Best "Natural Rheumatology" Tips: Rheumatoid Arthritis, Lupus, Fibromyalgia

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?

1. Is the pain hormonal? 
2. Is the pain a vitamin or nutrient deficiency and nutritional?
3. Is the pain caused by your diet?
4. Is the pain caused by an autoimmune condition?
5. Is the pain caused by an infection? 
6. Is the pain Neurological and you actually have Neuropathy throughout your entire body like I do and need a Neurologist to test your nerves with an EMG and nerve biopsy?
7. Is your pain psychological? I am not calling you crazy when I ask this, I am simply wondering if too much stress could be impacting your adrenal glands and causing a common condition my chronic pain patients have called “Adrenal Fatigue.” 

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: 

1. If you are someone that does not want to go through the above testing I have just described, if you don’t have the right insurance or money to afford the proper testing then it is a waste of your time and money to enroll in my practice. I rely on lab tests and metrics and blood work. I cannot help you if you cannot afford this. 
2. Pain Victims: I am a pain victim too but I choose to fight the pain and not let it take me over. I choose to work hard against my pain and not just lay in bed and eat Fast Food and chug a bottle of wine while I whine to my friends about my pain and be a victim of pain. Do you want to continue on the rest of your life as a victim of your pain or do you want to be a victor of your pain? I work really hard every day to battle my own chronic pain, and I cannot take your supplements for you. I cannot shove them down your throat and stroke it like I give my pet supplements. I cannot drive to your house and take away the foods you shouldn't be eating, and I can’t make you do the gentle yoga and exercise I recommend. Frankly I just don't have time for patients like this. If you want to wallow in your pain and live as a victim of it I will not be able to help you. In 2008 I was there myself and began drinking, eating fast food and even smoking cigarettes because I felt SO CRAPPY it seemed that nothing I did even mattered. I felt like I was 100 years old and was going to die. I actually wanted to die. But people with this lifestyle cannot be helped by Naturopathy. I cannot prescribe enough supplements to “Out supplement your crappy diet.” I just can’t. Please skip me as your holistic pain doctor if you refuse to change your diet to whatever we determine your body needs. 
3. Patients with pre-conceived notions as to what their diet and supplements should be. If you were a Fibromyalgia genius that already had everything fixed and wrapped up with a bow I doubt you would need my help. When patients don’t let me have control over their diet and treatment plan I just can’t help them. "Well I am an expert with nutrition and I believe...X,Y,Z" Yes I have heard it all. I don't care what you think is the right diet in your head. What I care about is what the right diet is for YOUR BODY. That is the diet we will work to discover together and that is the diet I will need you to follow. Every single time the patient decides they are in charge of their nutritional situation, the situation fails and therefore is a waste of everyone’s time. I have many doctors and nurses that trust me to take care of them and hire me as “their expert.” Nearly every day there is a doctor or nurse on my schedule because they respect what I know as a holistic pain doctor. So if you can’t trust that I am the expert and not you on this then we will not be able to get you better. I am not an arrogant doctor I am just efficient and no nonsense. And I am driven by results. I can't get the result when you won't let me be in charge of your nutritional plan.
4. I cannot help patients that do not take their supplements or follow their treatment plan. Whether you are being lazy or not taking it seriously, or argue with me about what the treatment plan should be. Patients that argue do not get better. Sometimes I think they actually don't want to get better. My old office manager said “It is so funny, the patients that follow your directions are better in a few weeks or a month, and the patients that don’t follow your directions seem to NEVER FEEL BETTER!” She would tell patients with extreme confidence, "Just get off Google and stop watching Dr. Oz, and do what Dr. Sundene says to do!” After fourteen years of treating pain patients I could not agree with her more.  And while I am the opposite of bossy I always fail patients when I let them be the boss. If you want to drive your "Chronic Pain Bus" around you will simply steer it in to a ditch and then blame me you didn't feel better. So decide now if you are willing to let me take my 22 years of clinical experience and fifteen years as a Fibro Warrior and Autoimmune patient to offer you the very best I have to offer. 
5. If you are someone with trust issues, please know, I am going to work as hard as I can with you to help you feel better, using EVERYTHING I know from both Naturopathic and Prescription medicine with over 22 years of experience. My least favorite Fibromyalgia patient is super paranoid and refuses to do anything I say. I usually see this on the first visit and immediately know I cannot help. Why is that? You cannot be your own doctor. I have my own doctors, and I trust them, and follow their advice. I realize at times patients cannot see the forest for the trees, and can get stuck on googling things and listening to other Naturopathic Doctor’s Podcasts etc. and not following my instructions. The patients that do not get better in my practice have "Naturopathic Medicine ADD" and are all over the place with doing too many different things at once. It is my expectation that you will be taking the supplements I prescribe and the nutritional plan I prescribe the best you can at all times unless you have an adverse reaction. For adverse reactions it is my expectation that you contact me to request a substitute. If you have a lot of allergies and food intolerances like I do that is not the problem and sometimes it is helpful information to know if you are not responding well to a specific herb or supplement. Otherwise the herbs don’t work when they are sitting in a bottle and I need patients to stop giving me excuses and start giving me the real reasons they are not taking care of themselves. For many it is a lack of self love and we cannot heal a body that you hate. If you are not capable of making healthy food decisions and taking supplements I recommend you work with a counselor or therapist first to determine why you don't love yourself, before signing up to work with me. Otherwise I simply cannot help you and I do take pride in my work and providing each patient with a successful outcome. When you hire me to help you, I am on your team. But I cannot be the only person on the team doing the work. Health is actually a four letter word...its called WORK and never shall the doctor be working harder on the patient than the patient is working. Please get out of your funk and choose to fight for your health back like Kathy Bates in "Fried Green Tomatoes," I need you determined and sick of feeling sick to get better.

6. If you are too sick to follow the diet and supplement plan I put together for your pain, or you don’t have a caregiver to implement it for you, then I cannot help you. Please know, I am permanently physically disabled. I can realistically only work part time in the office as a result of it.  Many people with my same physical disability don’t work at all but I am a busy body and cannot just sit at home and do nothing. I need to do something productive with myself and when I can use what I have learned from my own suffering to save another patient, to intervene BEFORE they have permanent damage like I do…. Then that gives me the sense of purpose I need to feel happy and not depressed about being physically disabled. I need you to get better for me. If you don't want to do it for you, at least do it for me, because I know my methods work. They just don't work when the patient does not do them.
7.  Something else to think about...if you feel you are too depressed or too sick to follow my instructions, the brutal truth is, I won’t be able to help you at all, and you'll just waste your time and money signing up with me. 
8. Are you coachable and friendly? Please be kind when you interact with me and my small office as I am simply not able to tolerate patients that are rude or verbally abusive to my employees or myself. When I worked as a nurse the doctor’s I worked for did not care if the patients screamed at me or grabbed me or treated me inappropriately. Now that I am the boss I do not tolerate abusive patients like this. I know it is hard to be in a good mood when you are in pain which is why I will only work with patients that can be respectful to my own mental and physical health needs. In a small office when you yell at my assistant you are also yelling at me because I have to hear about it….then I just fire you and you have wasted your money because I will not tolerate unacceptable behavior. If your caregiver or family member yells at me or my staff that will be the end of our relationship. I have dilligently put on my scrubs to kindly serve patients with a smile on my face since 1999. I expect and deserve respect for showing up to a tough job for that many years, especially while disabled, as does every other health care worker with a care giver’s heart. When I don’t like you I cannot pour my blood sweat and tears in to your case and you likely will not receive a good result. 
9. Patients that are unable to pay me for my time. I know the last thing I ever want to do is pay my dentist, but I do need to be compensated for my time and I believe my pricing is affordable and very fair for the amount of time you receive, my level of expertise and training. I have actually been told by multiple other Naturopathic doctors that are also my patients that for my level of expertise I should be charging double what you see on my fee schedule. But I prefer to always stay busy helping people and deliver a reliable service at an affordable price.  Please do not sign up to work for me if you expect me to feel sorry for you and take you on as a "Charity Case" after one appointment. I am already physically disabled and therefore a "Charity Case" myself. The Charity Case cannot take on any Charity Cases in her free time. I am also a single Mom so the time that I am working is time that is taken away from my child. I would rather just be at home with my child then working for people for free.  Therefore if you do not have a few hundred dollars to compensate me for the generous amount of time and attention I provide at each individualized appointment,  I do not want you to sign up to work with me as I do not expect anyone to work for me for free and I only want to work with people that are respectful, have integrity and also always expect to pay their service providers. I have met one too many entitled spoiled brats for one life time and have zero tolerance for this. Too many times I have been burned badly by dishonest patients saying they cannot afford to pay me only to see them at fine dining or off to a cruise the following month. I believe my fees are very reasonable and fair and that you are investing in a long term solution to your pain. You are paying me for a process that you must go through and not a prescription. This will require you to pay for 3-6 appointments for the average chronic pain patient. Please determine first before you sign up to work with me if this is something you can afford.
10. If you are not mentally capable of following complex instructions then Naturopathic medicine is generally very difficult for both the patient and the doctor. The majority of my patients take their treatment plan and run with it, if you struggle with directions on how to make a tea or how to track your macronutrients on an app then this may simply be too complicated for you. While I see these things as simple and easy, I understand that some patients are truly so sick that they cannot follow basic instructions. At one point I was so sick I could not fill out my own paperwork and I would have needed to have my Mom do this for me, so I get that, but someone HAS to do it and not waste a ton of my time asking me the same question five times a day. There is nothing more frustrating for me to have to clarify my instructions repeatedly to the same patient. This is not a healthy doctor patient relationship I will be able to tolerate. If you cannot appoint a friend or family member to ensure you are correctly facilitating your naturopathic plan please do not sign up to work with me. 

WHAT PATIENTS ARE THE MOST SUCCESSFUL WORKING WITH THE HOLISTIC PAIN SPECIALIST? 

1. My #1 most successful naturopathic pain patients show up to learn with a pad of paper and pen and are actively taking notes and writing down the things I say. These patients always get better because they are showing up as my student. Every master was once a disaster and I am now the master that helps your disaster. These patients want to learn everything I know about hormones, naturopathy,  and pain.  They are the kind of patients that help me help them,  and they want to make sure they understand all of my different instructions. They pay precise attention to the time of day or the time in their menstrual cycle that they should have their hormones tested and ensure the testing is done properly and while on consistent dosing of their hormones without any lapses. Please keep in mind I am NOT some narcissist that enjoys having people follow them around with a pad of paper and pen but when I see patients doing this I can tell they are taking their chronic pain treatment very seriously and even though I type each patient a written instruction plan I think taking your own notes helps you remember and learn your new way of taking care of this broken body that is sick and in pain. When I meet a new patient like this... they always get better!
2. Patients that are able to follow up monthly until they are better usually have the most successful outcomes. I will usually need to see you for a first appointment to order labs, then a follow up appointment a month later to go over the labs. Then we will meet either monthly or quarterly thereafter. My most successful patients are able to afford to do this financially and also with their time. If your job or life is too busy to dedicate to calling in to my office once a month for a telemed visit then you will not be my next success story as we will need to constantly fine tune your plan until your symptoms have resolved or you are at least as improved as we can expect you can be despite an autoimmune condition, painful joint, surgery disaster, motor vehicle accident, or so forth. 
3. Patients that truly enjoy using herbal medicines as teas and foods are always my best most successful patients. I prefer to avoid the use of relying on capsules by teaching you how to incorporate herbs in to your drinks, smoothies and foods. I am doing a "Happy Dance" when I hear you like the tea recipe I gave you and that you are doing it regularly because we are saving you money using bulk herbs and you aren't relying on a bunch of expensive capsules.
4. Patients that are willing to change their diet to whatever I say they need to eat will always be a success. I understand some people struggle to make changes and need to do so in steps… I am that type of patient myself but in order to truly be successful you have to trust that I know what I am talking about after working for chronic pain patients and being one myself for fifteen years. I know exactly what works best, and I know what absolutely does not work. I am also looking for what specific foods triggers that flare your pain and sometimes they are your favorite foods and sometimes they are foods you think you should be eating to be healthy that are making you worse. I don't make the rules I just teach you how to follow them.

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

(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!