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MaryO

Questions for Dr Friedman

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In your experience, is it common for post-op (cure?) Cushing's sufferers to suddenly acquire new allergies?

 

(asks the woman who is now allergic to cinnamon)

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What is the role of Cortisol Binding Globulin in testing and diagnosis of Cushing's Disease?

 

What does a low or low-normal CBG mean and what does a high or high-normal CBG mean in relation to test results of blood cortisol, urine tests (UFC's an d 17-OHC), and saliva.

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What role does hyperplasia play in being cured or not cured after pituitary surgery and why?

Can you explain exactly what hyperplasia is?

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1. If a person goes without sleep for at least 24 hours, followed by 2-3 hours of sleep, and repeats the process on consecutive nights, could

they inadvertantly "reset" their internal clock and thus disrupt their diurnal rhythm for an extended time?

 

2. If this is possible wouldn't their cortisol levels be flipped around and they would have high midnight serums and low daytime serums?

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DO YOU THINK THAT PREIMPLANTATION GENETIC TESTING CAN BE A USEFUL PROCEDURE FOR SOMEONE WHO IS SUSPECTED OF HAVING FAMILIAL CUSHING'S, AND DOESN'T WANT TO PASS IT ON TO THEIR CHILD? IS THERE JUST ONE GENE RESPONSIBLE FOR FAMILIAL CUSHING'S? WHAT ARE YOUR THOUGHTS ON PREIMPLANTATION GENETIC TESTING?

 

 

 

 

ALSO, DO YOU BELIEVE THAT "NATURAL" SUPPLEMENTS SUCH AS THOSE SOLD AT VITAMIN STORES THAT ARE MARKETED FOR GROWTH HORMONE PRODUCTION CAN BE BENEFICIAL FOR THOSE WHOSE INSURANCE DENIES GH, AND WHOM ARE SEVERELY DEFICIENT?

 

 

 

THANK YOU FOR DOING THIS~

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Is cortisol measurable in ear wax?

 

Is cortisol measurable in body fat, esp hump, supraclavicular fat pads or belly fat? Say via punches?

 

What is going on with research into hair and measuring cortisol?

 

What is going on with measuring cortisol in sweat (studies published seem to express hope of this working)?

 

My question is really are the measurements available and are they diagnostically relevant.

 

Can you give me an easy to understand analogy to the HPA axis, feedback loop and negative feedback loop?

 

Do all of the hormones that use the hypothamalic - pituitary axis have feedback loops and negative feedback loops? If not, which ones?

 

Is it true that endocrinology student doctors are at an all time low as a number and as a percentage of med students?

 

If I understand correctly: surgeons and physicians, endos, etc. who treat pituitary and adrenalectomy patients look at cortisol in blood levels and not urine and saliva. Why?

 

THANK YOU for your attention to the Cushings and pituitary disease community.

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Does he know any good doctors in Melbourne Australia? Im desperate!

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Would like to correct this question to read:

 

If I understand correctly: surgeons and physicians, endos, etc. who treat pituitary and adrenalectomy patients look at cortisol in blood levels and not urine and saliva POST OPERATIVELY. Why?

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If you have already had unsuccesful pituitary surgery and you are moved to BLA what, if any, are the consequences of any residual tumor on the pituitary?

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Are the terms 'end-stage' and florid Cushings synonymous?

 

Is there a standard description (Stage I, Class I, etc). to describe the progression of Cushings Disease (meaning from a pituitary source)?

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Regarding Hypothyroidism:

 

Does taking iron supplements, and/or topical oestrogel or bio-identical oral HRT, lower the available thyroid hormone meds/utilization in the body (ie. binding to TBG)?

 

Is it possible for hypothyroid symptoms to come back in this scenario if the patient was previously feeling euthyroid with medication?

 

If so, does this show up as lower levels of Free T3 and Free T4 in the blood or does it only show up physiologically in the patient?

 

If this change only shows up as in the patient symptoms and not in blood tests, then what is the treatment protocol?

 

If iron or calcium is taken at a different time than thyroid meds, does that eliminate the potential for lowered utilization of thyroid meds and interactions, even at high doses of these supplements?

 

Can bio-identical progesterone pills or topical progesterone and/or testosterone cream cause the same effects? What other supplements (like calcium?) or other meds, if any, have the potential to bind with thyroid meds and cause less to be utilized in the body?

 

Thanks!

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Why would someone have an elevated TSH, with mid-range normal T3 an T4 and zero antibodies? Could this have a relationship to Cushing's?

 

Thanks!

Melissa B.

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What is the long term prognosis for people who have had a BLA?

 

What are the death rates down the road for people who have had BLA's compared to people who have not?

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What is the relationship between thyroid and cortisol?

 

Why does diabetes get all the attention?

 

Do you believe there is a chance that the ubiquitous artificial light we are exposed to causes some disruption of the pineal, pituitary or other glands?

 

Do fictional shows like "House" and documentary shows like the one that featured you, "The Science of Obesity", help develop interest in endocrine research?

 

How can we help further endocrine research?

 

Why are so many doctors (other than you) so dismissive of patients symptoms?

 

What can we do to help our doctors figure out complex medical issues?

 

What changes would you like to see in the field of medicine?

 

What would you as a doctor like the public to know?

 

What changes would you like to see in the field of medicine?

or:

What have been the biggest changes you've seen in the field of medicine?

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Is it possible for a person who must take thyroid replacement hormone to sometimes be able to convert the T4 to T3 and sometimes not?

 

What would cause this? What would make a persons TSH soar into the 140's and dump below 2 in less than a week? This person had a thyroidectomy 18 years ago and 3 known pituitary tumors and never has had level thyroid numbers last more than 2 months.

 

What is the relationship between a high stress childhood, PTSD and a burned out endocrine system?

 

Do we all have Adrenal Fatigue? If so what can we do for that?

 

How do we get the understanding and respect we deserve from Dr.s?

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Are there any studies of 'the encapsulated' pituitary microadenomas responding to therapies like those used to collapse varicose veins (injection of substance into vein and vein collapses on self and withers away)?

 

Do I risk having unreadable pituitary MRIs the more dental implants I get? I am losing teeth at an alarming rate.

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Have you seen a patient with Cushing's with diagnosed hypertrophic osteoarthropathy and if so does the hypertrophic osteoarthropathy resolve after the Cushing's is addressed?

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Do thyroid meds lower cortisol levels?

 

If so, could this make it difficult for one to show high cortisol in their tests, even if that person has Cushings?

 

Can high cortisol levels in the body (ie. from Cushings) mask hyperthyroid symptoms? If so, in what ways?

 

Can being properly medicated on thyroid meds mask the physical signs of Cushings?

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