Pathology Associates Of Lexington, P.A.
Pathology Associates Of Lexington, P.A.
Pathology Associates Of Lexington, P.A.
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         Flushing, Causes
      
Hot Flashes, "flushing"

Ovarian failure (menopause) prior to the age of 40 years old is considered premature.  Similarly, problems with hot flashes prior to the age of 40 are more unusual and possibly more seriously suggest other causes than the onset of menopause.  The laboratory chemical diagnosis of primary ovarian failure (menopause) is made by demonstrating consistent elevations of LH and FSH (probably requiring multiple testing).  Because of this, laboratory testing is rarely used as the unequivocal means to diagnose menopause.

In the evaluation of hot flashes (flushing) for the possibility of onset of menopause, a screening test consisting of a single FSH determination is made. 

If the blood is drawn in a woman who is still having her periods and is drawn midway in the cycle, the value can come back high due to normal physiology.  However, it should rarely if ever be higher than 40; therefore, levels above 40 are "blood FSH hormone evidence of menopausal status".  But, I hasten to add, such levels are not diagnostic of menopause.  Levels between 16 to 29 are "marginal"; 30 to 40 is "suspicious for menopausal change". 

OTHER IMPORTANT CAUSES OF HOT FLASHES ARE:
  • Common causes
    • Panic attacks, hyper-anxiety situations [see symptoms]
    • Idiopathic (cause can never be determined).
    • Menopausal symptom (primary or secondary)
      • think of secondary due to pituitary tumor
    • Medication ingestion.
      • Glutamate (food seasoning, MSG; in hidden forms, many food types)
      • Calcium channel blockers (heart medications)
      • Diabinese (plus alcohol in diabetics)
      • Nicotinic acid (some people take this to lower cholesterol)
    • Alcohol intake
    • Pregnancy
  • Uncommon, rare causes
    • Cirrhosis of the liver
    • Hyperthyroidism (do a TSH screening test)
    • Men who have had testicles removed and/or who are taking certain types of hormone suppressing prostate cancer medications.
    • Tumors:
      • Carcinoid (abdominal pains)
      • Systemic mastocytosis (severe itching and hives episodes)
      • Chronic granulocytic leukemia (itching episodes due to elevated basophiles)
      • Medullary carcinoma of the thyroid (mass in neck)
      • Oat cell carcinoma of the lung (smoker)
      • Ovarian teratomas
      • Bile duct/pancreatic islet carcinomas
      • Pheochromacytoma (episodes of high blood pressure and headaches)
    • Focal temporal lobe epilepsy.

References:

  1. Dr. Shaw, 30 October 1991 memo to Kelly Gilbert, concerning menopausal screening in the patient-ordered lab testing program @ LMC-Irmo.

(posted 1 March 2004)

 
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