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Flushing: Neuroendocrine Mechanisms and a Structured Diagnostic Approach.

Manuel Ramón García-Sáenz1, Ernesto Sosa-Eroza1, Aldo Ferreira-Hermosillo2

  • 1Servicio de Endocrinología, Hospital de Especialidades "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.

Clinical Endocrinology
|May 12, 2026
PubMed
Summary
This summary is machine-generated.

Flushing, a common symptom of heat and redness, signals underlying neuroendocrine and vascular issues. Understanding these mechanisms aids in diagnosing serious conditions by distinguishing between wet and dry flushing.

Keywords:
flushinghypogonadismmenopauseneuroendocrine regulationserotonergic signalingsex steroidsthermoregulationvasomotor symptoms

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Area of Science:

  • Neuroendocrinology
  • Vascular Biology
  • Dermatology

Background:

  • Flushing is a common symptom of vasodilation and erythema, often with heat sensation.
  • It can indicate various endocrine, neuroendocrine, autonomic, inflammatory, pharmacologic, or neoplastic disorders.

Purpose of the Study:

  • To review neuroendocrine and vascular mechanisms of flushing.
  • To propose a structured diagnostic approach based on symptom patterns and pathophysiology.

Main Methods:

  • Narrative literature review on thermoregulation, neuroendocrine signaling, and vascular control.
  • Synthesis of evidence to develop a mechanistic framework and diagnostic algorithm.

Main Results:

  • Flushing involves disrupted thermoregulation, involving hypothalamic nuclei and peripheral pathways.
  • Vasoactive mediators like serotonin, histamine, and prostaglandins play key roles.
  • Neurotransmitters, endothelial function, and autonomic tone modulate vascular response.

Conclusions:

  • Flushing reflects integrated neuroendocrine and vascular dysregulation, not just a skin issue.
  • Distinguishing wet vs. dry flushing and using a mechanism-based approach improves diagnosis.
  • This facilitates earlier identification of significant underlying disorders.