Part II of The Voices of Cushing’s Disease video series discusses the daily challenges of people living with Cushing’s disease and highlights the importance of disease management.
For more information, please visit http://www.aboutcushings.com outside of the US or http://www.cushingsdisease.com in the U.S.
Filed under: Cushing's, pituitary, Video | Tagged: Cushing's Disease, video | Leave a comment »
Novartis is committed to supporting the pituitary community and continues to address the evolving needs of patients and caregivers.
In this video, a multidisciplinary panel discusses the diagnosis of acromegaly and Cushing’s disease.
For more information, visit: http://www.AboutAcromegaly.com and http://www.AboutCushings.com.
Filed under: Cushing's, pituitary, Video | Tagged: Acromegaly, caregivers, Cushing's Disease, Novartis, patients, pituitary, tumor, video | Leave a comment »
People sometimes ask me how I found out I had Cushing’s Disease. Theoretically, it was easy. In practice, it was very difficult.
In 1983 I came across a little article in the Ladies Home Journal which said “If you have these symptoms…”
I found the row with my symptoms and the answer read “…ask your doctor about Cushing’s”.
After that article, I started reading everything I could on Cushing’s, I bought books that mentioned Cushing’s. I asked and asked my doctors for many years and all of them said that I couldn’t have it. It was too rare. I was rejected each time.
Due to all my reading at the library, I was sure I had Cushing’s but no one would believe me. My doctors would say that Cushing’s Disease is too rare, that I was making this up and that I couldn’t have it.
In med school, student doctors are told “When you hear hoofbeats, think horses, not zebras“.
According to Wikipedia: “Zebra is a medical slang term for a surprising diagnosis. Although rare diseases are, in general, surprising when they are encountered, other diseases can be surprising in a particular person and time, and so “zebra” is the broader concept.
The term derives from the aphorism “When you hear hoofbeats behind you, don’t expect to see a zebra”, which was coined in a slightly modified form in the late 1940s by Dr. Theodore Woodward, a former professor at the University of Maryland School of Medicine in Baltimore. Since horses are the most commonly encountered hoofed animal and zebras are very rare, logically you could confidently guess that the animal making the hoofbeats is probably a horse. By 1960, the aphorism was widely known in medical circles.”
So doctors typically go for the easily diagnosed, common diseases. Just because something is rare doesn’t mean that no one gets it. We shouldn’t be dismissed because we’re too hard to diagnose.
When I was finally diagnosed in 1987, 4 years later, it was only because I started bleeding under the skin. My husband made circles around the outside perimeter each hour with a marker so my leg looked like a cut log with rings.
When I went to my Internist the next day he was shocked at the size of the rings. He now thought I had a blood disorder so he sent me to a Hematologist/Oncologist.
Fortunately, he ran a twenty-four hour urine test and really looked at me and listened to me. Both he and his partner recognized that I had Cushing’s but, of course, couldn’t do anything further with me. They packed me off to an endo where the process started again.
My final diagnosis was in October, 1987. Quite a long time to simply “…ask your doctor about Cushing’s”.
Looking back, I can see Cushing’s symptoms much earlier than 1983. But, that ‘s for a different post.
Filed under: Cushing's, pituitary, Rare Diseases | Tagged: bleeding, Cushing's, Cushing's Awareness Challenge 2015, Cushing's Disease, depression, hematologist, Hematologist/Oncologist, Internist, Ladies Home Journal, MaryO, oncologist, symptoms, weight, zebra | 7 Comments »
A condition in which the body produces too much cortisol, Cushing’s disease occurs when a tumor on the pituitary gland makes the gland create too much ACTH, the hormone that stimulates the production and release of cortisol (also known as “the stress hormone”). It may also occur with excess growth of the pituitary gland, known as hyperplasia. For most patients, Cushing’s disease will show itself through symptoms like red lines on the abdomen, abdominal weight gain and roundness to the face. And while the condition only affects 10 to 15 people per million per year, patients who suffer with it understandably wonder why. What are the causes? Where would a pituitary gland tumor come from? What leads to excess growth of that gland? To help answer these questions, here’s a look at Cushing’s disease causes:
The most common cause for Cushing’s disease is adenoma, a usually benign tumor on the pituitary gland. Because the tumors are normally pretty small, they can be hard to diagnose. For this reason, many patients who have Cushing’s disease don’t find out right away. Meeting with an endocrinologist can help the diagnosis process, improving your chances for a fast, successful recognition of the disease.
Even though it’s a rare condition, Cushing’s disease occurs more commonly in women, particularly those between the ages of 20 and 50. Other factors that may increase the risk of Cushing’s disease include obesity, type 2 diabetes, poorly controlled blood sugar levels and high blood pressure. While none of these factors are a direct cause of the condition, they are associated with higher prevalence of it.
Often mistaken for one another, Cushing’s disease and Cushing’s syndrome are actually not the same condition. What they have in common is that they both involve the body’s producing too much cortisol. Cushing’s disease is a medical condition, however, while Cushing’s syndrome is a symptom of it. Cushing’s syndrome will often occur when a patient is taking corticosteroid medication.
If you believe you or someone you love may have Cushing’s disease, it is best to see a specialist. Symptoms develop slowly and sometimes in cycles, so without proper testing it can be hard to identify what’s happening. A skilled endocrinologist can conduct hormone blood tests to measure blood cortisol levels at different times. He or she can also schedule an MRI for an individual who is not taking cortisol medications, in order to isolate the location of any tumors.
Have you been dealing with the symptoms of elevated cortisol levels, such as unexplained weight gain, particularly in the abdominal area and/or back of the neck? Is your skin or vision changing? These symptoms could be indicating a deeper problem in your body — so schedule an appointment to have your condition evaluated by a professional as soon as you can. Through proper treatment, you may be able to reduce or even eliminate your symptoms and be restored to full health again.
Filed under: Cushing's, FAQ, pituitary | Tagged: ACTH, cortisol, Cushing's Disease, MRI, pituitary, tumor, weight | 1 Comment »
March 06, 2015
OR17-Novel Aspects of Adrenal Tumors and the HPA Axis
Epigenetic modulation of DNA Is associated with fatigue, depression and anxiety in patients with Cushing’s syndrome in remission: A genome-wide methylation study
CAM Glad, JC Andersson-Assarsson, P Berglund, R Bergthorsdottir, O Ragnarsson, G Johannsson
Summary: Researchers conducted this study to determine whether patients with Cushing’s syndrome (CS) that is in remission have specific epigenetic alterations that are associated with persistent cognitive impairments, anxiety, fatigue, and depression. Patients with CS in remission were shows to have specific DNA methylation that differed from that of healthy controls and was strongly correlated with clinical traits of anxiety, depression and fatigue, they concluded, adding that their results may suggest that an interaction between the glucocorticoid and the retinoic acid receptor is implicated in the long-term outcome of patients with CS in remission. The persistent cognitive impairment observed in patients with CS in remission, therefore, may be due to epigenetic modulation of DNA, they concluded.
Methods:
Results:
This project has received financial support from the Swedish federal government under the LUA/ALF agreement, The Health & Medical Care Committee of the Regional Executive Board, Region Västra Götaland, The Swedish Society of Medicine and The Swedish Society of Endocrinology.
Filed under: adrenal, Clinical trials, Cushing's, Meetings and Conferences, pituitary | Tagged: adrenal adenoma, anxiety, cognitive impairments, cortisol, Cushing's Disease, Cushing's Syndrome, depression, DNA, ENDO 2015, fatigue, glucorticoid, remission, retinoic acid | Leave a comment »
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