Question: I was on prednisone for another medical condition and have tapered off. It is unclear at this point whether the medication caused Cushing’s symptoms. How long after stopping prednisone do I need to wait to be tested for endogenous Cushing’s? Answer: Steroid medications are the most frequent form of Cushing’s syndrome. High dose, long… Continue Reading
Category Archives: Doctor’s Answers
Colonoscopy and Stress Dose Replacement Need
Question: I am on cortisone replacement and am scheduled for a colonoscopy. Do I need to tell my doctors that I need a stress dose of hydrocortisone? Answer: I recommend that my patients be given intravenous hydrocortisone, usually 50 mg, just before the colonoscopy to cover the stress and light anesthesia for the procedure. By… Continue Reading
Age and Replacement Dose
Question: I have been on permanent replacement hydrocortisone for many years. Is there a need to increase or decrease my replacement dose as I age? Answer: This is a very good question. There is no literature that I am aware of that has addressed this specifically. However, as we age, we are at higher risk… Continue Reading
Negative MRI Results
Question: How often are pituitary tumors not seen on an MRI? Answer: Most pituitary tumors causing Cushing’s are small (< 1 cm) and are seen on pituitary MRI in about 60% of adults and 55% of children with Cushing’s disease when performed using SE T1 techniques on a 1.5 Tesla scanner, with a contrast agent.… Continue Reading
Pituitary Surgery for Cyclic Cushing’s
Question: I have a 4mm tumor on my pituitary gland and have had numerous tests showing high cortisol. An IPSS test confirmed that the pituitary gland is the problem. Unfortunately, my last several 24hr urine tests have been in the normal range. I am very symptomatic and am being told that the tumor cannot be… Continue Reading
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