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Vitamin D May Promote Hot Flashes?

April 9, 2025 | 31 Comments | SAFM Team

 

 

Hot flashes can be a seriously debilitating client symptom – and an excellent item to focus on in bringing a patient rapid relief early on in your program.  We’ve written before about potential remedies for hot flashes. Be sure, though, that you think about how other hormones might be affecting estrogen, including Vitamin D!

Yes, this is an example of interconnectedness in the body that might surprise you. It’s also a good reminder that Vitamin D is not “just a vitamin”; it functions as a steroid hormone.

Here are the studies referenced in the video:

Plus we already know that estrogen from oral contraceptives directly affects Vitamin D metabolism.   Also, estrogen affects Vitamin D receptors and vice versa. In menstruating women, having higher Vitamin D reduces estrogen levels (perhaps one of the avenues via which Vitamin D reduces the risk of breast cancer?). For peri/postmenopausal women, there’s no consistent evidence that hot flashes are correlated specifically with serum levels of Vitamin D.   Of course, bio-individuality matters, as several interactive factors can drive or mediate hot flashes.

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).

If hot flashes only happen at night and especially in the 3-4am window and impairing sleep, it’s much more likely that they are being driven by an early histamine surge (esp. in those with chronic allergy or asthma) or, more commonly, an early cortisol (Cortisol Awakening Response) surge.  You might consider checking their diurnal rhythm of cortisol (e.g. DUTCH testing) as well as their various estrogen metabolites (*not* just estradiol).

Another mechanism potentially at play in this dynamic involves magnesium.  Taking too much Vitamin D at once may drive an already borderline status magnesium too low (it’s needed for multiple stages of Vitamin D metabolism in the body).  Study shows that magnesium can help reduce hot flashes too.   Because insufficient magnesium is common, consider checking RBC Magnesium on nearly everyone as part of a thorough annual physical check-up.  The body takes up Vitamin D and Vitamin A in a same set of receptors, so it’s important that intake of these two are aligned as well.  Vitamin K2 is also synergistic – in protecting against soft tissue calcification that’s naturally a risk with higher levels of Vitamin D.  As usual, the devil in the detail is a powerful part of being a truly savvy (and confident!) practitioner in working with nutrients/supplements.  You can learn to master this level of detail, and SAFM’s comprehensive functional medicine immersion can teach you how.  Step by step.

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,

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31 Questions for “Vitamin D May Promote Hot Flashes?”

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  1. 16
    Carrie Richmond says:
    May 12, 2024 at 9:02 pm

    I stopped taking my Vitamin D3 supplement and replaced it with magnesium glycinate. I cannot tell you how much it has slowed down my hot flashes. They aren’t completely gone, but I can at least sleep at night without alternating between extreme hot and then freezing. I stiff suffer a bit during the day and I know I could stand to cut back on my caffeine during the day, but I am researching additional supplements to help out. Thank you for validating my experience with Vitamin D.

    Reply
  2. 15
    Terri Brucato says:
    April 11, 2024 at 4:08 pm

    I’m not able to use the Dutch test in my state. Do you have other suggestions of testing that are comprehensive other than Dutch?

    Reply
    • 15.1
      SAFM Team says:
      April 13, 2024 at 12:37 pm

      It is hard to find substitutes for DUTCH testing when it comes to hormone assessment. Many practitioners find creative ways to go around the state restrictions (e.g., have their patients order the test to relatives or friends out of state, admin person out of state, etc.). The next best option would be salivary hormones or serum hormone levels collected at the appropriate times during the female cycle.

      Reply
  3. 14
    Mila Krammer says:
    December 5, 2023 at 8:17 am

    Studying psychology, I’ve delved into the benefits of B Complex for mental well-being. The discussion on Vitamin D and mood disorders is intriguing. Have you come across cases where the combined use of B vitamins and Vitamin D has shown promise in supporting mental health, particularly in managing stress-related conditions?

    Reply
  4. 13
    Tabby says:
    December 6, 2022 at 11:30 am

    I’m 53 and am post menopausal. In the last I have been experiencing what I can only describe as an adrenal rush frequently in the middle of the night. This started shortly after I recovered from a upper resp virus. I’ve been racking my brain to figure out what is going on. When it hits, my bladder will become overactive the rest of the night and resuming sleep is impossible. As I think back, the only change I’ve made is that I have been semi regularly been taking emergenc supplement, only 800iu of d3 w/other vitamins, but I by nature am extremely sensitive to any form of supplement or medication. It dawned on me this morning that I think this might be happening on the days I’ve taken the supplement. I’m going to stop taking the emergenc supplement and see what happens. Just wondering if you think this could be contributing to my issue?

    Reply
  5. 12
    Debby says:
    September 18, 2020 at 1:15 pm

    I realize this is an older post, but Thank you so much for this article! I was beginning to think I was going berserk! I keep telling my doctor that every time I take vitamin D my hot flashes return and he says he had never heard of that before. I even tried transdermal D – same result. This correlation must not be widely known in the medical community.

    Reply
  6. 11
    Bridget says:
    July 24, 2020 at 9:05 am

    Started a new supplement for hair growth and it has a large amt of vitamin D. Hot flashes are constant! Prior to the new supplement, i was taking another product for hot flashes and haven’t had one since Dec 2019. Could the high vitamin d triggered a restart?

    Reply
    • 11.1
      SAFM Team says:
      July 27, 2020 at 11:00 am

      Yes, it is possible that high dose vitamin D in your supplement contributed to the return of hot flashes. As described in the article above you may want to check or ensure that your magnesium levels are adequate as means of getting the body back to balance and if the reduction of vitamin D is not possible. This study, in particular, speaks to that:
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085555/
      Also, keep in mind that you do want to monitor your vitamin D levels via blood work when taking larger amounts on a daily basis.

      Reply
  7. 10
    Cynthia says:
    May 5, 2020 at 8:07 pm

    This is interesting because I always get so hot and sweaty when I take D3. My level two years ago was 57 so I’m guessing it’s higher. I wake up in the nights with “warm” flashes that constantly wake me up. I take 400 mgs. of magnesium glycinate, but I’m thinking now to stop D3 altogether for awhile and see if I sleep better. Thank you for posting. I think my body must be saturated with too much D3 and it’s time for me to take a break. I am four years post menopausal and haven’t had a full night of sleep in 13 years. My cortisol is normal according to a saliva test. Have you heard of women sleeping better once they cut out or cut back on the D3?

    Reply
  8. 9
    Tracey says:
    January 29, 2020 at 11:50 am

    Hi I’m 36 and in the last few months I started
    taking 6000iu of vitamin d for Chronic fatigue.
    My levels were initially at 20 and in general
    I’ve noticed an improvement in my symptoms.
    However I’ve been experiencing period problems
    the last few weeks with an unusually short period,
    hot flashes, insomnia and extreme fatigue. Could this be
    this be perimenopause
    or is it possible that the
    cause is too much vitamin d affecting my
    hormone levels ?

    Reply
    • 9.1
      SAFM Team says:
      February 14, 2020 at 6:11 am

      Alas, we cannot comment on individual and personal questions in this venue. However, in the light of what you are presenting it would be worth checking your RBC magnesium levels and/or do a trial with magnesium in a supplement form.

      Reply
  9. 8
    Mary L White says:
    June 14, 2018 at 8:11 pm

    Hi, I’m on 50,000 units of vitamin d it’s my first week and I have hot flashes really bad and I have had a complete hysterectomy when I was 32yrs old I am now 52, how do I handle hot flashes and is it normal to be hungry from taking this large dose of vitamin d. Thank you

    Reply
  10. 7
    Marla says:
    March 14, 2018 at 9:38 am

    The lab results from a recent physical showed I was very low in Vitamin D…. 18 was the result. My doctor prescribed
    50,000 IU of Vitamin D once a week and 800 Vitamin D daily. The doctor did not say anything about Magnesium.
    After I take the weekly pill I have intense hot-flashes for a couple of days. What type of Magnesium would you
    recommend I use to help? Thank you.

    Reply
  11. 6
    HH says:
    December 4, 2017 at 7:51 pm

    Hi,

    Your link is the first one to help explain why I experience a “hot flash” early afternoon while taking vit D. I’ve tried ALL types of vitamin D (with or without oil, with or without K2, with or without magnesium, D2 or D3, etc) and have asked a handful of docs (psychiatrist, PCP, derms, etc) about this with no answers!! I am in my early 30’s, and didn’t even know it was a “hot flash”. Severity would correspond to the dosage. Thank you! Curiously, the same exact feeling (which I now realize to be like a hot flash) happened a few hours after I would take off my birth control patch.

    I am in my early 30’s + healthy. However I get painful burning hot face every evening. This had a sudden onset after I quit estrogen/progesterone birth control. The burning intensity correlates to high estrogen times in my menstrual cycle. Curious if you had any thoughts on this — over a dozen world-class MD’s are stumped.

    Reply
    • 6.1
      SAFM Team says:
      December 21, 2017 at 11:14 am

      You are very welcome! I can appreciate the ease that understanding can bring. Anything that causes a sudden “surge” in estrogen one way or another (regardless of whether the ongoing, average level is high, optimal, or low) can cause an adrenaline rush that creates the feeling of a “hot flash”. Give the specific burning in your face, however, this sounds like a potentially, completely different scenario, especially if it happens *every* evening. If you consume wine most evenings (other alcohol too, but especially wine), this could *easily* be the driver. A surge in histamine can cause what you describe, perhaps from a specific food or environmental trigger? A very common cause is also using a B-complex supplement or multivitamin which contains niacin. Being in a higher estrogen state might exacerbate this dynamic. Your birth control pill may also have been keeping your estrogen dominance under control; with natural (higher) levels of estrogen back in play (perhaps exacerbated by suboptimally low progesterone), you become more vulnerable to histamine issues. The evening might be a time when your cortisol level crashes or surges strongly which can be an exacerbating factor. A DUTCH Complete test and some support from a functional medicine practitioner might help you to get to the true root causes, but indeed, there are many possible, credible, hormonal causes of what you describe. I wish you the very best with your wellness journey!

      Reply
  12. 5
    Joan Zietlow says:
    August 20, 2017 at 11:47 pm

    Would you boost with mag during the high vit D also, and if so how much?

    Reply
    • 5.1
      SAFM Team says:
      August 24, 2017 at 1:17 am

      Keep in mind that this article is not necessarily highlighting an effect of “high” Vitamin D. In some cases, the hot flashes are happening as one supplements with Vitamin D to try to address a low or moderate level. Magnesium can indeed be driven down to suboptimal levels due to its uptake in the final Vitamin D conversion. And low levels may contribute to hormone balance as well. But this may or may not be at play in each individual case. I would use insight from the entire case to decide if/how much/what type of magnesium might be helpful (just as with any other client). RBC magnesium lab data can also be quite helpful (as we have discussed in many other posts).

      Reply
  13. 4
    Mara Schiffren says:
    October 4, 2016 at 11:55 am

    Hi. Dr. Ronald Hoffman has a protocol to use mega dose Vitamin D3 to cure colds. Take 50,000IU 3-4 days in a row. I’ve used that myself since I learned of it and it is the only thing in my life that cures incipient colds in a few days rather than them taking hold and going through a regular cold cycle. I’ve never noticed an issue with hot flashes or is that only a problem that would arise in certain cases?

    What is your perspective?

    Reply
    • 4.1
      SAFM Team says:
      October 4, 2016 at 4:31 pm

      Indeed – good for you! I too use an “immune boost” approach (for myself and also my own clients) to ward off symptoms from a viral or bacterial infection. I don’t personally recommend 50K IU Vitamin D but rather 10-20K IU Vitamin D, 40mg zinc piccolinate, and perhaps 10K IU Vitamin A (because it works in tandem with Vitamin D). And this works very well! I totally agree with the overall concept. And certainly for short-term boost issues, I doubt there would be any significant hormonal effects. The article topic here is really more about ongoing, maintenance use of Vitamin D at a level that has this effect on specific individuals.

      Reply
  14. 3
    Heather Green says:
    October 4, 2016 at 12:33 am

    Tracy, if Vitamin D is in fact exacerbating a woman’s hot flashes, would you recommend a lower dose? Using the sun instead? I know this can be harder in the Eastern part of the U.S.

    Reply
    • 3.1
      SAFM Team says:
      October 4, 2016 at 4:27 pm

      Indeed. Either of those options can help. As I said above, I would also want to be sure that their magnesium is optimal to ensure maximum benefit of the Vitamin D that they are taking. I have had a few female clients make this choice, allowing their Vitamin D to come down into the upper 40s (vs. 60s) for a better overall result in aggregate. It’s definitely going to be an individual balance choice for each unique individual.

      Reply
  15. 2
    Heather Green says:
    October 4, 2016 at 12:22 am

    Can low Vitamin D itself cause hot flashes?

    Reply
    • 2.1
      SAFM Team says:
      October 7, 2016 at 11:02 am

      Alas, I think the research into this topic is inconclusive. For example: https://www.sciencedaily.com/releases/2014/04/140416090801.htm . This most recent study showed no connection, but prior ones have done so. I have definitely had a few clients whose night sweats in particular (not during the day) improved significantly with raising their clinically-low vitamin D; I believe this is associated with Vitamin D’s role in promoting serotonin action (a neurotransmitter that helps to regulate body temperature). So bottom line: the research is unclear, but my limited experience in this particular arena with my own clients says there can indeed be a connection *sometimes*. http://www.medscape.com/viewarticle/834983

      Reply
  16. 1
    Aimee Peterson says:
    October 1, 2016 at 12:38 pm

    Hi Tracy,
    So what would you recommend for a perimenopausal client who is struggling with overall low hormones and low mood? Initially her D was very low but now is better since she started supplementing. She needs to continue with D supplementation, right? But maybe at moderate levels to minimize the effect on hormones? She is working with her doctor to balance hormones and thyroid. Any thoughts or recommendations in this scenario?
    Thanks for everything you do!
    Aimee

    Reply
    • 1.1
      SAFM Team says:
      October 4, 2016 at 4:21 pm

      Indeed, it’s a delicate balance! In these situations, I would definitely want to understand RBC magnesium and optimize that mineral in order to ensure the Vitamin D she is taking is being optimally used. I would definitely use the menopausal recommendations I have made elsewhere *first* (e.g. ground flaxseed, black cohosh, maca, etc.). My intent was to suggest Vitamin D as a possible missing puzzle piece if those other remedies in aggregate were not having the expected effect. I would not drill this down to a “to D or not to D” question. It’s important that D on its own be adequate for many other reasons as well. (As an aside, with overall low hormones, you especially want to make sure this client optimizes magnesium AND takes Vitamin K2 to help maximize retention of bone density.)

      Reply
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