Medical Forum / Diseases and Disorders / Diabetes / August 2007
Article on difficulty with Cushing's diagnosis
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Jim Chinnis - 14 Aug 2007 22:06 GMT Washington Post:
http://tinyurl.com/243orq -- Jim Chinnis Warrenton, Virginia, USA
Susan - 14 Aug 2007 22:39 GMT > Washington Post: > > http://tinyurl.com/243orq > -- Interesting to get coverage, but frustrating when so much is misrepresented.
Cushing's is not rare, it's rarely *diagnosed.* At least 10% of all type 2 DMs have undiagnosed Cushing's, according to a study that used a test to screen for it that is false negative at least one out of three times.
Some of us aren't fat, aren't red faced (though I was last year) and aren't moon faced. Some of us spend so much time feeling adrenally low that we have no appetite.
I did have an extra 20 unlosable lbs at one time, and exercise raises cortisol, so it didn't help me at all, except to preserve muscle that Cushing's causes to waste away.
Research has shown that a lot of psychosis, depression and bipolar disorder respond well to cortisol lowering treatment.
Susan
Jim Chinnis - 14 Aug 2007 22:49 GMT Susan <nevermind@nomail.com> wrote in part:
>x-no-archive: yes > [quoted text clipped - 20 lines] >Research has shown that a lot of psychosis, depression and bipolar >disorder respond well to cortisol lowering treatment. I found it interesting that someone with virtually a textbook case (all the signs) and seeing many doctors still had great difficulty getting diagnosed. -- Jim Chinnis Warrenton, Virginia, USA
Susan - 14 Aug 2007 23:15 GMT > I found it interesting that someone with virtually a textbook case (all the > signs) and seeing many doctors still had great difficulty getting diagnosed. Most folks who get diagnosed have seen at least that many doctors. Not only do docs not diagnose them, they are brutal in their condemnation of them for being fat.
It's so bad that recently, on Cushing board member who was at M.D. Anderson for her surgery for pituitary tumor was told by the endo there, the day before her surgery, that he would never have diagnosed her based upon her test results and that she should just go home and lose weight and exercise. This is the DAY before her skull neurosurgery, by a gifted neurosurgeon who had read her MRIs and seen all her myriad results.
Susan
Loretta Eisenberg - 14 Aug 2007 23:55 GMT Susan and Jim, an interesing thing happened.
Last week I was at the moves wih a friend. She said to me that I had the thinnest legs she had ever seen. I looked at them and they looked thinner than they had been.
When I went to the endo, I mentioned this little incident to him and he immediately said I should be tested for Cushings. I have no symptoms and I dont think I have it, but I didnt realize that skinny legs were a sign. Have you ever heard that. I have the apple body with the skinny legs. I dont have a moon face and I am not red. I think he is just taking precautions. but here is a thread on it.
Loretta
Emily - 15 Aug 2007 00:10 GMT > Susan and Jim, an interesing thing happened. > [quoted text clipped - 10 lines] > > Loretta Arms and legs both get quiet skinny with cushings from what I understand. There is a lot of muscle wasting that causes this. It is the middle that gets big from the belly fat gained. (at least that is what I've learned from my research).
Emily
Susan - 15 Aug 2007 00:31 GMT > Arms and legs both get quiet skinny with cushings from what I > understand. There is a lot of muscle wasting that causes this. It is the > middle that gets big from the belly fat gained. (at least that is what > I've learned from my research). Not necessarily skinny arms and legs, but muscle is lost with Cushing's and replaced by fat due to cortisol's effects.
Susan
Loretta Eisenberg - 15 Aug 2007 17:03 GMT Susan my upper arms are hadassah arms if you know what I eman. and the muscles in my arms or the bones are stronger than a thirrty year olds. I dont think I have that, I wont think I have that, until someone says I have
Julie Bove - 15 Aug 2007 04:13 GMT > Arms and legs both get quiet skinny with cushings from what I understand. > There is a lot of muscle wasting that causes this. It is the middle that > gets big from the belly fat gained. (at least that is what I've learned > from my research). Well, I'm all disproportional. Skinny legs but big arms. At least my arms are muscular.
Andrew B. Chung, MD/PhD - 15 Aug 2007 12:18 GMT > > Arms and legs both get quiet skinny with cushings from what I understand. > > There is a lot of muscle wasting that causes this. It is the middle that [quoted text clipped - 3 lines] > Well, I'm all disproportional. Skinny legs but big arms. At least my arms > are muscular. Your arms would become much less muscular if you were to start low- carb dieting.
Be hungry... be healthy... be happy... be blessed:
http://TheWellnessFoundation.com/PressRelease
Prayerfully in Jesus' awesome love,
Andrew <>< -- Andrew B. Chung, MD/PhD Cardiologist
Susan - 15 Aug 2007 00:30 GMT > When I went to the endo, I mentioned this little incident to him and he > immediately said I should be tested for Cushings. I have no symptoms > and I dont think I have it, but I didnt realize that skinny legs were a > sign. Have you ever heard that. I have the apple body with the skinny > legs. I dont have a moon face and I am not red. I think he is just > taking precautions. but here is a thread on it. Yes, Loretta, the conventional description is that central obesity with skinny arms and legs is a Cushingoid appearance. There is no such thing as a single test that can rule it out, since hormone secretion in Cushing's is so sporadic.
You sound very adrenally suppressed to me from your descriptions often; statins, bp meds, insulin and insulin sensitizers can all lead to adrenal suppression.
Susan
Julie Bove - 15 Aug 2007 04:12 GMT > Susan and Jim, an interesing thing happened. > [quoted text clipped - 8 lines] > legs. I dont have a moon face and I am not red. I think he is just > taking precautions. but here is a thread on it. I am not Susan or Jim, but it is a symptom. I have really skinny legs too. Even at my heaviest, my legs were relatively thin, but now they are like sticks. My chiropractor said he marveled that they could even be carrying me around.
Loretta Eisenberg - 15 Aug 2007 17:04 GMT JUlie do you have cushings
Loretta
Julie Bove - 15 Aug 2007 20:59 GMT > JUlie do you have cushings Not that I know of. I was tested for it.
KC - 15 Aug 2007 08:24 GMT > Susan and Jim, an interesing thing happened. > [quoted text clipped - 10 lines] > > Loretta I have skinny limbs too, and a red face, but not a moon face. I have only seen a handful of women in my life with as thin of limbs as mine, but with upper body obesity. Those of us who become obese in my family have long thin limbs before we become obese. I say that we are the ones who don't grow muscle well. This sublinical hypercortisolism does always interest me because I fit the profile somewhat, but it sounds like it is really tough to get diagnosed with overt cushings, so it would probably be darn near impossible to get diagnosed with subclinical hypercortisolism.
The L-tryptophan that I wrote about in another thread was also said to decrease stress induced cortisol levels in animals. But as I said in the other thread there is some controversy about the safety of L-tryptophan since it had been banned years ago when bad batches of it were sent to the US from Japan and made quite a few people sick, and even killed some.
I have one thing that I can't help but wonder if it is associated with hypercortisolism. When my thyroid function is low, I tend to have an easier time losing weight than when it is adjusted to normal. That seems so backwards, but I did read that hypothyroidism reduces cortisol levels, so I can't help but wonder if it is related to that.
KC
Andrew B. Chung, MD/PhD - 15 Aug 2007 12:10 GMT > > Susan and Jim, an interesing thing happened. > > [quoted text clipped - 33 lines] > > KC Low-carb dieting causes muscle wasting...
... **both** skeletal and cardiac.
The body sacrifices muscle to make the glucose to feed the brain.
Be hungry... be healthy... be happy... be blessed:
http://TheWellnessFoundation.com/PressRelease
Prayerfully in Jesus' awesome love,
Andrew <>< -- Andrew B. Chung, MD/PhD Cardiologist
KC - 15 Aug 2007 18:30 GMT >> > Susan and Jim, an interesing thing happened. >> > [quoted text clipped - 46 lines] > > The body sacrifices muscle to make the glucose to feed the brain. I've had thin limbs since childhood, so I doubt low carbing did it.
KC
Andrew B. Chung, MD/PhD - 15 Aug 2007 18:46 GMT > Andrew, in the Holy Spirit, boldly wrote: > >> [quoted text clipped - 50 lines] > > I've had thin limbs since childhood, so I doubt low carbing did it. Indeed, had you been low-carb dieting since childhood, we would not be having this written discourse.
Be hungry... be healthy... be blessed:
http://TheWellnessFoundation.com/PressRelease
Prayerfully in Jesus' awesome love,
Andrew <>< -- Andrew B. Chung, MD/PhD Cardiologist
Susan - 15 Aug 2007 14:09 GMT > I have one thing that I can't help but wonder if it is associated with > hypercortisolism. When my thyroid function is low, I tend to have an easier > time losing weight than when it is adjusted to normal. That seems so > backwards, but I did read that hypothyroidism reduces cortisol levels, so I > can't help but wonder if it is related to that. YES, hypothyroidism is a frequent consequence of hypercortisolism. IIRC, correctly, excess cortisol lowers TSH and T3.
Susan
Susan - 15 Aug 2007 14:10 GMT > Susan and Jim, an interesing thing happened. > [quoted text clipped - 8 lines] > legs. I dont have a moon face and I am not red. I think he is just > taking precautions. but here is a thread on it. Loretta, I want to revisit this to mention the obvious in your case: statins are associated with muscle loss, too, and I think you take one.
My mother's muscles started to just dissolve from statin use (that she never even needed) and Bill Wagner, who recently began posting here, lost much of his leg muscle.
Susan
Loretta Eisenberg - 15 Aug 2007 17:07 GMT Susan, and everyone, I want to tell you that I have had skinny legs all my life, I do believe that when we get older they get thinner so I am not worrying. They are quite shapely hahahahahahaha
I am on lipitor, but they were thin before, al the woman in my family have thin legs. I think it is an inherited trait.
Loretta
Susan - 15 Aug 2007 18:44 GMT > Susan, and everyone, I want to tell you that I have had skinny legs all > my life, I do believe that when we get older they get thinner so I am > not worrying. They are quite shapely hahahahahahaha > > I am on lipitor, but they were thin before, al the woman in my family > have thin legs. I think it is an inherited trait. Loretta, if you've always had skinny legs with a larger, round upper body/stomach, then you very well could have subclinical Cushing's at the root of your DM, depression, bp and lipids. Your recent tale about being completely wasted by the heat is also a mark of the disease for me; sunlight suppresses adrenal function.
Susan
Loretta Eisenberg - 15 Aug 2007 23:16 GMT Susan, I will be taking care of this with the doctor. I dont believe I have that kind of problem. All the woman have skinny legs from my mother to my cousins, to nieces to my daughter.
I am not going to think I have another condition until someone tells me I have it.
I cant drive myself crazy.
I have enough on my plate driving me nuts. :-)
Loretta
Alan S - 16 Aug 2007 00:50 GMT >Susan, I will be taking care of this with the doctor. I dont believe I >have that kind of problem. All the woman have skinny legs from my [quoted text clipped - 8 lines] > >Loretta Forget about it until you next see the doc. Cheers, Alan, T2, Australia. d&e, metformin 1500mg, ezetrol 10mg Everything in Moderation - Except Laughter. -- http://loraltraveloz.blogspot.com/ latest: Mossman Gorge in the Daintree Rainforest http://loraldiabetes.blogspot.com/ latest: Self-Testing and Type 2 Management
Susan - 16 Aug 2007 01:06 GMT > Susan, I will be taking care of this with the doctor. I dont believe I > have that kind of problem. All the woman have skinny legs from my [quoted text clipped - 6 lines] > > I have enough on my plate driving me nuts. :-) Hey, Loretta, YOU said your endo mentioned it, I didn't bring it up!!
Susan
Andrew B. Chung, MD/PhD - 15 Aug 2007 17:01 GMT > Washington Post: > > http://tinyurl.com/243orq The complaint of "an awful metallic taste in her mouth" tells us that she had not been hungry so that something other than overeating has been happening.
Be hungry... be healthy... be happy... be blessed:
http://TheWellnessFoundation.com/PressRelease
Prayerfully in Jesus' awesome love,
Andrew <>< -- Andrew B. Chung, MD/PhD Cardiologist
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