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mark01

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  1. Hi all! I have taken MelissaTX's signature to heart, especially the part about how preparing to speak with doctors is like preparing for a trial. Thanks so much for the advice Melissa! I have been doing my homework and have found quite a number of articles which have provided me with very useful information. I hope they can can be of help to others. All of these references are either: -Articles that have been published in a peer-reviewed journal OR -Articles from respectable sites such as the NIH or the Mayo Clinic Wikipedia and Yahoo Answers are very helpful resources, but I don't consider them appropriate references and hence they are not included in this list. For some of the articles, I only have access to the abstract. Usually this is the case with journals, where you must pay to have access to the full article (I guess they assume that the average Joe isn't going to be reading them). It's a real shame since this is where the newest findings are. Fortunately, I came across a database run by the NIH with hundreds of full-text journal articles, all for FREE! The address is: http://www.ncbi.nlm.nih.gov/sites/entrez?db=pmc I realize that this kind of reference can be very difficult to digest. Sometimes it seems like I have to google every other word just to find out what on earth they are talking about! In doing so, I have learned a lot about medicine and can even read and speak a bit of Medical-ese. I now am more knowledgable about my (as of yet undiagnosed) condition and about interpreting my lab results than my GP! So here's the list so far and some quotes out of the articles which I found helpful: Diagnosis and Complications of Cushing's Syndrome: a Consensus Statement "Reproductive function is often altered in CS; men usually exhibit hypogonadotropic hypogonadism whereas women of reproductive age have oligomennorhoea or anovulation. Hypercortisolism causes suppression of TSH and impaired conversion of thyroxine to trioiodothyronine (T3); consequently TSH and FT3 are low. However there is little evidence for the Consensus Statement that FT4 is also low in CS." Plasma testosterone profiles in Cushing's syndrome "Elevated plasma testosterone levels were found in 8 women with Cushing's disease and oligo-or amenorrhea and/or hirsutism. In 4 men with Cushing's syndrome either due to adrenal hyperplasia or adenoma, plasma testosterone levels were lowered." "Adrenalectomy or adenotomy restored the decreased plasma testosterone levels to normal [in men]" Cyclical Cushing's syndrome: prevalence in patients with Cushing's disease "Fifty-eight (24%) patients had evidence of cyclical disease." "Evidence of cyclic disease before diagnosis was present in 28 (45%) [of patients]" "In the female population cyclical disease was present in 27% (41/154) and in the male population in 35% (17/48)" "The findings in this large population study reveal that cyclic disease is not a rare presentation of Cushing?s disease" Five cases of cyclical Cushing's syndrome "Two of the five patients with a cyclical syndrome had paradoxical responses to dexamethasone." "The high incidence of the cyclical form of Cushing's syndrome has important clinical implications. A high index of suspicion of the syndrome is required in patients with symptoms or signs of Cushing's syndrome but with normal cortisol values, in patients with fluctuating cortisol values, and in patients with anomalous responses to dexamethasone. Because of possible variations in steroidogenesis the results of drug studies in Cushing's syndrome must be interpreted cautiously." "In virtually all patients with Cushing's syndrome cortisol production is considered to exceed normal at all times.' Exceptions have, however, been described and ascribed to (1) random fluctuations in cortisol secretion, (2) spontaneous remissions of the Cushingoid state, and (3) cyclical patterns of cortisol secretion." "In summary, we suggest that cyclical Cushing's syndrome is more common than suspected." In the future I will try to update this list. If anyone has any similar resources, I invite you to share them here. Only credible sources please. Mark
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