Q&A with Dr. Saru Bala

Our mission at Pollie is twofold: streamline the patient journey for women experiencing hormonal health issues, and help independent women's health specialists grow their practices. To help spread awareness about the (if we do say so ourselves) awesome providers on our platform, we'll be periodically sharing interviews on our blog. We hope this helps shine light on why Pollie's naturopathic doctors (NDs), registered dietitians (RDs), certified health coaches, and more have chosen to pursue their passion for women's health!

Today we'll be chatting with Dr. Saru Bala, who is a naturopathic doctor (ND) based in Phoenix, AZ. Recall from our previous post on NDs that these providers have undergone a lot of education about naturopathic medicine, and while they are indeed doctors, they differ from your conventional MD in that their training has emphasized integrative, whole-body health. In other words, folks like Dr. Bala are experts at knowing how to assess a patient holistically to uncover the root problem, rather than treat an ailment superficially.

If you find Dr. Bala's style resonates with you and you'd like to book an appointment, you can do so here.

With that, let's get started!

In a few sentences, explain to us what your practice focuses on.

Dr. Bala: My practice is aimed at women's health and children. I believe that kids are our future and women make everything happen, so when we support both of these individuals, our community thrives best. The current healthcare model doesn't have a lot of options for women's health outside of hormonal contraception, and that's where naturopathic doctors come in. By blending conventional guidelines with natural therapies and lifestyle habits, we can get the best outcomes for our women. I focus on preconception health, postpartum care, and any hormonal issues in between (PCOS, irregular cycles, PMS, etc). My biggest piece of focus in each visit is patient education. If I can get every woman to understand what is going on in her body and why we're doing each therapy, then we can make the greatest change.

Is naturopathic medicine something you grew up with, or did you have more of a conventional healthcare upbringing?

Dr. Bala: Unknowingly, I grew up with "natural medicine." My parents are Indian, so there was always a tea or some old traditional recipe that was made any time someone was sick. We also hardly ever ate out, and nutrition was a huge part of our life (which growing up, all I wanted to do was eat fast food like everyone else), but now I see that as a huge blessing . So in that sense, I grew up with naturopathic medicine. But I didn't have an ND, or even know about naturopathic medicine until after my mom's cancer diagnosis.

When did you decide you wanted to become a ND?

Dr. Bala: I always knew I was going to be a doctor. From the age of 5, I was interested in medicine. Growing up around natural medicine, I was interested in doing "functional medicine," as I had no idea that naturopathic medicine existed. But it wasn't until experiencing the healthcare system for myself, after being diagnosed with IBD at 13, and years later, seeing my mom get diagnosed with stage 4 ovarian cancer (and told there were NO other options) that I really found naturopathic medicine and knew this is the route I wanted all along.

In what instances should a patient consider seeing an ND? What would you recommend to those who want to dip their toes in more holistic healthcare do to get more comfortable with naturopathic medicine principles?

Dr. Bala: A naturopathic doctor can be considered at any point in your life. As long as you need a doctor, an ND will be a great option. We are trained as primary care doctors, so all of us can act as your PCP (depending on the state you're in- licensure varies by state), but many of us (like myself) have specialized in something else- such as women's health, pediatrics, integrative neurology, etc.

The naturopathic principles themselves can be found anywhere (just google 'naturopathic principles'). The AANP is also a great resource to learn more about naturopathic medicine and find providers in your area!

How did you decide to focus on women’s health specifically? What sub-areas do you focus on?

Dr. Bala: In the conventional model of healthcare, there are not a lot of options for women. If you go to your OB/GYN, they give you birth control and call it good. But birth control is not helping you regulate or address the issues with your hormones. It's just a bandage. It's not addressing the reason for your hormonal imbalances. Once you get off the birth control, you're right back in the same boat. Wouldn't it make more sense to fix it the first time rather than cover it up and save it for later? I wanted to offer personalized healthcare for women. We're all so different- our hormones, our genetic profile, our risk factors- we shouldn't have a 'one size fits all' model of care.

I focus on all areas of women's health. From acute to chronic. Yeast infections to infertility, to irregular menses, to acne, to postpartum depression/anxiety, and even GI issues. Everything in our body is connected- if your hormones aren't in sync, it's not a far leap to check out the GI system or nervous system. It's not separate systems operating individually, it's all one body.

What can one of your patients expect in their first few visits?

The first visit is a long visit- usually about 60 minutes. This will encompass all of your health history, from childhood until now. I want to hear everything! From day-to-day life, diet, stress, exercise routine, to how you sleep and how you poop. All of these things play a role in your health. I don't want to just hear about your periods. I want to know how you live.

After the first visit, you will leave with some recommendations for balancing hormones or general health (depending on what you need to work on the most) - either diet, lifestyle, nutrition, or herbal medicine. From there, we will also get some blood work to get a baseline of your hormones and overall health. After that, we have follow up visits, that last about 30 minutes, to check in and see how things are going and tweak things as needed. Because most of my therapies are herbal, lifestyle, or nutraceutical-based, they take time and consistency to see overt changes. So follow up appointments are generally every 3-4 weeks in the beginning, and you will have a weekly online check in to have answers to any questions that may arise during the process. The things I use the most in my practice are herbal medicines and lifestyle habits. In addition to blood work, stool analysis, breath tests, and food allergy testing can all be things we might do together in our appointments- depending on what you need and what your health picture looks like. While I do use mostly low invasive and naturopathic modalities, I'm not opposed to using pharmaceuticals or conventional methods if that's what the best option at that time (e.g. if you have a kidney infection, I'm not going to try to give you herbs. We'll start with antibiotics and build you back up once the infection is gone).

What are some of your favorite tips and tricks for managing a hormonal imbalance?

Dr. Bala: Let's break this one down:

• Liver support. Generally what we see with women who are having hormonal issues is that their liver needs a little bit of support. The liver plays a huge role in clearing out excess hormones. So I almost always start with some liver support- depending on the level of hormonal imbalance, I will either start with nutraceuticals, herbs, or just gentle liver cleansing with food (beets, dark greens, cruciferous veggies).
• Sleep! This is a huge one when it comes to hormonal health. You wouldn't believe how much this can change a woman's cycle. Most of the time, we go to bed too late and don't get enough sleep. Or, we are too wound up at night to fall and stay asleep. Good sleep hygiene does wonders for your hormones. We need that restorative reset at night to keep things running smoothly. A night here or there with poor sleep won't hurt, but when it turns chronic, that’s when we see issues.
• Whole foods diet. Eating whole foods regularly is so important. The most common type of PCOS we see is insulin-resistant PCOS. So, the main thing we focus on with these patients is regulating their blood sugar. We do this by reducing simple sugars (fries, pasta, sugary or processed foods), and incorporating whole grains, vegetables, proteins, and healthy fats. Basically, if it comes from a box, bag, or other packaging, try to avoid it.
• A good multivitamin. Even eating a completely whole foods diet doesn't always provide all the nutrition we need anymore. Our soil is just not as nutrient dense as it once was, and our produce is found to lack many of the vitamins and minerals we used to find in them. So supplementing with a good daily vitamin can help support some of our most basic processes in our body that we might be lacking! But be aware that most of the over the counter supplements don't always have enough of the nutrients we're trying to get in a supplemental product. This is why most NDs have their own online (or in house) dispensary with trusted brands that have gone through a thorough vetting process and are of high quality and standards.

How do you communicate with your patients?

Dr. Bala: I communicate via video chat and phone calls for my virtual clients, and face to face in their own homes for in person clients. I personally love being able to meet patients in their own home, in a setting they're comfortable in and provide care at their convenience. And for those who are not in the area, I want to make women's health available to anyone who might need it. This is why I love offering virtual visits. Telemedicine has come such a long way and I'm so fortunate to be able to be part of this new system and model of care!

What about in terms of communication style - what's your vibe?

Dr. Bala:I love to educate my patients. Understanding a treatment plan, the process, and goal of a therapy is so important for lasting change. If you're unaware of why we're taking a certain supplement, why we're adding in a nutritional therapy, or why we're changing your routine, you're less likely to do it. I also like to meet my patients where they are at. If you're not ready for a big change, if you're not ready to eliminate a certain food, if you're not ready to start a therapy, I'm not going to force you to do it. Compliance and sustainability is so important with naturopathic medicine and long term health. I also think it's important for you to understand your body and your health. No one will ever know your body better than you. You have the right to know how your body is working and what's going on. I didn't go to medical school to keep all my knowledge hidden away, I want to share it with you to help you better understand what you're dealing with!

What are the challenge areas in today’s health system for women trying to manage their hormonal health? Are there any “hacks” in the system patients should be aware of to maximize their access to quality hormonal health experts?

Dr. Bala: The healthcare system is set up to make big corporations (aka insurance companies) money. The doctors in this model are not making much money per patient (on average a PCP gets about $20 per patient visit), that's why they end up only spending 3-5 minutes with you. It's not that they don't care about you, it's that if they take insurance, they need to also make a living to pay off their overhead, their loans, their bills, etc. Because of this, many providers have now moved away from the insurance model, because we want to give all of our energy to our patients.

So think about where your money is going when you visit a healthcare provider! I can almost guarantee if you see an uninsured provider, you will have better care, just because of the fact that they're not bound to the ball and chain of the healthcare system! So while you might think you're paying a lot to see a provider, if you think about long term health and expenditure, you end up saving money, AND getting better care and support. It's really a win-win for everyone!

Note from Pollie: Dr. Bala has a great article written about this on her blog.

• Read more: https://www.drsarubala.com/blog/why-i-dont-take-insurance

What advice do you have for other men and women who are considering pursuing an ND degree?

Dr. Bala: Be passionate! If you don't truly love this medicine, or have a real "why" behind pursuing the degree, choose a different route. This program is very dense- we learn standards of care the same as an MD (diagnosis, treatment, and pharmaceuticals) and on top of that we learn botanical medicine, nutrition, and counseling. It feels very intense, and exhausting at times, but the community you gain, the knowledge you learn, and the experiences you become part of are so magical, it makes all the rigor and intensity feel so worth it! And the reward you get from patients being so appreciative and grateful for the work you do makes showing up to work such a joy.

• Be prepared for the critics. The conventional world will always be a critic to the naturopathic world, and that's something that we've been aware of for many decades. But just know that when getting into this medicine, family, friends, and other healthcare professionals will have their say of what they think naturopathic medicine is all about. I've found that the more we know the research and know the conventional "box," it's easy to rebuttal with evidence, science, and knowledge. Nothing we do is so "woo woo" that there's no research for it. All of our training is rooted in science, physiology, and research. So just know the haters exist, but you'll have a supportive, caring community to help you stand strong against them!

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