Long-Term Obesity Persists Despite Pituitary Adenoma Treatment In Childhood

Posted on January 9, 2026 by MaryO

Sethi A, et al. Clin Endocrinol. 2019;doi:10.1111/CEN.14146.

January 5, 2020

Obesity is common at diagnosis of pituitary adenoma in childhood and may persist despite successful treatment, according to findings published in Clinical Endocrinology.

“The importance of childhood and adolescent obesity on noncommunicable disease in adult life is well recognized, and in this new cohort of patients, we report that obesity is common at presentation of pituitary adenoma in childhood and that successful treatment is not necessarily associated with weight loss,” Aashish Sethi, MD, MBBS, a pediatric endocrinologist in the department of endocrinology at Alder Hey Children’s Hospital in Liverpool, United Kingdom, and colleagues wrote. “We have reported obesity, and obesity-related morbidity in a mixed cohort of children and young adults previously, but [to] our knowledge, this is the first time this observation has been reported in a purely pediatric cohort.”

In a retrospective study, Sethi and colleagues analyzed clinical and radiological data from 24 white children from Alder Hey Children’s Hospital followed for a median of 3.3 years between 2000 and 2019 (17 girls; mean age at diagnosis, 15 years). Researchers assessed treatment modality (medical, surgical or radiation therapy), pituitary hormone deficiencies and BMI, as well as results of any genetic testing.

Within the cohort, 13 girls had prolactinomas (mean age, 15 years), including 10 macroadenomas between 11 mm and 35 mm in size. Children presented with menstrual disorders (91%), headache (46%), galactorrhea (46%) and obesity (38%). Nine children were treated with cabergoline alone, three also required surgery, and two were treated with the dopamine agonist cabergoline, surgery and radiotherapy.

Five children had Cushing’s disease (mean age, 14 years; two girls), including one macroadenoma. Those with Cushing’s disease presented with obesity (100%), short stature (60%) and headache (40%). Transsphenoidal resection resulted in biochemical cure; however, two patients experienced relapse 3 and 6 years after surgery, respectively, requiring radiotherapy. One patient also required bilateral adrenalectomy.

Six children had a nonfunctioning pituitary adenoma (mean age, 16 years; two girls), including two macroadenomas. These children presented with obesity (67%), visual field defects (50%) and headache (50%). Four required surgical resections, with two experiencing disease recurrence after surgery and requiring radiotherapy.

During the most recent follow-up exam, 13 children (54.1%) had obesity, including 11 who had obesity at diagnosis.

“The persistence of obesity following successful treatment, in patients with normal pituitary function, suggests that mechanisms other than pituitary hormone excess or deficiency may be important,” the researchers wrote. “It further signifies that obesity should be a part of active management in cases of pituitary adenoma from diagnosis.” – by Regina Schaffer

Disclosures: The authors report no relevant financial disclosures.

From https://www.healio.com/endocrinology/adrenal/news/online/%7Bde3fd83b-e8e0-4bea-a6c2-99eb896356ab%7D/long-term-obesity-persists-despite-pituitary-adenoma-treatment-in-childhood

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Paraneoplastic Cushing’s Syndrome Due to ACTH-Secreting Acinic Cell Carcinoma of the Parotid Gland: A Rare Case

Posted on January 9, 2026 by MaryO

​​​​​​​​​​​​​​Although acinic cell carcinoma — a cancer of the glands that produce saliva — is usually considered low risk, it can behave aggressively and cause Cushing’s syndrome, according to researchers who described such a case involving a 58-year-old man in Turkey.

They added that if not recognized and treated at an early stage, it can rapidly become life-threatening.

“The rarity of this entity poses a diagnostic challenge,” wrote the group of four researchers from a hospital in Turkey. “Awareness of this association is critical, as early identification and intervention may be lifesaving in selected patients.”

The case was described in a letter to the editor, titled “Paraneoplastic Cushing’s syndrome due to ACTH-secreting acinic cell carcinoma of the parotid gland: A rare case,” in the European Annals of Otorhinolaryngology, Head and Neck Diseases.

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Pituitary adenoma growth rate influenced by multiple factors

Posted on January 9, 2026 by MaryO

Monsalves E. J. Clin Endocrinol Metab. 2013; doi: 10. 1210/jc.2013-3054.

The etiology of pituitary adenoma growth rate is multifactorial and may be influenced by patient age and gender, as well as adenoma subtype, hormonal activity, immunohistological profile and the direction of growth relative to the pituitary fossa, according to results of a retrospective study.

Researchers evaluated pre- and postoperative pituitary adenoma (PA) traits in relation to patient demographics, MRI specifications and histopathological factors. They examined 153 patients who underwent surgery for removal of a histologically-proven PA at Toronto Western Hospital between 1999 and 2011.

All patients had at least two preoperative and two postoperative MRIs to measure tumor volume doubling time. Both scans were completed a minimum of 3 months apart.

Patients all underwent a sella/pituitary imaging protocol, and volume was determined using partitioning and target volume software. Each patient was also reviewed by two endocrine pathologists, and standardized diagnostic synoptic pathology reports provided information on MIB-1 labeling index, p27 and N-terminally truncated fibroblast growth factor receptor 4 (FGFR4). Growth direction patterns were classified as superior, anterior, posterior and lateral in relation to the sellar fossa.

The researchers found a relationship between preoperative growth rate and age (P=.0001), as well as suprasellar growth (P=.003), existence of a cyst or hemorrhage (P= .004), the MIB-1 (P=.005), FGFR4 positivity (P=.047) and p27 negativity (P=.007).

Postoperatively, 34.6% of patients demonstrated residual volumes, while the remaining 100 patients did not. Residual volume was found to be associated with older patient age (57 vs. 51, P=.038), as well as growth patterns, including anterior, posterior, suprasellar and cavernous sinus extension (P=.001). There was a correlation between pre-and postoperative growth rates (r=0.497, P=.026). The rates of postoperative growth were linked with age (P=.015) and gender (P= .017).

“Due to the heterogeneity of PA, no single predictor of PA growth behavior can be taken in isolation as a means to predict its outcome,” the researchers wrote.  “These predictors must be combined in order to formulate the most accurate estimation of PA growth, which in turn will inform sound clinical management.”

Disclosures: The researchers report no relevant financial disclosures.

From http://www.healio.com/endocrinology/neuroendocrinology/news/online/%7B7cb2ec5d-eaa6-42a3-b279-2c2436d0fbd0%7D/pituitary-adenoma-growth-rate-influenced-by-multiple-factors

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High cortisol: Symptoms and signs

Posted on January 8, 2026 by MaryO

When we become stressed out bodies release cortisol – the stress hormone – which helps us cope with challenges. Cortisol’s role is to convert protein into energy by releasing glycogen and counteract inflammation. When cortisol is released in the body temporarily, this is okay and won’t have long-lasting detrimental effects to health as it is a natural response to a stressor. But when cortisol levels remain high chronically it can eventually begin to tear your body down thus causing health complications. This is why numerous health experts recommend the reduction of stress as much as possible because in the long run it can harm our health.

High cortisol levels over the long term can destroy healthy muscle and bone, slow down healing, impair digestion, metabolism and mental function, and weaken the immune system. Additionally, adrenal fatigue has been linked to numerous other health conditions including fibromyalgia, hypothyroidism, chronic fatigue syndrome, arthritis, premature menopause, and many others. High cortisol levels are also associated with many unwanted symptoms which we will outline below.

High cortisol symptoms

If you’re concerned about your cortisol levels, the following signs and symptoms associated with high cortisol levels can alert you and prompt you to make the necessary changes in order to reduce cortisol levels.

  • Unexplained weight gain
  • Skin symptoms including acne, skin infections, lesions, thin-appearing skin, bruising, growing facial hair, and reddish purple streaks on skin
  • Muscle and bone symptoms like a deep pain in the bones, weak muscles, chronic backaches, increased risk of bone fractures
  • Gender specific changes such as women developing male-pattern hair growth, irregular menstrual cycles, low libido, infertility
  • Neurological symptoms such as depression, irritability, headaches, chronic fatigue, and anxiety
  • High blood pressure (hypertension)
  • Poor sleep or lack of sleep
  • Swelling of hands and feet

If you notice any of the above symptoms, you may want to have your cortisol levels checked to confirm diagnosis. Living with high cortisol levels over the long term can have detrimental effects on a person’s health. Treating high cortisol as soon as possible can lower the risk of long-term health problems.

Causes of high cortisol

There are two main causes of high cortisol: Chronic stress and more rarely, Cushing’s disease. Cushing’s disease is caused by a hormone-secreting tumor on the adrenal gland which results in the release more cortisol than required.

Living with chronic stress also leads to high cortisol because the release of cortisol is a natural response from the body when it is stressed. The hypothalamic–pituitary-adrenal [HPA] axis is what regulates the timely release of cortisol during acute stress, but when stress becomes chronic the feedback from the HPA becomes damaged and so cortisol continues to be released.

Conditions that can contribute to chronic stress and high cortisol include:

  • Depression
  • Panic disorder
  • Generalized anxiety disorder
  • Post traumatic stress disorder (PTSD)
  • Anorexia nervosa
  • Bulimia nervosa
  • Alcoholism
  • Diabetes
  • Severe obesity
  • Metabolic syndrome
  • Polycystic ovary syndrome (PCOS)
  • Obstructive sleep apnea
  • Working in shifts
  • End-stage kidney disease
  • Chronic pain

Tips to lower high cortisol

Here are some tips that can help you lower your high cortisol levels and thus prevent long-term health problems associated with high cortisol. [MaryO’Note:  These will not work if you have active Cushing’s!    You must remove  the source of your Cushing’s first.]

  • Eat a well balanced meal with plenty of fruits and vegetables, avoid sugars, consume low glycemic index foods, avoid processed foods, eat a wide variety of health foods to ensure you receive all essential vitamins and nutrients
  • Exercise on a regular basis
  • Take time out of each day to relax – listen to music, meditate, pray, perform your favorite hobby, anything that promotes relaxation
  • Take up yoga or tai chi
  • Ensure you are getting adequate sleep
  • Drink tea
  • Watch funny videos or hang out with a funny friend
  • Go for a massage
  • Do something spiritual – attend a service
  • Chew gum
  • Limit caffeine intake
  • Stretch

By incorporating these helpful tips into your life you will find that your high cortisol symptoms begin to diminish and your overall health begins to improve.

From http://www.belmarrahealth.com/high-cortisol-symptoms-signs-look/

 

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Low Cortisol or an Adrenal Crisis – Learning the difference

Posted on January 8, 2026 by MaryO

Some are very sick and believe it can be treated at home, others are low on cortisol and believe they urgently need Emergency Department treatments. It can be very hard to tell the difference at times.

Many with Addison’s Disease, especially in the early years after diagnosis, don’t have a clear understanding of what an Adrenal Crisis is­.

Some are very sick and believe it can be treated at home, others are low on cortisol and believe they urgently need Emergency Department treatments.  It can be very hard to tell the difference at times.

Then we have the Dr’s view, based on books, not on experience, which is, don’t know so won’t treat.

THE FACTS:

  1. Low Cortisol WILL lead to an Adrenal Crisis, if not dealt with;
  2. Adrenal Crisis DOES need Emergency Medical Treatment;
  3. Adrenal Crisis WILL lead to Death (or worse) if not treated urgently and correctly;
  4. Dr’s DO cause Adrenal Crisis’ because they don’t know, or don’t listen to their patients.

I am guessing the first thing you are asking is…

View original post 2,110 more words

Tiggercat's avatarLiving with an Addisonian

(Low Cortisol or an Adrenal Crisis – PDF of this blog.)

Many with Addison’s Disease, especially in the early years after diagnosis, don’t have a clear understanding of what an Adrenal Crisis is­.

Some are very sick and believe it can be treated at home, others are low on cortisol and believe they urgently need Emergency Department treatments.  It can be very hard to tell the difference at times.

Then we have the Dr’s view, based on books, not on experience, which is, don’t know so won’t treat.

THE FACTS:

  1. Low Cortisol WILL lead to an Adrenal Crisis, if not dealt with;
  2. Adrenal Crisis DOES need Emergency Medical Treatment;
  3. Adrenal Crisis WILL lead to Death (or worse) if not treated urgently and correctly;
  4. Dr’s DO cause Adrenal Crisis’ because they don’t know, or don’t listen to their patients.

I am guessing the first thing you are asking is…

View original post 2,110 more words

Filed under: adrenal crisis, Cushing's | Tagged: , | Leave a comment »

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