Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

141 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

What does my CT scan report indicate?

Answered by
Dr.
Dr. Mirjeta Guni

Endocrinologist

Practicing since :2006

Answered : 2023 Questions

default
Posted on Wed, 5 Apr 2017 in Thyroid Problem and Hormonal Problems
Question: hi can you please check my adrenal ct scan. I have on and off elevated cortisols but are now constantly elevated. elevated blood cortisol and midnight saliva is high. normal epinephrine and metaphrines urine and blood plasma test.
doctor
Answered by Dr. Mirjeta Guni 31 minutes later
Brief Answer:
Some more images needed.

Detailed Answer:
Hello,
The images you attached are inconclusive. Only one of them has adrenal image and looks normal. But would be better if you attach some more.
Before doing radiological exams, a low dose dexametasone supression test is mandatory because cortisol level may increase for many reasons ( obesity, stress) but if it persists high after supression, it means that there is overproduction by adrenal or pituitary gland.
Pituitary gland tumors are the most common causes of Cushing syndrome.
So, to decide rather the radiological exams need to be done for the pituitary or adrenal, a high dose ( 8 mg) dexameatson test would help.
Please attach some more images of ct scan.
Regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Kampana
doctor
default
Follow up: Dr. Mirjeta Guni 47 minutes later
I tried to add more photos.. my pituitary is normal. my symptoms are caffeine and stimulant sensitivity, vasoconstriction, insomnia, weight gain, fat face, weird acne, oily hair and skin, raynauds everywhere, tachycardia , migraines I crash at around 3pm but will stay awake all night. I have Chronic urticaria, gastritis, mgus. out of all my tests the cortisol is persistently high. could it be systemic inflammation? eg vascular urticaria? don't know why I'm so sensitive even a sip of tea I get tachycardia and vomiting 5 mins after. when I get the tremors I also have uncontrollable vomiting. of adrenals look normal can you suggest a cause? the vasoconstriction is getting severe I know get ulcers
doctor
Answered by Dr. Mirjeta Guni 6 hours later
Brief Answer:
Chatechomaines should be checked also:

Detailed Answer:
Hello,
A small adenoma is seen at the left surrenal gland.
At these conditions i would recommend a low dose dexametasone suppression test.
If the cortisol persists over 5 mcg/dl it is probable an over secretion by the adenoma.
If it is suppressed (under 5 mcg/dl) chronic urticaria, systemic inflamation, stress, weight changes may be the cause of high cortisol .
I would recommend also to check the chatecholamines to rule out a pheochromacitoma that is manifested with tachychardia vasocontriction stimulated by caffeine ect.
Wish the information will help.
Kind regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
default
Follow up: Dr. Mirjeta Guni 6 hours later
thank you! I saw the adenoma myself I just wanted confirmation . I have been tested for chatechmaines that is all normal. the only abnormal tests are my cortisol Levels. the theory could be that having higher cortisol Levels could make me more sensitive to the epinephrine in my body and it is reacting. my symptoms are cyclic. which means it's very difficult to test accurately although with my past test results and current I am pretty certain it's a functioning adenoma. I have had a prolactinoma in the past as well and that's all clear. which makes me wonder if I am susceptible to endocrine problems. I have been suffering with this problem for 5 years.! burning scalp, hair loss, weight gain, now I have hair on My abdomen, flushing and vasoconstriction, ectopic heart beats, constant fungal infections etc etc. a elevated cortisol can cause this. I have cyclic symptoms at the moment I am losing weight but the insomnia is still lingering and then I will have a silent period and then it starts up again and gets worse ans longer with each flare. it's time for this thing to go. I am happy to get iT removed
doctor
Answered by Dr. Mirjeta Guni 4 hours later
Brief Answer:
Regarding the adenoma removal;

Detailed Answer:
Hi again,
I can understand your situation.
The symptoms of cortisol overproduction are very discrete and most of the patient suffer from years until the diagnosis is found.
The adenoma is small and it should be confirmed before intervention rather it is a functioning adenoma or incidentaloma as some preoperative and postoperative cautions should be done if it functioning adenoma (secreting cortisol tumor) to prevent adrenal insufficiency after removing the lesion.

So, you should discuss with your treating physician before making a decision.
Regards,
Dr.Mirjeta


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

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,   ,   ,  
Drug/Medication
Medical Topics

Recent questions on  Cortisol

doctor1 MD

MY partner had a pituitary apolexy 7 weeks ago which he had an operation on, but some of the tumour is still there. He is now on thyroxine 100 mcgs od and hydrocortisone 20mgs morning, 15mgs lunchtime and 5 mgs pm. How much alcholol is he allowed to consume in a day. Also is it possible that the pituiatary gland will work again as it was not all removed. Can hydrocortisone make you aggressive, especially when drinking alchohol his age is 42 years he is 178cm and 102 kgs

doctor1 MD

Hello Doctor,

My aunt was unwell for the past week with a possible cause of parasitic worms. She had a stay for about 3 days in the hospital which resulted in her being very week. This week when she was home she felt giddy and hit her head to the floor. The various tests conducted have all Thankfully been Fine. She though is very weak and cannot even sit down on the bed. She is currently recuperating in the hospital and the blood, stool tests were norma. The liver tests were having figures on a slightly higher side and are awaiting the cortisol results in a couple of days. The practioners are trying to find the actual cause of the weakness. The ammonia levels were high and sodium was less. She was on a saline 3 concentration sodium. Can you please advise what may be the trigger for this weakness.

doctor1 MD

I was gardening in the morning with garden gloves, big sun hat & big white long sleeve high collar shirt under the strong sun, because I burn badly. That evening suddenly my lower arms between the elbow & wrist are covered with bunch of red spots. At first I thought they are from the bugs, so I put the over the counter insect bite cream. It didn t help at all after frequent application overnight. They Itch badly, tiny dot size to 1/4 diameter, some have white or clear pointed center. I remembered I had a similar incident about 3 months ago on my lower legs & went to the dermotologist. She prescribed fluocinonide cream usp 0.05%, so I have been appling it this morning, but no improvement. Should I give more time ? I also have proctozone-HC TM 2.5% ( hydrocortisone cream usp 2.5% ) prescribed from another doctor. Is this the same as the first cream ? May I use ths instead or use it after the first one is gone ? How often may I use per day & how long may I use ? Or do I have totally another problem ?

doctor1 MD

Hi. I visited the doctor the other day, because I have numbness in my arms and fingers and palpitations, and so I was worried about my heart. They took bloods which showed I am anaemic. They also did an ekg and I am really worried now because they said it was abnormal. The doctor said there was a tiny bump which should be on a certain part, and it wasn't there, but that it "wasn't a big problem". The doctor also said the 2 leads which showed that issue with the bump were the ones under my breasts, and that "you have quite large breasts, so that could have cause this result". I told the doctor I am also really tired and stressed and she said also took some blood to test for low cortisol and low B12. I am awaiting the results. She said the symptoms I was describing were not to do with my heart. I have been referred for a stress test which I will do 4 weeks today, but I'm terrified that something is seriously wrong with my body and/or my heart. Please help me. I think the doctor is being pretty pro-active, but I'm so worried :-(

doctor1 MD

I HAVE HAD HYPOTHYROIDISM FOR WHAT SEEMS LIKE FOREVER. I HAVE GONE TO MANY DIFFERENT DOCTORS AND ALL THEY DO IS GO BACK AND FORTH WITH THE DOSAGE OF SYNTHROID AND IN THE MEANTIME, I AM EXHAUSTED, MY JOINTS HURT, AT THE MOST RIDICULOUS TIMES-MY...

doctor1 MD

Started fever 11 days ago. Nodes in 2 areas of neck swollen but better. Left arm near elbow broken out and itches. My right entire side of back is totally broken out. If i scratch seems like fluid inside. Very small breakouts but covers entire...

doctor1 MD

My daughter is obsessed with seeing people in pain. She watches movies and vid of people in pain all day long and thinks abour it to all day long. whats wrong?