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Pre-Diagnosis

Not every Cushing’s patient has every symptom, so Cushing’s cannot be diagnosed or ruled out strictly by the presence or absence of symptoms; the diagnosis requires appropriate testing. If you suspect you have Cushing’s, print the sections indicated below, discuss them with your primary care physician, and ask to be tested.

On this website, Cushing’s symptoms are covered under Understanding Cushing’s: The Basics and in the brochure. Print the Understanding Cushing’s: The Basics, the brochure, and the testing sections of this website and show them to your primary care physician; he or she can then order the tests listed in the flow chart in the testing section. Screening is usually done using a late-night salivary cortisol test, a 24-hour urine test, or an overnight dexamethasone suppression test. The Endocrine Society Guidelines for the Diagnosis of Cushing’s may also be of interest to your physician. For a patient version of these guidelines, click here. Additional information on diagnosing Cushing’s can be found in the diagnosis sections of Doctor’s Articles or Doctor’s Answers on this website.

Be sure to take photos that illustrate changes in your appearance over the past several years. Consider taking someone who is also concerned about your health to your appointment. You can also mail these materials to your physician before your appointment so he or she is prepared for what you wish to discuss.

Understand the testing required, and make sure you are adequately tested. Early, mild, and cyclic cases of Cushing’s can be challenging to diagnose. If your primary care physician does not wish to order the tests, you may need to see an endocrinologist. You can search by zip code or state at www.hormone.org. In addition, there are many physicians experienced in Cushing’s who are listed on our website under Cushing’s Doctors. Most specialists require some type of test abnormality or a referral, and getting an appointment may take some time.