Cushing Syndrome ???

[jenmac]

Hi!! I'm 40 years old(RN)...I had a LAVH in 2000 for endo.  I was also dx with POF...I have 2 adopted kids.  I am now experiencing (over the last few` years and now getting gradually worse) excessive abd. weight gain..HTN, elevated lipids&triglycerides, A1c=6, Blood Glucose=120, I have osteopenia (and have had 3 stress fractures in my feet needing casting) and I have now noticed a swelling of my upper back and neck region....I've been told (prior to this latest neck swelling)  that I have insulin resistance and that I should just DIET...but my weight gain is way out of proportion to my food intake...I've even hired a personal trainer..but my Belly Remains...this new neck/back swelling scares me...my husband even noticed it(without me calling attention to it)...could I be suffering from Cushing's Syndrome???  I have never had my Cortisol levels tested...I know I have a very Low DHEA level...I'm not sure if this has anything to do with Cushings.  Anyway...I'm scared...I think I should see an endo doc...am I overreacting??
My stomach looks`like I've had 5 kids...it hangs over, like the pictures on the web of Cushing Pts.....I've had no children...my weight gain in my abd. area makes`no sense.  HELP!!  Jen in NJ

[Dgrace]

Is it possible to have a disease or a syndrome without having textbook signs?  For years I have been gradually putting on weight around my midsection, fatugued beyond belief, unable to focus with a pretty good amout of short term memory loss, low blood pressure, now I am losing my hair on my head and growing it in other places where a woman should not even have hair, I have peach fuzz facial hair with some wiskers now too!, and bosy aches and joint pain, I have never been able to have children.

I have been tested for thyroid but that was normal.  Was also tested for Polycystic Ovarian Syndrome but GYN said I did not have it because my Prolactin and FSH were with normal limits he did not do a LH.

I have now gone to an Endocrinologist and he checked me for acromegaly because I am extremely tall with large hands and feet that seem to have grown over time(I dont know but strang}my labs were pretty much normal but these are some of the results.
Total Testosterone  52
Pro Insulin      32
Cortisole level am 1.1
ACTH           5.0
sex binding globuline   22
my creatine was mid range

Are these result ok?  I feel like I am crazy and should be committed somewhere, thats how bad I feel.
Dgrace

[Machelle Seibel, MD]

If you have insulin resistance, dieting can be very difficult unless you treat the insulin resistance. Usually, oral hypoglycemic medications such as  Metformin, are used for this condition. It does help with weight gain and helps control the underlying metabolism problem.

Cushing's syndrome can be very serious if not treated. You should either see an endocrinologist or a reproductive endocrinologist. Either should be able to help you. In addition to testing for Cushing's syndrome, check also for thyroid disease by getting a blood test for TSH and T4 and T3.  Once you have eliminated (or included) these medical hormonal problems, it will be much easier to determine the  best course of treatment.

Also, given the fact you have osteopenia and have had three stress fractures, it also makes sense to ask your doctor to investigate other conditions such as hyperparathyroid disease and take a careful look at diet and vitamin and calcium intake. Be sure to ask about being treated for the elevated lipids and triglycerides with a medication such as Lipitor to reduce your risk for heart disease.
Machelle M. Seibel, MD