]. Research demonstrated that cinnamon positively affects peripheral nerve restoration! Another study demonstrated it's ability to heal the sciatic nerve after crush injury [16]. This is amazing news for those with peripheral neuropathy from diabetes, long covid, or other causes. Unlike the central nervous system, the peripheral nervous system can actually heal and repair when we add herbal medicine and remove the “Obstacles to Cure” and address the “Root Cause."

Thrush: Cinnamon was found beneficial as a treatment against thrush and yeast species [4].

Nasal Spray: I fear to discuss this cinnamon nasal spray research and pray children on social media will not change the “Cinnamon Challenge” from eating cinnamon to snorting cinnamon! But,  since the research found cinnamon beneficial I will share that intranasal cinnamon solution improved seasonal allergies [6].  Keep in mind this was a nasal solution of cinnamon and nobody was snorting straight cinnamon!

Because cinnamon is anti-inflammatory, antiviral, and antifungal I would be excited to see a commercially available cinnamon nasal spray to help prevent and treat chronic sinusitis. Especially for allergy sufferers as oftentimes seasonal allergies inflame the tissues and thus increase risk of infection. 

Bladder Pain: Cinnamon applied over the bladder as a patch was found beneficial for reducing bladder pain in those with "Overactive Bladder" [13].

Lip Plumper: Cinnamon when combined with menthol and capsaicin was found to be a safe and effective lip plumper [14].

Mouth Ulcers: Cinnamon was an effective topical agent for mouth ulcers or apthous stomatitis [15].

Cinnamon Safety Research: Cinnamon was found to be extremely safe by researchers that concluded they found no significant side effects or toxicity with cinnamon including “hepatoxoxicity or anti-coagulation properties” [8] Meaning cinnamon is non-toxic, and does not actually interfere with blood thinning medications.  Cinnamon was also found not to cause electrical changes to the heart via ECG [17].

Researchers also concluded no side effects for cinnamon at doses that also “demonstrated anti-hyperlipidemic and blood pressure lowering effects among healthy adults” [9] 

So cinnamon is generally safe and non-toxic at therapeutic doses, while working to lower both cholesterol and blood pressure. Considering how effective cinnamon is for diabetes it should be considered as a first line treatment doctors can trust when treating diabetes, cramps, high cholesterol, seasonal allergies, thrush, and peripheral neuropathy. Especially in a mild range where diet and exercise may be sufficient to control the pre-diabetes or diabetes. 

I have personally reversed many diabetics A1c levels with cinnamon from 6.5-7% into the normal or just prediabetic range with cinnamon, carb counting, and exercise! 

CINNAMON CONTRAINDICATIONS: 

The most dangerous thing about using cinnamon as an herbal medicine is when patients buy grocery store garbage cinnamon. This is generally not real cinnamon just like how most vanilla extract is synthetic chemicals and not actual vanilla… which is why real vanilla is more expensive as is real cinnamon. To counteract this simply buy real cinnamon as I buy from either Mountain Rose Herbs or Starwest botanicals, or at the very least buy organic cinnamon at the grocery store from a reputable brand. 

Otherwise the worst side effects I generally see with cinnamon are nausea from its tannins. Tannins stop up the intestines. This is why cinnamon is a helpful antiviral herb against diarrhea and stomach flu symptoms. 

When implementing therapeutic levels many of my PCOS and Insulin Resistant patients become nauseated from the tannins. This tends to be alleviated by cutting the dose in half and slightly increasing carbs in the diet until the stomach has adapted to the treatment plan after a few weeks. Your stomach can get adjusted to the tannins, I promise. Rarely is it a long term side effect.

Suddenly dropping carbs and/or adding in high amounts of blood sugar herbs will cause side effects. These drastic sudden changes to blood sugar can cause nausea, vomiting, dizziness, and fatigue and thus it is best to implement the dose gradually. 

Patients on medicines for heart disease, diabetes, and high blood pressure should work with their Naturopathic Doctor to determine if cinnamon is a good choice. Often the interaction effect with cinnamon is improving these conditions as it provides a synergistic benefit, and therefore medications need to be monitored with labs and vitals and adjusted down over time as the herb begins to help.  

Do not use cinnamon at therapeutic levels if you are already overheated, having hot flashes or night sweats as it is a heating herb and it may make you feel warmer. As one of my diabetics on 2 capsules of cinnamon three times a day once described, “I can stand out in the snow with just shorts and a tank top on and feel warm. This much cinnamon gives me superhero powers against cold!”

While some women appreciate the gentle warming effect, and not all of my overheated patients are made worse by cinnamon, not every herb is the best fit for every woman as we have unique hormone patterns and constitutions like snowflakes. 

HOW TO USE CINNAMON IN RECIPES: 

Cinnamon pairs really well with berries, bananas, oats, apples, peaches, and chocolate for those that prefer to use it as “food as medicine.”

Cinnamon can be made as an herbal tea, added to smoothies, added to high fiber oat muffins, sprinkled over smoothie bowls, stirred into melted dark chocolate with stevia and walnuts for a lower carb therapeutic treat, or stirred into ¼ cup of applesauce. 

When using cinnamon therapeutically the typical dose is around 1 tsp of real organic cinnamon twice daily with meals. I recommend starting with ½ tsp and working up to that.  Do not take cinnamon on an empty stomach as it will cause vomiting from its blood sugar lowering properties and tannins effects on the stomach. This herb must be taken with food especially at high doses. 

Check out my Gingerberry Blaster, Elderberry Syrup, and Apple Bottomed Smoothie recipes to learn more ideas about how I like to use cinnamon in my daily diet. 

Need my help with your Women’s Health or hormone condition? Simply visit my SCHEDULE page to treat yourself to a Naturopathic visit. I would be happy to help.

Dr. Nicole Sundene

(480) 837-0900

Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause,  Thyroid,  Hashimotos,  PMS, PerimenopauseAutoimmunePostpartumChronic Fatigue, DepressionAnxiety, Food Allergies,  DigestionDermatology, AcnePsoriasis 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 InstagramTwitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!

References:

  1. Zare R, Nadjarzadeh A, Zarshenas MM, Shams M, Heydari M. Efficacy of cinnamon in patients with type II diabetes mellitus: A randomized controlled clinical trial. Clin Nutr. 2019 Apr;38(2):549-556. doi: 10.1016/j.clnu.2018.03.003. Epub 2018 Mar 11. PMID: 29605574.
  2. Borzoei A, Rafraf M, Asghari-Jafarabadi M. Cinnamon improves metabolic factors without detectable effects on adiponectin in women with polycystic ovary syndrome. Asia Pac J Clin Nutr. 2018;27(3):556-563. doi: 10.6133/apjcn.062017.13. PMID: 29737802.
  3. Zareie A, Sahebkar A, Khorvash F, Bagherniya M, Hasanzadeh A, Askari G. Effect of cinnamon on migraine attacks and inflammatory markers: A randomized double-blind placebo-controlled trial. Phytother Res. 2020 Nov;34(11):2945-2952. doi: 10.1002/ptr.6721. Epub 2020 Jul 7. PMID: 32638445.
  4. de Araújo MRC, Maciel PP, Castellano LRC, Bonan PRF, Alves DDN, de Medeiros ACD, de Castro RD. Efficacy of essential oil of cinnamon for the treatment of oral candidiasis: A randomized trial. Spec Care Dentist. 2021 May;41(3):349-357. doi: 10.1111/scd.12570. Epub 2021 Jan 21. PMID: 33475184.
  5. Jahangirifar M, Taebi M, Dolatian M. The effect of Cinnamon on primary dysmenorrhea: A randomized, double-blind clinical trial. Complement Ther Clin Pract. 2018 Nov;33:56-60. doi: 10.1016/j.ctcp.2018.08.001. Epub 2018 Aug 15. PMID: 30396627.
  6. Steels E, Steels E, Deshpande P, Thakurdesai P, Dighe S, Collet T. A randomized, double-blind placebo-controlled study of intranasal standardized cinnamon bark extract for seasonal allergic rhinitis. Complement Ther Med. 2019 Dec;47:102198. doi: 10.1016/j.ctim.2019.102198. Epub 2019 Sep 24. PMID: 31780001.
  7. Lira Neto JCG, Damasceno MMC, Ciol MA, de Freitas RWJF, de Araújo MFM, Teixeira CRS, Carvalho GCN, Lisboa KWSC, Marques RLL, Alencar AMPG, Zanetti ML. Efficacy of Cinnamon as an Adjuvant in Reducing the Glycemic Biomarkers of Type 2 Diabetes Mellitus: A Three-Month, Randomized, Triple-Blind, Placebo-Controlled Clinical Trial. J Am Nutr Assoc. 2022 Mar-Apr;41(3):266-274. doi: 10.1080/07315724.2021.1878967. Epub 2021 Feb 19. PMID: 33605836.
  8. Ranasinghe P, Jayawardena R, Pigera S, Wathurapatha WS, Weeratunga HD, Premakumara GAS, Katulanda P, Constantine GR, Galappaththy P. Evaluation of pharmacodynamic properties and safety of Cinnamomum zeylanicum (Ceylon cinnamon) in healthy adults: a phase I clinical trial. BMC Complement Altern Med. 2017 Dec 28;17(1):550. doi: 10.1186/s12906-017-2067-7. PMID: 29282046; PMCID: PMC5745724.
  9. Ranasinghe P, Jayawardena R, Pigera S, Wathurapatha WS, Weeratunga HD, Premakumara GAS, Katulanda P, Constantine GR, Galappaththy P. Evaluation of pharmacodynamic properties and safety of Cinnamomum zeylanicum (Ceylon cinnamon) in healthy adults: a phase I clinical trial. BMC Complement Altern Med. 2017 Dec 28;17(1):550. doi: 10.1186/s12906-017-2067-7. PMID: 29282046; PMCID: PMC5745724.
  10. Hameed L, Farooq AD, Qureshi T. Analysis of Unani coded formulation on the hormonal parameters of patients with polycystic ovarian syndrome. Pak J Pharm Sci. 2021 May;34(3):899-907. PMID: 34602412.
  11. The current research demonstrated that Cin positively affects peripheral nerve restoration. Therefore, Cin therapy could be considered as a potential treatment method for peripheral nerve regeneration and its functional recovery. 
  12. Cao Van H, Guinand N, Damis E, Mansbach AL, Poncet A, Hummel T, Landis BN. Olfactory stimulation may promote oral feeding in immature newborn: a randomized controlled trial. Eur Arch Otorhinolaryngol. 2018 Jan;275(1):125-129. doi: 10.1007/s00405-017-4796-0. Epub 2017 Nov 8. PMID: 29119319.
  13. Chen LL, Shen YC, Ke CC, Imtiyaz Z, Chen HI, Chang CH, Lee MH. Efficacy of cinnamon patch treatment for alleviating symptoms of overactive bladder: A double-blind, randomized, placebo-controlled trial. Phytomedicine. 2021 Jan;80:153380. doi: 10.1016/j.phymed.2020.153380. Epub 2020 Oct 12. PMID: 33091856.
  14. Boen M, Alhaddad M, Guiha I, Wu DP, Goldman MP. A Single Site, Open Label Clinical Trial, Evaluating the Duration, Efficacy, and Safety of a Novel Lip Plumper. J Drugs Dermatol. 2018 Sep 1;17(9):999-1004. PMID: 30235388.
  15. Molania T, Malekzadeh Shafaroudi A, Saeedi M, Moosazadeh M, Valipour F, Rostamkalaei SS, Salehabadi N, Salehi M. Evaluation of cinnamaldehyde mucoadhesive patches on minor recurrent aphthous stomatitis: a randomized, double-blind, placebo-controlled clinical trial. BMC Oral Health. 2022 Jun 14;22(1):235. doi: 10.1186/s12903-022-02248-5. PMID: 35701773; PMCID: PMC9199160.
  16. Jahromi Z, Mohammadghasemi F, Moharrami Kasmaie F, Zaminy A. Cinnamaldehyde Enhanced Functional Recovery after Sciatic Nerve Crush Injury in Rats. Cells Tissues Organs. 2020;209(1):43-53. doi: 10.1159/000507016. Epub 2020 May 11. PMID: 32392570.
  17. Pender DN, Crawford PF, Clark JM, Crawford AJ, Prats AA, Shah SA. Effect of water-soluble cinnamon extract on electrocardiographic parameters: An analysis of the CiNNaMON trial. Complement Ther Med. 2018 Dec;41:302-305. doi: 10.1016/j.ctim.2018.10.009. Epub 2018 Oct 21. PMID: 30477858.
  18. Hajimonfarednejad M, Nimrouzi M, Heydari M, Zarshenas MM, Raee MJ, Jahromi BN. Insulin resistance improvement by cinnamon powder in polycystic ovary syndrome: A randomized double-blind placebo controlled clinical trial. Phytother Res. 2018 Feb;32(2):276-283. doi: 10.1002/ptr.5970. Epub 2017 Dec 18. PMID: 29250843.

Dr. Nicole Sundene

Scottsdale Naturopathic Doctor

Did you know the best health habits bloom one at a time just like the Barrel cactus? 

While the Barrel cactus normally has a gorgeous crown of flowers…that crown did not arrive overnight!

Instead each flower in my picture actually bloomed one flower at a time over several months from April to May.

This beautiful crown reminds me of my most successful Naturopathic hormone patients.  Women that are the most successful reaching their goals are working on small goals one at a time to improve, and not expecting to do it all at once. 

They understand many pieces of the picture need to be addressed and they work through perfecting simple steps one at a time.

Many New Year’s Resolutions fail because women become too overwhelmed to be successful. Most women lack the energy, time, direction, organization, and focus to make it all happen at once. 

That's when I see women totally give up!

Expecting yourself to do everything perfectly all at once is just as unrealistic as expecting this Barrel cactus to suddenly pop out its majestic crown overnight. Building long term healthy habits takes patience and fortitude. 

Think of each bloom as one single habit. What will you look like after working on one habit at a time such as exercise, proper hydration, eating vegetables, increasing lean protein, getting 10,000 steps in per day, getting outside for natural light, eliminating sugar, quitting smoking, decreasing alcohol, meditating, yoga, and eating clean?

What if we stopped these annual New Year’s Resolutions and instead focused  on Monthly Resolutions? Wouldn’t that feel so much less overwhelming and easy to accomplish?

They say it takes 28 days to make or break a habit.  

Each month of the year lets work on a new self improvement!

When my patients see and feel success from their efforts they are all the more excited to tackle the next goal. Building that self efficacy and knowing you receive great benefits from investing time and effort into your body will motivate you to achieve more and more.

After fifteen years of helping women feel and look their best, I have learned that women are much happier once they are fit and eating clean because they feel confident in their own skin. They are happy with their weight, their complexion is glowing, and their friends and family are shocked by their “sudden transformation.” Something I know isn’t magic because I watched it happen gradually over several months as their Naturopathic Doctor.

But for the friend that has not seen them in a while it appears to be as magical as the beautiful bright flower crown from the Barrel cactus.

Most people succeed by focusing on one small goal at a time. 

“Inch by inch is a cinch. Yard by yard is hard.”

Instead of making one big giant overwhelming resolution this year and giving up by Valentine’s Day, think about setting twelve mini health goals this year and work through them in steps! Go grab a pen and write them on your calendar now.

Stay committed to the process to succeed!

Need help deciding what to work on first? Visit my SCHEDULE page to treat yourself to a Naturopathic visit! I would be happy to help.

Wishing you the best health, happiness, and energy for 2023!

Dr. Nicole Sundene

(480) 837-0900

Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause,  Thyroid,  Hashimotos,  PMS, PerimenopauseAutoimmunePostpartumChronic Fatigue, DepressionAnxiety, Food Allergies,  DigestionDermatology, AcnePsoriasis 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 InstagramTwitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!

Dr. Nicole Sundene, NMD

Female Hormone Specialist

Weight loss programs that fail to address female hormones in women often fail women!

Oftentimes in Women's Health the "Root Cause" of weight gain is hormone imbalance. We need to first diagnose and treat the hormone imbalance as well as implement my basic Naturopathic hormone balancing weight loss program that is 100% free for women to start below.

One thing that always brings me joy as a Naturopathic Hormone Doctor is helping women identify the specific weaknesses in their hormones and metabolism so we can target the exact nutrition program, macros, and hormone balancing supplements to aid weight loss.

Getting to see women transform to their fittest most beautiful version of themselves is such an amazing reward for doing this job! I often receive new patient referrals from my weight loss success stories as their friends and family have always seen them challenged by being overweight and suddenly like magic change right before their eyes.

The truth though is that it is not magic... it is hormone balancing with a splash of hard work.

When we don't understand women's complex female hormones, thyroid, and adrenal profile, expecting weight loss to happen is somewhat like vacuuming in the dark. While vacuuming in the dark will be somewhat helpful, we are missing things, it is inefficient, time consuming, lacks results, and is frustrating. Vacuuming just like hormone balancing becomes a lot easier when we "flip the lights on" and know exactly the obstacles we are dealing with as well as the areas of greatest concern!

By running a full panel of Naturopathic Hormone Labs women can target their nutrition to their own metabolism and understand exactly what ratio of fats, protein, and carbs will works the best for their specific constitution.

This is when I see "the lights come on" for my hormone weight loss patients and everything becomes much easier and efficient. Hacking macros and hormones with labs makes everything so much easier and my women are no longer "bumbling around in the dark" lacking a clear direction of how to best target their efforts.

Bumbling around in the dark is oftentimes why women fail with their weight loss program because they are busy trying different fad diets, and not gathering the specific information that helps optimize their personal metabolic challenges.

Naturopathy can work very well for weight loss when we can take the time to analyze nutrition, metabolism, hormones, and vitamins that can impact weight.

Female hormones are complex and precisely why weight loss for women can be very tricky when complex hormone imbalance is present. To further confuse matters, women experience hormone imbalance and constantly fluctuating hormones every month with PMS. As well as in their forties and fifties with perimenopause and menopause. Therefore it is important we rule out hormonal causes of weight gain with women first and foremost as this is impacting women monthly, and also in midlife when perimenopausal weight gain begins around forty.

When women cannot lose weight with diet and exercise I recommend we conduct hormone and macronutrient testing to determine the correct macro profile of carbs, fats, protein, and fiber needed. Looking at a full set of female hormones, thyroid, and adrenal tests can diagnose the particular hormone imbalance or imbalances impeding the metabolism.

As a thyroid specialist, I often see thyroid disease causing weight gain, and weight loss, but in women we MUST address all of the other hormones in the "hormone spider web" for a woman to feel properly balanced, healthy, and fit.

If we have a weakness in one part of the web it will impact the stability of the rest of the web.

The impact of estrogen deficiency that suddenly occurs in Menopause, can impact the rest of the hormone web and cause weakness in the thyroid, which is why it is imperative for women to have their thyroids checked when they are perimenopausal and menopausal in their forties and fifties. Some women will naturally start perimenopause earlier in their thirties.

The average age of menopause is 51, and perimenopause generally starts the ten years prior to menopause. Women that enter menopause at 45 will generally exhibit signs of hormone imbalance earlier, in their thirties. Premature Ovarian Failure occurs when women become menopausal sooner than age forty. POF is common in women with anorexia and low body fat as body fat levels directly increase estrogen levels whether too much body fat or not enough.

Menopause can also impact the adrenal glands in our spider web model. When the ovaries cease to produce estrogen, progesterone and testosterone, the adrenal glands become the sole source of hormone production. The hormones DHEA, and cortisol can begin to become deficient in menopause or sooner if there is "Chronic Stress."

Symptoms of adrenal fatigue can cause insomnia, joint pain, stiffness, moodiness, anxiety, depression, and a general blah unmotivated feeling where my patient has become flat and lost their zest for life.

The adrenals and the thyroid also interact with each other and when the adrenals become fatigued and cease to produce hormones that can impact the thyroid gland and tax it further. And vice versa. This is what is going on behind the scenes with many of my weight gain patient's labs.

It is not just always about the Thyroid! We must address our entire "Metabolic Web of Hormones" as I explain in my video about "Hormones and Metabolism" on my free class page.

Hypothyroidism, Hashimoto's, Insulin Resistance, and Adrenal Fatigue can also cause women to gain weight.

Testosterone deficiency occurs for most women around the age of 35, this is why our metabolisms slow down when we lose our lean muscle mass with menopause. Each year our metabolism goes down further as we lose our female hormones. Transitioning through perimenopause and menopause also causes the body to become more inflamed and Insulin Resistant. Insulin is the "Weight Gain Hormone," that causes women to gain weight despite following the same diet and exercise regime in their 20's.

"I am doing everything the same, I am not cheating." I commonly hear women complain as they continue to gain weight and cannot figure out why. Most women that are over-weight have insulin resistance and need supplements to address and correct this blood sugar disorder that is common in women with PCOS.

Sluggish liver can also impact the metabolism, as can inflammation from Food Sensitivities and Food Allergies.

Chronic Fatigue and Chronic Pain can cause women to exercise less resulting in less calories burned on the same diet.

The good news is that by addressing female hormone imbalance, and implementing the following Naturopathic weight loss program I will review today, I do see many cases of stubborn hormonal weight gain finally release!

Usually I treat the hormone imbalance with herbs and supplements. Herbal medicine takes time to work, most women only can lose one pound per week and need to be patient. If you have fifty pounds to lose as a woman, that is a year of hard work you need to mentally commit to doing for long term success to keep the weight off.

With menopause, generally Bioidentical Hormones are needed to reduce the inflammation spike causing weight gain. Women under fifty generally do not need hormones and instead have weight gain issues from excessive amounts of hormones as I discuss more in my "Estrogen Dominance" blog. Much of what I do for women and weight loss does involve making dietary changes and taking supplements.

In order to lose weight, one must follow the basic laws of physiology that you must consume fewer calories than you burn each day. This is especially important to follow if you have a thyroid condition, insulin resistance, or estrogen dominance! Expecting your twenty year old metabolism to burn a ton of calories is not realistic without first fine tuning your hormones and then creating a calorie deficit every day.

You must burn more calories from exercise than you consume. If you are inactive and not exercising this is why it is impossible to lose weight especially when lack of exercise is compounded by hormone imbalance.

Addressing the underlying causes behind poor eating and lifestyle habits with regular weekly counseling is the ONLY way to ensure a healthy and long-term approach to weight loss. Food should be fuel and not a treat. The treat is feeling and looking good from perfect fueling!

I know this very well based on how I used to look and feel before I went to Naturopathic school and how I look and feel now. Many people say I look better today than I did in college! That is because I am on the right fuel for my metabolism and hormones!

Eating wrong and not properly fueling your body is the hard way after living both options!

The best approach to weight loss emphasizes lifestyle changes that incorporate whole foods and activity. Many simple sustainable Naturopathic changes in diet and activity can lead to maintainable, long-term weight loss success.

Physical activity guidelines are recommended to complement the nutrition counseling and make this process easier and more productive.

If you are struggling with Seasonal Depression, or post holiday exhaustion it is imperative you get outside for an hour to get 10,000 lux of natural light every day to ensure your energy, metabolism and mood are optimal for weight loss. Especially for women that crave carbs! Lack of light puts us in a fatigued dormant state that is not conducive to fat burning.

Many of my weight loss patients have underlying mental health issues such as depression, anxiety, and PTSD and are using food for comfort instead of fuel. This can create a vicious mental health loop when choices for emotional reasons are worsening physical health, appearance, and self confidence which then drives more unhealthy food choices as "rewards."

Patients constantly seek instant gratification for emotional reasons to treat their poor mood. These poor fuel choices then cause them to feel more fatigued, lethargic, hopeless and depressed.

Depression, sadness, hopelessness and anger trigger more unhealthy food reward behavior and the vicious cycle continues as a woman continues to gain more and more weight.

By using Naturopathy and hormone balancing we can also treat these underlying mental health issues naturally and work to use new rewards such as jewelry, makeup, concerts, events, and fun trips rather than cookies, cake, and candy.

The interesting thing about women's health is that each woman generally has different hormonal metabolic challenges to address. It is not a one sized fit all program, although I generally need my patients following the basics below.

Please do not sign up for hormone balancing work with me if you are not willing to make at least some baby step changes with your diet. Occasionally I get new patients that seem to think all their problems will be fixed with popping a hormone or applying a cream. This is not realistic and we are working to balance the hormones so your metabolism is running optimally and you are receiving benefits from your efforts with diet and exercise.

Hormone testing is important in women's health since many women with hormone imbalance are starving themselves to death to compensate for their sluggish metabolism. Sadly, I see this happening often, and is why I am writing this blog so women know there is a better way than living on 800 calories a day in starvation!

Once I diagnose the metabolic problem and fine tune their hormones they are then able to eat a normal amount of food each day without gaining weight.

While each woman's metabolism is unique like a snowflake and will require labs to develop a custom tailored dietary macro program, I would like to share the basics for hormone balancing that generally work for most women with hormone imbalance. The best diet for balanced hormones is:

• HIGH in fiber-dense carbohydrates found in whole grains, beans, fresh fruits, and vegetables. Also, it is important to drink plenty of water= 60-80oz daily + 8 oz per "vice" of alcohol or caffeine and more water if you are exercising.

 MODERATE in fish and organic lean meats such as chicken and turkey.

 LOW in red meat, animal fats, hydrogenated oils, full-fat dairy products, pre-packaged, processed, and refined foods, sugar, alcohol, and caffeine.

General Tips
• Set a realistic weight loss goal, usually 1 to 2 pounds per week is recommended.
• Balance food intake with activity. The most successful weight loss programs combine increased activity with decreased caloric intake.

Tips to Increase the Amount of Physical Activity in a Day:
• Try some group activity classes at the local gym, fitness center, or swimming pool.
• Work out with family, friends, or neighbors. Motivation is increased with partners.
• Take a walk at lunchtime.
• Use a bike to run local errands and go for pleasure rides.
• Use the stairs instead of the elevator.
• Walk to the bus stop or work
• Park the car a few blocks away and walk.
• Dance to some favorite music at home or sign-up for a series of classes.

Tips to Reduce the Quantity of Food Eaten:
• Plan and prepare meals ahead of time.
• Identify foods that are often over consumed and set limits, or avoid.
• Identify and limit problem foods.
• Eat small, frequent meals and healthful snacks.
• Eat slowly and savor each mouthful. Allow 20-30 minutes for each meal, rest, set the fork down, and/or converse between bites. Chew the food well.
• Wait 10-15 minutes before taking a second helping.
• Serve food on a smaller plate.
• Drink two glasses of water or a cup of hot tea 30 minutes before meals to reduce appetite.
• Postpone a desired snack for at least 10 minutes. It may be helpful to take a walk, get some fresh air, drink a cup of water or tea, or take a short nap during this time.
• At restaurants eat half of the portion and take the rest home. Prepackage the food to go before starting the meal.
• Nurture with nonfood related activities, such as a hot bubble bath or a massage, developing a hobby, relaxing with a good book, or listening to some music.

Tips to Eliminate Eating Cues that Promote Overeating:
• Designate a specific place in the home to eat, preferably the kitchen or dining room. Eat snacks and meals only when sitting down at this place.
• Avoid watching TV, talking on the phone, reading, or driving while eating. This will help increase the awareness of fullness.
• Do the grocery shopping on a full stomach to decrease impulse buys.
• Create a schedule for eating. Plan meals and snacks at regular intervals, including the types of food to be eaten.
• Carry food to work or when going out, to eliminate long periods without eating.
• To prevent visual food distractions, keep all food stored in the kitchen cupboards or refrigerator, rather than out on the counter.
• Read or listen to motivational books, join a support group, or consider seeing a therapist to help with any emotional issues involving food, eating, and/or weight loss.

Diet, activity, and emotional work can provide feelings of health and wellness, which establish new patterns that support and nurture the body. Food should be eaten for fuel and not just for fun.

When we are on the best fuel we have the best energy and mental health.

Think well! Eat well! Be well!

If you need my help diagnosing and treating your personal hormone imbalance to determine your personalized weight loss plan, I would be happy to help!

Simply visit my SCHEDULE page to treat yourself to a Naturopathic hormone visit in my Scottsdale clinic or by telemedicine for all fifty states!

Dr. Nicole Sundene

(480) 837-0900

Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause,  Thyroid,  Hashimotos,  PMS, PerimenopauseAutoimmunePostpartumChronic Fatigue, DepressionAnxiety, Food Allergies,  DigestionDermatology, AcnePsoriasis 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 InstagramTwitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!

“Hi Dr. Nicole, Thank you for your great blog! I love your recipes. My depression is much worse this time of year.  Why am I more depressed in the winter? What do you recommend?”

Tara M. Scottsdale

Prescription: Vitamin L 10,000 Lux

"Vitamin L" or Light in the form of "Lux" is very important in seasonal depression. Depression patients need to schedule their outdoor time when the sun is out or invest in a lightbox.

During these dark times, we are exposed to less light. Light is needed by the brain to produce serotonin. Serotonin is needed for a happy calm mood without depression, anxiety, panic, or worrying. Deficient serotonin can lead to loss of sleep at night. The next day you wake up tired and even more depressed and the Vitamin L deficient cycle continues on and on progressively getting worse with each winter month. With less light, most depression patients already low in serotonin feel much worse. You should ensure you are getting at least 1 hour of time outside if you battle seasonal depression or "Seasonal Affective Disorder" aka SAD.

Ideally, for my depression patients, I want them outside walking or doing something active one hour twice a day to optimize their neurotransmitter production. If you are depressed and also struggle with chronic pain or an autoimmune condition like I have and can't always exercise, at least plan to sit outside twice a day in a sunny patch in your yard or drive to a park. Chronic pain patients that cannot exercise still need to get outside and get fresh air and sunshine.

Whether you have depression just during the winter months, or whether you struggle with depression all year round that is exacerbated by the low light conditions of winter; having a solid plan in place to better cope with the realities of winter depression is an important preventative measure.

My last name SUNDENE serves as the perfect mnemonic to help remember how to take care of yourself throughout the winter months. These are the basics to be doing for patients with seasonal depression along with connecting with their counselor or therapist by zoom or in person. Most decent insurance plans cover counseling so please enroll in counseling and have someone help you manage your depression if I am not your personal "Holistic Psychiatrist."

If you live in Arizona like I do it is easy for me to get plenty of "Vitamin L" and take a walk outside or schedule reading and other activities like phone calls and zoom meetings outdoors. If you live in a low light Northern Latitude like I did in Seattle you will find that using a lightbox twice daily can be enough to boost your mood like a medium to low level anti-depressant so that you feel happy on less medicine.

Let's make light a mandatory part of every depressed patient's mental health program!

The Sundene Protocol for Seasonal Affective Disorder

“Sun” – We need 10,000 lux of light every day in order to produce enough serotonin to feel happy. This can be achieved by 15 minutes outside on a BRIGHT BLUE sky sunny day, or 1 hour outside when it is overcast. You may wonder “What in the world is a lux?” A lux is the light equivalent put off by one candle. So you can light 10,000 candles in your home to cheer yourself up (a bit of an expensive fire hazard!) or you can just invest in a lightbox on Amazon or at a local sun shop. When I first bought a lightbox I bought the least expensive one that only put off 5000 Lux per hour and quickly realized it was very time consuming for me to spend so much time in front of a lightbox. However to save money, if you sit at an office desk all day this IS a feesable option.

A lightbox is an excellent idea for those with seasonal depression and is best used for twenty to forty minutes in the morning and afternoon depending on the manufacturer’s recommendations to achieve the 10,000 lux equivalent. What I did not understand when I first purchased one is that the Lux is generally per hour. So most that emit 10,000 Lux require you to use them for one hour. Therefore to get 10,000 Lux from the 5000 Lux Lightbox

If you are unable to afford a lightbox you can simply try full spectrum light bulbs as these often provide enough light for those with mild to moderate seasonal depression. Keep your windows open and move your desk or work station to natural light or a lightbox if you are depressed and aim for twice a day so your body can optimally make serotonin.

Don't use your lightbox before bed or it will keep you up as serotonin needs to be converted to melatonin which happens as our natural light goes down in the evening. Using a lightbox right before bed may upset your sleep and throw off your 24 Hour Circadian Rhythm resulting in hormone imbalance. So I don't recommend using a lightbox for depression right before bed.

The best winter options are near water or snow in beautiful settings in order to visit during the gloomy months of winter as the light is intensified as it is reflected back up to our eyes. If you are concerned about protecting your eyes from UV radiation, you can buy sunglasses with a clear or light lens, but that still provide UV filtration as it is the actual photons of light that our brains use and not UV radiation to produce serotonin.

Those struggling with seasonal depression need to make an appointment with the sun or the sun’s substitute via a lightbox every single day. Topping off your serotonin levels by day means that more of this neurotransmitter will be available for conversion to melatonin (the hormone that keeps us asleep at night). Using light as medicine should easily improve your sleep, leaving you more energetic for the following day.

“D” -Vitamin D is no longer considered a vitamin, but a “pro-hormone." Vitamin D is produced in our bodies when UV light touches our skin. Most people living in the northern latitudes are easily vitamin D deficient if they do not spend 20 minutes outside each day. Vitamin D is an important mental health vitamin we can test with lab metrics to ensure your dose is optimal. Some patients need more than 2000 iu and some patients may have toxicity at higher doses.

Elderly people are more at risk for depression because they have thinner skin, and thus produce less vitamin D, they also absorb less dietarily. If you struggle with depression, it only makes sense to be sure that you are at least not deficient in vitamin D. If you care for a senior in a care facility make sure they are wheeled outside twice a day in the morning and afternoon so they can receive natural light that is important for their bones and mood.

The RDA of Vitamin D for women is 800 IU. Food sources of vitamin D are milk, fish, and yeast. I typically recommend 2000 IU of vitamin D for my patients struggling with depression as a cheap and easy insurance policy that they are not deficient in vitamin D since it is also important to boost the immune system.

If you would like to have your levels checked be sure that your physician orders the “25-OH-D” as that is the most reliable indicator of vitamin D stores. Do not ever exceed 5000 IU of vitamin D daily unless under the care of your Naturopathic Doctor. Dangerous side effects such as hypercalcemia can occur. Be sure to have your vitamin D levels tested every 6 months so you are in an optimal range between 50-80. Levels above 100 are considered vitamin D toxicity. Too much Vitamin D can cause high calcium in the blood and can be dangerous. Please do not overdose with vitamin D as I am seeing a lot of toxic levels come through right now. It is critical the vitamin is dosed properly.

“E” -Exercise- is the drug of choice for anyone that is depressed. It is a tough medication to take though when depressed because as best summed up by Newton’s laws of motion: “An object at rest stays at rest until acted upon by another force.”

I know as someone that has personally struggled with depression that when you are down in that dark depressing hole it is tough to get exercising, but stagnation is just going to perpetuate your problem. I tell my depressed self that refuses the concept of the walk, "You can be in just as bad of a mood on your walk," and usually going on the walk results in a lifting of my mood. Worst case scenario you are in just as bad as a mood when you started. Rarely does exercise not help lift my patient's moods. Too much time indoors right now is affecting people mentally and physically so please get outside and walk, bike, hike, play tennis, swim, play basketball, ski, snowboard... if you are depressed it is your job to figure out which TWO sports you are going to be doing for fun, fitness, and light. I will let you pick! Rotate the two sports every other day and give yourself one rest day per week if you need it. By planning to exercise every day patients are more likely to achieve the 5 days of exercise a week that is optimal for mental and physical health.

Countless studies support the efficacy of exercise for depression. If you struggle with seasonal depression be sure to try to exercise outside EVERY SINGLE TIME the sun is out! Find a walking, running, or cycling buddy and take turns pushing each other out there. Put your exercise equipment in your backyard as a temporary gym and exercise outside in the light.

Whatever you do…just keep moving! Being cramped up indoors during the winter months is the problem and not the solution. Your brain needs to go on a walk every day. The best way to be successful with exercise is to schedule it and plan to walk or bike at the same time every day. I like to walk my Golden Retrievers first thing in the morning while I sip my tea, and mountain bike after work. I plan my exercise at the same time every day, twice a day, and follow the routine even when in a bad mood because as a Naturopathic Doctor I know that exercise is the best medicine for my brain. Plus it is free and when you look fit and healthy you also feel happier. If you are having trouble making decisions because your depression is that severe following your mental health daily schedule is very important. Some of my depression patients are so depressed they cannot decide where, when and what to do for their exercise that is why following a daily and weekly fitness schedule is imperative for depression patients.

“N” –Nutrition is fundamental for anyone struggling with depression. When the body does not feel good the mind is soon to follow. Depressed thinking often results in poor dietary choices.When we are depressed and in a low light setting we crave carbohydrates so that the body can produce more serotonin.

However, sugar is exactly what the body does not need in the long term for healing from depression. The best diet for those with depression, anxiety, and bi-polar to follow is my PGE-2 Diet as it is high in the Omega-3's mental health patients need, is high in protein for amino acids and also improves inflammation. You will also receive yoga and mediation videos that are only 10-15 minutes to do and easy to reset your brain and adrenals. Did you know multiple studies show a link between depression, anxiety and inflammation? When I started seeing my PGE-2 Diet improve my patient's moods, I realized how important this inflammation link is!

Protein is mandatory for depression patients. Female depression patients, in my experience as a naturopathic doctor are generally all eating very low protein causing their brains to be starved of the necessary amino acids needed to form hormones and neurotransmitters that help us feel happy such as tryptophan, taurine, and tyrosine. The thyroid needs tyrosine to make hormones and T3 is needed to make serotonin in your brain so not eating enough tyrosine foods can cause depression. Serotonin is formed from tryptophan which is why we give patients 5-HTP as an amino acid therapy precursor to boost serotonin levels. Eating a diet of all carbs is very common for my depression patients. We crave carbs because carbs give us a quick boost of serotonin, but then that goes away and is not sustainable when we lack a constant supply of amino acids needed for mental health.

Balancing your blood sugar will also help keep the mood at an even keel throughout the day. Be sure to eat protein and fiber with every meal to prevent low blood sugar crashes that can trigger depression, anxiety, and panic attacks. Especially focus on eating foods high in tryptophan such as turkey, cottage cheese, peanuts, fish, eggs, oatmeal, avocados, and bananas. Patients with Bipolar Depression may boost mania by eating some of those foods so please work with a Naturopathic Doctor experienced in these matters such as myself!

A high quality multi-vitamin will cover all the bases and ensure that you are not deficient in any of the B vitamins that are coenzymes for producing the neurotransmitters that make us feel happy. Be sure the b-vitamins are ACTIVE and not SYNTHETIC GARBAGE like Centrum or Flintstones vitamins. Synthetic vitamins will only make it worse. Invest in quality for your brain. Taking a high quality multivitamin is a simple and inexpensive thing to do that is especially important in Women's Health as low iron levels are the #1 thing I find causing anxiety, depression, sadness and chronic fatigue in women. Because women are losing blood every month it is important they replete iron stores sufficiently for anxiety, depression, and mental health.

My depression patients are also often deficient in Omega-3 Fatty acids from fish oil, flaxseeds, walnuts, chia seeds, or algae. That is it. There are essentially no other sources of Omega-3's and any other nuts or oils are full of omega-6 and omega-9 that can increase inflammation. Since there is a link between increased inflammation and depression and anxiety it is imperative that patients take a supplement of Omega-3's if they don't like the food sources. When I learned about this I realized that my severe aversion to fish is part of why I am prone to depression and simply taking a high dose fish oil every day was a huge game-changer for me. Those are the only sources of Omega 3's. Unless you are allergic to fish the active form of Omega-3's in fish oil will be more beneficial to your mood than vegan sources as the vegan source has to be converted to the active form which is a biochemical step that some people genetically lack the genes to make this conversion such as Scandinavians like myself.

“E” -For Everything Else please work with a doctor on your individualized care plan. There are many treatment options for depression. I could go on and on about amino acid therapy, herbal medicine, genetics and nutrition related to depression but it is important you work with someone overlooking your big picture. My most successful mental health patients in my practice work with me closely for 3-4 months checking their hormones, vitamins and amino acids related to their depression. They keep me updated with what is working and what is not working at monthly appointments until we have an effective treatment plan. As a Naturopathic Doctor I have helped many patients off of their anti-depressants but it is a process that requires we add in all of the correct nutrition and natural medicines first and then after a few months we gradually wean down the anti-depressant. Depression patients should never suddenly stop taking their anti-depressants. As a Naturopathic Doctor I really don't have a problem with anti-depressants. They are not a drug I see causing long-term effects that I find dangerous. The real problem with them is when they simply do not work because something is wrong with the patient and they don't make enough serotonin for instance to be recycled by the anti-depressant. By working closely together for a few months we can study your personal weak spots and target nutrition directly towards the weak spots to strengthen your mental health. Eventually I work my way out of a job when my mental health patients improve and they no longer need me.

Stay tuned for my blog on Neurotransmitter Testing as this was very helpful for me. Knowing that my body struggles to make serotonin and other neurotransmitters that calm the brain was a relief to know!

Please do not give up hope, I am providing an overview of what I do for depression patients so you do not ever give up hope. Rarely can I not help patients. The only patients I cannot help are the ones too depressed to follow their care plan. If you are in this boat you need someone to help you facilitate the plan for it to be effective and I reccomend bringing your Mom or Husband to your appointments, or have them listen in on your Telemedicine calls so they understand what you need to do. Be sure to implement the basics for your seasonal depression above and work with your doctor or book a visit with me below.

Counseling, herbs, amino acids, and of course anti-depressants when needed will help keep you out of that dark “hole." Naturopathic treatments for depression often take time as they are addressing the whole person and the long term.

As a physician, I give every depression treatment plan 2 to 4 weeks to determine its efficacy. Natural medicines take time to work. This is why I recommend monthly visits for mental health patients. Even a prescription antidepressant takes 2 weeks to work. If you are not experiencing improvement you may want to consider other treatment options but please don't throw away the depression treatment too soon. Too many of my depression patients have tried something for ONE DAY and then felt depressed and hopeless that the natural medicine did not work. We need to have realistic expectations for mental health. The same rules for Naturopathic Medicine apply to medications and you need to try something for at least a few weeks to give it a chance.

Various counseling and therapy techniques are also available to teach you how to cope and self-soothe, if you find you are not making progress with your therapist, consider a new referral for a different type of therapy such as EMDR or tapping. Sometimes talking about your problems can only get you so far and we need to focus on coping tools.

Remember that aside from physical and mental components, there is also a social component to seasonal depression. Much time spent inside, or repeatedly with the same people inside can contribute to a poor mood. Schedule weekly activities to get you out of the house and interact with others. If your relationship is struggling schedule yourself away to give everyone a break. Absence makes the heart grow fonder!

Did you know I have had to provide a lot of marriage counseling during the Pandemic for my patients? Everyone is struggling with too much time spent together. I promise you are not the only one!

If you live alone, the winter months can feel especially isolating. Find an elderly person that also lives alone to check in on, it will do you both a world of good. Many of my seniors are struggling with loneliness and it would be great if you could check on them for me. They need their neighbors to chat with them. It is okay to not feel your best right now. We have all been through a lot. It is very normal to feel down and depressed. After 22 years of working in Family Medicine, I have never seen people more sad, angry, frustrated, distressed, and depressed.

IF you need help looking at your hormones and nutrition related to your anxiety, depression or mental health challenges pop over to my appointment SCHEDULE page and book a visit. A lot of what I do is diagnostic if you are not in Arizona, we can still use Telemedicine to order your labs and work together to determine if your female hormones, thyroid, adrenals, and nutrition are all properly balanced or not. Herbs and supplements can still be prescribed to those out of state.

Ladies, as a Female Hormone Specialist I can assure you that female hormone imbalance is often the root cause of your mental health issues. Please remember mental health challenges like anxiety, anger, and depression in women that fluctuate monthly indicate high estrogen levels as seen with PMS. Feeling blah, depressed, lifeless and in a constant tired fog can be from imbalanced adrenal hormones or thyroid disease. Mental health challenges in women that start in the 30-40's can start because of low progesterone, perimenopause or pre-menopause. Sudden depression or anxiety that occurs with loss of estrogen in menopause can be treated with herbal medicine or bio-identical hormones. It is important if your body is changing with age that we get answers.

Thank you for your great Naturopathic Women's Health questions! Please continue to send them to my clinic address below on a postcard! I love to get something in the mail that is not a bill. Remember if your question can't fit on a postcard you need to schedule an appointment with me HERE.

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, PerimenopauseAutoimmune, Postpartum DepressionChronic 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 InstagramTwitter, and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!

By Dr. Nicole Sundene, NMD
Scottsdale Naturopathic Doctor

"How Do You Make Elderberry Syrup?" ~Holly S.

Great News! I have been passing out my pre-mixed Elderberry Gift Bags to all my patients to keep on hand for the second they feel that tickle of sickness in their throats and been hearing amazing feedback as to how well it works and even more important…how much better this works than a premade store bought elderberry syrup! Hooray, of course homemade is better.

Please keep your pretty elderberry bags in a dark cupboard and out of the window or they will lose potency in bright sunlight. These are great if you are fighting "The Virus" or any virus really!

The best part is you can invest $20-$50 in the bulk ingredients and then keep these Naturopathic bags on hand in your cupboard and they will be waiting for you when you need them. I would estimate one bag per 1-2 days per adult in your household. You can also check out my blog about more Immune Boosting Foods and Herbs in your Spice Rack in case you are stuck at home sick and need to rely on herbs and spices!

Elderberry Syrup Gift Bags:
1 Cup Elderberries
¼ Cup Licorice Root
½ Cup Ginger
6 Cinnamon Sticks
6 Star Anise
12 Cloves

Add 4 cups of water to the contents of the Elderberry Syrup bag. Then bring to a boil and reduce to a low simmer for 45 minutes. Let cool. Add 1/2 cup Manuka Honey (Optional) or 8-10 packets of Stevia before straining. Remove the cinnamon sticks and Star Anise so you can press the elderberries through your strainer the best you can as the medicine is in the dark pigments from the elderberries or the “Proanthocyanidins,” so make sure you are getting as much of that benefit as possible.

If you are making these bags for someone on cardiac medications, high blood pressure, or a blood thinner, you cannot use the ginger, or licorice, and should substitute those out with Echinacea Root or Thyme. Thyme is an amazing antiviral, as I discuss on my Naturopathic Favorite Things Blog, and has shown the best evidence thus far via research against “The Virus.” Patients with heart conditions or on medications should always work with their own Naturopathic Doctor before starting any new herbal medicines!

Adults: Drink ¼ cup of Elderberry Syrup every 2-3 hours diluted in hot water or tea at the immediate onset of illness.
Studies show that herbal medicine works the best at the IMMEDIATE ONSET of your illness so make sure you are making this and starting the rest of the immune support regime I use the second you feel that funny tickle in your throat. “Treat the Tickle!”
Children: Check with your Naturopathic Doctor on dosing Elderberry Syrup based on weight and age. This is generally safe for children though, and my own daughter says it is "Delicious!"

Always buy organic bulk herbs from a trusted herbal medicine company such as MountainRoseHerbs.com and Starwest Botanicals are what I personally trust as a Naturopathic Doctor and Herbalist for my patients and myself! I do not buy bulk herbs on Amazon as a Naturopathic Doctor this scares me because they may be stored in hot warehouses and therefore lose their medicinal properties. Also, there is no quality control in the US so you must be working with a trusted supplier!

These Elderberry Syrup Bags are great presents to make up for those you care about and drop off with my instructions. My Immune Boosting Blog linked above also has the preventive plan that I am following myself right now, based on the best scientific evidence I have been able to find, which I will share very soon in my next blog! Make sure you are following me on Instagram.com/dr.nicolesundene to get my latest Naturopathic updates and Herbal Medicine Recipes!

Stay healthy my friends!

With Love,

Dr. Nicole Sundene, NMD
Naturopathic Medical Doctor
(480) 837-0900



By Dr. Nicole Sundene

Holistic Psychiatry & Hormone Specialist

Anxiety disorder in Women's Health is best managed by a Holistic Hormone Doctor that can work to evaluate the root cause of the anxiety. For women hormone imbalance such as PMS, PCOS, Perimenopause, Menopause, Adrenal Fatigue, Hypothyroidism, and Hashimoto's Thyroidtis are often the culprits behind what appears to be a generalized anxiety disorder. Especially when typical anti-depressants or anti-anxiety medications do not help.

While many of my patients are currently feeling anxious and can benefit from a natural anxiety treatment the real clue that the anxiety or depression is caused by hormone imbalance is when women experience fluctuating symptoms.

Anxiety that fluctuates monthly is absolutely hormonal. Women that suddenly develop anxiety later in life such as in their 40's or 50's that have never experienced anxiety before are most likely being triggered by peri-menopausal or menopausal hormone changes that can impact mood. Patients with a family history of thyroid disease that suddenly develop anxiety should also have their hormones checked by a female hormone expert.

While different herbs help patients with their anxiety the real issue with anxiety is that we work to discover the root cause. Some women are just more anxious than others but the real clue that there is an underlying hormone issue is when a woman that has never had anxiety before is suddenly feeling anxious, agitated, angry or impatient. Especially when nothing situational is actually going on to contribute to the anxiety.

As a Naturopathic Doctor I honestly don't really even care WHAT herb we use to treat your anxiety. That is pretty boring to me to just prescribe HERB X for SYMPTOM X. Dr. Google can do that for you....what my Detective brain always wants to know is what is the ROOT CAUSE? Until we understand the root cause the patient will just continue to perseverate with their symptoms and nothing will ever truly fix the problem or provide lasting results.

I have included a brief blurb so that you can get an idea of the herbs that I generally find safe for most women to try for their anxiety. Please always check with your Naturopathic Doctor before combining herbs with prescription drugs. Do not take sedative herbs during pregnancy or breastfeeding. More importantly treat yourself to a Naturopathic consultation to discover the root cause of your anxiety by popping over to my SCHEDULE page.

#1 Passionflower- The intricate purple flower pictured above was shown to be as effective as sedatives in the benzodiazepine (valium) family, the aerial parts of this herb are great for nervous tension and anxiety. In recent research, passion flower extract at 45 drops daily (tincture) was shown to be as effective as oxazepam (similar to valium). This nervine herb is also “antispasmodic” which makes it great for people with constant nervous twitching.

#2 Ashwaganda- This is probably one of my favorite herbs. Unlike most of the herbs on this list that are designed to be taken at night or at least late afternoon, both ashwaganda and schisandra (listed below) are terrific “adaptogenic” herbs that help us tolerate our stressful days that much better. You can make some tea, or grab some capsules of the organic root and take two capsules twice a day.

This herb is specifically intended for those that are exhausted and agitated or debilitated by stress. In ayurvedic medicine ashawganda is a renowned anti-aging and rejuvenating herb.

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#3 Schisandra- Referred to as “Chinese Prozac” this herb is commonly unappreciated and underutilized in American herbal practice. Schisandra is a terrific day time adaptogen herb and should be taken as is recommended with Ashwaganda, two capsules with breakfast and lunch, or a cup of tea in the morning and afternoon. The berries can be made in to a nice aperitif for those with a low libido.

#4 California Poppy- The bright orange flowers of the California poppy, leaves and other aerial parts are sedative, anti-spasmodic, and mild pain relievers. This is also a gentle herb used for colic and agitation in children. Do not use this herb or any other sedative herbs in pregnancy.

#5 Hops- No I am not recommending that you drink more beer to calm down. However, the herb commonly used to make beer bitter also works as a sedative. It is extremely bitter though so is best given a small part in your herbal tea formula for insomnia or stress. Do not combine with prescription sleep aids due to an additive effect.

#6 Kava Kava- A well known Polynesian psychotropic sedative, this herb is sedative and “spasmolytic” and thus helpful for chronic pain conditions. Several conflicting studies debate the safety of using this herb with alcohol. Liver damage is thought to occur if used in large doses in conjunction with alcohol. This research however was used to scare many people away from using kava kava for whatever reason.

People need to simply remember that herbs are medicines and that an herb with actions similar to prescription sleep aids and analgesics will of course pack the same side effects. A strong herb demands respect. When used ceremoniously, or occasionally this herb does not run the risks it runs when it is heavily abused.

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The best way to safely use kava kava is in an organic tea form. Look for a tea blend that includes kava, or make your own. This herb should not be used in large doses, and large doses should not be used over long term. Do not combine with alcohol, or use during pregnancy or nursing. Chronic abuse will result in a horrible scaly skin rash.

#7 Lavender- Try adding lavender to your favorite baked good recipe. Purple lavender flowers will offer a sophisticated herbal makeover to your favorite shortbread cookies, or white tea cakes.

Lavender is great in your herbal medicine blend, and can also be used to stuff pillows, or as an aromatherapy stress reliever throughout the day. Lavender should not be used in pregnancy due to it’s emmenagogue effect.

#8 Lemon Balm- Also known as “Melissa officinalis” this herbal sedative should not be used by those with hypothyroidism as it inhibits the thyroid and is used to treat hyperthyroidism, however for everyone else it is a common simple herb to grow in your garden and make in to your own calming sedative tincture each summer. Do not use this herb in pregnancy.

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I grow lemon balm in my garden and harvest it, rinse it, let it dry and then pack it in a jar with enough room for it to swim around in some vodka. Shake the jar once a day for two weeks. The vodka will extract the constituents and after a few weeks you can strain out the plant part leftovers and put a half a teaspoon of this liquid “anxiety medicine” in a little bit of water when you need something to calm you down.

#9 St. John’s Wort- Although we think depression the second we hear about St. J’s Wort, we also need to address that depression and anxiety tend to walk hand in hand and this herb is not just an anti-depressant it is a mild sedative as well. St. John’s Wort has also been shown to have a lower risk of side effects than conventional anti-depressants and is worth trying for those that don’t quite have severe enough depression to mandate the use of a prescription pharmaceutical, but instead need something to take the edge off and boost the mood a bit.

If you are suffering from anxiety that has a form of depression associated with it, then this would be a great herb to consider in your herbal sedative blend pending that you are not on any anti-depressants or anti-psychotic medications. The condition “serotonin syndrome” may occur from combing this herb with those classes of medications or other herbs and supplements that boost neurotransmitter levels.

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This herb should not be used by those on oral contraceptives, or any medications as it increases the cytochrome p450 enzyme system which results in a more rapid detoxification of drugs from the system. The drugs or birth control pills are then rendered useless. Standard dose of St. John’s Wort for those not on any other medications, is 300 mg three times daily of the 0.3% standardized extract.

#10 Red Clover- Not traditionally recognized as a sedative, but as a mineral source and blood thinner, this “cooling” herb calms the system and has a special affinity to the lungs, throat, and salivary glands.

This is a terrific balancing herb to include in your herbal sedative blend as the dried flower blossoms make for a beautiful addition to a glass teapot. Do not use in pregnancy, or if on blood thinning medications.

#11 Catnip- Not just for cats. Catnip is actually a gentle nervine herb for humans. No it won’t make you roll around on the carpet or chase after things (at least not to my current knowledge) but it is still a great mild sedative.

This herb should absolutely NOT be used during pregnancy, as most herbs should never be used during pregnancy without checking with your naturopathic midwife, however it can safely be used in children by making a very weak tea. Be sure to only give your children organic herbs and check with their pediatrician or naturopath prior to use.

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#12 Valerian- Definitely one of the more potent herbal sedatives, valerian is also a great pain killer for those with chronic pain. Some people prefer not to use this herb because it can cause quite the herbal hangover the next morning and most complain that it makes them feel really groggy, or desire to sleep through the day.

Look for a tea formula that includes a bit of valerian to avoid the hangover, and if you have severe anxiety, chronic pain, or insomnia talk to your naturopathic doctor about using this at a more therapeutic dose. Always use organic root.

#13 Motherwort- The perfect herb for fried and frazzled mothers; it strengthens a weak heart and is great for nervous palpitations. Motherwort is best taken over a prolonged period of time, and because it is a uterine stimulant, it should not be used in pregnancy.

#14 Skullcap- A bitter, cooling sedative herb that is best used for nervous fear, restless sleep, and is also thought to lower blood pressure. This herb is great for people with the inability to pay attention—huh what was that? And has been used effectively to calm down children with ADHD. Some kids concentrate better when they are sped up, and some do better when they are calmed down.

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#15 Chamomile- One of the most common kitchen herbs, chamomile is a great mild sedative and digestive bitter.

Be careful in using chamomile tea if you experience ragweed allergies, formally known as the “asteracea family” and previously recognized as “composite family.” If you have a history of seasonal allergies you should exercise caution.

If not, make your tea up strong, use a heaping tablespoon and not a teaspoon per 8 oz cup of water, and allow to steep 15 minutes covered. If you don’t cover your chamomile tea you will lose the calming essential oils to evaporation. Only elitist herbalists know to do that. Welcome to the club!

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Traditional Herbal Sedative Use: Establishing a nighttime or daytime tea ritual is a great way to reduce stress, avoid binge eating, and help those that fight insomnia get to sleep at a decent hour.

Directions: For most of these herbs simply make a tea with about 1 tsp (milder herbs use a tablespoon) to 8 oz cup of boiling water. Allow to steep covered 15 minutes. Or if you aren’t a tea drinker just look for a pre-made organic herbal formula to take in tincture or capsule form, and follow the manufacturer’s recommendations.

Please check with your Naturopathic Doctor before combining any herbal medicines with prescription medications or making any changes to your health care routine or simply treat yourself to a Naturopathic consultation with me by popping over to my SCHEDULE page. I am able to help patients that are not in Arizona via Telemedicine with their anxiety, we can conduct hormone testing and implement naturopathic medicine by phone consult.

Dr. Nicole Sundene

Female Hormone Expert

(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 MenopauseThyroid, Hashimotos, PMS, PerimenopauseAutoimmune, 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 InstagramTwitter 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

(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 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 InstagramTwitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!

REFERENCES:

  1. Choudhary D, Bhattacharyya S, Bose S. Efficacy and Safety of Ashwagandha (Withania somnifera (L.) Dunal) Root Extract in Improving Memory and Cognitive Functions. J Diet Suppl. 2017 Nov 2;14(6):599-612. doi: 10.1080/19390211.2017.1284970. Epub 2017 Feb 21. PMID: 28471731.
  2. Sharma AK, Basu I, Singh S. Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid Patients: A Double-Blind, Randomized Placebo-Controlled Trial. J Altern Complement Med. 2018 Mar;24(3):243-248. doi: 10.1089/acm.2017.0183. Epub 2017 Aug 22. PMID: 28829155.
  3. Lopresti AL, Smith SJ, Malvi H, Kodgule R. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study. Medicine (Baltimore). 2019 Sep;98(37):e17186. doi: 10.1097/MD.0000000000017186. PMID: 31517876; PMCID: PMC6750292.
  4. Langade D, Thakare V, Kanchi S, Kelgane S. Clinical evaluation of the pharmacological impact of ashwagandha root extract on sleep in healthy volunteers and insomnia patients: A double-blind, randomized, parallel-group, placebo-controlled study. J Ethnopharmacol. 2021 Jan 10;264:113276. doi: 10.1016/j.jep.2020.113276. Epub 2020 Aug 17. PMID: 32818573.
  5. Gannon JM, Brar J, Rai A, Chengappa KNR. Effects of a standardized extract of Withania somnifera (Ashwagandha) on depression and anxiety symptoms in persons with schizophrenia participating in a randomized, placebo-controlled clinical trial. Ann Clin Psychiatry. 2019 May;31(2):123-129. PMID: 31046033.
  6. Dongre S, Langade D, Bhattacharyya S. Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Improving Sexual Function in Women: A Pilot Study. Biomed Res Int. 2015;2015:284154. doi: 10.1155/2015/284154. Epub 2015 Oct 4. PMID: 26504795; PMCID: PMC4609357.
  7. Wankhede S, Langade D, Joshi K, Sinha SR, Bhattacharyya S. Examining the effect of Withania somnifera supplementation on muscle strength and recovery: a randomized controlled trial. J Int Soc Sports Nutr. 2015 Nov 25;12:43. doi: 10.1186/s12970-015-0104-9. PMID: 26609282; PMCID: PMC4658772.
  8. Jahanbakhsh SP, Manteghi AA, Emami SA, Mahyari S, Gholampour B, Mohammadpour AH, Sahebkar A. Evaluation of the efficacy of Withania somnifera (Ashwagandha) root extract in patients with obsessive-compulsive disorder: A randomized double-blind placebo-controlled trial. Complement Ther Med. 2016 Aug;27:25-9. doi: 10.1016/j.ctim.2016.03.018. Epub 2016 Apr 9. PMID: 27515872.
  9. Tiwari S, Gupta SK, Pathak AK. A double-blind, randomized, placebo-controlled trial on the effect of Ashwagandha (Withania somnifera dunal.) root extract in improving cardiorespiratory endurance and recovery in healthy athletic adults. J Ethnopharmacol. 2021 May 23;272:113929. doi: 10.1016/j.jep.2021.113929. Epub 2021 Feb 15. PMID: 33600918.
  10. Chengappa KN, Bowie CR, Schlicht PJ, Fleet D, Brar JS, Jindal R. Randomized placebo-controlled adjunctive study of an extract of withania somnifera for cognitive dysfunction in bipolar disorder. J Clin Psychiatry. 2013 Nov;74(11):1076-83. doi: 10.4088/JCP.13m08413. PMID: 24330893.
  11. Kumar R, Rai J, Kajal NC, Devi P. Comparative study of effect of Withania somnifera as an adjuvant to DOTS in patients of newly diagnosed sputum smear positive pulmonary tuberculosis. Indian J Tuberc. 2018 Jul;65(3):246-251. doi: 10.1016/j.ijtb.2017.05.005. Epub 2017 May 21. PMID: 29933868.
  12. Devpura G, Tomar BS, Nathiya D, Sharma A, Bhandari D, Haldar S, Balkrishna A, Varshney A. Randomized placebo-controlled pilot clinical trial on the efficacy of ayurvedic treatment regime on COVID-19 positive patients. Phytomedicine. 2021 Apr;84:153494. doi: 10.1016/j.phymed.2021.153494. Epub 2021 Feb 4. PMID: 33596494; PMCID: PMC7857981.

Dr. Nicole Sundene, NMD

Female Hormone Specialist

With Holistic Psychiatry, we are treating your mood disorder such as anxiety, depression, bipolar, ADHD, addictions, PTSD, OCD, and even schizophrenia with natural medicines. We also are more importantly using 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!

Fear not, there IS HOPE! 

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 40’s or 50’s 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, anxiety about my school work. I was an overachiever that would cry over an A- or a “Chinese F’ as they call it. 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. You can watch my Free Presentation on “Hormones, Metabolism and Weight Gain” to see my case study about Jenny, who was a crying mess while her husband called me frantically, not sure what to do with her. 

I emailed him a lab slip and said “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 or AHCCCS 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, and that is 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. 

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 PATIENTS ARE NOT SUCCESSFUL WITH HOLISTIC PSYCHIATRY?

After serving patients for 22 years, I know exactly the patients I can and cannot help so please read this section carefully and do not sign up for my service if any of the following scenarios apply to you. I cannot help mental health patients in the following scenarios: 

  1. If you are too depressed to take supplements, get your labs drawn, or make dietary changes, or you do not have a caregiver that can ensure the plan I prescribe is implemented, you will not be successful with my Holistic Psychiatry program, and I will not be able to help you. I only want patients that will be compliant with their instructions to enroll in my practice. If you cannot do it and you cannot appoint a family member of friend to ensure you make these changes it will not work.
  2. If you do not have insurance to pay for hormone and nutrition testing or do not have finances to pay for the cash lab pricing of this ~$500 depending on the patient’s symptoms, then I will not be able to help you. 
  3. If you are not friendly and coachable and cannot maintain good boundaries with our working relationship I will not be able to help you.
  4. If you are unwilling to take vitamins, supplements and make dietary changes to support your mental health. You have to be open to changing your diet to whatever I think you need to change it to.
  5. I generally do not provide counseling and recommend you use a therapist for additional emotional support. Think of me more as your “Holistic Psychiatrist” that helps you adjust your medications, supplements and vitamins and looks for the root cause of your mental health from a physical standpoint. 
  6. I will not prescribe antidepressants, anti-anxiety medications (valium or benzodiazepines) outside of a scheduled appointment. I refill your medication until you are legally due back in, and it is the patient’s responsibility to schedule their med checks. I cannot prescribe stimulant medications for patients with ADHD, only an MD psychiatrist can do this.
  7. Anyone expecting a “Quick Fix” will end up disappointed as Naturopathy is investing in long term solutions to health problems. My mental health patients generally take 3-6 months to improve. Please check my fee schedule to ensure it is affordable for your budget.
  8. If you are very angry and agitated and cannot control your emotions and lash out on others, I will not be able to accept you in to my practice.

WHAT PATIENTS ARE THE MOST SUCCESSFUL WITH HOLISTIC PSYCHIATRY?

  1. My favorite and always successful patients are the ones that show up with a pen and paper handy to take notes and want to be a student and learn everything they can about their mental health and how to improve it.
  2. Women that enjoy making herbal teas, taking capsules and vitamins, and prefer to support their body in this manner, I specialize in food as medicine. You are my perfect mental health patient!
  3. Women that want to make the diet changes to what I think their brain/body needs.
  4. Women that have a care team that will ensure they are following their plan if they are slipping. 
  5. Women that are also working in conjunction with a counselor or therapist on their issues will always have awesome results!
  6. Women with inquiring minds that also "Need to Know" what is causing their symptoms. I like patients that are just as involved in helping me solve the riddle as I am.

That is how I help my mental health patients as a Holistic Psychiatrist. 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. I want to go through this detective process together so we can determine what your individual weak spots are when it comes to your personal mental health. 

Sincerely, 

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 MenopauseThyroidHashimotosPMS, PerimenopauseAutoimmune, 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 InstagramTwitter, and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!

Dr. Nicole Sundene, NMD

Holistic Hormone Specialist

Menopause symptoms can be truly miserable between hot flashes, night sweats, insomnia, constipation, dry skin, and mood disturbances such as anxiety, depression, trouble concentrating, poor memory, ADHD, and generalized brain fog.

Many women experience hormonal anger from constantly feeling too hot.

Ladies, let food be thy medicine with this easy Menopause Milkshake recipe designed to help calm hot flashes and night sweats. This recipe is packed full of herbal medicines to help women stay cool.

Whether the heat is bothering us in Arizona, or we are having a hot flashes or night sweats the cooling properties of spearmint, red clover, and nettles combine nicely with blueberries and pears to help cool women down. In Herbal Medicine, every food has a "temperature" and it is either heating, neutral or cooling. We need to avoid the hot foods, and heating herbs if too hot as I explain in my blog about how I gave myself a hot flash from mixing them all together!

Nettles were found to help menopausal hot flashes after 8 weeks at 450mg daily. Spearmint is cooling and refreshing.

Red clover is a phytoestrogen herb that also works for anxiety as a mild sedative to help women sleep better. I also love Red Clover for gentle ongoing detox support as a clogged liver often causes imbalanced hormones.

By combining multiple cooling foods and phytoestrogens this is how many of my menopause patients manage their menopause symptoms with Bioidentical Hormones!

Menopause Milkshake Recipe:

1-2 cups of chilled “Hot Flash Iced Tea”= Spearmint, Red Clover, and Nettles Herbal Tea

1 cup frozen Blueberries

½ frozen Pear

½ cup of Kefir

1-3 Tbl freshly ground Flaxseed

1-2 Packets of Stevia to taste (optional)

1 Scoop of Protein Powder or Collagen

Mint to Garnish

Instructions:

Add chilled herbal tea, fruit, flaxseeds, kefir, protein, and stevia to blender. Mix well and garnish with mint. Drink 1-3 shakes per day for hot flashes and night sweats. 

To make your “Hot Flash Iced Tea,” combine 1 tsp each of nettles, red clover, and spearmint per 8 oz of water. 

Tea should be made fresh every 1-2 days and discarded after 48 hours in the refrigerator. 

To make 2 nights' worth of iced tea at once, you will need 3 cups of boiling water and 3 Tbl of each:

1) Nettles 2) Red Clover 3) Spearmint

Cover herbs with boiling water, stir, and let steep covered to preserve the mint essential oils for 15-45 minutes. Letting your tea steep a little longer helps absorb the minerals and phytoestrogens that mimic estrogen into your tea. Chill your tea before using it in my Menopause Milkshake. 

Women should drink their menopause shake 1 hour before bedtime for optimal, cool sleep.

Dr. Nicole Sundene

(480) 837-0900

Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause,  Thyroid,  Hashimotos,  PMS, PerimenopauseAutoimmunePostpartumChronic Fatigue, DepressionAnxiety, Food Allergies,  DigestionDermatology, AcnePsoriasis 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 InstagramTwitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!

Dr. Nicole Sundene

Female Hormone Specialist

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

(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!

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Location: 14300 N Northsight 
Blvd Ste 124
Scottsdale, AZ 85260
Ph: 480-837-0900
Fax: 480-409-2644
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