I am having hot flushes quite severe and need help please. I…

Hi! Sorry to hear about your trouble with hot flashes. The following assumes you have hot flashes due to menopause. [If the reason is other than menopause, the following advice does not apply, and probably will not help you. Just let me know and I'll re-answer.]

In Chinese medicine menopause is considered a very natural process and not a disease to be treated with pharmaceutical replacements. Instead it is a stage of life which requires re-balancing the whole body. This is accomplished by shifting our diet (a link for this is enclosed below) and by using acupuncture and/or herbal formulas to prompt the body to balance a little faster. (Most of us do want this stage of life to pass by a little faster!) The diagnosis for menopause is Kidney Yin Deficiency.

To provide a little background: in Chinese medicine we understand the physiology of the body differently than western. We use the same words but have a different meaning for them. For example, when I say you have a Kidney, Liver, or Blood deficiency,etc., I do NOT mean the actual physical organ or blood supply. So, if I have capitalized something like that, I am referring to the Chinese understanding of the role of that organ in the body - not the Western physiological functioning. For this same reason our Chinese diagnoses may sound peculiar but they mean something very specific to us, just like the words "diabetes" or "atrial valve fibrillation" mean something very specific to a western physician. Chinese herbal formulas are based on the Chinese diagnosis.

The primary Chinese herbal formula for Kidney Yin deficiency with hot flashes during the day is Liu Wei di Huang Wan. If you also have night sweats, the primary formula is Zhi Bai di Huang Wan. They are both available in pill form. I have also had some patients swear by Black Cohosh - taken simultaneously with the Zhi Bai di Huang Wan if the Zhi Bai di Huang Wan does not seem strong enough on its own.

The extreme exhaustion is possibly due to the Yin deficiency but is more likely due to an underlying Spleen Qi or Kidney Qi deficiency. Without knowing more about your health history and underlying constitution it's hard for me to specify which formula would be best for you, since there are many variations of Qi deficiency.

IF you have Kidney Qi deficiency (most likely scenario if the fatigue started when menopause hit), there are numerous formulas and only an herbalist who sees you in person and can do an examination would be able to pick the best one. A few of the most commonly used are: Ren Shen Shou Wu Wan, Jin Gui Shen Qi Wan, and also single herbs, like Ren Shen (ginseng).

IF the fatigue is more of a chronic issue that you have had before that worsened when menopause started it it more likely to be a Spleen Qi deficiency and the first formula to try would be Liu Jun Zi Wan.

You can take two formulas simultaneously, but I strongly recommend seeing an herbalist first so that (A) you know are taking the right formulas for YOU, and (B) to ensure there are no negative interactions with your western medications.

I am also enclosing a link discussing very good nutritional advice for Kidney Yin Deficiency: http://www.mybodywisdom.net/pdf/Nutrition_for_Kidney_Yin.pdf

[The article is written for practitioners not patients; you may find it interesting, but if it's too boring, just skip to the last couple pages with the dietary recommendations. ]

Once you have seen an herbalist (or just started on one of the two primary herbal formulas I mentioned above for menopause: Liu Wei di Huang Wan or Zhi Bai di Huang Wan) be patient. Change in the body is not sudden, as with western medicine. Herbs are more gentle and work more slowly. They are basically food therapy - herbs are simply plants, but plants you would never choose to eat if you tasted them!

I hope that this has been helpful. Even if you do nothing you will be fine -- but these various suggestions will definitely coax your body into finding a new balance faster (and I know from personal experience that will be a big relief).

The very best of good health to you,