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Suggest Treatment When In Remission For Cushings Disease

Posted on Thu, 19 Mar 2015

Question: Hello

I optained my lab results from my doctor and wanted a second opinion. Last year i was dianosed with Cushings Disease and had surgery in November of last year. I was on hydrocortisone and was tapering my medication by 5mg a week. After i was completely off the medicine, we went ahead and did some tests. My doctor recieved the results and said i was in remission. Do you think its too early to tell or judging by yhe results am i in remission? The first three tests are the most recent

Answered by Dr. Ajish TP (25 minutes later)

Brief Answer:
These reports are showing you are in remission

Detailed Answer:
Hi XXXXXXX

Welcome to HCM. I have gone through the question and understand your concerns.

The 24 hour urine cortisol and salivary cortisol are showing normal reports. You don't need hydrocortisone now as the basal cortisol is normal. These results are showing that you are in remission. Additional test you can suggest your Endo to do is a dexamethasone suppression test.

Hope I have answered your questions. If you have any further queries I will be happy to help you.

Regards,

Dr Ajish TP [MD,DM]
Consultant Endocrinologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajish TP (1 hour later)

Thank you fod the reply

With the cushings i experienced Thinning of skin. With remission is this something that improves overtime? If so how long would you say

Answered by Dr. Ajish TP (5 hours later)

Brief Answer:
It depends on the duration of disease

Detailed Answer:
Hi XXXXXXX

I understand your concerns. The recovery depends on the duration and severity of Cushing's syndrome.

After complete recovery, thinning usually start improving by 6 weeks and usually it take 2-3 yrs to be back to near normal state. Complete recovery to normal skin is seen in some cases - usually when duration is short are cortisol excess is less severe.

wishing you early recovery

Regards
Dr Ajish TP

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajish TP (10 minutes later)

I see

Also, since i was diagnosed with Cushings i been having trouble breathing through my stomach especially after eating a light meal. Also when i am in a seated position. I dont know if the cushings caused some sort of gastrointestinal problems and i dont know how to fix the issue or what type of doctor to see for this.

I can discuss this with my endocronologist but i dont think he would have a solution for this problem.

However, in 2013 i had a habit of binge eating which lasted about 2-3 months. Im not sure if this could have caused any problems or if it was the cushings

Answered by Dr. Ajish TP (15 minutes later)

Brief Answer:
it could be the cortisol excess

Detailed Answer:
Hi XXXXXXX

These symptoms could well be due to Cushings disease. High cortisol will cause thinning of stomach mucosa, increase gastritis etc.

There are lot of problems which persists even after remission of Cushings. This is because cortisol is a steroid hormone which can cause permanent changes in body.

The recovery is usually gradual and may take years. You have to stick on to regular diet and moderate aerobic exercise to keep your body fit and try meditation or relaxation exercises to keep your mind calm.

Good health.
Regards
Dr Ajish TP

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar