Menopause vs Thyroid Hot Flashes and How to Stop Them
To effectively treat hot flashes, you need to know exactly what’s causing them.
Hot flashes are most commonly associated with menopause. But they can also be triggered by thyroid disease.
“Symptoms like hot flashes can easily be misidentified as menopause, when in fact they may signal a thyroid imbalance such as hyperthyroidism,” says Dani Dominguez, MS, RDN.
Further complicating matters, hot flashes aren’t the only overlapping symptom between menopause and thyroid disorders. In a 2024 position statement, the European Menopause and Andropause Society noted that thyroid disease can mirror menopausal symptoms like mood swings, decreased libido, and menstrual irregularities, making diagnosis difficult. 1
Here are some ways to tell whether hot flashes are caused by thyroid issues or menopause, and how to treat them.
About the Experts
Chhaya Makhija, M.D., is a triple-board-certified physician; a specialist in diabetes, endocrinology, and metabolism; and the founder of Unified Endocrine & Diabetes Care
Dani Dominguez, MS, RDN, is a full-time fellow with All Access Dietitians, where she provides virtual nutrition counseling and health coaching.
Menopause vs. Thyroid Hot Flashes
Thyroid hot flashes are caused by high thyroid hormone levels, while menopause hot flashes are linked to low estrogen levels.
- Thyroid hot flashes: Caused by an overactive thyroid (hyperthyroidism), which speeds up the body’s metabolism. People with hyperthyroidism are intolerant of heat and feel hotter than others, says Chhaya Makhija, M.D., a triple-board-certified physician and specialist in diabetes, endocrinology, and metabolism.
- Menopause hot flashes: Caused by declines in estrogen that affect temperature regulation in the brain. Up to 80 percent of women experience menopause hot flashes, according to The Menopause Society, as estrogen fluctuates wildly in perimenopause, then sharply declines when menstruation stops. 2
Research suggests that thyroid issues can make menopause hot flashes worse. 3
Hyperthyroidism
Hot flashes in hyperthyroidism happen because your body is producing too much thyroid hormone, which speeds up your metabolism. The excess thyroid hormone tells your body to burn more energy, thereby creating more internal heat.
At the same time, thyroid hormones, including TSH, T3, and T4, trigger “fight or flight” response, which makes you feel flushed, sweaty, and overheated, often without warning. The resulting intense waves of heat feel like menopausal hot flashes.
Hyperthyroidism affects 1.3 percent of people in the U.S., the majority of them women. 4 Nearly 40 percent of women with the condition are diagnosed between the ages 45 and 64—a period that overlaps with the menopause transition. 5 This may be because estrogen seems to regulate thyroid disease, potentially by impacting thyroid hormone receptors. 6
What do hyperthyroid hot flashes feel like?
What sets hyperthyroid hot “flashes” apart from menopausal hot flashes is timing: Hyperthyroid heat waves tend to be constant and worsen in waves, but tend to be unrelenting between these episodes (meaning: these patients are either hot or hotter). Hyperthyroid patients’ skin often remains flushed and warm to the touch, and is sometimes referred to as “hyperthyroid skin.” Menopausal hot flashes, on the other hand, typically last one to five minutes and women can feel relatively cool between episodes. 7 8
In addition to hot flashes, hyperthyroidism also leads to symptoms like weight loss, sweating, anxiety, rapid or irregular heartbeat, and increased sympathetic activity—which prepares the body for ‘fight or flight’—making the entire system metabolically overactive. 9 Weight loss is the biggest differentiator: it’s common in hyperthyroidism and unusual as a symptom of menopause.
Hypothyroidism
Hypothyroidism, or an underactive thyroid, isn’t linked to hot flashes, though it can cause cold flashes—as can menopause.
While hypothyroidism is typically diagnosed during the reproductive years, up to 20 percent of women in menopause have the condition. 10 It’s often treated with thyroid replacement medications such as:
How to Know Whether You Have a Thyroid Condition
Thyroid disorders are diagnosed through blood tests that measure several thyroid biomarkers: 11
- Thyroid-stimulating hormone (TSH): TSH is akin to a manager for your thyroid. It tells your thyroid when to get to work making T3 and T4, which help to control your energy, metabolism, and mood.
- T4: Think of thyroxine (T4) as the “storage” hormone; it’s made in larger amounts and floats around in your blood, waiting to be converted into T3 when your body needs it. You might have enough T4, for example, but if your body isn’t converting it into T3 properly, it can lead to fatigue and weight gain.
- T3: Triiodothyronine (T3) is the “active” hormone that actually does the work, helping control your metabolism, energy levels, body temperature, and even your mood.
“Depending on these hormone levels, antibody testing may also be performed to differentiate between types of thyroid dysfunction,” Makhija says
The most common causes of hyperthyroidism are Graves’ disease (an autoimmune issue), thyroid nodules that are making too much hormone, and temporary inflammation after pregnancy or a virus, Makhija says.
To help determine why you’ve developed hyperthyroidism, a nuclear medicine thyroid scan can be used to measure the gland’s functioning. Thyroid antibody tests and ultrasound can also be performed to help detect Graves’ disease.
How to Stop Thyroid Hot Flashes
Treatment for thyroid hot flashes typically includes antithyroid medications and lifestyle changes, but in some cases, radioactive iodine or surgery might be recommended.
Medication
Hot flashes due to hyperthyroidism can often be treated with an antithyroid medication like methimazole or propylthiouracil (PTU).
Methimazole slows down the production of T3 and T4 to ease many of the symptoms of hyperthyroidism, including hot flashes and night sweats. It’s often the first treatment doctors try, especially for Graves’ disease. 12
PTU works similarly to methimazole, reducing the amount of thyroid hormone your body produces. It’s sometimes used during pregnancy or in people who can’t tolerate methimazole. By lowering those hormone levels, PTU can also bring relief from hot flashes and other symptoms like a racing heart or unexplained weight loss. 13
Lifestyle Changes to Stop Thyroid Hot Flashes
In addition to medication, lifestyle changes can also help ease hot flashes from hyperthyroidism.
- Watch your iodine intake. Your body needs iodine for a healthy thyroid, and most people handle extra (from iodized salt, seaweed, supplements, or even drinking water) just fine. But it’s believed that in some cases, having too much iodine can lead to hot flashes.14 Dominguez recommends limiting extra iodine and incorporating key nutrients such as zinc, selenium, and vitamin D to support thyroid function. Just be careful to check the RDA and maximum recommended doses to avoid possible side effects.
- Avoid thyroid hot flash triggers. Strenuous exercise in hot environments may make hot flashes more likely because it, too, increases heat production in the body. And while there are limited large-scale studies on whether caffeine and alcohol trigger hot flashes, it might not hurt to limit your intake. “Hyperthyroidism can heighten the activity of the sympathetic nervous system, so it stands to reason that stimulants like caffeine can further exacerbate this response and potentially worsen hot flashes,” Dominguez says. “Alcohol is known as a vasodilator, which means that it causes the blood vessels to widen. Due to hot flashes having the same mechanism, alcohol can contribute to the sensation of a hot flash and should be a trigger to keep in mind for those who deal with this condition.” 15 16. Niacin (vitamin B3), which is included in some vitamins and energy drinks, may also trigger hyperthyroid hot flashes.
The Bottom Line
Thyroid hot flashes are typically caused by hyperthyroidism, a condition in which the body produces too much thyroid hormone. Symptoms of a thyroid hot flash and a menopause hot flash can overlap, but thyroid hot flashes tend to feel sustained. Hot flashes from hyperthyroidism are typically treated with medication, but can be further managed with certain lifestyle changes.
Mintziori, Gesthimani et al. (2024.) EMAS position statement: Thyroid disease and menopause.
↑The Menopause Society. Menopause Topics: Hot Flashes
↑Slopien, R. et al. (2019.) Climacteric symptoms are related to thyroid status in euthyroid menopausal women
↑Doubleday, Amanda R. et al. (2020) Hyperthyroidism
↑Gietka-Czernel, Małgorzata Gietka-Czernel. The thyroid gland in postmenopausal women: physiology and diseases
↑Santin AP, Furlanetto T (2011) Role of estrogen in thyroid function and growth regulation
↑Safer, Joshua D. Thyroid hormone action on skin
↑Freeman EW, et al. (2011). Duration of menopausal hot flushes and associated risk factors.
↑Doubleday, Amanda R. et al. (2020) Hyperthyroidism
↑British Thyroid Foundation. Thyroid and menopause
↑Armstrong, Maggie et al. (2023.) Physiology, Thyroid function
↑Awosika, Ayoola O. et al. (2023.) Methimazole
↑Amisha, Fnu et al. (2023.) Propylthiouracil (PTU)
↑Farebrother, Jessica et al. (2019.) Excess iodine intake: sources, assessment, and effects on thyroid function
↑Ahmad, Mahlika et al. (2022.) Hyperthyroidism and the Risk of Cardiac Arrhythmias: A Narrative Review
↑Fuchs, Flavio D. (2005.) Vascular Effects of Alcoholic Beverages: Is It Only Alcohol That Matters?
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About the author
Kelly Bryant is a freelance writer and editor of over 20 years, covering the health and wellness space for media outlets like The Healthy, Reader's Digest, Parents and more
About the reviewer
Dr. Steven D. Wise is board-certified in endocrinology, diabetes, metabolism, and internal medicine. He is a fellow of the American Association of Clinical Endocrinologists (FACE).
