Possible/Pseudo Cushing syndrome

Posted by jmb73 @jmb73, Dec 21, 2020

I am belng tested for high cortisol levels. Recently, I have put on 25 lbs and have developed a lump above my collar bone. I really thought I had lost weight as I am only eating 2 small meals a day. I am pre-diabetic and in Nov., my PC diagnosed possible pneumonia as I have/had streaky opacities in the left basilar region of my lung. I was given prednisone and she increased my Doxycycline to 100mg 2x/day. I take 20 mg 2x/day for my ocular rosacea. Every 3 months I have steroid shots in my feet for tenosynovitis. I can't take any NSAIDS because I have AFIB. My endocronologist said it could be caused by too much predinisone. I will take 1 mg of DST Sun. at midnight and then have blood work at 7:15 on Mon. I am really nervous that it could be Cushing Disease and I won't be able to take prednisone for my lung issues. I would really like to connect with anyone who has adrenal problems and or Cushing Disease. Thank you, Joan

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@mishkamilad

Just discovered this great resource. Over the past 12 years I have gone from 105 lbs to 190. Before this I was always around 103-110 (even after two pregnancies).

I started seeing doctors 10 years ago when at 115 because I knew it was not normal. No doctor has been able to diagnose. Now I have many other problems including diabetes, have very little stamina and can't even walk a block without shortness of breath. I used to run 20 miles a week and bike ... but my whole personal and professional lives are horrible now ... can't even make it to programs and meetings because I don't feel well.

I've done many blood tests of all sorts over the years and several MRI of pituitary and adrenal.

Now, I am exhibiting all the symptoms associated with Cushings Syndrome except the 24 hour urine cortisol test. While I do show small adenoma on pituitary and all the symptoms, they don't think its Cushings related due to the 24 hour urine cortisol coming back 'normal.' I've done saliva test and morning is 'in range' but night time and afternoon are high. The suppression test is also coming back 'normal.'

One thing I do know is that I don't sleep well. But 85 lbs due to poor sleep?

One observation I have shared with the doctors (but they continue to disregard it but worth mentioning) is that for 1.5 years 13 years ago I took Ativan which caused a huge weight loss (but had severe negative side effects including delirium and retrograde amnesia). It might be a clue, however, that research has shown in some patients it lowers cortisol levels. I took it 3 times more a few years ago (each time only for 3 days or so when close family members passed away and each time I exhibited all the same symptoms including huge weight loss). So, this may be just coincidental or may be a clue.

I've seen doctors at Stanford and UCSF, but none really listen and keep repeating the same tests over and over again.

So now, 12 years later I've gone from an active person to basically one who can't even walk a block. At 50 I was in best shape I had ever been and now at 60, well.

I am a moderate eater, Mediterranean diet.

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@mishkamilad - I understand how upsetting it is not getting a straight answer from so many doctors.
My daughter spent years going to numerous doctors for similar symptoms- she gained a lot of weight quickly- this girl was a competitive swimmer-, developed diabetes, muscle weakness etc.
She finally found a doctor who knew what was happening to her.
There are many of these illnesses that are rare and most doctors never see a patient with an unusual diagnosis such as Cushing’s.
That’s why you have to find a major teaching hospital that is known to specialize in pituitary problems. Your best bet would be to be seen at Mayo Clinic.
Would you be able to visit one of the Mayo Campuses?
By the way, I have another daughter overseas who is struggling to find a doctor knowledgeable enough to understand that she may also have Cushing’s. She had one elevated cortisol and can barely function because of extreme exhaustion and body pain.

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@astaingegerdm

@mishkamilad - I understand how upsetting it is not getting a straight answer from so many doctors.
My daughter spent years going to numerous doctors for similar symptoms- she gained a lot of weight quickly- this girl was a competitive swimmer-, developed diabetes, muscle weakness etc.
She finally found a doctor who knew what was happening to her.
There are many of these illnesses that are rare and most doctors never see a patient with an unusual diagnosis such as Cushing’s.
That’s why you have to find a major teaching hospital that is known to specialize in pituitary problems. Your best bet would be to be seen at Mayo Clinic.
Would you be able to visit one of the Mayo Campuses?
By the way, I have another daughter overseas who is struggling to find a doctor knowledgeable enough to understand that she may also have Cushing’s. She had one elevated cortisol and can barely function because of extreme exhaustion and body pain.

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Thank you for your comment and sorry to hear about your daughters. I consider both Stanford and UCSF as teaching hospitals and consulted with both but neither was helpful.
Are there any Mayo Clinic campuses in California? Would love to know.

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The closest Mayo campus for you would be in Arizona. Is that a possibility for you?

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@pinkrosebud

Does anyone here have a diagnosis of Pseudo Cushing’s? I was diagnosed with Polycystic Ovarian Syndrome and T2D, but I have elevated cortisol levels in blood, 24 hour urines, and midnight salivas. I have normal ACTH levels, I suppress on dexamethasone, normal pituitary MRI and normal abdominal CT scan. I also took the DDAVP stim test, which was normal. I haven’t met a lot of people with Pseudo Cushing’s. I’m not a drinker, in fact i don’t drink at all. I do have OCD and wonder if that is where my HPA axis dysregulation stems from. Being a case of pseudo, no endocrinologist has really been able to offer me a solution to regulate this imbalance and living with this is making it very difficult to balance my PCOS, weight, and glucose levels. I also have elevated prolactin, but again no pituitary tumor behind the cause. It’s idiopathic. Anyone else in a similar situation? It seems pretty rare, but maybe it’s not, maybe it’s simply under reported or diagnosed?

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Consider looking into Cyclical Cushing's. It is nightmare to diagnose though but hair testing is the most promising method.

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