Q. What is a Naturopathic Doctor?

A. A naturopathic doctor is a practitioner of naturopathic medicine—a system of primary health care focused on the diagnosis, treatment prevention of illness and specialists in integrative and functional medicine by stimulation and support of the body's natural healing mechanisms.  Naturopathic Doctors (NDs) are trained as primary care physicians with an emphasis in natural medicine in ambulatory settings, although their scope of practice varies by state.  Naturopathic Physicians are the only physician level specialists in Natural Medicine. We are trained to identify and remove causes of a disease and treat patients using natural, non-toxic therapies. Our primary goal, as your natural medicine expert, is to not only treat your condition, but also maximize your health. Naturopathic doctors treat holistically by looking at each patient as a whole person, rather than only focusing on one specific symptom, disease or diagnosis. This means considering all the factors that comprise a person’s overall health, including a combination of genetics, environmental exposures, lifestyle habits, diet, exercise history and social/emotional factors. The ultimate goal of naturopathic care is restoring balance in the body to support its natural healing process. At its core, naturopathic medicine is distinguished by six underlying principles:

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1. First, Do No Harm: Use the most natural, least invasive and least toxic therapies.

2. The Healing Power of Nature: Trust in the body's inherent wisdom to heal itself.

3. Identify and Treat the Causes: Look beyond the symptoms to the underlying cause.

4. Doctor as Teacher: Educate patients about the steps to achieving and maintaining health.

5. Treat the Whole Person: View the body as an integrated whole in all its physical and spiritual dimensions.

6. Prevention: Focus on overall health, wellness and disease prevention.

 

Q. What is the education of a Naturopathic Physician?

A. Naturopathic physicians undergo training that is similar in structure and scope to that of medical and osteopathic doctors. Naturopathic medical colleges are four-year graduate schools with rigorous admissions requirements comparable to other medical schools. The Doctor of Naturopathic Medicine (ND) degree is awarded after classroom, clinic and practical study. ND’s are trained in medical sciences including anatomy, physiology, biochemistry, microbiology, immunology, pharmacology, cardiology, neurology, radiology, minor surgery, obstetrics, gynecology, embryology, pediatrics, psychology, genetics, pharmacology, minor surgery, dermatology, and clinical and physical diagnosis. The training also includes extensive study of naturopathic philosophy and therapeutics including therapeutic nutrition, botanical medicine, homeopathy, hydrotherapy, manipulative therapy, and counseling. Because coursework in natural therapeutics and nutrition is added to a standard medical curriculum, naturopathic doctors receive significantly more hours of classroom education in these areas than the graduates of many leading medical schools, including Yale, Stanford, and Johns Hopkins. Like all states with licensure for Naturopathic Physicians, Pennsylvania and Connecticut’s laws require graduates of naturopathic medical schools to pass rigorous national and state board examinations (NPLEX 1 and NPLEX 2) similar to MD/DO, in order to qualify for licensure. 

 

Q. What Can a Naturopathic Doctor Do?

A. Naturopathic doctors are highly trained diagnosticians that rely on the least invasive and least toxic therapies to address the underlying causes of health issues —not just the condition itself. By going to the root of the problem, naturopathic remedies support the body’s own ability to prevent and combat disease, inflammation and deterioration. Naturopathic doctors specialize in preventative care. Preventative medicine means establishing habits now that help ward off health issues later. Naturopathic doctors are increasingly being sought out to effectively help their patients develop and stick to healthier practices that will improve their overall long-term health and well-being. For the millions of Americans with chronic conditions, naturopathic doctors aim to provide relief by offering holistic perspectives and treatment options. They are able to address a broad range of chronic health issues such as diabetes, asthma, heart disease, allergies, chronic pain, digestive issues, respiratory conditions, fertility issues, menopause and chronic fatigue syndrome.

 

Q. Can you be my primary care physician (PCP)?

A. No. Unlike other states, New Jersey does not license Naturopathic doctors currently so Dr. Cruz cannot serve as your primary care provider in NJ—though she can work with you in a holistic healthcare capacity to help you achieve optimal health. Therefore, you will be required to have an MD or DO on board with your care and serve as your PCP.  The state of NJ does not allow NDs to legally diagnose or treat an illness, prescribe pharmaceutical medications, or perform minor surgery as other licensed states allow.  Those 22 states that are licensed for NDs are Alaska, Arizona, California, Colorado, Connecticut, Washington, DC, Hawaii, Idaho, Kansas, Maine, Maryland, Massachusetts, Minnesota, Montana, New Hampshire, New Mexico, North Dakota, Oregon, Pennsylvania, Rhode Island, Utah, Vermont, Washington state, and US territories including Puerto Rico and US Virgin Islands. Scope of practice may differ from state to state.  Pennsylvania NDs are registered as of a recently (2018) passed bill recognizing the credentials of NDs who have attended accredited institutions. Some insurance companies may cover naturopathic services, please check with your insurance. The Pennsylvania Association of Naturopathic Physicians (PANP) is working to expand the scope of practice covered by the licensure.  Dr. Cruz is currently working on becoming registered in the state of Pennsylvania and licensed in the state of Connecticut where Naturopathic Physicians are licensed to diagnose and treat all medical conditions and are primary care physicians.

 

Q. How Your Naturopathic Doctor Complements your Primary Care Provider?

A. Licensed naturopathic doctors (even in unlicensed states, such as NJ) can provide an essential level of support to your primary care MD/DO by focusing on areas of your health that are easily overlooked in the conventional health system. Your ND looks very closely at your health history, family history, diet, lifestyle, areas of stress, current health conditions and medications, and recent lab work, and makes holistic health recommendations that can fit in safely with your current medical protocol. They are trained to communicate professionally with your doctors and understand contra-indications, interactions, side effects, and complex physiology, all while staying informed of the most current health and scientific research to support their alternative approach.  Sometimes, symptom management with medications alone is not enough. Through a naturopathic viewpoint, all areas of your life and health are addressed. When you implement naturopathic recommendations that address your sleep, diet, stress, genetic predisposition, exercise, and/or happiness, your level of care is exponentially higher, and your body’s response to healing and balance is significantly improved.

 

Q. What is the difference between a traditional naturopath and a licensed naturopathic doctor?

A. While both traditional naturopaths and licensed naturopathic doctors aim to help the body heal through natural substances such as food, herbs, and water, their education is very different, and their scope of practice and regulatory status vary from state to state —and in some states there are not yet any regulations pertaining any types of naturopathic practice. The titles “traditional naturopath” and “naturopathic doctor” (or “naturopathic physician”) are not interchangeable. A licensed naturopathic doctor (ND/NMD) is a primary care physician who is trained to diagnose and prescribe in licensed states, while a traditional naturopath is not able to do either. In some states where naturopathic medicine is not yet a regulated medical profession, a traditional naturopath may on his/her own, choose to use the title, “naturopathic doctor,” which is likely to be confusing to patients looking for a licensed ND.  Look up “Find a Doctor” at https://naturopathic.org/ to find out if your ND is licensed.

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Q. Are naturopathic treatments scientific?

A. Many of the therapies used by Naturopathic Physicians have been subjected to controlled scientific studies. Dr. Cruz makes every effort to use therapies with documented scientific efficacy, and/or, just as importantly, a long history of clinical safety and effectiveness.  

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Q. What is Naturopathic Medicine especially good at treating?

A. Naturopathic physicians are trained to provide the best in natural medicine to men, women, and children. We see patients with health problems that include minor ailments to severe life threatening illness and everything in between. Because we treat people, not just body parts, we can help you resolve issues that fall into many categories including:

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• Constitutional: Fatigue, Chronic Fatigue Syndrome, Weight management, Autoimmune Disease, Fibromyalgia

• Psychiatric: Depression, Anxiety, Autism, Attention Deficit-Hyperactivity Disorder (ADD, ADHD)

• Ears/Nose/Throat: Ear infections, Tinnitus, Sinusitis, Allergies, Sore Throats, Chronic or Recurrent infections

• Cardiovascular: High Blood Pressure, High Cholesterol, Angina, Atherosclerosis, Congestive Heart Failure, Palpitations 

•Respiratory: Infections, Asthma, Allergies, Emphysema or COPD, Bronchitis 

•Gastrointestinal: Diarrhea, Constipation, Gas and Bloating, Heartburn (reflux or GERD), Irritable Bowel Syndrome (IBS), Gallstones, Hepatitis, Colitis, Crohn’s disease, Ulcers, Abdominal pain, Hemorrhoids, Yeast overgrowth, H. pylori infection

• Musculoskeletal: Arthritis, Osteoporosis, Osteopenia, Low Back Pain, Neck Pain, Muscle spasms, Tendonitis, Bursitis, Plantar Fasciitis, Gout, Fibromyalgia 

•Dermatologic: Acne, Eczema, Psoriasis, Rosacea, Rashes

• Neurological: Headaches, Migraines, Sciatica, Seizures, Multiple Sclerosis, Parkinson's disease

• Men’s Health: Benign Prostatic Hyperplasia (BPH), Prostatitis, Erectile Dysfunction, Kidney Stones

• Women’s Health: Menopause, Vaginal Infections, Bladder Infections, Interstitial Cystitis, Premenstrual Syndrome (PMS), Endometriosis, Fibroids, Polycystic Ovarian Syndrome (PCO)

 

Q. How often will I need to have visits?

A. This varies depending on the patient and condition.  Unlike standard healthcare, Naturopathic medicine looks for the root cause of the condition while treating the symptoms, so you may need to check in more often than the conventional yearly.  A normal follow up after the initial visit is done within 2-3 weeks if labs are ordered and 4-6 weeks following a treatment protocol.  For acupuncture visits, some patients need to come 1-2x per week to start. As the condition improves, visits are needed less often. For acute conditions a patient may need treatments for a short period of time. For chronic conditions longer term treatment may be necessary. This is something you will discuss with Dr. Cruz at your first visit and as you progress.

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Q. I don’t understand my condition, do you have time to explain?

A. Dr. Cruz is first and foremost a teacher.  She believes that education is imperative to the success of the treatment, thus she will explain the mechanism of your condition, why you are having symptoms related to your diagnosis and reason for a specific treatment.  Because Naturopathic doctors look at the whole person, our intake visits will always be longer than a conventional yearly visit to your MD/DO.  Part of this is because we take the time to listen to you and your needs and explain any questions.

 

Q. What do I need to bring with me to my appointment?

 A. If you have had any labs or imaging done within the past year, it is helpful to have a copy of them with you. Also, be sure to write down any questions or concerns you may have ahead of time so that you do not forget to ask during your visit. You can find your intake and consent forms in your portal once your appointment is confirmed by us.  Please fill these out and submit at least 24 hours before your appointment.  This enables the practitioner to maximize her time with you.   

 

Q. How does Telemedicine work?

A. Telemedicine or Phone consultations are normally scheduled like regular appointments, but we welcome you to call anytime in the event of questions or concerns. We are dedicated to providing you with the highest quality care, which often requires us to spend time charting and developing plans beyond the length of the phone call. 

Due to time constraints, scheduled and unscheduled phone consultations that exceed 5 minutes are charged per minute at the regular hourly rate. To make an appointment simply choose the Telemedicine/Telehealth tab under scheduling.  Once your appointment is confirmed you will be emailed a Zoom/Doxy.me link.  On the date of appointment just click on the link and wait for the Doctor to begin.  We ask you to login 15 min in advance to ensure connectivity and avoid taking your time away from your consultation.

 

Q. Do I have to stop taking my prescription medication?

A. No. Many patients come to a Naturopathic Physician because they are concerned about the risk, cost, and side effects of pharmaceuticals. In many cases, there are natural therapies that can replace or decrease the need for prescription medication. In addition, naturopathic physicians can often help reduce unwanted side effects using adjunctive natural therapies. Above all, we want you to reach your health goals safely. Therefore, any changes in a prescription medication regimen must involve collaboration with your other doctors. When prescription medication is involved, we firmly believe that an integrated, collaborative approach to health care is ideal.

 

Q. Can Dr. Cruz fill or order prescription medicine?

A. No, in the state of Pennsylvania and New Jersey, Naturopathic physicians cannot order prescription medication.  Only your (PCP) prescribing doctor.

 

Q. Can Dr. Cruz order labs and imaging?

A. Dr. Cruz can order labs but will be at an out-of-pocket cost. Any insurance covered labs and imaging will be referred to your PCP or specialist.  We will work with your PCP/specialist to obtain medical records and test results to provide the best care plan.  

 

Q. Where do I purchase my supplements?

A. Supplements are not all created equally. The supplements I recommend are of the highest quality, made by companies that I have vetted and trust. Currently, I use FullScript and Wellevate to provide supplements for my patients. I am able to prescribe specific products, which then get shipped directly to my patients. Herbal medicine is at the heart of my practice. I blend custom herbal formulas in-office for immediate use following your visit. If you need a refill of your herbal formula, just email me to arrange for pick-up or delivery!  I cannot vouch for the integrity, authenticity, or storage of similar products purchased at other online distributors like Amazon.

 

Q. Why should I see a Naturopathic Doctor when they sell herbs and vitamins at the Health Food Store?

A. The multitude of nutritional and botanical supplements available over the counter can be overwhelming. Furthermore, it is inappropriate and possibly dangerous to get medical advice from persons not appropriately trained. Naturopathic physicians have a comprehensive understanding of physiology, pharmacology, botanical medicine, nutritional biochemistry, and interactions between natural and drug therapies. Without this training, one cannot safely make recommendations about Natural Medicine.    

 

Q. Will I have to take a lot of supplements?

A. Dr. Cruz puts emphasis on lifestyle medicine, including proper nutrition, exercise, sleep, and stress management. When patients are successfully implementing these modalities, they tend to need less support from supplements. There are times when patients need a more intense treatment plan, which may entail several supplements for a time. Dr. Cruz’s goal is to give each patient a manageable treatment plan, while doing enough to successfully treat their healthcare concerns and eliminate symptoms.

 

 

 

Acupuncture Q & A

 

Q. How does acupuncture help?

A. In Traditional Chinese Medical theory, acupuncture works by restoring balance to the meridian channel system; draining stagnation and blockage in areas where too much Qi is accumulated, and boosting and tonifying areas of insufficient flow. The goal is to have a smooth flow of qi and good reservoirs of blood, yin, and essence.

From a scientific perspective there have been tests done where patients had blood taken before and after Acupuncture. What they found is that Acupuncture boosts the immune system (it raises levels of specific hormones, prostaglandins, white blood counts, gamma globulins, and overall antibody levels). It also stimulates the secretions of endorphins in the body, as well as affects neurotransmitter levels such as serotonin and noradrenaline, thus de-stressing an individual. This is why people feel like they are floating on a cloud after a treatment. It has the effect of constricting or dilating blood vessels. This may be caused by the body’s release of vasodilators, such as histamine, in response to Acupuncture. Acupuncture also closes certain nerve gates by strategically overloading them with impulses, thus reducing pain transmission.

 

 Q. What is acupuncture used for?

A. Because the goal of acupuncture is to promote and restore the balance of energy, which flows throughout the body, the benefits of acupuncture can extend to a wide variety of conditions, from emotional disorders (anxiety, depression) to digestive complaints (nausea, vomiting, irritable bowel syndrome). It can be beneficial for pain syndromes due to an injury or associated with chronic degenerative diseases such as rheumatoid arthritis. It can also be helpful in treating neurological problems like migraines or Parkinson’s disease, or as a rehabilitation strategy for individuals who suffered a stroke. Respiratory conditions, including sinusitis and asthma have been relieved with acupuncture, as have many gynecologic disorders and infertility. Acupuncture has also proved beneficial for reducing fatigue and addictions, and for promoting overall well-being.

Dr. Cruz can treat any symptom with painless Acupuncture (and/or other modalities). Using high quality needles, symptoms from A-Z can be treated, even for the most sensitive patient.

 

Q. How long will it take to see results? Will I need acupuncture forever?

A. Likely not, but this also depends on the reason you’re receiving treatment in the first place. For short-term issues, a handful of acupuncture treatments could do the job. For chronic or long standing issues, a “maintenance schedule” would be set up in order to ensure that your body’s systems are running smoothly and steadily after the initial period of relief and change.

Acupuncture is also a great preventative health measure. Remember, increased blood flow means your body is better able to heal itself, and will increase your immune system response—helping you better fight off and prevent disease.

 

Q. How often should I come for Acupuncture?

A. Usually when you first come in for Acupuncture, treatments are done on a weekly basis, usually once, and sometimes twice or three times per week depending on your specific care plan and progression towards healing. Once the condition has been controlled and you are symptom-free, the treatments are done less frequently. Problems that have been around for a long time usually take more treatments to resolve than ones that have appeared more recently. Your treatment course will be determined after the first visit and reassessed after each session.

 

Q. Does Acupuncture just relieve pain or will it treat the problem at the source?

A. Dr. Cruz main focus is to treat the reason behind why the symptoms exist, and not JUST the symptoms. She aims to both relieve pain and support the body’s ability to heal itself. From an acupuncturist’s point of view, there’s no separation between pain relief and healing—pain is reduced because there is healing. The two are inextricably entwined.

The needles are just simple, sterile, unaltered filiform needles. They don’t use any pain-numbing agents, but rather reduce pain by promoting movement of blood and bodily fluids, relaxing tissues and the nervous system in general.

 

Q. Do the acupuncture needles work?

A. This is the most common question asked about Chinese acupuncture, since many people associate needles with pain. Acupuncture needles are a similar thickness to a dog’s whisker and are virtually painless when inserted. The practitioner will insert the needle to the appropriate depth. You will then usually feel a very unique sensation that can vary from tingling, to heaviness, to warmth, or even nothing at all. Each person’s experience is different. Should you experience any discomfort, it is important to let us know, so we can adjust the needles accordingly. All needles are sterilized and disposable. 

 

Q. What does an acupuncture treatment feel like?

A. It is common to experience a deep ache for a short time in some of the points. The depth to which the acupuncture needles are inserted varies according to the treatment and the individual. The pins are usually left in place for five to 20 minutes, usually no longer than 40 minutes (depends on treatment), and then removed. Following an acupuncture treatment, we will usually reassess how you are feeling, and often give suggestions for home care. Acute symptoms may require only two to four treatments; whereas for chronic cases, it is common to have as many as 12 or more treatments, usually over a course of eight to 10 weeks. Regular monthly visits are suggested as preventive measures to decrease stress, improve energy or boost immunity.

 

Microneedling Q&A

Q. How does Microneedling work?

A. The microneedle device is safer and more effective in piercing the skin than traditional skin micro needling rollers due to its unique vertical micro needling technology.  The micro needle’s multi-speed and adjustable needle depths allow the needles to pierce the skin’s layers at 90 degrees and increases the effectiveness of treatments by increasing the absorption of products, generating less pain and down time for the patient. Micro needles can effectively treat hard-to-reach places (e.g. around the eyes, nose, and lips).  Because of the vertical delivery, the needles can easily penetrate scar tissue. They also promote scar less healing similar to fractional laser treatments, IPL, laser resurfacing, and chemical peels, but without the side effects and downtime.  The mechanism of injury is a natural process, which makes micro needling a holistic approach to skin therapy. The mechanism of injury is a natural process, which makes micro needling a holistic approach to skin therapy.

B. Microneedling works by creating micro-injuries in your skin, sending a signal to your body to begin the repair process. Your body sends healing factors to your skin, increasing collagen production. The increase in collagen creates firmer, more supple skin, and works to restore healthy, youthful skin. Over the weeks following your treatment, you will see your skin becoming firmer and more resilient, reducing the signs of aging.

C. Four major phases of physiological wound response help in stimulating new healthy tissue growth:

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1. An inflammatory response (1-3 days), to the initial injury promotes the chemotaxis response and proliferation of fibroblasts. The body’s platelets also respond to initiate a wound matrix.  This response is the early phase of cell migration to remove debris and bacteria and stimulate the next proliferative phase.

2. Proliferative phase (3-5 days), the new fibroblasts, monocytes, and keratinocytes of the first phase continue to proliferate and multiply.  New collagen will be laid down and deposited with new tissue formation.

3. A fibrotic response (5-20 days), of growth factors are released and fibroblasts release collagen.

4. The maturation stage of new healthy skin takes place from day 28 to two years after treatment. Collagens mature and stiffen and the matrix of new tissue shows 80% to full tensile strength.

 

Q. What can Microneedling do for my skin?

A. Microneedling can significantly improve your skin quality, treating any of the following:

• Acne scarring

• Fine lines and wrinkles

• Loose skin

• Enlarged pores

• Brown spots, age spots

• Stretch marks

• Hyperpigmentation

 

Q. Am I a candidate for Microneedling?

A. If your skin is losing its firm, youthful quality, with lines, wrinkles, or acne scars affecting your facial appearance, you are likely a good candidate for microneedling– almost everyone is safe to undergo this regenerative treatment. 

 

Q. What is the treatment like to experience?

A. After initial skin evaluation a treatment plan is made specific for you.  You will then receive a pre-treatment regiment which explains which products/procedures to avoid and allow before, during and after treatments.  During your treatment first, your skin is prepared to receive a numbing topical cream, so the treatment is comfortable. The needling device is then passed over your skin to create micro-channels and trigger skin regeneration and an infusion serum specific for your condition is applied.  You should not experience any pain or discomfort during the treatment.  Your practitioner will prescribe post-procedure skincare after the procedure to help soothe, calm and protect the skin.

 

Q. What is the recovery time?

A. There is no real recovery time after Microneedling; everyone varies in the healing process, but most have minor swelling and reddened skin, like a mild sunburn, for one to three days after the procedure. These side effects are minor, and well worth the results.

 

Q. How long will it take to see results?

A. Most people see some improvement immediately after treatment, but you will need some patience to experience the full results of your microneedling treatment. As your skin produces more collagen over the following four to six weeks, your skin will become firmer, more resilient, and evenly toned.

 

 Q. Are there any contraindications for Microneedling?

A. • Severe high blood pressure (it is OK when the blood pressure is under control and you are seeing a medical doctor)

    • Severe migraines (if you are having a migraine only once every 3 months or so, you can receive facial acupuncture treatments)

    • Laser resurfacing: Be aware that it takes 3 weeks to recover from laser resurfacing on the face, microneedling is contraindicated during this time.  If you had microdermabrasion it is recommended to wait one week before microneedling.  

    • Botox: injected within 3 months 

 

Q: Why chose Dr. Cruz for Microneedling?

A. Dr. Cruz provides a superior patient experience. She founded Nature Care Wellness skincare division to ensure safe and organic ingredients in skincare products.  Dr. Cruz is board-certified by the Governmental body in Pennsylvania: Board of Osteopathic Examiners/Board of Medical Examiners, in New Jersey by the State Board of Medical Examiners and in Connecticut.

Dr. Cruz medical training and experience were obtained at the University of Bridgeport Naturopathic Medical School in addition to a Master degree in Acupuncture Magna Cum Laude.  She also obtained a Master in BioMedical Sciences from the School of Osteopathic Medicine (SOM)- Rutgers in NJ (previously UMDNJ), graduating Summa Cum Laude.  She graduated from Kean University with a BA in Psychology and a BS in Biology.  Your Microneedling procedure will be performed under her professional direction and guidance.

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Q. Do you take insurance?

 A. Dr. Cruz strongly believes in working directly for you and not for your insurance company.  Insurance companies dictate the care that you receive, limiting labs and treatment plans.  She feels this hinders the individualized care she is able to provide in your path to wellness   Because of this, she is not working “in-network” with any insurance. Our patients who have out-of-network coverage do get reimbursed by their health insurance provider. 

She is happy to provide you with an itemized superbill receipt that you can submit to your insurance provider. If your plan covers acupuncture and/or other services your insurance provider will reimburse you directly. It is up to you to know the extent of your insurance coverage as it pertains to acupuncture/other services.  For laboratory work, in general most insurances will completely cover our referrals to your PCP/Specialist.  Please check with your insurance and individual plan if this applies to you.