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Adrenal Tumor Cushing’s Diagnosis

Question: I have an adrenal tumor and signs and symptoms of Cushing’s. Diagnosis is proving challenging. I am looking for an experienced endocrinologist to obtain a diagnosis. Should I contact one of the major pituitary centers or am I looking for an adrenal expert?  Answer: Most pituitary endocrinologists see Cushing’s patients no matter whether itContinue Reading

Bilateral Adrenal Tumors

Question: How common are bilateral adrenal adenomas? Is there a way to tell if the adenomas on both glands are functional? Could this actually be bilateral adrenal hyperplasia? Answer: Almost certainly bilateral adenomas are a form of hyperplasia, which I have called type-I macronodular hyperplasia. I suppose there could be the individual patient where thisContinue Reading

Bipolar Disorder and Psychosis Symptoms

Question: How many patients with active Cushing’s have bipolar disorder? Also, are psychotic symptoms very common?  Answer: This is great question. I will start by including short definitions of bipolar illness and psychosis. According to the National Institute of Mental Health (NIMH), “Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causesContinue Reading

Blood Sugar and the Dexamethasone Suppression Test

Question: I am being tested for Cushing’s and my blood sugars are already running 400-600. I have been asked to do an overnight dexamethasone suppression test. I am afraid that the dex will further increase my blood sugar. Do you have any suggestions? Answer: Dexamethasone can increase blood sugar. You definitely should not receive dexamethasoneContinue Reading

Cortisol Levels and Exercise

Question: Does strenuous exercise effect cortisol levels? If so, should I avoid exercise during a 24 hr urine test and/or for how long before starting the test? Answer: Strenuous exercise may be stressful enough to increase cortisol levels transiently. If one wishes to obtain a perfect baseline cortisol level it would be best to avoidContinue Reading