Question: There seems to be some controversy about Cyclic Cushing’s – some doctors don’t even believe in it. Many patients get frustrated because they “chase highs” hoping to test during an active period and, in a worst case scenario, spend many months or even years getting worse while trying to test only during periods when… Continue Reading
Category Archives: Doctor’s Answers
Using DHEA During Diagnosis
Question: I’ve heard people talk about having testing for 17-OH and DHEA in their pursuit for a diagnosis. I had my first round with Cushing’s five years ago and only remember cortisol tests. What are these and how do they help diagnose Cushing’s? Answer: DHEA is a low-potency sex steroid produced by the adrenal gland.… Continue Reading
Symptoms of Pituitary Tumor Recurrence
Question: If someone is having a recurrence of Cushing’s Disease, will the symptoms be the same as the original Cushing’s? What symptoms should we be looking for? Answer: Patients who experience a recurrence of Cushing’s are often more perceptive of changes the second time and are often accurate in suspecting a recurrence. In my clinical… Continue Reading
Percentages for Pituitary Tumor Recurrence
Question: What percentage of patients with Cushing’s due to a pituitary tumor experience a recurrence? Answer: In the hands of an experienced pituitary neurosurgeon, the majority of patients (70-85%) with small ACTH-secreting pituitary tumors (microadenomas) have a remission; however, the initial remission rate is less (35-50%) in patients with large pituitary tumors. The recurrence rate… Continue Reading
Creatinine Measurement in 24hr Urine Test
Question: Why is creatinine measured in a 24 hr urinary cortisol test? Answer: The reason that urinary creatinine is measured in all patients having a 24 hr urine collection (regardless of what analyte is being measured) is to ensure that the collection is adequate and can be compared to the adequacy of future collections. Urinary… Continue Reading
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