Cushing’s Awareness Challenge, Day 4

Another idea I borrowed from Robin – using a Wordle as inspiration for today’s post.
Even though I’m “in remission” since 1987, I’m still way too fatigued, napping every afternoon for several hours.  People think I should be normal since my pituitary surgery was so long ago.  Well, no.
Just a few days ago, I posted this abstract on Severe fatigue in patients with adrenal insufficiency.  I don’t think that they needed to do this study at all.  Just ask any Cushie!



Fatigue is a frequently experienced complaint in patients with adrenal insufficiency (AI) and may be influenced by cortisol levels.


The objective of this study was to determine the prevalence of severe fatigue in adrenal insufficiency (AI) patients, to assess which dimensions contribute to fatigue severity and to determine the association between salivary cortisol levels and momentary fatigue.


We performed a cross-sectional study in the outpatient department of a university hospital. Included were 27 patients with congenital adrenal hyperplasia (CAH), 26 patients with primary AI (PAI), 24 patients with secondary AI (SAI) and 31 patients with adrenal insufficiency after treatment for Cushing’s syndrome (Cush-AI). Measurements included computerised questionnaires to determine fatigue severity and physical and psychosocial contributors. Patients took four saliva samples at home, in which cortisol levels were measured.


Severe fatigue was experienced by 41 % of the CAH patients, 42 % of the PAI patients, 50 % of the SAI patients and 42 % of the Cush-AI patients. Psychological distress, functional impairment, sleep disturbance, physical activity, concentration problems and social functioning contributed to the subjective experience of fatigue. Salivary cortisol levels were not correlated with momentary fatigue.


A considerable proportion of AI patients experience severe fatigue. Salivary cortisol level is not a significant predictor for momentary fatigue in AI patients.

[PubMed – in process]



Back to my nap now…

maryo colorful zebra

3 Responses

  1. Hi Mary
    I’m “clinically cured”. I had successful transphenoidal surgery to remove my pituitary tumour in November 2010, and although i know I should be grateful that I have survived I find I am left with lots of unexplained symptoms ….. Occasionally Fatigue been one of them! After a while I feel I shouldn’t be really perusing the reasons or mentioning the pains etc as I have been told all is as it should be, are you or any other Cushing survivors experiencing things such as muscle weakness, joint aches and pains, lack of energy, headaches? This can be periodically and often not all symptoms together but frequent, in fact probably daily with general aches and pains oh and let’s not forget the fact my eyesight has deteriorated fairly quick with several different prescriptions for glasses in the last 18 months and of course the horrendous memory issues !! Sometimes I have what I call “cushie days” unable to focus or concentrate and general day to day tasks become difficult, any of this familiar, if so I’d love to hear your post cushings story so I don’t feel like a freak ! Xx

  2. Nina, I’m sorry you’re going through all this post-op but it seems that lots of us do, even though we’re supposedly cured.

    There’s an area of the message boards for post-op folks like us at

    I’ve posted much of my post-op story on my bio at

    Best of luck to you!

  3. Thanks Mary. I get great comfort knowing I’m not a freak x

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.

%d bloggers like this: