By Dr. Nicole Sundene
Author of "The Hormonal Acne Diet"
Eczema was getting out of control for Ken, as his hands became painful as they began to crack and bleed from his serious eczema condition.
Overly conscious of the way his hands looked, Ken was embarrassed of the cracking and bleeding and began to avoid shaking hands with people. Eventually, Ken's fingers and hands became so painful, it was difficult for him to ride his motorcycle. It was so bad, at one point he could see he was actually losing the fingerprint on two of his fingers.
Ken finally went to a dermatologist who diagnosed him with Dyshidrotic Eczema and gave him some cream and oral steroids to help reduce inflammation.
But his hands never really got better. He began to worry he had a more serious issue, maybe MRSA because of the erosive nature of his eczema. He actually thought he had flesh eating bacteria.
The dermatologist was prescribing higher doses of steroid creams, but his issues didn’t get better. After 5 appointments for his skin and trying different remedies, there was only slight relief, the skin would not fully heal.
While his Dermatologist seemed happy with some of the progress, and mentioned “it could be worse.” Ken knew his hands were not all the way better. They still continued to feel really itchy and would still form blisters despite all the steroids.
He finally decided to try Naturopathic Medicine to treat the ROOT CAUSE of his skin problem. He felt that there had to be another solution.
Within a month of using my naturopathic approach, Ken’s eczema improved dramatically, and was almost gone! His hands were back to normal within 2 months.
Ken feels better than ever, and is happy in his skin again. The main thing I did for Ken was improve his nutrition. Eczema patients always have triggers we need to identify in their diets as well as hormone imbalance we need to test for to understand why the skin is so unhappy, as I discuss more in my "Hormones and Dermatology" blog. This is why women in perimenopause and menopause develop eczema later in life.
Need my help treating eczema? Simply visit my SCHEDULE page to treat yourself to a Holistic Dermatology visit. I would be happy to help!
Dr. Nicole Sundene, NMD
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
Dr. Nicole Sundene
Thyroid hormones impact a variety of roles in the body. Right before my thyroid went into hypothyroidism or low thyroid function, I was suffering from a variety of bizarre symptoms as I tell in my tale of "Why I Became a Naturopathic Doctor."
What happened a few years after all the sudden onset skin problems, allergies, depression, ADHD, and stomach aches was my start of taking thyroid hormone. First I was put on synthetic levothyroxine which was only somewhat beneficial for energy, but I was still tired and it did not fix my skin, hair, or aid with weight loss.
Next I saw a Naturopathic Hormone Doctor and started the better Armour thyroid and began to feel back to "normal." This is when many of the symptoms went away for good. My body was not happy because my thyroid level was too low. This is a genetic condition that runs on both sides of my family. Some thyroid patients need hormones, and some do not and just need nutritional or herbal support.
However, I do not believe in waiting until official hypothyroidism or Hashimoto's has occurred and my patient is forty pounds overweight with cystic acne boils all over their face to begin treatment, as this makes zero sense to me as a bioidentical hormone doc.
With mild symptoms as listed below we can use natural vitamins, supplements, and herbs, and natural thyroid gland. Most women feel better on natural thyroid gland, or NDT "Natural Dessicated Thyroid," yet few doctors want to deal with prescribing it because it IS annoying for them to have to conduct hormone labs twice a year to monitor it, and prescribing levothyroxine only requires one test per year.
While everyone knows that hypothyroidism causes fatigue, hair loss, and weight gain, my patients are often shocked to realize a lot of the medications they are taking is a result of their thyroid being sub-optimally dosed. So today I want to review less common symptoms of hypothyroidism that can occur from lack of proper thyroid medication management, thyroid deficiency, borderline hypothyroidism, and un-diagnosed hypothyroidism.
Many women actually already have all of these symptoms and truly do have hypothyroidism yet their Family Doctor checks just their TSH (a third of a minimal thyroid panel) and tells them their thyroid is fine. Meanwhile, after I have checked the remainder of the missing minimal thyroid test panel I find deficient or completely missing actual thyroid hormones. If you have the below symptoms this is not okay! If you are just getting this as a routine screening a TSH is fine with your check up. But it is not sufficient in my opinion to decipher if your hormone levels are actually sufficient.
Ladies, please look at your labs and if your doctor is just checking your TSH, they are doing you a grave disservice! This is a sign the doctor barely understands the basics about hormones and you should just stop asking them to manage your hormones. Visit my schedule page, and make an appointment with me immediately so we can conduct proper hormone testing, especially important if you are undiagnosed with a cluster of the below symptoms.
Just checking TSH is eighties medicine that should be drop kicked out to pasture with prescribing women synthetic “Horsey Hormones” prescribed in the nineties for hot flashes.
This is not modern preventive medicine in Women's Health. We have better natural things!
First of all spot testing just one hormone when a woman has hormonal symptoms is like mammogramming one breast, looking in one ear, and one eye and assuming the other half is fine. Women are complicated and need a complete female hormone panel with their thyroid. TSH should be used only as a screening tool, as it is actually testing the brain’s messenger, TSH to check what the thyroid.
This is as grossly unhelpful and inaccurate as testing FSH, to determine what a woman's estrogen levels are. FSH is a message the brain sends down to the ovaries to make more hormones. This would be considered completely stupid for me to do by any doctor I have ever worked with in the past twenty years. MD or ND. So why is everyone obsessed with this minimalist TSH testing and synthetic thyroid hormones? Why and ew?
The truth is that most MD's do not want to deal with natural hormones and have been brainwashed against them in the eighties, when they were told they are dangerous by the synthroid rep, despite my hearing time and time again from women that they feel better on natural thyroid hormones verses synthetic synthroid or levothyroxine.
Synthetic hormones and lack of proper thyroid testing is failing women at a rate faster than I can work to keep up with, so I am writing this blog and I ask that you please share this with your girlfriends that need to know so women can be educated up front about the following symptoms that indicate you may have low thyroid function, hypothyroidism, Hashimoto's or suboptimal thyroid dosing from T4 monotherapy aka Levothyroxine.
These symptoms are likely to erupt in the forties and fifties with perimenopause and menopause as female hormones suppress thyroid function when too high or too low.
LOW THYROID SYMPTOMS: HYPOTHYROIDISM
HIGH THYROID HORMONE SYMPTOMS: HYPERTHYROIDISM
Isn’t it interesting how some of the thyroid symptoms occur when the thyroid dose is either too high or too low like shortness of breath, fatigue, hair loss, nerve pain, and moodiness?
No matter how the thyroid ball bounces, getting thyroid hormone dosed correctly is imperative in Women’s Health. Especially in my patients that are menopausal , perimenopausal, or have PCOS, Insulin Resistance, or PMS as very few doctors understand the interconnection of adrenal, thyroid and female hormones that occurs at menopause, and oftentimes I hear women “just don’t feel right” until I get the entire “Spider Web” of interconnected hormones corrected.
Need my help testing hormones and correcting thyroid function? That is one of my favorite things to do as a Female Hormone Specialist and thyroid patient myself. Getting the thyroid perfected is one of the most important ways to help women feel energetic, fit, happy and optimal!
Dr. Nicole Sundene
(480) 837-0900
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Specialist in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
Dr. Nicole Sundene, NMD
Author of "The Hormonal Acne Diet Program"
Cystic Acne is a form of Hormonal Acne that does not respond to the same treatments I use for my regular acne patients. Topical treatments for cystic acne are generally ineffective because they tend to only aggravate and dry the skin on the surface while failing to address the root cause of the cystic acne forming deep below the layers of skin.
Today I will share "Dr. Nicole’s #1 Cystic Acne Potion Recipe"
I am posting this simple recipe here for someone that might need it, and also as an important reminder to TEST your essential oils on your wrist before applying to your face. The skin is sensitive and inflamed, especially in hormonal acne and cystic acne. So start with 1 drop of thyme per 1 oz of aloe vera.
Most women use about 2-5 drops of organic thyme or lavender or a mixture of the two. Try one first before the other so we can observe your skin is improving and not aggravated by anything. Allergies are rare with natural medicines but they do happen so it is important to start with a low amount and work up to what is not too strong to smell. This should not sting or burn when you apply it to your skin. It should only soothe it.
Pure lavender can be used undiluted and dabbed on with a q-tip, although I don’t recommend doing this for cystic acne or hormonal acne as oil is the last thing the skin needs and we need to work to make the skin less greasy overall to prevent clogged pores.
In traditional acne, oil from the sebaceous glands trap dirt and bacteria into the pore causing acne lesions. Cystic acne forms below the layers of the skin and generally topical treatments do not help, except what I will share today.
Aloe vera is an important anti-inflammatory treatment that can also help reduce the scarring associated with cystic acne. Thyme has been researched as an effective acne treatment, as has lavender. I find thyme to be far more effective for my acne patients in my Holistic Dermatology and Hormone practice.
If you have cystic acne it is very important that you work with a skilled hormone doctor that understands this condition and can help diagnose the "Root Cause" of the cystic acne. Oftentimes there are multiple hormone imbalances going on that I find, and not just one. Patients will say "I got my hormones checked," and there is 1-2 tests which is not the 5-7 pages of hormone tests that I generally first order for cystic acne patients to determine the hormone imbalance.
A Naturopathic Hormone Doctor will be able to diagnose the multiple factors impacting the skin for your cystic acne which include: 1) Hormone Imbalance 2) Dietary Triggers 3) Environmental Triggers
Without a proper program to address cystic acne at the root cause, such as "The Hormonal Acne Diet Program," patients generally end up with terrible scarring from having cysts form all over their faces from this form of hormonal acne. Once a cyst forms the sac around it will always continue to fill back up with fluid and recur.
If you have cystic acne and need my help preventing permanent scars on your face, simply pop over to my SCHEDULE page to treat yourself to a Naturopathic visit. I would be happy to help! I will have scars on my face forever, and as a result of that I hope to always work to prevent women from having scarring due to cystic acne.
Dr. Nicole Sundene
Author of "The Hormonal Acne Diet Program"
(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, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology, Acne, Psoriasis, Eczema, and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 23 years of experience in both Prescription and Natural women's health and hormones, she presents to women the best-integrated health solutions for their Chronic Disease.
She has been an Herbalist for over 28 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan (not Medicaid) and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!
Dr. Nicole Sundene, NMD
Holistic Psychiatry & Hormones
Is Your Brain Starved of Progesterone?
Progesterone plays a very important role in the brain and for anxiety and mental health. Women with anxiety and depression should be tested for progesterone deficiency as it can create an adverse impact on mental health when not properly addressed.
A simple progesterone cream or pill can help replace the depleted progesterone levels. We need to monitor our mental health patients properly because too much progesterone can cause anger, agitation, moodiness, and depression. Although I rarely hear that reported as a side effect of taking progesterone cream. Progesterone pills and lozenges are more likely to cause this side effect.
I like the Metabolic Maintenance progesterone cream available via my Vitamin savings page. This cream is in a nice base, is by a trusted reputable company, and does not contain any other herbal medicine ingredients which some of my patients do love having in their progesterone cream, while others with a lot of food and herb allergies such as myself prefer to keep their ingredients simple.
The limitations to OTC progesterone cream is generally dose. Most of the OTC brands I have evaluated provide around 25mg per pump of progesterone that a woman then applies to her wrists, bikini line, backs of knees and non fatty areas. Applying 4 pumps of this body lotion can become annoying and this is when my patients ask for a prescription at the compounding pharmacy so they have a more concentrated cream. However, for my patients over 55 that I am phasing hormones down on these OTC doses are often the perfect amount for keeping hot flashes, insomnia, anxiety, and rapidly aging skin away!
Progesterone cream should always be applied at bed time as it aids with sleep. Some of my anxiety patients do apply some in the morning to also aid with anxiety and hot flashes.
I commonly receive new patients with progesterone deficiency that are on several mental health drugs to compensate for a simple hormone deficiency that begins to occur around age 35. Back in the 90's when I worked for a Hormone Doctor, we gave everyone synthetic estrogen and believed that progesterone cream or pills were not necessary for women that do not have a uterus. Boy were we ever wrong!
This is antiquated hormone thinking, and about as old-fashioned as prescribing Premarin for menopause patients. I no longer work in an office that prescribes synthetic "horsey hormones" and I have since witnessed the dramatic importance of progesterone on mental health.
Women's eyes, and vaginal mucosa also need progesterone cream. Nightsweats and insomnia also can occur from progesterone leaving women in state of chronic fatigue, brain fog, memory loss, difficulty concentrating, and ADHD.
Hormone imbalance can strike more than just the female organs. As a Women's Health doctor, I actually see it impacting women’s mental health even worse than how low progesterone causes heavy bleeding, fibroids, and endometriosis.
While women commonly think of pregnancy when they think of progesterone, I hope this blog will serve as an important mental health PSA about the importance of progesterone for mental health!
When progesterone deficiency is occurring women report to me they are having physical symptoms like insomnia, autoimmunity, night sweats, weight gain, and vaginal dryness.
10 Mental Health Warning Signs of Progesterone Deficiency:
Did you know progesterone cream aids with neuroregneration and works as a neuro-steroid? Those with concussions, and damage to the nervous system such as in Neuropathy, MS, and ALS generally report feeling better on progesterone!
It is time to stop the hormone insanity from the 1990's and JUST GIVE WOMEN PROGESTERONE.
There is absolutely no reason not to give women progesterone cream unless they have a family history of cancer, then I do not prescribe any hormones. I also do not prescribe any female hormones to women that won't get cancer checks such as pap smear and mammograms as that is simply dangerous.
But for mental health reasons, women need more than just estrogen to feel mentally healthy and balanced. They need progesterone, and they also need testosterone. Low testosterone is related to low self esteem and "Imposter Syndrome" in women. I commonly see women with high testosterone behaving more confidently and assertive than their testosterone deficient counterparts.
As I discussed in my article on "Natural Treatments for Night Sweats," synthetic hormones should be put out to pasture with the horses they collect urine from to make them. Prescribing ONLY estrogen to women should ALSO be put out to pasture. Women everywhere should be educated that they need all three female hormones in proper balance to feel mentally healthy.
Let's stop wrongly labeling and stigmatizing women with anxiety and depression, when they should instead be labeled with hormone imbalance or hormone deficiency.
For most women, a simple balanced combination of bioidentical estrogen, progesterone, and testosterone, in a cream or lozenge aka "troche" is really all most need in order to feel optimal mentally and physically. A lot of my female patients don't even require herbs or supplements then to correct their mood because the hormones are doing their job. While I am happy to prescribe herbs for anxiety, I also prefer to use the least amount of things possible along with a very healthy diet to keep my patients healthy.
The best thing you can do for your future hormone doctor to have your hormones tested in the first half of your cycle when they are low and you feel happy so that your doctor can mimic those same levels with bioidentical hormones such as estrogen and progesterone cream if need be for your mental health someday.
If you need my help with your hormones now, simply pop over to my SCHEDULE page to treat yourself to a Naturopathic visit!
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, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology, Acne, Psoriasis, Eczema, and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 23 years of experience in both Prescription and Natural women's health and hormones, she presents to women the best-integrated health solutions for their Chronic Disease.
She has been an Herbalist for over 28 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan (not Medicaid) and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!
Semaglutide is the newest “Naturopathic” weight loss fad I am already sick of talking about because it is not natural and it is not Naturopathic. So I basically wrote this blog so that when patients with just 5-15 pounds to lose ask me if they should try Ozempic for weight loss, I can just text them: “NO!” with a link to my research here that concludes we should take a “wait and see” approach unless it is for severe obesity caused by insulin resistance.
Let’s review the current existing research and separate the facts from all the false marketing materials I am seeing my patients bring me about the shot. Much of what these weight loss centers, even the Naturopathic ones, are stating about this shot is grossly untrue. We will also discuss the natural alternatives to Ozempic and how Naturopathic nutrition works to lower insulin naturally without medication.
NATURAL ALTERNATIVE TO SEMAGLUTIDE
If you need the hormone balancing nutrition program I specifically designed to help balance female hormones and insulin you can pick up my Hormonal Diet Program. I should of course first disclose that I have my own hormone program, as a hormone doctor, and of course I think is much better for women's hormones and health, and safer than taking a weekly diabetes shot before we get started.
For my patients that are doing the shot against my advice we are in agreement they are working on their nutrition while using the weight loss shot so they have solid healthy habits in place for when they reach their goals and eventually go off the shot. Because Insulin is the "Mother of Female Hormone Imbalance" the diet program I have already designed does work to lower insulin over time. Nutrition and treating insulin resistance at it's root cause....nutrition takes time. Especially when diabetes runs in my patient's family, and they are genetically predisposed to higher insulin levels.
I must also admit that I never participate in Naturopathic fads. I never prescribed HCG, or HGH, I don't give my patients IV's because I am a classic Bastyr trained Naturopathic Doctor and prefer to treat my patients at their “Root Cause.” So I will offer a second opinion on the safety of this weight loss medication so that in the event women choose to use this shot they do so fully informed and not lied to as I see in the existing marketing hype.
There is no question about the weight loss shot's efficacy. I do see it helping my insulin resistant patients lose weight but we have to look at the long term side effects and existing research before you go signing yourself up for $300/month for the rest of your life as an Ozempic Test Bunny please read this blog!
WHAT IS SEMAGLUTIDE INJECTION FOR WEIGHT LOSS?
Semaglutide also known as Ozempic, Rybelsus, and Wegovy became approved in 2021 for obesity. These weekly shots or pills are currently hitting every weight loss center near me, along with their marketing materials to my patients that are only 5-30 pounds overweight and are reading marketing materials that they are “natural” “thyroid boosting” “immune boosting” and “good for them.” So my “Norwegian Rant” today includes all the latest research on the safety and efficacy of these drugs to burst the Utopian bubble with the realities that the new “Skinny Shot” has REAL safety issues and potential long term consequences women should be educated on before remotely considering.
The take home message if you don’t want to read my entire rant about semaglutide injections for weight loss is to wait and see unless you are severely obese and have tried everything natural with me including testing your hormones, balancing your hormones, improving your nutrition, counseling , exercise, and stress management.
Grab a cup of herbal tea and let's go over this weight loss shot together and look at the pro’s and cons.
IS SEMAGLUTIDE SAFE?
I believe the safest option is to first do everything correctly to avoid taking weight loss medication, such as using my Hormone Balancing Diet program to naturally lower insulin. But that is just how I think and practice medicine and always use natural alternatives and herbal medicine before prescription drugs.
I also must be honest and confess that I do sincerely believe that whether you are going to do semaglutide shot or not you will need my program. My patients following my program on the shot are doing really well and I am seeing their insulin numbers come down over time with their weight to the point they are planning to taper off the shots and use my hormone program for maintenance.
WHAT IS #1 SIDE EFFECT OF SEMAGLUTIDE?
Otherwise the most clear cut side effect is dependency with semaglutide. We may never be able to get you off the shot if you do not adhere to a proper clean Naturopathic nutrition and exercise program.
DOES SEMAGLUTIDE MESS WITH HORMONES?
YES! Anything that stimulates receptors in the hormone system will somewhat “mess up” hormones. Here is what you need to know to protect yourself from the latest marketing nonsense about a new drug with a fresh black box warning for thyroid cancer.
Is it worth risking thyroid and hormone health as well as the other potential side effects of semaglutide medications? Not yet in my humble biochemistry opinion.
Let's separate the facts from the fiction so that women are fully informed up front of the potential side effects and risks of becoming dependent upon semaglutide therapy for the rest of their lives.
WHAT IS SEMAGLUTIDE MADE OF?
Semaglutide is a synthetic peptide drug that is manufactured in a lab. Semaglutide is made of amino acids and is a man made chemical that is NOT natural in my opinion as it has two different amino acid changes from the actual natural or endogenous form and only mimics it by 94%. So anyone purporting that semaglutide is “natural” or calling it a “natural peptide” is either intentionally lying or very stupid when it comes to biochemistry. Most likely they making fraudulent claims which is morally and legally wrong.
First off, calling semaglutide “natural” is like calling the thyroid hormone synthroid or levothyroxine “Natural” when it is chemically manufactured. Nor is synthroid derived from a “Natural source” so calling such a medication natural is a false statement and biochemical FRAUD. The synthetic thyroid hormone from the pharmacy does not come from a natural source like Armour thyroid, but instead comes from synthetic manufacturing. Synthetic manufacturing is also the case with semaglutide and thus is not actually “natural peptides.”
Semiglutide only mimics natural human GLP-1 by 94% and is not the same exact “natural peptide.” This is an annoying false claim that is inaccurate and misleading for women. I have zero respect for any Naturopathic Doctors that are purporting this as a “Natural Peptide” or “Natural and Safe” weight loss system. There are risks, we don’t know the long term consequences beyond a few years, and it's not 100% natural. So please consider these factors before deciding to shoot up with Semaglutide!
My gravest concern aside from cancer is the autoimmune research I found that we will discuss below. The fact that some patients are making antibodies to semaglutide and their own natural GLP-1 after receiving the shot is concerning and may result in some new form of an autoimmune disease at some point that doctors have never seen before. As a doctor with chronic pain from an autoimmune disease, I find this gravely concerning, because once the antibodies form, it is difficult to get them to stop. I know this very well because this is what many autoimmune patients seek me out to help with and it can take a solid 6-12 months to get Hashimoto's antibodies down if not longer.
SEMAGLUTIDE IS NOT NATURAL
Any Naturopathic Doctor, Endocrinologist, or Weight Loss Clinic falsely labeling their semaglutide weight loss shot as “Natural” or “Natural peptides” should have their license revoked for either being stupid or a scam artist. Patients are not medically trained to know the difference between natural and synthetic man made chemicals. This is the #1 sign you are being lied to by an unethical doctor that is desperate for money and now hopping on the Semaglutide Gravy Train.
Sorry if I sound rude but I am disgusted by the utter lack of ethics from some of the people in the medical industry that are capitalizing on something they have falsely led consumers to believe is natural. It only takes a few bad Naturopathic Doctors to make our entire profession look horrible to MD’s and the public. If someone wants to offer the shot to patients that is their professional choice, but they should at least be honest about the ingredients and side effects.
WHAT IS THE RISK OF PEPTIDE THERAPY, SEMAGLUTIDE, OZEMPIC?
Since early 2022 women are calling me, texting me and asking me daily thanks to misleading marketing scams in my profession about the latest weight loss shot or “Skinny Shot” semaglutide, or Ozempic I felt compelled to post the research of the “Other side” of the shot like Ozempic Face, Rebound Weight Gain, Dependency, Gallbladder Disease, Thyroid Cancer, Diabetic Retinopathy, Immune Response, Autoimmunity to endogenous GLP-1, Nausea, Vomiting, Diarrhea, GI Adverse side effects, loss of lean muscle, appetite control, eating behavior changes, intestinal obstruction, serious allergic reaction, anaphylaxis, increased heart rate, increased hospitalization for heart failure, potential kidney failure, unknown long term cardiac risk from stimulating the GLP-1 receptors in the heart and increasing heart rate over the long term, rats given semaglutide had increased thyroid and endocrine system cancer [1-13].
For most of my patients that is all they need to read and know that in my mind it’s a solid NO for the big O shot. For everyone else that wants to dig through these research studies that currently exist both bad and good I will break down each research study demonstrating side effects in detail. If you are going to choose to use semaglutide at least be properly informed and not a victim of marketing hype that is not true or supported by research, data, and facts we currently are lacking.
IS SEMAGLUTIDE WORTH IT FOR WEIGHT LOSS?
Any patient that knows me well knows I hate most medications, especially all new medications. This is because I have been working in Family Medicine for over twenty five years on both the prescription and natural side and I have seen all the shiny new drugs that were once regularly used by patients recalled. I have also seen bad side effects from drugs, that I have never seen with herbal medicine and nutrition in Naturopathy.
But dozens of times in my career have I sat at a “Drug Rep Lunch” with a fancy shiny new drug that sounds too good to be true, only for the FDA to recall it, or the company to recall it themselves just a few years later.
I can go on and on about watching Vioxx, Accutane, Fen Phen, Baycal, Bextra, Premarin, Prempro, Zantac/Ranitidine, come and go but we will focus on semaglutide today.
Doctors that have been around a while are generally less Utopian about a new drug and instead a bit skeptical of anything new, as we should be. Patient safety should always come first, and doctor’s have taken an oath to “First, Do No Harm.”
So the truth about semaglutide at this point, is that if you are taking a new drug that has not been tested long term, you have essentially signed yourself up as a “Test Bunny” for the drug as nobody really knows its long term effects until the Test Bunny group of people all try it for twenty years. This is why many new drugs do not survive the five year mark because they are shown to cause serious adverse side effects within a few years.
So we cannot just get sucked into the marketing as women, and we do not need to have unrealistic expectations of our perimenopausal and menopausal bodies and risk a potentially dangerous shot just to lose 5-10 pounds.
So today I will discuss the questions patients are most frequently asking about the weight loss shot semaglutide, what you should know about it’s risks and potential benefits.
Ok #1 as a Naturopathic Doctor that has been around since Herbal Phen Fen, regular Phen Fen, the HCG diet, the HGH diet, Keto Diet, Celery Juice, etc…. I must disclose up front that I never participated in any of those other weight loss programs as I see them as scams, and not in a woman’s best interest for her long term health.
I will admit I do have many patients on this weight loss shot right now, and they are doing it against my advice and we have just agreed to disagree about it. The one positive thing I do actually see happening to consider is that it does reduce hunger and cravings. A lot of my patients are using the appetite suppressant effect along with my hormone balancing diet program, knowing that the recipes are all designed to balance the female hormones and insulin resistance that naturally occurs with aging induced hormone imbalance in women.
This way when we do finally decide to take the semaglutide shot away they are eating in a manner that is continuing to balance their hormones and are already on a system that they can sustain to prevent the rebound weight gain that is the main concern I have for many of my patients that are severely overweight.
I worry my obese patiuents cannot afford to gain more weight back after they discontinue the shot, and the research studies indicate that discontinuing the shot may be the problem. Once you start the shot you may not be able to stop, you may end up twice as overweight as you started if you do stop the shot.
FREE COUPON FOR SEMAGLUTIDE? YOU MAY PAY FOR LIFE
Getting people hooked on drugs for free is the ultimate drug dealer scam. So are the first month of semaglutide shots really “free?” If the shot is something you may have to be dependent on for the rest of your life to maintain your weight, it is a bait and switch scheme.
This is the #1 bait and switch game that drug manufacturers play to get patients hooked on their medication, so they are stuck paying for it for the rest of their lives. At this point we don’t know how long you will need to take the semaglutide shot for, in order to maintain weight loss. Since most research studies are conducted for two years this is not a quick fix but something you may need to pay >$1000.month for two years or longer! The problem is that most research finds discontinuing the shot results in going back to being obese [13]. You may need to afford to stay on this medication for two years or even longer [14-17].
If you are rich and famous and can afford to potentially be addicted to a shot for $1000/month then that is one thing. Most of my patients cannot afford that risk financially. In a New England Journal of Medicine 2021 research study, semaglutide was found to be the inferior choice for doctors to combine with metformin in diabetes, which makes me wonder if some of this new weight loss shot push is because the manufacturer is losing out on diabetes business they once had.
Before starting this shot ask yourself if it is affordable for you to continue paying for it weekly for the rest of your life. If you can afford to be twice as overweight as you are right now should you experience “Rebound Weight Gain,” and if you can afford to risk the side effects that potentially include cancer.
SEMAGLUTIDE MISUSE OF “PEPTIDE THERAPY” IN MARKETING
Semaglutide is being misrepresented in a very clever biochemical way by weight loss centers. First of all they are categorizing the benefits of all peptides into one entire group of benefits. We cannot just refer to “peptides” or “natural peptides” as just one thing. Peptides can be natural or synthetic and are represented by many different drugs.
This is like me stating the benefit of all herbal medicines that have ever existed and say these benefits are for nettles. Just because nettles are an herbal medicine and other herbal medicines also have benefits does not mean that nettles share that same benefit for being in the same descriptive category.
Peptides are a description of a type of medication or a class of medications doctors refer to as “Peptide Therapy.”
Peptides are a category of drugs made from amino acids designed to treat MANY different conditions like Diabetes and Multiple Sclerosis. Stating the benefits of all of these peptides as a whole when stating the benefit of using just one form of a peptide is fraudulent marketing and is happening at weight loss centers everywhere. Most women are not educated enough to understand they are being lied to.
While it is one thing for a weight loss center to honestly offer this shot, inform people it is synthetically manufactured and has a black box cancer warning with it but may be the only solution to stubborn weight loss…
What truly disturbs me as a Naturopathic Doctor are the other Naturopathic weight loss clinics that are upright lying to women and telling them these are “Natural peptides” or “peptide therapy” that is “good for their thyroid and heart” when there is a clear black box warning for thyroid cancer, and demonstrated research I will discuss that causes an increased heart rate and potential increased risk for heart failure.
Currently nobody knows the actual long term side effects of using semaglutide. So anyone purporting it as the safe and natural is crazy in my medical opinion.
Any doctor or clinic that says semaglutide is “natural” and “good for you” and acting like they actually know what is going to happen to you twenty years from now from taking weekly semaglutide shots is a liar, and clearly lacking good ethics.
PEPTIDE THERAPY IS A CATEGORY
Semaglutide is merely mimicking just ONE TYPE of peptide that occurs in the body. Many doctors and weight loss centers are using the word “Natural Peptide” incorrectly to mislead the patient into falling victim that this is 100% natural and safe. This is a chemically manufactured medication that does contain natural amino acids but they are manufactured in a lab into a protein sequence that is not “natural.”
This is NOT like how we give women bioidentical hormones from yams or soy. This is not manufactured as the exact same chemical your body naturally makes. Semaglutide is only 94% similar to the natural form. I believe doctors using the word “Natural” for semaglutide products are making false statements and misleading patients.
IS SEMAGLUTIDE SAFE AND EFFECTIVE?
Whether you have chosen to avoid semaglutide or are choosing to go against my advice and do it anyway, I do recommend to my patients on the injections that they follow my Hormone Balancing Diet designed to help balance female hormones, insulin resistance, and weight gain. By eating my hormone balancing diet you can lose weight without an expensive weekly injection and avoid its inevitable side effects.
While I originally designed the diet to treat my hormonal acne patients, I have since used it for balancing female hormones and insulin. So for those on the injections they still need a solid Hormone Balancing nutrition program in place or they will not be able to ever stop the shot, and will likely have the same “Rebound Weight Gain” that I had to deal with when patients stopped their HCG Diets that I also told them not to lose and then we had to work to help them lose eighty pounds instead of forty.
So this is why I approach this new shot with dread because ultimately patients may end up in the same metabolic mess after using HCG and diets that are too restrictive in calories!
SHOULD I TAKE SEMAGLUTIDE FOR WEIGHT LOSS?
Moral of the story. You cannot cheat the system. When you try to cheat the system and lose weight without a solid nutrition plan in place, you will fail and either gain double the weight back, or never be able to stop the semaglutide injections and need to pay for them for the rest of your life. For a drug that has only been approved since 2017 we are already seeing gallbladder disease, intestinal obstruction, and cancer as potential consequences. The majority of diabetes drugs already have class action lawsuits related to cancer, so before I even looked at the existing research on semaglutide I knew that it would have cancer listed as a potential side effect.
IS THERE A NATURAL SUBSTITUTE TO SEMAGLUTIDE, PEPTIDE THERAPY?
The safer, more cost effective alternative to being an unpaid Lab Test Bunny for Semaglutide shots is using proper nutrition and herbal medicine for weight loss and hormone balancing. My Hormone Balancing Diet has helped many women achieve hormone balance and optimal weight in my practice and I trust it works when patients properly follow it. Whether you are going to choose to risk it and try the shot or not, my program will help you achieve success and you will STILL need a hormone balancing diet program that specifically lowers insulin like the shot in place in order to withdraw from the semaglutide shot without the risk of rebound weight gain.
So I do have a handful of obese patients using the shot with my program and planning to taper off the shot towards just my program. I do hear that it is easier for them to adhere to the program because they have less hunger and cravings. So I am going to state the positive about the shot without overinflating it.
One concerning side effect I am already seeing in my practice with these patients is higher than normal total estrogen levels. Since most hormone doctors just test the estradiol and not the total hormone levels, this is most likely missed and likely the mechanism behind increased endocrine cancer from semaglutide.
BEST NATURAL ALTERNATIVE TO BALANCING INSULIN AND HORMONES
Proper nutrition and herbal medicine is the better natural alternative to risking dependency on semaglutide injections. I truly believe my Hormone balancing diet program is a safer, better, anti-aging option that has me looking and feeling my best at forty-seven.
My own Naturopathic health journey involves struggling with postpartum depression, anxiety, weight gain from insulin resistance after the birth of my daughter. So I have been through it and know exactly how to test and treat hormonal weight gain.
The best part about my hormone balancing diet program is the majority of my patients say it is super easy to follow, they are saving money on the recipes, they enjoy eating clean, and they look and feel amazing! Investing in nutrition is always the better alternative than prescription drugs. To follow my simple Mind/Body/Spirit Naturopathic program and improve your health and weight via nutrition and herbal medicine.
To pick up my Hormone balancing diet program visit: www.FHnaturopathic.com/hormone
If you need my help with using natural medicine, herbs, and natural hormones for your female hormones, insulin resistance, or weight loss I would be happy to help you! Simply pop over to my SCHEDULE page to treat yourself to a Naturopathic visit. For those doctors and nurses, and researchers that want to review the existing semaglutide research, we will dive deeper into the existing peptide therapy research studies.
REBOUND WEIGHT GAIN AND PERMANENT DEPENDENCY ON SEMAGLUTIDE
In clinical trials, semaglutide led to an average weight loss of approximately 15% at 68 weeks among participants without type 2 diabetes, with sustained results observed at the two-year mark. That is 15-20 pounds for the average woman. I see women in my practice losing that much weight a lot faster than over two years. Occasionally I hear my patients telling me they lost thirty pounds in just one month on my Hormone Balancing Diet Program. Very often women lose the 15-60 pounds they need to lose in three to six months of working with me using herbal medicine and natural hormones. So if we can use an alternative to semaglutide then we should because the weight loss may not be as dramatic as women expect.
Especially, when the main concern with semaglutide use is the potential for dependency and affordability. In a trial extension, participants who withdrew from semaglutide treatment regained 11.6 percentage points of lost weight by week 120, resulting in a net loss of 5.6%. Cardiometabolic improvements observed with semaglutide reverted towards baseline at week 120, indicating that ongoing treatment might be necessary to maintain weight loss and health improvements [1].
LONG TERM SAFETY OF SEMAGLUTIDE: LACKS RESEARCH
Semaglutide is a newer drug that has only been FDA approved for diabetes since 2017. While semaglutide has shown promise in treating Type 2 Diabetes and obesity, there are several concerns to consider before using it for weight loss. The long-term safety of semaglutide is still uncertain, as there is no complete Phase IV clinical trial investigating its side effects, efficacy, and safety in the long run. Until more comprehensive studies are conducted, it is advisable to avoid the risk of a new medication until the long term studies have been conducted. For mild or moderate weight loss the shot is simply ludicrous and should not be used.
SEMAGLUTIDE OZEMPIC RISKS BLACK BOX WARNING: THYROID CANCER
Semaglutide carries a black box warning for thyroid C-cell tumors in the US, based on rodent studies. Though medullary thyroid carcinoma (MTC) is rare, regulatory authorities require additional monitoring of MTC incidence in the US for at least 15 years, with results expected by 2035-2037. Semaglutide is contraindicated in patients with a personal or family history of thyroid disease, thyroid cancer, MTC and patients with multiple endocrine neoplasias (MEN) type 2 in the US [2]. As a doctor that specializes in Hashimoto's I would not recommend taking this drug as my Hashimoto's patients are more likely to have benign thyroid nodules. Hypothyroidism, or low thyroid function is also associated with thyroid nodules. However, nodules can sometimes become cancerous over time. Therefore I do not recommend any of my thyroid disease patients take Ozempic.
VISION: INCREASED DIABETIC RETINOPATHY ISSUES ON SEMAGLUTIDE
In the SUSTAIN-6 trial, an increase in diabetic retinopathy complications (DRP) were reported for semaglutide compared to placebo. In PIONEER 6, unadjudicated diabetic retinopathy complications occurred in 5.8% of oral semaglutide-treated and 4.8% of placebo-treated patients [2].
Early worsening of pre-existing diabetic retinopathy complications was secondary to the initial and rapid improvement in glycemic control in SUSTAIN-6. A large trial is ongoing (FOCUS trial, NCT03811561) assessing the long-term effects of semaglutide on diabetic retinopathy complications in patients with Type 2 Diabetes. Until then, caution should be exercised when using semaglutide in patients with diabetic retinopathy complications [2].
SEMAGLUTIDE INDUCED AUTOIMMUNITY: ANTIBODIES TO GLP-1
Semaglutide can trigger an immune response, leading to the production of antibodies against the drug. In some cases, these antibodies may cross-react with endogenous GLP-1. Clinical trials revealed that 2.9% of patients treated with Wegovy, a semaglutide formulation, developed anti-semaglutide antibodies. Among these patients, 56% had antibodies that cross-reacted with endogenous GLP-1. The impact of anti-semaglutide antibodies on treatment efficacy and hypersensitivity reactions remains unknown and may potentially cause a new type of brand new unknown autoimmune disease, with unpredicatble symptoms [2].
DIARRHEA, VOMITING, NAUSEA, AND GI SIDE EFFECTS ARE COMMON
Phase 3 trials have shown that oral and subcutaneous semaglutide can cause gastrointestinal disturbances, such as nausea, vomiting, and diarrhea. Higher doses of both formulations are often associated with more frequent stomach adverse effects. A dose escalation scheme is advised, starting with a low dose. Stomach complaints with semaglutide generally occur during dose escalation in the first 8-12 weeks of treatment and wane over time. Overall, the adverse effects are mild to moderate in severity and often self-limiting [2].
GALLBLADDER INCREASED EVENTS ON SEMAGLUTIDE
Although it is unclear exactly why, the patients in the research study receiving weekly injections of semaglutide had increased adverse gallbladder events. GLP-1RA treatment, including semaglutide, has increased the risk of gallbladder events.
In the SUSTAIN program, 1.4% of patients treated with semaglutide developed a gallbladder event, mainly cholelithiasis. In the PIONEER program, cholelithiasis occurred more often in the semaglutide-treated group (0.6% vs. 0.1% with placebo). Gallbladder events have not been linked to mortality. The cause of these gallbladder events is unclear, with several potential mechanisms being suggested [2, 3].
LEAN MUSCLE MASS LOSS AND RAPID WEIGHT LOSS CONCERNS
Another concern is the potential loss of lean muscle mass in patients experiencing more than 15% weight loss with semaglutide. This issue can arise when patients consume too few calories to maintain adequate protein intake, leading to muscle loss. This is why Ozempic face happens, and skin can look droopy, losing it's elasticity as is common with menopause and hormone imbalance such as hypothyroidism.
OZEMPIC FACE: FACIAL CHANGES FROM SEMAGLUTIDE WEIGHT LOSS
Individuals taking semaglutide may observe a decrease in facial fullness, referred to as "Ozempic face," due to rapid and significant weight loss leading to facial fat loss, looser skin, and more prominent wrinkles. Coupled by the fact that most insulin resistant weight loss patients in my practice eat a high carb low protein diet, so without correcting the protein deficiency and continuing to eat carbs their facial skin will become very saggy. At minimum take a protein shake if choosing to risk taking this drug. Especially if you are in menopause and already have lost a lot of collagen and skin turgor and elasticity from it.
Aggressive weight loss can also result in nutrient deficiencies, muscle loss, and collagen loss, which may contribute to the appearance of facial aging [6].
SEMAGLUTIDE APPETITE SUPPRESSION AND EATING BEHAVIOR CHANGES
Importantly, semaglutide may impact appetite control by interacting with specific brain cells and chemicals, potentially leading to changes in eating habits or food intake behavior. This alteration in the brain's appetite-regulating pathways could cause nausea or contribute to the development of eating disorders [7].
SEMAGLUTIDE AND INTESTINAL OBSTRUCTION RARE SIDE EFFECT
Although no cases of gastric outlet obstruction have been reported with semaglutide, healthcare providers should be aware of potential risks and monitor patients closely for symptoms. A case of a 29-year-old male with type-1 diabetes experiencing symptoms of intestinal obstruction after a single injection of semaglutide highlights this concern [8].
SEMAGLUTIDE MENTAL HEALTH SIDE EFFECTS: SUICIDAL BEHAVIOR AND IDEATION
Clinical trials have reported mental health issues such as suicidal behavior and ideation with weight management products, including semaglutide. Healthcare providers should closely monitor patients for signs of depression, suicidal thoughts, or unusual mood changes. Semaglutide should be avoided in patients with depression, or a history of suicidal behavior and discontinued in patients who develop depressed thoughts or suicidal ideation.
SEMAGLUTIDE SEVERE ALLERGY AND ANAPHYLAXIS: HYPERSENSITIVITY
Severe allergic hypersensitivity reactions, such as anaphylaxis and angioedema, have been reported in patients using semaglutide. It is advised to avoid its use in patients with a history of reactions to semaglutide and exercise caution in those with a history of reactions to other GLP-1 analogs [2].
SEMAGLUTIDE PANCREATIC SAFETY: PANCREATITIS AND PANCREATIC CANCER?
SUSTAIN 6 and PIONEER 6 trials showed no signals of pancreatic adverse events with semaglutide. A meta-analysis of available cardiovascular outcome trial data argues against any effect of GLP-1RA on pancreatitis and pancreatic cancer incidence. A subtle and asymptomatic increase in plasma lipase and amylase levels is consistently found but is not associated with pancreatic events. The FDA and EMA concluded that a causal association between incretin-based drugs and pancreatitis or pancreatic cancer is inconsistent with the current data [2].
SEMAGLUTIDE HEART RISKS: INCREASED HEART RATE AND HEART FAILURE
Semaglutide, like all GLP-1RAs, increases heart rate, as reported in research studies. However, it did not lead to an increase in cardiovascular outcomes. The effect of GLP-1RAs on heart rate is important in patients with heart failure. While the semaglutide cardiovascular outcome trial did not show an increased incidence of hospitalization for heart failure, studies with other GLP-1Ras, like liraglutide, in heart failure patients showed an increased incidence of serious cardiac events. The underlying mechanisms for the GLP-1RA-induced heart rate increase remain unclear [9, 10].
SEMAGLUTIDE KIDNEY FUNCTION: ACUTE KIDNEY INJURY REPORTS
Initial case reports suggested that GLP-1RA treatment could cause acute kidney injury (AKI) in some patients. In the SUSTAIN program, acute kidney failure was only reported in SUSTAIN 6, where its occurrence was similar between semaglutide and placebo. In the PIONEER program, acute kidney injury occurred in 2.0% of patients treated with oral semaglutide and 2.3% of placebo-treated patients [11, 12].
IS THERE A NATURAL SUBSTITUTE FOR SEMAGLUTIDE OR OZEMPIC?
For women with under 100 pounds to lose, they likely do not need semaglutide and can lose the weight with diet, hormone, and nutrition changes. My Mind/Body/Spirit Naturopathic Hormone Balancing Program works to naturally help balance female hormones, insulin, and inflammation similar to the benefits purported with the semaglutide shot. So for those of you seeking natural alternatives to semaglutide or needing a program to maintain the benefits of semaglutide without rebound weight gain please use my hormone balancing diet program.
CONCLUSION: IS SEMAGLUTIDE WORTH IT FOR WEIGHT LOSS?
Semaglutide, a peptide medication, is used for the long-term management of Type 2 Diabetes and Obesity. As a glucagon-like peptide-1 (GLP-1) receptor agonist, stimulates insulin production, slows gastric emptying, extends satiety, and suppresses appetite. While semaglutide has demonstrated efficacy in managing blood glucose levels and promoting weight loss, it is crucial to be aware of its potential risks before considering its use for weight loss purposes. Semaglutide is approved for treating type 2 diabetes since 2017, and weight loss in those with a BMI >30 since 2021.
Nevertheless women that do not have much weight to lose are seeking to use it for mild to moderate weight loss. Many clinics now are helping some of these individuals engage in off-label use of the medication for weight loss, which can potentially harm their health in exchange for a quick way to drop a few pounds, which the research studies show will just return when you stop the shot.
SEMAGLUTIDE ALTERNATIVES: OZEMPIC, RYBLESUS, AND WEGOVY
Semaglutide is available in both injectable and oral forms. Ozempic, the injectable form, is administered weekly via injectable pens in doses ranging from 0.5 mg to 2 mg. Rybelsus, the oral form, comes in 7 mg or 14 mg tablets and is taken daily. Wegovy, another injectable form for weight management, is administered through a weekly pen injection at a higher dose of 2.4 mg.
CONCLUSION ON PEPTIDES, SEMAGLUTIDE, OZEMPIC, RYBELSUS, AND WEGOVY
Semaglutide has shown promise in managing type 2 diabetes and obesity, with significant weight loss results observed in clinical trials. However, it is essential to consider the potential risks associated with its use. The long-term safety of semaglutide remains uncertain,
and there are concerns about various side effects, including gastrointestinal disturbances, gallbladder events, diabetic retinopathy complications, and potential effects on the heart and kidneys.
Given these potential risks, patients and healthcare providers must carefully weigh the benefits and risks of semaglutide treatment. It is strongly advised to consult with a medical professional before considering semaglutide for weight loss or other purposes. As more research and long-term studies become available, we will gain a clearer understanding of the safety profile of this medication. Until then, it is essential to approach semaglutide treatment cautiously and stay informed of the latest research findings.
WHAT CAN BE USED INSTEAD OF SEMAGLUTIDE?
Of course I have to recommend my Hormone balancing diet program designed specifically to help balance female hormones, manage weight, insulin resistance, and inflammation through my years of research and experience helping women with hormone imbalance. Proper nutrition and herbal medicine is the tried and true, time tested way to lose weight properly, healthfully, and maintain it over the long run.
The eight weeks of recipes, meal plans, and grocery shopping lists put together by my nutritionist will ensure you have plenty of healthy ideas to help you reach your weight loss goals. If you need my help with your hormones or weight loss, simply visit my SCHEDULE page to treat yourself to a Naturopathic Hormone Consultation.
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, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology, Acne, Psoriasis, Eczema, and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 23 years of experience in both Prescription and Natural women's health and hormones, she presents to women the best-integrated health solutions for their Chronic Disease.
She has been an Herbalist for over 28 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan (not Medicaid) and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!
References:
By Dr. Nicole Sundene
PCOS or Polycystic ovarian syndrome is a common Women's Health Hormone condition that is improved best by working with a Naturopathic Doctor in my humble opinion after twenty three years of experience working in both prescription and natural Women's Health.
My treatment for PCOS patients as a Holistic Hormone Doctor almost never require medications or birth control pills. There are alternatives to birth control pills and medications for PCOS patients that we will discuss today as well as the risks vs the benefits of many common medications prescribed for PCOS.
PCOS causes hormonal imbalance such as the disruption of estrogen, testosterone, DHEA, cortisol, and progesterone levels. As a result, various clinical symptoms develop, including PMS, Estrogen Dominance, abnormal heavy periods, irregular periods, no period or amenorrhea, anemia, infertility, and a high risk for cancer of the breast, uterus and ovaries when the hormone imbalance is left untreated.[1, 4, 7]
PCOS is common among women of childbearing years, between 15 to 44 years of age. PCOS is affecting 6% to 12% of US women aged between 15–49 years. A research study estimated the worldwide prevalence of PCOS between 6% and 26%. Women with a family history of PCOS or who have diabetes, insulin resistance, or obesity are at higher risk of developing PCOS. [1, 2]
Symptoms of PCOS
PCOS symptoms vary from mild to severe and mostly appear in the late teens or early 20s. It involves a few or many of the below symptoms. [1, 3, 7, 8]
Types of PCOS
Research studies categorized PCOS into many types based on the clinical symptoms and causes responsible for the development and progression. While mainstream prescription medicine manages all PCOS patients with oral birth control pills, metformin and spironolactone, these treatments often fail when we do not have the correct treatment for the correct type of PCOS. Determining which category of PCOS the patient falls in should be done first and foremost prior to implementing any PCOS treatments. The main PCOS types include: [8, 9]
New research on PCOS presented the following subgroups of PCOS patients based on genetic markers. [8, 9]
PCOS Diagnosis and its Criteria
Diagnosis of PCOS should begin with the patient's questioning, family history, physical examination, and checking the other endocrine parameters. As PCOS is a complex disease, so research studies devised criteria for its diagnosis; based on the presence of hyperandrogenism, ovulatory dysfunction, and polycystic ovaries. The presences of any two clinical symptoms in the patient among the hyperandrogenism, ovulatory dysfunction, and polycystic ovaries are necessary for PCOS diagnosis. [2, 3]
The clinician should consider the menstrual history, weight gain or loss, and cutaneous findings such as excessive hair, acne, alopecia, and dark patches for hyperandrogenism confirmation. Plus, ask and evaluate the presence of ovulatory dysfunction via oligomenorrhea and amenorrhea. Also, check for the other medical complications associated with PCOS. [3]
Other lab approaches to assist the diagnostic criteria to include; [2, 3]
Medical Complications of PCOS
Women with PCOS are at high risk of developing certain medical complications. These include type 2 diabetes, gestational diabetes, heart disease, hypertension, depression, sleep disorders, eating disorders, anxiety, plaque formation, and stroke. [6]
PCOS Treatment Guidelines
Although there is no definite cure for PCOS; however certain kinds of treatment interventions are recommended for resolving PCOS symptoms and complications. These interventions include both pharmacological and non-pharmacological approaches that treat symptoms and regulate normal physiological function. While I do not recommend or prescribe pharmaceuticals for PCOS and do not personally find them effective for managing this condition as a female hormone specialist, I will still discuss the risks and benefits of medications for PCOS. [1, 2, 5]
Non-Pharmacological approach
Non-pharmacological approaches involve applying electrolysis that passes electric current into the hair follicles, damage them, and arrests hirsutism. [3]
Weight loss
Weight loss is considered a gold standard for managing PCOS symptoms as weight loss improves insulin sensitivity, particularly in obese PCOS women. Also, obesity increases the risk of metabolic and reproductive abnormalities associated with PCOS. Weight loss is recommended as the first line of treatment for infertility in obese women with PCOS. Unfortunately, there is no approach for permanent weight loss, and weight decrease relapsed in around 90-95% of patients. However, bariatric surgery significantly sustains and reduces weight in obese individuals. Moreover, a hypocaloric diet also helps weight reduction in women with PCOS. But there is no clear evidence of the positive impact of weight reduction on PCOS symptoms. [2, 3]
Natural Diet & Lifestyle For PCOS Symptoms
PCOS Medication Treatment
Different classes of medicines are used for the treatment of PCOS complaints. These include;
Metformin: It is an oral anti-diabetic medication that improves insulin resistance and decreases insulin concentration. Mostly, it is recommended as a second-line drug of choice after clomiphene that induces ovulation, lowers serum androgen, and helps menstrual frequency. Moreover, it showed the best results in combination with clomiphene in obese women with PCOS. Side effects associated with the use of metformin include lactic acidosis and gastrointestinal symptoms such as diarrhea, nausea, vomiting, abdominal bloating, flatulence, and anorexia. [1-3, 5]
Oral contraceptives: Oral contraceptives such as estrogen and progestin therapy help treat PCOS symptoms via inhibition of Luteinizing and androgen hormone secretion, increasing the Sex hormone-binding globulin level, and also act as steroids receptors blocker. The side effects of oral contraceptives include a high risk of thromboembolic events, developing type 2 diabetes, elevated cholesterol and triglyceride level, and may impair insulin sensitivity. Therefore a low dose of oral contraceptives is recommended as the above adverse events are high dose-dependent in high-risk women with PCOS. [1-3, 5]
Progesterone therapy: Natural progesterone and synthetic progesterone such as Cyproterone acetate and drospirenone provide anti-androgenic properties. Some women with PCOS may need a combination or natural progesterone with an oral contraceptive to treat PCOS. The side effects of progesterone therapy include mood elevation or depression, weight gain, and abnormal periods, heavy bleeding, cramping, and spotting. [1-3, 5]
Spironolactone: It helps the treatment of excessive hair and acne. However, there are limited studies about its effectiveness. It is advised to use it with caution in women with renal impairment as it aggravates hyperkalemia as a side effect. Also, it is not recommended during pregnancy due to teratogenicity (congenital disabilities). [1-3, 5]
Please Note: If you do not want to take medications for PCOS and prefer a nutrition and herbal medicine approach then you will be a perfect fit for treating your PCOS. Otherwise, the medicine I use to treat PCOS is nutrition changes, supplements and herbs so there is no point in signing up to work with me if you or your teenager are not willing to make dietary changes. I understand they are hard to do and struggle with them myself, but we at least need to be comitted to making these changes gradually over time to be successful with Naturopathy when treating PCOS symptoms.
If you think you will be able to use Naturopathy and need help diagnosing or treating your PCOS symptoms simply pop over to my SCHEDULE page to treat yourself to a Naturopathic visit!
Dr. Nicole Sundene, NMD
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
References
By Dr. Nicole Sundene
Depression caused by thyroid disease such as Hypothyroidism and Hashimotos Thyroiditis feels like a dead plant in need of water. Often patients will feel flat, blah, lifeless and disinterested in participating in activities when their thyroid level is low. Many patients are also experiencing extreme emotional symptoms while their levels are hovering at the bottom of the normal range. More often than not this chronic thyroid deficiency is going on despite being told their thyroid level is normal. T3 the most active thyroid hormone helps the brain make serotonin. When the thyroid is deficient less serotonin is made. This is why patients with hormonally triggered depression do not improve as expected on antidepressants.
TSH is generally the only test conducted by their doctor to evaluate it. TSH is only accurate 1 in 5 times at diagnosing hypothyroidism. Free T3 and Free T4 levels should always be checked when we suspect a thyroid problem. Just checking TSH is “90’s Medicine” in my opinion that should be stopped. I would never measure just measure your FSH to try to understand your estrogen levels. I would simply check your actual estrogen levels. FSH is also a message the brain is sending down in a feedback loop with estrogen and is elevated in severe states of estrogen deficiency such as menopause. Yet time and time again patients ask for their thyroid to be checked and it is only a TSH checked which tells us only about what your brain is telling your thyroid to do for it and tells us very little about how much hormone your thyroid is or isn’t making.
Depression or anxiety coupled with thyroid symptoms such as fatigue, weight gain, swelling, cold intolerance, constipation, dry skin, hair loss, arthritis and joint pain should be worked up by a doctor that specializes in hormones. Doctors that specialize in fine tuning hormones can help you understand the complex web of hormones and ensure each hormone pathway is optimal and not just “In the normal range.”
I have heard this TSH story nearly every single day of my career for the past 13 years! Let's put an end to the mental health problems caused by hormone imbalance. There are enough depressing things going on right now and we don’t need hormone imbalance causing moodiness.
Please share this important message on Thyroid Depression as many patients are silently suffering and don’t know why they do not respond to the typical antidepressants.
If you need help with your hormones I am always happy to help. Simply pop over to my SCHEDULE page to treat yourself to a Naturopathic visit!
Dr. Nicole Sundene
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
By Dr. Nicole Sundene
Naturopathic Doctor
Acne, formally called "Acne Vulgaris" is an inflammatory skin condition characterized by pimples on the face or body. Acne can be an especially frustrating women's health condition when hormone imbalance is to blame. Topical treatments are often useless or even worsen the acne by drying out the skin or causing too much chemical irritation.
I never had acne as a teenager because the acne I struggled with in my 20's and 30's was triggered by hormone imbalance and my diet as I share in my story "The Acne Doctor's Battle with Hormonal Acne" Nothing I ever tried for my acne ever worked until I found Naturopathic Medicine! At the time I was working for 3 Dermatologists and nothing they tried could ever help my skin.
This is when I learned about Naturopathic Medicine and Nutrition for Acne as is now available in my complete Mind-Body-Spirit- Glow Up Guide "Hormonal Acne Diet Program."
Nutrition is critical for hormonal acne. There is little sense signing up to work with me on your acne, if you are not going to change your nutrition. I understand it is hard, but it will be necessary and it will be the only way I will be able to fix your skin and hormone imbalance.
The reason why I bring this up, is that the body continues to send negative messages such as acne to us when we are missing the "Root Cause" of the acne, especially if it is caused by a Hormone Imbalance, which is the most common cause for women. Women have a much higher rate of acne than men, despite the fact men have 10 times higher testosterone levels. Testosterone is not the only hormone that causes acne. If it did then men would have acne more often than women? This is why my female hormone balancing Hormonal Acne Diet is so important for women to follow (and yes it does help men with acne too as excess estrogen oftentimes is to blame for male acne.)
Estrogen Dominance, Progesterone Deficiency, and Insulin Resistance are often the culprit behind female adult onset acne. While I am happy to discuss all the latest research for treating acne topically in the naturopathic realm...it is imperative we address and treat the root cause of the acne. Which is often triggered by diet and hormone imbalance and requires a full work up by a women's health doctor that understands hormone imbalance and dermatology such as myself.
In 1999 I started my first job in medicine working for a Dermatologist and also a Hormone Doctor. Interestingly enough life has been training me for many years to understand the delicate balance of female hormones and dermatology conditions which is now my considered area of expertise as a women's health doc. I often receive referrals for patients from Dermatologists and other Naturopathic Doctors to help solve the mysterious hidden link behind complex Dermatology conditions.
How Do I know if I have Hormonal Acne?
Signs that acne is caused by hormone imbalance can be determined at no cost to the patient by simply downloading a period tracker app and tracking when the acne breakouts are occurring. If they are constantly occurring prior to a women's menstrual cycle, or worsening around that time, then we know the underlying cause of the acne is likely hormonal. And until we investigate, test, diagnose and treat the hormone balance, topical treatments will generally continue to fail women and simply do not work until we address the acne at the root cause. I discuss this in my Dermatology webinar that explains the simple 3 step process I use to treat acne naturally.
Generally, acne affects the face, chest, forehead, chin, shoulder, neck, and upper back. In Acne, the hair follicle gets clogged with oil, hair, bacteria, and dead skin cells that result in whiteheads, blackheads, cysts, and other types of pimples. Both estrogen and testosterone can impact the skin and make it more oily. Testosterone especially stimulates the sebaceous glands to secrete MORE oil which then causes bacteria to adhere into the pore and cause a breakout. Women commonly complain about their skin becoming dryer with menopause and too oily with PMS and Perimenopause.
Acne is not just a physical ailment but can also scar women emotionally. I know first hand how much acne can impact a woman's self esteem. When my acne was at its worst I didn't want to go anywhere or even worse, have my photo taken. I wanted to go to college with a paper bag over my head. I would not even smile for my mom in the acne photo I share in my webinar, because I was so unhappy having my cystic acne documented. I was embarrassed of my skin and while I don't ever judge other people for how they look, I bring this up because it may be impacting teens, and young adults adversely by causing them low self esteem, depression, anxiety, stress and isolation.
Studies report that Acne can occur at any age but is highly prevalent among adolescents or young adults and teenagers. Research shows Acne significantly impacts the lifestyle of both teens and adults, causing discomfort, distress, permanent skin scarring, low self-esteem, disfigurement, anxiety, and embarrassment. These negative effects highly contribute to poor social and mental well being. [1, 3]
Acne Causes
Around 80% of acne cases are related to genetic factors. However, medical studies reported that the majority of acne cases are highly connected with the following factors. [3, 4]
Moreover, other factors such as poor diet, stress, excessive oil secretion, and smoking also increase the risk of developing Acne. [1, 3]
Signs and Symptoms of Acne
Signs and symptoms of Acne include the appearance of whiteheads comedones, blackheads comedones, microcomedones, nodules, papules, pimples, cysts, and pustules. Acne can also cause permanent skin scarring and permanent changes to pigmentation. Making it even more important to address as soon as possible for young women and teens so they do not end up with permanent damage to their skin as I have today. We can prevent scarring with Naturopathy and Hormone Balancing! [1, 3, 5, 6]
Acne Treatment
Acne treatments should be targeted towards balancing the skin from the inside rather than just applying topical medication to treat and suppress symptoms. For many years I attempted to suppress my acne with 1) Retinol 2) Differin 3) Doxycycline 4) Tetracycline 5) Facials 6) Proactive. I literally tried everything up until the Dermatologist said Accutane was the only other option! That was when I discovered Naturopathic Medicine for Acne in 2002 while attending Bastyr University.
Natural topical treatments for acne involve managing existing lesions and other symptoms, reducing skin scarring, arresting further progression, and decreasing the risk of other acne-associated complications. The application of treatment interventions depends on the acne severity, the patient’s current medical condition, the patient’s endocrine history, and the nature of lesions. Both topical and systemic therapeutic options are available for the treatment of acne. Moreover, along with pharmaceutical drugs, natural herbs and other treatment modalities also help manage acne symptoms. It is important to know that the application of multiple treatment modalities of acne significantly performs better than single therapy. [2, 6]
Topical Acne Treatment
*Topical treatments will 100% NOT CURE A WOMAN'S ACNE!
Please keep in mind the following information I have compiled for educational reasons for my patients to have a list of treatments that have research behind them and I believe are generally safe to try and understand their different options compared to pharmaceutical agents for acne. Likewise some of my Natural Medicine Acne patients may want to learn about stronger prescription options to utilize while we treat their acne from the inside out. But none of these treatments ever seem to cure acne. The cure is in investigating and treating the hormone imbalance.
My #1 Dermatology pet peeve with treating acne is strictly relying on topical treatments when there is always a Hormone Mystery for me to solve.
Whether the agent is natural or prescription, these topical Dermatology treatments all share the same problem, they are only helpful in controlling the acne via the pore, slowing breakouts, calming the skin down, exfoliation, reduction of inflammation, repair and prevention of scarring. Until we balance a woman's hormones properly they will continue to just suffer with acne especially when they already are diagnosed with PMS, PCOS, PMDD, Perimenopause, CAH, Hirsutism, Infertility or Amenorrhea.
So ladies if you have learned nothing from me today...please take home with you from this "Acne and Hormones" blog that acne is an internal medicine problem not a failure to find the right topical treatment problem. Nothing bores me more to tears, than having patients that want me to treat their acne from the outside with topical treatments. Which is why I have compiled this list of topical natural and prescription treatments for acne. I know this sounds horrible... but I don't really care WHAT you put on your skin. I care about WHY your skin is behaving this way in the first place and I want your skin to go into remission so you no longer need to ever worry about applying things to your acne again.
Nothing on this list will actually cure acne, until we treat the underlying hormone imbalance with your female hormones. But that is just my opinion as a Women's Health Naturopathic Doctor that has helped hundreds of women with their hormones and skin conditions over the past 14 years as well as what I saw over an 8 year period working for 3 Dermatologists. While mild symptoms can be treated and resolved with prescriptions, I would often see my Prescription Dermatology patients with chronic acne, psoriasis, eczema, dermatitis, MRSA, seborrheic dermatitis also fail to improve in the conventional Dermatology model simply because we had not sat down and taken a proper history to address and examine the Root Cause of the skin condition. Sometimes it has nothing to do with Naturopathic Medicine, but it's the time I take to create a thorough history of health complaints and the development of the skin condition that help us solve the Dermatology Mystery. Which is why my "Hormonal Acne Diet Program" works to help reduce inflammation, understand triggers, all while balancing female hormones and lowering the evil insulin.
It is easy to cure skin problems when patients are on board with what I need them to do, and it's nearly impossible for me to ever help patients that want to "put a magical herb from the rain forest on their skin to make it perfect" ...if there was such a thing I would be using it myself but unfortunately Hormone Imbalance in women is such a powerful problem that no magical herb we apply will usually be enough and we need hormone labs to determine the cause.
Natural treatment of Acne
Many different natural herbs and supplements also help the management of acne symptoms. These remedies act on sebum production, bacterial growth, inflammation, and keratinization. Plus, they also provide moisturizing and soothing effects upon topical application that aid the acne treatment. [2, 6]
The latest research for acne natural remedies include:
Herbal Medicines also gaining popularity in the treatment of acne vulgaris: [7]
Natural Topical Treatments for Acne
Generally Harmless Topical Prescription Acne Agents:
Topical Retinoids: Retinoids such as Isotretinoin, tazarotene, tretinoin, motretinide, adapalene, and retinoyl-β-glucuronide control the formation of comedones and lesions. Plus, they help existing lesions, reduce sebum production and improve epithelium integrity. Studies reported that retinoids show anti-inflammatory action and suppress the formation of both microcomedones and comedones. Further, they support the therapeutic action of other anti-acne agents, decrease pigmentation, and repair skin scarring. The common side effect of retinoids includes the flare-up of acne during the first week of application, dryness, irritation, sensitivity to the sun, and chemical sensitivity. [2, 6]
Topical Antibiotics: Antibiotics such as clindamycin and erythromycin are intended for topical application to manage the severity of mild to moderate inflammatory acne. They inhibit the growth of bacteria and decrease their colonization on the skin surface and within hair follicles. Thus, their agents are highly effective against P. acnes bacteria responsible for inflammation of the lesions. Note that topical antibiotics are preferred for a short period of up to 3 months due to the high risk of resistance. Medical research studies recommend using topical antibiotics combined with benzoyl peroxide, zinc, or retinoids to minimize the risk of bacterial resistance. It is recommended to avoid topical and oral antibiotics for acne as long term antibiotics can impact the microbiome and natural flora of the skin. [2,3]
Oral Acne Medications Not Recommended:
When topical prescriptions fail, Dermatologists prescribe oral agents for the treatment of acne. The oral-systemic options significantly improve the nodules, lesions, and scarring. The commonly recommended systemic therapeutic interventions include oral retinoids, antibiotics, and hormonal agents. [2, 6]
Oral Retinoids: Retinoids such as Isotretinoin is a first-line agent for acne associated with severe nodular or inflammatory lesions. It significantly benefits mild to moderate acne and acne resistance to topical agents. Isotretinoin relieves the symptoms of severe acne on the trunk and face. Note that the course of Isotretinoin therapy ranges from 16 weeks to 24 weeks. It decreases sebum production and reduces the risk of bacterial colonization that help the management of acne conditions. [2, 6]
Oral Antibiotics: Antibiotics such as erythromycin, levofloxacin, minocycline, lymecycline azithromycin, roxithromycin, doxycycline, and co-trimoxazole are indicated for the treatment of moderate to a severe acne condition. They inhibit the growth of acne-causing bacteria and also provide an anti-inflammatory activity that manages the acne symptoms. Remember that the use of antibiotics increases the risk of bacterial resistance. So, they are always preferred combined with topical benzoyl peroxide or retinoids to minimize the risk of resistance. Also, don’t use antibiotics for more than 12 weeks. [2, 6]
Birth Control Pills: Synthetic hormones antagonize the effect of androgen on the sebaceous gland and control sebum production. Most oral contraceptives, especially progestins, are used for this therapeutic approach. They halt the action of androgen and increase the sex hormone-binding globulin level in the body. Moreover, the hormonal agents work better in combination with other options such as antibiotics, retinoids, and spironolactone in the treatment of acne. [2, 6]
Topical Corticosteroids: Cystic Acne and Inflammatory acne.
Benzoyl Peroxide: Provides antibacterial properties, prevents pores clogging, and decreases the comedones formation. Benzoyl peroxide helps mild to moderate acne and can be applied for 6-8 weeks as a monotherapy for acne management. Do not combine with topical retinoids as will cause dryness and irritation. Side effects of topical benzoyl peroxide include dryness, erythema, stinging, and burning.
Dapsone, Sodium Sulfacetamide, and Triclosan: Also show antibacterial and anti-inflammatory activities that help the treatment of acne. Note that they are not recommended as first-line agents for acne management.
Other prescription topical options for acne involve chemical peels, dapsone, corticosteroids, niacinamide, sulfur, triclosan, salicylic acid, and sodium sulfacetamide. [2, 6]
Other Oral Acne Medications Not Recommended:
Along with the previously discussed options I don't recommend, other random oral therapeutic agents I consider dangerous when Naturopathic Medicine is safer and more effective anyways include: corticosteroids, ibuprofen, and clofazimine also provide an anti-inflammatory activity that helps manage acne symptoms. Systemic corticosteroids like oral prednisolone help treat the severe form of inflammatory Acne vulgaris, Acne fulminans and Pyoderma faciale.
Types of Acne
Acne is divided into four groups or grades based on the severity of symptoms. [2]
Antibiotics, steroids and accutane are hard on the liver and best for children and teenagers with acne to avoid. Especially when there are much better natural options for acne as long as your child is open to making diet changes and taking herbal supplements. It is important to treat acne immediately at the ROOT CAUSE in order to prevent permanent damage to the skin and acne scars.
Always check with your Naturopathic Doctor before starting new natural treatments or herbal remedies for acne!
Need a good acne doctor? I would be happy to help? Simple visit my SCHEDULE page to set up your new patient visit.
Dr. Nicole Sundene
Author of "The Hormonal Acne Diet Program"
Naturopathic Medical Doctor
(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 Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
References
Dr. Nicole Sundene, NMD
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
Dr. Nicole Sundene, NMD
"I can't sleep. Why can't I sleep? Is it my hormones? What is the best natural cure for insomnia in women? Why is my husband snoring away and sleeping more soundly than me?"
Tracy M, Scottsdale, AZ
Insomnia for women is often related to hormone imbalance. Conditions such as menopause, perimenopause, hypothyroidism, adrenal fatigue, anxiety, depression and postpartum depression can all trigger sleepless nights. In menopause estrogen deficiency is the primary trigger for sleepless nights. In perimenopause, it is generally progesterone causing the patient to wake up at 3am and not be able to fall back asleep. Especially when women feel over-heated. If you are suddenly waking up at 1-3am and then unable to get back to sleep, you need to contact me for hormone testing!
Your husband is sleeping just fine while you toss and turn all night because men have a ton of testosterone in their tanks which converts to estrogen naturally as it is being detoxified by the body so they generally have at least 40 points of estrogen in their system. When women develop menopause their levels generally go lower than that and trigger insomnia, hot flashes, anxiety, negative mental health, and brain fog.
While I can certainly prescribe a bunch of bioidentical hormones, herbs, and supplements for insomnia, the best way to get a solid night's sleep for most of my female patients is to eat a properly balanced bedtime snack with lots of flaxseeds!
Flaxseeds especially can help when women need something natural and non-hormonal to help them sleep during menopause. A proper bedtime snack as I will discuss today along with proper hormone testing and balancing via herbal medicine and nutrition often is all women need to help them get a restful night's sleep.
Many of my menopause patients don't need much more than that. We do have to dose the flaxseeds to match the severity of symptoms. If a woman has severe hot flashes and thinks 1 tsp of flaxseeds will be sufficient that is the equivalent of taking a click of estrogen cream once a month and is simply not realistic.
Flaxseeds fail when not dosed high enough. Most patients need 1-2 Tbl per day but some will need 3-6 Tbl per day and other supporting herbs. Be sure to check in with your doctor around menopause and have your blood pressure, cholesterol and thyroid checked. While it is not always necessary for women to be on hormones for menopause they should still not neglect other basic blood chemistry that can be impaired by menopausal or perimenopausal changes.
While everyone always assumes I am going to give them an herb or hormone as a Hormone Doctor to help them sleep that will not always be effective if we are not addressing the Root Cause of the insomnia. While it is normal for women to occasionally have a night of missed sleep, many days in a row can trigger chronic fatigue, chronic pain, inability to concentrate, brain fog, anxiety, and depression.
Generally I see this daytime fatigue pattern results in my patient reporting they "Feel like a Zombie" and no longer having the energy to exercise which is critical for proper sleep, and the pattern just worsens due to lack of physical and mental exercise the brain needs each day to feel tired enough to sleep.
Often retired patients struggle with this because they are no longer working and while they may have the time to exercise, they are deficient in enough brain exercises to "wear out their brains for sleep" and need to do some crossword puzzles, Jeopardy, reading, or Sudoku to give their brain a work out.
While I don't recommend eating a big meal right before bed, I do recommend some of the following healthy bedtime snacks for better sleep.
Only 200-300 calories for your snack is required. Otherwise, food just “sits there” and doesn’t optimally digest when we are inactive, as the peristaltic contractions of our gut are enhanced by exercise and movement. Still some people insist they can’t sleep without a bedtime snack. I actually might argue that some people might NEED a bedtime snack. Those that struggle with low blood sugar issues or “hypoglycemia” typically wake up in the middle of the night because of it.
Once awake, they can’t get back to sleep, and can’t figure out why.
I see insomnia as three different tedious breeds. There is the insomnia typically caused by stress when you can’t fall asleep (Adrenal Fatigue.) The insomnia when you wake up in the middle of the night and can’t get back to sleep (Estrogen and Thyroid Deficiency), and the insomnia that wakes you up much earlier than the actual time you care to start your day such as in Progesterone Deficiency.
You can also be amongst the “lucky ones” and have a combo pack of the three. This unlucky triad is typically the result of high stress, daytime inactivity, alcohol, too bright of a bedroom, and low blood sugar.
The best bedtime snacks are high in protein, fiber, complex carbs, minerals, and the amino acid tryptophan. To ensure a good night’s sleep, be sure to eat a light snack about 90 minutes before your anticipated bedtime. Shoot for 8:30pm if you typically go to bed around ten.
In the presence of carbohydrates, the amino acid tryptophan is able to pass the blood brain barrier, where it is then made into serotonin (the neurotransmitter that makes us happy) and in a dark atmosphere serotonin then converts to melatonin (the hormone that makes us sleepy). Boosting serotonin levels is also beneficial for those with anxiety or depression.
The WORST bedtime snacks for women are: #1 Alcohol #2 Sugar/Candy/Carbs #3 Toast
Remember that alcohol especially red wine causes women to have hot flashes which interfere with sleep as well as impact blood sugar which also interferes with sleep. Hypoglycemia is the enemy and that is exactly why women need a healthy bedtime snack designed to balance their blood sugar, neurotransmitters, and hormones.
If you have menopausal hot flashes keeping you up at night you might especially benefit from the ground flaxseeds as the lignans have a phyto-estrogenic effect, and the omega-3 oils are very important for ensuring hormonal imbalance as I disscuss more in my "Naturopathic Favorite Things" blog.
If you are going nuts from insomnia, nuts just might be the answer as they are high in protein, fiber, and minerals. Eat RAW nuts and raw nut butters to avoid the rancid fats that develop in the roasting process. Roasting turns the biochemistry of nuts into nasty rancid fat that pack on pounds, trigger hormonal acne, and clog our arteries. Raw nuts such as peanuts and cashews in moderate quantities are a great treat to keep on hand.
The healthiest foods highest in tryptophan are: Cottage cheese, peanuts, salmon, cashews, halibut, shrimp, granola, oatmeal, avocado, turkey, cheese, milk, wheat germ, eggs, collard greens, raisins, chicken, yogurt, sweet potatoes, and spinach.
Try giving up dessert for a week or two, and see if that helps. Substitute one of the health bedtime snacks below. Most night-time waking in my patients I find is caused by low blood sugar, because Americans commonly eat a sugary evening dessert that jacks their sugar up super high right before bed. As we sleep the sugar then comes crashing back down. The body always wakes us up to alert us of these kinds of imbalances.
Keep in mind that excess fluids before bed also wakes us up, so ultimately it is best to not have any food or drink at least 90 minutes before bed. The older you are, the more you may need to restrict your evening fluids to ensure you don’t need a night-time trip to the restroom. Just be sure you drink up upon waking and stay hydrated throughout the rest of the day.
The ultimate recipe for success is pairing light proteins such as vegetable proteins, turkey, and white cheeses with a high fiber friend such as a fruit, vegetable, or a whole grain choice. These foods also are typically rich in calcium and magnesium, minerals that serve to relax the nervous system and alleviate muscle tension.
THE FORMULA FOR SUCCESS:
Protein + Fiber + Good Fat + Good Carbs + Minerals= Perfect Sleep!
Using these basic rules of biochemistry, I have craftily put together a list of snacks that should induce relaxation as well as ensure proper blood sugar. The last one is what I personally have for my bedtime snack every night. Enjoy!
The Best Bedtime Snacks for Female Insomnia:
Additional Sleep Tips for Women:
Thank you for the great Naturopathic Women's Health questions. Please continue to send them to me on a postcard to my address below. Remember if your Naturopathic question can't fit on a postcard then you need to BOOK A VISIT!
Dr. Nicole Sundene, NMD
(480) 837-0900
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology, Acne, Psoriasis, Eczema, and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 23 years of experience in both Prescription and Natural women's health and hormones, she presents to women the best-integrated health solutions for their Chronic Disease. She has been an Herbalist for over 28 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan (not Medicaid) and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!
Dr. Nicole Sundene
Scottsdale Naturopathic Doctor
Food Sensitivity Testing is much different than Food Allergy testing. IgG Food Sensitivity Testing is primarily what I use in my Naturopathic women's health practice as I find it very helpful for many chronic disease conditions such as neurological, behavioral, gastrointestinal, and dermatological.
Beware of cheap food sensitivity tests I have seen on Facebook, they resulted in not providing me with any of the information I expected to see with the foods I normally react to and the foods that are safe. This is a test that should be ordered by your Naturopathic Doctor, and not online, and oftentimes the #1 reason I am struggling to get my patient better because I do not have the correct information about the best nutrition for their body. "Yes I did that test and it said to eliminate ___________" Which later turns out to be totally false and unhelpful.
Why does this matter?
Food is the biggest form of inflammation in the body so we have to get each individual patients nutrition right and understanding which foods may or may not be triggers is an imperative piece of the process as I explain in my own story of "Why I Became a Naturopathic Doctor" and described going from doctor to doctor to Dermatologist, to Gastroenterologist, to Psychiatrist, to no avail.
Looking at Food Sensitivities and Triggers helps you take less supplements and herbs because you are eating the foods that are right for your individual body type and constitution. This helps us get to the "Root Cause" of health symptoms.
Should I test for IgE allergy or IgG allergy?
While I do occasionally order IgE allergy testing this is a different type of allergy, or a true allergy. Whereas IgG reactions are generally more of a sensitivity and do not generally cause severe symptoms unless a lot of the offending food is consumed at once. Although I do have women that tell me they will never eat the food again because it makes them so sick!
FOOD SENSITIVITY SYMPTOMS:
IMPORTANT NOTE: You do NOT need to have ANY stomach symptoms to have food sensitivities! This is oftentimes the #1 reason my patients are not successful with Naturopathic Medicine and my Functional Medicine nutrition principles because they assume they "do not need this test because my digestion is fine and I have no digestive issues."
I have most commonly been told this by women with Anemia and Osteoporosis, yet it turns out to be exactly why they are not absorbing calcium, magnesium, vitamins iron, and minerals.
Yet, I find it very difficult to remove inflammation without a ton of supplements and herbs when patients have multiple symptoms of food sensitivities but decide not to proceed with the testing. The testing is essentially the fastest most efficient way I help my patients with chronic disease symptoms feel better.
Food sensitivity testing is a miraculous thing in my Naturopathic opinion as it helps us custom tailor the diet to the individual.
Back in the 80's I always complained of stomach aches and fatigue and therefore often went to the doctor. Spending so much time at the doctor for my stomach aches is probably a huge part of "Why I Became a Naturopathic Doctor." My doctor would run a chem panel and CBC and say I had anemia and tell my mom to give me more Wheaties for the iron. The stomachaches would get worse and back to the doctor we would then go. Again and again.
Unfortunately, we did not have fancy Food Sensitivity Testing back in the 80's and had he run a simple blood test on me he could have told me to STOP eating Wheaties because I have a severe gluten allergy which was causing my fatigue stomach aches, and malabsorption picture contributing to the anemia.
Now I can live free of stomach aches and have learned that too much gluten also triggers migraine headaches and eczema. So if I did not do a Food Sensitivity Test I would be on a dozen prescription medications to treat all my different symptoms caused by the reactive foods. This was the case in the 90's until I found Naturopathic Medicine and learned to treat my stomach pain at THE ROOT CAUSE. Even natural medicines and herbs can pile up when we ignore the patient's diet. At one point working in a health food store, I managed to switch all my prescription drugs to natural medicines to control my symptoms. Yet I was still taking a lot of natural medicines to treat each individual symptom while failing to address them at their Root Cause.
Symptoms from food sensitivities can last hours to days and remain in the system much longer than IgE allergies. While IgE allergies may come on swiftly and leave suddenly with treatment, IgG sensitivities can linger and create prolonged inflammation. My patients can be affected for 1-7 days after consuming the food which makes it much more difficult to pinpoint than a peanut allergy that comes on very quickly after consumption.
Clinical studies have found the elimination of IgG positive foods specific to the individual helpful in improving irritable bowel syndrome (IBS), autoimmune diseases such as rheumatoid arthritis, ADHD, epilepsy, autism, and even cystic fibrosis. The mechanism of action is the reduction of inflammation from foods the patient is sensitive to. This reduces inflammation, phlegm, and swelling which tend to worsen most chronic disease states.
Many patients are led to believe they have had their “food allergies” tested but this was done via IgE allergy testing by an MD or allergist by a blood draw or skin prick testing. Rarely has the patient been properly tested for Food Sensitivity or IgG reactions by their MD which can cause a completely different set of symptoms.
In Naturopathy we often use the term “Food Allergies” incorrectly when what we are really referring to are “Food Sensitivities,” or foods that you can eat in small amounts that will not require the use of an epipen such as in a true food allergy. Patients with true food allergies generally have breathing problems, dermatology skin rashes, and hives and require treatment with Benadryl and epinephrine. Whereas patients with food sensitivities have a wider range of symptoms that can occur which we will discuss today.
Think of most food sensitivities more like “food hangovers.” Generally, patients feels fine and happy while eating the food, it is the next day or next few days when we see the reaction. While you are not going to die from eating the food, nor will you need an Epipen for food sensitivity, instead a wide array of annoying symptoms from dermatology, mental health, inflammation, diarrhea, constipation, IBS, chronic fatigue, chronic pain, and autoimmunity can be impacted by the regular consumption of foods that are inflammatory specific to the individual.
FOOD SENSITIVITY TEST KIT REVIEWS
While I am not going to say bad things about certain food sensitivity test companies, many of them are total garbage and not worth the piece of paper they are printed on. Whatever you do if you think you have food triggers, please do not buy a random test. Please do not test your food sensitivities with some food test kit on Facebook, as often those are not accurate and there are only four food sensitivity test companies that I trust as a Naturopathic Doctor.
I have tried many of the commercially available food sensitivity tests and found them to be completely inaccurate in confirming the foods I already know I am sensitive to. I was left very disappointed, confused, and upset I had wasted my money on inaccurate tests. I was even more upset that I wasted my time eliminating foods that did not cause a reaction at all when I challenged them by eating high amounts of the food three times daily for three days after being completely off of it for three weeks.
If you want to have your food sensitivities tested you should not do this alone but under the guidance of a skilled Functional Medicine Doctor or Naturopathic Doctor.
Otherwise, we will not be able to heal your body from the food sensitivity and you will need to continue to avoid the food for a long time when better options exist. A good Naturopathic Doctor will help you determine the root cause of the food sensitivities and help heal your gut so you can return to eating the food moderately.
Food Sensitivity Testing is simple to conduct via a quick finger poke. When you receive your test kit in the mail, be sure to write the date of collection on the test kit, and fill in the correct number of circles fully to avoid test rejection. The blood should dry at least four hours before mailing to the food testing company.
Oftentimes it is difficult for me to help patients as a Naturopathic Doctor when they are not able to check their food sensitivities. This is because food sensitivities, are different for each patient, and create a lot of inflammation. I can only prescribe so many supplements and herbs to combat this inflammation which also becomes expensive and time-consuming. Or as one of my colleagues likes to say "I cannot out supplement your crappy diet." The more complicated the symptom picture and amount of supplements the patient requires, the more likely we are missing something very critical at the foundation. The foundation of health is the patient's nutrition.
By identifying trigger foods that cause food reactions we can reduce inflammation, heal the ROOT CAUSE of the food sensitivities and return the patient to a normal diet over time. Most patients can eat the foods they are sensitive to on occasion while some patients prefer to strictly avoid anything that may cause them to feel sick or inflamed.
To request your Food Sensitivity Test kit prior to your new patient visit, simply call the office at (480) 837-0900. If you are out of state we can work with you via telemedicine. Simply call to order your Food Sensitivity Test kit and then we will review the results at your new patient telemedicine visit four weeks after you have mailed the test in. While I am unable to prescribe medications to patients outside of Arizona, the majority of what I do as a Naturopathic Doctor rarely involves prescribing medications. Therefore it should be relatively easy to address your Food Sensitivities via Telemedicine and work to cure the underlying leaky gut syndrome that tends to cause them.
Please allow the lab 3-4 weeks to process your sample to provide us with the results of your Food Sensitivity Test. We recommend scheduling your dietary counseling visit to review the results and develop your new allergy-free diet at least four weeks after you send your test kit in.
Dr. Nicole Sundene
(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 Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
