Hormonal Hot Flashes: Tips to Survive the Heat

By Dr. Linda J. Dobberstein, DC, Board Certified in Clinical Nutrition

July 6, 2021

Hormonal Hot Flashes: Tips to Survive the Heat
The transition into menopause is a challenge for many women. Hot flashes, in particular, can be disruptive, embarrassing, and distressing. Here are some recent findings that may help you survive the hot flashes of menopause during the heat of summer and this natural season of life.

Iodine & Hot Flashes

A recent study evaluated 210 healthy postmenopausal women with hot flashes. Researchers measured iodine status via a urine test. Due to the changes of menopause and its effect on the cardiovascular system, the cholesterol markers lipoprotein a Lp(A), LDL, triglycerides, and total cholesterol were also evaluated.

Results showed that women with lower iodine levels had more hot flashes. In addition, researchers found increased levels of lipoprotein(A) or Lp(a) in the blood. Lp(a) is a strong risk factor marker for cardiovascular concerns, far more of an indicator than cholesterol levels. Low iodine status was found with two prevalent concerns linked with menopause – hot flashes and increased Lp(a).

Inadequate iodine intake has been an increasing problem in the last several years with salt-phobia and use of gourmet salts, i.e. sea salt, Himalayan or Celtic salt. Although these types of salt are healthier, they do not supply adequate iodine. Supplemental iodine is necessary if one does not consume iodine-rich foods like fish, seaweed, shrimp, or dairy, is on a low sodium diet, and/or predominantly uses gourmet salt.

We offer Iosol Iodine, a non-toxic, water-soluble form of iodine that is easily absorbed. It does not contain potassium iodide that can be an irritant, especially when consumed in large doses. If you are suffering hot flashes, consider supplemental intake of Iosol Iodine. Dosage may range from the basic RDA 150 mcg up to 5 drops or more per day. It may be taken orally or applied topically.

You can learn more about Lp(a), cholesterol, and heart health in the articles:

Health Clues and Tips for Your Heart and Weight: Part II

Saturated Fat Myth – Debunked Again

Folate & Hot Flashes

Folate has also been found beneficial for women with hot flashes. One study demonstrated that women who used 1 mg of folate per day over the course of just 4 weeks experienced reduction in severity, frequency, and duration of hot flashes.

Folate helped improve hot flashes due to its ability to lower activity of noradrenaline/norepinephrine in the brain. Noradrenaline is part of the catecholamine family that acts as a hormone and neurotransmitter. It affects sleep-wake cycles, energy/arousal/wakefulness, cognitive activities, and anxiety levels. Release of noradrenaline is one of many neurochemicals known to trigger hot flashes.

Many individuals need more folate than what is consumed by diet because of gene SNPs and methylation imbalances. An increased blood level of homocysteine in your blood is one indicator that you may need much higher levels of folate.

Natural folic acid is noted as folate, folacin or folinic acid, which is already a coenzyme or methylated form. Natural whole food folate sources include dark green leafy vegetables, fruits, nuts, beans, peas, seafood, eggs, dairy, meat, poultry, and grains. Some of the best folate sources are beef liver, boiled spinach, asparagus, and Brussels sprouts. If the package/product label states folic acid, it is fortified by an added synthetic and oxidized form.

Folate is in the B-vitamin family. Always take a B complex rather than taking one B vitamin by itself to avoid depletion of the other B vitamins.

You may learn more about natural folate forms and methylation in these articles:

Are You Taking Folate or Folic Acid? Read This First

MTHFR Gene Defects, Methylation, and Natural Support

B Vitamin Deficiency: Are You at Risk?

Stress, Brain-Cortisol Rhythm and Menopause

Think about when your hot flashes occur. Some women may find that there is a pattern – such as upon awakening, at bedtime, after meals, or with certain foods. Some of these cyclical patterns may relate to the hypothalamic-pituitary-adrenal (HPA) axis. Studies demonstrate a link between hot flashes and HPA axis dysfunction.

One recent study evaluated 101 perimenopausal women ages 45-55. For 12 weeks, scientists evaluated saliva and urine levels of cortisol and other hormones managed by the HPA axis. Results showed that women who experienced more frequent and severe hot flashes had HPA dysfunction. The natural rhythm and output of hormones was under duress and out of balance as seen with a “blunted cortisol awakening response” (CAR).

All physical, mental, and emotional stress activates the HPA. Whether it’s hitting the brakes on your car to avoid an accident, hearing bad news, skipping a meal, experiencing an injury or illness, having a stressful conversation, or more traumatic concerns, these events trigger a response from the HPA axis to release a variety of hormones, neuropeptides, and neurotransmitters.

Repetitive and/or excessive life demands can cause a loss of homeostasis to the HPA axis. This affects the natural rhythmic output of the HPA and it becomes dysregulated. For some individuals, it can lead to a blunted cortisol awakening response, or CAR. This reflects brain stress and does not indicate that the adrenal glands have shut down. Cortisol levels are down at the wrong time of the day and may be up at other odd times of the 24-hour cycle. This is contrary to a normal increased cortisol level in morning that naturally wakes you up with levels that slowly decline through the day.

Low blood sugar has been found as a trigger for hormonal hot flashes and is a cause for HPA activation. Low blood sugar levels stimulate the release of noradrenaline. If this happens at night, it may cause hot flashes and even night sweats. It may be part of a dysregulated HPA axis and affect CAR.

A low or blunted CAR makes you feel sluggish and have low energy in the morning. It can be very hard to get out of bed. You may feel out-of-sync and have significant daytime lethargy and fatigue like your energy never turned on.

Adaptogenic Herbs and Additional Resources

Alarm clocks and coffee may be your “go to” stimulants to get you out of bed. Instead of more stimulants to the HPA axis, how about feeding your brain with things that are more nourishing and help to restore homeostasis. Use support like holy basil, rhodiola rosea, eleutherococcus/Siberian ginseng, and/or ashwagandha during the day. Other support like L-theanine and phosphatidylserine at bedtime help support sleep and calm the day’s HPA stress response.

If you are about to enter those transition years, use herbal adaptogenic herbs and nutrients to help the daily stress toll prior to entering perimenopause and the menopause transition.

Consider using a more gentle setting on your alarm clock as to not blast you out of bed in the morning as this sends alarm signals to your HPA. Natural light exposure first thing in the morning is also very helpful and gentler. Take time to manage stress before you go to bed with shutting off blue-light emitting devices and other stimulants. You may learn more about stress, the HPA axis and adaptogenic herbs at

Stress and Adrenals: Restoring the HPA Axis

Adaptogens, Stress, and the HPA Axis

Grumpy and Exhausted? Support Your Mitochondria, Brain, Adrenals

Menopause is a natural transition into a different season of life. Disruptive hot flashes do not have to dominate your life, yet many women suffer hot flashes for years or even decades after their last period. Hormone replacement therapy is not for every woman as there may be gene SNPs that require caution, other illness, or intolerance to hormone replacement therapy (HRT). Yet others may take HRT for decades with no end in sight for getting off of the supplemental hormones. You have to ask yourself what effect this has on your body.

Consider support with non-hormonal options such Iosol Iodine and folate with other B vitamins like Super Coenzyme B Complex or Daily Energy Multiple Vitamin. If you struggle to get out of bed in the morning and energy is slow to turn on, then support your HPA axis – adrenal connection with Adrenal Helper. It is a blend of adaptogenic herbs that support your brain and adrenal gland stress tolerance. Additional support for hormone balance includes Female Plus and Femme Balance. Take charge of your health in ways beyond the addition of more hormones.

Additional Resources:

Mastering Menopause: Make It a Smooth Transition

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