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What Causes Weight Gain On My Face?
Question: Hell Dr.
I have a question regarding weight gain on my face primarily. I was diagnosed with cushings disease last year and had surgery to remove the tumor in November. I also recieved my test results and my cortisol level is at a normal range. My doctor said i am now in remission. I am noticing that my facial cheeks look larger and i can feel the weight of my cheeks hanging. I have lost about 6lb since my surgery. It looks as if im gaining weight but only from my facial area. What could be the cause of this? And is there a solution to combat this problem?
I have a question regarding weight gain on my face primarily. I was diagnosed with cushings disease last year and had surgery to remove the tumor in November. I also recieved my test results and my cortisol level is at a normal range. My doctor said i am now in remission. I am noticing that my facial cheeks look larger and i can feel the weight of my cheeks hanging. I have lost about 6lb since my surgery. It looks as if im gaining weight but only from my facial area. What could be the cause of this? And is there a solution to combat this problem?
Brief Answer:
Facial weight gain
Detailed Answer:
Sorry to learn about this problem you are experiencing.
I have reviewed our previous correspondence too.
Facial weight gain can be a sign of Cushing's disease/syndrome.
Are you on any hydrocortisone after your surgery?
If yes, then I would like to know the dose. Taking amounts in excess of what the body needs can induce a state of 'Exogenous Cushing's' syndrome ie due to medications.
If you are not taking hydrocortisone/other steroids then it is very important to screen for the possibility of incomplete cure or re-ocurrence of the tumor.
The best way to go about this is to see an endocrinologist in person, preferably one in an academic / university hospital where they see Cushing's cases frequently. This is because it is a rare condition so the typical endocrinologist in private practice may likely be seeing only a couple cases per year on an average.
There are several tests to assess this such as the ones I have alluded in my previous replies:
Midnight salivary cortisol
1 mg Overnight Dexamethasone Suppression test
24 hour Urinary free cortisol
Now if after running these tests, your endocrinologist pronounces no evidence of disease activity then there is a possibility of this being a cosmetic problem in which the skin may sag due to fat in the area gradually reducing after surgery 'cured' the tumor.
Facial weight gain
Detailed Answer:
Sorry to learn about this problem you are experiencing.
I have reviewed our previous correspondence too.
Facial weight gain can be a sign of Cushing's disease/syndrome.
Are you on any hydrocortisone after your surgery?
If yes, then I would like to know the dose. Taking amounts in excess of what the body needs can induce a state of 'Exogenous Cushing's' syndrome ie due to medications.
If you are not taking hydrocortisone/other steroids then it is very important to screen for the possibility of incomplete cure or re-ocurrence of the tumor.
The best way to go about this is to see an endocrinologist in person, preferably one in an academic / university hospital where they see Cushing's cases frequently. This is because it is a rare condition so the typical endocrinologist in private practice may likely be seeing only a couple cases per year on an average.
There are several tests to assess this such as the ones I have alluded in my previous replies:
Midnight salivary cortisol
1 mg Overnight Dexamethasone Suppression test
24 hour Urinary free cortisol
Now if after running these tests, your endocrinologist pronounces no evidence of disease activity then there is a possibility of this being a cosmetic problem in which the skin may sag due to fat in the area gradually reducing after surgery 'cured' the tumor.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Yes my doctor did say i was in remission after reviewing my lab results
I am no longer on hydrocortisone. Ive been off the medication for about 6-7 weeks.
If its a cosmetic thing then weight loss would be the best thing for this?
I am no longer on hydrocortisone. Ive been off the medication for about 6-7 weeks.
If its a cosmetic thing then weight loss would be the best thing for this?
Brief Answer:
Follow up
Detailed Answer:
Good to note you are remission, but I strongly suggest regular checks ate certain intervals deemed appropriate by your endocrinologist.
Yes weight loss will definitely help.
The effect of prolonged Cushings while you had it, also takes time to settle down, as does the effect of having been on hydrocortisone.
So reassess the situation in couple months and periodically thereafter.
Considerable improvement in facial appearance can occur by 6 months to a year after cure to Cushings
Follow up
Detailed Answer:
Good to note you are remission, but I strongly suggest regular checks ate certain intervals deemed appropriate by your endocrinologist.
Yes weight loss will definitely help.
The effect of prolonged Cushings while you had it, also takes time to settle down, as does the effect of having been on hydrocortisone.
So reassess the situation in couple months and periodically thereafter.
Considerable improvement in facial appearance can occur by 6 months to a year after cure to Cushings
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Ok thank you
Another thing that i am concerned about is my breathing. I have trouble breathing properly and even taking deep breaths. For example, im usually taking short breaths. Even after i have a meal i find hard in inhale. I dont know if this is cushings related. I did however have a problem with binge eating for 2-3 months after months of dieting. This was a couple of months after i was diagnosed with cushings.
Another thing that i am concerned about is my breathing. I have trouble breathing properly and even taking deep breaths. For example, im usually taking short breaths. Even after i have a meal i find hard in inhale. I dont know if this is cushings related. I did however have a problem with binge eating for 2-3 months after months of dieting. This was a couple of months after i was diagnosed with cushings.
Brief Answer:
Second follow up
Detailed Answer:
If your Cushings is in remission now then it should not cause breathing difficulty.
I would suggest seeing a Pulmonologist directly or an Internist first.
Second follow up
Detailed Answer:
If your Cushings is in remission now then it should not cause breathing difficulty.
I would suggest seeing a Pulmonologist directly or an Internist first.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I also read while doing some research that high levels or cortisol can cause thinning of the stomach mucosa
Brief Answer:
Third follow up
Detailed Answer:
Cushings can cause stomach ulcers too. But as you say, yours in in remission now. So whatever known or unknown damage that might have occurred to your stomach mucosa, complete recovery can be expected
Third follow up
Detailed Answer:
Cushings can cause stomach ulcers too. But as you say, yours in in remission now. So whatever known or unknown damage that might have occurred to your stomach mucosa, complete recovery can be expected
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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