Author of "The Hormonal Acne Diet"
Did you know I look at your female hormones a lot like a spider web? As a Naturopathic Women’s Health and Hormone Specialist, I am not just checking one hormone I am looking at how all of your female hormones and related hormones are working together (or not working) along with your nutritional markers and inflammation. This gives me the entire hormone picture or "web" as I like to think about it. Each hormone interacts either positively or adversely with another. Just like with a spider web, if we increase or decrease your female hormones aka ONE area of the hormone web it affects the entire web.
Most of the past “Hormone Lab Tests” I receive from my new patients done by their other doctors contain just one key strand of my “Hormone Spider Web” or worse half of the web….just enough to waste the patient's time and money but not actually enough of the full picture to be helpful in my mind as a doctor that has been looking at women’s hormones from a holistic perspective for nearly twenty years.
What I am looking at in my patient's “Hormone Spider Web” are the "Pillars of Hormone Balance"
1. Female Hormones: Estrogen, Progesterone, and Testosterone
2. Thyroid function as FREE hormones actually working and not trapped in storage
3. Insulin, Fasting Glucose, and Long Term Glucose Average ie: Hemoglobin A1c
4. Inflammation (Yes inflammation spikes hormone imbalance and hormones spike inflammation)
5. Nutrients: Macros, Protein, Carbohydrates, Electrolytes, and Fats
6. Liver, Kidney Health, and overall wellness
7. Adrenal Health with Cortisol and DHEA
8. Immune System Health (Chronic infections, yeast infections, spike inflammation and hormones)
9. Vitamins, Minerals, and Functional Medicine Nutritional testing (optional not covered per insurance)
By looking at all of these numbers at once in concert as a comprehensive holistic hormone lab panel that is how I can better understand what treatment my patient in Perimenopause or Menopause actually needs. Women with Hormonal Acne, PMS, and PMDD deserve actual answers.
Labs are important and help me confirm my suspicions, but occasionally they are off and we need the labs to confirm the actual diagnosis as many hormonal conditions can mimic symptoms. Sometimes we think the labs will show female hormone imbalance and instead it is a new thyroid diagnosis that can occur when female hormones become low in menopause. Sometimes my patients have been severely ill with a chronic infection causing chronic fatigue and burnout and the true hormone imbalance is in low adrenal function as I discuss further in my article about "Licorice for Blah Depression."
Sometimes my patient has already consulted with ChatGPT and has hired me to find their hidden thyroid disorder like hypothyroidism, Hashimotos, or other thyroid disease that I agree it sounds like they have, yet instead the labs come back with insulin resistance which requires a totally different treatment plan for hormonal weight loss.
Many women with heavy, missing or irregular periods have PCOS, estrogen dominance, high DHEA, high cortisol, while others have thyroid disorders, eating disorders, and genetic conditions like COMT or the adrenal disorder CAH: Congenital Adrenal Hyperplasia. Adrenal gland, thyroid, diabetes, and insulin resistance disorders can also cause irregular or heavy periods. Even worse with missing periods is when I find signs of early menopause in young women ages 20 to 30 showing signs of POI or Premature Ovarian Insufficiency. With hormone imbalance it is not a one size fits all prescription as the diagnosis in women's health are all so different and unique!
Regardless of the diagnosis, what is going on with the adjacent and opposing strands of the spider web is of utmost importance in my mind as well. This is why I don't like it when other doctors interfere with my hormone testing process or provide me with just one hormone value and not the entire web. Women's hormones are super complicated and I have treated women with PMS assuming "Estrogen Dominance" only to realize the reason why they are bed ridden with severe fatigue, weepy, moody, depression on their period was because of severe anemia. So we must look at nutritional markers as part of a woman's hormone web in order to be effective in women's health.
We also should not test female hormones without addressing the adrenals. First of all, the adrenals actually can produce half of our female hormones and can make both estrogen and testosterone from DHEA. During times of severe or chronic stress, the adrenal glands actually STEAL our progesterone to make the stress hormone cortisol. So it is imperative I understand what is precisely going on here and most MD's refuse to order these adrenal tests that I find imperative to understanding the full picture, nor do they understand how to analyze them. The progesterone steal is why the old saying was that women needed to relax and calm down or go on vacation to get pregnant and is also probably behind a lot of "Irish Twins" resulting from women thinking they are infertile and then finally relaxing once they know they have an adopted baby arriving enough to make progesterone needed for fertility.
Adrenal Health for women with any form of hormone imbalance is a critical piece to the puzzle. Especially when anxiety, chronic fatigue, PTSD, and depression. The adrenals can make female hormones, steal female hormones, and clog up the detoxification of female hormones with too much adrenaline leaving women angry and in a stereotypical hormonal rage! So in my mind there is no sense in treating a woman's hormones without first understanding the whole pictures.
We cannot just prescribe female hormones, without also monitoring thyroid and optimizing adrenal function to prevent the adrenals from constant hypoglycemic spikes and cortisol crashes that cause constant mood disruption throughout the day, it is tough for most doctors to make progress properly resolving common complaints in women's health. Because female hormones are complicated and everything interacts with everything. Adrenal fatigue also results in something called the "Cortisol Steal" and results in low progesterone. Whether progesterone is low from chronic stress or a normal part of Perimenopause it will still cause new onset anxiety, sweating, migraines, chronic pain, and insomnia at night that begins to worsen before a period and can become unbearable the week of PMS once depleted.
So that is how Holistic Hormone labs and doctoring is quite different from hormone labs conducted by your Endocrinologist, Family Doctor or OBgyn.
Need my help getting started with my holistic hormone testing process? Simply visit my schedule page to get started with my Holistic Hormone balancing process towards feeling amazing! You must have insurance that is not Medicare or Medicaid in order for me to affordably process your hormone labs via your insurance plan.
Dr. Nicole Sundene
(480) 837-0900
Dr. Sundene is the author of "The Hormonal Acne Diet" and specializes in Holistic Dermatology and Hormones. She is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert in Women's Health and Bioidentical Hormones.
Dr. Sundene specializes in Holistic Women's Health conditions 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!
