adrenal

ℹ️ Basics: Cushing’s Syndrome Overview

MaryO Cushing's Awareness Challenge , , , , , , , ,

Cushing’s syndrome is a rare disorder that occurs when the body is exposed to too much cortisol. Cortisol is produced by the body and is also used in corticosteroid drugs. Cushing’s syndrome can occur either because cortisol is being overproduced by the body or from the use of drugs that contain cortisol (like  prednisone ).

Cortisol is the body’s main stress hormone. Cortisol is secreted by the adrenal glands in response to the secretion of adrenocorticotropic hormone (ACTH) by the pituitary. One form of Cushing’s syndrome may be caused by an oversecretion of ACTH by the pituitary leading to an excess of cortisol.

Cortisol has several functions, including the regulation of inflammation and controlling how the body uses carbohydrates, fats, and proteins. Corticosteroids such as prednisone, which are often used to treat inflammatory conditions, mimic the effects of cortisol.

Stay tuned for more basic info…

ℹ️ Basics: Adrenal Surgery: One Patient’s Experiences

MaryO Basic Info , , , ,

​Extracted and adapted from this series: https://cushings.invisionzone.com/topic/51040-on-my-way-to-getting-well/

Post 1) I was officially diagnosed with Cushing’s yesterday. I have a CT scan to check on my adrenal tumor and a meeting with my surgeon tomorrow. Hopefully they will schedule surgery for Monday or Tuesday. I have suffered over a year with this, been in congestive heart failure, and believe this cortisol caused my son to be stillborn in March. It’s been the year from hell. Please pray that all goes well tomorrow and that I will be cured of this once and for all!!

Post 2) Surgery set for the 23rd!!!!! He is planning a right adrenaltectomy. I am so darn excited…

Post 3) I’m almost two weeks out of adrenal surgery. He removed the tumor & my gland. This has been the hardest and most painful two weeks of my life. I am already noticing little changes in my body. My skin is getting texture, my hair is not as brittle, my swelling goes down each day, and my nails are white instead of yellow and are stronger. I am getting hair back on my arms, legs, & feet too. I can’t wait to continue to get well. I am ready to be able to get out and about. I am pretty much housebound now because of the pain of the withdrawal from the cortisol. I stay on my painkillers and rest in my recliner. Hubby bought it for me because I can’t sleep in the bed comfortably. He’s the best. He’s been sleeping on our air mattress in the living room with me for almost 2 weeks now. He is always there to help me get out of the recliner when I need to. He is amazing. Just wanted to update you all. Getting better everyday.

Post 4) I am on 40mg Hydrocortisone daily right now. I will have my first wean close to Christmas. I have an appt. on the 21st with my endo. She is fantastic and saved my life from this stuff. I am so blessed. Today is a rough day. I did have 2 good days in a row which was a huge blessing. Thanks for thinking of me!

Post 5) Well, I just survived month 1 of recovery. It was HORRIBLE. I have never had so much pain in my life. I am still on 40 mg and my endo. wants me to wean 10 mg starting on the 27th. We’ll see how it goes. I have so much pain, shaking, chills, no sleep NOW. I can’t imagine how its going to be on a lower dose. My cortisol level was SO HIGH (2107) before surgery. I knew this withdrawal was going to be terrible. SHe had never seen a level as high as mine before. The lab actually tested my urine twice because they didn’t believe it the first time. I am doing a lot of resting right now. I am very nervous about my mother leaving on New Year’s Day. I don’t know how I am going to handle my 3 year old on my own. I hurt so badly and my vision isn’t the greatest yet. Thanks for thinking of me and writing me back.

Post 6) We have another call into my endo about my suffering. I have done nothing but shake uncontrollably all day so far. I hurt so badly. I am up every hour at night writhing in pain. I refuse to suffer like this anymore. I want some relief. Thank you so much for all of the advice. It means the world to me. Great news is that I am off my BP meds as of today!! Cardiologist’s office said I could quit them. I am thrilled. Now to get this pain under control.

Post 7) Endo said we can do whatever I can tolerate. I am now doing 20/20/10 instead of 20/10/10. I am still in pain, but it’s a little more tolerable. She said if I am just miserable and can’t take the pain, then I can do a bedtime dose. I am going to try melatonin to help me sleep per her suggestion. She wants to see how I do on this new dose and start a slow wean in a few weeks.

Post 8) Things have been getting better by the week. New years day was my best physical and mental day so far. I can actually feel my old self returning! !! Today I have lots of bone/muscle pain. Its better than a few weeks ago by far. Yesterday I was able to enjoy my son and play with him for the first time in a long time. I could even dance a little with him. He was so happy. I am down to 20/17.5/10& am handling it well. The pain is tolerable. My hump is almost gone, my stomach is mushy and shrinking, skin is peeling and improving, hair is growing in normally. I will be six weeks out this Wed.

 

​

ℹ️ Basics: Cushing’s Syndrome vs Cushing’s Disease

MaryO Basic Info , , ,

What is Cushing’s syndrome?

Any condition that causes the adrenal gland to produce excessive cortisol results in the disorder Cushing’s syndrome. Cushing syndrome is characterized by facial and torso obesity, high blood pressure, stretch marks on the belly, weakness, osteoporosis, and facial hair growth in females.

Cushing’s syndrome has many possible causes including tumors within the adrenal gland, adrenal gland stimulating hormone (ACTH) produced from cancer such as lung cancer, and ACTH excessively produced from a pituitary tumors within the brain. ACTH is normally produced by the pituitary gland (located in the center of the brain) to stimulate the adrenal glands’ natural production of cortisol, especially in times of stress.

When a pituitary tumor secretes excessive ACTH, the disorder resulting from this specific form of Cushing’s syndrome is referred to as Cushing’s disease.

As an aside, it should be noted that doctors will sometimes describe certain patients with features identical to Cushing’s syndrome as having ‘Cushingoid’ features. Typically, these features are occurring as side effects of cortisone-related medications, such as prednisone and prednisolone.

ℹ️ Cushing’s Basics: The Endocrine System

MaryO Basic Info , , , ,

The endocrine system is a complex network of glands and organs. It uses hormones to control and coordinate your body’s metabolism, energy level, reproduction, growth and development, and response to injury, stress, and mood. The following are integral parts of the endocrine system:

 

  • Hypothalamus. The hypothalamus is located at the base of the brain, near the optic chiasm where the optic nerves behind each eye cross and meet. The hypothalamus secretes hormones that stimulate or suppress the release of hormones in the pituitary gland, in addition to controlling water balance, sleep, temperature, appetite, and blood pressure.
  • Pineal body. The pineal body is located below the corpus callosum, in the middle of the brain. It produces the hormone melatonin, which helps the body know when it’s time to sleep.
  •  Pituitary . The pituitary gland is located below the brain. Usually no larger than a pea, the gland controls many functions of the other endocrine glands.
  • Thyroid and parathyroid. The thyroid gland and parathyroid glands are located in front of the neck, below the larynx (voice box). The thyroid plays an important role in the body’s metabolism. The parathyroid glands play an important role in the regulation of the body’s calcium balance.
  • Thymus. The thymus is located in the upper part of the chest and produces white blood cells that fight infections and destroy abnormal cells.
  •  Adrenal gland . An adrenal gland is located on top of each kidney. Like many glands, the adrenal glands work hand-in-hand with the hypothalamus and pituitary gland. The adrenal glands make and release corticosteroid hormones and epinephrine that maintain blood pressure and regulate metabolism.
  •  Pancreas . The pancreas is located across the back of the abdomen, behind the stomach. The pancreas plays a role in digestion, as well as hormone production. Hormones produced by the pancreas include insulin and glucagon, which regulate levels of blood sugar.
  • Ovary. A woman’s ovaries are located on both sides of the uterus, below the opening of the fallopian tubes (tubes that extend from the uterus to the ovaries). In addition to containing the egg cells necessary for reproduction, the ovaries also produce estrogen and progesterone.
  • Testis. A man’s testes are located in a pouch that hangs suspended outside the male body. The testes produce testosterone and sperm.

📽 Video: How an Emergency Injection works!

MaryO Uncategorized , , , , , , , , ,

What should you do if an Addison crisis threatens? How do you prepare an emergency injection and how do you administer it?

If you have a gastrointestinal infection, accompanied by diarrhea and vomiting, there is a big risk of an Addison crisis.

Always discuss with your specialist what you have done and what else needs to be done. Explain to your family, colleagues and friends what illness you have, and what they should do if necessary.

Show them the animated clip below.

🎬 Video: How the Body Works: The Adrenal Cortex and Medulla

MaryO Cushing's Awareness Challenge , , , , , , ,

The adrenal glands sitting above the kidneys are richly supplied with blood and with sympathetic nerve endings. Block sections show the blood supply and cellular arrangement of the adrenals.

Two different regions are distinguishable–the cortex, controlled by the pituitary hormone ACTH, produces hormones which maintain body chemistry, and the medulla, which secretes adrenaline and noradrenaline to increase body activity.

 

⁉️ Would *YOU* Do This?

MaryO What do you think? , , , , , , ,

I remember someone on the House TV series trying a stunt like this on the episode titled Deception.

At a betting parlor where House happens to be, a woman collapses and House makes sure she gets to the hospital. He thinks she has Cushing’s syndrome while Cameron starts to think she has Münchausen syndrome, a syndrome at which the patient creates the symptoms of a disease, guaranteeing them attention and sympathy.

Rare Case of Woman Manipulating Saliva Tests to Support Cushing’s Diagnosis

Late-night measures of cortisol levels in saliva may not be all that helpful in diagnosing Cushing’s syndrome, a group of physicians discovered upon learning that a difficult to diagnose patient had manipulated the samples.

Although this behavior is extremely rare, the research team from the University of Calgary in Canada, argued that — when a diagnosis becomes difficult — it may be advisable to confirm suspicions using another and more reliable method that can distinguish natural from synthetic glucocorticoids.

The study, “Factitious ACTH- dependent, apparent hypercortisolism: the problem with late night salivary cortisol measurements collected at home,” was published in the journal Clinical Endocrinology.

The case report described a woman who was admitted to a specialist clinic after two endocrinologists had failed to diagnose what they suspected was cyclic Cushing’s syndrome.

The woman had complained of fatigue and weight gain over the past four years despite weight loss banding surgery, and declined taking steroid medications. The examination did not reveal particular Cushing’s symptoms.

Physicians started an investigation, including overnight dexamethasone suppression tests and late-night salivary cortisol tests, which indicate increased levels of cortisol likely caused by abnormal functioning of the ACTH hormone.

Imaging did not show any suspected lesions in the pituitary and adrenal gland, and all further examinations did not reveal any disease changes that might have contributed to the increased cortisol.

The woman was put on a dopamine agonist. This treatment triggered a loss of eight kilograms (almost 18 lbs) over six months, and the woman said she was satisfied with it. But two late-night cortisol measurement showed continuing high cortisol levels.

When the clinic started using a new type of analysis to measure cortisol, however, findings changed. The new test, which was more sensitive, indicated massively higher doses of cortisol in re-analyzed saliva samples compared to the older results.

The new test could detect synthetic glucosteroids, but could not indicate if synthetic steroids were responsible for the higher levels seen in the retest. So the team used a method called liquid chromatography-tandem mass spectrometry. This technique can identify specific molecules, and revealed that the women had manipulated the samples using prednisone.

The woman’s physician also paid a surprise visit to collect a new saliva sample, which turned out to have normal cortisol levels.

The woman neither denied or confirmed manipulating the samples. And the team was contacted two months later by her new physician, requesting confirmation of her Cushing’s syndrome and details on her case.

The researchers believed the woman most likely has what is known as Munchausen’s syndrome, a mental illness that leads patients to feign physical disease. A 1995 report by the National Institutes of Health showed that 0.7 percent of all people investigated for too high cortisol had this syndrome.

Despite the rarity of this case, the team argued that chemical analysis is a valuable tool for both determining sample manipulation in difficult Cushing’s syndrome cases, or a different potential problem.

They also cautioned against putting too much trust in very elevated late-night cortisol, particularly when the symptoms do not match the cortisol increase.

From https://cushingsdiseasenews.com/2017/10/05/rare-case-of-woman-manipulating-late-night-saliva-cortisol-tests-to-get-cushings-diagnosis/

ℹ️ Reasons You or Your Friend or Family Member Should See Dr. Friedman

MaryO Five Star, Helpful Doctors , , , , , , , ,

 

Refer a friend or family member to see Dr. Friedman as a new patient and get a $50 voucher for your next appointment.

Here is a list of reasons you or your friend or family member should see Dr. Friedman

  1. Dr. Friedman thinks outside the box, as willing to look beyond standard testing and treatment approaches.
  2. Dr. Friedman is an expert in pituitary, thyroid and adrenal issues as well as several other endocrine conditions, while most endocrinologists specialize in diabetes or just thyroid disease.
  3. Dr. Friedman has seen and diagnosed more patients with Cushing’s disease, growth hormone deficiency or adrenal insufficiency in a month than most Endocrinologists see in a lifetime.
  4.  Dr. Friedman is well-trained and knows the Endocrine literature well
  5. Dr. Friedman is not beholden to protocols that many university-based Endocrinologists need to follow
  6. Dr. Friedman listens and cares.
  7. Dr. Friedman works with you and not against you
  8. A new patient who wants to be seen by Dr. Friedman can usually get in within a few weeks as opposed to months for other Endocrinologists that are booking out several months.
  9. Dr. Friedman uses conventional medicines, compounded medicines and supplements to optimize your health.
  10. Dr. Friedman works with several compounding pharmacies that prescribes weight loss medications so you can lose weight while you get your hormones optimized.
  11. Dr. Friedman believes should learn all about their health and provides scientific, yet easy to understand articles to help educate his patients.
  12. Dr. Friedman has hired extra staff members, so your needs are addressed in a timely manner.

For more information go to Dr. Friedman’s website https://www.goodhormonehealth.com or contact his office at mail@goodhormonehealth.com.

ℹ️ Cushing Syndrome and Hormone Disorders

MaryO Basic Info , , , , , , ,

MaryO’Note:  This is really basic information.  Maybe News 9 should have checked with a doctor who has actually been diagnosed with Cushing’s or at least tested for it!

~~~~~~~~~~~~~~~~~~~~~~~

In our Daily Dose, a viewer is asking about hormone problems that can cause your face to become round. Dr.  Lacy Anderson  joined News 9 to explain how some hormone disorders, like Cushing syndrome work.

Cushing’s syndrome is a rare disorder caused by the body making too much cortisol over a long period of time. It can be caused by a tumor of the adrenal gland, which makes cortisol, or it can be caused by a tumor of the pituitary gland, which controls the adrenal gland.

Cushing’s syndrome can cause a rounded face, known as a moon face. It can cause weight gain and fat deposits on the upper back, known as a buffalo hump. It can also cause stretch marks on the abdomen. It can cause high blood pressure, and high blood sugar, and increase the risk of cataracts and osteoporosis. Occasionally, Cushing’s syndrome can be caused by long-term, high-dose steroid use.

For pituitary or adrenal tumors, surgery can cure this condition. I’ve had several patients wanting me to check their cortisol levels recently, so this condition may have hit social media feeds, but I’ve never diagnosed Cushing’s syndrome because it’s so rare. I can usually take one look at my patients and reassure them that they don’t have Cushing’s syndrome.

Stay healthy and take care!

A video is included in the article at https://www.news9.com/story/6658b8f860ad19ad44c6da8f/daily-dose:-cushing-syndrome–hormones-disorders

📚 Merck Manuals: Answering Common Questions About Cushing Syndrome

MaryO Basic Info ,

MaryO’Note:  Cushing’s Disease is a subset of Cushing’s Syndrome and is caused by pituitary issues.

High cortisol – and its deleterious effects on the body – may be a more commonly recognized phrase in today’s healthcare lexicon. Still, doctors say there is a need for more awareness of a rare and potentially life-threatening condition involving cortisol, known as Cushing’s Syndrome

 

In a new editorial from MerckManuals.com, Ashley B. Grossman, MD, University of Oxford; Fellow, Green-Templeton College, addresses common patient questions around Cushing syndrome.

1. What causes Cushing syndrome?

Adrenal glands release hormones that help control blood pressure, heart rate, balance of water and salt, response to stress, and more, says Grossman. Cushing syndrome occurs when these glands release too much of the hormone cortisol, or you are taking a hormone like cortisol.

This typically has one of two causes:

  • a tumor in the adrenal glands or cancer in another part of the body
  • taking a corticosteroid medicine for a long time

2. What are the symptoms of Cushing syndrome?

Cortisol is an essential hormone in the body. Having too much can cause many changes, including increases in blood sugar and cholesterol. Corticosteroids also alter the amount and distribution of body fat, says Grossman.

Other symptoms of Cushing syndrome include:

  • Large round face (called a “moon face”)
  • Large amounts of belly fat and fat at the top of your back (often called a “buffalo hump”)
  • Thin skin that bruises easily and heals slowly
  • Purple streaks that look like stretch marks on your chest and belly
  • Getting tired easily
  • Sometimes, extra face and body hair
  • In females, sometimes sudden hair loss from their head

Cushing syndrome can be life-threatening, says Grossman. Very high cortisol will lower your potassium level, which can cause heart problems.

3. What can I expect at a doctor’s appointment for Cushing syndrome?

For patients not taking high levels of steroids, Cushing syndrome is rare, and many symptoms can have other causes. At the same time, the physical changes can be a good indicator of Cushing syndrome, says Grossman.

If you’re experiencing these symptoms, it’s a good idea to see your primary care doctor right away. Bring some photos of yourself from a few years ago so doctors can see how your body may have changed. Doctors will also ask about anything that could increase steroid levels, such as using creams with steroids or inhaled steroids, as well as recreational drug use.

Once a patient is diagnosed with Cushing syndrome, it’s important to see a specialist for further guidance and treatment, says Grossman. Treatment will depend on whether the problem is in the adrenal glands, the pituitary gland, or elsewhere.

4. Is it safe to take steroids?

Steroids can be a game-changing treatment for many patients, but they do have a risk of side effects, says Grossman. They need to be taken as prescribed. Doctors never stop the use of corticosteroids abruptly if people have been taking them for more than two or three weeks. Instead, doctors gradually reduce (or taper) the dose over weeks and sometimes months.

To read more of Grossman’s insights on Cushing syndrome, visit this editorial on MerckManuals.com.

About The Merck Manuals and MSD Manuals

First published in 1899 as a small reference book for physicians and pharmacists, The Merck Manual grew in size and scope to become one of the world’s most widely used comprehensive medical resources for professionals and consumers. As The Manual evolved, it continually expanded the reach and depth of its offerings to reflect the mission of providing the best medical information to a wide cross-section of users, including medical professionals and students, veterinarians and veterinary students, and consumers. In 2015, The Manuals kicked off Global Medical Knowledge 2020, a global initiative with the goal to make the best current medical information accessible by up to three billion professionals and patients around the world by 2020. The Manuals achieved that goal, and today its medical information is available in nearly 250 countries and in 14 languages. It’s continuing its ambitious mission through outreach, education and creating new reliable medical resources. For access to thousands of medical topics with images, videos and a constantly expanding set of resources, visit MerckManuals.com or MSDManuals.com and connect with us on social media: For Consumers in the U.S. and its territories: X (formerly Twitter) and Facebook. For Professionals in the U.S. and its territories: X (formerly Twitter) and Facebook

About Merck

At Merck, known as MSD outside of the United States and Canada, we are unified around our purpose: We use the power of leading-edge science to save and improve lives around the world. For more than 130 years, we have brought hope to humanity through the development of important medicines and vaccines. We aspire to be the premier research-intensive biopharmaceutical company in the world – and today, we are at the forefront of research to deliver innovative health solutions that advance the prevention and treatment of diseases in people and animals. We foster a diverse and inclusive global workforce and operate responsibly every day to enable a safe, sustainable and healthy future for all people and communities. For more information, visit www.merck.com and connect with us on  X (formerly Twitter) , Facebook, Instagram, YouTube and LinkedIn.

Cision View original content to download multimedia: https://www.prnewswire.com/news-releases/merck-manuals-answering-common-questions-about-cushing-syndrome-302422038.html 

SOURCE The Merck Manuals