Hormone Replacement Therapy (HRT) and Bioidentical Hormone Replacement Therapy (BHRT) are potent tools for managing peri- and postmenopausal symptoms. However, navigating the complexities of HRT can be daunting. This article discusses how partnering closely with your provider at PIM ensures a personalized and effective approach to your HRT experience.

Building a Strong Foundation: Screening Exams

Before starting HRT, your PIM provider will conduct a thorough review of your medical history. This includes screening exams to assess your overall health and identify any potential risk factors or contraindications to HRT and BHRT. These exams may involve blood tests to check hormone levels, mammograms, PAP tests, colorectal screenings, and tests for underlying conditions like diabetes or high blood pressure. Unlike many hormone clinics that focus solely on hormone management, your PIM provider will address and manage any health concerns that may pose risks with HRT use.

Tailored Solutions: Individualized Plans

Your HRT journey should be uniquely yours. Your provider will discuss various HRT options, including formulations (pills, patches, gels, and/or injections) and types of bioidentical hormones (such as estrogens, progesterone, and testosterone). They will tailor a plan based on your specific symptoms, medical history, family history, and lifestyle preferences. Additionally, they will explore insurance coverage options to ensure affordability. For specific needs, compounding pharmacies can create medications customized to your preferences, including any drug sensitivities.

Finding the Right Balance: Effective Dosing

Successful HRT hinges on finding the optimal dose to alleviate symptoms while minimizing potential side effects. Your provider will typically start with a low dose and adjust it gradually based on your response. Regular monitoring and communication are crucial throughout this process. Your provider at PIM ensures easy access to them through a HIPAA-compliant platform, supporting a comfortable and well-supported treatment journey.

A Holistic Approach: Considering All Aspects of Health

HRT is not a one-size-fits-all solution. Optimizing your overall health is crucial in managing hormonal health. Your provider at PIM will recommend lifestyle modifications tailored to you, such as nutrition guidance, exercise/movement, and stress management techniques. These practices can complement HRT for a more holistic approach to well-being and enhance your response to the treatment.

Open communication with your provider at PIM is vital throughout your HRT journey and we encourage our patients ask questions and express any concerns. Together, we will craft a personalized HRT plan that effectively manages your symptoms and improves your overall health, all while keeping you safe!

Coenzyme Q10, commonly known as CoQ10 or ubiquinol, has gained popularity as a dietary supplement, especially for enhancing cardiovascular health. But what exactly is CoQ10, and how can it support our well-being? In this article, we’ll delve into the science behind CoQ10 and examine whether it deserves a place in your heart-healthy routine.

What is CoQ10?

CoQ10 is a naturally occurring substance found in all cells of the body, with the highest concentrations in vital organs like the heart, liver, kidneys, and pancreas (2). It plays a pivotal role in energy production, acting as a spark plug for our cellular engines. Additionally, CoQ10 possesses potent antioxidant properties, combating harmful free radicals that may contribute to cell damage and disease.

CoQ10 and Heart Health

Several studies suggest that CoQ10 may offer various benefits to the cardiovascular system:

1. Heart Failure: Research indicates that CoQ10 supplementation can enhance exercise capacity and improve the quality of life for individuals diagnosed with heart failure, attributed to improved energy production and antioxidant activity found in CoQ10 (2).

2. High Blood Pressure/Hypertension: Studies propose that CoQ10 may provide a modest reduction in systolic blood pressure, particularly for those with uncontrolled hypertension (3).

3. Statin Side Effects: CoQ10 may help alleviate muscle aches and fatigue, common side effects of statin drugs used to lower cholesterol.

4. Recovery after Heart Surgery: Preliminary evidence suggests that CoQ10 supplementation before and after heart surgery may improve heart function and reduce the risk of complications.

If you’re considering incorporating CoQ10 into your routine, consult your naturopathic provider at Peninsula Integrative Medicine. Dosage, form, and quality are important considerations, with recommended doses ranging between 100-300mg per day with food. Natural sources of CoQ10 include organ meats and cold-water fish like salmon, mackerel, anchovies, sardines, and herring (SMASH).

Lastly, we want to emphasize that good nutrition, regular exercise, and stress management create an important foundation in supporting overall cardiovascular wellness. The providers at Peninsula Integrative Medicine are ready to guide you in developing customized treatment plans and also help you determine if CoQ10 should be part of your daily regime!

1. Greenberg S, Frishman WH. Co-enzyme Q10: a new drug for cardiovascular disease. J Clin Pharmacol 1990;30:596-608
2. Molyneux, S. L., et al. Coenzyme Q10: an independent predictor of mortality in chronic heart failure. J Am Coll.Cardiol. 10-28-2008;52(18):1435-1441
3. Zhao D, Liang Y, Dai S, et al. Dose-response effect of coenzyme Q10 supplementation on blood pressure among patients with cardiometabolic disorders: A GRADE-assessed systematic review and meta-analysis of randomized controlled trials. Adv Nutr 2022

Have you ever experienced a lingering cold that just won’t seem to disappear? If so, you might be dealing with chronic rhinosinusitis, a troublesome inflammatory condition affecting the nasal cavity and its lining. Chronic rhinosinusitis disrupts sinus drainage, causing swelling, inflammation, and infection, leading to a range of uncomfortable symptoms. Learn more about this condition and effective treatments for it:

Section 1: The Role of Allergies in Chronic Rhinosinusitis

When nasal tissues become inflamed, it triggers an increase in immune system cells that regulate inflammation, including T helper type 2 cells, cytokines, interleukin-5, and interleukin-13. Additionally, there are often elevated levels of histamines and increased allergic sensitivity to Staphylococcus aureus (Staph). While Staph is a normal component of the human nares, in chronic rhinosinusitis, the body treats it as a foreign invader, causing inflammation and related symptoms.

Section 2: Addressing Chronic Rhinosinusitis

To effectively manage chronic rhinosinusitis, it’s crucial to obtain a proper diagnosis from your healthcare provider and tackle the underlying cause, often inflammation. Additionally, focusing on gut health can help reduce the overall inflammatory burden. Incorporate more fresh fruits, vegetables, whole grains, and fiber into your diet. These foods are rich in antioxidants and vitamins that aid in the body’s recovery and healing process. Fiber assists in binding with toxins and facilitating their elimination. Adequate sleep, with 8 to 10 hours each night, is also essential during this period.

Section 3: Nutraceuticals, Pharmaceuticals, and Natural Treatments

Once you’ve addressed the basics of health, consider using specific nutraceuticals and pharmaceuticals as needed. An effective natural treatment for chronic rhinosinusitis is contrast hydrotherapy, involving warm compresses followed by cool washcloths. You can perform this procedure two to three times a day. Steam inhalation with essential oils like thyme, followed by nasal irrigation using a Neti pot, nasal irrigation syringe, or squeeze bottle, can help break up bacterial biofilms and eliminate them from the body.

Individualized Herbal Medicine and Homeopathy

Individualized herbal medicine and homeopathy can be valuable in managing chronic rhinosinusitis. Discuss these options with your naturopathic provider, who can guide the right form and dosage of medicine.

When to Seek Professional Help

If at-home treatments prove ineffective, your symptoms worsen, or your individual needs are not met, it’s advisable to consult a healthcare provider at Peninsula Integrative Medicine. They can assist you in developing a personalized treatment plan that suits your specific needs.

What does the gut have to do with cancer?

Dr. John Bastyr, a legend in the naturopathic field, taught that treating the gut was the foundation for preventing and addressing cancer. Flash-forward more than 30 years and the research shows that the gut relationship with cancer and immunity, once considered heresy, is a well-demonstrated function of human physiology.

The bacteria in one’s gut can affect it’s host’s immunity and this growing body of knowledge continues to underscore the importance of the gut biome, immune system function, and cancer. i,ii


The evidence is mature enough to suggest that managing gut flora and function should translate to value for cancer survivors as well, but no silver bullet has been identified. Probiotics have been shown to be effective in maintaining gut flora and should be used with caution since some have been found to contain pathogens and have resulted in documented deaths in immune-compromised patients. We always run laboratory microbial testing for patients to ensure the probiotics we recommend fit their needs.

Generally speaking, the approach of integrative oncology is to restore gut function to as normal as possible. Given the negative effects of stress, anxiety, and some treatments on the gut function of cancer patients, we approach this with a comprehensive review of your whole health. We then address the issues that can affect the gut biome such as gas, bloating, burping, indigestion, reflux/GERD, heartburn, constipation, diarrhea, etc. We also evaluate how well you absorb nutrients and how your elimination is working.


We address these with botanical remedies, carefully selected digestive enzymes, and other targeted therapies that help to decrease inflammation in the gut, bolster the microbiome and improve overall function. We also frequently help with nutrition, diet, and stress management, including mind-body approaches and therapy, to ensure we achieve the best results possible.

As the research continues to evolve, so will the specific treatments we use in integrative oncology, and we’ll be ready to assist you on your journey.

Morgan Schuster, ND

i. Jin, Y., Dong, H., Xia, L., Yang, Y., Zhu, Y., Shen, Y., . . . Lu, S. (2019). The diversity of gut microbiome is associated with favorable responses to anti-PD-1 immunotherapy in Chinese non-small cell lung cancer patients. Journal of Thoracic Oncology. doi:10.1016/j.jtho.2019.04.007 ii Bai, J., Behera, M., & Bruner, D. W. (2017).

ii. The gut microbiome, symptoms, and targeted interventions in children with cancer: A systematic review. Supportive Care in Cancer,26(2), 427-439. doi:10.1007/s00520-017-3982-3