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What Causes High Cortisol Levels?
Question: Hello Doctor,
I have been through a series of test to determine the cause of my high cortisol levels. I recently had an Inferior Petrosal Sinus Sampling. I received the results from my endocrinologist and she suggested i should see a Neurosurgeon. I had to go through this procedure because the MRI did not show any signs of a tumor. I suspect in some cases the tumor is to small and undetectable in some MRI's. I have the test from the inferior petrosal sinus sampling. Does this indicate that i have a tumor?
I have been through a series of test to determine the cause of my high cortisol levels. I recently had an Inferior Petrosal Sinus Sampling. I received the results from my endocrinologist and she suggested i should see a Neurosurgeon. I had to go through this procedure because the MRI did not show any signs of a tumor. I suspect in some cases the tumor is to small and undetectable in some MRI's. I have the test from the inferior petrosal sinus sampling. Does this indicate that i have a tumor?
Brief Answer:
Probably Cushing disease.
Detailed Answer:
Hi, I had gone through your question and understand your concerns. Those values of ACTH stimulation test with Desmopresin ( > 3:1 ratio after simulation compared to baseline) and inferior petrosal sinus sampling, are highly indicative of Cushing's disease from pituitary adenoma ACTH secreting. If you are diagnosed clinically previously with Cushing's, then there is need for Transsphenoidal Pituitary Microsurgery to explore and remove any MRI undetectable adenoma responsible for your disease. Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing
Probably Cushing disease.
Detailed Answer:
Hi, I had gone through your question and understand your concerns. Those values of ACTH stimulation test with Desmopresin ( > 3:1 ratio after simulation compared to baseline) and inferior petrosal sinus sampling, are highly indicative of Cushing's disease from pituitary adenoma ACTH secreting. If you are diagnosed clinically previously with Cushing's, then there is need for Transsphenoidal Pituitary Microsurgery to explore and remove any MRI undetectable adenoma responsible for your disease. Hope this answers your question. If you have additional questions or follow up questions then please do not hesitate in writing
Above answer was peer-reviewed by :
Dr. Shanthi.E
Thank you for the reply. Can it be possible that i do no have a tumor? And that the ACTH is caused by something else? Stress?
Brief Answer:
Most probable is Pituitary Adenoma.
Detailed Answer:
Hi and thanks for asking again. Stress is a possible cause of high ACTH, but since there is a positive stimulation test of ACTH, there is more probably Adenoma than stress producing high ACTH levels. Usually stress causes moderate high levels of ACTH, and generally doesn't cause Cushing's disease. Hope this helps.
Most probable is Pituitary Adenoma.
Detailed Answer:
Hi and thanks for asking again. Stress is a possible cause of high ACTH, but since there is a positive stimulation test of ACTH, there is more probably Adenoma than stress producing high ACTH levels. Usually stress causes moderate high levels of ACTH, and generally doesn't cause Cushing's disease. Hope this helps.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Would surgery be needed or can medication be used to treat cushings?
Brief Answer:
Surgery is first choice.
Detailed Answer:
Hi and thanks for asking again. Cushing's disease from well diagnosed pituitary adenoma, is treated firstly surgically. Medical treatment is possible but should continue whole life. Hope this helps.
Surgery is first choice.
Detailed Answer:
Hi and thanks for asking again. Cushing's disease from well diagnosed pituitary adenoma, is treated firstly surgically. Medical treatment is possible but should continue whole life. Hope this helps.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
I was wondering what might have caused cushings. In april of this year i had 2 shots of corticosteroids(within a month span/1 week apart) and was on methylprednisolone for a week and Duexis the following week. I noticed cushing like symptoms immidiately after the corticosteroid shots(weight gain, fatigue, round face, thinning of the skin, muscle fatigue, acne). I contacted my doctor who told me my side effects werent due to the medication since it was in a low dose but i disagree because i knew what my body was going through. Could the corticosteroid shots and medication have been the cause of my cushings? Also, could it be possible that i have cushing like symptoms without a tumor ?(due to medication still in my system)
Brief Answer:
Pituitary is causing your disease.
Detailed Answer:
Hi again. There are two conditions to evaluate: Cushing's syndrome may be caused by corticosteroids, or other causes, and Cushing's disease that is caused from pituitary adenoma. I don't think corticoids are still in your system after this long time. Your pituitary is producing high amounts of ACTH and there is need this condition to be treated. Hope this helps.
Pituitary is causing your disease.
Detailed Answer:
Hi again. There are two conditions to evaluate: Cushing's syndrome may be caused by corticosteroids, or other causes, and Cushing's disease that is caused from pituitary adenoma. I don't think corticoids are still in your system after this long time. Your pituitary is producing high amounts of ACTH and there is need this condition to be treated. Hope this helps.
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Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
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