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Reddish Face, Over Weight, Severe Anxiety, Depression. Borderline High BP & Blood Sugar, Abdomen CT Scan With One Exception. Taking Xanax. Cushing's Syndrome?

Posted on Sat, 23 Jun 2012

Question: In Nov.2010 I had a CT scan of my abdomen. The results were fine. with one exception. I will state below:

"There is a 3 cm right adrenal mass present. Some low density areas withis this suggest fat most likely indicating a benign mass. No left adrenal abnormality is identified"

Nothing was done until I went out on sick leave this past Julu 2011 In September I had a 24 hour urinalysis to check for a pheochromocytoma. That test was negative. I assumed nothing further would be done. However, my doctor now suspects I might have Cushing's syndrome. My symptoms are as follows:

Fat round face. I uploaded a picture of my face.
Overweight ranging from 285-303 pounds with alot of it in the mid section. I am 6'1"
Reddish face at time
Severe Anxeity
Depression
Difficulty sleeping
Borderline high blood pressure 04/25/11 128/88
07/11/11 110/90
07/15/11 148/104
09/01/11 128/82
12/20/11 120/90
Borderline high glucose on one blood test 11/1/10 117
08/02/11 93

I am currently on 8 medications:

Xanax 1 mg 4 times a day
Cymbalta 60 mg daily
Remeron 45 mg Daily
Gabapenton 800 mg three times a day
Metroproplol 25 mg twice a day
Zocor 20 mg once daily
Allopurinol 300 mg daily
AMbien CR 6.25 mg at bedtime

Do I seem like a candidate for Cushing's syndrome?

Answered by Dr. V. Kumaravel (8 hours later)

Hi,
Thanks for posting your query.

I understand your concern about having Cushing’s syndrome as you have been diagnosed with an incidental adrenal mass of 3 cm.

Generally whenever we diagnose an adrenal mass, the next step is to assess the functional status of the mass. We need to do a battery of tests to rule out Cushing’s syndrome, pheochromocytoma, conns syndrome and so on. If it is not a functioning tumor, we need to see whether it is arising from an infective process or is a benign or malignant enlargement. A biopsy would be needed to ascertain this.
Most of these adrenal masses are completely curable and would require surgical intervention.

Your history suggests that there is a high probability of Cushing’s syndrome and I would recommend that you consult your local endocrinologist for further evaluation.

Regards

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. V. Kumaravel (9 hours later)

Is it possible I could have had Cushing's Syndrome for years withhout even knowing it? Losing weight has always been difficult and my severe anxiety has been difficult to control. I forgot to mention that on Friday night at 11pm I am to take a one mg of decadron. And then have blood drawn at 8 am the next day? MY family doctor is checking my cortisol level. I guess I should wait until the results of the test before asking my family md for a consultation to see an endocrologist. I have been under alot of stress the last 8 years which have included the death of my wife to suicide three years ago and the death of my mother this past year. Could I have adrenal exhaustion also?

Thanks alot

Answered by Dr. V. Kumaravel (1 hour later)

Hello

Thanks for your followup.

Your physician has rightly screened you for the cushings syndrome, by giving decadran in night and checking your cortisol. These reports will help you diagnose cushings syndrome.

It is definitely possible to have cushings syndrome for a long time and they manifest very slowly.

I do understand the amount of stress you had gone through, but adrenal exhaustion is very unlikely in your case.

Hope I have answered your query. Please do write back to me if you have further concerns.

Wishing you good health.

Regards

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Yogesh D