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What Causes Cushing's Syndrome?

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Posted on Tue, 24 Jun 2014
Question: I have had cushings syndrome in the past and my doctor ordered a 24 hour urine suppression test. In the past I remember doing a blood draw before and after the urine catch is that true?
doctor
Answered by Dr. Binu Parameswaran Pillai (55 minutes later)
Brief Answer:
Hello

Detailed Answer:
Hello,
Good day.
Cushing's syndrome can be due to various reasons: pituitary, adrenal, other sources of cortisol etc. It is not clear what type did you have and what treatment was done in the past. Could you please explain that?

There are a number of tests we do in Cushing's syndrome as screening tests and if screening tests are positive, we do confirmatory tests.

24 hour urine free cortisol and Dexamethasone suppression test, midnight salivary cortisol etc are screening test. If your doctor ordered a 24 hour urine test for cushing's syndrome, then it must be 24 hour urine free cortisol ( UFC) test. This doesnt require a blood test before and after. If you do a dexamethasone suppression test, that require a blood test before and after it.

However, dpending on the 24 hour urine test results, your doctor may then order some blood works ( depending on urine test results)
Hope it is clear now.
Kind regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (13 minutes later)
When I had cushings syndrome I had an adrenalectomy and it took me almost a year to get back to normal and just as a point of information, my 3 month old daughter got it as well. Anyway I guess what I am asking is, what are the chances of this coming back. As it was in 1984 or 85 and there is far more known about this now than then.
doctor
Answered by Dr. Binu Parameswaran Pillai (8 minutes later)
Brief Answer:
Hello

Detailed Answer:
Hello,
Adrenal Cushing;s sundrome is unilateral in majority of cases except in some familial and genetic diseases ( eg: CArney's complex, MAcronodular adrenal hyperplasia, mc cune albright syndrome etc). Since your daughter had same issues, i suspect there was a genetic component involved. The correct picture can only be obtained by looking at your old biopsy report. In familial cases, it can recur in the other side sometimes.

Since you have lots of symptoms and looking at the number of blood pressure pills, i wouldnt stop by seing a negative urine test. I would order another screening tets like a dexamethasone suppression test or a md night salivary cortisol test .

Please meet an endocrinologist

Did you have a blood test for glucose and potassium ?
Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (26 minutes later)
no, but I had a CBC, magnesium thyroid
doctor
Answered by Dr. Binu Parameswaran Pillai (2 minutes later)
Brief Answer:
Indirect clues

Detailed Answer:
Hmm, worth doing it. If you have cushings now, you may develop high blood glucose and Potassium levels can reduce . These will be indirect clues
Regards
B
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (11 minutes later)
Is severe fatigue and muscle weakness and depression symptoms of this
and do you have any idea how to get a copy of the biopsy that was done on my tumor and my daughters where it was so long ago
doctor
Answered by Dr. Binu Parameswaran Pillai (2 minutes later)
Brief Answer:
Hi

Detailed Answer:
yes, these can occur in Cushings, however, they occur inother diseases like diabetes, vitamin D deficiency etc as well
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. Chakravarthy Mazumdar
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Answered by
Dr.
Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1439 Questions

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What Causes Cushing's Syndrome?

Brief Answer: Hello Detailed Answer: Hello, Good day. Cushing's syndrome can be due to various reasons: pituitary, adrenal, other sources of cortisol etc. It is not clear what type did you have and what treatment was done in the past. Could you please explain that? There are a number of tests we do in Cushing's syndrome as screening tests and if screening tests are positive, we do confirmatory tests. 24 hour urine free cortisol and Dexamethasone suppression test, midnight salivary cortisol etc are screening test. If your doctor ordered a 24 hour urine test for cushing's syndrome, then it must be 24 hour urine free cortisol ( UFC) test. This doesnt require a blood test before and after. If you do a dexamethasone suppression test, that require a blood test before and after it. However, dpending on the 24 hour urine test results, your doctor may then order some blood works ( depending on urine test results) Hope it is clear now. Kind regards Binu