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Inferior Petrosal Sinus Sampling in the Diagnosis of Cushing’s Disease

Inferior Petrosal Sinus Sampling (IPSS) plays a vital role in the diagnosis and treatment of Cushing’s disease. Cushing’s disease/Cushing’s syndrome is one of the most challenging diagnosis’ in all of Endocrinology. Testing to aid in the diagnosis can be extensive, time consuming, and can take months to complete. Initially, hypercortisolemia (overproduction of cortisol in theContinue Reading

Salivary Cortisol Test for Cushing’s Syndrome

Cushing’s syndrome — endogenous hypercortisolism — is characterized by a loss of normal 24 hour rhythm in cortisol secretion (circadian rhythmicity). In healthy patients, cortisol levels peak in the early morning hours and decrease to substantially lower levels at night. Rather than the normal decrease in late evening cortisol, patients with Cushing’s syndrome of anyContinue Reading

Diagnosing Cushing’s — Patient Experiences and What They May Mean for Doctors

As a neurologist and head of university outpatient departments in Germany, I see many patients with pituitary adenomas. In this capacity, I oftentimes hear the stories of patients with Cushing’s disease (CD; pituitary-induced Cushing’s) after years of bothersome symptoms and a long and winding road through the medical system before the correct diagnosis of Cushing’sContinue Reading

“Looking” for a Tumor in Patients with Cushing’s Syndrome

Cushing’s syndrome occurs when the adrenal glands produce too much cortisol for a long time. It is most often caused by excessive production of the adrenocorticotrophin hormone (ACTH), which normally is produced by pituitary gland and controls the production of cortisol by the adrenal glands. Excessive ACTH can be made by a tumor in theContinue Reading

Do I have Cushing’s? A physician’s perspective

This is a very personal commentary, based on over 25 years of work with patients with pituitary and adrenal problems, particularly Cushing’s syndrome and Cushing’s disease. I have also been fortunate to conduct many research and treatment studies in patients with pituitary disorders and to be part of a dedicated Neuroendocrine (Pituitary) group of NeuroendocrinologistsContinue Reading