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For years before and after their diagnosis, people with Cushing’s disease use more psychotropic medications — those that affect mood, thoughts, or perception — for mental health problems than their healthy peers, a study in Sweden found. Notably, patients experiencing long-term disease remission still showed higher use of antidepressants and sleeping pills than healthy individuals. These findings highlight Cushing’s persistent negative effects on mental health, according to researchers. Additionally, the results of this study, based on prescribed medication dispenses in Sweden, support the importance of earlier diagnoses of Cushing’s disease — and the need for close and long-term monitoring of neuropsychiatric symptoms in this patient population, the researchers said. The study, “Psychotropic drugs in patients with Cushing’s disease before diagnosis and at long-term follow-up — a nationwide study,” was published in the Journal of Clinical Endocrinology & Metabolism. Mental health issues such as anxiety, depression, sleep disturbances, and cognitive impairments are part of the wide range of symptoms caused by the abnormally high levels of the cortisol hormone that characterize Cushing’s syndrome. Of note, Cushing’s disease is a form of Cushing’s syndrome caused by a tumor in the pituitary gland. A “few” studies have reported the elimination or partial lessening of neuropsychiatric symptoms after successful Cushing’s treatment, according to the researchers. But others noted that “impaired cognitive function and quality of life seemed to persist for a long time after biochemical [cortisol level-based] remission had been achieved,” the team wrote. Now, these researchers, from several universities in Sweden, have assessed the use of psychotropic medications — reflecting mental health burden — in 372 people with Cushing’s disease. The use of such medications was assessed five years before diagnosis, at the time of diagnosis, and at five and 10 years post-diagnosis. The patients, diagnosed between 1990 and 2018, were identified through the Swedish Pituitary Register, which covers 95% of all people with Cushing’s disease in the country. Most of the patients (76%) were women. Altogether, the patients’ mean age at diagnosis was 44 years. For each individual with Cushing’s, four sex-, age-, and residential area-matched healthy individuals were used as controls for comparative analyses. Data on each individual’s dispenses of medications commonly used for neuropsychiatric issues were obtained from the Swedish Prescribed Drug Register. This register, which fully covers all prescribed medications given throughout the country, also was used to determine each patient’s dispenses of other medications for Cushing’s disease symptoms, such as high blood pressure, also called hypertension, and diabetes. The results showed that the use of antidepressants, anxiolytics — medications to lessen anxiety — and sleeping pills was at least twofold higher in Cushing’s patients than in healthy individuals during the five-year period before diagnosis, and at the time of diagnosis. Five years after diagnosis, the proportion of patients using antidepressants (26%) and sleeping pills (22%) remained unchanged, and even individuals in remission showed significantly higher use of such medications than did controls (20–26% vs. 8.6–12%). According to the results, one-third of the patients on antidepressants since their diagnosis were able to discontinue treatment before the five-year assessment — most having achieved disease remission. However, 47% of those receiving antidepressants at five years had initiated such treatment at a median of 2.4 years after diagnosis. During the five-year follow-up, older age and being a woman appeared to increase the risk of antidepressant use among Cushing’s disease patients. At 10 years of follow-up, the use of antidepressants and sleeping pills was not significantly different between groups, despite the fact that antidepressants use remained about the same among patients. Notably, researchers conducted an analysis of 76 patients with sustained remission for a median of 9.3 years, and 292 matching controls. That analysis showed that the use of antidepressants and sleeping pills was significantly higher among patients. The use of other medications, such as those for hypertension and diabetes, also was significantly more common among Cushing’s disease patients before, at diagnosis, and at five years post-diagnosis — although the post-diagnosis numbers dropped by half during that period. After 10 years, only the use of anti-diabetic medications remained significantly higher in patients as compared with controls. These findings suggest that other conditions associated with Cushing’s disease, such as hypertension and diabetes, are effectively lessened with treatment. However, they also highlight that “many patients with CD [Cushing’s disease] will have persistent mental health problems,” the researchers wrote. In addition, visits to a psychiatrist and hospital admissions for treatment of psychiatric disorders tended to be more common among Cushing’s disease patients, even before diagnosis, the team noted. “This nationwide register-based study shows that use of psychotropic drugs in CD patients is increased from several years before diagnosis,” the researchers wrote, adding that this use “remained elevated regardless of remission status, suggesting persisting negative effects on mental health,” the researchers wrote. These findings highlight the importance of early diagnosis of Cushing’s disease and of considering neuropsychiatric symptoms “as an important part of the disease,” they concluded. There is a “need for long-term monitoring of mental health” in Cushing’s, they wrote. From https://cushingsdiseasenews.com/2021/02/24/cushings-found-to-cause-persistent-negative-mental-health-effects-swedish-study/
untilAre Sleep Apnea and Snoring the causes of your Weight Gain and Fatigue? Dr. Theodore Friedman hosts Jay Khorsandi, DDS from Snore Experts for a fascinating webinar on the relationship between Sleep Apnea, Snoring, Weight Gain and Daytime Fatigue. Topics to be discussed include: • Why does poor sleep lead to weight gain and fatigue? • Why are home sleep monitors better than in lab monitors? • What are the treatments for Sleep Apnea and Snoring? • Will the treatments lead to weight loss and more energy? • Dr. Friedman will also add some comments about the endocrine effects of poor sleep. Sunday • June 24th • 6 PM PST Click to start webinar at https://axisconciergemeetings.webex.com/axisconcierg…/j.php… OR Join by phone: (855) 797-9485 Meeting Number (Access Code): 287 844 283 Your phone/computer will be muted on entry. There will be plenty of time for questions using the chat button. Meeting Password: dreams For more information, email Dr. Friedman at email@example.com
When we become stressed out bodies release cortisol – the stress hormone – which helps us cope with challenges. Cortisol’s role is to convert protein into energy by releasing glycogen and counteract inflammation. When cortisol is released in the body temporarily, this is okay and won’t have long-lasting detrimental effects to health as it is a natural response to a stressor. But when cortisol levels remain high chronically it can eventually begin to tear your body down thus causing health complications. This is why numerous health experts recommend the reduction of stress as much as possible because in the long run it can harm our health. High cortisol levels over the long term can destroy healthy muscle and bone, slow down healing, impair digestion, metabolism and mental function, and weaken the immune system. Additionally, adrenal fatigue has been linked to numerous other health conditions including fibromyalgia, hypothyroidism, chronic fatigue syndrome, arthritis, premature menopause, and many others. High cortisol levels are also associated with many unwanted symptoms which we will outline below. High cortisol symptoms If you’re concerned about your cortisol levels, the following signs and symptoms associated with high cortisol levels can alert you and prompt you to make the necessary changes in order to reduce cortisol levels. Unexplained weight gain Skin symptoms including acne, skin infections, lesions, thin-appearing skin, bruising, growing facial hair, and reddish purple streaks on skin Muscle and bone symptoms like a deep pain in the bones, weak muscles, chronic backaches, increased risk of bone fractures Gender specific changes such as women developing male-pattern hair growth, irregular menstrual cycles, low libido, infertility Neurological symptoms such as depression, irritability, headaches, chronic fatigue, and anxiety High blood pressure (hypertension) Poor sleep or lack of sleep Swelling of hands and feet If you notice any of the above symptoms, you may want to have your cortisol levels checked to confirm diagnosis. Living with high cortisol levels over the long term can have detrimental effects on a person’s health. Treating high cortisol as soon as possible can lower the risk of long-term health problems. Causes of high cortisol There are two main causes of high cortisol: Chronic stress and more rarely, Cushing’s disease. Cushing’s disease is caused by a hormone-secreting tumor on the adrenal gland which results in the release more cortisol than required. Living with chronic stress also leads to high cortisol because the release of cortisol is a natural response from the body when it is stressed. The hypothalamic–pituitary-adrenal [HPA] axis is what regulates the timely release of cortisol during acute stress, but when stress becomes chronic the feedback from the HPA becomes damaged and so cortisol continues to be released. Conditions that can contribute to chronic stress and high cortisol include: Depression Panic disorder Generalized anxiety disorder Post traumatic stress disorder (PTSD) Anorexia nervosa Bulimia nervosa Alcoholism Diabetes Severe obesity Metabolic syndrome Polycystic ovary syndrome (PCOS) Obstructive sleep apnea Working in shifts End-stage kidney disease Chronic pain Tips to lower high cortisol Here are some tips that can help you lower your high cortisol levels and thus prevent long-term health problems associated with high cortisol. [MaryO'Note: These will not work if you have active Cushing's! You must remove the source of your Cushing's first.] Eat a well balanced meal with plenty of fruits and vegetables, avoid sugars, consume low glycemic index foods, avoid processed foods, eat a wide variety of health foods to ensure you receive all essential vitamins and nutrients Exercise on a regular basis Take time out of each day to relax – listen to music, meditate, pray, perform your favorite hobby, anything that promotes relaxation Take up yoga or tai chi Ensure you are getting adequate sleep Drink tea Watch funny videos or hang out with a funny friend Go for a massage Do something spiritual – attend a service Chew gum Limit caffeine intake Stretch By incorporating these helpful tips into your life you will find that your high cortisol symptoms begin to diminish and your overall health begins to improve. From http://www.belmarrahealth.com/high-cortisol-symptoms-signs-look/