The Columbus Dispatch

Low testostero­ne may be cause of mysterious hot flashes


Dear Dr. Roach: I am an 85-yearold male. I walk a mile every day, have a pacemaker and hearing aids, and use a CPAP machine. All in all, I feel pretty good, but there is something that bothers me and my doctor has no answer. Several times a day, or at night in bed, with no consistenc­y, I get hot flashes and a cold sweat. There is no pain and no fever. It lasts from three to around seven minutes, then goes away. Could it a symptom of something else? Any suggestion­s? Thanks!

— R.P.C.

Hot flashes in men can be a sign of low testostero­ne. They are common in men who are treated with medication­s to lower testostero­ne as part of prostate cancer therapy; they are uncommon in men who lose the ability to make testostero­ne as part of normal aging. However, it would be wise to check your testostero­ne level. This test should be done at about 8:00 in the morning, as that is normally the highest level in the day. High thyroid levels cause sweating, but not normally of the intermitte­nt type you describe.

Hot flashes can also be caused by certain rare tumors. Carcinoid tumors and pheochromo­cytoma are tumors that affect blood pressure. People with symptomati­c pheochromo­cytoma always have high blood pressure, usually very high at the time of the flushing. These tumors can also be looked for with 24-hour urine testing by the lab.

Some infections can cause intermitte­nt hot flashes and sweats. Tuberculos­is

is the classic cause, but other serious causes, such as infections of the heart valve, may also cause intermitte­nt sweating.

None of these scary-sounding conditions is likely, but since this seems to have been going on for a while, it might be time for your regular doctor to try to identify a possible cause. However, sometimes a cause is never found. In your case, the sleep apnea (presumably that’s why you use a CPAP machine) has often been associated with sweats at nighttime (but not so much during the day).

No cause may be identified, but I think it’s worth a look, for your peace of mind.

Dear Dr. Roach: I am going to a very competent optometris­t who has diagnosed glaucoma in both of my eyes six months ago. As there is good history and documentat­ion of the condition of my optic nerve over several years, I do not have to use drops for now. I must continue to return every six months to have my eyes checked so that he may assess my condition. Zith a condition such as glaucoma, would I better served by going to an ophthalmol­ogist? — J.P.

Optometris­ts can treat glaucoma in all 50 states now. Optometris­ts are expert in diagnosing and treating most cases of glaucoma; however, they may still refer to an ophthalmol­ogist. In your case, it sounds like an ophthalmol­ogist isn’t needed. I believe optometris­ts would refer their patients to an ophthalmol­ogist if they felt it were necessary.

Contact Dr. Roach at Toyourgood­

or 628 Virginia Dr., Orlando, FL 32803

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