Question: What is the best way for a patient to convince you to test them for Cushing’s? I spent three years getting worse while my endocrinologist would only test every six months. I live in a small town and don’t have easy access to Cushing’s specialists.  After gaining almost 70 lbs and having many classic symptoms, I finally had a series of high enough tests for my doctor to refer me to a specialist several hours away who diagnosed me and sent me to surgery.  I’m frustrated about all the wasted time feeling horrible when I knew in my heart all along that I had it.  I wish I had been more aggressive in the beginning.

Answer:  The feeling of a need to convince someone is not a good one, and we all sympathize with this problem.  It would be best to copy a list of the symptoms and signs of Cushing’s Disease from an authoritative paper or book chapter or book on the subject. Then check them off, and if you see that they really fit, request a referral to an endocrinologist who is familiar with pituitary and adrenal disease, and also with PCOS and its differential diagnosis. The endocrine testing should fully support the diagnosis and is necessary to avoid ineffective and potentially dangerous medical or surgical treatment.

By Dr. Edward Laws, Brigham and Women’s Hospital, Boston, MA (Summer 2018)