48 replies to this topic

[MaryO]

• January 29, 2009 8:30-9:30PM Eastern: Dr. Ted Friedman
  
  Please note the changed date and later time!
  
  Dr Ted Friedman will be our guest in the weekly Interview/Podcast series.
  
  We will take written questions first. If there is time at the end, we will take callers.
  
  Short Bio:
  
  Theodore C. Friedman, M.D., Ph.D. has opened a private practice, specializing in treating patients with adrenal, pituitary, thyroid and fatigue disorders. Dr. Friedman has privileges at Cedars-Sinai Medical Center and Martin Luther King Medical Center. His practice includes detecting and treating hormone imbalances, including hormone replacement therapy. Dr. Friedman is also an expert in diagnosing and treating pituitary disorders, including Cushings disease and syndrome.
  
  Dr. Friedman's career reflects his ongoing quest to better understand and treat endocrine problems. With both medical and research doctoral degrees, he has conducted studies and cared for patients at some of the country's most prestigious institutions, including the University of Michigan, the National Institutes of Health, Cedars-Sinai Medical Center, and UCLA's Charles Drew University of Medicine and Science.
  
  He has a private practice in Los Angeles specializing in hard-to-diagnose and treat cases of adrenal, pituitary, and thyroid disorders. He is the father of three children. Dr. Friedman lives in California.
  
  He's the "Dr House" of endocrinology. He loves complicated cases and is an outstanding diagnostician.
  
  He also has a PhD in pharmacology.
  
  
  
  Kate (Fairley) and Dr. Ted Friedman on National Geographic TV, September 2007/
  
  
  
  Read Dr. Friedman's First Cushing's Help and Support Guest Chat
  November 11, 2003 »
  
  Dr. Friedman's Second Cushing's Help Guest Transcript, March 2, 2004 »
  
  The Everything Health Guide to Thyroid Disease: Professional Advice on Getting the Right Diagnosis, Managing Your Symptoms, And Feeling Great (Everything: Health and Fitness) (Paperback)
  
  by Theodore C., M.D., Ph.D. Friedman (Author), Winnie Yu (Author)
  
  If you have a thyroid condition, you are not alone. An estimated 13 million Americans suffer from thyroid disease. The Everything Health Guide to Thyroid Disease, cowritten by acclaimed thyroid specialist, Theodore C. Friedman, is the authoritative handbook you need to help you live with this disease. You'll learn about:
  • How the thyroid functions and dysfunctions
    
  • Who is at risk for thyroid disease
    
  • Well-known thyroid disorders-hyper, hypo, and Grave's disease
    
  • Far-reaching effects (weight loss and gain, anxiety, depression)
    
  • Treatments and living with the disease
  Complete with a glossary, additional resources, and even a section on thyroid disease in children, The Everything Health Guide to Thyroid Disease is the complete guide for everyday healthy living.
  
  Sample chapters (PDF format)
  
  • Chapter 1
    
  • Chapter 2
    
  • Chapter 3
    
  • Chapter 4
    
  • Chapter 5

Please note that we will take written questions first. IF there is time at the end of the hour, we will take calls.

You may post your question here, in the chatroom at http://www.blogtalkr...om/CushingsHelp during the chat, or by sending me an email at cushingshelp@gmail.com

Your name will not be mentioned on the air.

Similar questions may be combined to make the most of our time together.

Thanks for understanding!

[aautomo884]

Can you be Hyperthyroidism and Hypothyroidism at the same time?

[venus445]

What are reasons that your TSH would continue to rise even though you are increasing your thyroid/Synthroid doseage from 88mcg, 100, 125 to 150mcg in one year? with TSH doubling at the end of the year?

[philb]

After thyroidectomy and radiation, are there side effects that can cause salivary gland problems?

[SusanM]

Cool.....thanks for organizing, Mary.

[Rissa]

Great to hear Mary!! His web chats with this website were one of the first things that led me on this path. They helped explain so much to me about what might have been happening to me! So glad to see another chat with Dr. F.

Rissa

[Rissa]

I have two questions:

1. Is there any group of experts who work with Cushing's syndrome/disease (including complicated/cyclical patients), working on a consensus statement or guideline to identifying and treating these patients to help the medical community better understand this disease and possibly identify patients sooner. Is there enough published evidence for a guideline to be developed?

2. What is the current role of IPSS in diagnosing Cushing's disease, particularly in cyclical Cushing's patients?

Thanks Mary!

Rissa

[twinkie]

Thanks Mary!

It seems most cyclical cushing's patients have tumors that are of a "snotty" consistancy. This makes it difficult if not impossible for complete removal of the tumor, resulting in lower cure rates. Can a form of chemotherapy be invented to kill off any tumor cells that are left after surgery?

love,
melly in nv

[venus445]

I have another question, sorry my thoughts come out in spurts kind of like my cortisol!!

For those of us who are testing and testing and testing for cushings, I can envision my tumor sending off shoots and turning into hyperplasia. What is the liklihood of the tumor growing or developing hyperplasia for those that seem to have to test for a long time?

[staticnrg]

 twinkie, on Jan 8 2009, 11:50 PM, said:

Thanks Mary!

It seems most cyclical cushing's patients have tumors that are of a "snotty" consistancy. This makes it difficult if not impossible for complete removal of the tumor, resulting in lower cure rates. Can a form of chemotherapy be invented to kill off any tumor cells that are left after surgery?

love,
melly in nv

Melly, not to butt in, but there is new research on that and I just posted some articles on my blog. The most recent has a link to another one.

xoOX
Robin

[twinkie]

 staticnrg, on Jan 9 2009, 05:07 AM, said:

Melly, not to butt in, but there is new research on that and I just posted some articles on my blog. The most recent has a link to another one.

xoOX
Robin

Any imput from you Robin is never considered "butting in!" Thanks for the information, I'm going there now!
melly

[staticnrg]

 Rissa, on Jan 8 2009, 11:16 PM, said:

I have two questions:

1. Is there any group of experts who work with Cushing's syndrome/disease (including complicated/cyclical patients), working on a consensus statement or guideline to identifying and treating these patients to help the medical community better understand this disease and possibly identify patients sooner. Is there enough published evidence for a guideline to be developed?

2. What is the current role of IPSS in diagnosing Cushing's disease, particularly in cyclical Cushing's patients?

Thanks Mary!

Rissa

Hi, Rissa. In answer to question 1, here is what has been done recently: http://home.comcast.net/~staticnrg/Cushing...mansArticle.pdf

There is a good thread about it here: http://cushings.invisionzone.com/index.php...8&hl=nieman

What I took issue with, and maybe we could expound on your excellent question(s), is that they say in there

"The evidence on which many of these recommendations have been made is of low to very-low

quality because there are limited data linking diagnostic strategies to patient outcomes as much

of the work has focused on developing, validating, and ascertaining diagnostic test performance."

But we all know that any doctor who MAY take the time to read it will not see that sentence nor will he see what's on down about the need for further research, etc.

Gotta get to bed..... more another time...

XOOX

Robin

[missaf]

Are there instances when high cortisol levels can not be captured, but a hypopituitary patient with a validated tumor present would require surgery for tumor removal?

[emilysmommie]

Thanks Mary!!!!


Great Rissa, I too was going to ask about IPSS because that is my next big step (after my 3T).

[JenS]

Patient post BLA 2 years ago has and ACTH of over 2000 and rising, and the patient has muscle weakness, hyperpigmentation, MRI comes back clear (Cushing's diagnosis was ACTH secreting corticotroph hyperplasia and MRI before pituitary surgery was also "clear"), IPSS confirmed cells are still there. Is this Nelson's, and should any treatment be done? If so, what? Thank you.

[MaryO]

Don't thank me - Robin did the initial email inviting Dr Friedman - and several other doctors - to do an interview.

It looks like we're going to have lots of questions, maybe more than an hour worth! If so, perhaps Dr F will come back for a second time.

When we did the first 2 text chats in 2003 and 2004 he did just that because there were so many questions.

Maybe some of the other doctors Robin invited will also come on and give THEIR answers to these great topics or others more specific to their practices.

If you want to invite your endo or other doctor, feel free. Maybe Robin can share the email she used as an invite (?).

[maecar]

Some doctors are predicting that SOM 230 will be the new conventional treatment for Cushing's Disease. The trial has only included patients who achieved high ufc's on several occasions (untainted by any normal tests) Do you believe it will be an effective treatment for cyclical or intermittent Cushing's as well?

[venus445]

Probably the most important question for me....can you have a few highs like a midnight serum of 11.8 and not have cushings?

[SusanM]

QUESTION FOR SUBMISSION:

Some doctors say that in cyclical Cushings the 'tumor' turns off and on thus causing its cyclical nature. Question: In your opinion, what causes cylical Cushings if a person has a confirmed tumor? Same question, however, what if the patient has confirmed hyperplasia?

[rhyliesmom]

Can something other than cushings cause high ACTH's?