As long as I can remember, I have had a holistic approach to health care and a strong belief that many of the chronic illnesses we see in today's society could be avoided with proper nutrition, the correct supplementation and lifestyle modification. Nutrition, optimal health and weight control have been of central importance in my life. For this reason, I went into public health before attending medical school. I believed this path would provide me with the information and experience I needed to practice preventive medicine. Furthermore, I wanted to be well versed in the basic scientific knowledge and thought an M.D. would supply me with this. However, in medical school I was told there was no literature that supported most of my beliefs. Now I know we do have the literature that supports my strong beliefs, I just did not have access to it.
I graduated from UC Davis School of Medicine with the honor of "The Most Outstanding Student in Family Practice"; attended a residency in family practice in Santa Rosa, CA and returned to my home town of Watsonville, CA. When I started practicing medicine in Watsonville in 1996 I was one of few female family practitioners. At that time, many women came to me suffering from the "one pill fits all" approach to menopause. In order to fill my patient's needs and to fully understand what was going on with them, I had to learn the different approaches to menopause that encompassed complementary-alternative medicine and bio-identical hormone replacement on my own. As part of the work-up for menopause, I checked thyroid levels and started diagnosing subclinical hypothyroidism. This led me to research thyroid disease and all the different approaches to its treatment. So I took more courses and read more books on thyroid.
After I had balanced thyroid and menopausal hormones, some women still had issues unresolved by thyroid and female hormone replacement. Pushing on to figure out what was missing and how to best address my patient's symptoms led me to research adrenal dysfunction (aka adrenal fatigue), a diagnosis that conventional medicine still doesn't recognize or accept and which is in large part a result of our stressful lifestyles. Pursuing this put my practice into another realm. I started doing things that were a little outside the medical model. The extra time I was spending learning on my own was still not enough to address menopausal women's concerns about "the change" as well as how to live healthier and happier lives. I was becoming stressed and frustrated with our health care system and suffering from burn-out myself.
By this time I had spent years attempting to practice medicine with a holistic approach while working at non-profit clinics and in private practice clinics. I had enrolled in as many courses as I could on nutrition, hormone replacement and complementary medicine while working full-time. I incorporated what I was learning into my everyday practice. This was extremely difficult given the time constraint of 15 minute appointments and the mindset of today's conventional medical model. Too often, it would attribute my patient's symptoms to being "all in their head." I felt I was mostly putting a band-aid on patients rather than working on how to prevent the illness in the first place. Meanwhile the Women's Health Initiative study was released, and we all had to deal with patient concerns and the aftermath of being told we had to stop all hormone replacement!
Consequently, I quit my job as Medical Director of a large non-profit and decided to devote my time to learning more about preventive medicine. I enrolled in a fellowship in functional and anti-aging medicine, and then started my own private practice. The fellowship has provided me with the scientific research on bio-identical hormone replacement, detoxification, adrenal health, neurotransmitters and the field of nutragenomics which states we can change our gene expression based on nutrition and lifestyle. Further, it introduced me to the field of functional medicine. I feel this has helped me bridge the gap that I have so desperately tried to bridge on my own for the last 15 years. I feel blessed to have patients that have tested the limits of my knowledge and encouraged me to continue to pursue my education. There is still a lot I do not know and I look forward to continuing to learn and expanding my horizons.
Today I have the good fortune to teach in the fellowship at Metabolic Medical Institute (MMI); a Master's degree program at the Morsani School of Medicine, University of South Florida. I am also faculty at the Institute for Functional Medicine (IFM). Additionally, I am excited to say that I am currently very active in developing teaching programs in Functional Medicine in the USA, Latin America and Europe! You can find my work published in the Townsend Letter, Guide to Anti-Aging & Regenerative Medicine, Saude Actual and the Border Health Journal, among others.
Currently my clinical emphasis is on each patient's individual risk and addressing that in order to prevent disease. I especially enjoy “connecting the dots” between patient’s complaints and exam to find the root cause of their illness or dysfunction. This includes paying particular attention to a patient's family history, exposures, lifestyle habits and health issues in order to prevent or treat illnesses. This can be in the context of a chronic condition such as hypercholesterolemia, arthritis, eczema or in attempting to address a woman's menopausal symptoms or weight concerns. I love working with women and providing bio-identical hormone replacement, and also enjoy addressing the body as a whole and being able to treat most health problems for men and women.
My Areas of Special Interest
Personalized Medicine: Individualizing care based on family and personal history, lifestyle, and behavior, (including stress management), psychospiritual factors can avoid many illnesses. A lot of diseases are manifested through behavior. That is, even though you have a predisposition for some illness it may not be expressed unless you participate in certain behaviors or lifestyle choices. Furthermore, there are many ways men and women can live healthier, happier and more productive lives.
Women's Health: Addressing the menopause, the perimenopause, Pre-Menstrual Syndrome (PMS), breast health, and osteoporosis both naturally as well as with bio-identical hormones.
Men's Health: Including andropause, osteoporosis prevention and available treatment options for aging concerns.
Optimizing Vitality and Longevity: Focusing on nutrition, metabolism, lifestyle and hormone balancing in order to prevent conditions associated with aging.
Nutrigenomics: Nutritional Influences on illness. We cannot change our genes. However, with individualized nutrition based on each person's unique biochemical individuality, it is possible to change how genes are expressed.
Weight Loss: A natural, science based approach without the use of chemicals or stimulants. This is individualized for each patient depending on their Bio-Impedance Analysis results.
Townsend Letter - October 2015: "Your Mood's Micromanager."
Townsend Letter - January 2014: "The Continuum of Insulin Resistance."
Townsend Letter - December 2013: "The Next Longevity Revolution: Estrogen Metabolism in Men."
Townsend Letter - December 2014: "Adrenal Dysfunction."
The Official Anti-Aging Revolution: A Physician's/Practitioner's Guide to Anti-Aging & Regenerative Medicine, 2nd Edition, 2013. Chapter 20, “The Continuum of Insulin Resistance.”
Encyclopedia of Clinical Anti-Aging Medicine & Regenerative Biomedical Technologies. 2012. Chapter 20, "The Continuum of Insulin Resistance."
Smart Life: Silicon Valley Health Institute – January, 2013: "Practical Detoxification."
Saude Actual - January 2015: "Disfunção Adrenal"
UCD School of Medicine Family Practice Student Research – April, 1993: “Farmworkers Opinions Regarding Pesticide Exposure.”
Family Practice Newsletter, UC Davis – March, 1993. “Why I Chose Family Practice.”
Border Health Journal - Vol.V No.3, 1989 (original research). “Heavy Metals in Sediments and Fish of the Tijuana Estuary.”
CMSA Newsletter – September, 1989. “The Watsonville Earthquake.”
MBRS/MARC Conference, Washington DC – April, 1984. “Energetics of Lactation of the Northern Elephant Seal: Poster Presentation.”
Clinica Tepati - 1990 “Model of a Student Run Clinic"
My Credentials and Professional Experience
Functional Medicine/Anti-aging fellowship 12/05 – 12/07. Santa Rosa Community Hospital Family Practice Residency Program 7/93 - 6/96. University of California Davis Med School 8/88 - 6/93 M.D. San Diego State University 1/87 - 7/88 M.P.H. in Environmental Health, electives in Epidemiology.University of California Santa Cruz 9/80 - 6/85 B.A. in Biology. Honors: Most Outstanding Alumni - UCSC 6/04. Scholarship to attend course Harvard School of Public Health for non-profit org. 3/02. Elected by Chief of Staff to serve on Ethics Committee of Watsonville Community Hospital 1/98 - 3/2000. American Dream Award 4/98. Elected to be part of exchange program with Family Practice Department at the Saga Medical Center in Saga City Japan 5/97. "Japanese Connection" trophy for residency graduating class 6/96. Resident with most Community Service (Cesar Chavez Award) 6/96. Organized the 5th Annual Latino Health Conference in Sonoma County 3/96. Project Hope - developed and implemented a hospital certification course for lay midwives working in very rural areas in Quetzaltenango, Guatemala 4/95. Residency Selection Committee 9/93 - 6/96."Most Outstanding Graduating Medical Student in Family Practice" UCD 6/93. Elected Co-Director of Clinica Tepati - the only completely student run clinic in the U.S. 4/89 - 3/90. AAFP Minority Scholarship7/91 and 7/92. Chico Community Hospital Scholarship for three years (88-89, 91-93). Elected by peers & Dean of Student Affairs to serve on the Minority Admissions Committee for 1991 entering class to UCD School of Medicine. Award for Outstanding Commitment - Clinica Tepati 1990.
Faculty: Fellowship in Regenerative and Functional Medicine 2009-present. Faculty: IFM (Institute for Functional Medicine) 02/07-present. Speaker: Genova Diagnostics 11/09 – present. Private practice: functional medicine and nutrition 2/04 - present. Santa Cruz Women’s Health Center (non-profit; part-time) 3/04 - present. Medical Director: San Benito Health Foundation non-profit rural clinic serving the underserved farmworkers of San Benito County 2/99 - 8/03. Physician: Plazita Medical Clinic, a very busy private practice catering to the needs of farmworkers in Watsonville, CA. Duties included preventive, urgent care, colposcopy, minor surgery, supervising 2 to 3 PA'S while seeing patients. Also simultaneously performing hospital admissions, surgical assisting, newborn exams, covering call for our group and the emergency room, caring for 7 to15 nursing home patients and doing home visits on a few patients 9/96 - present. Locum Tenems at Santa Cruz Women's Health Center 4/96. Moonlighting Alianza Medical Center 4/95 - 7/96. Mentor: Developed and implemented a high school mentoring project with the SR FP Residents 8/93 - 6/96. Teacher: Co-taught a lower division class (family Practice 80C) to undergraduate students participating in Clinica Tepati spring 1989 and winter 1990. Laboratory Researcher: Applied Atomic Absorption Spectrophotometry to identify and quantitate heavy metals in water, sediment and fish 1/87 - 6/88. Income Tax Preparer 12/85 - 5/87. Research Assistant: Applying High Performance Liquid Chromatography (HPLC) to qualitate and quantitate protein and amino acid composition of the Northern Elephant Seal milk 6/81 - 9/85. Tutor and University recruiter: Educational Opportunity Program UCSC 9/83 - 6/85. Health Educator: Taught health and hygiene (in Spanish) to students K-12 and adults at Migrant Camps Medi-Corps 6/81 - 9/81. Farmworker: Seasonal field laborer as a child and from 3/78 - 9/86.
Teaching site for UCD FNP/PA program and Stanford PA program 1998 - present. UCSC Alumni Executive Board: VP of Administration 4/04 - present, Chair of Outreach Committee 2002 - 2004, Alumni council member 2001 - present. Portuguese Radio Show at KLBS/KSQQ and Monterey Los Banos discussing health issues for 1 hour monthly. Translator for Portuguese and Spanish speaking immigrants through various community organizations. Speaker / Presenter for various universities, colleges, high school and grammar school students in my community encouraging them to seek a higher education.
Multiple PPT presentations on various Functional Medicine topics. Please ask for list.