Posted by Phillipa on May 15, 2009, at 17:12:47
In reply to Re: nardil side effects and cushings? » yoda, posted by Phillipa on May 15, 2009, at 17:09:38
Cushings Disease Love Phillipa
Cushings Syndrome
On this page:What is Cushings syndrome?
What are the signs and symptoms of Cushings syndrome?
What causes Cushings syndrome?
How is Cushings syndrome diagnosed?
How is Cushings syndrome treated?
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What is Cushings syndrome?
Cushings syndrome is a hormonal disorder caused by prolonged exposure of the bodys tissues to high levels of the hormone cortisol. Sometimes called hypercortisolism, Cushings syndrome is relatively rare and most commonly affects adults aged 20 to 50. People who are obese and have type 2 diabetes, along with poorly controlled blood glucosealso called blood sugarand high blood pressure, have an increased risk of developing the disorder.[Top]
What are the signs and symptoms of Cushings syndrome?
Signs and symptoms of Cushings syndrome vary, but most people with the disorder have upper body obesity, a rounded face, increased fat around the neck, and relatively slender arms and legs. Children tend to be obese with slowed growth rates.Other signs appear in the skin, which becomes fragile and thin, bruises easily, and heals poorly. Purple or pink stretch marks may appear on the abdomen, thighs, buttocks, arms, and breasts. The bones are weakened, and routine activities such as bending, lifting, or rising from a chair may lead to backaches and rib or spinal column fractures.
Women with Cushings syndrome usually have excess hair growth on their face, neck, chest, abdomen, and thighs. Their menstrual periods may become irregular or stop. Men may have decreased fertility with diminished or absent desire for sex and, sometimes, erectile dysfunction.
Other common signs and symptoms include
severe fatigue
weak muscles
high blood pressure
high blood glucose
increased thirst and urination
irritability, anxiety, or depression
a fatty hump between the shoulders
Sometimes other conditions have many of the same signs as Cushings syndrome, even though people with these disorders do not have abnormally elevated cortisol levels. For example, polycystic ovary syndrome can cause menstrual disturbances, weight gain beginning in adolescence, excess hair growth, and impaired insulin action and diabetes. Metabolic syndromea combination of problems that includes excess weight around the waist, high blood pressure, abnormal levels of cholesterol and triglycerides in the blood, and insulin resistancealso mimics the symptoms of Cushings syndrome.[Top]
What causes Cushings syndrome?
Cushings syndrome occurs when the bodys tissues are exposed to high levels of cortisol for too long. Many people develop Cushings syndrome because they take glucocorticoidssteroid hormones that are chemically similar to naturally produced cortisolsuch as prednisone for asthma, rheumatoid arthritis, lupus, and other inflammatory diseases. Glucocorticoids are also used to suppress the immune system after transplantation to keep the body from rejecting the new organ or tissue.Other people develop Cushings syndrome because their bodies produce too much cortisol. Normally, the production of cortisol follows a precise chain of events. First, the hypothalamus, a part of the brain about the size of a small sugar cube, sends corticotropin-releasing hormone (CRH) to the pituitary gland. CRH causes the pituitary to secrete adrenocorticotropin hormone (ACTH), which stimulates the adrenal glands. When the adrenals, which are located just above the kidneys, receive the ACTH, they respond by releasing cortisol into the bloodstream.
Cortisol performs vital tasks in the body including
helping maintain blood pressure and cardiovascular function
reducing the immune systems inflammatory response
balancing the effects of insulin, which breaks down glucose for energy
regulating the metabolism of proteins, carbohydrates, and fatsThe hypothalamus sends CRH to the pituitary, which responds by secreting ACTH. ACTH then causes the adrenals to release cortisol into the bloodstream.
One of cortisols most important jobs is to help the body respond to stress. For this reason, women in their last 3 months of pregnancy and highly trained athletes normally have high levels of the hormone. People suffering from depression, alcoholism, malnutrition, or panic disorders also have increased cortisol levels.
When the amount of cortisol in the blood is adequate, the hypothalamus and pituitary release less CRH and ACTH. This process ensures the amount of cortisol released by the adrenal glands is precisely balanced to meet the bodys daily needs. However, if something goes wrong with the adrenals or the regulating switches in the pituitary gland or hypothalamus, cortisol production can go awry.
Pituitary Adenomas
Pituitary adenomas cause 70 percent of Cushings syndrome cases,1 excluding those caused by glucocorticoid use. These benign, or noncancerous, tumors of the pituitary gland secrete extra ACTH. Most people with the disorder have a single adenoma. This form of the syndrome, known as Cushings disease, affects women five times more often than men.Ectopic ACTH Syndrome
Some benign or, more often, cancerous tumors that arise outside the pituitary can produce ACTH. This condition is known as ectopic ACTH syndrome. Lung tumors cause more than half of these cases, and men are affected three times more often than women. The most common forms of ACTH-producing tumors are small cell lung cancer, which accounts for about 13 percent of all lung cancer cases,2 and carcinoid tumorssmall, slow-growing tumors that arise from hormone-producing cells in various parts of the body. Other less common types of tumors that can produce ACTH are thymomas, pancreatic islet cell tumors, and medullary carcinomas of the thyroid.Adrenal Tumors
In rare cases, an abnormality of the adrenal glands, most often an adrenal tumor, causes Cushings syndrome. Adrenal tumors are four to five times more common in women than men, and the average age of onset is about 40. Most of these cases involve noncancerous tumors of adrenal tissue called adrenal adenomas, which release excess cortisol into the blood.Adrenocortical carcinomasadrenal cancersare the least common cause of Cushings syndrome. With adrenocortical carcinomas, cancer cells secrete excess levels of several adrenocortical hormones, including cortisol and adrenal androgens, a type of male hormone. Adrenocortical carcinomas usually cause very high hormone levels and rapid development of symptoms.
Familial Cushings Syndrome
Most cases of Cushings syndrome are not inherited. Rarely, however, Cushings syndrome results from an inherited tendency to develop tumors of one or more endocrine glands. Endocrine glands release hormones into the bloodstream. With primary pigmented micronodular adrenal disease, children or young adults develop small cortisol-producing tumors of the adrenal glands. With multiple endocrine neoplasia type 1 (MEN1), hormone-secreting tumors of the parathyroid glands, pancreas, and pituitary develop; Cushings syndrome in MEN1 may be due to pituitary, ectopic, or adrenal tumors.
poster:Phillipa
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