Approach to testing growth hormone (GH) secretion in obese subjects.

Posted on July 5, 2013 by MaryO

Source

Faculty of Medicine, University of Belgrade, Department of Neuroendocrinology, Clinical Center Serbia, Dr Subotic 13, 11000 Belgrade, Serbia. popver@eunet.rs

Abstract

Identification of adults with GH deficiency (GHD) is challenging because clinical features of adult GHD are not distinctive and because clinical suspicion must be confirmed by biochemical tests.

Adults are selected for testing for adult GHD if they have a high pretest probability of GHD, ie, if they have hypothalamic-pituitary disease, if they have received cranial irradiation or central nervous system tumor treatment, or if they survived traumatic brain injury or subarachnoid hemorrhage.

Testing should only be carried out if a decision has already been made that if deficiency is found it will be treated. There are many pharmacological GH stimulation tests for the diagnosis of GHD; however, none fulfill the requirements for an ideal test having high discriminatory power; being reproducible, safe, convenient, and economical; and not being dependent on confounding factors such as age, gender, nutritional status, and in particular obesity.

In obesity, GH secretion is reduced, GH clearance is enhanced, and stimulated GH secretion is reduced, causing a false-positive result. This functional hyposomatotropism in obesity is fully reversed by weight loss. In conclusion, GH stimulation tests should be avoided in obese subjects with very low pretest probability.

PMID:
23650336
[PubMed – in process]

J Clin Endocrinol Metab. 2013 May;98(5):1789-96. doi: 10.1210/jc.2013-1099.

From http://www.ncbi.nlm.nih.gov/pubmed/23650336

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Cushing’s FAQ

Posted on May 21, 2011 by MaryO

A FAQ (Frequently Asked Questions).  Directions are in each category for adding your own question.

IMPORTANT: The information and material posted on this Web site is intended as general reference information only. Specific facts and circumstances may alter the concepts and applications of materials and information described herein. The information provided is not a substitute for professional advice and should not be relied upon in the absence of such professional advice specific to whatever facts and circumstances are presented in any given situation.

Please note that there are several questions waiting to be answered at this time. Your question will be answered as soon as possible.

This is a different website than the message boards and requires a different log-in, although you may use the same log-in name and password.

 

Adrenal Insufficiency

Adrenal insufficiency is a life threatening chronic illness. An active and vigorous lifestyle with normal life expectancy is possible as long as the prescribed medications are taken regularly and adjusted when indicated. As with most chronic diseases, adrenal insufficiency demands that the patients take responsibility and develop self-management skills and techniques.

Read an article on Adrenal insufficiency

Cushing’s Types

Cushing’s Disease/ Cushing’s Syndrome: Cushing’s is a hormonal disorder caused by prolonged exposure of the body’s tissues to high levels of the hormone cortisol. Your adrenal glands, which are right above your kidneys, release cortisol when they receive a chemical message from your pituitary gland. The message comes in the form of adrenocorticotrophic hormone (ACTH), which travels through the bloodstream.

Cushing’s Disease Is the result of a pituitary tumor which causesthe emergence of secondary male characteristics (like hair growth, acne, etc.), and ovarian failure. Other symptoms usually include high blood pressure and water retention.

Cushing’s Syndrome: Causes the same symptoms, but is a disorder marked by overproduction of adrenal hormones, which can cause a drop in LH and FSH.

An estimated 10 to 15 of every million people are affected each year. Cushing’s is an increased concentration of glucocorticoid hormone (ACTH) in the bloodstream that is being produced by an adrenal gland tumor (adenoma). Ectopic Cushing syndrome refers to the production of ACTH in a location other than the pituitary gland or adrenalgland. Examples of ectopic sites include thymoma, medullary carcinoma of the thyroid, pheochromocytoma, islet cell tumors of the pancreas, and oat cell carcinoma of the lung.Symptoms include weight gain, central obesity, moon face, weakness, fatigue, backache, headache, increased thirst, increased urination, impotence, mental status changes, and muscle atrophy.

Treatment varies with cause. If an ACTH secreting tumor is involved then it must be removed surgically.

More about Cushing’s.

Talk about Cushing’s with people who understand.

Subcategories:

Growth Hormone

Human Growth Hormone (hGH) is produced in the pituitary gland of humans, and the hormone is secreted throughout a person’s lifetime. It promotes growth in children and plays an important role in adult metabolism.

More about HgH

Where Can I Find…?

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Can Anyone Help?

Posted on May 18, 2011 by MaryO

what is the most successful with the least amount of risks and side affects. What is the easiest to live with for the rest of your life in trying to cure cushing’s disease? Removal of an adenoma in my 7 year old son seems not to be successful, now we are trying to weigh our options to get him the cure that he needs, the cure that he deserves. They said we have 3 options….removal of the pituitary gland, removal of the adrenal glands, or radiation. I would like to know your first hand experiences and the pros and cons for everything…….

Please respond here or on Facebook

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Medical treatment of Cushing’s disease: Overview and recent findings

Posted on October 21, 2009 by MaryO

Published Date October 2009

Journal: International Journal of General Medicine

Stephanie Smooke Praw1, Anthony P Heaney1,2

1Department of Medicine, 2Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

Abstract: Cushing’s disease, due to pituitary adrenocorticotropic hormone (ACTH) hypersecretion, is the most common etiology of spontaneous excess cortisol production. The majority of pituitary tumors causing Cushing’s disease measure <1 cm and the excess morbidity associated with these tumors is mostly due to the effects of elevated, nonsuppressible, ACTH levels leading to adrenal steroid hypersecretion. Elevated circulating cortisol levels lead to abnormal fat deposition, hypertension, diabetes, coronary artery disease, osteoporosis, muscle weakness and psychological disturbances. At experienced centers, initial surgical remission rate via transnasal, transphenoidal resection approaches 80% for tumors less than 1 cm, but may be as low as 30% for larger lesions and long-term recurrence in all groups approaches 25%. Residual disease may be managed with more radical surgery, pituitary-directed radiation, bilateral adrenalectomy, or medical therapy. This paper addresses current and novel therapies in various stages of development for Cushing’s disease.

Keywords: Cushing’s disease, treatment, pasireotide, PPAR-γ, 11 β-hydroxysteroid dehydrogenase inhibitors, dopamine agonists

Download article (Free!): http://dovepress.com/getfile.php?fileID=5388

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