WHO IS THE NATUROPATHIC DOCTOR?
Dr. Nicole Sundene is a Naturopathic Women's Health Doctor with nearly 20 years of experience as a Female Hormone Specialist and is the author of "The Hormonal Acne Diet." For the past 30 years, she has served patients either as a Naturopathic Doctor, or for MD's that were Female Hormone Doctors, Endocrinologists, Dermatologists, Urologists, Gastroenterologists, Opthalmologists, and Internists. She thus has an integrated background and understands many different treatment options from her time working for a large hospital clinic for many specialists as a nurse and surgical assistant.
Dr. Sundene works to manage chronic disease in women naturally, specializing in hormone imbalance and other complex women's health conditions, her favorite subject is "Hormones and Dermatology."
HOW DOES NATUROPATHIC WOMEN'S HEALTH, HORMONE AND HOLISTIC DERMATOLOGY WORK?
ARE YOU ACCEPTING NEW PATIENTS?
Yes. However, we are generally booked out 2-4 weeks so please check what month you are looking at when booking online or call my assistant if you need a sooner time. After nearly 20 years of working as a Naturopathic Women’s Health Doctor, my enrollment is limited to only patients I trust I can achieve a successful outcome with.
To confirm you will have a successful outcome with Naturopathy please submit my New Patient Application first for my assistant to review. I do not accept men, and am generally only accepting women ages 18-60 that are a match for my specialty and have insurance that covers their hormone testing, that is not medicare or medicaid. If it is a marketplace plan through the government I can order your labs and they are generally well covered. For female teens in need of my hormone service please read more below if my service will be a good fit for your teenage daughter to be successful. While I don't normally work with children as a Hormone Doctor, I have heard it is hard to find a Pediatric Endocrinologist, however, I am a Female Hormone Doctor, and not an Endocrinologist.
HOW HOLISTIC DERMATOLOGY AND NATUROPATHIC HORMONE SESSIONS WORK
APPLY FOR HOLISTIC DERMATOLOGY AND WOMEN'S HEALTH:
Since we do not take insurance for the visits, we want to only accept women that are a good match for our service and thus will have a good outcome. As a doctor my agenda is to diagnose your condition, provide a long term solution to it, and work with you monthly until your symptoms are resolved. This requires my Holistic Educator to review your New Patient Application prior to receiving a booking time so she can confirm you will be my next success story. At this point in my career I only want patients that are happy because I hit a “Naturopathic Home Run” so we need to make sure you are able to make nutrition changes and take natural hormones or herbal medicines.
WHAT STYLE OF NATUROPATHY DO YOU PRACTICE?
Keep in mind I am a "Root Cause" Naturopathic Doctor from Bastyr University which means I am digging deep to understand WHY the body is sending us these messages. I do not believe in prescribing an herb or supplement for every symptom you have like I once did in the 90’s working four years at a GNC health food store while in college. "Health Food Store Medicine" is basically the same failed model I worked in for 8 years at a hospital, where every patient was given a specific drug or surgery for each symptom. This does not work in my opinion over the long run.
Instead, I am evaluating your symptoms as a SYSTEM of functioning as a Functional Medicine Doctor at their ROOT, in order to understand the message your body is sending so we can implement a plan to achieve optimal balance through nutrition, natural hormones, herbal medicines, and supplements.
WHY DO I HAVE TO FILL OUT A NEW PATIENT APPLICATION?
To confirm you will be successful. If you cannot do the things I need you to do that actually work over the long term...then I do not get that magical joy of fixing you! Also, I personally know how frustrating it is to be caught in a nonstop referral loop and going from specialist to specialist without answers. I know how stressful it is to have to keep telling your story over in tears, shaking with stress, trying to remain hopeful...yet again it ends with no hope. So, it is not my goal to give false hope. The medicine I practice requires some work on the patient's end which is why their is a LONG section below to read if you want to send your teenager to my hormone clinic so you are not upset with them and/or me when they refuse to make any diet changes or take supplements, although teen girls with Hormonal Acne are by far my most compliant and successful patients. I cut the age group off the application so parents can stop and read below first if this is a good idea for their kid and/or how to make it their idea so they are excited there are options to the acne, eczema, stomach aches, constipation, anxiety, or depression. As a mom, I feel like what I do is a million times safer in general for kids than giving them prescription drugs, especially Adderall and Accutane. Parents should not try to invest their money in finding answers if their kid is not ready. Read below to figure out if they are or you can help them become interested in learning how to find the best nutrition for their body and discover the cause of their symptoms.
I know many of the women that I help with Menopause, Perimenopause, Stomach Pain, Headaches, Autoimmune Disease, Lupus, Rheumatoid Arthritis, Hair Loss, Chronic Fatigue, Chronic Pain, Fibromyalgia, Hormonal Acne, Eczema, Psoriasis and severely frustrating itchy and painful skin rashes deserve to hear from me whether or not I can be of help first.
Just like I share in my own tale of woe about “Why I Became a Naturopathic Doctor.” My own frustrating health conditions made me realize that despite being a “PreMed” student on my way to MD medical school to be an OBgyn, that system completely failed me. Only as a last restore when my friend sent me to her excellent and highly skilled Naturopathic Doctor 30 years ago, was I finally able to get answers, connect the dots and feel better. So we only want I really only want patients enrolling are excited to get healthy and optimal and that understand this is a process to improve their body and not a one time prescription. Trust me if there was that "Magical Herb from the Rainforest" to cure everything, I would be on it, and you would not need to read this.
As I got older and developed the Autoimmune disease, Lupus, after receiving many wrong diagnosis, and dismissals that I look fine so I must be fine, I personally know how hard it is for patients to be stuck in that "Neverending Story" of specialist to specialist to specialist and back to your family doctor in tears with no hope. So, in order for me to know if you can be successful with my Naturopathic process, I will need you to fill out and application to confirm.
WHAT CONDITIONS DO YOU ACCEPT IN HOLISTIC DERMATOLOGY AND WOMEN'S HEALTH?
I am only accepting new female patients that match my specialties in Women's Health, Hormones and Dermatology.
I do not treat cancer such as skin cancer, breast cancer or uterine cancer. That requires an MD. I do not do check ups or mole checks.
I will NOT agree with you that going the 100% natural route on these serious conditions is acceptable after seeing patients die from trying to self treat their skin cancer, breast cancer, and other types of cancer that could have been prevented with proper MD intervention. Please go to a MD if you have cancer and not me. Even if you want Naturopathic support I will insist you see my FABNO Naturopathic Oncologists, because that is what I would personally do, and I always want the best for people.
NEW PATIENTS: WHAT CONDITIONS DO YOU TREAT?
I want every patient enrolling in my practice to be a success story, and only accepting new female patients with Women's Health conditions such as female hormone imbalance, thyroid, breast pain (not breast cancer), Urology, Rheumatology, Psychiatry, Gastroenterology, and Dermatology conditions. Women with these conditions can enroll into my practice. If your chronic disease health condition is not listed, I can most likely help you with my near 20 years of experience working as a Naturopathic Doctor, but you should call my assistant to first apply and confirm that we will be successful working together. Please ensure your NEW PATIENT PAPERWORK is submitted at least 48 hours prior to your appointment for me to review prior to meeting you!
I am very detail oriented and ask a great deal of questions. Sitting down and putting thought and time in will help me help you the best rather than rushing to fill out a bunch of stuff the morning of your appointment.
HOW DO I GET STARTED WITH NATUROPATHIC WOMEN’S HEALTH AND HORMONES WHAT OTHER SERVICES DO YOU PROVIDE?
Fill out the New Patient Application to apply for my help with Holistic Women's Health, Natural Psychiatry, Natural Endocrinology, Natural Dermatology, Natural Rheumatology, Natural Cardiology, Natural Gastroenterology, Natural Urology, or BHRT in order to confirm you will be successful with our holistic methods.
I AM NOT IN ARIZONA. CAN YOU BE MY DOCTOR?
No. Please do not enroll.
I WANT YOUR NATUROPATHIC HELP BUT UNDER 18 OR OVER 60
If you are female and want help with my Holistic Dermatology and Women's Health specialty or would like me to help you with something that is outside of my specialty please submit the application to evaluate if we will be successful and review your insurance.
HOW DO I SCHEDULE MY NATUROPATHIC SESSION?
Naturopathic Medicine, Hormone Management, and Hormone Renewal Med Checks are conducted by appointment only.
WHAT IS YOUR PREFERRED HORMONE LAB?
Sonora Quest is our preferred lab as they can get us our hormone labs in 1-2 weeks whereas Labcorp requires 3-4 weeks. Please only go to Labcorp if your insurance mandates it. Once your labs are final you will receive an email to book your follow up or you can automatically book it online or by calling us to schedule the day of your blood draw.
WHEN SHOULD I TEST MY FEMALE HORMONES IN MY MENSTRUAL CYCLE?
For Perimenopause, PMS, Hormonal Headaches, PCOS, Hormonal Acne, PMDD, etc: Days 21-23 of the menstrual cycle unless otherwise stated on your lab slip. The first day you start bleeding is day 1. Once you have your period that is when you should set your lab visit 21 days out. Please load that period tracker app with the pink flower on your phone to start tracking your period for proper targeted testing.
DO YOU DO SALIVA TESTING OR DUTCH TESTING?
No. I have worked in blood hormone labs through insurance since the 90's. I do not care to ever hear about Saliva testing again after graduating from Naturopathic school, and think it is stupid for women to pay thousands of dollars for something that is paid by their insurance plan. Furthermore it is "not better" this is just nonsense the naturopathic doctor sells you so they make a lot of money off your hormone lab testing that should be free or around a couple hundred dollars via your insurance. If Saliva Hormone testing actually helped me do my job better, that would be one thing but, it does not. For more information on hormones and Hormone Testing, please visit our Bioidentical Hormone page.
HOW TO ENSURE ACCURATE HOLISTIC HORMONE TESTING:
DOES MY INSURANCE COVER NATUROPATHIC VISITS?
No. Naturopathic Doctor's spend a great deal of time ie: 30-60 minute sessions with their patients via a detective process to understand the "Root Cause" of symptoms and are quite different than the standard MD version of Endocrinologist, Dermatologist, Rheumatologist, Gastroenterologist, Urologist, and Cardiologist that work on a 1-10 minute schedule with their patients. I worked for a lot of doctors that felt like anything more than 30 seconds was too much of their time. Their actual goal was to be "Gone in 60 Seconds."
So please keep in mind that when you are in an insurance model you are not getting proper care in my opinion and that is why you are not better. The doctor is barely listening and prescribes something to just slap a band-aid on it while you wait 3 months to see a specialist. We call this the “Sick Care System” and in my experience the worst services we provided in Family Medicine were for Bladder Pain, Frequent Urination, Recurrent Yeast Infections, Anger, Menopause, Perimenopause, chronic disease management with anxiety, anemia, arthritis, insomnia, palpitations, blood pressure, cholesterol, depression, weight gain, hair loss, constipation, heartburn, stomach problems, diarrhea, chronic fatigue, and diabetic patients. No education or diet instructions were generally given to these patients only rotating and combining more drugs with increasing doses that just mask symptoms and don’t get to the “Root Cause."
WHY DOESN'T MY INSURANCE PAY FOR NATUROPATHIC CARE?
Naturopathy is a complicated process that uses Functional Medicine, Nutrition, Natural Hormones, Herbal Medicine, Vitamins, and Supplements to address the "Root Cause" of these conditions, rather than just prescribing the antiquated failed "Sick Care" American Medical Model that we use X drug to suppress X symptom. This is why Naturopathic Doctors do not accept insurance and do not run their appointments on a five to ten minute schedule like most doctors that accept insurance. Or in family medicine it was 30 to 60 seconds. Not 30 to 60 minutes.
While some patients do receive reimbursement for their visits from their insurance, we do not work with any insurance companies as it is too time consuming and the payment system is based on the typical 1-5 minutes an MD spends with a patient not the 30-60 minutes I reserve for each patient.
Instead of handing a patient a prescription after 60 seconds of listening to their symptoms, we are looking at the symptom set as a whole to understand which Functional Medicine systems need to be addressed to reduce inflammation, and aid healing of the affected tissues. Please read the blogs associated with the conditions you seek treatment for to better understand how my medicine is more of a "detective process" and not just a "prescription." This is why the new patient visit is 60 minutes and follow up appointments are 30 minutes. Time is required to solve the symptoms which cannot be conducted outside of a scheduled appointment. Anyone can hand you an antibiotic, steroid, or anti-depressant in 30 seconds.
HOW DO I SUBMIT LABS AND DOCUMENTS?
I do not accept outside hormone labs to diagnose you or adjust your hormones when run by an MD as they will not be correctly ordered and waste my time and your time. If you have been to a specialist or want to submit prior reports for comparison reasons please directly upload them into my
SECURE DOCUMENT FORM to your portal and then immediately SCHEDULE an appointment to discuss.
UPLOAD DOCUMENTS SECURELY STEP BY STEP INSTRUCTIONS
WHAT CAN I UPLOAD TO THE DOCTOR?
Only the “Official Lab Report” should be uploaded.
There is an area in your lab portal to access the PDF report and that is the only thing you should give to any doctor. If you cannot figure that out, call the lab or ordering doctor and ask them to fax it.
I CANNOT USE ONLINE FORMS WHAT SHOULD I DO?
Hormones Labs, Functional Medicine Labs, and relevant imaging can be faxed to us at (480) 409-2644 by calling your lab, or by calling your doctor's office and requesting only the tests, not the notes sent to Dr. Sundene for "continuity of care," just about any office will be happy to send that. You can also drop them in the mail to the address below or simply make copies and hand them to the me at your visit. Keep in mind you do not want to waste your precious visit time watching me make copies. We understand everyone is not tech savvy and therefore mailing the information is the perfect solution.
Always just mail the labs if you cannot do this properly.
WHAT PAST LABS ARE HELPFUL FOR A NATUROPATHIC DOCTOR?
I only want the past 1-2 years of your labs, Functional Medicine Labs performed by your previous Naturopath, and anything pertinent that is abnormal related to your chronic disease condition. Providing too much information ie: more than 20 pages will require multiple visits. Overwhelming any doctor with too much information is never good. If you are not sure what is pertinent simply ask me at your session before worrying about it, I always prefer to have what I call “A clean read” on all my cases anyways, and will be looking at your documents until after I hear your story first. This is so as to not take on another doctor’s diagnosis and be sure I understand what is actually going on.
HORMONE REFILLS
We always refill your bioidentical hormones until you are legally due for a lab and follow-up visit.
Please set your visit on my SCHEDULE page regardless if you have performed your labs. If you have not done the labs while on the hormones consistently they are dangerous to adjust your hormones off of and instead you should schedule your renewal visit and I will email you any changes after I receive the labs.
HOW TO REQUEST A HORMONE LAB SLIP
All labslips are given directly to the patient at their appointment, or via a portal email while on a telemedicine call. Please call to have your labslip emailed if you do not have it, or simply book a visit on our SCHEDULE page if you do not have a labslip and it has been over a year since we have seen you.
WHERE DID YOU SEND MY LABSLIP?
We never send your labslip to the lab. Check your email searching “Sundene” for the email with your labslip I sent at your last appointment. If you are a new patient, you must be enrolled prior to receiving your labslip which I will hand you at your visit. Please do not have some other doctor order hormone testing right before your visit with me or your labs 100% will be botched and not want I want, and then they will also not be covered to immediately repeat hormones testing when insurance allows it only so often.
Oftentimes new patients think they are "helping me" by doing this and going to their family doctor or even worse, OBgyn for a hormones panel, this actually just makes it impossible for me to get the answers I need. If you cannot follow this most important hormone step then please read my rant at the end of this page about why that is the worst possible thing to do, how little the family doctors I worked for knew about the female hormone testing I do, and how it actually stops me from being able to solve your hormone puzzle as a Female Hormone Specialist.
I CHANGED INSURANCE OR DROPPED IT AND CAN’T DO MY LABS?
Patients without insurance, or poor insurance coverage due to high deductibles, should discuss with me at the visit what is medically necessary to confirm their hormones are safe. If you have run out of hormones and cannot afford to do your labs you must at minimum check in with me to discuss if/what labs are necessary to continue to receive refills. There are Arizona Board of Pharmacy and DEA laws that all hormone prescriptions must be in compliance with. If you are having financial issues please discuss at the visit if we can delay your labs, decrease them or both. This must be done at your appointment though, as I will need to assess your vitals and how you are feeling to make any necessary hormone safety adjustments outside of “Best Practice Guidelines” when prescribing hormones for the safety of my patients.
REFILLS: HORMONES, SUPPLEMENTS, VITAMIN AND HERBS
HORMONE RENEWAL VISITS: Are required legally for your safety every 3 months the first year you start a new hormone regardless if you have done your labs. After that we check your hormones every 6 months thereafter or if you are having symptoms. If something is not right you can always take your labslip in and get the levels checked sooner. We recommend scheduling your labs the day the doctor says the next lab is due and then scheduling your follow up 3-4 weeks after your labs are drawn but prior to running out of your hormones.
VITAMIN AND HERB REFILLS: Our clinic uses Fullscript for all prescription grade supplements, vitamins, and herbal medicines the doctor needs to balance your hormones or resolve your dermatology or women’s health symptoms. Once you have set up your account, you can continue to order the supplements and refill them as needed. Patients do not need a prescription to continue to order prescription grade supplements. We do need you to continue taking your Naturopathic plan to ensure it continues to work once your symptoms are resolved. If your symptoms return, please schedule a follow up visit.
ANNUAL HORMONE CHECK UP: If you do not take hormones but just want to see where you are at with everything, we recommend every patient has an annual hormone check up, this is optional for patients that are not on hormones, and have resolved their symptoms of hormone imbalance.
HOW OFTEN DO I NEED A HORMONE APPOINTMENT?
HORMONE MAINTENANCE SCHEDULE: Patients should plan to be seen monthly until their symptoms improve. Natural medicines take several weeks to work. Generally Naturopathic Hormone Doctors need to work with patients monthly to see how they are responding to their herbs and supplements until they have improved. Once improved you do not need to come back in unless you want to. If you are prescribed hormones you will need to come in per the legal requirements of your hormones.
To confirm natural hormones are safe, testing and follow up visits are required every 3-6 months. Once your hormones are properly adjusted you should just need to check in every 6 months.
CAN YOU HELP MY TEENAGE DAUGHTER WITH HER HORMONES?
YES and NO. If you have a female teenager that actually wants to make nutrition changes and take supplements then I will consider enrolling teenagers with hormone imbalance issues I work with such as Hormonal Acne and PCOS. I have heard horror stories from many moms of teenage girls with hormone imbalance, thyroid disease, and painful periods that it is “Impossible to find a Pediatric Endocrinologist in Phoenix,” so since this does somewhat match my specialty as a hormone doctor (I am not an Endocrinologist but a Naturopathic Doctor) I am willing to accept teen girls that actually want to do Naturopathy.
However, I am a Holistic Dermatology and Female Hormone Specialist, not a pediatrician. I do not provide vaccines or well child checks, and all children under 18 must go to their pediatrician for everything unrelated to my Hormone, Holistic Psychiatry, and Dermatology specialty.
If your teenager refuses to get their blood drawn, even medicated (which I can provide) then I cannot help them. I refuse to prescribe hormones to young women without proper testing. They are still growing and developing and this is utterly dangerous. If your teenager refuses to be open to making diet changes to the best fuel for their body I also will not be able to help them.
PLEASE CHECK WITH YOUR TEEN BEFORE SIGNING THEM UP!
I am also a mom and understand that some kids are not ready to make changes, where some need the information and run with it. I recommend with teenagers you try to make it their idea and, instead vaguely mention you “heard of a natural way for their XYZ symptoms to be managed naturally and wonder if we should look into that.”
Then together you can look at my blog related to their symptoms and decide if they will be willing to do it or not. As I do have blogs for PCOS, Hormonal Acne, Anemia, Weight Gain, Anxiety, Hormones and Sweating. Insomnia, Depression, and believe that some teens really need my help! Furthermore as a parent and doctor that has worked on both sides of medicine, I personally feel that Naturopathy is the better way to go and safer than medications.
Teenagers are some of the best and most compliant patients I have ever had, but every parent already knows that if it is not something they want to do….then we generally are not going to be successful. This must be your teens' idea to come and see me that you are nodding along in agreement that you are willing to try “So long as you are willing to make nutrition changes and take supplements then I will pay for it.” If you act like you don’t really know if you want to pay for it or do it, that generally makes them more motivated in this age group! LOL ;)
They must want to do these things as I know what it is like as a mom to struggle with trying to get my kid to do things. Just remember I am only a mere mortal doctor, and I am not Mary Poppins and cannot "bippity boppity boo" them into place against their will.
However, children resonate well with Naturopathy because it makes sense to them that the right food makes their body work right. The wrong food makes their stomach hurt or their skin break out. Many of them have inquiring minds that really want to know and show up with a notepad like a professional adult patient.
Teens also don’t have all the bad habits and dietary hang ups that most of us older adults have and can be more open to improving their nutrition. The BEST most compliant patients in my practice are teen girls with acne as they are willing to do WHATEVER I say to clear their complexion and have likely already tried the regular Dermatologist and over the counter stuff that makes hormonal acne worse. Many are relieved to find out this is an option. Many resolve their acne in just a few appointments. So nothing makes me happier than that. My other favorite part of helping teens with their hormones is showing them on paper that their is indeed a hormone balance causing their symptoms, bad mood, weight gain, or painful periods. This always makes them happy to know because we all were insecure as teenagers and feel better when something is not really our fault from doing things wrong.
Nonetheless, we need to get your teen daughter on board with my holistic ways of doing things so please present my option mysteriously to your teen like you do not know anything about it at all and just heard about it from some other parent that had success and wonder if they want to look into it and check out my website later. The more we can make eating healthy, exercising, meditating, and taking vitamins and supplements your teenager's idea the faster we will be able to help them clear the skin or symptoms. Also there was nothing like this for me in the 80's and I think I would have been super excited to have someone like me to help figure out why my stomach always hurt and my periods were crippling to a point I could not function or go to school at times. The best part of Naturopathy for teen girls is that we are not only getting answers, but also building a foundation of future healthy habits that you as a parent are helping them reinforce and practicing getting healthier together.
So, I only want happy patients and their parents in my practice so please do not enroll your kid if she will see this as some type of punishment. I went through a good teen stage and an evil teen stage so I know how it all works! ;)
Furthermore, I have seen plenty of MAD parents over the years that signed their kid up and got blood work and answers but then the worst most frustrating part....their kid then refuses to do anything about the Naturopathic puzzle I have solved. So it is important you understand where your teen is at right now and if this is a good time for them to make changes to improve on their health or not. Please fill out my new patient application and discuss with my assistant if you think we can help your teenage daughter. Everytime a mom in my practice asks if I can help their teenage daughter my response is always, "Can anyone help your teenage daughter?" Then we have a good laugh and realize that they either will love the concept of Naturopathy and be a perfect fit... or hate it.
MY DOCTOR SAYS I ONLY NEED ONE HORMONE TEST A YEAR WHY DO I HAVE TO GO TWICE A YEAR?
Yes, and I am guessing they are an MD family doctor that does not specialize in hormones. While you can legally opt to only do a one time a year hormone test if taking synthetic hormones that we do not recommend, this is because it is easier for the doctor to manage. Meanwhile, the patient is not feeling at their best on synthetic hormones. So basically you are now fat, bald, moody, angry, tired, and not sleeping well all so your doctor has less work to do? This makes little sense to me, and again I do not believe in synthetic hormone garbage, I hate Semaglutide and Levothyroxine and you can read my 90's Horsey Hormone Rant about synthetic hormones Premarin and Prempro that should no longer be prescribed in Canada stuck in the dark ages with women's health on my "Night sweats" blog.
If you want annual only lab testing, then please go to a doctor that prescribes synthetic thyroid hormone and thus agrees this is good for you, as I do not agree with the use of synthetic hormones, nor sloppy lack of proper lab follow up, and only believe in prescribing natural hormones for women after having to see how bad all the synthetic hormones caused breast cancer, stroke, and blood clots in patients first hand, well before the research confirmed it was bad in 2002. I personally witnessed a higher rate of these adverse events in the hormones doctor's practice that was prescribing synthetic hormones, than my docs that prescribed zero hormones for women and just gave them Prozac and said they were crazy.
Yes you can take this synthetic crap and have it tested in a sloppy annual manner, but no I will not be participating with that program, and do not believe that is safe or effective in women's health and hormones. Especially for women with hypothyroidism, perimenopause, Diabetes, Insulin Resistance, PMS, and menopause. We need to be monitoring you more often than once a year!
MY DOCTOR SAYS I CAN TAKE FEMALE HORMONES NOW WITHOUT TESTING THEM?
Yes, while that is certainly an option, I find it utterly sloppy and dangerous after prescribing and testing the same doses of natural hormones for nearly 20 years. Women are all different. Once I had to drive a friend’s stick shift truck with a broken speedometer and it was pretty challenging. I had no idea how fast I was going unless I could follow someone else. I was not used to driving a stick and it was a lot of extra work and super confusing. The experience as a whole was utterly terrifying and I still remember it like it was yesterday. So yes, we can do things differently and stop all metrics and number values to monitor what we are doing...but is that a good idea? No.
First off, I have been doing this job long enough to tell you that I can give a 1mg tablet of estradiol to 100 women and get 100 different labs and feedback with side effects. So I find this DANGEROUS from my direct experience working in hormones for 30 years. I will just be blunt to save you a long Norwegian Rant about why this makes me so mad and all the patients that had bad outcomes not following my "Best Practice" hormone follow up schedule properly.
It is especially dangerous to skip labs for women with a family history of breast cancer or reproductive cancer these levels need to be checked, a lot of women with this family history do not detoxify estrogen properly due to genetic mutations and therefore this philosophy gets an eyeroll from every GOOD hormone doctor that I know. To us this is like saying that people with diabetes can just randomly guess their dose and not test it and just inject the same dose of insulin regardless of what they eat or what their numbers say.
So if you want to be in dangerous unregulated uneducated hormone prescribing cancer land then feel free to listen to dumb male doctors I 100% disagree with, as that sloppy prescribing, and will not be prescribed under my name. I have seen enough bad outcomes from patients I could not get to comply to know this is a ridiculous philosophy.
The reason I follow my hormone guidelines with testing and annual mammograms is because the women that don’t do this all end up with bad outcomes. Even with “natural hormones” untested they ended up with breast cancer because they refused to follow my “Best Practice” guidelines that I have in place for their safety and to stop women from becoming fat and bald from improperly managed levels. Even worse I have seen women get divorced because they refused to follow my instructions and became a psychotic angry hormonal rage cat and by the time they finally did do their testing they were divorced or separated because their husband deemed them an “evil psycho” and left them for a happy thin blond 20 year old.
Home wrecking is just not a desired outcome in my hormone practice. This is why I am a fan of maintenance testing to confirm my patients hormone levels are safe and that they are reacting well with them mentally….especially for women in perimenopause or menopause.
WHAT ARE BIOIDENTICAL HORMONES?
Hormones are important chemical signals that regulate and control multiple functions in the body. Each individual hormone is responsible for turning on and off multiple body functions. Patients with hormone imbalance commonly suffer from a multitude of disruptive and frustrating symptoms that tend not to resolve until the “Root Cause,” the imbalanced hormones, are addressed and corrected.
WHAT IS A FEMALE HORMONE SPECIALIST?
Dr. Sundene’s career in hormones serendipitously began when she was offered a job by a Hormone Doctor in the 90’s who specialized in Hormones, Osteoporosis, and Chronic Pain. This early training in Endocrinology prior to starting Naturopathic School at Bastyr University is what sparked her interest in the biochemistry of hormones needed to solve complex Female Hormone cases. She especially enjoys researching how hormones and neurotransmitters are impacted by vitamin, mineral and amino acid cofactors.
She now practices an integrated style of hormone management, utilizing herbal medicine, vitamins, minerals, amino acids along with natural hormones to treat and address the “Root Cause” of the hormone imbalance from a Naturopathic perspective. She therefore has an Integrated background and knowledge of women’s health from a traditional MD Endocrinology approach as well as her skills as a Naturopathic Doctor and Herbalist to bring women the finest natural medicine options available to achieve perfect hormone balance and optimal health.
Dr. Sundene has worked in Female Hormones for over 26 years. She is the author of "The Hormonal Acne Diet" program designed to help women with estrogen dominance balance their hormones via simple recipes using herbal medicine and targeted nutrition specific for hormone balance. She combines her years of experience working in female hormones with her passion for reading biochemistry research studies to provide a comprehensive diet program and recipes. so women do not need to rely on birth control pills, surgery or supplements to treat their estrogen dominance, PMS and Perimenopause symptoms causing weight gain, pain and inflammation.
Dr. Sundene specializes in treating women with Hypothyroidism, Menopause, Perimenopause, PMS, PCOS, Hashimotos, Autoimmune, Osteoporosis and Complex Female Health Conditions.
Dr. Sundene provides a natural integrative health approach to women with Hypothyroidism and Hashimotos. Functional medicine is used to support the thyroid. Natural hormones are preferred over synthetic hormones along with diet, nutrition and hormone testing to ensure the endocrine system is balanced in female patients with hypothyroidism. When the thyroid is not properly managed patients can still have symptoms of cold intolerance, weight gain, constipation, depression, anxiety, insomnia, dry skin, brittle nails and hair.
The goal of the Naturopathic Doctor is to provide as much natural support as possible and address other hormonal imbalances such as female hormones and adrenal hormones that may be worsening thyroid function.
DO YOU DO SEMAGLUTIDE SHOTS AND IV’S?
No. I am not a fad diet or “IV Naturopath” I treat patients at the root cause of their disease with nutrition and herbs mainly. I already hate Semaglutide, simply read my rant about “Semaglutide Safety” and how bad it is as a lot of my new patients are accustomed to in Phoenix getting a ton of IV’s and shots I see as poison as a biochemist and hormone doctor.
I do not feel the solution to every symptom is an IV. I believe all my patients that are overweight losing weight on Semaglutide against my medical advice all have the same self discipline and self love issues and really just get blown up even fatter after they finally stop it because it has caused so many adverse effects. Now they are 60 pounds heavier than when they started the semaglutide.
Furthermore Semaglutide is only 94% natural, so that is like saying that Donatella Versace is “natural.” With varying degrees of what natural means it is difficult to say. But I am not impressed with semaglutide, I am scared of it, and that fear actually grows worse each year my patients take it to the point where they are actually self harming yet do not care, which returns back to the original problem we never fixed at the “Root Cause” lack of self love causing lack of self discipline. My patients that love themselves want to give their body the best, and the ones that hate themselves are constantly on the “Struggle Bus” with the latest stupid fad which Semaglutide is, until it gets proven as dangerous as I have seen it. Even worse is Tirzepatide. That has caused some of the most dangerous lab abnormalities I have ever seen in my career.
I have never seen an estrogen of 3000 in a non pregnant woman that does not have cancer until I met someone on Tirzepatide.
NATUROPATHIC HORMONE PRACTICE STYLE FROM BASTYR
As a graduate of Basyr University, my methods are quite different than the Naturopathic college teaches here and are referred to as “Old School Naturopathy,” “Functional Medicine” or “Traditional Herbalism” and I understand that can feel frustrating for patients seeking a quick fix. Instead of giving you expensive IV’s for the rest of your life, and thousands of dollars in pills and teas to take forever, my goal is to teach you about the fuel, foods, herbs, and supplements that are best to support your body for optimal health. I firmly believe in our Naturopathic rules to “Treat the Cause,” “Remove the Obstacle to Cure,” “Doctor as Teacher, and “Stimulate the Vis” or the Vital Force Energetically in your body.
Once I have worked my way out of a job helping you feel AMAZING without a bunch of expensive IV’s and fads I feel are utter garbage in Arizona, is when I feel the proudest as a doctor. I am addicted to that sense of joy when my patient tells me that I fixed something every other doctor failed to do. While some of my patients need to continue with “Hormone Maintenance” visits to be optimal, half of my new patients eventually have their cases solved and do not need any supplements, or can continue their supplements and only follow up if something has changed.
So unlike the Chiropractor I once worked for that needed his patients to follow a Mon/Wed/Fri adjustment schedule for the rest of their lives to pad his pocket, and actually told me to stop fixing his “bread and butter patients” before I left his practice, that is not what I do and I see that type of medical model as a failure on the doctor’s part to provide adequate solutions. Yes certain situations like thyroid disease and menopause, holistic psychiatry, etc will need ongoing support and I cannot “cure” those things to the point you don’t need hormones.
I DON’T HAVE INSURANCE CAN YOU HELP ME?
YES and NO. Sometimes it is not a good idea for new patients without insurance to enroll because I cannot diagnose hormone imbalance without a ton of introductory labs to diagnose and solve your symptoms. Once I know what hormones are off then we are just spot checking after that.
Please do not enroll in my practice if you do not have insurance and it is unaffordable for you to see me and get your labs done properly especially if you are a thyroid patient, perimenopausal, or menopausal I will need to check things every 3 months the first year and every 6 months or as needed after. I cannot prescribe natural (BHRT) hormones, natural thyroid hormones, and certain medications without labs. Most of my women’s health, and Holistic Dermatology specialties require blood labs at minimum and sometimes Naturopathic Specialty Functional Medicine labs for me to get to the “Root Cause” of symptoms. I follow “Best Practice” hormone prescribing guidelines so patients without insurance generally are generally not a good fit, although many of my patients do not have insurance and say it saves them money working with me than going to a bunch of specialists since I am treating them as a “Whole Person” and not just giving something for each symptom. I have heard of patients telling me it cost them $10,000-$30,000 in hospital visits and stays until I was able to problem solve things for them. So it may be more affordable than most people think since we charge a flat rate for my time. However, if you are not able to do what I deem as safe with your labs and follow up then I am going to discontinue the hormone treatment as the safer option than not properly monitoring it.
HOW WILL I KNOW HOW MUCH MY HORMONE LABS WILL COST?
If you do not have insurance and want hormone or functional medicine testing please submit the above application first to make sure you will be accepted. Once you have been accepted we will need you to fill out the Naturopathic paperwork above to give you an estimate on labs as most people are on a budget. If you do not care about your budget you are free to enroll so long as you understand that most cash labs for new patients do cost around $1000+ to get answers or more if the symptoms are super complicated. Once I have “solved the puzzle” follow up labs are around $200-$500 but that is depending on the patient’s symptoms, diagnosis, hormones they are taking, age, and overall health condition.
MY HORMONE LAB EOB IS $2000! YOU SAID LABS ARE COVERED?
EOB's ARE NOT BILLS: They are emails or paper statements informing you they are billing your insurance to prevent fraud in the event someone went to the lab with your insurance card. Hormone lab testing may look very expensive upon receiving your first EOB or "Estimate of Benefits" until your insurance adjusts the lab's bill with their allowed amount. Most of my patients with decent insurance have their labs covered per their insurance plan. For instance, I recently went to my doctor who ordered $3200 worth of labs. I got a scary EOB email but the final bill from labcorp was $12.96. So please do not freak out over an EOB.
Patients with high deductibles usually end up having to pay the most around $100-200 dollars or whatever the "contracted price is" toward their deductible. I have never seen a patient in my practice with insurance receive an actual bill from the lab for $2000 unless the diagnostic codes are missing, or the patient failed to give the lab their insurance card, or update a new card.
The worst case of hormone labs not being paid with a HUGE BILL that was very abnormal was when a patient got shifted to Medicare and just assumed that the lab had it on file. It literally took TWO MONTHS and a team of 5 people between me and the lab to fix this patient error, until we finally figured out her insurance was old and not updated. Rest assured if I don’t think your labs will be covered I will tell you ahead of time so you don’t hate me. That is why I do not accept Medicare and Medicaid patients because I already know they will get huge bills they cannot afford. Most normal insurance policies should cover your hormone testing “per your plan” as long as I have adequate diagnostic codes to support medical necessity.
DIY HORMONE LAB INSURANCE FIX: Please do a quick DIY on your BILL if you received an actual thousand dollar BILL, not an EOB, but an actual bill FROM Labcorp or Sonora Quest. I will not take the time to discuss theoretical bills you have not yet received.
I have ordered the same hormone lab panels for years and only heard of a thousand dollar bill when one of the following issues occurred.
Please call your lab first and go through my lab error check list:
#1 The phlebotomist did not enter the diagnostic codes on the lab slip and forgot.
#2 The patient did not give the lab their new or existing insurance card. The lab did not enter the new information into their system about the patient’s insurance. Confirm what insurance they are trying to bill.
#3 Check they are billing the correct plan. I have had patients give the lab their old insurance card and that was the cause of the huge bill. This is something no doctor can problem solve, our office does not keep your insurance card on file and plans also change annually.
#4 The patient got their blood drawn but did not follow up with a doctor’s appointment: Doctors must make visit notes in the event insurance challenges the medical necessity of the testing. Recent visit notes either right before your labs or immediately after with the doctor are required to get your hormones covered per most plans. If you have not followed up with me, then I do not have the legal documentation to make your labs medically necessary should they request that.
SHOULD MY MALE FAMILY DOCTOR ORDER MY FEMALE HORMONE LABS FOR YOU?
No. Please listen to the 50 year old female hormone doctor and just stop trying to problem solve my job I have been doing for nearly 20 years by re-inventing the wheel. This just makes it harder for me to help you. Furthermore, I worked for two dozen male family doctors for eight years. None of them I would trust to fill out a proper hormone labslip or conduct my hormone labs. They are good doctors, but not at what I specialize in. Furthermore, they admittedly do not understand what I do. Most of the MD's I am friends with hand my patient's packet of hormone tests right back to them and say to talk to me about it. My OBgyn literally told me she refuses to even look at it with them because she does not have time, and does not understand half of my Naturopathic hormone tests. So if the MD's don't understand it why should anyone ask them to order it?
Yes, the MD's I worked for were excellent doctors yet they were clueless about nutrition, vitamins, minerals, thyroid and female hormones. So to even contemplate them ordering my Naturopathic women's health labs truly horrifies me. Please just stop them from botching your labs into an oblivion and then cause them to be repeated and just take my labslip straight to Sonora Quest or Labcorp if your insurance requires.
While I loved the doctors I worked for, they were NOT trained in any adrenal testing, vitamin or mineral testing. So whatever you get out of them will be the wrong version of the test, or half the information I need and lack the complete hormones profile I use to assess women. Hormones and vitami testing is actually super complicated and there are 2-3 options to choose from with each test name if not more. The option on my labslip is what I need to help women, so when that is not provided to me, my hands are tied and I cannot diagnose or provide hormones treatment.
Therefore this is dangerous for the patient, while extremely time consuming, annoying, and frustrating for the hormone doctor to receive half the information they need. I just see women mad at me that I cannot help them or properly adjust their hormones off the sloppy testing crap their MD botched to an oblivion. This is the MOST DANGEROUS thing that women can do when taking hormones. Please only have your prescribing hormones doctor order your labs for your own safety, I do not accept outside hormone labs. I only will doctor patients with labs I ordered from a lab I trust.
Please only have the specialist that knows how their own specialty testing works order your labs. Every hormones doctor is different as well. I have only one time in my 20 years of hormones testing seen a panel from another Naturopathic that was as complete as I require to get answers and solve that puzzle! :)
READY TO TAKE CHARGE OF YOUR HORMONES?
If you have symptoms of hormone imbalance it is important to take charge of your health today and submit your Naturopathic application to get started on the path of feeling amazing!
Menopause has been a passion for Dr. Sundene since 1999 when her medical career first began. Her first doctor specialized in Women’s Hormones for Menopause, Pain and Osteoporosis. As a result, Dr. Sundene has an integrated hormone approach to bioidentical hormone replacement therapy (BHRT). While Premarin/Prempro were commonly used as the #1 choice for HRT over 20 years ago to treat menopausal patients, women now have much better and safer options.
Dr. Sundene believes the safest and most efficacious options for women are via Bioidentical creams, troches, lozenges, pellets, capsules and patches
PCOS, PMS, Hormonal Acne, PMDD (Severe PMS) are frustrating women’s health hormone conditions that can adversely impact women on physical and mental planes. Imbalanced hormones can cause moodiness, fatigue, bloating, weight gain, frequent crying, anger, depression, sadness and insomnia. Addressing these conditions with Naturopathy using a Mind-Body-Spirit perspective can help women take charge of their menstrual cycle rather than feeling like a victim of it. A Naturopathic approach using Eastern medicine along with the metrics of lab testing with Western medicine can be of great benefit for patients with these frustrating hormone conditions.
Many women do not get help with their acne from a regular Dermatologist because their acne is hormonal. By testing female hormones in the proper hormonal acne window, we can learn what hormones are truly triggering acne and work to balance the hormones to improve the skin. We also use our nutritional program to reduce inflammation to the skin, improve hormone balance, and increase antioxidants to the skin to aid reduction of scarring and speed the healing process of acne lesions.
Painful periods, heavy cramps, heavy bleeding, anemia, endometriosis, ovarian cysts, fibroids, uterine cysts, uterine pelvic congestion syndrome, and adenomyosis are painful female uterine conditions that are generally caused by hormone imbalance and can be corrected with Naturopathy. Changes to diet, nutrition, herbs and bioidentical hormones can be implemented to address these common and often very painful female conditions. Did you know that an anesthesiologist I know says period cramps are the worst 10/10 pain that most people can experience? They conducted a study and found that many women are struggling with a 10/10 level of pain while trying to survive their day.
While periods are annoying and messy they should not have to be super painful and life disrupting. By working testing your hormone panel to understand which female hormones or other hormones are out of balance, and reducing inflammation with nutrition and herbal medicine women should be able to have a normal period after a few cycles in order to be able to just be "annoyed" about their period rather than having their lives disrupted.
Giving women their lives back by correcting hormone imbalance and either fixing a missing or irregular period, or fixing painful cramps and heavy abnormal bleeding is one of my favorite things I do as a Naturopathic Women's Health Doctor! Women should not have to be miserable, bloated, moody, and exhausted and in pain. We must stop normalizing these symptoms and understand that I see all of them as a red flag your body is waving that something is not quite right.
With blood hormone labs timed correctly in a woman's cycle we can work together to improve painful horrible periods. Did you know I have actually seen women reverse their fibroids, ovarian cysts, heavy bleeding, and even endometriosis?
While I cannot help all women with this, as it does require some work with nutrition changes, herbal medicine and occasional natural hormones... the women that want to use my Naturopathic methods generally achieve success in about 1-3 cycles.
Keep in mind when using natural methods that are not birth control pills or surgery we are going to need to let the imbalanced eggs still being made right now to "clear" your system which will take 3 months. By month 3 most of my abnormal period cases are resolved and I have worked my way out of a job. Some of my patients do improve sooner and resolve things like bad cramps in just a month by following my nutrition program to reduce inflammation and balance hormones. Although some women with more severe hormone imbalance or larger cysts, fibroids, and ovarian cysts will require natural treatment for 3-6 months typically.
Bladder symptoms, bladder pain, frequent urination, night time urination, chronic yeast infections, and vaginitis are an area of expertise for me as a Women’s Health Doctor.
Bladder pain in women, anemia and menopause were pretty much the ONLY times the MD’s I worked for over an eight year period would get desperate enough to ask the Naturopathic student for an herbal remedy to help their female patients sitting in the exam room demanding answers. Of course this would make me laugh because they would always tell me I should “Go to regular medical school and be a real doctor.” :C…..
Once they would watch my herbal medicine magic work with their own patient they became believers in Corn Silk tea for bladder pain!
I would pass out my “Corn Silk Tea for Bladder Pain” recipe to them like candy, and was always happy to see the shocked look on their face when they reported to me that my weird herbal medicine recipe is actually helping their patient not be in pain and feel like they have to pee all the time! Yay Herbal Medicine was powerful enough to open the eyes of even the most stubborn MD’s that I worked for that liked me, but hated that I was in Naturopathic school.
The recipe that is 100% free for all women on my blog to have access to is gentle yet powerful and works to coat the angry, irritated bladder lining with Hyaluronic Acid and glycoasminoglycans, or the “Mucilaginous layer” that can be damaged by inflammation, post bladder infection, taking antibiotics, surgery, bladder food triggers, and hormone imbalance.
The problem with bladder pain in conventional medicine, is that every MD asking for my help had a patient demanding answers, yet already knew that there was no real solution to bladder pain other than doing Kegels that they had to offer or would just refer women to a Urologist.
Naturopathic approach to these frustrating Women’s Health conditions as there is often an imbalance in the microbiome, nutritional and hormonal system which integrated medicine addresses beautifully to help treat the condition at the root cause. Recurrent Vaginal Yeast Infections, Vaginitis, BV, Lichen Sclerosus, Herpes, HPV are common conditions women can expect improvement with by utilizing Naturopathic Medicine. While we cannot necessarily cure some of these issues we can understand the triggers, reduce inflammation with nutrition changes and use hormone testing and hormone balancing therapies to make this sensitive skin of our private parts less prone to have a flare up.
Bladder Incontinence, Interstitial Cystitis or (IC), Nightime Urination (Nocturia) blood in the urine, and Recurring Bladder Infections are some of my favorite things to help women with as a Naturopathic Women’s Health Doctor as they are interrelated with healthy hormones and healthy nutrition. It is common for women to see changes with their female anatomy as they transition through their reproductive years to Perimenopause and Menopause.
Vaginal Dryness, low libido, and painful intercourse are caused by hormone changes with Menopause and Perimenopause are very common female issues that can be addressed with Naturopathy and natural hormone balancing techniques.
“It is important to me as a Women’s Health doctor that women feel comfortable discussing their private health concerns with me. While it is normal for women to have a yeast infection or bladder infection on occasion. It is not normal if it is constantly happening, that is when I need to put on my detective cap and figure out what is causing the chronic symptoms. Just think of me like a car mechanic for your vagina or bladder symptoms. Write down a list of all the symptoms so if you get nervous you can just give the lists to the “mechanic” so she can fix them.
When I was a young woman, I was terrified to talk to my doctor about these subjects. Women should not live in fear of talking to their doctors about their private parts, as this is what most doctors do all day long. We have heard it all. Please just ask your doctor for help, or go to a female doctor that specializes in women’s health and talks about nothing but bladders, hormones and vaginas all day, if that makes you feel more comfortable discussing your recurrent bladder or vaginal issues. ”
-Dr. Nicole Sundene, NMD
Hormones are natural chemicals that are secreted by glands in the body. These chemicals control most bodily functions and processes, including metabolism, muscle formation, immune functions, and reproduction. Bioidentical Hormones are synthesized from vegetable sources and are molecularly identical to the same hormones made in a woman’s body. Synthetic hormones such as premarin, prempro and progestins in oral contraceptives have hormone-like actions, but are not structurally identical to a woman’s own natural hormones.
Synthetic female hormones are not the same from a biochemistry standpoint but may mimic the action of natural hormones. Proper hormone balance with a woman’s own natural hormones is important for the physical, emotional, and mental wellbeing.
The fast pace and stressful nature of life these days have resulted in an increase in the rate of hormonal imbalances, especially among women. Even a slight imbalance of hormones can have a big impact on the health and wellbeing of a person, leading to several health issues.
This is where Bioidentical hormone therapies come in.
Also known as natural hormone therapy, the process involves using human-made hormones that are synthesized from plant extracts. They react with the body in a similar way to most natural hormones, such as estrogen, testosterone, and progesterone. These hormones come in several forms, such as pills and injections, and are 100% FDA approved.
Women taking hormones or utilizing Naturopathy for hormone imbalance should have their hormones tested periodically.
Dr. Nicole Sundene is the author of "The Hormonal Acne Diet" and combines 30 years of integrated health experience for women with her nearly 20 years of experience as a Naturopathic Women's Health Doctor to provide first-rate focused care for women. As a Naturopathic expert in women’s health she addresses all aspects of women’s health both in clinic and via telemedicine. She provides complex integrated medical care, as well as preventive care, for chronic and acute women’s health conditions.
Dr. Sundene believes that optimal health leads to a more successful and satisfying life. Her Bioidentical Hormone Therapy treatments are targeted to improve energy levels, ensure optimal nutrition, strengthen the immune system, and enhance the overall physical and mental health of her female hormone patients.
