"Do hormones impact high blood pressure? I never had high blood pressure until menopause."
Dr. Nicole Sundene
Naturopathic Cardiology and Hormones
Hormones can impact blood pressure especially during a woman's forties and fifties with menopausal and perimenopausal changes. The reason for this is primarily our loss of progesterone. Progesterone relaxes the smooth muscles in our arteries and digestive tract which is why women often complain of stomach problems at the same time they develop high blood pressure.
Next thing we know around forty or fifty a lot of women make their first visit to an ER, urgent care, or Cardiologist for an EKG because their heart is suddenly racing or they have sudden onset high blood pressure that they never had before. While I highly recommend all my patients always work with an MD Cardiologist, I want to take a moment to explain what I actually do in Female Naturopathic Cardiology.
Keep in mind my patients have already been thoroughly worked up by the ER, sent to a Cardiologist, who then sent them to me because they know the problem is hormonal, they just don't know exactly what.
Thyroid hormones, are also notorious for causing high blood pressure, palpitations, chest pain, and oddly too low of blood pressure regardless if the thyroid hormones are too high or too low. Many times I have nagged a thyroid patient to check their blood pressure daily while starting thyroid hormones, only to have them report to me that their blood pressure is suddenly dropping to a normal range, and they don't need as much blood pressure medication.
Thyroid hormone increases the pulse rate because T3 stimulates the heart to contract. When we increase heart rate we generally increase blood pressure in our basic BP math equation. But this is where the interesting thing happens in women's health....women report their blood pressure has normalized. I believe this is because when the thyroid is deficient the heart is not contracting efficiently.
Insulin Resistance as seen in PCOS and Type 2 Diabetes, is a classic cause of High Blood Pressure that no doctor but me seems to test for. Insulin should be under <4 or it is causing an osmotic high blood pressure from too much sugar in your system.
Cortisol is the easiest hormone for my patients to wrap their brains around as we have all heard of the connection between stress and high blood pressure. Many times I have taken a patients blood pressure in the office and it is 200/100 and I am sending them to the ER or the doctor I was working for was screaming at them to go to the ER, while they are busy telling us they have "White Coat Hypertension."
Patients with "White Coat Hypertension" should check their BP daily with an Omrom BP machine, and also bring their machine in to appoinments to calibrate that the readings are the same as the more reliable doctor's office version that is not electronic. The electronic machines can be inaccurate from my experience using them for over twenty years. I only trust Omron brand as it was top consumer reviewed, and it is dangerous if you do not check your BP meter regularly against your Pharmacy or Doctor's office machine.
I wish women knew that the #1 thing they should do if they develop high blood pressure suddenly in midlife is to have a skilled hormone doctor check all their hormones to insure they are correct. Simply visit my SCHEDULE to get your BP hormones checked.
One thing everyone with high BP can do under the guidance of their own doctor, is to use my high blood pressure nutrients and lifestyle tips below and on my High Blood Pressure blog. I do not recommend using my "Hibiscus High Blood Pressure Tea" recipe without my Naturopathic guidance as not all cardiac herbs can safely be added to all cardiac medicines and this must be done under the guidance of someone that is skilled and experienced with doing this. While I want my patients OFF their BP meds or on doses that are low, I also know that stroke and kidney failure are the consequences women experience when they don't tend to their blood pressure. As it is the equivalent of driving your car around with half flat tires, and half over-inflated tires... something is bound to pop.
Aside from having hormones related to blood pressure checked, eating therapeutic foods for BP are the best way to avoid reliance on a blood pressure medication. If you already take BP meds and want to get off of them you need to work with a Naturopathic Doctor (preferably me 😉 add natural stuff in, monitor BP twice daily at 6am and 6pm when possible so you are keeping a consistent BP Log. I recommend grabbing a small half page sized spiral notebook and draw lines down the center so you can track on the top the date/time, BP, Pulse, and a space for notes like "forgot to take BP med" or "stressful day at work."
While high blood pressure is dangerous over the long term, too low of blood pressure is more of an immediate risk we are taking on by adding synergistic natural remedies for high blood pressure. We don't want the blood pressure to be too low or too high.
FOODS TO EAT TO LOWER BLOOD PRESSURE NATURALLY
To combat age related high blood pressure, and mild high blood pressure from menopausal changes, I do recommend eating as many foods known to reduce blood pressure as possible. By ensuring nutrients needed for cardiovascular health are sufficiently topped off we can prevent the need for taking blood pressure medications. Although I do prescribe them when women have high blood pressure because it should not go untreated.
It is a condition that occurs when the pressure inside of your arteries is too high. Because it is a silent disorder the only way to detect hypertension is to have your blood pressure measured.
THERAPEUTIC HIGH BLOOD PRESSURE FOODS
• Increase vitamin C-rich foods (citrus fruits, strawberries, red peppers, dark green leafy vegetables)
• Increase consumption of vitamin E-rich foods (almonds, hazelnuts, wheat germ, peanut butter)
• Increase consumption of magnesium-rich foods (soybeans, tomatoes, beans, walnuts, nuts & seeds, squash, broccoli, dark green leafy vegetables, tofu, wheat germ, halibut, swiss chard)
• Increase consumption of potassium-rich foods (grapefruit, grapes, tomatoes, beans, apricots, asparagus, beets, broccoli, corn, cucumbers, dates, salt-water fish, lamb)
• Increase consumption of calcium-rich foods (yogurt, sardines, salmon (canned with bones), milk, cheese, dark green leafy vegetables, broccoli)
• Try cooking with less salt. Experiment with spices such as, parsley, basil, oregano, ginger, sesame, dill, cilantro, curry, pepper, and thyme to reduce the amount of salt used in cooking
• Cut back on sodium, including that in processed foods and in many drugs (check labels for soda, sodium, or salt). Avoid commercial sauces like soy or Worcestershire and commercial salad dressings (check labels for sodium content)
• When eating out, ask for your food cooked without added salt
WHAT IS HIGH BLOOD PRESSURE?
Hypertension is a very common problem that affects about 50 million people in the United States alone.
That’s about 1 out of every 4 adults. It is more common as people grow older and is more common and more serious in African Americans.
What do the numbers mean?
Blood pressure measures the natural pressure created by blood pumping through your veins and arteries. Blood pressure is read as two numbers, one over the other. The top number, or systolic blood pressure, measures the blood pressure when the heart pumps. The bottom number, or diastolic blood pressure, measures the blood pressure between heartbeats when the heart rests.
Hypertension is blood pressure that is over 140/90
Optimal blood pressure is under 120/80
Risk factors you can control
9 out of every 10 people who have hypertension do not have a known cause for their condition. A family history of hypertension is a risk factor for developing the condition.
WHAT LIFESTYLE CHANGES WILL LOWER MY BLOOD PRESSURE?
• Keeping your weight under control
• Keeping physically fit
• Eating a healthy diet low in sodium and rich in nutrients potassium, magnesium and calcium
• Limiting alcohol intake (no more than 2 mixed drinks or two 12 oz. cans of beer or two 6 oz. glasses of wine daily)
• Never smoking or quitting immediately
• Avoiding medications that might increase your blood pressure like decongestant nasal sprays and pain medications called non-steroidal anti-inflammatory drugs (NSAIDS) aspirin, tylenol, ibuprofen, naproxen.
EXERCISE AND HIGH BLOOD PRESSURE
Start slowly and build up gradually. American College of Sports Medicine (ACSM) recommends 20 to 60 minutes of aerobic activity 3 to 5 days per week. Aerobic activity will strengthen your heart and reduce your risk of developing heart disease. It will also help to control your weight. Try brisk walking, jogging, biking, hiking, group exercise classes (water aerobics, kick-boxing, judo), running stairs, rowing, and team sports (football, soccer).
CONSEQUENCES OF IGNORING HIGH BLOOD PRESSURE:
Routinely monitoring your blood pressure is important. If you really want to upset any doctor, tell them you are not treating your high blood pressure. "I am not worried about it," I have heard many women state over the years. I promise that I will freak out, your MD will freak out. Everyone will freak out because you could have a stroke and suddenly drop dead. While I don't like my patients on high blood pressure medications they need to stay on them, until the "Root Cause" has been addressed and I have determined it is time to taper them.
Hypertension has been called a “silent killer” because it has no specific symptoms and it can lead to death. A dangerous disease that has no symptoms oftetimes results in the story of someone that just suddenly dropped dead in the middle of a family activity.
People who have hypertension that is not treated with lifestyle modifications and medications (if necessary) are likely to experience one or several of the following conditions:
• Coronary artery disease, heart attack, heart failure, or abnormal heart beat.
• Kidney failure
• Peripheral vascular disease, hardening and narrowing of the arteries (atherosclerosis) that supply blood to the arms, legs, and other parts of the body
• Retinopathy, or damage to the tiny blood vessels that supply blood to the light-sensitive lining of the back of the eye
• Stroke
Need help with testing or treating your hormones for high blood pressure? Simply visit my SCHEDULE page to treat yourself to a Naturopathic Hormone visit! I would be happy to help!
Dr. Nicole Sundene
(480) 837-0900
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Specialist in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!
By Dr. Nicole Sundene, NMD
Osteoporosis symptoms do not occur until it is too late, therefore we will discuss very important tips today for preventing "The Silent Killer of Women." Osteoporosis is the silent killer of women because it often goes without symptoms until a patient has a bad fall or accident causing a fracture. The patient has an X-ray and their doctor says, "Wow your bones are very brittle and losing mass," and puts them on a medication for Osteoporosis such as Boniva, or another bisphosphonate medication that builds brittle bone that is more likely to fracture. Once we have found Osteoporosis it is somwhat too late and a realistic treatment goal is to prevent further progression. Occasionally I am able to reverse the Osteoporosis.
How do fractures kill women?
When a woman slips and falls and breaks a hip she is at high risk for a fat embolus coming out of the fracture site as it heals, further inactivity from fractures also further increases risk of blood clots. It is common for women to die after a bad fracture, and this can all be prevented with Naturopathy and Bio-identical Hormones.
Osteoporosis is best addressed by a Naturopathic Doctor as it is a complex nutritional issue that requires an integrated approach and a Female Hormone Specialist that can test and treat for Hormone Imbalance such as testosterone and estrogen deficiency that is common in Osteoporosis due to menopause and perimenopause.
Men don't get Osteoporosis at the same rate as women because of all the testosterone in their systems which is also bone building. Most women worry about their estrogen level but they should also be concerned about testosterone for Osteoporosis.
Osteoporosis and Osteopenia are diseases characterized by low bone mass and the deterioration of bone tissue, both mineral and nonmineral matrix, leading to enhanced bone fragility and a consequential increase in fracture risk.
In these patients, bone density has been reduced to 2.5 (or more) standard deviations below the young adult mean bone density on DEXA.
Diminished bone mass can result from a failure to reach optimal bone mass early in adulthood such as POF or "Premature Ovarian Failure," from increased bone resorption, or from decreased bone formation after peak bone mass has been achieved.
Presumably, in osteoporosis, the rate of bone formation is inadequate compared to the rate of bone resorption and so there is an inability to maintain the structural integrity of the bones.
In the United States, the estimated prevalence of osteoporosis is high, affecting 20-30 million people.
The major risk factors for osteoporosis are increased age, female gender, white or Asian race, positive family history of osteoporosis and thin body build. Other risk factors include decreased lifelong exposure to estrogen, low calcium intake (affected also by low stomach acid and Vitamin D deficiency), sedentary lifestyle (lack of weight-bearing exercise), cigarette smoking, diet, chronic alcohol and drug use.
The primary goals in the treatment and prevention of osteoporosis are to:
(1) Preserve adequate mineral mass.
(2) Prevent loss of the protein matrix and other structural bone component.
(3) Assure optimal repair mechanisms to repair damaged areas of bone.
Note: At present, there is conflicting scientific information available regarding the benefits and/or risks of soy (or other phytoestrogen-containing foods) consumption by individuals with estrogen receptor positive breast cancer lesions. In such cases, consumption of phytoestrogen-containing foods (such as soy) by these individuals is a personal decision that their Oncologist and team of physicians can guide them in making. Many herbalists believe that phytoestrogens are actually protective against estrogen dominant conditions. The decision is ultimately up to the Oncologist.
For many women I have doctored they are cleared to use phytoestrogens after cancer treatment, and sometimes even bio-identical hormones such as testosterone and DHEA. Generally their doctor does not want me to give them hormones for their menopausal hot flashes, nor do I. Thankfully I have herbs to prescribe! Some Oncologists find testosterone therapy for Osteoporosis to be perfectly acceptable and give me permission to prescribe it after cancer, but we will leave that up to the Oncologist!
In some hormone triggered cancers we cannot risk any phytoestrogens, but I always leave that decision up to the Oncologist providing the cancer care. I have provided care for women in many different situations for their menopause after cancer, and many are only allowed to use herbs such as nettles for hot flashes and night sweats.
In addition, the dietary suggestions below include foods to which some individuals may have allergies, intolerances or sensitivities and, in those cases, those foods should be avoided. Dietary choices should be modified to meet your personal dietary needs.
Women taking medications for Osteoporosis should not consume any of the herbal teas described without first consulting your Naturopathic Doctor regarding potential interactions. See your Naturoapthic Doctor for further information regarding nutrition and your individual medical condition.
Dietary Considerations
Avoid sugar, refined carbohydrates, coffee, soft drinks and alcohol.
Choose whole foods, especially organic, whenever possible. Eat a variety of them, vegetables and fruits especially, paying special attention to those foods that are high in bone-supporting nutrients: calcium, magnesium, boron and other minerals, Vitamins A, D, E and K, B vitamins, C, etc. The boron in pears, for example, helps to prevent osteoporosis. The vitamin E and calcium in almonds, also make this food a good choice.
Fresh foods are always preferable to frozen and frozen foods are always preferable to canned.
Avoid excessive intake of animal protein as well as overall protein deficiency. Daily protein goal is 0.8g/kg body weight. For instance, an average 150 pound woman should then consume 55g of protein daily. As protein deficiency is not good for the bones, nor is protein excess.
Excess protein can lead to a high metabolic production of acids that can leach minerals from the bones. Rely more on plant protein sources such as legumes, nuts and seeds, as opposed to meat, poultry, eggs and dairy products.
Use bone broth, collagen or gelatin if you do use animal protein, as collagen production is the precursor to bone formation and this helps push the pathway of bone production forward to simply throw a scoop of collagen in your smoothie every day for beautiful bones as well as beautiful hair, skin and nails!
Cold-water fish (halibut, mackerel, salmon, etc.) is still a good protein source and has other nutritional benefits, such as omega-3 essential fatty acids and Vitamin D. Tuna and Swordfish should not be consumed along with other high mercury fish as the mercury can displace calcium from the body and create a deficiency.
A diet high in vegetables and fruits favors an optimal physiological phosphorus/calcium ratio and acid/alkaline balance, is preventing the accelerated calcium loss that is observed in individuals who consume a diet high in meat, dairy products and grains.
Use organic low-fat or non-fat dairy products and dark green leafy vegetables that are high in absorbable calcium. The vegetables highest in calcium (in order of calcium content) include turnip greens, lambs quarters (herb), collard greens, rhubarb, spinach, broccoli, dandelion greens, mustard greens and kale.
Other non-dairy foods that contain significant calcium include oatmeal, fortified rice milk/soy milk/nut milk, soybeans and tofu, sesame seeds and tahini, sea vegetables, chickpeas, molasses, almonds, filberts, chestnuts, baked beans, oranges, halibut, flounder, clams, oysters, shrimp, canned sardines or salmon with bones.
Women should have three to four servings of calcium enriched nut milk, yogurt or kefir every day. Please count your calcium consumption and if you are not getting 1000mg daily you need to be taking a calcium supplement to fill in the missing milligrams.
Eat salads and dark green leafy vegetables with lemon juice or cider vinegar to help increase calcium absorption.
Some studies indicate that foods such as spinach, chard, beet greens and chocolate contain oxalates that bind with calcium, preventing its absorption.
Phytic acid found in wheat and oats will bind calcium and prevent its absorption.
Drink two to four cups daily of organic tea for trace minerals. Check out Amanda's Bone-Building Tonic Tea (recipe below).
Bone-Building Tonic Tea
Combine all herbs and make a decoction by simmering one ounce of this mixture in one quart of water, covered for 20-30 minutes. Strain and drink 2-4 cups daily.
Consult your Naturopathic Doctor for a comprehensive osteoporosis prevention or management plan that is tailored to fit your individual medical and personal needs.
Many women have digestive issues from IBS: Irritable Bowel Syndrome, heartburn, constipation, diarrhea or food sensitivities and allergies causing a malabsorption picture that should always be addressed when we are looking at miserable painful fractures tarnishing our "Golden Years."
Both of my Grandmas had terrible fractures that would not heal as they got older. This is a disease that can easily be prevented when women dedicate themselves to spreading the word on these important bone-building tips!
If you need help with your hormones, nutrition, and Osteoporosis simply pop over to my SCHEDULE page and treat yourself to a Naturopathic visit! I would be happy to help. Read more about calcium deficiency and nutrition in "Why Does My Eye Twitch?"
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!
"When I get stressed out my heart skips a beat or races. Is this from my hormones? Is this because of menopause? Is there an herb for that?"
~Jen H. Scottsdale, Arizona
Motherwort was at least properly named to help point moms in the right direction for their stress. While I am not an MD Cardiologist, I have done quite a bit of both prescription and Naturopathic Cardiology in my twenty five years of experience, treat a lot of women for Integrated Cardiology conditions, and want to take the time to explain the type of female patient that will benefit the most from this #1 fave Cardiology herb.
Leonarus Cardiaca or “Motherwort” is one of my favorite gentle herbs to calm fried and frazzled mothers. There is no coincidence in my mind that “motherwort” rhymes with “worrywart”.
This herb may as well have been hand-designed for worried stressed mothers. For women with High Blood Pressure, Paliptations, and chronic anxiety from little children constantly screaming "MOM!" and burning out their mom's adrenal glands.
Motherwort is typically a “nervine” or anxiety herb that is recommended for those with the kind of anxiety that results in occasional heart palpitations. If you are suffering from disturbed sleep as a result of emotional or physical stress this herb might just be right for you.
Motherwort serves to strengthen the heart, and is also used in Naturopathic Medicine for PMS and menopause. This herbal medicine can additionally be used as a preventative agent for herpes zoster (shingles and chicken pox) as well as herpes simplex (traditional “herpes”).
This herb should NOT be used during pregnancy or breastfeeding. Always talk with your Naturopathic Doctor before starting any new herbal medicines.
Perhaps life does not grant you the relaxation time that you deserve as a mother, but you can still find a bit of calm amidst the storm by using an herbal medicine such as Motherwort to help reduce stress and your reaction to it.
Happy Mother's Day!
If you wish to treat yourself to a Naturopathic visit simple pop over to my SCHEDULE page. I would be happy to help!
Dr. Nicole Sundene
(480) 837-0900
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology, Acne, Psoriasis, Eczema, and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 23 years of experience in both Prescription and Natural women's health and hormones, she presents to women the best-integrated health solutions for their Chronic Disease.
She has been an Herbalist for over 28 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan (not Medicaid) and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!
By Dr. Nicole Sundene
Adrenal Fatigue is a condition of Hormone Imbalance caused by constant stress, worry, or anxiety.
When you are under stress do you go into fight, flight, or fright?
Fight, flight and fright are all normal responses to stress. Everyone generally has an anxiety pattern of what they lean towards or have a combination of a few. I am personally not a fighter so I tend to like to ride my bike when I am stressed or wrap up in a ball in bed in fright.
Understanding how we respond to stress is critical to addressing adrenal fatigue, chronic fatigue, and burn out. Every time we are triggered by mental or physical stress our adrenal glands respond by zapping us with adrenaline, cortisol, norepinephrine, and epinephrine. In nature, the purpose of this is so that we can “Run From a Bear" as I explain in my last hormone blog.
But these adrenal gland stress hormones don't help our anxiety one bit and can make us feel even more anxious. One easy way to burn off high cortisol and adrenaline is to go running or do some type of endurance event for at least 45 minutes. Most long distance athletes end up with burnt out adrenal glands because long distance exercise generally depletes adrenal hormones over time. But if you need to blow off some steam and the stress is becoming too much make sure you exercise. As it is obviously the best choice in my picture above.
Excess cortisol causes weight gain around the mid-section and insulin resistance.
Conversely, those with severe adrenal fatigue that end up with low adrenal hormones and low cortisol should not do long distance running or cycling but anabolic activities that build hormones such as weight lifting.
Many women have PTSD from traumatic events and it is difficult to return PTSD patients with panic attacks back to baseline without addressing the adrenal response. When I volunteered as a Naturopathic Doctor for vets with PTSD I learned very quickly how important adrenal support herbs were in addition to counseling and medications. Once we addressed the adrenal glands my vets reported less random episodes of panic attacks and began sleeping better through the night.
Psychological worry will trigger the adrenal glands to create stress hormones just like running from a bear. Your body does not know the difference. This is why it is important to do a butterfly hug and gently tap your shoulders or tap your heart to trick your body into thinking it is receiving a hug so it thinks everything is okay. This releases Oxytocin the "Love Hormone" that helps us feel calm and like everything is okay.
If there is nothing you can do about the psychological stress I recommend visualizing a stop sign and telling your brain to stop thinking about it. Worrying about matters beyond our control is the #1 scenario I see as a Naturopathic Doctor causing adrenal fatigue.
With high cortisol and adrenaline surging in our systems, many of us are guilty of going into FIGHT MODE...and we should be doing much more flight and fright than spreading more anger and rage. Try excessive kindness rather than acting in anger as I discuss the mental health benefits of kindness vs gratitude.
Evaluate the activities and people that make you angry and put you into fight mode and try to eliminate and minimize them. Instead of starting the next fight...head out on a flight. You can go for a run, swim, bike, ski, walk or just drive outside to a beautiful lookout area and sit and enjoy the magic of nature.
Nature will heal and restore you!
When fighting happens too much in households it's important you give each other a break and get out of the house at different times. If you are struggling with your hormones and dealing with PMS, Postpartum Depression, Hypothyroidism, Hashimotos, Perimenopause or Menopause its time to work with a Hormone Doctor on balancing your hormones! Imbalanced hormones can cause depression and anxiety as I discuss in my "Hypothyroidism Causes Depression?" blog.
Make sure you work with a Holistic Hormone Doctor as most MD's are not trained in adrenal testing, don't know which tests to order, and won't know how to treat your adrenals even if they order some testing because there are very few medications that address the adrenals. Herbal medicine and nutrition are needed to repair this condition along with stress management and counseling.
Getting your hormones tested and balanced is the first step to healing from adrenal fatigue. Many different herbs are used for the three different stages of adrenal fatigue or "Maladaptive Stress Syndrome" and using cortisol lowering herbs when cortisol is already low or cortisol boosting herbs when cortisol is running high can result in a worse outcome. It is important to work with a skilled holistic hormone doctor that specializes in Holistic Psychiatry when battling anxiety, stress, and adrenal fatigue.
Amidst this ongoing mental health crisis, please send this important article on stress management to any friends or family members that can benefit from learning about their adrenal glands!
If you have signs of adrenal fatigue or hormone imbalance I would be happy to measure your hormone labs and help you. Simply pop over to my SCHEDULE page to treat yourself to a Naturopathic visit!
Dr. Nicole Sundene
(480) 837-0900
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is 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
Holistic Gastroenterology, Nutrition and Hormones
Heartburn can impact women more often than men because of hormone imbalance. While I am not a Gastroenterologist, nor a Cardiologist this is one of the top complaints I received from women, especially after they have been to the ER thinking they are dying of a heart attack, only for the Cardiologist to tell them they just need to go to a Gastroenterologist. The GI doctor gives them an antacid and they continue to have worsening heartburn.
A serious pet peeve of mine is how we all traditionally deal with indigestion and heartburn with THE WORST DRUGS for women: Prevacic, Tums, Ranitidine, Omeprazole, etc. The use of calcium carbonate antacids, proton pump inhibitors, and H2 blockers can cause a full host of women's health diseases for me to manage when really we just need to get the patient off these horrible medications that block stomach acid.
They seem pretty benign right? You can buy them at any grocery store or pharmacy so it should be totally fine to take heartburn medications since a doctor doesn't even need to prescribe them.
But these are also my #1 LEAST FAVORITE MEDICATIONS for women to take because they actually block absorption of minerals, iron, zinc, magnesium, protein, B-12 and therefore result in anemia, hair loss, muscle spasms, and Osteoporosis.
Even more unfortunate, I find heartburn meds totally unnecessary, as a Naturopathic Doctor that has worked for fifteen years to treat the Root Cause of heartburn and reflux. I know how easy it is to fix this problem so women don't have to rely on medications that suppress their stomach acid and block mineral absorption and B-12 that are important for immune boosting, mental health, depression, anxiety, and chronic fatigue.
By neutralizing the pH in the digestive track it also makes women more susceptible to yeast overgrowth and Yeast Infections. Candida overgrowth in the digestive tract results in chronic gas and bloating.
Once half of the women's hair falls out and they have Osteoporosis it is somewhat too late for Naturopathic Medicine. Prevention is critical. Today I am writing this very important women's health PSA on heartburn. Please share this with other women so we can prevent miserable, painful Osteoporosis that can cause painful fractures during your "Golden Years."
I understand that at times we need to suppress our stomach acid just to provide some short-term relief, or to prevent it from burning our stomach lining and potentially causing ulcers and permanent scarring to our stomach and esophagus. But these medications were never designed to be taken daily as many women chronically rely on them.
Before we make any major decisions regarding inhibiting the natural processes of our digestion let’s first investigate what stomach acid was designed by nature to do for us.
Stomach acid is Hydrochloric Acid (HCL) which is produced to help break down our food for digestion and absorption. HCL is the biochemical “mother” of the digestive process triggering resultant chemical reactions and productions of enzymes as your food moves through your intestines. Certain vitamins, minerals, and macronutrients are unable to be properly metabolized without the aid of HCL. Protein, vitamin B12, iron, calcium, zinc, and most other minerals require an acidic environment for proper activation and absorption.
Now antacids are not designed for long term use, because obviously in the long term we run the risk of being deficient in protein, B12, and minerals.
Some common signs of these deficiencies can be seen as brittle hair and nails, neurological problems, anemia, osteoporosis, and fatigue to name a few. Over the counter antacids neutralize stomach acid rendering it ineffective; while most typical prescription medications for heartburn and GERD like proton pump inhibitors and histamine receptor blockers work different biochemical angles to suppress the production of stomach acid.
An alternative approach to heartburn and acid reflux is to avoid irritating substances, as well as those that cause the esophageal sphincter to relax and allow acid to creep back up such as chocolate, caffeine, mint, spicy foods, orange juice, sugar, coffee, caffeine, tomatoes and acidic foods, white refined foods, fried foods, and those foods that you may be specifically sensitive to. Herbs with volatile oils such as mint make your esophageal sphincter relax, and thus acid is able to continue to creep up from your stomach and burn your esophagus resulting in “Gastroesophageal Reflux Disorder” aka GERD. Eliminating cigarette smoking and coffee are critical to recovery for anyone with an ongoing acid reflux or active peptic or duodenal ulcer.
Aside from avoiding irritating foods, and foods that relax the esophageal sphincter, its imperative that we investigate foods you may be intolerant or allergic to further with a Food Allergy Sensitivity Test. Foods that should always be avoided in acid reflux and heartburn patients are: citrus, spicy foods, acidic foods like tomatoes, and chocolate because it relaxes the esophageal sphincter causing the esophagus to have stomach acid shooting up in to it. Women with heartburn and acid reflux should also avoid drinking a lot of water before bed since stomach acid is actually lighter than water it will cause the acid to float on top of the water and mechanically cause heartburn symptoms.
Women with heartburn are often kept up all night with insomnia from the pain. Lack of sleep can result in poor concentration, decreased memory, brain fog, and even ADHD symptoms.
Stress is an important factor to deal with because it thins the mucous that protects our stomach lining. Without a healthy protective layer of mucous covering the stomach lining, HCL becomes the enemy as it erodes the tissues and results in very painful ulcers. Stress also inhibits our stomach acid production resulting in gas and indigestion. Furthermore the suppression of stomach acid typically results in a rebound effect. Stomach acid will only be suppressed for so long before the body produces more in a natural feedback loop.
The stomach senses a high pH not conducive to digestion and overshoots by producing too much HCL to lower the pH at times when we don’t even need it… like between meals and at night time. Many people under high stress all day long will experience painful night time reflux as their body finally relaxes and has time to make some stomach acid. Unfortunately this is painful and keeps us up all night. Especially when we lack a healthy layer of mucous covering the lining of our stomach.
Eliminating aggravating foods and stressors whenever possible is a great first step towards healing from ulcers and GERD. Once irritating foods have been eliminated one can add in some soothing “demulcent” herbs such as Glycyrrhiza glabra also known as good old-fashioned licorice root. Look for the chewable “DGL” chewable licorice tablets at your health food store, Enzymatic Therapy makes a great one of you can purchase in your Fullscript account. Patients with High Blood Pressure should not take licorice in any form without checking with their Naturopathic Doctor!
Chew the tablets three times daily as directed 20 minutes prior to meals. DGL means that the component that raises blood pressure in the licorice has been removed but the demulcent properties have remained intact, however I would still use this treatment with caution and monitor your blood pressure daily if you are prone to hypertension.
You can also make teas or powder pastes with Marshmallow and Slippery Elm root. Taken between meals or twenty minutes or prior, these healing herbs will calm down the irritated lining of the stomach and allow the acid to work when it is supposed to work. Aloe vera juice is also a great therapeutic agent for those not susceptible to diarrhea. However, the “latex free” form of juice can typically be consumed without incident. Drinking fresh cabbage juice is also a highly researched remedy for healing the mucosa. The amino acid l-glutamine can also be used. None of these things will work though if we do not address Food Sensitivities and triggers that are individualized with each patient.
Many women experience chronic gas and bloating which is simply the result of lack of stomach acid from use of antacids or eating too quickly before the body has time to properly build up the digestive juices. Some will resolve with HCL supplementation (please don’t take this without advisement from your naturopathic doctor.) Eating a bitter green salad or taking Swedish Bitters before a meal can also stimulate stomach acid.
Alternatively, a shot of concentrated lemon juice, or even a teaspoon of apple cider vinegar in two ounces of water can also help with stomach acid production. If you have active acid reflux or heartburn I would advise against using foods to increase stomach acid until the reflux problem is resolved, and the stomach mucosa is healthy.
To test your stomach acid production take 1/4 teaspoon of baking soda powder in a little bit of water and wait with a timer. If you do not burp from this within 2 minutes, then there is little to no stomach acid in your stomach. If you burp between 2-5 minutes then there is low stomach acid.
Generally, I am working to first improve symptoms, and then I will work to taper medications down as they are no longer needed. Never stop taking your medications without consulting your Naturopathic Doctor.
All of these things are great quick fixes but they aren’t really addressing the root cause of most digestive upset which is that we are either eating under stress, eating the wrong foods for our specific body, or we are not slowing down and taking the time to enjoy our food properly.
Make every meal an event to give your stomach time to produce sufficient stomach acid.
Make a point with your friends and family to savor the eating ritual. An average lunch in some European countries is 1-2 hours and an average dinner is 2-4 hours. That is the spirit that we need to embrace in America in order to truly make the most out of our digestion. Not eating on the run, or at our desks while doing stressful work. Stop watching the news while you eat! Just turn it off.
If you need my help finding your Heartburn Root Cause, simply pop over to my SCHEDULE page to treat yourself to a Naturopathic visit! I would be happy to help.
Dr. Nicole Sundene
(480) 837-0900
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology, Acne, Psoriasis, Eczema, and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 23 years of experience in both Prescription and Natural women's health and hormones, she presents to women the best-integrated health solutions for their Chronic Disease. She has been an Herbalist for over 28 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan (not Medicaid) and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!
Dr. Nicole Sundene, NMD
Women's health is a little bit more complicated than men's health because of the constantly fluctuating hormones we experience every month and throughout our lives. It is completely normal for women to experience hormone imbalance. We must talk about it and educate women to spread awareness so they can take charge of it. When we don't properly address women's hormones, I see many women develop anxiety, depression, panic attacks, and insomnia.
In honor of "International Women's Day," I have put together multiple resources for women to help understand their hormones. Thank you to everyone who shares my hormone posts on their social media. Together we can empower women to take charge of their hormones and not be embarrassed to talk about these issues with their friends, family, and doctors!
Night Sweats- Natural Remedies
Hot flashes, Heatwaves & Hormones
Hormone Imbalance Feels Like Your House is On Fire and Nobody Knows Why
Insomnia: Bedtime Snacks for Women
Progesterone for Mental Health
Female Bloating & Constipation
Hormonal Anxiety is Like Snowflakes
Anxiety: Fight, Flight or Fright?
Happy International Women's Day! I hope you find the articles I have put together on Naturopathic Women's Health helpful.
It is a joy serving so many amazing women. I love working for you as your Hormone Doctor, and helping you reach your health goals with Naturopathic Medicine!
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!
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!
Dr. Nicole Sundene, NMD
Good news for women with anxiety! We can now treat your anxiety, libido, weight gain, diabetes, and loss of lean muscle all at once with schisandra thanks to the latest research! Menopausal women that took my favorite anxiety herb, schisandra, had improved quadriceps muscle strength in a few recent research studies [1,2]
This is important because loss of female hormones with menopause causes Osteoporosis AND a loss of lean muscle. When women lose lean muscle they are essentially losing their metabolism, as your muscles are pretty much the only thing burning calories in your body. Therefore taking a super safe, gentle herb like schisandra or ashwaghanda is important to prevent that postmenopausal weight gain that tends to happen in perimenopause and menopause. It is all about prevention ladies!!
I should forewarn women that I prescribe schisandra not just for anxiety, but also for poor libido and liver support. So if you don’t want a libido then definitely proceed with caution as I certainly don’t want you getting into trouble for picking up a second husband!! 😉
I am certainly not a homewrecker!
Otherwise, most of my menopausal patients need the libido enhancing effects of schisandra and research also found it effective in treating menopausal symptoms so this is a game changer! [4]
Plus the best part is that it is a very safe, gentle herb, as it is just Chinese berries. Personally, I prefer capsules to the tea or tincture form which has a bit of a bitter, Christmas tree type of flavor. I have most women on about 2 capsules twice daily of Schisandra for anxiety, weight loss, libido, and menopausal support.
The flavonoids in schisandra or the red berry color were also shown via research to help with weight loss. Managing high blood sugar is likely the mechanism for weight loss, as in a recent research study schisandra was found effective at lowering both high fasting glucose and high insulin levels and is therefore safe, and effective for women with diabetes and insulin resistance. [3]
But the most cost effective way of getting schisandra in your system is via the tincture method in my Instagram video. I fill my bottle about half full of berries and continue to shake it every few days for about 4-6 weeks and be sure to ensure the vodka is always covering the berries. Then strain and take a full or half teaspoon twice daily or more for anxiety.
The giant bottle of schisandra tincture I made in my Instagram video will last me for several years and is super inexpensive and fun to make! So if you are on a budget then the tincture is the way to go!
Be sure to only buy organic herbs from reputable brands trusted by your Naturopathic Doctor.
Check out my latest Women’s Health Masterclass “Mental Health and Hormones” to learn more of my best tips for your mental health. This free women's masterclass is not something you will want to miss! Plus it is 100% FREE so there are no excuses getting yourself educated on how female hormones impact mental health:
If you want to treat yourself to a Naturopathic visit simply give us a call, or pop over to my SCHEDULE page. I would be happy to help you with your anxiety, or women's health!
Dr. Nicole Sundene
(480) 837-0900
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology, Acne, Psoriasis, Eczema, and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 23 years of experience in both Prescription and Natural women's health and hormones, she presents to women the best-integrated health solutions for their Chronic Disease.
She has been an Herbalist for over 28 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan (not Medicaid) and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!
References:
Dr. Nicole Sundene
Why is cinnamon one of my favorite herbs as a Naturopathic Hormone Doctor you ask? Cinnamon is not only super effective, but most women find it a delicious herb to incorporate in their daily diet. Today I will go over the latest women’s health research on cinnamon, and how to use cinnamon as a tea and in foods.
The most important condition I think of using cinnamon for is PCOS. As cinnamon is one of the most helpful herbs for PCOS, especially when it is the insulin resistant or “metabolic type” as I discuss on my PCOS blog.
Exciting new research shows diabetes and peripheral neuropathy pain improve with cinnamon! Cinnamon actually helps regenerate nerve damage [11].
CINNAMON’S LATEST RESEARCH:
Cinnamon research demonstrates benefit in Type 2 Diabetes, PCOS, Migraines, Cramps, improved nerve damage in Peripheral Neuropathy, and improved pain [1-11]. Cinnamon aromatherapy actually helped newborns in the ICU go home an average of 3-4 days sooner [12].
Diabetes: Researchers found that only 500mg of daily cinnamon was needed to improve Type 1 Diabetes [1, 7]. This is fantastic because I have most of my diabetics taking 2 x 500mg capsules of cinnamon twice daily with meals and see this dose helping lower the need for Metformin. Some can’t handle taking that much as I discuss in the contraindication section further, so it is amazing to know that even one capsule daily provides benefits!
Most capsules of herbal medicine are 500mg. Most of the research studies cited here were done with 500mg capsules. Make sure you check the product you are using so you know the dose and then always stick with the same brand to avoid dose variations especially for those with diabetes and high blood pressure relying on cinnamon as medicine. You don't want to unwittingly increase or decrease your dose of cinnamon. Check out my Diabetes Diet for more tips.
I immediately prescribe 1000mg of cinnamon twice daily with meals to all of my diabetic patients and ask them to take as much as they can tolerate with food. Cinnamon is nature’s metformin and it works beautifully to support the pancreas and help stabilize blood sugar. With stable blood sugar my diabetics can mentally make healthier choices and have less episodes of low blood sugar causing them to crave carbs and fall off their diet.
PCOS: Three x 500mg capsules of cinnamon daily were beneficial for both PCOS and Insulin Resistance [2]. In another study, 1500mg of cinnamon not only improved PCOS symptoms but also lowered insulin and cholesterol [17].
An herbal formula containing 1) Cinnamon 2) Licorice 3) Flaxseed 4) Vitex was found beneficial for improving menstrual flow in PCOS patients better than metformin [10].
Migraines: Cinnamon is commonly used to treat pain. Researchers studied fifty patients with migraine headaches given cinnamon, and found cinnamon to be beneficial for migraines [3].
Cramps: Hooray! Researchers found that “cinnamon can reduce the intensity of primary dysmenorrhea” or painful cramps. Cinnamon was given at onset of cycle for 72 hours for 2 cycles and found helpful [5].
Peripheral Neuropathy Pain: Cinnamon improved nerve damage in peripheral nerves [11]. Research demonstrated that cinnamon positively affects peripheral nerve restoration! Another study demonstrated it's ability to heal the sciatic nerve after crush injury [16]. This is amazing news for those with peripheral neuropathy from diabetes, long covid, or other causes. Unlike the central nervous system, the peripheral nervous system can actually heal and repair when we add herbal medicine and remove the “Obstacles to Cure” and address the “Root Cause."
Thrush: Cinnamon was found beneficial as a treatment against thrush and yeast species [4].
Nasal Spray: I fear to discuss this cinnamon nasal spray research and pray children on social media will not change the “Cinnamon Challenge” from eating cinnamon to snorting cinnamon! But, since the research found cinnamon beneficial I will share that intranasal cinnamon solution improved seasonal allergies [6]. Keep in mind this was a nasal solution of cinnamon and nobody was snorting straight cinnamon!
Because cinnamon is anti-inflammatory, antiviral, and antifungal I would be excited to see a commercially available cinnamon nasal spray to help prevent and treat chronic sinusitis. Especially for allergy sufferers as oftentimes seasonal allergies inflame the tissues and thus increase risk of infection.
Bladder Pain: Cinnamon applied over the bladder as a patch was found beneficial for reducing bladder pain in those with "Overactive Bladder" [13].
Lip Plumper: Cinnamon when combined with menthol and capsaicin was found to be a safe and effective lip plumper [14].
Mouth Ulcers: Cinnamon was an effective topical agent for mouth ulcers or apthous stomatitis [15].
Cinnamon Safety Research: Cinnamon was found to be extremely safe by researchers that concluded they found no significant side effects or toxicity with cinnamon including “hepatoxoxicity or anti-coagulation properties” [8] Meaning cinnamon is non-toxic, and does not actually interfere with blood thinning medications. Cinnamon was also found not to cause electrical changes to the heart via ECG [17].
Researchers also concluded no side effects for cinnamon at doses that also “demonstrated anti-hyperlipidemic and blood pressure lowering effects among healthy adults” [9]
So cinnamon is generally safe and non-toxic at therapeutic doses, while working to lower both cholesterol and blood pressure. Considering how effective cinnamon is for diabetes it should be considered as a first line treatment doctors can trust when treating diabetes, cramps, high cholesterol, seasonal allergies, thrush, and peripheral neuropathy. Especially in a mild range where diet and exercise may be sufficient to control the pre-diabetes or diabetes.
I have personally reversed many diabetics A1c levels with cinnamon from 6.5-7% into the normal or just prediabetic range with cinnamon, carb counting, and exercise!
CINNAMON CONTRAINDICATIONS:
The most dangerous thing about using cinnamon as an herbal medicine is when patients buy grocery store garbage cinnamon. This is generally not real cinnamon just like how most vanilla extract is synthetic chemicals and not actual vanilla… which is why real vanilla is more expensive as is real cinnamon. To counteract this simply buy real cinnamon as I buy from either Mountain Rose Herbs or Starwest botanicals, or at the very least buy organic cinnamon at the grocery store from a reputable brand.
Otherwise the worst side effects I generally see with cinnamon are nausea from its tannins. Tannins stop up the intestines. This is why cinnamon is a helpful antiviral herb against diarrhea and stomach flu symptoms.
When implementing therapeutic levels many of my PCOS and Insulin Resistant patients become nauseated from the tannins. This tends to be alleviated by cutting the dose in half and slightly increasing carbs in the diet until the stomach has adapted to the treatment plan after a few weeks. Your stomach can get adjusted to the tannins, I promise. Rarely is it a long term side effect.
Suddenly dropping carbs and/or adding in high amounts of blood sugar herbs will cause side effects. These drastic sudden changes to blood sugar can cause nausea, vomiting, dizziness, and fatigue and thus it is best to implement the dose gradually.
Patients on medicines for heart disease, diabetes, and high blood pressure should work with their Naturopathic Doctor to determine if cinnamon is a good choice. Often the interaction effect with cinnamon is improving these conditions as it provides a synergistic benefit, and therefore medications need to be monitored with labs and vitals and adjusted down over time as the herb begins to help.
Do not use cinnamon at therapeutic levels if you are already overheated, having hot flashes or night sweats as it is a heating herb and it may make you feel warmer. As one of my diabetics on 2 capsules of cinnamon three times a day once described, “I can stand out in the snow with just shorts and a tank top on and feel warm. This much cinnamon gives me superhero powers against cold!”
While some women appreciate the gentle warming effect, and not all of my overheated patients are made worse by cinnamon, not every herb is the best fit for every woman as we have unique hormone patterns and constitutions like snowflakes.
HOW TO USE CINNAMON IN RECIPES:
Cinnamon pairs really well with berries, bananas, oats, apples, peaches, and chocolate for those that prefer to use it as “food as medicine.”
Cinnamon can be made as an herbal tea, added to smoothies, added to high fiber oat muffins, sprinkled over smoothie bowls, stirred into melted dark chocolate with stevia and walnuts for a lower carb therapeutic treat, or stirred into ¼ cup of applesauce.
When using cinnamon therapeutically the typical dose is around 1 tsp of real organic cinnamon twice daily with meals. I recommend starting with ½ tsp and working up to that. Do not take cinnamon on an empty stomach as it will cause vomiting from its blood sugar lowering properties and tannins effects on the stomach. This herb must be taken with food especially at high doses.
Check out my Gingerberry Blaster, Elderberry Syrup, and Apple Bottomed Smoothie recipes to learn more ideas about how I like to use cinnamon in my daily diet.
Need my help with your Women’s Health or hormone condition? Simply visit my SCHEDULE page to treat yourself to a Naturopathic visit. I would be happy to help.
Dr. Nicole Sundene
(480) 837-0900
Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology, Acne, Psoriasis, Eczema, and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 23 years of experience in both Prescription and Natural women's health and hormones, she presents to women the best-integrated health solutions for their Chronic Disease.
She has been an Herbalist for over 28 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan (not Medicaid) and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!
References:
Dr. Nicole Sundene, NMD
I have a lot of my chronic viral patients follow this diet in addition to testing their food triggers. It makes sense that by starving a virus from the raw materials it needs to grow by changing our diets to be more protected against viruses that we can also work to naturally boost our immune system.
I have been helping women with herpes outbreaks since 1994 working in a health food store and selling lysine, lemon balm, and certain remedies to specifically treat an outbreak. This can be a very frustrating Dermatology condition that has brought many women to my clinic in tears over the years.
The most important thing I have learned as a Women's Health Naturopathic Doctor, is that a woman's diet makes a BIG difference in the strength of their immune system against a virus.
The second a woman feels that burning sensation if they stop sugar, nuts, chocolate, citrus and the high arginine foods below the outbreak will slow down and generally we can manage it without the need for medications.
Food Allergies and Food Sensitivities are often an underlying cause, along with too many irritating foods to the skin such as citrus, and spicy foods that often can just mechanically irritate herpes outbreaks on the lips.
The virus needs arginine to replicate. By eating a diet high in lysine you are impeding the virus from being able to replicate and "flare-up." Women should use the following diet for prevention and then always have effective natural remedies on hand or prescriptions. Sometimes it is good to just have a written prescription for acyclovir on hand, or valtrex which I am happy to prescribe as an Integrative Health Doc.
Stress management is also important for the immune system to become strong enough to keep this virus in check. Many people are exposed to herpes and never develop an outbreak. It is possible to calm the flares down with natural medicine from your Naturopathic Doctor.
Optimizing the immune status via diet is key to the prevention and control of herpes infection. A diet that avoids arginine rich foods while promoting lysine-rich foods can be quite effective for prevention and following it strictly during times of outbreaks will lessen the pain, discomfort, and severity.
Foods to Emphasize
Especially during active cases of Herpes
Foods to be Eaten with Discretion
These foods must be balanced with L-Lysine* and foods in the first group when herpes is inactive. During active herpes, these foods must be eliminated.
* Foods high in lysine include most vegetables, legumes, fish, turkey, and chicken.
Foods to Always Avoid
If you are suffering with this, fear not there is help with Naturopathic Medicine! I have seen many women completely devasted from receiving this diagnosis and it is possible to get it under control with an aggressive preventive plan as I have outlined above along with the right immune support, herbal medicines and topical treatments.
If you need my help simply pop over to my SCHEDULE page.
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!
