❓What Do *You* Think?

This came up in the comments to https://cushingsbios.com/2018/11/17/jayne-in-the-media/

The question is

I dropped by this site because my friend’s daughter has Cushings and I wanted to learn more. Is there any chance that Cushings might be manageable or improvable in a way similar to what Izabella Wentz proposes for Hashimotos?

What do you think?

Basics: The Role of Endocrinology in Managing Polycystic Ovary Syndrome and Diabetes

Introduction to Endocrinology

Endocrinology is a medical specialty that focuses on the diagnosis and treatment of diseases related to hormones. Endocrinologists are experts in managing and treating diseases related to the endocrine system, which includes the thyroid, pituitary, adrenal glands, and pancreas. Endocrinologists are trained to diagnose and treat conditions such as diabetes, thyroid disorders, pituitary disorders, and other conditions related to hormones. Endocrinologists also specialize in reproductive health and fertility issues, including PCOS.

Endocrinology is a complex field that requires a deep understanding of the endocrine system and its role in regulating the body’s hormones. Endocrinologists must be able to interpret laboratory tests and understand the underlying causes of endocrine disorders. They must also be able to develop individualized treatment plans to address the specific needs of each patient.

Diagnosing PCOS and Diabetes

Endocrinologists are experts in diagnosing and managing PCOS and diabetes. PCOS is a hormonal disorder that affects the ovaries, and it is characterized by irregular menstrual cycles, excess facial and body hair, and infertility. To diagnose PCOS, an endocrinologist will perform a physical exam and order laboratory tests to measure hormone levels. The endocrinologist will also ask the patient about her symptoms and family history to determine if PCOS is the cause.

Diabetes is a chronic condition that affects the body’s ability to process sugar. To diagnose diabetes, an endocrinologist will perform a physical exam and order laboratory tests to measure blood sugar levels. The endocrinologist may also order imaging tests to check for signs of diabetes-related complications.

Treating PCOS and Diabetes

Once the endocrinologist has diagnosed PCOS or diabetes, they will develop an individualized treatment plan to address the patient’s specific needs. For PCOS, the endocrinologist may recommend lifestyle changes such as weight loss, exercise, and dietary changes to help manage symptoms. The endocrinologist may also prescribe medications to regulate hormone levels and improve fertility.

For diabetes, the endocrinologist may recommend lifestyle changes such as weight loss, exercise, and dietary changes to help manage blood sugar levels. The endocrinologist may also prescribe medications to help regulate blood sugar levels. In addition, the endocrinologist may recommend regular check-ups to monitor the patient’s progress and to adjust the treatment plan if needed.

Conclusion

Endocrinology plays an important role in managing PCOS and diabetes. Endocrinologists are experts in diagnosing and treating these conditions, and they are trained to develop individualized treatment plans that address the specific needs of each patient. By working with an endocrinologist, patients can get the help they need to manage their PCOS or diabetes and achieve their health goals.

Endocrinology is a complex field that requires a deep understanding of the endocrine system and its role in regulating the body’s hormones. An endocrinologist can help patients with PCOS and diabetes manage their conditions and achieve their health goals. By working with an endocrinologist, patients can get the help they need to manage their PCOS or diabetes and achieve their health goals.

From https://www.diabetesincontrol.com/the-role-of-endocrinology-in-managing-polycystic-ovary-syndrome-and-diabetes/

ℹ️ Basics: The Pituitary Gland: Small But Mighty

 

The pituitary gland works hard to keep you healthy, doing everything from ensuring proper bone and muscle growth to helping nursing mothers produce milk for their babies. Its functionality is even more remarkable when you consider the gland is the size of a pea.

“The pituitary is commonly referred to as the ‘master’ gland because it does so many important jobs in the body,” says Karen Frankwich, MD, a board-certified endocrinologist at Mission Hospital. “Not only does the pituitary make its own hormones, but it also triggers hormone production in other glands. The pituitary is aided in its job by the hypothalamus. This part of the brain is situated above the pituitary, and sends messages to the gland on when to release or stimulate production of necessary hormones.”

These hormones include:

  • Growth hormone, for healthy bone and muscle mass
  • Thyroid-stimulating hormone, which signals the thyroid to produce its hormones that govern metabolism and the body’s nervous system, among others
  • Follicle-stimulating and luteinizing hormones for healthy reproductive systems (including ovarian egg development in women and sperm formation in men, as well as estrogen and testosterone production)
  • Prolactin, for breast milk production in nursing mothers
  • Adrenocorticotropin (ACTH), which prompts the adrenal glands to produce the stress hormone cortisol. The proper amount of cortisol helps the body adapt to stressful situations by affecting the immune and nervous systems, blood sugar levels, blood pressure and metabolism.
  • Antidiuretic (ADH), which helps the kidneys control urine levels
  • Oxytocin, which can stimulate labor in pregnant women

The work of the pituitary gland can be affected by non-cancerous tumors called adenomas. “These tumors can affect hormone production, so you have too little or too much of a certain hormone,” Dr. Frankwich says. “Larger tumors that are more than 1 centimeter, called macroadenomas, can also put pressure on the area surrounding the gland, which can lead to vision problems and headaches. Because symptoms can vary depending on the hormone that is affected by a tumor, or sometimes there are no symptoms, adenomas can be difficult to pinpoint. General symptoms can include nausea, weight loss or gain, sluggishness or weakness, and changes in menstruation for women and sex drive for men.”

If there’s a suspected tumor, a doctor will usually run tests on a patient’s blood and urine, and possibly order a brain-imaging scan. An endocrinologist can help guide a patient on the best course of treatment, which could consist of surgery, medication, radiation therapy or careful monitoring of the tumor if it hasn’t caused major disruption.

“The pituitary gland is integral to a healthy, well-functioning body in so many ways,” Dr. Frankwich says. “It may not be a major organ you think about much, but it’s important to know how it works, and how it touches on so many aspects of your health.”

Adapted from http://www.stjhs.org/HealthCalling/2016/December/The-Pituitary-Gland-Small-but-Mighty.aspx

Thoughts? Share on the message boards.

ℹ️ Basics: Testing: What Is a TSH Test?

A TSH test is done to find out if your thyroid gland is working the way it should. It can tell you if it’s overactive (hyperthyroidism) or underactive (hypothyroidism). The test can also detect a thyroid disorder before you have any symptoms. If untreated, a thyroid disorder can cause health problems.

TSH stands for “thyroid stimulating hormone” and the test measures how much of this hormone is in your blood. TSH is produced by the pituitary gland in your brain. This gland tells your thyroid to make and release the thyroid hormones into your blood.

The Test

The TSH test involves simply drawing some blood from your body. The blood will then be analyzed in a lab. This test can be performed at any time during the day. No preparation is needed (such as overnight fasting). You shouldn’t feel any pain beyond a small prick from the needle in your arm. You may have some slight bruising.

In general, there is no need to stop taking your medicine(s) before having your TSH level checked. However, it is important to let the doctor know what medications you are taking as some drugs can affect thyroid function. For example, thyroid function must be monitored if you are taking lithium. While taking lithium, there is a high chance that your thyroid might stop functioning correctly. It’s recommended that you have a TSH level test before starting this medicine. If your levels are normal, then you can have your levels checked every 6 to 12 months, as recommended by your doctor. If your thyroid function becomes abnormal, you should be treated.

High Levels of TSH

TSH levels typically fall between 0.4 and 4.0 milliunits per liter (mU/L), according to the American Thyroid Association. Ranges between laboratories will vary with the upper limit generally being between 4 to 5. If your level is higher than this, chances are you have an underactive thyroid.

In general, T3 and T4 levels increase in pregnancy and TSH levels decrease.

Low Levels of TSH

It’s also possible that the test reading comes back showing lower than normal levels of TSH and an overactive thyroid. This could be caused by:

Graves’ disease (your body’s immune system attacks the thyroid)

Too much iodine in your body

Too much thyroid hormone medication

Too much of a natural supplement that contains the thyroid hormone

If you’re on medications like steroids, dopamine, or opioid painkillers (like morphine), you could get a lower-than-normal reading. Taking biotin (B vitamin supplements) also can falsely give lower TSH levels.

The TSH test usually isn’t the only one used to diagnose thyroid disorders. Other tests, like the free T3, the free T4, the reverse T3, and the anti-TPO antibody, are often used too when determining whether you need thyroid treatment or not.

Treatment

Treatment for an underactive thyroid usually involves taking a synthetic thyroid hormone by pill daily. This medication will get your hormone levels back to normal, and you may begin to feel less tired and lose weight.

To make sure you’re getting the right dosage of medication, your doctor will check your TSH levels after 2 or 3 months. Once they are sure you are on the correct dosage, they will continue to check your TSH level each year to see whether it is normal.

If your thyroid is overactive, there are several options:

Radioactive iodine to slow down your thyroid

Anti-thyroid medications to prevent it from overproducing hormones

Beta blockers to reduce a rapid heart rate caused by high thyroid levels

Surgery to remove the thyroid (this is less common)

Your doctor may also regularly check your TSH levels if you have an overactive thyroid.

From https://www.webmd.com/women/what-is-tsh-test

ℹ️ Cushing’s Basics: The Endocrine System

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.

❓Can You Help?

I think I have Cushing’s I have about 10 symptoms…my cortisol levels came out high with a 24 hour urine hormone panel but my endocrinologist did not even mention it. At the time when I had the test done, (March 2020)I had no idea what cortisol was. I just figured and trusted my endocrinologist would prescribe me with whatever hormones and or treatment I needed and would have me take whatever tests he order. Anyhow, in a range from 1-10 for bedtime cortisol, my result was 27! Cortisol metabolites, range from 1160-2183, my result was 5370!!!

The only reason I started to do more research on cortisol is because just a few weeks ago I started experiencing severe chest pain from the moment I wake up and any little thing stresses me out and gives me anxiety and I feel like I’m gonna have a heart attack any moment!  So I looked back at my paperwork and noticed these really elevated cortisol levels. But my endocrinologist never mention them… Why? This is how I found this disease,  I have so many symptoms of Cushing’s disease, And it is not a result of exogenous stuff causing cortisol levels to rise. I don’t take any medication whatsoever and was not taking any medication at that time or for the past year. All I have taken for the past year is what he prescribed, thyroid medication and progesterone. Someone please tell me if these levels are of concern from your perspective.

Please respond here or on the message boards.

Thanks!

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

 

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.

Considered the “father of neuroendocrinology,” Roger Guillemin died February 21 at age of 100

Salk Distinguished Professor Emeritus Roger Guillemin, recipient of the 1977 Nobel Prize in Physiology or Medicine and neuroendocrinology pioneer, died on February 21, 2024, in Del Mar, California at the age of 100.

Roger Guillemin
Roger Guillemin
Click here for a high-resolution image.
Credit: Salk Institute

“We are incredibly saddened to learn of Roger’s passing,” says Salk President Gerald Joyce. “He leaves a remarkable legacy at Salk and around the world. His brilliance, commitment, and passion for discovery brought forth some of the last century’s most significant advances in our knowledge of the human brain. He was a cherished colleague and mentor to many. I personally mourn his loss and know I speak for the entire Salk community when I say our world is less bright without him in it.”

Guillemin joined Salk in 1970 to head the newly established Laboratories for Neuroendocrinology. He and his group discovered somatostatin, which regulates the activities of the pituitary gland and the pancreas. Somatostatin is used clinically to treat pituitary tumors. He was among the first people to isolate endorphins, brain molecules that act as natural opiates, and his work with cellular growth factors (FGFs) led to the recognition of multiple physiological functions and developmental mechanisms.

Guillemin played a key role in discovering the brain’s role in regulating hormones, substances that act as chemical messengers between different parts of the body and regulate bodily functions. While scientists had long believed that the brain ultimately controlled the function of hormone-producing endocrine glands, there had been scant evidence to prove exactly how it did so.

After meticulous study of materials harvested from 1.5 million sheep brains, Guillemin and his team made a breakthrough. They discovered releasing hormones, produced in small quantities in the hypothalamus of the brain. These are delivered to the adjacent pituitary gland, which in turn is triggered to release its own hormones that are dispersed through the body. Guillemin and Andrew Schally separately extracted a sufficient amount of one releasing hormone to determine its structure in 1969. They subsequently were able to produce it with chemical methods.

Their work would lead them to the 1977 Nobel Prize in Physiology or Medicine, shared also with Rosalyn Yalow for a separate but related discovery, for “discoveries concerning the peptide hormone production of the brain.”

This breakthrough resulted in the identification of a molecule called TRH (thyrotropin-releasing hormone), which ultimately controls all the functions of the thyroid gland. In the following years, he and his colleagues isolated other molecules from the hypothalamus that control all functions of the pituitary gland—for instance, GnRH (gonadotropin-releasing hormone), a hypothalamic hormone that causes the pituitary to release gonadotropins, which in turn trigger the release of hormones from the testicles or ovaries. This discovery led to advancements in the medical treatment of infertility and is also used to treat prostate cancer.

Guillemin was born in Dijon, the capital of France’s Burgundy region, on January 11, 1924. He entered medical school at the Université de Bourgogne in 1943, receiving his MD from the Faculté de Médecine in Lyon (then under the same academic administration as his university in Dijon) in 1949. Although he enjoyed learning about medicine and would practice it for several years before committing to research full-time, much of Guillemin’s youth and college experience was wrought with challenges—not the least of which was the German occupation of France. “Dark years of no fun these were,” he wrote.

Earning his Doctor in Medicine required the composition and defense of a dissertation, something that Guillemin looked forward to doing. “I had always been interested in endocrinology,” said Guillemin. “[An MD thesis] was usually pro forma. I decided, however, to write a dissertation… that I would enjoy, hopefully on some work I could perform in a laboratory.” A challenge to his desire to conduct research was a dearth of lab access. “There was no laboratory facility of any sort in Dijon, except for gross anatomy.”

In a fortuitous turn of events, Hans Selye was lecturing in Paris. Selye was a fellow pioneer of endocrinology, and an eager Guillemin made the journey to hear him speak. “A few months later,” Guillemin said, “I was in Selye’s newly created Institute of Experimental Medicine and Surgery at the Université de Montréal.” Guillemin would go on to earn his PhD in physiology, with a special focus on experimental endocrinology, from the university in 1953.

Shortly after completing his PhD, Guillemin became an assistant professor of physiology at the University of Baylor College of Medicine. Once there, he began to pursue the identity of the chemical mediators of hypothalamic origin, which were primary suspects for controlling pituitary function in the brain.

Guillemin was a mentor to many future leaders in endocrinology and medical research while at Baylor, including Catherine and Jean Rivier and Wylie Vale, who would all follow Guillemin to Salk in 1970 and themselves become professors there.

In addition to the 1977 Nobel Prize, Guillemin was the recipient of numerous accolades for his work. These included the Gairdner International Award, the Dickson Prize, the Passano Award, the Lasker Award, and the President’s National Medal of Science, presented to him by then-President Jimmy Carter. He was also an elected member of the National Academy of Sciences (1974) and the American Academy of Arts and Sciences (1976). Guillemin’s native France recognized his contributions to science and health by naming him a Commander in the Legion of Honour, the country’s highest order of merit. He served as the Salk Institutes’s interim president from October 2007 to February 2009.

For all of his accomplishments, Guillemin was always quick to point out the contributions of the many people who worked alongside him. “I have had the extraordinary privilege to work with wonderful collaborators, some so much more knowledgeable in their own field than I was (or still am), all full of enthusiasm and sharing the common ethics of science,” he wrote as he reflected on achieving the Nobel Prize.

When asked in a September 2017 interview with the La Jolla Light what his philosophy in life was, Guillemin responded, “Help people. I really wanted to be a physician… [and] I knew all my efforts would be to help people.”

Up until his last few years of life, Guillemin was an active member of the La Jolla, California community and was an avid collector of French and American paintings and sculptures, as well as Papuan and pre-Columbian pottery.

Guillemin is survived by his five daughters, one son, four grandchildren, and two great-grandchildren. He was pre-deceased by his wife, Lucienne, a talented musician, who died at the age of 100 in 2021, after the couple was married for 69 years. Guillemin died on her birthday.

From https://www.salk.edu/news-release/salk-institute-mourns-the-loss-of-nobel-laureate-roger-guillemin-distinguished-professor-emeritus/

Dr. Friedman Webinar on Optimal replacement for Hypopituitarism and Sheehan’s

Dr. Theodore Friedman (the Wiz) will be giving a webinar on Optimal replacement for Hypopituitarism and Sheehan’s: Oxytocin, testosterone, growth hormone, stimulants and beyond

Learn what most Endocrinologists don’t know about but will improve your quality of life

Topics to be discussed include:

• Oxytocin-the love hormone

• Testosterone, not just for men

• Stimulants to treat pituitary apathy

• Growth hormone, not just for kids

• Thyroid optimization

• Cortisol, the right and wrong way to give

• Learn about the common medicine you should never take if on growth hormone

Wednesday • December 6th• 6 PM PST

Via Zoom Click here to join the meeting or

https://us02web.zoom.us/j/4209687343?pwd=amw4UzJLRDhBRXk1cS9ITU02V1pEQT09&omn=84521530646

OR

+16699006833,,4209687343#,,,,*111116#

Slides will be available before the webinar and recording after the meeting at

slides or on Dr. Friedman’s YouTube channel

OR

Join on Facebook Live https://www.facebook.com/goodhormonehealth at 6 PM PST

Meeting ID: 420 968 7343 Passcode: 111116

Your phone/computer will be muted on entry. There will be plenty of time for questions using the chat button.

For more information, email us at mail@goodhormonehealth.com

💉 Dr. Friedman: COVID-19 Vaccine Third Shots vs Booster Shots

Dr. Friedman is getting a lot of emails on booster shots versus third shots. Third shots are for immuno-compromised patients that the FDA is recommending for a small group of patients The FDA also has the intention to soon make booster doses widely available to all healthy individuals. I am writing to clarify the difference between booster shots and third doses.

Third Doses for Immuno-Compromised Patients
The purpose of a third dose of mRNA vaccine is to give immuno-compromised patients the same level of protection that two doses provide someone who has a normal immune system.
It is recommended that the following people get a third dose

  • Been receiving cancer treatment for tumors or cancers of the blood
  • Received an organ transplant and are taking medicine to suppress the immune system
  • Received a stem cell transplant within the last two years or are taking medicine to suppress the immune system
  • Been diagnosed with moderate or severe immunodeficiency conditions (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)
  • An advanced or untreated HIV infection
  • Been under active treatment with high-dose corticosteroids (> 20 mg of prednisone or 100 mg of hydrocortisone) or other drugs that may suppress immune response

Dr. Friedman thinks it is unlikely that any of his patients have these conditions.
Patients with Cushing’s syndrome, Addison’s, diabetes or thyroid disorders do not qualify.

In contrast, a Booster Dose is for Patients With Healthy Immune Systems
A booster dose—which is different from a third dose for immuno-compromised patients—is for healthy patients and is meant to enhance immunity and may protect against new variants of the virus. The Biden administration has announced that it intends to make booster doses available for people with healthy immune systems in September 2021, after they are authorized or approved by the FDA. This has not happened yet, but when it happens, Dr. Friedman would encourage his patients to get it.

Dr. Friedman is expecting a booster shot against the Delta variant to be released in the fall of 2021 and would recommend that for his patients.
Dr. Friedman wishes everyone to stay healthy.