"I will confess," admitted Marsha Nunley, MD.
"I did become my own doctor."
"I tried all the different ways to do hormones. I think I've tried every protocol that there is, and I finally found the one that was right for me and started down that path."
"I think many physicians that get into this—that's how they get there," she added, referring to the field of functional medicine. "They don't feel well."
"Or they look at their patients and they think 'I don't know what to do for these people that come in.'"
"Not to put my colleagues down. They don't know. They're not trained . . . They don't know what to do with you, so they give you the antidepressants and move you down the road."
* * *
The effort to understand her own symptoms led Dr Nunley to become a specialist in bioidentical hormone replacement, which involves the prescription of hormones that are identical to those produced in the human body.
The subject isn't taught in medical school. At the beginning of Dr Nunley's journey, there was only one week-long functional medicine course available.
"It was a whole different world and it did start me down a path. It is truly like doing another residency because it's very different--and looking at the body from a different perspective. In traditional medicine, it's sort of like 'one problem, one drug.' This was a whole different way of thinking and really did require a great deal of study to do this."
Suzanne Somers commented that she's shocked at how many of her peers are on "the menopause cocktail" of regular antidepressants, sleeping pills and diuretics. Yet the fewer foreign molecules (such as those in many prescription and over-the-counter drugs) we allow into our bodies, the better our chances of thriving and surviving.
Dr Nunley agreed that there's "far too much thinking that drugs are benign. Nothing occurs in a vacuum. If that drug interferes with a biochemical pathway, it's going to impact other areas."
"I'm sure that's part of your teaching with your patients," Suzanne Somers remarked. "What I love about functional medicine, integrative medicine, alternative medicine is the way the patient and the doctor work together. The more educated a patient is, the easier it is for you. You don't have to start in kindergarten."
After helping her patients restore their hormones to optimal levels, gut-diet-lifestyle is the next area that Dr Nunley addresses. "You will definitely feel better with the hormones, but you will not restore your health with hormones alone," she cautioned. "You must change your diet and lifestyle."
Suzanne Somers noted that bloating is a common complaint voiced by perimenopausal women. Dr Nunley recommends that those who experience chronic bloating eat organic food and try eliminating gluten and dairy products. If one is going to eat meat, one needs to consume grass-fed, pasture-raised beef and poultry. Stopping the input of toxins is big, in Dr Nunley's eyes. Depending upon what one has been putting into one's body for years, there may be a need for digestive enzymes and healing supplements for the gut.
"You can't keep eating pizza and Pop tarts," Dr Nunley remarked. "You really must make those changes in order to get a healthy gut and that may mean supplements (enzymes) because as we get older and stuff happens, we don't make the enzymes, and the intrinsic factors to absorb B12."
The top five supplements recommended by Dr Nunley include vitamin D3, omega 3 fatty acids, B vitamins, minerals, and antioxidants (particularly CoQ10, vitamin C, alpha-lipoic acid). For those who have been prescribed bioidentical hormones, she recommends adding vitamins A, E and K, and iodine.
To obtain optimal 25-hydroxyvitamin D levels of at least 50 ng/mL, Dr Nunley suggests supplementing with 5,000 to 10,000 international units (IU) vitamin D3. However, it is first necessary to test for serum levels of 25-hydroxyvitamin D. "Thirty [ng/mL] might be adequate, but 30 is not optimal," she advised. "Vitamin D is not just a vitamin, it's a hormone, and it's incredibly important for healthy neurological function, cancer prevention, etc."
Vitamin D is important for brain, bones, heart, gut, endocrine system, muscles, hormones, "everything," Dr Nunley asserted. "I can't emphasize enough the importance of vitamin D."
On the subject of iodine, Suzanne Somers observed that there's research that links iodine deficiency to an increased risk of breast cancer. "What's the big deal--one little tablet you take every day," she noted. "In today's world, in order to thrive and survive, we need to take at least these basic supplements."
Dr Nunley agrees. Using supplements isn't the same as taking a pill that makes your pain go away. People don't realize that it can take months to years to recover from environmental insults and that supplements "absolutely" make a difference in the long term. There are a number of studies that confirm this, although few long term randomized, controlled trials have been conducted in this area.
Suzanne Somers brought up the topic of Alzheimer's disease. She noted that a leaky gut can allow toxins into the bloodstream that lodge in fat, which the brain has in abundance. "You're losing thoughts because your brain is not operating at peak," she suggested.
Detoxification regimens could be of help, but the first step is to prevent toxins from entering the body, Dr Nunley explained. According to researcher Dale Bredesen, MD, of the Buck Institute for Research on Aging, there are three types of Alzheimer's disease: type 1 (inflammatory), type 2 (non‐inflammatory or atrophic, referring to a loss of hormones that promote growth), and type 3 (cortical). In a recent paper published in the journal Aging, he reported that type 3 disease is the result of toxin exposure that is most commonly inhalational (such as mold), which leads to a chronic inflammatory response.1 There is no one factor that causes Alzheimer's disease. Even if one has a genetic factor that increases the risk of the disease, it's not inevitable that one will develop it.
Suzanne Somers asked Dr Nunley whether her patients come to her wanting to work with her to get better. Often men and women seek out medical practitioners like those in the Forever Health network when they are at their wits' ends concerning their ongoing symptoms.
"By the time patients get to me, they have exhausted their primary care doctor, their specialist—they've been to them and they have tried all that," Dr Nunley stated. "I think it was Mark Hyman that said he's a 'resort doctor'—a doctor of last resort. That's kind of what many of us are because people are going to try the regular routes to try to regain their health and then when it just doesn't happen, that's when they're ready."
"It is truly a collaboration and a lot of detective work. And the more things people have going on, the longer it takes."
"What I see when I look at you is 'ageless,'" Suzanne Somers observed. "And that's the goal, isn't it? It's not about being the youngest. There's so many great things about our ages and that, I believe, is wisdom and perspective—something no young person can buy or have. I'm just trying to say that, so younger women don't dread getting to our ages, but look forward to it, because we possess a very special gift."
"I think my life now is better than it's ever been," Dr Nunley, who is 67 years old, affirmed. "I feel better now than I did when I was in my forties."
"Everything is much better."
To learn more about Dr. Nunley, visit her profile.
- Bredesen D. Aging (Albany NY). 2016 Feb;8(2):304-13.