Vitamin D causes Hot Flashes?
March 19, 2019 | 24 Comments | SAFM Team
Yes, this is an example of interconnectedness in the body that might surprise you! And a good reminder that Vitamin D is "not just a vitamin"; it functions as a steroid hormone.
Hot flashes can be a seriously debilitating client symptom – and an excellent item to focus on in bringing them rapid relief early on in your program. I've written before about potential remedies for hot flashes. But be sure you think about how other hormones might be affecting estrogen, including Vitamin D! Here are the studies I referenced:
- Higher levels of Vitamin D may reduce both estradiol and progesterone in premenopausal women
- Vitamin D repletion in postmenopausal women reduced estradiol (note that this study did not use a mega dose: just 2000 IU/day, a common dose taken to keep levels optimal, especially in northern climates that lack sufficient year-round sun exposure to promote Vitamin D synthesis via the skin)
Plus we already know that estrogen from oral contraceptives directly affects Vitamin D metabolism. And that estrogen affects Vitamin D receptors and vice versa. For peri/postmenopausal women, there's no consistent evidence that hot flashes are correlated specifically with serum levels of Vitamin D. However, in menstruating women, having higher Vitamin D reduces estrogen levels (perhaps one of the avenues via which having Vitamin D reduces the risk of breast cancer).
Given research insights on this topic, Vitamin D supplementation may have a stronger effect as the body gets hit with high one-time doses in a supplement (typical with prescription Vit. D) which is more likely to cause significant fluctuations in hormones (the real culprit in hot flashes) vs. smoother, continuous synthesis of Vitamin D from sun exposure or lower-dose daily supplement intake. Please note this post is not at all discouraging appropriate Vitamin D supplementation! It's just a reminder that each patient has unique needs. Obviously the effect of reducing estradiol and increasing sex hormone binding globulin can be quite positive for some of our clients (and is likely at least one reason why higher levels of Vitamin D have been shown in large studies to be associated with a lower incidence of hormone-mediated cancers).
In the spirit of always balancing noted benefits with prudent caution, you might enjoy too this deeper dive into Vitamin D Caution You Need to Know.
If hot flashes only happen at night and especially in the 2-4am window and impairing sleep, it's much more likely that they are being driven by a cortisol surge. You might consider checking their diurnal rhythm of cortisol (e.g. DUTCH testing) as well as their various estrogens (*not* just estradiol).
I could go on and on… It's also true that magnesium helps the body to regulate and produce hormones. Taking too much Vitamin D at once can drive magnesium too low (it's needed to convert Vitamin D into its final form in the body). Studies show that magnesium can help reduce hot flashes too. Because insufficient magnesium is so common, I believe that RBC Magnesium should be run on nearly everyone as part of a thorough annual physical check-up. And the body takes up Vitamin D and Vitamin A in the same receptor, so it's important that intake of these two are aligned as well. Vitamin K is also synergistic! As usual, the devil in the detail is a powerful part of being a truly savvy (and confident!) practitioner in working with nutrients/supplements.
I hope these tips helps you to use functional medicine know-how competently *and* confidently.
Wildly satisfied clients and patients build wildly successful practices!
Warmly,
P.S. If you are passionate about transforming healthcare through the power of functional medicine, we encourage you to learn more about our training program here.
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