Category Archives: Doctor’s Answers

IPSS and Sedation

Doctor's Answers | Sep 17, 2015 | Diagnosis, Doctor's Answers, Pituitary Tumors and Surgery

Question: Why do you need to be awake for the IPSS procedure? Answer: Inferior petrosal sinus sampling (IPSS) for ACTH is a procedure that is needed in patients with an ACTH secreting tumor causing Cushing syndrome and a normal pituitary MRI. This test samples blood from the venous drainage of the pituitary: small catheters are… Continue Reading

Libido During Cushing’s

Doctor's Answers | Sep 17, 2015 | Doctor's Answers, Reproductive Issues

Question: How is libido affected during active Cushing’s and why? Does this return to normal post Cushing’s? Answer: The effect of Cushing’s on libido has not been well studied and is a complex issue. Many women with Cushing’s report a decrease in libido. The effects of high amounts of cortisol have many effects that may… Continue Reading

Non-functioning Pituitary Tumors

Doctor's Answers | Jun 9, 2015 | Doctor's Answers, Pituitary Tumors and Surgery

Question: How often are pituitary tumors not hormone secreting? Also, how often do non-functional pituitary tumors become functional for hormone secretion? Answer: The incidence of non-functioning tumors depends on what is being reported. For example, whether the numbers are obtained from those requiring surgery, observed on an MRI or CAT scan, or from population… Continue Reading

Testing for Recurrence

Doctor's Answers | Jun 9, 2015 | Diagnosis, Doctor's Answers, Recurrent Pituitary Cushing's

Question: I had successful pituitary surgery for Cushing’s 15 years ago. Recently my lab work showed elevated cortisol. What cortisol or ACTH levels are considered high enough for further testing? What would be the next level of testing for re-occurring Cushing’s? Answer: The recurrence of Cushing’s disease is relatively frequent and has been described even… Continue Reading

Exercise and Replacement Dose

Doctor's Answers | Jun 9, 2015 | Doctor's Answers, Steroid Replacement

Question: I am on permanent replacement steroids. Do I need to increase my dose with exercise? Answer: Some patients remain on permanent replacement with glucocorticoid steroids because the pituitary gland is not able to produce enough ACTH (following extensive pituitary surgery for Cushing’s disease or other pituitary tumor or disease); others are on permanent replacement… Continue Reading