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Suggest remedies for hot flashes during menopause

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Posted on Wed, 14 Sep 2016
Question: Related to my previous question. TSH is normal. I am post menopausal and my gynocologist will no longer order me my estrogen therapy since I had the PE and lung infarction. I have tried every over the counter meds and herbal supplements with no improvement in my hot flashes that are due to menopause . What supplements were you referring to? Also do you know of any MD's who specialize in the diagnosis and treatment of Dysautonomia ? Other than a tilt table test for POTS what tests are included indetermining if someone has dysautonomia ?
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Answered by Dr. Shehzad Topiwala (5 hours later)
Brief Answer:
Dysautonomia

Detailed Answer:
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.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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Suggest remedies for hot flashes during menopause

Brief Answer: Dysautonomia Detailed Answer: 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.