Severe hot flashes: Hi there, guys. Its... - British Liver Trust

British Liver Trust

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Severe hot flashes

Motik profile image

Hi there, guys. Its been few months since my last question. Im not going to talk about my sickness... I just want to ask.

For several weeks I have hot flashes that become more friquent every day. Can liver problems be related to these unpleasant symptoms ? I don't sweat, but I feel like i'm in menopause . . . I tested thyroid hormone, sugar . . . Everything seems to be normal . . . I'm relatively calm so its not related to stress . I take only lactulose and rifaximin as drugs, no HE.... . . Can you give me some advice please.?

35 Replies

Various reasons for hot flushes in men, I don't know whether anything here will help.

nhs.uk/conditions/male-meno...

Not sure whether you've had a confirmation of liver disease but men with advanced liver disease often have hormone problems, less testosterone and more oestrogen leads to loss of libido, sexual function, testicle shrinkage, loss of male pattern body hair, Gynaecomastia. I know my hubby gets roasting hot in his bed - actually hot to the touch.

Katie

Motik profile image
Motik in reply to AyrshireK

Thanks for the reply, Katie. I dont have diagnose yet, but im close. Seems like liver vascular disease that causes many problems. My testosterone is on lower limit according to the blood tests, but I think I have to test the oestrogen as well. Here in Bulgaria its hard to have proper diagnose if the liver disease is non - cirrhotic.... About menopause Im 38.. still young for it... :)

Fibro2021 profile image
Fibro2021 in reply to Motik

Vascular liver disease is often very difficult to diagnose. Fibroscan, ultrasound, MRI, CT are not very informative and LFT are normal or slightly elevated. Terminal hepatic failure, hepatic encephalopathy, coma can be the end of the disease but cirrhotic transformation does not occur.

Motik profile image
Motik in reply to Fibro2021

There should be some kind of alterations that had to be observed, as chronic disease it should leave traces..

Fibro2021 profile image
Fibro2021 in reply to Motik

Unfortunately, in some cases, only a biopsy (preferably a laparoscopic biopsy, since a puncture biopsy can also be uninformative) helps to confirm or exclude the diagnosis. I went through all these diagnostic steps. The causes of these disorders can be very different...

Lets go back to my particular symptom, I found some article about the liver disease and hot flashes, but in my case there are some big discrepancies, yet I will share it FYI, im still open for some experienced answers, thank you!

"Why does a dysfunctional liver cause the body to overheat?

The answer goes back to Chinese medicine which explains that when the liver is overworked or under pressure, it generates too much heat within itself. Because the liver is such a large organ this causes our whole body to overheat. The excess sweating is a reaction of the overheated body to cool body temperature and allow increased excretion of toxins through the skin. These symptoms are very unpleasant especially if you live in a hot, humid climate and the associated fatigue can be overwhelming."

So, if the liver generates heat, the body temperature should be increased even a bit, regardless of thermoregulation.

I dont have, temperature, I dont sweat....

I was thinking more that the hot flashes are caused by the toxins in the blood circulation causing tissue imflamatory, but this should be seen in some blood tests...so...i dont know exactly what is happening with my body at this age, but i think these question has to be answered by GP and Liver doctors...

Im just and IT guy with nonspecific liver disease...

WorriedUK01 profile image
WorriedUK01 in reply to Motik

Have you had any blood tests, ultrasound, fibroscan yet?

Motik profile image
Motik in reply to WorriedUK01

Yes, I have done all, few times.... But there isnt much except dilated portal vein and slight portal hypertension..Even the last time doc. said that my portal hypetension is missing.. But I do have severe symptoms... and the most bothering now is this....

WorriedUK01 profile image
WorriedUK01 in reply to Motik

What was your fibroscan score?

Motik profile image
Motik in reply to WorriedUK01

The fibro scan results are 6Kpa (f0-f1).

Mine was 6.5kpa , I had 4x ultrasound all normal, and lots of bloods which were normal. However I still get RUQ pain, and I’m getting these weird hot flashes where my forehead feels like I have a temperature, but I don’t, and my neckline and neck goes very red. Lasts a few hours along with extreme nausea and just feeling very unwel. Then it goes as quick as it came. I’m late 40s so wondered if it’s the “change” or if it’s my liver despite all the clear tests. Portal veins etc on my ultrasound were all normal - even when they listened to the blood flow through them.

However still no explanation for the pain in my liver area which when I’m in bed and lay on that side it sounds like I’m laying on something. I’m going back to GP spent to insist on further tests on that area to get to the bottom of it.

Motik profile image
Motik in reply to WorriedUK01

Yes, talk to the doctor, dont live him/her alone until there is no resolution... Normal liver syntethic functions doesnt mean that the liver is working well ... The fibroscan is usefull in fibrosis - cirrhosis, but obviously there is other liver diseases that has to be diagnosed with other approaches. Do you have weight loss, headaches, dizziness ?

WorriedUK01 profile image
WorriedUK01 in reply to Motik

I’ve lost a little bit but have been under a lot of stress and busy at work so I expected a bit of loss. No headaches but dizziness yes - almost like Motion sickness -comes and goes

Would have thought 4 ultrasounds would have shown something though especially when looking at the portal vein

Motik profile image
Motik in reply to WorriedUK01

Yeah, definitely... All of the ultrasounds made by the same doctor?

WorriedUK01 profile image
WorriedUK01 in reply to Motik

No all different (I went private to different places) they talked be through the scans, said I has a text book liver! No explanation for the pain though

One of the ultrasound specialists told me exactly the same phrase "Your liver is like a textbook".

Motik profile image
Motik in reply to Fibro2021

Let me show you my latest Ultrasound report, not exactly as text book, but closely:

Ultrasound of the abdomen:

There is no free fluid in the abdomen.

Liver - not enlarged, with hyperechogenic structure and without focal lesions.

Undilated intra- and extrahepatic bile ducts. Gallbladder - filled with many calcium-dense concretes with solutions up to 15 mm. Its walls are independent, there is no fluid perivessically.

Spleen - not enlarged, without focal lesions. The pancreas is normal.

Both kidneys are of normal shape and location, without drainage disturbances.

Bladder - well filled, without intraluminal defects.

CONCLUSION: Steatosis. Cholelithiasis.

Date: 28.07.2021

And this is my progress since december 2020 till now, from right to left:

weight loss

How were you finally diagnosed because the Doppler ultrasound and imaging with blood flow on my scans showed everything ok?

Only on liver histology with laparoscopic and puncture biopsy. Varices of the 1st degree were found during gastroscopy, which also speaks of portal hypertension. The symptoms were searched for cirrhosis, but nodular regenerative hyperplasia (NRH) of the liver and non-cirrhotic portal hypertension (NCPH) were found. The fibroscan result was 5 kPa and the liver elastography was 7.5 kPa.

What has been the contributing factor to this condition? Alcohol? Diet? Etc and what’s the prognosis?

I guess the reason is alcohol. I drank about 100 ml of brandy for quite a long time and regularly several times a week. The prognosis is probably not positive, since I have a persistent form HE for more than three years. Hepatologists do not know this condition well, to be honest, they don’t know at all, as far as I understood.

From what I understand portal hypertension should be easily diagnosed by ultrasound - perhaps you didn’t have a very good sonographer!

This is a misconception. The normal diameter of the portal vein and spleen does not exclude portal hypertension according to recently published scientific data in medical reports. It all depends on the degree of development of collateral blood flow, including through small vessels that are not visualized on ultrasound. The versatility of ultrasound research is a big medical myth.

Motik profile image
Motik in reply to Fibro2021

The body is very adaptive. It always compensate, compensate and try to restore its defaults, in our case - the portal vein diameter (creating collateral blood vessels and normalizing blood pressure ). In the middle of April my portal vein was 6-7 milimeters above normal diameter according the abdomen CT scans. And now its only ONE milimeter above. BTW the CT scan in my opinion seem to be much more precise when comes to dimentions ...But Im not a doctor.. these are only personal observations.

WorriedUK01 profile image
WorriedUK01 in reply to Motik

Do you have RUQ pain? I’m confused because the liver doesn’t have pain receptors so would only cause pain if swollen. That’s what I’ve read. So if it’s something to do with the P Vein why would you get pain. An ultrasound would show the liver swollen I would have thought? What’s causing the pain?

Motik profile image
Motik in reply to WorriedUK01

I have RUQ mild pain / more like disscomfort regulary. The liver is surrounded by fibrous capsule, this capsule if full of nerve endings, Im not sure if there is science explanation of the liver aches.. but somethimes when liver is enlarged because of inflammatory process (viral hepatitis, NASH, autoimmune hepatitis, alchohol, drugs) it stretches the capsule and then one might feel uncomfortable RUQ . Btw, did you make hepatitis tests A,B,C,D,E.... cytomegalovirus, epstein barr?

WorriedUK01 profile image
WorriedUK01 in reply to Motik

No not been tested for those. Basically my tests since January 2020 have been:

4x ultrasound (2 last year 2 this year) all normal

4x blood work checking liver function, playlets, full blood counts (normal, no drop in platelets or WBC)

Fibroscan 6.5kpa told normal and not to worry

Various GP appointments and feeling of liver etc all ok

However the pain persists and is quite bad today. Feels like a dull ache and sometimes a stabbing pain. Also been feeling light headed lately. When I lay in bed on my side it feels like I am laying on something. However I feel no lump.

Thing I don’t understand is yes I know the liver is surrounded by a capsule with nerves, however, if the liver is normal size which mine has been with no fluid or swelling, then I can’t see where the pain comes from. Just reading about Portal Hypertension it doesn’t suggest anything about pain but more about blood in stools, reduced platelets, confusion etc.

Motik profile image
Motik in reply to WorriedUK01

Check you self for viruses, I had hep C for 14 years, and Yes it causes such aches.. And it can progress without any signs or Stigmata till it makes severe damages.. Make the tests for all of the hepatitis just to exclude them as cause...

p.s

Sorry for my English..

WorriedUK01 profile image
WorriedUK01 in reply to Motik

Your English is very good no need to apologise

Today was the first day in long time I didnt have hot flashes and I ate a lot. I did make testosterone and Oestrogen tests, because I decided that it might be a problem caused by hormonal dissorder. But not - my Testosterone is in upper limit and my oestrogen is in normal limits for men.....so ,, If the flashes appeared again I will check my thyroid hormones again...

WorriedUK01 profile image
WorriedUK01 in reply to Motik

Keep us posted!

Motik profile image
Motik in reply to WorriedUK01

I ate a lot today but the flashes appeared for a very small period of time,. My mom's meals .... what can I say. Unfortunatelly I have severe shortness of breath, headaches, confusions, feel very drowsy...the symptoms become serious some time.... its scary, The bad thing is that even refaximin does not help a lot (obviously the ammonia is not the only toxic substance) ..... I am taking some relaxing mood improoving tea...not much of effect today(it should increase the serotonin levels)....I hope i will feel better tomorrow because its national holliday here. :)

WorriedUK01, do you think to do blood tests about the viral infections?

WorriedUK01 profile image
WorriedUK01 in reply to Motik

I’m seeing my GP next week so will ask.

Are you anxious or worried at the moment? Stress can play a huge role in how we feel if you are .

Motik profile image
Motik in reply to WorriedUK01

Im getting use to the disease, little less worried than a month ago...but its kind of scary when I dont have real idea what exactly is happeing with my body... what are the consequences, lots of aggression sometimes because of inability to handle situation...

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