Suggest remedies for hot flashes during menopause
Sorry to learn about your bothersome symptoms.
Autonomic testing is typically reserved for patients with neuropathy. The composite autonomic scoring scale (CASS), which includes measurements of orthostatic blood pressure, the quantitative sudomotor (sweating) axon reflex test, heart rate response to tilt, heart rate variability with deep breathing, and changes in blood pressure with the Valsalva maneuver, appears to provide a useful measure of autonomic function and can help support a diagnosis of small fiber sensory neuropathy. The evaluation of intraepidermal sweat glands is a viable technique to evaluate sudomotor function.
Quantitative sudomotor axon reflex testing (QSART) is widely utilized for the detection of early loss nerve supply. Galvanic skin responses offer a simple measure of the presence of sympathetic innervation ('nerve supply') in the hands and feet. Sweating may also be assessed using the indicator plaster Neuropad test. This test consists of a patch that is applied to the skin in order to measure sweat production visually by a change in color from blue to pink that occurs with absorption of water.
Measurement of vascular responses in the foot is an alternative method to detect dysautonomia.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
None of these tests require any fasting and can be done at any time of the day.
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