Cushing 's Syndrome : Whole Body Impairment

Cushing’s syndrome is a rare endocrine disorder that occurs when your body is exposed to an overabundance of the hormone cortisol.3 Cortisol is known as the stress hormone. The interruption of cortisol secretion can cause weight gain and can ultimately determine where you put the weight on.8 There are many underlying causes such as Pituitary Adenomas, Ectopic ACTH Syndrome, Adrenal Tumors, and Familial Cushing’s Syndrome.2 The majority of these people affected by this hormonal disorder experience weak muscles, increase fat, high blood pressure, etc.1 Although thousands are affected in various ways, there are currently several channels of treatment administered by medical professionals. Through the use of improving technology, medical professionals are better understanding the disorder, allowing them to develop better treatment practices.

Other common features include self-induced vomiting, laxative abuse, excessive exercising, distorted body image, and morbid preoccupation with energy intake. Physical findings include dehydration, electrolyte imbalance, hypothermia, poor peripheral circulation and even circulatory failure, cardiac arrythmias, hepatic steatosis, and ovarian and uterine regression (Bryant-Waugh and Lask, 1995).

The symptoms adults experience are much the same as the children experience without the stunning of growth and affect on puberty. Some adults having a mild form of the disease exhibit almost no symptoms. Others may experience a loss or gain in appetite, abdominal pain, bloating, gas or indigestion. In addition, other people have bothersome symptoms including diarrhea, weight loss, abdominal discomfort, and excessive gas caused by vitamin and nutrient deficiencies (The Mayo Clinic staff, 2011).

Another diagnostic method to diagnose adrenal tumors is cortisol saliva testing. In this test, the amount of cortisol in the saliva at or near midnight is normally very low. Multiple repeats of the test to confirm elevated cortisol levels can diagnose Cushing's syndrome. Cushing's syndrome is excess cortisol levels, possibly due to the body secreting too much

3. The symptoms that accompany Cushing's disease will vary among patient's, but most people will have upper body obesity and thin arms and legs, round, red, full faces and slow growth rate in children. They will also have skin changes that include; acne or skin infections, purple marks called striae on the abdomen, thighs, and breasts, and they will have a thin skin with easy bruising. You will also notice changes in bones and muscles, such as bone pain or tenderness, collection of fat between the shoulders, back aches, weak muscles and rib and spine fractures. Women who have Cushing's disease may

themselves are malfunctioning that is called primary adrenal insufficiency. Another reason that cortisol production is lacking might be because not enough ACTH is being generated by the pituitary gland. The second order effect of inadequate levels of ACTH being secreted results in cortisol not being produced. When this is the case it is called secondary adrenal insufficiency (MedlinePlus, 2011).

A person should visit their doctor for the diagnosis of this disease if they have severe fatigue, muscle or joint pains, salt cravings, unintentional weight loss, and gastrointestinal problems, such as vomiting and abdominal pain and nausea.

Each year about 340 horses die due to effects of insulin resistance. That is almost half the deaths caused by horse racing. If a horse or pony suffering from Insulin Resistance and they eat high sugar feed, and eat normal, unsoaked hay the large increase in sugar may cause death or lead to serious life threatening conditions. In horses that don’t suffer from Insulin Resistance and Cushing’s it wouldn’t be as great a concern if they got out and ate feed and hay, but thus act becomes life threatening and fatal for horses and ponies suffering from Insulin Resistance and Cushing’s. Insulin Resistance, Cushings, and Endocrinopathic Laminitis are all very complex diseases that many experts are still gaining an understanding for. Glucose, insulin, and cortisol are major factors not only in Insulin Resistance (IR) and Cushings (PPID) as individual diseases, but they also serve to link the two diseases to Endocrinopathic Laminitis in addition to each other. Insulin Resistance and

5.Cushing's syndrome: a constellation of symptoms caused by steroid excess in the blood. The symptoms include humped back, muscle thinning and weakness, and lowered immunity.

Increased androgen hormone levels within the body can negatively affect the normal ovulation process and cause fluid-filled cysts to form on the ovaries. PCOS prevents ovarian egg release during the menstrual cycle, which causes infertility in women with this condition. Additional symptoms of PCOS include pelvic pain, acne, oily skin, hair loss or excessive hair growth on the body or face. Currently, there is no cure for PCOS but hormone therapy can help regulate your menstrual cycle or clear up your skin.

A review of a patient’s medical history based on the symptoms, especially the dark tanning of the skin, can lead a doctor to suspect Addison’s disease. The most specific test for diagnosing Addison’s disease is the ACTH stimulation test. In this test, urine and/or blood cortisol levels are measured before and after a synthetic form of ACTH is given by injection. Patients with either form of adrenal insufficiency will respond poorly or not at all. There is also an Insulin-Induced Hypoglycemia Test which is used to determine how the hypothalamus, pituitary and adrenal glands respond to stress. Blood is drawn to measure blood glucose and cortisol levels followed by an injection of fast-acting insulin. The normal response is for blood glucose levels to fall and cortisol levels to

"The onset of the disease usually occurs when 90 % or more of both adrenal cortices are destroyed" (Griffing & Khardori, 2014). Several hormones function are compromised due to the impairment of the adrenal cortex. This hormones are glucocorticoids that are essential in cell metabolism, aldosterone & mineralocorticoids which are the main regulator of sodium and potassium levels in the blood as well fluid balance in our body and androgens the sex hormones are all affected with Addison’s disease. This explain why Ms. Thomas cortisol level, blood pressure, blood glucose, blood sodium, are all low and her blood urea nitrogen (BUN) and blood potassium are all high. In addition she is showing classic symptoms of the disease crisis.

A 23 year-old otherwise healthy African American active duty male admitted directly from Endocrinology clinic for expedited work-up of suspected Cushing’s syndrome. Patient had been treated by his primary care provider for acute-onset hypertension, but had escalated rapidly to use of three antihypertensive agents within 6 months. Other than tobacco dependence (1/3 pack per day), patient had no known pertinent personal or family medical history. Patient was referred to Endocrinology due to refractory hypertension (190/100s on three agents) and signs of truncal obesity (30 lbs despite active lifestyle), moon facies, buffalo hump and violaceous striae concerning for Cushing’s syndrome. He also reported symptoms of generalized fatigue, limb weakness, lower extremity edema, easy bruising, nocturia, insomnia, and irritability. Patient was found to have elevated ACTH (252-290) with non-suppressible cortisol levels upon dexamethasone suppression testing at 1-mg (32.7) and 8-mg (37.56). Adjunctive studies included thyroid function tests, renin:aldosterone ratios, plasma metanephrines, 24-hour urine

c.i. Fatigue, weight gain, cold intolerance, depression, and slowed heart rate are just a few of the many symptoms

Cushing’s Syndrome is a condition that results from chronic exposure to excessive amounts of glucocorticoids circulating in the blood stream for an extended period of time. The disease was first reported by Harvey Cushing over one hundred years ago, yet the condition still plagues endocrinologists today. Reasons for this difficulty include the vast amount of often vague symptoms that the syndrome presents, most of which are found in a plethora of other conditions as well, combined with the multiple forms that the condition can manifest itself. Symptoms of Cushings Syndrome include, but are not limited to, weight gain, hirutism, easy bruising, hypertension, acne, facial plethora, muscle weakness, striae, depression,