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Category Archives: Doctor’s Articles

An Update on Pituitary Surgery for Cushing’s Disease

Introduction Although there are now several new methods for the medical management of Cushing’s disease, for patients who have progressive severe signs and symptoms, surgery provides the best chance of a long lasting remission. Making the diagnosis of a pituitary tumor secreting excess levels of ACTH as the cause of Cushing’s disease can be complicated,Continue 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

Summary of the Endocrine Society Clinical Guideline on the Treatment of Cushing’s Syndrome: Part 2

A previous issue of this newsletter covered the first line treatment options for Cushing’s disease and Cushing’s syndrome as outlined in the recently published Endocrine Society guidelines. This summary will discuss the options for treatment in cases of recurrent or persistent Cushing’s disease or in patients where surgery is not an option. Cushing’s Disease ReportedContinue Reading

The Role of Cortisol in Food Intake and Food Choice Behavior: Two Studies in Patients with Cushing’s

Any endocrinologist familiar with Cushing’s hears from patients that the weight gain associated with Cushing’s is unstoppable, even with calorie restriction and exercise. Several factors have been shown to be causal, including cortisol’s direct effects on fat mass, function, and distribution. Specifically, exposure to excess cortisol increases total fat, and abdominal fat in particular, whileContinue Reading

Cushing’s and Osteoporosis

Editor’s Note: This article uses the term Cushing’s syndrome, which includes all forms of Cushing’s, including Cushing’s Disease. Cushing’s syndrome has multiple effects on bone metabolism. Elevated cortisol levels directly inhibit bone formation and indirectly influence the skeleton via effects on reproductive hormones, growth hormone, muscle and fat tissue, intestinal calcium absorption, and renal calciumContinue Reading