💉 Helpful Doctors: New York

 

Michele M (Michele), added her Helpful Doctor, Toni Murphy, to the Cushing’s MemberMap

How would you rate your Helpful Doctor? 5/5
Your Doctor’s Name Toni Murphy
Your Doctor’s Address Street Address: Harlem Road
City: West Seneca
State / Province: NY
Postal / Zip Code: 14224
What are your Doctor’s Specialties? Endocrinologist
What are your Doctor’s Hospital Affiliations? Mercy Hospital

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ℹ️ Understanding Cortisol: The Stress Hormone Explained

The Double-Edged Sword of Cortisol

Cortisol often receives negative attention, typically branded as the “stress hormone.” This steroid hormone plays a crucial role in the body’s ability to manage stress. However, many people remain unaware of the signs of elevated cortisol levels and what they might signify.

Recognising Elevated Cortisol Levels

You may have encountered social media trends that equate certain physical features, like facial puffiness, with high cortisol, often referred to as “cortisol face” or “moon face.” These viral portrayals have sparked curiosity and concern, but they may not paint the complete picture. Experts emphasize understanding cortisol’s broader role in health.

According to Dr. Jeannette M. Bennett, an associate professor in psychological science at the University of North Carolina at Charlotte, cortisol is vital for regulating inflammation and supporting immune function. It helps us fend off illnesses by managing the body’s responses to toxins and pathogens. This hormone also has significant effects on metabolism, blood pressure, blood sugar regulation, and the sleep-wake cycle.

As Dr. Nia Fogelman, associate research scientist at the Yale Stress Center, points out, cortisol enables the body to respond effectively to immediate dangers, providing the energy needed for fight-or-flight responses. However, certain medical conditions can lead to abnormal cortisol levels, either too high or too low, such as Cushing’s syndrome or Addison’s disease.

Identifying Symptoms of High Cortisol

Elevated cortisol levels don’t manifest through a single, obvious symptom, making them tricky to pinpoint. Nonetheless, there are several signs to watch for, including:

Sleep Disturbances**: Difficulty falling asleep or frequent awakenings can be indicative of high cortisol levels, though the relationship remains unclear.

Physical Changes**: Symptoms such as weight gain around the face and abdomen, increased hair growth, fat accumulation between the shoulders, and the appearance of purplish stretch marks may occur.

Mood Swings**: Increased irritability or overreacting to minor annoyances can signal high cortisol levels.

Food Cravings**: A strong desire for sugary, salty, and fatty foods can be a coping mechanism for underlying stress.

Persistent Fatigue**: Increased fatigue, headaches, and muscle weakness may also hint at elevated cortisol levels, particularly in the arms and thighs.

Hidden Issues**: High blood pressure, elevated blood sugar, and bone fragility are silent symptoms that require medical diagnosis.

 Understanding the Root Causes of High Cortisol

Several factors can lead to heightened cortisol levels:

Chronic Stress**: Unlike temporary stress, chronic stress can keep cortisol levels elevated long after a stressor has passed. Chronic stress may result from traumatic events or ongoing pressures in one’s personal or professional life.

*Mental Health Issues**: Conditions such as chronic alcohol abuse, depression, and anxiety can similarly elevate cortisol levels.

Cushing’s Syndrome**: This rare condition results from prolonged high cortisol levels and can lead to serious complications, including diabetes and bone loss. It may arise from high doses of corticosteroid medications or specific tumors that induce excess hormone production.

When and How to Test Cortisol Levels

Cortisol testing is not routinely done during medical check-ups, and there currently aren’t any at-home tests available to assess cortisol levels. Most healthcare providers only recommend testing for cortisol if there are symptoms indicative of conditions like Cushing’s syndrome.

If you experience symptoms linked to high cortisol, your doctor may suggest conducting tests to investigate further. Keeping track of your stressors and observable symptoms can help guide this conversation. Noticing that your symptoms worsen with increased stressors might indicate you’re not dealing with chronically elevated cortisol.

Several methods exist for testing cortisol levels, and they often involve multiple assessments due to natural fluctuations in cortisol throughout the day. These methods include:

Blood Tests**: Useful for diagnosing adrenal insufficiency and Cushing’s syndrome, but the timing of tests is crucial.

ACTH Stimulation Test**: Measures how well the adrenal glands respond to ACTH, requiring blood samples before and after an injection.

Urine Tests**: A 24-hour urine collection can be used to screen for Cushing’s syndrome.

Saliva Tests**: These are often done at home and can help identify risk for Cushing’s syndrome.

What Constitutes Normal Cortisol Levels?

Cortisol levels are typically highest in the morning and decline throughout the day, reaching their lowest point around midnight. The interpretation of cortisol levels depends on the specific tests performed.

It is essential to discuss test results with your doctor, who can help determine if your levels fall within a healthy range or indicate potential health issues.

The Importance of Awareness

Cortisol is integral to our body’s response to stress and various essential functions. However, persistently high levels can lead to multiple health concerns, including fatigue, weight gain, and mood fluctuations. If you suspect your cortisol levels may be elevated, it is advisable to consult your physician for evaluation and possible testing.

From https://aseannow.com/topic/1347298-understanding-cortisol-the-stress-hormone-explained/

 

Dr. Friedman Has Partnered With Ulta Lab Tests to Offer Affordable, Hassle-Free Lab Testing at About One-Tenth the Cost of Going Through Insurance

Ulta Lab Tests Overview for Dr. Friedman’s ​​​​​​​patients.

Ø  Tired of dealing with insurance or the Quest/Labcorp bureaucracy to get your labs done.

Ø  Frustrated at the slow turnaround times at Quest/Labcorp.

Ø  Dr. Friedman understands your concerns and has partnered with Ulta Lab Tests to offer affordable, hassle-free lab testing—typically at about one-tenth the cost of going through insurance, with fast turnaround times.

Ø  The Ulta Lab Tests platform is especially helpful if you are uninsured, underinsured, or have a high deductible.

Ø  Both you and Dr. Friedman will get the results in a few days.

Ø  Please note that Ulta Lab Tests does not work with insurance or handle any insurance billing or reimbursements; all services are self-pay. The only exception is that HSA and FSA cards may be used at checkout.

Patient Instructions 

1.         Change your preference for labs to Ulta Lab in Acuity and/or let Dr. Friedman know at the time of appointment you want to use Ulta Lab

2.         Go to https://www.ultalabtests.com and sign up for an account.

3.         Open the Ulta Lab Tests email from Dr. Friedman’s staff and click the link to your pre-filled cart. This will display the corresponding prices for the selected tests.

4.         Activate your patient account by entering the required demographic information.

5.         Choose a patient service center based on your ZIP code (Quest charges $12.95; “Premium Draw” fees vary).

6.         Complete payment for your order.

7.         Check your email for your order confirmation. Click the embedded link to access your Patient Portal, where you can view and download your Patient Service Center Requisition Form.

6.         Schedule your blood draw (Quest and other appointment optionscan be made through your patient portal).

7.         Review your patient instructions listed on your requisition form to view fasting and testing requirements.

8.         You will receive an email notification once your results are available. From there, you can access them in your patient portal. Dr. Friedman will also have access to your results once they are available.

9.         If you are a new patient, wait for Dr. Friedman to send you a summary of your labs. If you don’t hear from him, send us an email. If you are a follow-up patient, discuss the labs with Dr. Friedman at your next appointment

💉 Helpful Doctors: New Jersey

James K. Liu, MD
Professor of Neurosurgery
Director of Skull Base and Pituitary Surgery
Rutgers University, New Jersey Medical School
RWJ Barnabas Health

Dr. James K. Liu is the Director of Cerebrovascular, Skull Base and Pituitary Surgery at the Rutgers Neurological Institute of New Jersey, and Professor of Neurological Surgery at Rutgers University, New Jersey Medical School. He is board certified by the American Board of Neurological Surgery, and has a robust pituitary tumor practice at University Hospital and Saint Barnabas Medical Center.

Dr. Liu graduated summa cum laude from UCLA with Phi Beta Kappa honors, and obtained his MD from New York Medical College with AOA honors. After completing a neurosurgery residency at the University of Utah in Salt Lake City, he was awarded the Dandy Clinical Fellowship by the Congress of Neurological Surgeons, and obtained advanced fellowship training in Skull Base, Cerebrovascular Surgery & Neuro-oncology at the Oregon Health & Science University in Portland.

Dr. Liu is renowned for his comprehensive treatment of complex brain tumors and skull base lesions, including pituitary tumors, acoustic neuromas, meningiomas, craniopharyngiomas, chordomas, and jugular foramen tumors. His robust clinical practice encompasses both traditional open and minimally invasive endoscopic endonasal skull base approaches. He also specializes in microsurgery of cerebrovascular diseases including aneurysms, arteriovenous malformations (AVMs), cavernous malformations, and carotid artery stenosis. He also has expertise in cerebrovascular bypass procedures for moya moya disease, carotid artery occlusion, vertebral artery occlusion, complex aneurysms and skull base tumors, as well as endoscopic-assisted microvascular decompression for trigeminal neuralgia and hemifacial spasm.

As one of the most active researchers in his field, Dr. Liu has published extensively with over 250 peer-reviewed publications and 25 textbook chapters. He has taught many hands-on cadaver dissection courses in skull base surgery and has lectured extensively nationally and internationally throughout North America, Latin America, Europe, and Asia. Dr. Liu’s research is focused on the development of innovative and novel skull base and endoscopic techniques, quantitative surgical neuroanatomy, microsurgical and microvascular anastomosis skills training, virtual surgical simulation, pituitary tumor biology, and clinical outcomes after skull base and cerebrovascular surgery.

Dr. Liu is an active member of the American Association of Neurological Surgeons, Congress of Neurological Surgeons, North American Skull Base Society, Pituitary Network Association, The Facial Pain (Trigeminal Neuralgia) Association, AANS/CNS Cerebrovascular Section, Tumor Section. He serves on the medical advisory board of the Acoustic Neuroma Association of New Jersey, and is the current Secretary-Treasurer of the International Meningioma Society.

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