Question: I had Cushing’s due to an adrenal tumor and from what I’m told, no longer require replacement medication. My 8 AM ACTH is elevated and very variable and my 8 AM cortisol levels vary as well. Should this be a concern? Does the variability have anything to do with how tired I am? Should… Continue Reading
Category Archives: Doctor’s Answers
Different Steroid Replacement Medications
Question: What are the differences between hydrocortisone, cortisone acetate, prednisone, and dexamethasone? Are there any guidelines as to when one is used versus another? Answer: These compounds are all adrenal steroid analogs; specifically, they are called glucocorticoids. Glucocorticoids affect carbohydrate, protein, and fat metabolism, bone metabolism, and immune and inflammatory functions. In contrast, the mineralocorticoid… Continue Reading
Determination of Replacement Steroid Dose
Question: How is the proper dosage of maintenance medication determined? Answer: Your endocrinologist begins with a “standard” dosage of steroid, which lies within a very narrow range. For an average adult, the usual daily dosage for glucocorticoid replacement would be .5 to .75 mg of dexamethasone taken as a single dose, 5 to 7.5 mg… Continue Reading
ACTH Stimulation Test to Determine Discontinuation of Steroid Replacement
Question: What is an ACTH Stimulation Test and what is it used for? Answer: An ACTH stimulation test is most commonly used in patients with Cushing’s Syndrome many months after surgery to determine whether their hypothalamic-pituitary-adrenal axis is recovering and whether it is therefore safe to discontinue their steroid medications. It is a 1 hour… Continue Reading
Pregnancy After Cushing’s
Question: Is it possible to become pregnant and have a normal pregnancy after having had Cushing’s syndrome? Answer: Assuming that the treatment of the Cushing’s syndrome has not interfered with reproductive function (e.g., that the neurosurgeon has not removed so much of the pituitary gland that it cannot secrete normal amounts of follicle-stimulating hormone (FSH)… Continue Reading
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