By Dr. Nicole Sundene, NMD
Scottsdale Naturopathic Doctor
Anxiety anyone? Pretty much every patient I talk to lately is experiencing anxiety for one reason or another. Which is the inspiration behind my "ANTI-RAGE LATTE" recipe. So if you are feeling overwhelmed, stressed, drained, and hopeless please know that you are not alone. Life for many of us, has never been more stressful. So I am going to be writing a lot about anxiety, the adrenals glands, adrenal fatigue, and the importance of female hormone health with PMS, Perimenopause, "Hormone Rage," and Menopause until things can return to normal.
In the meantime, the Ruler of My Herbal Queendom shall be...Ashwagandha! While in Ayurvedic medicine they call it "King of All Herbs", in my women's health practice it of course shall be referred to as THE QUEEN OF HERBS! For many years my female patients have said things like "What is that ashwaghandadaddda thingy you put me on again? I need more of that immediately!"
One of my favorite anxiety disorder treatments for patients that are struggling from chronic fatigue and excess stress is Ashwagandha, formally known as Withania somnifera. With so many women feeling tired and stressed these days I am going to have to vote ashwagandha the #1 Best Herb to Help Women Cope! Which is why I put it in my "Invincible Mommy Tea." The best thing about Ashwagandha is it is gentle enough you can take it during the day while at work, it is tonifying so it helps restore you back to normal over time, and as I talk about in my "Anti-Rage Latte" Blog very much needed while everyone is extra angry, annoyed and agitated.
The root of this plant is best for those feeling very frazzled and in need of a nervous system reset. If you feel like you need to push the reboot button for your brain then this is the herb for you!
Ashwagandha is helpful especially for women that are extremely agitated. I love that it is also considered safe for women that are pregnant and breastfeeding (obviously check with your own OBgyn before starting any herbs.)
If you know someone that is annoying to be around you might want to sneak a 1/2 teaspoon in their coffee... (just kidding instead just anonymously email them this article, or print it, and leave it on their desk??)
In a 2017 Randomized Control Trial 300mg of Ashwagandha twice daily improved memory and cognition in just eight weeks. [1} Another study found it beneficial in suboptimal hypothyroidism. [2} A 2019 study found it decreased anxiety, decreased cortisol stress hormone, and increased testosterone levels in men with zero adverse side effects reported! [3] 2021 Randomized control trial found it improved sleep and was beneficial for insomnia patients! [4] 2019 research on schizophrenic patients administered 1000mg daily found it beneficial for improving their depression and anxiety. [5] In 2015 Ashwagandha was found to improve libido and lubrication in women. [6]
In 2015 ashwagandha was found to improve lean muscle mass at 300mg twice daily. [7] This is why we commonly prescribe this herbal medicine to weak patients with cachexia or muscle loss and wasting in cancer. When you are menopausal you lose your testosterone and muscle mass which causes your metabolism to slow down since the only thing really burning calories in your body is muscle! 2016 research found it beneficial to the reduction of OCD or obsessive-compulsive disorder symptoms. [8] 2021 research found it to enhance and improve cardiorespiratory performance in athletes. I have since been recommending it to my Long Hauler patients that need help getting their lungs and hearts back on track. [9] 2013 research found benefits with ashwagandha to bipolar patients. [10] A 2018 study found it helpful as an adjunctive treatment for Tuberculosis patients. [11] In 2019 it helped Covid-19 patients recover faster when used in conjunction with other herbal medicines so while we are sipping it for our mental health it should be considered as a potent antiviral for further research against Covid. [12]
Because the cinnamon in my "Anti-Rage Latte" Recipe is also antiviral I like to think that maybe we can treat our crappy moods and boost the immune system at the same time! Please let's get more research on Ashwagandha!
As I have been doing a lot of marriage counseling for my patients lately because they are simply spending too much time together, perhaps if men take ashwagandha to boost their testosterone and women take it to boost their libido and vaginal hydration we may have less fighting and more exercise at home!
Ashwagandha as an added bonus supports the immune system, is anti-inflammatory, anti-aging, and also helpful for those with impotence. It supports the woman that is feeling exhausted, deficient, and drained. If you are feeling somewhat like Scarlett O'hara's horse that is frothing at the mouth while she screams at it and beats it to keep going... then you probably should chat with your Naturopathic Doctor about starting some Ashwagandha or a similar adrenal adaptogen herb! As you need to work with an herbalist that knows what they are doing and some patients with Autoimmune disease such as myself do not feel good on certain immune-boosting herbs. Although I have thousands of autoimmune patients in my women's health practice and find this to be more of a myth as most adaptogen herbs are "Immune Modulating". This is why it is important to work with a Female Hormone Specialist such as myself if you have a chronic disease and are using herbs!
Otherwise, Ashwagandha is the REJUVENATOR that you need right now to pick your sad little stressed mess of life up and keep going if you have not been doing well. According to a 2011 Review article of Ashwagandha, it was found to be anti-tumor, protective to the adrenal glands, effective against tumors, fibroids, and neuro-regenerative for patients with Neuropathy, Parkinson's, Alzheimer's, Dementia, Huntington's, and children with ADHD and cognitive deficits. For children I divide their weight by an average adult weight of 150 pounds and that become their dose aka 1/2, 1/3 or 1/4 of a standard 500-1000mg adult dose twice daily is what I typically prescribe to my female hormone patients, as is also used in the majority of the above studies.
Ashwagandha was also found to help regenerate dendrites (the portion of the nerve cell that conducts electrical signals) which is amazing if you have neuropathy such as myself or a disease that causes nerve damage.
Studies show Ashwagandha improves energy, improves both Osteoarthritis and Rheumatoid arthritis, and is an anxiolytic that mimics GABA aka "Nature's Valium." This is why it is the leading herb in my "Anti-Rage Latte" recipe that you can watch me make on my Instagram page! Don't forget to follow me for my latest herbal recipes as I don't always have time to post the random herbal medicine videos I enjoy sharing on Instagram.
According to Naturopathic healing principles, women should notice the effects of their adrenal adaptogen herbs within three days, feel a restoration of their emotional and physical well-being after three weeks, and should no longer need to take the herb after three months. Hopefully once that three-month period is up, better coping mechanisms for stress management have been implemented! Such as breathing exercises, yoga, pilates, meditation, exercise, or my favorite is...crafting!
Are you beyond an "Anti-Rage Latte"? Is it time for you to start feeling your absolute best? Then treat yourself to a Naturopathic Hormone consultation with me by popping over to my SCHEDULE page so we can work together as a team to help you feel awesome! If you don't want to come into my clinic or are not in Arizona I am happy to help you by phone consult!
Dr. Nicole Sundene, NMD
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology, Acne, Psoriasis, Eczema, and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
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By Dr. Nicole Sundene
Seborrheic Dermatitis, dandruff, itchy scalp, scalp eczema and psoriasis are so annoying they drive patients in droves to see me as a Naturopathic Doctor that specializes in Dermatology. This condition can become so severe it can even cause hair loss!
The good news is I have such a high success rate from treating these patients over the past fifteen years that we usually can get an itchy scalp problem better in just a few appointments. Often just one appointment is needed for my Seborrheic Dermatitis patients!
Nothing makes me happier than hitting a "Naturopathic Home Run," aka fixing a chronic annoying Dermatology problem in just one visit. Keep in mind that is generally the case with kids and teens, and that adults generally need multiple visits because their hormones are imbalanced and that is the #1 trigger for seborrheic Dermatitis.
Here is what my solution is to this frustrating skin condition:
WHAT IS SEBORRHEIC DERMATITIS?
An itchy dry, flaky scalp is typically “Seborrheic Dermatitis”commonly referred to as dandruff in adults and “cradle cap” in babies. Most standard anti-fungal shampoos, topical steroids, and topical treatments such as selenium sulfide and pyrithione zinc typically only provide temporary relief because they are not addressing the ROOT CAUSE of their Seborrheic Dermatitis. This requires me to put on my detective cap to figure out what is actually wrong and why the body is sending this negative itchy message that something is not quite right.
The fact that the body is out of balance must be addressed or the shampoo will simply not be enough. Although I do agree these shampoos are helpful for reducing symptoms while the actual cause is treated, they frankly are not the “be all end all”.
First of all seborrheic dermatitis is an inflammatory condition of the scalp that can manifest in the form of mild dandruff to dense, greasy scaling of the scalp. Mild cases of dandruff will typically resolve with the addition of fish oil, biotin and b-complex, zinc, and selenium, however more severe cases of seborrheic dermatitis will require further investigation.
The reason for this is that in babies the condition typically remits after 6-8 months, but in adults the Seborrheic Dermatitis is almost always chronic and will just tend to relapse and remit while it worsens over time. So let’s get this figured out now, shall we?
This condition is commonly correlated with a yeast, Pityrosporum ovale, but that yeast is predominantly everywhere right? It is not some random infectious disease like Ebola, it is simply a common thing in our environment, which gets me thinking…why doesn’t EVERYONE that is exposed to P. ovale have Seborrheic Dermatitis? The reason for that is that not everyone is pre-disposed to being susceptible to such a problem. There is a high familial correlation with this disease. Typically our diet, genetics, environment, lifestyle, and stress levels all contribute to causing Seborrheic Dermatitis, and an illness just chooses to show up on the body somewhere to show us that we are out of balance. Especially with dermatology it is as if your body is screaming at you to pay attention to what is wrong with it when the embarrassing dermatology condition shows up on the face or scalp. We can no longer ignore it and cover it up with clothes. Whether we choose to listen to the message or ignore the message while suppressing it with shampoos and topicals or what not is up to us, but rarely to patients find permanent relief from topical treatments from Seborrheic Dermatitis very similar to my long acne rant about how we need to treat the underlying ROOT CAUSE.
So what is out of balance? Most likely digestion and stress.
When I have worked with patients with very refractory cases of seborrheic dermatitis in the past they have all had food sensitivity components, especially to wheat, dairy, and citrus that needed to be addressed. For whatever reason imbalances in our gut always show up on the skin first. I always know my dermatology patient is going to have a great outcome when they understand the problem on their outside is actually caused by a problem on their INSIDE. My guess surrounding this is that people are naturally pretty vain and will easily ignore a stomachache, but not a skin problem. The body is very wise when sending messages. Also since 70% of our immune systems surround our gut in the form of “Gut Associated Lymphatic Tissue” or GALT, any inflammatory condition will improve by simply going on a trial hypoallergenic diet for several weeks and then testing for food sensitivity once the condition has cleared.
Be sure to start a whole foods diet whenever possible free of your individualized food sensitivities until the Seborrheic Dermatitis improves. Of added interest, this problem is predominantly male which suggests a male hormone component or imbalance. Most hormones are easily brought back in to balance by improving sleep and cleaning up diet and stress.
I would recommend for anyone with an itchy skin problem to read my article on eczema, as in my mind they are all basically the same thing and tend to resolve by using similar traditional nature cure means. All my friends that are Dermatologist friends hate me for saying that but I have worked in both conventional Dermatology for eight years for three Dermatologists and Naturpathic Dermatology for over fourteen years so with twenty two combined years of experience in Dermatology I feel I am entitled to my own opinion.
Of course Seborrheic Dermatitis in adults has been shown with good research to improve specifically from taking zinc daily (start with 15-20mg, but you can bump it up to 50mg daily, yet I would not do this long term as it will throw your other minerals out of balance), as well as selenium (150-200mcg), biotin (10mg), Folic acid (10mg), and B12 (1000mcg), but we really need to address the cause of the inflammation, or most people will have to be on these supplements long term. Please check with me or your own Naturopathic Doctor before starting any new vitamins, herbs or supplements.
For mothers of infants with cradle cap that are breastfeeding you can ensure that you are not deficient in these vitamins and minerals by taking a high quality prenatal vitamin at the full dose (don’t take mega doses of ANYTHING when you are breastfeeding unless prescribed by your Naturopathic Doctor!!!). But ultimately I would investigate food allergies, as a food you are eating is most likely upsetting the baby. Do add cultured foods like yogurt in to your diet to improve your digestion.
Topically a 5% Tea Tree oil shampoo has been shown to be effective against Seborrheic Dermatitis, but I would make my own conditioner instead and let it sit on the scalp. My rationale for this is that shampoos are really drying and the scalp is already dry and irritated. We want the medicine to sit on the scalp long enough to kill yeast in Seborrheic Dermatitis. I would prepare a topical solution using aloe vera gel or borage oil and tea tree oil. Add about 20 drops of tea tree oil to a ten ounce bottle of aloe vera gel. Shake that up and apply it to your scalp daily for 15 minutes to treat the Seborrheic Dermatitis. Depending on your sensitivity, you can add more tea tree oil than that, however it should NOT ever feel like it is burning. Never apply any essential oils directly to your skin without diluting them in aloe or a carrier oil first as they are caustic and will burn you. If you ever experience burning, rinse it off immediately. Topically aloe vera gel and borage oil have also been shown to be soothing for this condition. For babies you can simply rub their head with olive oil and then comb all the flakes out. Please do not treat your baby for Seborrheic Dermatitis without the help of a skilled herbalist or Naturopathic Doctor such as myself. If you need my help simply pop over to appointment SCHEDULE page and I would be delighted to help you!
Remember that if you discover you have food allergies it is not the end of the world, you simply eliminate the food for a period of time while the immune system forgets about it (typically three months for those blood cells to die and forget the food allergy or intolerance), take probiotics daily to reseed healthy gut flora, adopt better stress management coping techniques, and then rotate the foods that were causing the inflammation back in moderately.
As a final note on Seborrheic Dermatitis I would like to add that you should NOT ever take any new supplements without checking with your Naturopathic Doctor first (preferably me) and be sure that you have the correct diagnosis before attempting any home remedies or self treatments for dermatology issues. Heaven forbid my advice ever does more harm than good. Please read my long acne rant about how nothing you put on your skin ever really fixes your skin until we get to the underlying ROOT CAUSE of the Dermatology and Hormone symptoms of Seborrheic Dermatitis.
Dr. Nicole Sundene, NMD
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
Dr. Nicole Sundene, NMD
Scottsdale Naturopathic Pain Doctor
Chronic Pain: What is a Holistic Pain Specialist?
As a Naturopathic Doctor that has survived fifteen years of varying levels of severe pain from an Autoimmune disease causing Fibromyalgia and Neuropathy the first and most important thing I will do is BELIEVE you, and provide you with empathy and compassion. I have been to too many doctors that thought I was a whiner, a hypochondriac, or just a bored depressed woman that had nothing better to do with her time but go from doctor to doctor, specialist to specialist, and simply needed an antidepressant to cure all that was ailing me. Please watch my 30 minute free presentation, “Hormones, Metabolism & Pain” on my free class page for the full story.
Many chronic pain patients do improve from taking anti-depressants, simply because being in constant pain is depressing. As I tell the story of my own Fibromyalgia journey, I went from being an avid mountain biker that could mountain bike for eight hours a day and ride the STP- Seattle to Portland bike ride with my Dad to being completely bedridden. I lost connection with a lot of my friends because I was too sick to go to parties or social events. I was too tired to talk on the phone with anyone…and simply getting through a regular day of work or going to the grocery store was more exhausting to me than actually doing an actual Triathlon. As a former endurancd athlete, I was used to being in constant pain but it was “Good Pain.” My legs were weak and like Jell-O from riding my bike for 8 hours on the weekends. I loved that feeling.
But when I developed Fibro, my legs burned and felt weak when I had done nothing. I could barely climb the 8 steps out of my condo and walk to my car. Nobody knew what was wrong with me and I wasted many years of my life not getting the right treatments. Because we NEED to know what the diagnosis is in order to provide the chronic pain patient the correct treatment. When I was in Naturopathic school at Bastyr University, I learned a pain protocol for Fibromyalgia: Magnesium, Vitamin D, and Malic Acid. I literally graduated from Naturopathic school thinking this was what Fibro patients need and that is all we needed to do for them. Very sad right? And precisely why pain patients need to hire an expert such as myself that specializes in pain management.
In 2006 God gifted me with the Fibromyalgia label by a well-meaning doctor that tried to help me but simply did not know enough to order the correct tests, and my understanding of chronic pain shifted dramatically. As I graduated from school I was gifted this "Internship" by Life in Fibromyalgia and although I have felt very angry and frustrated with my body over the years.... Fibromyalgia has been my #1 Biggest Teacher. When the correct women in constant pain find my practice and finally feel heard and understood I get goose bumps and tears well up in my eyes because I realize that although Fibromyalgia was a brutal teacher... it taught me very well. Fibromyalgia has taught me many lessons that are important I share with my patients and the medical community so that we can shift how we perceive Fibromyalgia and we can stop failing all of our Fibromyalgia patients.
First of all, I tell my patients with Fibromyalgia to stop using the “F Word,” and I don’t mean the actual F word because I know people in pain often can ONLY say the F word, because they are hurting so badly that they really DO need to use that word. However, the F word I want them to stop using is Fibromyalgia. The reason for this is that as a Fibromyalgia Doctor with Fibromyalgia I believe with my whole heart that it is an utterly useless diagnosis that means nothing and allows your pain specialist or family doctor to continue to doctor you in a somewhat lazy way because it sounds like you finally have a diagnosis right? I remember calling my Mom in 2006 and saying in a state of shock, "They said I have Fibromyalgia!" And that is when my journey down the Fibromyalgia rabbit hole first began. That is why I hate and detest the word Fibromyalgia and that is why I encourage my patients to use more descriptive words like burning, stabbing, aching and so forth so that we are focused on the actual problem. Treating patients with Fibromyalgia is a lot like looking at snowflakes, while they may look similar from a distance there is quite a difference between the hundreds of Fibromyalgia patients in my practice. Should you be happy to be diagnosed with Fibromyalgia? Does this help you as a patient get the correct "Fibromyalgia" treatment or care? Fibromyalgia actually means something, doesn't it?
NO THAT IS 100% WRONG
Fibromyalgia means you have pain aka “myalgia” in your “Fibro” which is your joints and muscles. What good does this diagnosis do for you as a chronic pain patient? While I understand some patients are very attached to their Fibro label and I know thousands of Fibro Warriors between my Fibro practice and the online groups I participate in....personally as a Fibromyalgia Doctor I would encourage you to work to get your label undone. Personally, because I have a caregiver's heart and care about people, especially those also in pain, I want you to hate the word Fibromyalgia as much as I do as a chronic pain specialist for women. Mainly because the word Fibromyalgia tells me ZERO about what is actually wrong with you, and it provides the doctor ZERO help to provide you with the correct treatment plan.
I feel for some over-booked busy doctors and pain specialists, using the label Fibromyalgia allows them to take off their thinking caps and stop working to determine the ROOT CAUSE of your pain. My job as a chronic pain specialist is to ask the following questions like a detective, to look to find the actual cause of your chronic pain. Fibromyalgia is a description and not a diagnosis!
What is the cause of the patient's fibromyalgia or chronic pain?
When the adrenal glands burn out as I discuss in my Adrenal Gland Blogs: 1) “Adrenal Hormones: Are you Running from the Bear?” 2) “Adrenal Fatigue: Fight, Flight, and Fright?” When these adrenal glands become depleted, the patient feels exhausted, depressed, and has pain in their joints and lower back, with joints that are constantly cracking or popping. This is a picture of the adrenal fatigue patient. Constant stress and anxiety about a condition with no known cause and no known cure can cause adrenal fatigue and living with constant pain while people have unrealistic expectations because they may look completely healthy on the outside, as I do, yet are miserable and struggling with serious pain on the inside.
Your adrenals will likely need some treatment, which only exists in herbal medicine and naturopathic medicine, because other than prescribing a beta-blocker medication and telling you to take a vacation or do yoga, your MD has little to offer you for your adrenals, that are under constant stress from being in constant pain.
You can probably see there are already a bunch of tests that you likely have not been offered as a Fibromyalgia or Autoimmune patient. It is imperative you commit yourself to this process of working with me as a team so that we can unearth the cause or the causes of your pain. Often it is a combination of a few things on my list above. Seldom am I unable to help patients with their chronic pain. I may not be able to make it go away completely, but I can take the level of pain down once we target the correct herbs and nutrition to the correct chronic pain diagnosis.
Aside from listening and providing compassion, the second and more important thing we will do together as a team when you treat yourself to a Naturopathic pain consult with me, is to rely on lab metrics to determine the cause of your pain. Together we will order the proper labs to determine the cause of your pain. If you have decent insurance then your labs are covered per your insurance plan. There may be a few Naturopathic Specialty tests I will need to do for your pain, but I prefer to start with the testing that insurance will cover (Naturopathic Doctors cannot order labs in Arizona for patients on Medicaid or AHCCSS) but can order tests via most insurance plans such as Cigna, BCBS, Aetna, Ambetter, United Healthcare and so forth. Medicare labs are only covered if you go to Labcorp and some tests will simply not be paid for as the government could seriously care less about your vitamin levels although hormone testing for women is covered and patients with good secondary insurance generally receive a final bill under $100 for thousands of dollars worth of chronic pain testing. It is not realistic to expect 100% of anything to be covered by your insurance. But the initial Lab detective work is critical to the chronic pain patient's diagnosis and prognosis. Patients with Fibromyalgia that lack a diagnosis generally will have a worse prognosis because we are just throwing spaghetti noodles on the wall for your pain management plan and not targeting it towards an actual solid diagnosis. It is critical that you know what lab is contracted with your insurance plan for Fibromyalgia testing as it is the insurance’s preference of Labcorp vs Sonora quest that is more important than the ordering doctor.
More times than not, my fibromyalgia and autoimmune patients have not had the proper battery of tests that should be conducted. While hormone imbalance is not always the cause of chronic pain in my women’s health practice it is more commonly the problem, which is exactly why more women have fibromyalgia than men. Rarely if never do I receive adequate hormone testing or chronic pain testing done by a previous doctor. Many patients think they have had their hormones checked and I get one piece of paper with a TSH and progesterone level.
Often my new pain patient thinks they have been tested for autoimmune disease and just an ANA with reflex test was conducted with a CBC. I cannot help any pain patient that does not let me do my detective process properly and my #1 pet peeve is having someone's primary care doctor or another specialist that does not know what I know mess up my lab tests. Keep in mind I worked in regular Family Medicine for eight years and processed the lab letters for 20 doctors, so I already know what your Family Doctor is going to do for you, and since hormone testing is super complicated 9/10 times another doctor just screws it up and your valuable lab dollars are wasted and my hands are tied because the wrong doctor ordered the wrong tests and now we have to wait 6 weeks before your insurance will allow me to re-conduct the testing I need to help you. So please take your labslip directly down to the lab that is contracted with your insurance plan if we are working together so your time and money are not wasted.
Even if your pain is not caused by hormone imbalance, we will need to cross the hormone testing off your “Chronic Pain Bucket List.” As your holistic pain specialist, I will look at the big picture of your nutrition, stress, exercise, hormones, and blood tests.
My skills as a Female Hormone Specialist are extremely important to my chronic pain patients because oftentimes pain for women is related to hormone imbalance. If you notice fluctuations in your pain with your monthly cycle and get migraines or pain flares with PMS then there is likely a hormonal component to your pain. For women that have always been healthy and develop pain when they become menopausal, this is a very important reason to work with a holistic pain specialist. When estrogen levels decline inflammation goes up and that can cause women to have more pain in their hips, hands, and joints.
Too much estrogen such as in perimenopause, PCOS, and PMS can also cause joint pain and inflammation. So working with a doctor that understands optimal ranges for estrogen is extremely important. Estrogen is like water, and too much causes pain, inflammation, and weight gain, and too little causes joint pain, thyroid issues and inflammation.
The third most important thing I do for you as your integrated chronic pain specialist is prescribe medications, herbs and supplements to help you with your pain. I cannot do this properly and can only guess at what you need until we have gone through the process of testing your pain labs and hormones. There is no magical herb from the rainforest that will cure all of your fibromyalgia symptoms. If there was, I would be on it!
The treatments I provide as a naturopathic doctor will fail if we are not targeting the correct diagnosis.
I want to always treat the root cause, and while I am knowledgeable from working 8 years in conventional Family Medicine and know how to prescribe these meds, I am comfortable doing this for you. Prescribing pain meds is somewhat boring to me. Pretty much anyone can slap you on a bunch of vicodin, gabapentin, amitriptyline, gabapentin, Naproxen, and cyclobenzaprine and then quarterly test your liver and kidneys to ensure they do not fail.
If that is the route you prefer for your chronic pain then I am not the right doctor for you. I prefer to only prescribe pain medications for the purpose of tapering you down from them, which saves the pain patient from going to multiple specialists, as I personally know how exhausting that is. My goal is to taper you down from these meds that can be toxic to your liver and kidneys once your Naturopathic protocol begins to take effect.
As a chronic pain patient with Neuropathy, when I finally received that diagnosis, the supplements I used to treat the neuropathy were a huge game-changer for me. I was now targeting my treatment plan to heal and repair nerve damage, whereas before I was taking herbs and supplements for muscle pain. This is why it is critical to me that I know what the diagnosis is as a pain specialist otherwise I cannot get a good result for my patient and then I don’t get the “Joy of fixing you,” which is what puts a smile on my face every day as a doctor knowing that my patient is better and that the riddle of their Fibromyalgia has been solved.
Many chronic pain patients cry in my office because they realize quickly that my own horrific experience as an autoimmune patient has gifted me with a vast set of skills they could never find anywhere else prior to working with me. I am not trying to sound arrogant but unless you have lived severe pain you simply do not understand what it is like. I admit that I worked with autoimmune and fibro patients for eight years without fully understanding.
Due to my own medical mysteries causing my pain I have a lot of experience in specialties that are necessary to help chronic pain patients: Endocrinology, Pain Management, Gynecology, Urology, Family Medicine, and even Psychiatry. Because at one point I fell victim to a Psychiatrist actually convincing me that everything that was wrong with me was all in my head and I took five psychiatric meds that just made me and my chronic pain much much worse. So I know a lot about antidepressants and anti-anxiety medications as a result. I understand the anxiety and depression related to chronic pain too well and can easily help you with that.
Finally and maybe even the most important, what I can promise you as your holistic chronic pain specialist, is to oversee the big picture of your chronic pain treatment plan. This includes your referrals to Neurology, Rheumatology, or Infectious Disease, to make sure what we are doing for you is helping and not making you worse. Often my pain patients have bounced around from specialist to specialist and nobody is talking to each other. What I promise to do as your personal nerdy little detective, is to look at all your tests and make sure we have left no stone unturned.
This way, we have you at the RIGHT specialists and we are not wasting your precious energy on being a “Professional Patient.” Which I have wasted much of my time doing, and know exactly how emotionally exhausting these appointments can be. I understand how frustrating it is to keep telling your story to a new doctor over and over again, and what it feels like to be judged, criticized, and sadly I know also what it feels like to be yelled at by some MD’s.
WHICH PATIENTS ARE NOT GOOD CANDIDATES TO WORK WITH A HOLISTIC PAIN SPECIALIST?
I never want to enroll a patient into my practice that I cannot help. I don’t want to waste anyone’s time with fibromyalgia, chronic pain, or autoimmune that I cannot help. While I have a great success rate improving my patient’s chronic pain and my pain patients are constantly referring me new pain patients it is always important to me that the correct patient matches up with the correct doctor
Below are the patients I 100% CANNOT help as a holistic pain specialist. Please do not sign up to work with me if you match any of the following scenarios:
WHAT PATIENTS ARE THE MOST SUCCESSFUL WORKING WITH THE HOLISTIC PAIN SPECIALIST?
To learn more about my Naturopathic process treating pain, inflammation, and hormones you are invited to watch my free presentation, “Metabolism, Hormones & Pain” on my Free Class page. There is no charge to watch the presentation and the purpose of it is to educate you on the exact simple three-step Naturopathic Process I have used to help hundreds of women achieve relief from their chronic pain. If you already KNOW that I am the right doctor for you and that you are the PERFECT Naturopathic Patient then simply pop on over to my SCHEDULE page and treat yourself to a Naturopathic Consult immediately. We need to get to work on you before you have permanent damage to your body like I have. I found out my diagnosis ten years too late. I could have had answers sooner. I don't ever want anyone to suffer like I did when I just didn't have the right testing done. I was frustrated, my parents were frustrated and we simply lacked the proper blueprint to follow that could have saved me years of misery.
I am able to help you in my clinic and by telemedicine phone consultation. If you do not live in Arizona I can still help relieve your pain by doing the detective process work of diagnosing your pain, I simply cannot prescribe medications for you if you live out of state. Many Family Doctors and Pain Doctors are happy to work with me remotely in the event you need hormones or medications so if you do not live in the Phoenix area but have a supportive doctor that is open to Naturopathy we can still work together to help you feel better with your Chronic Pain, Fibromyalgia or Autoimmune Disease. Did you know I have patients in ALL 50 states? A lot of what I do is easy to help you with via telemedicine!
I look forward to helping you get back on track and feeling awesome again!
Dr. Nicole Sundene, NMD
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
Why did you become a Naturopathic Doctor? Who will be successful with Naturopathic Medicine and who will not be successful with Naturopathic Medicine? Jen Phoenix, AZ
"Naturopathic Doctor" was a term I had never heard of growing up. I always wanted to be a doctor as a child and was working to get a Pre-Med degree so I could become an OBgyn. As I started a Pre-Med program in college, I experienced a cluster of symptoms that all started up at once. I was having terrible headaches, stomach aches, and acne. I constantly went to the Campus Doctor who eventually sent me to an Internist who then sent me to a variety of specialists: Dermatologist, Pain Management Doctor, Migraine Specialist, Psychiatrist, Gastroenterologist, Neurologist, and many more. It went on for a year and I continued to get worse. I gained weight from the side effects of the different medications and I became depressed and began to lose hope. On top of my symptoms that did not improve, the antidepressants caused my weight to balloon to 200 pounds! I was suddenly trapped in a fat suit, on a bunch of medications that were not working, and did not feel like myself. I was not getting any benefits from the anti-depressants and just getting the side effects of weight gain.
Each doctor I was sent to gave me a different medicine and then referred me to a different specialist for my other symptoms. I continued to down spiral with my health and depression until a friend recommended I visit her Naturopathic Doctor. Within a few weeks, I gradually began to feel better with herbal medicine. When my “Food Sensitivity Test” came in I rapidly became better as I was now able to exactly pinpoint the foods causing my stomach aches, headaches, and acne.
My spirits lifted and I was no longer depressed as I began to feel better and regained hope I did not have to live like that anymore. The ND also took the time to get to know me and acknowledge my stress levels from moving 90 minutes away from my family and sudden reliance on flavorless unhealthy dorm food that we often avoided and instead went out for even worse Fast Food. My Naturopathic Doctor encouraged me to return to my normal healthy diet, stop the Fast Food, exercise for my anxiety and depression and my depressed mood returned to normal. He kept track of the big picture and pointed out how my change in diet was the Root Cause of my sudden issues.
As I returned to a perfect state of health thanks to Naturopathy, the experience made me stop and think about what I was planning on doing with my life as a doctor. I was struggling with severe disappointment in the medical system and realized how ineffective it could be for chronic disease management. I realized my own personal hero in this challenge was the Naturopathic Doctor and not all of the MD's that spent no more than 5 minutes with me and just gave me ineffective prescriptions that caused side effects. I then decided if I really wanted to be an effective doctor with the time to get to know my patients, I was going to have to become a Naturopathic Doctor and study Functional Medicine, Naturopathy, Nutrition, and Herbal Medicine.
I wanted to be a doctor that took the time to listen and put the whole story together and not just treat each symptom with medication. Part of what my Naturopathic Doctor did that was so helpful was to take the time to understand what had changed with my dietary habits, dorm food, lack of sleep from studying all the time, and increased stress being away from my parents for the first time. The dorm cafeteria food was unhealthy, high in calories, and full of triggers from my Food Sensitivity Test.
At the same time in 1994, a lady in my Microbiology class changed my life forever when she recruited me to work at her Health Food Store. She was impressed with my quick ability to memorize everything and wanted me to help run her health food store. As a Biochemistry major, I was in absolute heaven getting to learn about all of the vitamins, herbs, and supplements! I couldn't believe it was actually my job to read about the products in the health food store when I was not cleaning, stocking, or helping customers! Amidst all the books in the health food store, I found several books by Naturopathic Doctors that went to Bastyr University, and the light bulb went off! I then felt inspired to attend Bastyr University for my medical degree instead of the University of Washington as I had first planned.
After I graduated from college in 1999 I began working for a Hormone Doctor, which is when my love of Women's Health and Hormones began which you can read more about in my Hormone Doctor blog. Which is why I love answering your Women's Health and Hormone questions on my blog! Please drop me a postcard with your questions. Remember if it can't fit on a postcard then you need to SCHEDULE an appointment with me.
Here are a few more Naturopathic questions I received this week from patients. Everyone always should know how Naturopathy works so they don't invest their time or money in something they cannot follow through on. I want every patient I see to be a success story. The following is more information on how Naturopathic Medicine works, the type of timeline to expect, as well as what kind of patients should not sign up for Naturopathic Medicine that I cannot help as well as the patients that I can most easily help.
Remember that Naturopathy is a process you go through, and I don't actually have a magic wand to wave. I know it appears that way at times when you see a patient of mine. But I can promise they did some level or work. Instead, I am teaching you about what diet and lifestyle your particular body needs and using herbs and vitamins to heal your system and provide temporary relief of symptoms while we are working to address the symptoms at their Root Cause.
#1 Question I receive as Naturopathic Doctor: Can you help me?
The #1 question I constantly receive every day blowing up my phone is "Can Naturopathic Medicine help me?" I can never answer that question until I can review with the patient what Naturopathic Medicine entails they do as I list below. In my mind as someone that has served patients for 15 years as a Naturopathic Doctor is not if what I do will be effective. I know it works. My concern is whether or not the patient is going to do it. Patients that do not follow the instructions as I have listed below simply don't get better. So please know I would not waste my time practicing ineffective herbal medicine as an Integrated Doctor that also knows how to prescribe medications. When it comes down to the decision I want to do what is the most effective, with the least side effects. So really when patients want me to prescribe their medications it is pretty boring for me. I feel like anyone can sit and write you a book of prescriptions and that my talents are being wasted. This is why I prefer patients read the information listed below carefully to ensure they will be successful with Naturopathy. Practicing prescription Family Medicine is truly boring to me and their are millions of other places you can go for that. I want to help women transform into their ultimate healthy best most beautiful anti-aging version of themself and that is what truly brings joy to my heart as a doctor!
Who are the most successful Naturopathic Patients?
My most successful Naturopathic patients understand that healing is a process and not a prescription. They trust me, my methods, and my expertise. They don't Google everything I prescribe and call to argue about potential side effects...instead they just follow their treatment plan and let me know when they have an adverse reaction to something I have prescribed so I can provide a substitute. They let go of any pre-conceived notions as to what diet they should be on and trust their body will tell them through the Naturopathic process of testing their Food Sensitivities, hormones, vitamins, cholesterol, and blood sugar what diet they should be on.
They are committed and highly capable of following my instructions and are eager to learn about what helps their bodies function the best. They love to use metrics such as hormone and nutrition labs to understand their body and thrive from the detailed information. They know we will need to work closely together monthly until their symptoms have improved and budget this in accordingly so they can be successful with the Naturopathic process they start. They understand they are investing in a new system of living that is a learning process in order to find long-term solutions to avoid the use of medications. They know all of that will require more than one appointment.
Who can you not help with Naturopathic Medicine?
What is the #1 factor that determines if a patient will be successful with Naturopathic Medicine?
Trust is the #1 factor that determines if my patient will be successful with Naturopathic Medicine. I always have better outcomes with patients who trust Naturopathy and trust me as their Naturopathic Doctor. I always find it easier to help patients that are referred by another patient. Especially for weight loss. They have seen with their own eyes how my hormone fine-tuning and herbs work and they are eager to do everything I say to do. They have already seen the magic of Naturopathy with their own eyes! They know it works.
I will be honest and admit that I have trust issues myself, and sometimes want to be skeptical. But my skeptical patients rarely improve. They are too busy researching everything I say to do to determine if it is "right" and figuring out why it is wrong and then go to another doctor to see if they have a different plan and cannot commit to any one particular doctor's plan. The issue with this is that when we have 10 Naturopaths in the room we have 12 different ideas is the joke in my profession because we all do things differently. There is a huge abundance of effective herbal medicines to potentially try.
Every doctor has their "style" of practicing medicine and you will never go to two Naturopathic Doctors that are exactly the same. I offer a completely different skill set with my background in Women's Health and Family Medicine. I know how to prescribe many medications from working 8 years in regular Family Medicine, and therefore practice very complex Women's Health care. This can save women from going from many doctors as I explain was my experience before I found a Naturopathic Doctor of my own to see.
I understand it is scary for women with trust issues to trust me or any doctor, but I also completely cannot help you if you cannot decide upfront that you can trust me and my 15 years as a Naturopathic Doctor and 23 years of experience in Women's Health and Family Medicine 28 years of experience as an Herbalist. Keep in mind I have been essentially prescribing herbs for people since 1994! That is what I have done every day with my life as an adult is to try to help people with their health issues.
But I cannot help everyone and most commonly it is because the patient is too busy being a skeptic and not actually rolling up their sleeves and doing the work. Health is technically a four-letter word and it is called WORK. I need patients committed to doing the work with me. It doesn't work if you don't help me do the things I need you to do things on your end. Successful patients show up with a pen and paper and take notes.
Naturopathy is a process and you have to be able to trust the process. People that know me well, know my personality is "No Nonsense. " I not going to waste your time when I personally know how it feels to be sick and scared, so I will always tell you the truth if I cannot help you. If we are working together regularly that means I expect you can get better, and I have seen other patients with similar symptoms improve. If I cannot help you I will refer you to a doctor that can help you. Otherwise, I always need patients following their exact plan as prescribed and following up monthly for adjustments to their Chronic Disease plan until improved. That is how we become successful together as a team. That is how I work my way of out a job after 2-3 months the majority of my patient cases are solved and they don't need to return. We may need to continue doing Hormone Checkups every 6-12 months but their problems are resolved and managed with natural medicine. I have many doctors and nurses as my patients who trust me wholeheartedly and they know that avoiding medications is our mutual goal and trust my Naturopathic healing process and expertise. They also know it is a process to even find the right drug for a patient which is the same in Naturopathic Medicine.
My Naturopathic patients that simply follow my exact instructions almost always improve by taking herbs, supplements, and a proper nutrition plan! How can I say that? Because my assistant is always calling to remind people to follow up and she tells me they are better and don't need to follow up again. Or even better I get a text message from you that says "Hey, my XYZ problem is totally fixed and I just wanted to say thank you for how much better I am feeling!"
My favorite though is when women text me to tell me they are pregnant after finally getting their hormones balanced. While I don't specialize in fertility my process of treating PCOS, endometriosis and complex hormone issues has resulted in a lot of surprise babies that nobody was planning on, and did not think they could have. So I do get to see the magic of Naturopathy happen before my eyes every day and that is my favorite part of my job. But that magic does not happen unless you are willing to make dietary changes, take herbs in the form of capsules, teas, or tinctures and take some vitamin supplements. So is it actually magic or is it just what happens when we listen to the body and give it what it needs?
Please plan to budget in monthly appointments if you decide to give Naturopathic Medicine a try so that you can be my next success story! There is an element of trust involved on the patient's end and it is imperative you choose a Naturopathic Doctor with a proven track record of success. A good Naturopathic Doctor will not require you to follow up constantly for the rest of your life. You should get better and only need to come in 1-2 times per year once your issues are resolved for an annual check-up. Once your plan is in place and you have learned your new system you will generally not need to constantly be returning to your Naturopathic Doctor.
If you think you will be a good fit for Naturopathy, please book your visit on my SCHEDULE page.
Dr. Nicole Sundene, NMD
(480) 837-0900
By Dr. Nicole Sundene
Holistic Psychiatry & Hormone Specialist
While I am not a true MD Psychiatrist many of my patients refer to me as their "Natural Psychiatrist" because I am fulfilling the role of prescribing natural medicines, hormones, and nutrition as discussed below with my favorite anxiety herbs to treat my patient's mental health. However, I am not a true Psychiatrist, but simply practice "Holistic Psychiatry," which means together we will look at your anxiety not as a prescription, but as a process to first:
#1 Look for the Root Cause of the anxiety
#2 Test female hormones and balance hormones to optimize mental health
#4 Test nutrition aka vitamin and mineral deficiencies that may be contributing to lack of neurotransmitter production. Neurotransmitters such as serotonin and dopamine are needed to make us feel happy, and like everything is okay, and we can properly focus and get things done as procrastination caused anxiety which then makes anxiety worse.
#5 Work with you weeks in holistic counseling sessions or have you work with your counselor covered by your insurance plan to implement better coping skills and support the process of improving your nutrition, lifestyle, stress, exercise, and supplement routine.
So that is how I treat my Anxiety patients in my Holistic Psychiatry practice. Keep in mind if your mental health disorder is severe such as in bipolar, schizophrenia, or severe suicidal depression I will require you to have a board certified Psychiatrist MD working in conjunction with me, as well as a counselor.
Anxiety disorder in Women's Health is best managed by a Holistic Hormone Doctor that can work to evaluate the root cause of the anxiety. For women hormone imbalance such as PMS, PCOS, Perimenopause, Menopause, Adrenal Fatigue, Hypothyroidism, and Hashimoto's Thyroidtis are often the culprits behind what appears to be a generalized anxiety disorder. Especially when typical anti-depressants or anti-anxiety medications do not help.
While many of my patients are currently feeling anxious and can benefit from a natural anxiety treatment the real clue that the anxiety or depression is caused by hormone imbalance is when women experience fluctuating symptoms.
Anxiety that fluctuates monthly is absolutely hormonal. Women that suddenly develop anxiety later in life such as in their 40's or 50's that have never experienced anxiety before are most likely being triggered by peri-menopausal or menopausal hormone changes that can impact mood. Patients with a family history of thyroid disease that suddenly develop anxiety should also have their hormones checked by a female hormone expert.
While different herbs help patients with their anxiety the real issue with anxiety is that we work to discover the root cause. Some women are just more anxious than others but the real clue that there is an underlying hormone issue is when a woman that has never had anxiety before is suddenly feeling anxious, agitated, angry or impatient. Especially when nothing situational is actually going on to contribute to the anxiety.
As a Naturopathic Doctor I honestly don't really even care WHAT herb we use to treat your anxiety. That is pretty boring to me to just prescribe HERB X for SYMPTOM X. Dr. Google can do that for you....what my Detective brain always wants to know is what is the ROOT CAUSE? Until we understand the root cause the patient will just continue to perseverate with their symptoms and nothing will ever truly fix the problem or provide lasting results.
I have included a brief blurb so that you can get an idea of the herbs that I generally find safe for most women to try for their anxiety. Please always check with your Naturopathic Doctor before combining herbs with prescription drugs. Do not take sedative herbs during pregnancy or breastfeeding. More importantly treat yourself to a Naturopathic consultation to discover the root cause of your anxiety by popping over to my SCHEDULE page.
#1 Passionflower- The intricate purple flower pictured above was shown to be as effective as sedatives in the benzodiazepine (valium) family, the aerial parts of this herb are great for nervous tension and anxiety. In recent research, passion flower extract at 45 drops daily (tincture) was shown to be as effective as oxazepam (similar to valium). This nervine herb is also “antispasmodic” which makes it great for people with constant nervous twitching.
#2 Ashwaganda- This is probably one of my favorite herbs. Unlike most of the herbs on this list that are designed to be taken at night or at least late afternoon, both ashwaganda and schisandra (listed below) are terrific “adaptogenic” herbs that help us tolerate our stressful days that much better. You can make some tea, or grab some capsules of the organic root and take two capsules twice a day.
This herb is specifically intended for those that are exhausted and agitated or debilitated by stress. In ayurvedic medicine ashawganda is a renowned anti-aging and rejuvenating herb.
#3 Schisandra- Referred to as “Chinese Prozac” this herb is commonly unappreciated and underutilized in American herbal practice. Schisandra is a terrific day time adaptogen herb and should be taken as is recommended with Ashwaganda, two capsules with breakfast and lunch, or a cup of tea in the morning and afternoon. The berries can be made in to a nice aperitif for those with a low libido.
#4 California Poppy- The bright orange flowers of the California poppy, leaves and other aerial parts are sedative, anti-spasmodic, and mild pain relievers. This is also a gentle herb used for colic and agitation in children. Do not use this herb or any other sedative herbs in pregnancy.
#5 Hops- No I am not recommending that you drink more beer to calm down. However, the herb commonly used to make beer bitter also works as a sedative. It is extremely bitter though so is best given a small part in your herbal tea formula for insomnia or stress. Do not combine with prescription sleep aids due to an additive effect.
#6 Kava Kava- A well known Polynesian psychotropic sedative, this herb is sedative and “spasmolytic” and thus helpful for chronic pain conditions. Several conflicting studies debate the safety of using this herb with alcohol. Liver damage is thought to occur if used in large doses in conjunction with alcohol. This research however was used to scare many people away from using kava kava for whatever reason.
People need to simply remember that herbs are medicines and that an herb with actions similar to prescription sleep aids and analgesics will of course pack the same side effects. A strong herb demands respect. When used ceremoniously, or occasionally this herb does not run the risks it runs when it is heavily abused.
The best way to safely use kava kava is in an organic tea form. Look for a tea blend that includes kava, or make your own. This herb should not be used in large doses, and large doses should not be used over long term. Do not combine with alcohol, or use during pregnancy or nursing. Chronic abuse will result in a horrible scaly skin rash.
#7 Lavender- Try adding lavender to your favorite baked good recipe. Purple lavender flowers will offer a sophisticated herbal makeover to your favorite shortbread cookies, or white tea cakes.
Lavender is great in your herbal medicine blend, and can also be used to stuff pillows, or as an aromatherapy stress reliever throughout the day. Lavender should not be used in pregnancy due to it’s emmenagogue effect.
#8 Lemon Balm- Also known as “Melissa officinalis” this herbal sedative should not be used by those with hypothyroidism as it inhibits the thyroid and is used to treat hyperthyroidism, however for everyone else it is a common simple herb to grow in your garden and make in to your own calming sedative tincture each summer. Do not use this herb in pregnancy.
I grow lemon balm in my garden and harvest it, rinse it, let it dry and then pack it in a jar with enough room for it to swim around in some vodka. Shake the jar once a day for two weeks. The vodka will extract the constituents and after a few weeks you can strain out the plant part leftovers and put a half a teaspoon of this liquid “anxiety medicine” in a little bit of water when you need something to calm you down.
#9 St. John’s Wort- Although we think depression the second we hear about St. J’s Wort, we also need to address that depression and anxiety tend to walk hand in hand and this herb is not just an anti-depressant it is a mild sedative as well. St. John’s Wort has also been shown to have a lower risk of side effects than conventional anti-depressants and is worth trying for those that don’t quite have severe enough depression to mandate the use of a prescription pharmaceutical, but instead need something to take the edge off and boost the mood a bit.
If you are suffering from anxiety that has a form of depression associated with it, then this would be a great herb to consider in your herbal sedative blend pending that you are not on any anti-depressants or anti-psychotic medications. The condition “serotonin syndrome” may occur from combing this herb with those classes of medications or other herbs and supplements that boost neurotransmitter levels.
This herb should not be used by those on oral contraceptives, or any medications as it increases the cytochrome p450 enzyme system which results in a more rapid detoxification of drugs from the system. The drugs or birth control pills are then rendered useless. Standard dose of St. John’s Wort for those not on any other medications, is 300 mg three times daily of the 0.3% standardized extract.
#10 Red Clover- Not traditionally recognized as a sedative, but as a mineral source and blood thinner, this “cooling” herb calms the system and has a special affinity to the lungs, throat, and salivary glands.
This is a terrific balancing herb to include in your herbal sedative blend as the dried flower blossoms make for a beautiful addition to a glass teapot. Do not use in pregnancy, or if on blood thinning medications.
#11 Catnip- Not just for cats. Catnip is actually a gentle nervine herb for humans. No it won’t make you roll around on the carpet or chase after things (at least not to my current knowledge) but it is still a great mild sedative.
This herb should absolutely NOT be used during pregnancy, as most herbs should never be used during pregnancy without checking with your naturopathic midwife, however it can safely be used in children by making a very weak tea. Be sure to only give your children organic herbs and check with their pediatrician or naturopath prior to use.
#12 Valerian- Definitely one of the more potent herbal sedatives, valerian is also a great pain killer for those with chronic pain. Some people prefer not to use this herb because it can cause quite the herbal hangover the next morning and most complain that it makes them feel really groggy, or desire to sleep through the day.
Look for a tea formula that includes a bit of valerian to avoid the hangover, and if you have severe anxiety, chronic pain, or insomnia talk to your naturopathic doctor about using this at a more therapeutic dose. Always use organic root.
#13 Motherwort- The perfect herb for fried and frazzled mothers; it strengthens a weak heart and is great for nervous palpitations. Motherwort is best taken over a prolonged period of time, and because it is a uterine stimulant, it should not be used in pregnancy.
#14 Skullcap- A bitter, cooling sedative herb that is best used for nervous fear, restless sleep, and is also thought to lower blood pressure. This herb is great for people with the inability to pay attention—huh what was that? And has been used effectively to calm down children with ADHD. Some kids concentrate better when they are sped up, and some do better when they are calmed down.
#15 Chamomile- One of the most common kitchen herbs, chamomile is a great mild sedative and digestive bitter.
Be careful in using chamomile tea if you experience ragweed allergies, formally known as the “asteracea family” and previously recognized as “composite family.” If you have a history of seasonal allergies you should exercise caution.
If not, make your tea up strong, use a heaping tablespoon and not a teaspoon per 8 oz cup of water, and allow to steep 15 minutes covered. If you don’t cover your chamomile tea you will lose the calming essential oils to evaporation. Only elitist herbalists know to do that. Welcome to the club!
Traditional Herbal Sedative Use: Establishing a nighttime or daytime tea ritual is a great way to reduce stress, avoid binge eating, and help those that fight insomnia get to sleep at a decent hour.
Directions: For most of these herbs simply make a tea with about 1 tsp (milder herbs use a tablespoon) to 8 oz cup of boiling water. Allow to steep covered 15 minutes. Or if you aren’t a tea drinker just look for a pre-made organic herbal formula to take in tincture or capsule form, and follow the manufacturer’s recommendations.
Please check with your Naturopathic Doctor before combining any herbal medicines with prescription medications or making any changes to your health care routine or simply treat yourself to a Naturopathic consultation with me by popping over to my SCHEDULE page. I am able to help patients that are not in Arizona via Telemedicine with their anxiety, we can conduct hormone testing and implement naturopathic medicine by phone consult.
Dr. Nicole Sundene
Female Hormone Expert
(480) 837-0900
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for 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
Holistic Psychiatry & Women's Health
Menopausal women recently reported in a June 2023 study feeling happier on saffron! Did you know that saffron has repeatedly been proven as safe and effective for anxiety, insomnia, and depression?
The world’s most expensive spice is not only delicious but important medicine. Saffron costs about twenty dollars per gram because the harvesting process is extremely tedious and each flower only produces three threads of saffron. Saffron is most commonly used in expensive and exotic dishes, Morrocan and East Indian cooking. The herbal medicinal components of saffron contain powerful antioxidants, vitamins, minerals, beta carotene and mental health benefits!
The stigma is actually the female reproductive part of the plant which is why its pigments are full of nutrition and antioxidants to attract bees, butterflies, and pollinators. After the crocus blooms the red stigmas come out shortly after.
Saffron is a warming spice used in risotto, boulibasse, and paella that is plucked from the crocus flower. The saffron stigmas are then dried for use in cooking or as medicine.
Since so many of my mental health patients have been asking me about saffron, I wanted to share the latest saffron research. We have two new research studies on saffron released in June of 2023! These studies again confirm that saffron made menopausal women happier, and was also safe and effective for anxiety and depression.
Ever since 2014 I have been using saffron on my patients, when I read the research study showing saffron as effective as Prozac for depression. Another study found saffron was safe and effective when combined with the common antidepressants Prozac, Zoloft, and Celexa, and provided a mood boosting synergistic effect. This is important because there is often grave concern in the holistic psychiatry community that too many medications or herbal supplements may cause "Serotonin Syndrome" which can cause dangerous High Blood Pressure. This did not happen with these medications plus saffron!
Researchers also found saffron was as effective as Ritalin for children with ADHD, with less side effects and potential for stunting of growth. When I worked in conventional medicine, we were always measuring kids on ADHD medications for fear the medication would stunt their growth, and it often did. So this is a good first option to try along with my "ADHD Diet" as oftentimes kids don't need us to kill a fly with a cannonball when they cannot concenterate or hold still, and something gentle and safe like saffron plus an omega-3 rich diet, and food trigger removal is all a lot of the kids I treat for ADHD need. Then I work with their psychiatrist to taper them down from their Adderall, Ritalin, or ADHD medication.
My own experimenting with saffron on many patiens has resulted in it being a totally beneficial and benign substance that lifts mood with little side effects.
It is so safe that researchers used it in breastfeeding women with postpartum depression and found it to be a safe and effective natural antidepressant for depressed new moms. This is important in my women’s health practice as many new moms are depressed yet also terrified of taking a prescription drug while breastfeeding. In mild to moderate cases of postpartum depression saffron is safe and effective. As well as beneficial when combined with Zoloft in severe postpartum depression. Although most of my mom's need saffron, along with correcting hormone imbalance and nutritional deficiencies that occur postpartum as I discuss on that blog.
The worst thing that happens with saffron that I see happening in my practice is that patients decide they feel fine on saffron, are no longer depressed, and then mistakenly think they don't need to take it anymore.
Especially when the saffron pharmacy doesn't text you a million times to refill your saffron, pick up your saffron, and then continuously threaten to put your saffron back on the shelf if you don’t pick it up today like our pharmacies do with prescription antidepressants. So within 1-2 weeks after forgetting to take saffron my patients do report going right back to their depressed blah slumpy state.
So if you do choose to start saffron put it on autoship please! Saffron in capsules is not super expensive, so figure out how many capsules you need each month of it and put it on autoship when you order your Vitamins.
Other things to consider with saffron is that it shown to be effective for many conditions. Having a synergistic benefit is generally a good thing, except when the patient or their doctor is not aware of how saffron may be impacting certain medications and medical conditions.
Many research studies have been conducted on saffron safety and efficacy. Researchers also found saffron helpful for ADHD, Insomnia, Diabetes Type 2, Alzheimer’s, Stroke Recovery, Allergies, Asthma, Macular Degeneration, Diabetic Eye Disease, Poor Libido, Erectile Dysfunction, and improves Cholesterol, Blood Pressure, and Chronic Pain. The mechanism of action appears to be that saffron is a potent anti-inflammatory herbal medicine that likely works by improving optimal gene expression.
So keep in mind that you should be supervised by a Naturopathic Doctor if you have medical conditions, or are taking any medications while using saffron as generally I DO need to adjust patient’s medications down. Especially for Anxiety, Depression, Diabetes, High Blood Pressure, High Cholesterol, and Pain. While these are basically good problems to have, a Naturopathic Doctor should be monitoring blood work and blood pressure to ensure your numbers do not become too low as either extreme of too high or too low of blood pressure and blood sugar are not good.
Now keep in mind another key point about using saffron, is that if you use it alone it is likely not powerful enough for the severe depression cases I treat. This is when I use it as an “Adjunctive Therapy” as it was found safe and effective to combine synergistically with Prozac, Zoloft, and Celexa. It is afterall just a food. But still be careful, especially with things like depression. I would never want to give someone false hope with severe depression that this will be the only medicine they will need.
Saffron is best for mild and moderate depression and safe as an adjunctive therapy to most prescription antidepressants. Which is important since I commonly hear that antidepressants help my patients somewhat, but do not get their mood to 100%. Until we add saffron!
Saffron also helped reverse the poor libido side effects many patients on antidepressants experience which makes sense considering that it traditionally has been prescribed and studied for male erectile dysfunction. So things that help men's erectile dysfunction generally help women on antidepressants and/or in menopause that have zero libido.
With the epidemic of mental health issues plaguing the public I continue to regularly blog about mental health, thank you to everyone that follows me and shares my posts on their social media. It brings me great joy as a Women's Health Doctor to see my male friends even sharing this important news for women!
I have a lot of mental health patients in my practice that can look very well put together and can put on an amazing show. Only their doctor knows they are anxious, depressed, spinning out in constant panic attacks, battling PTSD or even suicidal.
Together we can fight this mental health epidemic. I am asking for everyone’s help as I cant do it without you. Please help me by sharing my posts, text them to your depressed friends. This is free information. While I prefer everyone to work with me so I can properly help them, I also know many people are not aware of other options to prescription drugs, and do not feel "normal" on antidepressants, yet need to take something.
I do also understand that many people cannot afford medical care right now or are unemployed. I also want to bring awareness of this powerful yet gentle and safe natural remedy for depression. So to save our loved ones we all have to do this together.
The other dangers are using cheap fake forms of saffron. Please stick with doctor recommended reputable sources for your supplements, I prefer the Life Extension brand available to my patients in Fullscript, be careful with the Happy Saffron brand as it contains soy, a high dose of zinc, and carnuba wax. So the Life Extension "Optimized Saffron" choice is what I prescribe to my patients as it has 88.25mg of PURE saffron in it. Most depression studies used only 30mg of saffron. So this product is a healthy pure source of saffron, I see it effectively working for my patients, it is double the researched dose, and I trust Life Extension uses reputable sources that are not full of lead as many herbs from India and China are.
Most research studies I have listed below used 15 mg for children and 30mg for most adults. Some studies did use up to 100mg of saffron! So now I am buying myself several bottles and wondering how amazing I could feel mentally and sleep better at night by trying a full 100mg! Crocus petals were also studied to be effective for mental health, if you do grow this plant.
Thank you for sharing my important holistic nutrition recommendations for depression, anxiety, and PTSD, Everything is free to read and relatively inexpensive on my blog “Depression Tips” and my "ADHD Diet" is critical for all mental health patients to follow as it contains a high amount of Omega-3's while eliminating trigger foods.
Read more about “Anxiety Herbs”, like Schisandra and Ashwaghanda for more of my favorite mental health natural remedies.
Visit my SCHEDULE page to treat yourself to a Naturopathic visit, so we can get to the “Root Cause” of mental health and chronic disease. 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 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!
References:
Dr. Nicole Sundene, NMD
Hormone doctoring affords me more generous appointment times with each patient so that I am able to solve the health problem at the root cause...and it doesn’t always have to be a hormone problem!
Today I figured out that a patient's high blood pressure that had been going on for 6 months was simply caused by a medication interaction from her GI doctor's office. They started her on a medication for her IBS, and it interfered with her high blood pressure causing it to no longer work. Mystery solved!
Sometimes, I don't even need to use hormones or herbs. Just the fact I have enough time to review the patient's diet, supplements, medications, and emotional state to figure out what has suddenly changed causing the new symptoms is all that is truly needed.
I wanted to share this story today because a lot of patients are feeling very frustrated by the current state of shambles the health care system is in and it is important that you decide not to become a victim of it.
With lab and pharmacy delays due to the Pandemic, come more inconveniences and stressors on every doctor's plate. Your doctor's time, patience, and attention span have never been shorter or more taxed than right now while patients are trying to get care at clinics and hospitals everywhere.
It is important people know this and not just assume their doctor has it all figured out as they are brushing off symptoms and rushing them out the door with a prescription of something that may actually have a dangerous drug interaction with other medications.
This is called "Iatrogenic Error" and I see it happening more often than normal right now.
Here is how to keep yourself safe and protected from Iatrogenic error.
My #1 tip: Doctors fail patients because they simply don't have enough time to understand what is going on. Before I became a Naturopathic Doctor, I worked in regular Family Medicine for eight years. While the urgent care was great if you had a broken bone, strep throat or needed stitches...often we would fail patients with chronic disease such as High Blood Pressure, Diabetes, Hypothyroidism, and Autoimmunity mainly because each doctor only had about 1-5 minutes to actually spend with each patient.
The hospital I worked for kept doctors on a very harsh schedule that would burn them out after having to see 40-60 patients each day.
God forbid the patient spends their 5 minutes talking about their vacation, literally nothing would be done other than the doctor handing the patient their best guess on what prescription will stop their symptoms and then walk out of the room after 1-5 minutes. A long appointment was 15 minutes. Rarely could the doctors afford the luxury of spending 30 minutes with a patient.
#2 Did what your doctor do actually work? If it did, good. If it did not help then you need to get a second opinion.
#3 Did your doctor ACTUALLY "Check all your hormones?" Everyday I am told this and a great deal of time out of my patient's appointment is wasted while they attempt to pull up previous labs on their phone. When I look at their "Full hormone panel," it is often just 1-2 tests! A TSH and an estrogen level is not a full hormone panel. My lab panels when you get blood work done are no shorter than 5 pages, so if all your labs fit on one page then you are likely a victim of The Sickcare System.
I mean no disrespect to my MD friends, because I know how hard the past few years have been on me, and I don't run even half of the schedule of patients they run every day. I actually have a lot of respect for MD's and I know firsthand how hard they work. Yet our health care system is officially broken, and patients need to learn to take responsibility for their own symptoms when they don't get the right answers they seek. Women with chronic disease symptoms such as menopause, hypothyroidism, weight gain, postpartum depression, anxiety, and high blood pressure can easily get lost in this vicious cycle!
Five minutes is not enough time for me to help you or do my job. The doctor does not have enough time to establish a root cause of symptoms, to educate the patient about symptoms, or to even take a proper history to determine if the symptoms are being caused by a new medication or supplement the patient started.
I can't tell you how many times as a Naturopathic Doctor I have figured out that a patient is just having a side effect from a new medication they recently started. If I did not have time to take a proper history I would have never solved it and instead piled a bunch of useless supplements and herbs on top of the medication error instead of addressing it.
While I personally choose not to be a victim of this "Sick Care System," and have my own Naturopathic Doctors I go to, many women do not know anything other than going to the doctor to get a prescription for what ails them.
When I first moved to Arizona I realized that there are very few MD's doing primary care and most providers covered by my insurance were PA's that did not know what to do for any of my symptoms and instead sent me to multiple specialists.
If you have a busy job like I do, you really just don't have time to keep going to different doctors and specialists and you need someone that can manage all your symptoms in one which is why Naturopathy excels. We treat the whole person and the whole set of symptoms!
Many patients that perceive Naturopathy as unaffordable really should look at it from a cost benefit analysis because constant appointments also means constant missed work. Lack of permanent lasting solutions means more sick days from disease, and more hospitalizations.
I have treated many patients in my career that had symptoms so severe they kept ending up in the hospital and spending thousands of dollars even with insurance. So sometimes the Sick Care System actually costs the patient more money overall, more time, and more misery.
Many of my patients that have been through hospitalizations before they received natural solutions from me see me as someone that saves them money every year AND keeps them out of the hospital!
When was the last time someone sat down with you for an hour and went through each and every symptom that you have to try to connect the dots and find the underlying cause?
My #1 pet peeve in Women’s Health is when women get bounced around from specialist to specialist without any answers yet they continue to feel poorly and nobody knows why. Each specialist prescribes a drug for their symptoms and eventually, they are on 5-6 prescription drugs to maintain all the symptoms. Sometimes the prescriptions don’t even help, and the patient feels even more frustrated and hopeless that nobody can actually help them.
Often this model of medicine will completely fail women because nobody is connecting the dots between their symptoms and their female hormones. Women with hypothyroidism, menopause, perimenopause, and PMS experience a cluster of symptoms that when ignored will result in the patient being on multiple medications when really they just need their hormone imbalance addressed.
We need to listen to the symptoms and understand them before we try to shut the symptoms up with medications. Doctors need to take a proper history of the symptoms and need time to do that. Oftentimes just the mere fact I am not rushed at my 45 minute visits with women is why we are able to sort out the cause.
“Tolle Causam” means “Treat the Cause” in Naturopathic Medicine, the cause is the #1 most important principle in Naturopathy. Treating the cause requires proper investigative work. I always rely on metrics such as labs for hormones, vitamins, minerals, liver, kidney, glucose and blood count.
While I love making teas with my jars of herbs, many of us know that when they are not used to “Treat the Cause” we are prescribing them in the same way we prescribe drugs. This is how patients can end up on 20 bottles of supplements.
In the 90’s I practiced ‘Health Food Store Medicine” when I worked at a GNC nutrition center for 4 years. Every day I said: “For stomach aches people use Marshmallow root, for headaches Feverfew, for anxiety Chamomile, for trouble sleeping Valerian, for hot flashes Black Cohosh, for hip pain Arnica, for weight gain Garcinia. for depression St. John’s Wort, for immunity Echinacea, for bladder infections Cranberry, and for vaginal dryness Aloe.”
But what if a woman has ALL of the symptoms listed above, at once?
If you are wise, you know that I just described the typical symptoms of a menopausal woman. Doctors need time to take a detailed history and evaluate their patient with proper hormone labs and blood chemistry.
If you need my help with your chronic disease symptoms, simply pop over to my SCHEDULE page and treat yourself to a Naturopathic visit! I will be happy to help.
Dr. Nicole Sundene
(480) 837-0900
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum Depression, 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 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
Palpitations and hormones go hand in hand especially when women are in perimenopause or menopause in their forties and fifties. While many of my patients refer to me as their "Natural Cardiologist," really what I am doing is working to perfect hormones and nutrition which then results in better Cardiology numbers. Too many times I have seen women prescribed a variety of cardiac drugs for high blood pressure, high cholesterol, palpitations, and heart issues when the real underlying “Root Cause” is female hormone imbalance, hypothyroidism, or Hashimoto’s.
So today I am blogging for those women with sudden onset palpitations, high blood pressure, and cholesterol that previously were healthy before forty and are suddenly shocked that I have found something "off." Some women in my practice begin to experience these heart symptoms in their twenties and thirties. Women can quickly be prescribed high blood pressure medication like propranolol for racing heart, when the real problem is their racing or fluctuating hormones.
The reason for this, is that a variety of hormones that we will discuss today impact the heart. Hormones are part of our emergency and reproductive systems and therefore will impact a wide array of bodily systems.
When hormones are fluctuating, then heart rate fluctuates as well, so it is imperative that we do not ignore women’s hormones and only focus on heart function.
Perimenopausal women and those with Hashimoto's Thyroiditis often report to me going to the ER multiple times for terrifying chest pain and palpitations only for the ER doc to tell them they are totally fine, and to go see me to get their hormones checked.
The irony in my Holistic Women's Health practice, is that ER doctors are often my #1 referral source because they have either A) Done a full work up and found nothing wrong or B) Know the consequences of patients not properly taking care of their health. Once one of my ER doctor friends has run a full cardiac panel of labs, CT, EKG, Echocardiogram, Stress Test, and so forth that all come back normal….that is when they send them to the hormone doctor. They don't know exactly what the problem is, but they know it may be a woman nearing menopause with hormones that are suddenly changing and thus impacting cardiac function.
Menopause causes increased inflammation and decreased thyroid function.
As I discuss further in my High Cholesterol and High Blood Pressure blogs, thyroid hormone stimulates the heart to contract. Without sufficient thyroid hormone we have lazy contractions or a fluttering heart rate. These lazy rapid flutters are not efficient and women get either palpitations, high blood pressure, or PVC’s “Preventricular contractions.”
While nutritional supplements and herbs can help these symptoms we also need to address what is going on at the “Root Cause,” the fact my patient is likely entering perimenopause, or menopause, or experiencing hypothyroidism, Hashimotos, or another autoimmune disease, such as Grave’s disease that can impact the heart.
Whether estrogen is too high or too low inflammation spikes. Both estrogen deficiency in menopause and estrogen excess in perimenopause and PMS trigger inflammation.
This is why women feel the worst during their PMS phase, and also why I call Perimenopause “Permanent PMS.”
When inflammation is higher our body functions less optimally and annoying PVC’s and palpitations can occur.
Hypoglycemia especially from insulin resistance is another common cause of palpitations I find in my patients. When blood sugar drops it triggers cortisol which is a stress response that causes our hearts to pound as our body thinks it is “Running From a Bear” with stress.
Correcting and stabilizing blood sugar in women with palpitations is imperative for proper cardiac function and prevention of terrifying palpitations that have sent many women to the ER thinking they are having a heart attack.
While iron is not an actual hormone, iron deficiency anemia from heavy perimenopausal bleeding is another cause of palpitations that I regularly find. So I cannot post about palpitations without a brief reminder to women to take their iron! No you are not getting enough from food if you are having your period. I disagree!! Especially with heavy bleeding, if you bleed more than five days you absolutely must be on iron or your heart cannot function properly. Annoying palpitations, hair loss, depression, and scary levels of dizziness occur in this group of my patients.
This is why I tell every woman to take a multivitamin with iron in the form of ferrous bisglycinate at around 28mg daily at minimum to correct anemia from perimenopausal heavy bleeding. Your heart should not have to overwork because there is not enough hemoglobin to carry oxygen around to your organs and brain. This is dangerous! And also really bad for your hair. No women are going bald under my strict watch! That multivitamin is like putting money in the bank. You must do it!
Hashimotos and thyroid issues are the #1 most common hormonal issue I find causing palpitations. Oftentimes womens thyroids are not even truly hypothyroid but just functioning in a suboptimal low range. This is when the family doc says “Thyroid is fine” but they have just checked the TSH and not properly evaluated the free T3 and free T4 which have dropped to the bottom of the normal range.
Oftentimes borderline low Free T3 is what I find with my women with palpitations. Their T3 may be in the normal range but I often find it at 2.0 which is the very bottom of the normal range.
While this is considered “normal” it may not be optimal if you are exhibiting symptoms. Especially scary palpitations causing expensive trips to the emergency room to no avail, and nothing is found actually wrong with the heart or cardiovascular system.
While a car can drive on both a full tank of gas and an empty tank of gas, nobody likes to drive around all day on an empty tank of gas because we all know that inevitably the car will stop running. This is what often happens to my patients that hover in the bottom of the normal thyroid range. Certain days they are fine, and other days they are having symptoms.
With using natural medicines to improve thyroid function and/or natural thyroid hormones we can correct these thyroid palpitations that occur from the thyroid functioning too low.
Too high of thyroid function from autoimmune disease like Grave’s, Hashimotos, or with inappropriate dosing can result in painful crushing palpitations that can cause sweating and make many women convinced they are having a heart attack.
The majority of my autoimmune patients have gone to the ER at some point for these terrifying palpitations. The reason for this is that an immune system that is attacking is also causing a lot of inflammation and the heart does not like inflammation.
Cortisol stress hormones trigger palpitations when under physical, emotional stress, at times of low blood sugar, and in women with Congenital Adrenal Hyperplasia (CAH) that have excessively high production of adrenal gland hormones such as DHEA and Cortisol.
CAH is often misdiagnosed as PCOS, and appears very similar to PCOS although the hormone imbalance is not caused by insulin resistance triggering the DHEA, the DHEA is simply too high due to increased adrenal gland production. These patients often have abnormal facial hair, acne, anxiety, rage, blood sugar issues, weight loss or gain issues, nausea, and vomiting.
The moral of the story with hormones and heart issues is to get your hormones checked by a skilled holistic hormone doctor... preferably me 😉
Female hormones naturally change and fluctuate throughout a woman’s monthly cycle as well as during her thirties, forties and fifties thanks to perimenopause and menopause. Hormones absolutely impact the cardiovascular system and should be checked especially when women were previously healthy and suddenly started to have palpitations or heart symptoms.
Other hormonal conditions such as diabetes, insulin resistance, PCOS, adrenal fatigue, hypothyroidism, Hashimoto’s and autoimmune disease can also impact the heart.
Need my help getting to the “Root Cause” of what is off with your cardiovascular system? Solving the cause of women’s palpitations is one of my favorite joys as a Women’s Health and Hormone Doctor! I would be happy to help. Simply visit 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 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 Cardiology and Hormones
QUESTION: "My blood pressure is 135/85. My Cardiologist just says to watch it for now. What else can I do to reduce it naturally without medications?" Linda S. Scottsdale, AZ
High blood pressure or “hypertension” in a mild to moderate range responds beautifully to Naturopathic Medicine in my twenty five years of experience in chronic disease and Women's Health! Women with blood pressure ranging from 130/85- 159/95 can expect to have their blood pressure lowered effectively with natural medicine. As a Naturopathic Doctor, I have helped hundreds of patients avoid the use of high blood pressure medications.
Although this should be done gradually and with someone experienced at doing so (such as myself) that I explain further in my "Hibiscus High Blood Pressure Tea" blog.
Patients with suspected high blood pressure should check their numbers twice daily preferably at 6 am and 6 pm for at least one month and contact their doctor if they have two readings above 140/90 on either number. As we must have at least two abnormal readings to diagnose high blood pressure.
Usually, medication is required in addition to natural herbs, vitamins, supplements, and diet when it is a more severe range ie: >160/90 - 180/100
Patients with a blood pressure above 180/100 on either number have "Malignant Hypertension" and should be at the hospital. IV blood pressure medications are needed in this emergency to get the numbers down and prevent stroke.
High Blood Pressure is the "Silent Killer" of women. Women will not have any symptoms related to high blood pressure and are at risk for stroke, heart attack, kidney damage, eye damage, blood clots, and premature aging.
My #1 biggest pet peeve as a Naturopathic Doctor is finding women have high blood pressure and/or borderline "grey zone" blood pressure that they are not going to do anything about. Too many times I have heard, "the cuff is squeezing my arm too tight," or "It gives me too much anxiety to check it." Yes, the anxiety of suddenly becoming blind or having kidney failure could also be very high, and sadly most women with high blood pressure that have not properly cared for their BP have just suddenly dropped dead of ruptured aneurysms, strokes, or heart attacks.
So please do not ignore your blood pressure just because you have "medical anxiety" or "White coat hypertension." The studies show that you also have high blood pressure in other stressful situations and ignoring it will have zero symptoms until it is too late. Once that happens my patient is either dead, eating an awful kidney disease diet/getting kidney dialysis, getting eye surgery after eye surgery.... or recovering from a stroke.
So for my patients that tell me they are too busy to check their blood pressure my Scandinavian doctor response is, "Are you too busy to learn to walk again? Because that can take around six months."
I may blog very bluntly, but I also know that people search for protocols and information such as mine to avoid going to the doctor and avoid using prescription medications, which is not at all what I want.
I always want the best for people. #1 Always do what your Cardiologist says unless I say otherwise. My method of dealing with female Cardiology issues is to fine tune and test for hormone imbalance, nutrient deficiencies, test and remove trigger foods individual to the patient, and improve overall nutrition prior to even entertaining the thought of tapering medications.
By working with your Naturopathic Doctor and slowly adding natural treatments in which we will discuss today, I generally see my patients require LESS medication and thus we taper the dose of their medications down as they improve.
The most dangerous thing high blood pressure patients can do with herbal medicine and Naturopathy is to not be monitoring their numbers daily. Generally, after 2-3 months my patients improve and need less medication when we implement natural medicine. Therefore, it is dangerous to not be monitoring the numbers when using herbal medicines to lower BP.
Of course, there are many etiologies to this common disease; however, most cases are because we have gotten fat, old, and out of shape.
Yes I said it outloud, but it is true and my blood pressure patients are almost always inactive which is why I see so many women that are thin with high blood pressure... because they don't have to exercise to maintain their weight. Exercise is needed to maintain the body as a machine. Ignoring exercise with blood pressure is the equivalent of never putting air in your tires, putting too much air in your tires... never checking the air level in your tires and then wondering why the "tire pops" in the form of a heart attack or stroke. Sometimes we care for our cars better than our bodies.
Yes, there are exceptions to the rule, such as insulin resistance, thyroid disorders and hormone imbalance causing high blood pressure in Women's Health. Otherwise the #1 reason I see why my patient has high blood pressure is lack of physical fitness. Exercise is needed to tonify the cardiovascular system and maintain the elasticity of the arteries. Without exercise, the arteries harden and become more narrow. So you must exercise for your arteries and it must be at a level that makes you slightly out of breath and makes you sweat or it generally does not work.
Regardless, I just announced the pink elephant in the room and everyone is mad at me for calling them fat and old...but I promise to help fix this in exchange of stating the facts.
In order to do that with Naturopathic Medicine we must understand elasticity. We want an “elastic” cardiovascular system and not a hard or "non-compliant" one as we say in medical terminology. And when I say non-compliant, I am not talking about a badly behaving cardiovascular system. I am talking about the elasticity of your arteries.
Non-Compliant Arteries=Hard Arteries = Old Garden Hose
Alternative treatments are not as efficacious as they could be when it comes to hypertension, and diet and exercise are the keys to keeping blood pressure low. The fact that you are no longer young and fit is the real problem, and we all inevitably develop hardening of the arteries known as “atherosclerosis”, which is the leading cause of high blood pressure. The arteries harden like an old garden hose that is then at risk for cracking in the form of an aneurysm.
While you are working to adopt a healthier lifestyle, I typically prescribe a basic Naturopathic regime of a Whole Foods Diet, magnesium, coQ10, vit C, Potassium, and fish oil as my first step.
Please note: Do NOT take fish oil if you are on anti-coagulants. Otherwise most of these nutrients combine well with most medications but your Naturopathic Doctor should supervise you.
*Always remember to check with your naturopathic doctor or MD before implementing ANYTHING new as even vitamins can be dangerous.
Monitor your blood pressure three times a day while making new changes to ensure you are not over-medicating with natural remedies. Signs of low blood pressure will look like fatigue, dizziness, seeing floaters, feeling cold, and feeling light headed when you get dehydrated or change positions.
The best natural medicines for high blood pressure:
1. Magnesium: 300-500mg daily of magnesium glycinate (may need to divide doses to avoid diarrhea) Magnesium is a muscle relaxant and the arteries are all surrounded with smooth muscle. Magnesium oxide at high doses will cause diarrhea. Magnesium glycinate is better for cardiac patients.
When the smooth muscle surrounding your arteries relaxes, it causes your arteries to dilate which results in a drop of blood pressure. Most people are deficient in magnesium anyway, as the richest sources are found in green veggies. I would guess about 90% of American’s are magnesium deficient.
2. CoQ10: 100-200 mg daily. You should be on this anyway if you have high cholesterol as statins deplete this nutrient, and the common sign is muscle weakness or pain, or in the severe form rhabdomyolyosis.
CoQ10 is depleted by statins (lipitor, lovastatin, etc) inhibition of HMGCoA reductase in the cholesterol pathway, so it is best to replete this potent antioxidant, and you may feel more energetic on your lipitor. I am just waiting for a pharmaceutical company to smartly come out with a statin that includes CoQ10. This nutrient is expensive, but it is worth the bang for the buck if you can afford it.
If you can’t afford it, remember that exercise is free and it is one of the better treatments anyway. If you have high BP check with your doc before starting a new exercise program as they may want to do an EKG or exercise stress test. Otherwise, be sure to purchase a high quality brand of CoQ10 in an emulsion (liquid capsule not tablet) form as this nutrient is fat soluble.
3. Garlic: Liberally in the diet (cooking does reduce the allicin content, so raw is best but I understand if you still need to keep a few friends around…it just means you have to eat more cooked or roasted garlic to attain the same therapeutic effect.)
Or just take garlic as directed if you are going with a supplement form. (Kyolic brand has been widely studied and shown to be efficacious according to the studies.)
Because various studies have shown garlic to be effective as an anti-hypertensive agent, I would start low and monitor blood pressure. Garlic also lowers blood sugar, so if you are diabetic you should check your blood sugar numbers more often while implementing this natural therapeutic for hypertension.
4. Potassium: at 24 mmol (ask your doc for a prescription, but chances are you are already on this as most anti-hypertensives are potassium depleting) If you want to get this from dietary sources, then just eat avocadoes, green leafies and fruits like bananas. Check with your doctor before using this as a therapeutic agent if you have kidney disease or if you are already on a potassium sparing diuretic medication (used for high BP.)
5. Vitamin C: 1000 mg twice daily. Emergen-C packets are the simplest way to achieve this along with vitamin C rich foods.
One of the cheapest and most well studied anti-oxidants by Linus Pauling: the theory with vitamin C and blood pressure is that high blood pressure typically results from a few causes.
Hyptertension is caused either by problems in the kidneys, or “atherosclerosis” or hardening of the arteries. We want arteries to be elastic and stretchy.
Vitamin C is a very cheap antioxidant that helps prevent the LDL from “oxidizing” and forming the hardened plaques in our arteries that cause them to lose their elasticity. Think of vitamin C as the nutrient that keeps your pipes from rusting. Just about everyone should be on vitamin C anyways.
6. Calcium: 800 mg daily. Most Americans do not achieve this in the diet. Research has shown that calcium will slightly help to lower blood pressure…and we’ll take every little bit we can. Natural medicines work well in incremental steps and synergistically.
The goal with most of these supplements is to create an additive effect. Most people are deficient in this essential nutrient anyway, as 800mg is required for the average adult. Take your calcium and magnesium 1-2 hours before bed to ensure a good night’s sleep as they are also great muscle and nervous system relaxants.
7. Fish Oil: 1 tablespoon of fish oil daily. Taking a liquid is more powerful and less expensive than capsules. Omega 3 fatty acids, as noted in my article “Fish vs Flax” if you have hypertension, I frankly wouldn’t waste my time with flax oil unless you are Vegan as it is not the active Omega-3 your cardiovascular system needs in high blood pressure. Not trying to upset my Vegan patients, but I always try to offer realistic expectations.
Trust me, I love flaxseeds, and I put every menopause patient on them, but if you are really trying to get a therapeutic effect you need something that is ACTIVE aka further along the anti-inflammatory pathway.
Many nutrient cofactors and coenzymes that most Americans are also deficient in are needed to convert flax to what fish oil is. Also those of Northern European descent such as Scandinavians likely are deficient in the enzyme needed to convert flax seeds, as their traditional diet is based on cold water fish rich in Omega 3′s.
8. Rauwulfia: Don’t use this herbal medication without consulting your naturopathic doctor. This is “big medicine” in my opinion, and should not be used without being adequately monitored. However, a randomized study showed less depression when compared to reserpine. Ask your naturopathic doctor about this medicine. I am happy to prescribe this herb as alternative to blood pressure medicine but it must be taken daily like a drug or it will not be effective.
9. Stevia: The herb known for its sweetness has also been shown to reduce blood pressure at 500 mg three times daily! If you have high blood pressure, you have my permission to try out some of the new stevia containing foods and beverages such as Zevia soda. I prefer the “Wisdom of the Ancients” in the green packets as my fav Stevia. Keep some packets on you and try it in your coffee or tea instead of your typical sweetener. Just don’t use too much as it is REALLY sweet! I have messed up many of my meals by adding too much which is why I always buy it in packets. Make sure your stevia is pure and not combined with erythritol or other artificial sweeteners that cause diarrhea.
10. L-Arginine: 2 grams three times daily. The amino acid that is famous in those late night infomercials for “Extenze” L-arginine works to enhance blood flow by being the precursor to nitric oxide production. Nitric oxide dilates our blood vessels and when we go back to the garden hose analogy we decrease the flow when we take our thumb off the hose. That is what L-arginine and similar nutrients for vasodilation do for hyptertension.
11. The Dash Diet: Involves extreme sodium reduction to <2000mg daily. But most people should be reducing sodium in the diet anyways. The best way to do this is to avoid packaged food and cured meat. Salt your food with organic sea salt when it is finished cooking….not during. Salt just makes us look unnecessarily fat and bloated anyways. Eat fruits and veggies, lean proteins, and learn to cook with herbs and citrus foods to enhance the flavor of your foods. Salt and pepper as the final garnish.
12. Tai Chi: This gentle exercise is perfect for everyone trying to lose weight or reduce arthritis, stress, or just increase agility, balance and peace of mind. Tai Chi is a powerful tool to calm yourself, stretch and tone muscles. Find a few favorite Tai Chi moves from classes at your gym or favorite video and try to incorporate at least five to twenty minutes of these gentle stretches in to your day. Do you know when I do them? When someone says “Can you hold please?” I then put them on speaker phone and say “sure no prob.” Sometimes I can get a whole fifteen minutes in. First thing in the AM and before bed every night I want my blood pressure patients starting their day with something calming that is heart health such as Ta Chi, Meditation and Yoga.
13. Weight Loss: Nag, nag, nag…lose weight. Yah, yah, yah….You’ve heard it. If you are struggling to lose weight you need an appointment with me.
If you are over-weight you most likely already know it so I would recommend following my simple weight loss plan at www.PGE-2.com and if you can’t do that then please consider investing in some long term help such counseling. If you can't afford counseling I suggest the bookk “The Gift of Our Compulsions” by Mary O'Malley to begin to address the route underlying cause of over-eating issues.
Of course our metabolism gloriously slows down about 1% each year, which accounts for the 10 pound weight gain each decade.
It may be just a discipline thing. Each year we have to learn to eat 1% less, otherwise each decade we will gain at least ten pounds. How is that for a birthday present?
14. Decrease/Eliminate Caffeine: Caffeine is just like throwing gasoline on the hypertensive fire.
Now the reason why people get those “caffeine headaches” is because they are used to caffeine restricting all their blood vessels…but once the body metabolizes all the caffeine we get the painful rebound headache effect called “vasodilation” which means that our arteries dilate and cause a throbbing headache.
So why do we care about caffeine headaches? Because when we constrict blood vessels we increase blood pressure.
Remember again sticking your finger over the hose when you were a child and making the water shoot further? Well that is not necessarily a good thing in the body. A cup or two of coffee a day typically isn’t the problem, it is caffeine in excess.
If you have severe hypertension you may want to consider switching to decaf green tea, or herbal tea. Otherwise, you can likely enjoy certain caffeinated beverages socially, or moderately as long as your hypertension is within optimal range through the use of other natural modalities or prescription medicines. Generally, 1-2 cups of coffee or tea is not the problem but a pot of coffee every day is a massive problem for hypertension. I have many patients with high blood pressure still enjoying their caffeinated beverages and not giving them completely up.
15. Quit sugar. Sugar is the culprit for many diseases, and although not typically associated with hypertension may be the root cause. Try eliminating sugar or cutting back for a few weeks and track your daily BP numbers.
I have seen hundreds of my Naturopathic patients reduce their salt and not see any results. Because salt has wrongfully been made the only villain in hypertension and it is not always the bad guy.
When I tell these patients not improving to instead reduce sugar... SHAZAM…the blood pressure goes down! This is because Insulin Resistance is a leading cause of high blood pressure. Blood pressure can be affected by basic osmosis meaning the dilution or concentration of their blood with salt, electrolytes, and sugar. Too much sugar or salt can increase blood pressure.
Refined sugar throws the body out of balance because it simply is just not natural. Everyone ishould read my Naturopathic friend Dr. Scott Olson’s brilliant book “Sugarettes,” to fully understand how refined sugar is destroying your body from the inside out.
16. Consider food intolerances and allergies. A recent study has linked food allergies to hypertension. Food allergies can cause a myriad of problems and a food allergy elimination diet is a great thing for everyone to try at some point. A Food Sensitivity Test can help uncover problem foods.
Many patients struggle to complete a 3 Week Elimination Diet, as it entails you have to eat completely differently for about a month and then you test the foods you most commonly eat to determine if they are causing a symptom within a three day window.
What is the first thing your doctor does if they think you are having an allergic reaction? They check your pulse and BP! Low grade allergies may go unnoticed, and high blood pressure or a rapid pulse may be the only clue. If you have high blood pressure check your pulse before and after your meals. If it is high then you need to call me to schedule a Food Sensitivity Test.
17. Not enough good oil, too much bad oil. We want to increase our good fats such as olive, fish, and flax, and decrease fried and fatty foods.
Think of saturated fat as little cement bricks building up in your arteries and making them hard and narrow. The good fats as recommended in “The Mediterranean Diet” are what will keep your cardiovascular system running like a race car. Most men worry about changing the oil in their cars more than they do than changing the oils in their body. But, just remember impotence is better prevented.
18. Coleus forskhohlii: Ask your naturopath about this herb. I don’t recommend self-treatment with herbs for high blood pressure. But the studies show it to be efficacious, and it is certainly worth trying.
19. Manage Stress. Blah blah blah stress. I can see you all rolling your eyes as you read this, but really stress is often the root cause of hypertension. Having worked 22+ years checking blood pressure, I have seen enough cases of “White Coat Hypertension” to know that stress causes high blood pressure.
The doctor’s office may not be that thing that gets your blood pressure raging, but if you have high blood pressure you likely need to cut back on activities, work, and practice some breathing exercises shown to reduce BP such as “Square Breathing” where you breathe in to the count of five, hold for five, breathe out for five, and hold for five. Consider taking up a relaxing hobby, musical instrument, or new craft.
20. Eat celery and parsley. Who knew that garnish on your plate is an actual diuretic? Celery has been used anecdotally with many patients. If you are trying to lose weight, increase fiber, or just be healthy….celery should be a daily snack anyway. Parsley is a diuretic that lowers blood pressure similar to dandelion.
21. Exercise *shudder* I know. I know. But in my expert medical opinion, you HAVE high blood pressure because you don’t exercise. I put this last because it is the most important and I would like to go off on a little bit of a rampage on why none of the aforementioned natural substances or pharmaceutical medications will work in the way that diet and exercise will.
Why is that? Well, hypertension is a sign that you are in poor physical condition, that is if you have the typical form of high blood pressure caused by being overweight and over the whole exercise thing. There are other forms, but the average American has high blood pressure because they are out of shape.
It is time to start eating better, exercising daily, as well as add in a few supplements to help maintain a healthy “flexible” cardiovascular system. Your cardiovascular system cannot be “conditioned” without a minimum exercise of twenty minutes daily in the cardio zone which is 70-80% of your max heart rate (220- (your age) x .7= Target cardio zone. Shoot for daily and then if you hit five days a week or even three days a week it will make your Naturopathic Doctor very happy!
So in order for me to make any progress with preventing cardiovascular disease I need my patients exercising. If you are not out of breath you are not exercising hard enough. If you are working out too hard you may be causing damage. High Blood Pressure patients should always exercise with a heart monitor. So if you are reading this the good news is you get to go shopping for a Fitbit and an Omrom blood pressure cuff.
Keep in mind that herbs such as dandelion that have been shown to be efficacious against anti-hypertensive medications such as furosmeide require HIGH doses in order to be effective. In order to lower pressure using dandelion, you have to literally take tablespoons of the tincture daily…and that is LEAF not root. The root serves to detox the liver and the leaf is used for blood pressure. You must work with a Naturopathic Doctor that knows how to safely combine cardiac medications and herbs such as myself!
Be sure you are always using the correct form of the plant. Many research studies done to show herbal medicines as ineffective have been done on the wrong form of the plant, whether intentional or not. Always read the label and make sure you are purchasing the correct form of the herb you are using.
Exercise, Whole Foods Diet, fish oil, vitamin C, CoQ 10, magnesium, and potassium are the most benign substances on this list if you are concerned about combining them with anti-hypertensive drugs. That combined with diet and exercise should help you gain better control of your numbers.
You may at some point want to discuss lowering your blood pressure medicine if not phasing off it, as the goal is to be on as few meds as possible, and many patients do not like the typical side effects of high blood pressure medicine such as fatigue, dizziness, and so forth.
Once stable on natural meds, your blood pressure should still be monitored daily to ensure there is not an additive effect and you end up with too low blood pressure aka “hypotension." BP below 90/50 is not good and indicates too low of sodium or adrenal issues. Perfect BP is between 120/80- 110/60. It is important for anti-aging reasons that your BP is optimally under 120/80 if not 120/70.
If you tend towards hypertension remember that anytime you are not feeling well the first thing you should grab is your home blood pressure cuff (the best brand is Omron according to my experience.)
High blood pressure with any of the following symptoms requires the patient to go to the ER or call 911 because you are having chest pain or any other potential cardiac symptoms such as pain in the neck, arms, flu-like symptoms, sweating, and so forth. As my very wise cardiology teacher, Dr. Pournadeli states, “anytime there is pain above the belly button assume MI (Myocardial Infarction=Heart Attack) until ruled out.” Blood pressure >180/110 requires hospitalization.
Stroke, heart attack, impotence, kidney failure, and eye disease are all part of the ugly sequalae to uncontrolled high blood pressure. Prevention of chronic disease and aging is key with hypertension. Try one new thing at a time and give it a few days to make sure it is not causing adverse side effects.
Thank you for sending me your Naturopathic questions to blog about. You can drop me a postcard with your question. If your question can't fit on a postcard then you need an appointment with me!
Dr. Nicole Sundene
Naturopathic 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!
Dr. Nicole Sundene, NMD
Female Hormone Specialist
"Why don't I lose weight since I turned forty? What is wrong with my hormones? I still have my period." Mindy, Scottsdale, AZ
Weight loss, especially for women, is a very complicated multifaceted hormonal and nutritional condition in my mind as a Naturopathic Hormone Doctor. Women in their forties and fifties dealing with perimenopausal and menopausal weight gain definitely need a skilled Naturopathic Hormone Doctor.
Battling weight gain, especially when you are doing everything right and the needle on the scale is not budging can be very stressful and stress ironically worsens weight gain.
Sadly, many of my hormone imbalance patients are basically starving themselves on very few calories to maintain their weight because their metabolism simply does not work correctly. Especially when they have a thyroid condition or an autoimmune disease such as Rheumatoid Arthritis and Hashimoto's. We correct the metabolism, and they can eat food again in reasonable amounts.
I am sure you would not be googling natural solutions to solve hormonal weight gain unless you were not getting lasting solutions to maintain your weight that actually worked as I describe in my story about “Why I Became a Naturopathic Doctor.”
To quickly summarize the story, I was having depression, anxiety, acne, and stomach aches while gaining weight at 205 pounds on a hamster wheel chasing all my different annoying symptoms with prescription drugs and specialty visits. None of the prescription drugs helped me at all, and actually made me gain more weight, until I met a Naturopathic Doctor that fixed me. This is when the trajectory of my career permanently changed because I realized I did not want to go to school to be a pill pushing MD doctor, I wanted to go to school to provide natural lasting solutions that actually solved women's health challenges!
So, I do understand the frustration of not getting lasting solutions that work for weight loss and having to pay a high amount of money in doctor visits, labs, specialty visits, and prescription drugs. Some patients against my advice are maintaining their weight with expensive semaglutide shots (that I do not recommend.) Let's talk about instead what is healthy for your aging body when dealing with weight loss.
First, I would like to take a minute to explain how I help women actually lose weight for good in my Women’s Health and Hormone practice. What we want to do is achieve lasting solutions so that they do not have to rely on prescription drugs.
Here is what I want to do as your Naturopathic Hormone Doctor to fix your weight:
#1 Why do you have weight gain in the first place?
#2 What is the "Root Cause” of your weight gain?
#3 Comprehensive Female Hormone Labs, Macronutrients, Cholesterol, Chem Panel, CBC, inflammatory markers, vitamins, minerals, macronutrients, etc
#4 Look at other health factors such as Diabetes, Insulin Resistance, Anemia, Hypothyroidism, Hashimotos, and other Hormone and Metabolic issues.
#5 Order Comprehensive Nutrition Testing to understand the right diet for your body specifically.
#6 Implement my 4 week Vegan or 4 Week Meat- Naturopathic Meal Plans I recommend set at 1500 calories per day to create a gradual calorie deficit over a long period of time. While tedious, especially over 40, the studies show slow and steady weight loss is lasting permanent weight loss. As my patients learn new healthy recipes they enjoy eating, they naturally begin to feel better. Proper nutrition means less expensive supplements and medications!
#7 Make sure you are working out with a trainer that is helping you enforce my plan, and/or a counselor or therapist that is helping with any emotional issues making proper nutrition choices. Some of my patients need weekly appointments. Most need monthly at first.
#8 Continue to fine tune nutrition, and use herbal medicine, vitamins and supplements as well as natural hormones or “BHRT” and Armour Thyroid to help you feel your very best and most energetic.
Without understanding #1 and #2 on my list, I sadly have seen many of my hormonal weight loss patients fail over the years, so I write these blogs so my potential new patients understand if they will be a good fit for my women’s health practice or not.
I want every single patient in my practice to be a success story. Please do treat yourself to a Naturopathic visit with me if you want want real answers, if you have an inquiring mind that wants to know, if you want the right nutrition for your body, want me to fix the underlying hormone imbalance that is most often causing your female hormonal weight gain then lets really do this!
While I love helping women with weigh loss, and am a proud “Mother Hen” watching them transform, I also have been doing this job for over seventeen years as a Naturopathic Doctor, and twenty five years total in family medicine and have seen women fail to lose weight because these hormone challenged were never properly tested for and treated.
If the same hormone imbalance or nutritional challenges made every woman fat then we would all have the same pill for that, however I see a variety of different types of female hormone imbalance, thyroid, adrenal, insulin, and inflammatory aka autoimmune weight gain that are all completely different from each other, and required different approaches, different hormones, and different herbs and supplements. That is what is so uniquely amazing about women's health! Just like in my "Female Hormones and Anxiety" blog I talk about how we are somewhat like snowflakes with our mental health. While weight gain symptoms all look the same, the Root cause is not always the same!
So if my investigative Women’s Health Naturopathic Hormone process sounds like exactly what you need to feel like the absolute best version of yourself…. then please visit my SCHEDULE page and let’s get working on your weight loss program now!
#1 question I am asked as a doctor is: "Why can't I lose weight?"
Weight loss programs that fail to address female hormones in women often fail women!
Oftentimes in Women's Health the "Root Cause" of weight gain is hormone imbalance. We need to first diagnose and treat the hormone imbalance as well as implement my basic Naturopathic hormone balancing weight loss program that is 100% free for women to start below.
One thing that always brings me joy as a Naturopathic Hormone Doctor is helping women identify the specific weaknesses in their hormones and metabolism so we can target the exact nutrition program, macros, and hormone balancing supplements to aid weight loss.
Getting to see women transform to their fittest most beautiful version of themselves is such an amazing reward for doing this job! I often receive new patient referrals from my weight loss success stories as their friends and family have always seen them challenged by being overweight and suddenly like magic change right before their eyes.
The truth though is that it is not magic... it is hormone balancing with a splash of hard work.
When we don't understand women's complex female hormones, thyroid, and adrenal profile, expecting weight loss to happen is somewhat like vacuuming in the dark. While vacuuming in the dark will be somewhat helpful, we are missing things, it is inefficient, time consuming, lacks results, and is frustrating. Vacuuming just like hormone balancing becomes a lot easier when we "flip the lights on" and know exactly the obstacles we are dealing with as well as the areas of greatest concern!
By running a full panel of Naturopathic Hormone Labs women can target their nutrition to their own metabolism and understand exactly what ratio of fats, protein, and carbs will works the best for their specific constitution.
This is when I see "the lights come on" for my hormone weight loss patients and everything becomes much easier and efficient. Hacking macros and hormones with labs makes everything so much easier and my women are no longer "bumbling around in the dark" lacking a clear direction of how to best target their efforts.
Bumbling around in the dark is oftentimes why women fail with their weight loss program because they are busy trying different fad diets, and not gathering the specific information that helps optimize their personal metabolic challenges.
Naturopathy can work very well for weight loss when we can take the time to analyze nutrition, metabolism, hormones, and vitamins that can impact weight.
Female hormones are complex and precisely why weight loss for women can be very tricky when complex hormone imbalance is present. To further confuse matters, women experience hormone imbalance and constantly fluctuating hormones every month with PMS. As well as in their forties and fifties with perimenopause and menopause. Therefore it is important we rule out hormonal causes of weight gain with women first and foremost as this is impacting women monthly, and also in midlife when perimenopausal weight gain begins around forty.
When women cannot lose weight with diet and exercise I recommend we conduct hormone and macronutrient testing to determine the correct macro profile of carbs, fats, protein, and fiber needed. Looking at a full set of female hormones, thyroid, and adrenal tests can diagnose the particular hormone imbalance or imbalances impeding the metabolism.
#2 Question I am asked as a Naturopathic Doctor: "Is my thyroid making me fat?"
As a thyroid specialist, I often see thyroid disease causing weight gain, and weight loss, but in women we MUST address all of the other hormones in the "hormone spider web" for a woman to feel properly balanced, healthy, and fit.
If we have a weakness in one part of the web it will impact the stability of the rest of the web.
The impact of estrogen deficiency that suddenly occurs in Menopause, can impact the rest of the hormone web and cause weakness in the thyroid, which is why it is imperative for women to have their thyroids checked when they are perimenopausal and menopausal in their forties and fifties. Some women will naturally start perimenopause earlier in their thirties.
The average age of menopause is 51, and perimenopause generally starts the ten years prior to menopause. Women that enter menopause at 45 will generally exhibit signs of hormone imbalance earlier, in their thirties. Premature Ovarian Failure occurs when women become menopausal sooner than age forty. POF is common in women with anorexia and low body fat as body fat levels directly increase estrogen levels whether too much body fat or not enough.
Menopause can also impact the adrenal glands in our spider web model. When the ovaries cease to produce estrogen, progesterone and testosterone, the adrenal glands become the sole source of hormone production. The hormones DHEA, and cortisol can begin to become deficient in menopause or sooner if there is "Chronic Stress."
Symptoms of adrenal fatigue can cause insomnia, joint pain, stiffness, moodiness, anxiety, depression, and a general blah unmotivated feeling where my patient has become flat and lost their zest for life.
The adrenals and the thyroid also interact with each other and when the adrenals become fatigued and cease to produce hormones that can impact the thyroid gland and tax it further. And vice versa. This is what is going on behind the scenes with many of my weight gain patient's labs.
It is not just always about the Thyroid! We must address our entire "Metabolic Web of Hormones" as I explain in my video about "Hormones and Metabolism" on my free class page.
Hypothyroidism, Hashimoto's, Insulin Resistance, and Adrenal Fatigue can also cause women to gain weight.
#3 Will testosterone help me lose weight?
Testosterone deficiency occurs for most women around the age of 35, this is why our metabolisms slow down when we lose our lean muscle mass with menopause. Each year our metabolism goes down further as we lose our female hormones. Transitioning through perimenopause and menopause also causes the body to become more inflamed and Insulin Resistant. Insulin is the "Weight Gain Hormone," that causes women to gain weight despite following the same diet and exercise regime in their 20's.
"I am doing everything the same, I am not cheating." I commonly hear women complain as they continue to gain weight and cannot figure out why. Most women that are over-weight have insulin resistance and need supplements to address and correct this blood sugar disorder that is common in women with PCOS.
Sluggish liver can also impact the metabolism, as can inflammation from Food Sensitivities and Food Allergies.
Chronic Fatigue and Chronic Pain can cause women to exercise less resulting in less calories burned on the same diet.
The good news is that by addressing female hormone imbalance, and implementing the following Naturopathic weight loss program I will review today, I do see many cases of stubborn hormonal weight gain finally release!
Usually I treat the hormone imbalance with herbs and supplements. Herbal medicine takes time to work, most women only can lose one pound per week and need to be patient. If you have fifty pounds to lose as a woman, that is a year of hard work you need to mentally commit to doing for long term success to keep the weight off.
With menopause, generally Bioidentical Hormones are needed to reduce the inflammation spike causing weight gain. Women under fifty generally do not need hormones and instead have weight gain issues from excessive amounts of hormones as I discuss more in my "Estrogen Dominance" blog. Much of what I do for women and weight loss does involve making dietary changes and taking supplements.
In order to lose weight, one must follow the basic laws of physiology that you must consume fewer calories than you burn each day. This is especially important to follow if you have a thyroid condition, insulin resistance, or estrogen dominance! Expecting your twenty year old metabolism to burn a ton of calories is not realistic without first fine tuning your hormones and then creating a calorie deficit every day.
You must burn more calories from exercise than you consume. If you are inactive and not exercising this is why it is impossible to lose weight especially when lack of exercise is compounded by hormone imbalance.
Addressing the underlying causes behind poor eating and lifestyle habits with regular weekly counseling is the ONLY way to ensure a healthy and long-term approach to weight loss. Food should be fuel and not a treat. The treat is feeling and looking good from perfect fueling!
I know this very well based on how I used to look and feel before I went to Naturopathic school and how I look and feel now. Many people say I look better today than I did in college! That is because I am on the right fuel for my metabolism and hormones!
Eating wrong and not properly fueling your body is the hard way after living both options!
The best approach to weight loss emphasizes lifestyle changes that incorporate whole foods and activity. Many simple sustainable Naturopathic changes in diet and activity can lead to maintainable, long-term weight loss success.
Physical activity guidelines are recommended to complement the nutrition counseling and make this process easier and more productive.
If you are struggling with Seasonal Depression, or post holiday exhaustion it is imperative you get outside for an hour to get 10,000 lux of natural light every day to ensure your energy, metabolism and mood are optimal for weight loss. Especially for women that crave carbs! Lack of light puts us in a fatigued dormant state that is not conducive to fat burning.
Many of my weight loss patients have underlying mental health issues such as depression, anxiety, and PTSD and are using food for comfort instead of fuel. This can create a vicious mental health loop when choices for emotional reasons are worsening physical health, appearance, and self confidence which then drives more unhealthy food choices as "rewards."
Patients constantly seek instant gratification for emotional reasons to treat their poor mood. These poor fuel choices then cause them to feel more fatigued, lethargic, hopeless and depressed.
Depression, sadness, hopelessness and anger trigger more unhealthy food reward behavior and the vicious cycle continues as a woman continues to gain more and more weight.
By using Naturopathy and hormone balancing we can also treat these underlying mental health issues naturally and work to use new rewards such as jewelry, makeup, concerts, events, and fun trips rather than cookies, cake, and candy.
The interesting thing about women's health is that each woman generally has different hormonal metabolic challenges to address. It is not a one sized fit all program, although I generally need my patients following the basics below.
Please do not sign up for hormone balancing work with me if you are not willing to make at least some baby step changes with your diet. Occasionally I get new patients that seem to think all their problems will be fixed with popping a hormone or applying a cream. This is not realistic and we are working to balance the hormones so your metabolism is running optimally and you are receiving benefits from your efforts with diet and exercise.
Hormone testing is important in women's health since many women with hormone imbalance are starving themselves to death to compensate for their sluggish metabolism. Sadly, I see this happening often, and is why I am writing this blog so women know there is a better way than living on 800 calories a day in starvation!
Once I diagnose the metabolic problem and fine tune their hormones they are then able to eat a normal amount of food each day without gaining weight.
While each woman's metabolism is unique like a snowflake and will require labs to develop a custom tailored dietary macro program, I would like to share the basics for hormone balancing that generally work for most women with hormone imbalance.
#4 What is the best diet to support imbalanced female hormones in weight loss?
The best diet for balanced hormones and weight loss is:
• HIGH in fiber-dense carbohydrates found in whole grains, beans, fresh fruits, and vegetables. Also, it is important to drink plenty of water= 60-80oz daily + 8 oz per "vice" of alcohol or caffeine and more water if you are exercising.
• MODERATE in fish and organic lean meats such as chicken and turkey.
• LOW in red meat, animal fats, hydrogenated oils, full-fat dairy products, pre-packaged, processed, and refined foods, sugar, alcohol, and caffeine.
General Tips
• Set a realistic weight loss goal, usually 1 to 2 pounds per week is recommended.
• Balance food intake with activity. The most successful weight loss programs combine increased activity with decreased caloric intake.
Tips to Increase the Amount of Physical Activity in a Day:
• Try some group activity classes at the local gym, fitness center, or swimming pool.
• Work out with family, friends, or neighbors. Motivation is increased with partners.
• Take a walk at lunchtime.
• Use a bike to run local errands and go for pleasure rides.
• Use the stairs instead of the elevator.
• Walk to the bus stop or work
• Park the car a few blocks away and walk.
• Dance to some favorite music at home or sign-up for a series of classes.
Tips to Reduce the Quantity of Food Eaten:
• Plan and prepare meals ahead of time.
• Identify foods that are often over consumed and set limits, or avoid.
• Identify and limit problem foods.
• Eat small, frequent meals and healthful snacks.
• Eat slowly and savor each mouthful. Allow 20-30 minutes for each meal, rest, set the fork down, and/or converse between bites. Chew the food well.
• Wait 10-15 minutes before taking a second helping.
• Serve food on a smaller plate.
• Drink two glasses of water or a cup of hot tea 30 minutes before meals to reduce appetite.
• Postpone a desired snack for at least 10 minutes. It may be helpful to take a walk, get some fresh air, drink a cup of water or tea, or take a short nap during this time.
• At restaurants eat half of the portion and take the rest home. Prepackage the food to go before starting the meal.
• Nurture with nonfood related activities, such as a hot bubble bath or a massage, developing a hobby, relaxing with a good book, or listening to some music.
WHAT DO I DO IF MY PROBLEM WITH WEIGHT LOSS IS BINGE EATING?
Tips to Eliminate Eating Cues that Promote Overeating:
• Designate a specific place in the home to eat, preferably the kitchen or dining room. Eat snacks and meals only when sitting down at this place.
• Avoid watching TV, talking on the phone, reading, or driving while eating. This will help increase the awareness of fullness.
• Do the grocery shopping on a full stomach to decrease impulse buys.
• Create a schedule for eating. Plan meals and snacks at regular intervals, including the types of food to be eaten.
• Carry food to work or when going out, to eliminate long periods without eating.
• To prevent visual food distractions, keep all food stored in the kitchen cupboards or refrigerator, rather than out on the counter.
• Read or listen to motivational books, join a support group, or consider seeing a therapist to help with any emotional issues involving food, eating, and/or weight loss.
Diet, activity, and emotional work can provide feelings of health and wellness, which establish new patterns that support and nurture the body. Food should be eaten for fuel and not just for fun.
When we are on the best fuel we have the best energy and mental health.
Think well! Eat well! Be well! Let's get to work ladies!
If you need my help diagnosing and treating your personal hormone imbalance to determine your personalized weight loss plan, I would be happy to help!
Simply visit my SCHEDULE page to treat yourself to a Naturopathic hormone visit in my Scottsdale clinic or by telemedicine!
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!
