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A Comprehensive Guide to Cushing’s Disease (and other elevated cortisol conditions) – symptoms, tests, diagnoses and treatments
Eighteen physicians contributed current information about Cushing’s disease to this medical textbook. The co-authors, specialists in in endocrinology and/or neurosurgery, wrote this book to educate other health professionals, medical students and researchers. Patients will also find clear and helpful information in this important book.

Cushing’s disease sounds like a single diagnosis but, as this book explains, there are several subtypes. Some patients with Cushing’s have pituitary tumors; others have hormone-producing adrenal nodules. Still other patients have ectopic ACTH-producing tumors or other reasons for elevated cortisol.

The healthy human body produces cortisol according to a circadian rhythm and in response to stress. Cortisol, an essential adrenal hormone, helps to maintain homeostasis by optimizing metabolism, blood sugar, blood pressure and the immune system. Above-normal levels of cortisol can cause a variety of symptoms. Patients and skeptical doctors can spend years trying to make sense of fluctuating, seemingly non-specific and gradually-worsening symptoms. How can this sort of medical mystery get solved? Patients can ask for cortisol tests, then referrals to endocrinologists or pituitary specialists who know how to diagnose Cushing’s disease, differentiate the subtypes and treat safely and effectively. Treatment may involve surgery (to remove a hormone-secreting tumor) or medication.

Recovering patients can expect new symptoms, including chronic fatigue, as they adapt to lower cortisol levels. In worst cases, a patient can experience a life-threatening adrenal crisis after surgery. Treatment of an adrenal crisis requires the urgent injection of a bolus of cortisol.

Patients can join the Cushing’s Support and Research Foundation. Quarterly CSRF newsletters share patients’ stories, coping strategies, diagnosis and treatment guidelines and research in-progress.

This comprehensive guide to Cushing’s disease describes the functions of pituitary, adrenal and other hormones, lists the typical and atypical symptoms of Cushing’s disease and several subtypes. Then it outlines the causes of elevated cortisol and explains how clinicians can test for, diagnose and treat Cushing’s disease. Readers will find this 240-page book detailed, thorough and well-referenced.

Review by Robert Sealey, BSc