A Year of Naturopathic Medicine
Last October, I was exhausted.
It wasn’t quite as bad as the autumn before, when I realized that lump in my neck might be why I was able to sleep for 11 hours a night and not feel well rested the next day. I had half my thyroid removed for a smidge of cancer and was diagnosed with the autoimmune disease, Hashimoto’s thyroiditis, an underactive thyroid.
Despite my underachieving half a thyroid, I didn’t go on any thyroid medication. As micro as my microcarcinoma was, I felt much better once I recovered from my surgery. But a year later, the fatigue had crept back into my life. My thyroid levels were coming back normal from the lab, my ultrasounds were clear. But of course, there was still the endometriosis, a known cause of chronic fatigue syndrome, not to mention all the work I was putting into managing it. And you know, all the nutrients I was losing with my period each month, and I am sure half a dozen other causes of fatigue.
I had seen my endocrinologist for my yearly checkup, and she gave me my choice — I could go on synthetic thyroid hormone, or I could wait. Eventually, I’d have to. Hashimoto’s is degenerative, and that little semi-thyroid will continue to erode as I get older. Technically, though my labwork was normal, what is considered the “normal” range for thyroid hormones also includes abnormal conditions, like say, half a thyroid or Hashimoto’s. Don’t ask me what genius decided that was a good standard to go by. I remembered my surgeon telling me that women in particular often go through life feeling low-grade crappy due to an underactive thyroid that keeps spitting out “normal” results.
Still, I wasn’t wild about starting a life-long drug any sooner than I had to, and I wondered if more wasn’t going on. If my endo was better under control, would I have more energy? If I could get higher-quality sleep, maybe I’d feel better. If I could get my cycles to last longer than 24 days, spacing my periods further apart, then I wouldn’t bleed so often and maybe lose less precious iron. I started exploring adrenal fatigue, not a “medically recognized” condition, but any stressed out, type A woman in her 30s who spends every day grinding against the patriarchy will tell you that shit is real.
But I wasn’t sure what to do. At that point, I was on my third endocrinologist and could not find one who treated both the thyroid AND reproductive hormones. I was going to physical therapy, acupuncture, and massage therapy regularly. I wasn’t perfect 100 percent of the time, but I was pretty friggin’ careful about how I ate, incorporating both cycle syncing and being relentless about seed cycling. And I was exercising regularly, maybe overdoing it at times, but definitely not as much as I had in the past, being sure to incorporate regular rest days.
I thought about seeing a nutritionist, but ever the wise one, Dr. Sam DuFlo of Indigo Physiotherapy suggested I look into a naturopathic doctor whom she highly recommended. She knew I had the basics of nutrition worked out and thought I’d get more value from someone taking a more holistic approach.
Holistic! That is what I needed. If I couldn’t find an endocrinologist who would look at, well, my whole endocrine system, then I was game to try naturopathic medicine.
I went in for fatigue, but I arrived at my first appointment with a litany of complaints I wanted my doctor to try to fix. Yes, there was the precipitating factor, the fatigue, but could she also help with my PMDD? Could she lengthen that ever-shortening menstrual cycle? Could she help my skin clear? Could she help me figure out why I was carrying around an extra 10 lb despite having trained for and run a 12-mile race the month before?
I didn’t know what to expect, but I knew this doctor had her work cut out for her. No matter how many things I did to take care of myself, I wasn’t exactly thriving.
To my pleasant surprise, she didn’t seem phased.
I was used to doctors smiling sympathetically at me while shrugging and dismissing my issues as “bad luck,” “normal,” and “just life.” But this doctor was like an incredibly well-prepared, dogged detective.
We went through my health history but also covered how I felt from top to bottom. I didn’t think I had digestive problems; it wasn’t on my lengthy list of issues to talk about. Sure, I didn’t poop every day like Alisa Vitti said I should, but most foods didn’t bother me, and I wasn’t developing any lactose intolerance issues like so many of my friends as we get older.
I figured it was normal that I was bloated by the end of the day most days, especially given the existence of the dreaded “endo belly,” bloating that for some people with endo can look like an eight-month pregnancy. In comparison, my bloating wasn’t even that bad! I chalked up my particularly foul-smelling farts to my Jewish intestines. And despite what Vitti had told me, I didn’t consider myself constipated with the exception of the days leading up to my period.
But that day I learned that many of these symptoms were common with small-intestinal bacterial overgrowth (SIBO). And SIBO is *quite* common with endometriosis. The adhesions caused by endo often slow down the bowel, leading bacteria that are usually only found in the large intestine to slowly creep into the small intestine, causing vague digestive problems that could be chalked up to anything.
We also talked about gut dysbiosis, a condition in which the “bad” bacteria in the gut outnumber the “good” bacteria. I had been religiously taking a probiotic at this point, but to no avail. And from my complaints of heartburn and a physical exam, she identified that I likely had a mild hiatal hernia and did some manual manipulation on my abdomen that did indeed improve my symptoms.
Beyond digestion, we discussed sleep. I’m religious about sleep hygiene, but I never slept well. I struggled to fall asleep and I woke up a lot during the night. I never felt well-rested and we talked about the role chronic stress plays in that, maxing out cortisol and my adrenal glands.
We talked about hormones; I knew my estrogen was out of control based on my premenstrual symptoms, but I was doing everything I could think of to manage it from sweating regularly to excrete excess to seed cycling to dry brushing to promote lymphatic drainage. My doctor explained that there was more to it than just estrogen — we needed to ensure I had adequate levels of progesterone too in order balance out the estrogen. Since I was at the right time in my cycle, she took blood to test my progesterone right there.
And yes, we talked about my thyroid health. She too gave me the option to start the synthetic thyroid medication, saying it’s relatively benign but understanding if I wanted to try other options before embarking on a new drug for life.
I left impressed and excited with a completely new plan. I had lab orders for a number of blood tests, including a full hormone workup — something no doctor had ever ordered for me, despite the fact that almost my major health issues (endometriosis, PMDD, thyroid cancer, blood clot) were ALL tied to hormones in one way or another. I also had kits to complete a SIBO test and a GI mapping test to learn more about the bacteria in my gut.
I had a new supplement regimen as well, including melatonin nightly. The doctor had research that showed an improvement in endometriosis symptoms with regular melatonin, and this simple new regimen immediately improved my fatigue. I still felt fatigued leading up to my period and during it, but I was no longer dragging ass every single day regardless of where I was in my cycle. I also switched some of the supplements I was already taking, like multivitamins and fish oil, to more high-quality brands and began to take a supplement to support my adrenal glands, also giving me an energy boost.
And although this was a lot, I appreciated that my doctor was cognizant of the cost, working with me to layer in different interventions, both to see what worked and what didn’t, but also to spread out the costs and figure out how to get the most bang for my buck. This is huge considering insurance will not cover naturopathic medicine.
Some real bullshit if you ask me, since I can only count on one hand the number of MDs I’ve seen in my life who were that thorough and knowledgeable. And I’ve seen a lot of MDs.
It turns out I did have SIBO. I also had gut dysbiosis. And with an herbal tincture (made of extracts from common foods like garlic, raspberry, and shiitake, among others!) followed up by something as simple as oregano oil (a natural antibiotic), I learned what it felt like to *actually* have normal digestion. Suddenly I no longer wondered why I desperately wanted to unbutton my pants after lunch when the waist had been loose in the morning. Alisa Vitti would have been proud of me — morning poops like a champ, even before coffee! Even my running improved; I no longer had the unenviable experience of running with what felt like both a full and empty stomach, twisted in knots for no apparent reason.
I learned more from the blood tests too. My cortisol levels were too low in the morning, indicating they were too high the rest of the time, a sign of uncontrolled, high stress. My progesterone wasn’t high enough to balance out my estrogen. My iron levels were “normal,” but lower than optimal, according to my doctor. I wasn’t quite anemic, but I could use more iron in my diet. As predicted, my thyroid levels were “normal” too, but not optimal.
Over the following months, we continued to work on these things. Once my gut was reset following the course of oregano oil, I started adding supplementary fiber to “feed” the good bacteria and optimize my health. My skin cleared up. My energy improved. I shed the stubborn extra 10 lb that had come out of nowhere.
This is not to make it sound like naturopathic medicine has solved all my problems within a year. Now that we’ve tackled the big picture stuff, like the gut, which is apparently the root of all potential evil, we’ve focused in on the issues still bothering me — pain during my periods, PMDD symptoms, and fatigue close to my period. We’re focusing on boosting my progesterone and clearing out that excess estrogen.
And she’s been there for smaller questions too — like how do get this swelling down when these apeshit mosquitoes chew up my ankles? Should I ask my acupuncturist about XYZ? Can I get away with topical antibiotics for this or should I take oral antibiotics?
In general, I think there’s a place for alternative and complementary medicine and it’s right beside traditional, Western medicine. Where does naturopathic medicine fall? In my experience, with this particular doctor, right in the middle. She has the same training as a regular MD and specializes in thyroid and women’s health — meaning she’s the perfect doctor for me, especially when no “traditional” endocrinologist that I can find will treat both sets of hormones at the same time.
It’s time for insurance companies to start covering naturopathic medicine too. This is higher-quality care than I’ve received from doctors who are covered, whether in-network or out. American insurance supports the current Western model of medicine, which is becoming increasingly hyper-specialized. The fact of the matter is thyroid hormones and estrogen are part of the same system; it’s absurd I cant find a doctor who can/will treat both, looking at the full picture. The fact that years ago, my gynecologist did not know how to treat endometriosis, a gynecological disease that affects the whole body, is also a function of this — she was trained only to dole out birth control, perform well-woman exams with Pap smears, and deliver babies.
What I learned in the past year of working with a naturopathic doctor is the culmination of where my health journey’s been leading me all along — holistic care is superior care. Digestion matters because if it’s slow, I’m not excreting estrogen quickly enough. If I don’t excrete estrogen quickly enough, I experience horrible PMDD symptoms. My skin breaks out and my mood teeters precariously between rage and depression. I comfort eat, usually some kind of sugar, which makes me feel worse and negatively affects my full endocrine system, including my thyroid. I could go on with further examples of how the body is a whole made up of parts that interact, rendering hyperfocused care less useful, but I won’t.
The point is, I’m not a walking uterus, a floating thyroid, or sentient bowel (lol). I’m a whole person with whole-person needs and I found this kind of care with naturopathic medicine. I realize this is starting to sound a little bit like an infomercial, and I know naturopathic medicine isn’t for everyone. I also know the quality of my doctor is because she’s a great doctor, not merely because she’s a naturopathic doctor. But I’ve learned so much about my body through this experience and am continuing to learn more every day. So if you were curious about naturopathic medicine, I’d definitely encourage you to go for it.
Have you seen a naturopathic doctor? What were your experiences? Let me know in the comments or on Instagram!
xo,
S
